Showing papers by "Donald A. Williamson published in 1999"

Cognitive bias in eating disorders: implications for theory and treatment.

Abstract: Research testing the predictions of cognitive-behavioral theory related to the psychopathology of eating disorders has lagged behind treatment outcome research. Central to cognitive theories of eating disorders is the hypothesis that beliefs and expectancies pertaining to body size and to eating are biased in favor of selectively processing information related to fatness/thinness, dieting, and control of food intake or body weight. In recent years, controlled investigations of the predictions of cognitive theories of eating disorders have yielded empirical support for these theories. This paper reviews research which has tested the predictions of cognitive-behavioral theory and discusses the implications of these findings for the treatment of eating disorders. Understanding of information processing biases may assist the clinician in understanding a range of psychopathological features of anorexia and bulimia nervosa, including denial, resistance to treatment, and misinterpretation of therapeutic interventions.

Development and Validation of a Multifactorial Treatment Outcome Measure for Eating Disorders

Abstract: The purpose of this investigation was to develop a brief self-report inventory which could be used to evaluate treatment outcome for anorexia and bulimia nervosa The Multifactorial Assessment of Eating Disorders Symptoms (MAEDS) was constructed to measure six symptom clusters which have been found to be central to the eating disorders: depression, binge eating, purgative behavior, fear of fatness, restrictive eating, and avoidance of forbidden foods The factor structure of the MAEDS was found to be stable and it was found to have satisfactory reliability and validity Normative data were collected so that raw scores could be converted to standardized scores While still in the experimental stages, the MAEDS shows promise as a valid and economical measure of treatment interventions for anorexia and bulimia nervosa

Binge eating disorder: a review of the literature after publication of DSM-IV.

Abstract: Binge eating disorder (BED) is a syndrome marked by recurrent episodes of binge eating, in the absence of the regular use of inappropriate compensatory behaviors. Since the inclusion of BED in DSM-IV as a Diagnostic Category in Need of Further Research, a great deal of research has been conducted. This paper reviews research on BED since publication of DSM-IV in 1994. We conclude that questions about the definition of BED persist. Furthermore, recent studies which have strictly used the DSM-IV definition of BED have found that the full syndrome is found in less than 3% of obese adults seeking weight loss treatment and occurs in less than 1% of the general adult population. Binge eating is a common symptom associated with obesity, however. BED may be conceptualized as a psychiatric syndrome or it may be viewed as a behavioral symptom associated with obesity. We conclude that clarification of this conceptual issue is needed if research on BED is to progress.

The Prediction of Negative Events Associated with Anxiety and Dietary Restraint: A Test of the Content Specificity Hypothesis

Abstract: The prediction of future negative events was studied in a sample of undergraduate students varying on measures of anxiety and dietary restraint. Cognitive theories of psychopathology hypothesize that the emotional concerns of an individual determine which types of information are most often cognitively processed with a biased interpretation. This prediction has generally been called the content specificity hypothesis. Based upon this aspect of cognitive theory, we hypothesized that a high level of trait anxiety would be associated with higher ratings of the probability of future physically threatening events. In addition, it was hypothesized that a high level of dietary restraint would be associated with lower ratings of the probability of future occurrences of overeating. The results of the study supported these hypotheses. These prediction biases were found to be more pronounced in women, as compared to men. The findings were interpreted as supportive of the content specificity hypothesis.

Estimation of food intake: Effects of the unit of estimation

Abstract: While many studies have shown that individuals under-estimate caloric intake few studies have examined how individuals estimate intake when using other units of mea surement (e.g. cups, ounces). Forty-one women (21 obese, 20 normal weight) ate a test mea of Haagen-Dazs® chocolate ice cream and were asked to estimate the amount they ate in both calories and cups. As expected, participants under-estimated intake when asked to esti mate how much they ate in calories, but considerably over-estimated their intake when mea sured in cups. Thus, individuals can both under- and over-estimate how much of the same food they have eaten, depending on the unit they are asked to use for estimation. Obesity and eating disorders treatment programs should take into account the tendency to over-estimate volumetric portions as well as under-estimate caloric intake.

Implications for Theory and Treatment

Abstract: Research testing the predictions of cognitive-behavioral theory related to the psychopathology of eating disorders has lagged behind treatment outcome research. Central to cognitive theories of eating disorders is the hypothesis that beliefs and expectancies pertaining to body size and to eating are biased in favor of selectively processing information related to fatness/thinness, diet - ing, and control of food intake or body weight. In recent years, controlled investigations of the predictions of cognitive theories of eating disorders have yielded empirical support for these theories. This paper reviews research which has tested the predictions of cognitive-behavioral theory and discusses the implications of these findings for the treatment of eating disorders. Understanding of information processing biases may assist the clinician in understanding a range of psychopathological features of anorexia and bulimia nervosa, including denial, resis - tance to treatment, and misinterpretation of therapeutic interventions.