Showing papers by "Stephen Touyz published in 2010"
TL;DR: Recognition of muscle dysmorphia as an eating disorder may offer more clinical utility in recognizing the male experience of eating disorder pathology and also help reduce the number of current male cases falling into the EDNOS category.
Abstract: Objective: Muscle dysmorphia is a relatively recently identified psychological condition that, since its inception, has been variously conceptualized as an eating disorder and subsequently as a type of body dysmorphic disorder within the somatoform disorders. This review aims to inform and encourage ongoing debate surrounding the diagnostic placement of this disorder. Method: We present a review and synthesis of the extant literature with a view to informing future decisions regarding the conceptualization of muscle dysmorphia. Results: The validity of muscle dysmorphia as a clinical entity has been empirically demonstrated. While the condition bears little semblance to somatization as currently conceptualized, the research suggests a strong conceptual similarity
172 citations
TL;DR: It is proposed that anorexia nervosa reflects a core disturbance in emotion at the earliest time stage of information processing with subsequent effects on the later stages of thinking, feeling and self-regulation.
Abstract: We reviewed the evidence for emotion-related disturbances in anorexia nervosa (AN) from behavioural, cognitive, biological and genetic domains of study. These domains were brought together within the framework of an integrative neuroscience model that emphasizes the role of emotion and feeling and their regulation, in brain organization. PsychInfo and Medline searches were performed to identify published peer-reviewed papers on AN within each domain. This review revealed evidence for 'Emotion', 'Thinking and Feeling' and 'Self-regulation' disturbances in AN that span non-conscious to conscious processes. An integrative neuroscience framework was then applied to develop a model of AN, from which hypotheses for empirical investigation are generated. We propose that AN reflects a core disturbance in emotion at the earliest time stage of information processing with subsequent effects on the later stages of thinking, feeling and self-regulation.
75 citations
TL;DR: This study explored the effectiveness of an innovative day patient programme by examining whether the seven key treatment goals improved across treatment and were maintained or further improved at 3 months after discharge.
Abstract: There is a dearth of literature evaluating day patient treatment for eating disorders based upon the targeted goals of treatment, to conclude that day patient programmes are effective This study aimed to explore the effectiveness of an innovative day patient programme by examining whether the seven key treatment goals improved across treatment and were maintained 3 months after discharge Of the 58 participants who completed measures assessing BMI, eating disorder cognitions, behaviours, core beliefs, readiness to change, quality of life and perpetuating factors at admission, discharge and follow-up, 44 completed the day programme with 14 non-completers The results demonstrated that all seven treatment goals improved across treatment and the improvements were maintained or further improved at 3 month follow-up The results are discussed in context of the published day patient programme literature with implications for future research to maximise optimal treatment outcomes from day patient treatment Copyright © 2010 John Wiley & Sons, Ltd and Eating Disorders Association
34 citations
TL;DR: There is likely a core, generic disturbance in AN in the early "automatic" neural processing of emotion irrespective of weight or nutritional status, and new innovative emotion-based psychologic or pharmacologic treatments targeting these nonconscious processes may prove beneficial.
Abstract: Background: Identification of the biological markers of anorexia nervosa (AN) is crucial for the development of new treatments. We aimed to determine whether AN is associated with disturbances in the nonconscious neural processing of innate signals of emotion and whether these disturbances persist after weight gain. Methods: In a retest design, 28 adolescent females with AN were tested at first admission to hospital and again after they had gained weight. Matched healthy control participants were tested at the same times. We assessed emotion-elicited event-related potentials (ERPs) during overt and covert presentation of emotion expressions, scores on an emotion-identification behavioural task, and symptom measures. We performed between and within group analyses. Results: Individuals with AN had a marked alteration in ERPs relative to healthy controls. Irrespective of the form of stimulus, early and late ERP components were significantly reduced in AN patients at baseline (when underweight) and on retest (after weight gain), especially in the temporo-occipital regions, suggesting a persistent disruption of the early automatic appraisal of salient emotional signals. Limitations: This study could have been improved with a longer standardized retest interval. Conclusion: There is likely a core, generic disturbance in AN in the early “automatic” neural processing of emotion irrespective of weight or nutritional status. New innovative emotion-based psychologic or pharmacologic treatments targeting these nonconscious processes may prove beneficial.
30 citations
Posted Content•
TL;DR: It is argued that coercion into treatment has a very limited, but potentially vital, role to play in dealing with anorexia patients presenting with life-threateningly low Body Mass Indices (BMI’s) or equivalent compromise of their current or future health status.
Abstract: This chapter concentrates on the medical and ethical turbulence regarding management of anorexia nervosa at that intersection between law and medicine. While not overlooking the emerging literature on ‘when’ and ‘why’ clinicians actually invoke whatever powers the law permits, our emphasis is on the issues of principle at stake. The chapter reviews the diverse pattern of laws (if any) which may be used in aid of involuntary treatment of anorexia nervosa suffers in different jurisdictions, before setting out some of the ethical principles informing the use of involuntary treatment. The main section of the chapter then examines the clinical practice and therapeutic role of coercion within the overall treatment options for dealing with a condition whose chronicity, morbidity and mortality rates understandably puts pressure on clinicians to find ‘solutions’. The chapter concludes by arguing that coercion into treatment has a very limited, but potentially vital, role to play in dealing with anorexia patients presenting with life-threateningly low Body Mass Indices (BMI’s) or equivalent compromise of their current or future health status.
9 citations