A qualitative assessment of provider-perceived barriers to implementing family-based treatment for anorexia nervosa in low-income community settings.

Background: Family-based treatment (FBT) is a front-line empirically supported intervention for adolescent anorexia nervosa, but it is often inaccessible to families from lower income backgrounds, as it is most typically available in specialty research and private practice settings. In preparation for a pilot trial of FBT delivered in the home setting, this study qualitatively examined provider perceptions of implementing FBT in lower-income communities.

Methods: Eating disorder clinicians working in community clinics (therapists, medical doctors, dietitians, and social workers; n = 9) were interviewed about their experiences using FBT.

Multi-electrolyte disturbance and supplementation in severely malnourished hospitalized adolescents with restrictive eating disorders.

Background: This study describes the prevalence of hypophosphatemia, hypokalemia, and/or hypomagnesemia and resulting electrolyte supplementation during refeeding in severely malnourished youths hospitalized for restrictive eating disorders.

Methods: Hospitalized patients between 11-26y (N = 81) at < 75% treatment goal weight (TGW) were assessed through retrospective chart review. Outcomes were compared between participants < 70% TGW and those 70-75% TGW.

Adapting family-based treatment for adolescent anorexia nervosa delivered in the home: A novel approach for improving access to care and generalizability of skill acquisition.

Background: Anorexia nervosa (AN) is a serious mental illness associated with high rates of morbidity and mortality. Family-based treatment (FBT) is a well-established treatment for adolescent AN, yet it is underutilized in community settings and is unavailable to many families, particularly those from lower income and racial and ethnic minority backgrounds. Furthermore, some families do not respond optimally to FBT, possibly because of challenges translating skills acquired in office-based treatment settings to naturalistic settings.

The parents aren't alright, either: Commentary on Wilksch (2023).

Eating disorders (EDs) present high costs to the individual and society, and need for services far surpasses their availability. Caregivers are often on the "front lines" of managing their child's illness yet may have very little support to sustain them in this role. It is well-established that caregiver burden related to EDs is high, although most research has focused on caregivers of adult patients.

Implementation and outcomes of home-based treatments for adolescents with anorexia nervosa: Study protocol for a pilot effectiveness-implementation trial.

Objective: Although family-based treatment (FBT) is considered a first-line treatment for adolescent anorexia nervosa (AN), it is underutilized in community settings and is unavailable to many families for a multitude of practical reasons (e.g., costs of treatment, transportation constraints).

Disseminating Education and Treatment for Children and Adolescents with Eating Disorders Across Levels of Care.

Background: Eating disorders (EDs) are psychiatric illnesses with high rates of morbidity and mortality. Healthcare providers often receive inadequate training in evidence-based ED assessment and treatment.

Design: Project CORE (Creating Opportunities for Rhode Island Eating Disorders Professionals) was developed to disseminate ED training/education and treatment approaches to the healthcare workforce.

Medical Considerations in Children and Adolescents with Eating Disorders.

Eating disorders are a group of psychiatric disorders with potentially fatal medical complications. Early integrated care including the family as well as pediatric medicine, nutrition, psychology and psychiatry is critical for improving prognosis and limiting negative outcomes. Mental health services are a critical component of treatment; timely weight restoration maximizes efficacy.

Problems applying the DSM-IV eating disorders diagnostic criteria in a general psychiatric outpatient practice.

Objective: A substantial number of patients treated in specialized eating disorder programs fail to meet criteria for anorexia nervosa or bulimia nervosa, the 2 eating disorders with specified criteria in DSM-IV, and are diagnosed with eating disorder not otherwise specified (NOS). In a general psychiatric setting, where the severity of eating pathology is likely to be milder than in specialty programs, we predicted that most patients with disordered eating would fail to meet the full criteria for one of the DSM-IV eating disorders and instead would be diagnosed with eating disorder NOS.

Method: Two thousand five hundred psychiatric outpatients were interviewed with the Structured Clinical Interview for DSM-IV (SCID) upon presentation for treatment.

Childhood abuse and neglect in body dysmorphic disorder.

Objective: No published studies have examined childhood abuse and neglect in body dysmorphic disorder (BDD). This study examined the prevalence and clinical correlates of abuse and neglect in individuals with this disorder.

Methods: Seventy-five subjects (69.

Social functioning in body dysmorphic disorder: assessment considerations.

Individuals with body dysmorphic disorder (BDD) have markedly poor social functioning; however, previous reports may underestimate impairment. Scoring on certain functioning measures such as the Social Adjustment Scale-Self Report (SAS-SR) potentially excludes more severely ill individuals from some domains, thereby possibly underestimating functional impairment. To explore this issue, 73 individuals with BDD who reported having no primary relationship (and were therefore excluded from scoring on the SAS-SR Primary Relationship domain) were compared to 58 individuals with BDD who had a primary relationship.