Eating concerns in youth with functional abdominal pain disorders.

Objectives: Adolescents with functional abdominal pain (FAP) often experience pain and other gastrointestinal symptoms in the context of eating, which may place them at risk for eating disorders. This study compared disordered eating and its sequalae in adolescents with FAP to those with chronic headache.

Methods: Participants in this retrospective chart review study were 270 adolescents and young adults (mean age 15.

Partnerships with primary care providers: Opportunities to prevent eating disorders and mitigate their progression in young people.

Epidemiologic research has identified numerous interpersonal and individual risk factors for and warning signs of emerging eating disorders in adolescents. These findings have informed public health prevention and treatment strategies, including translation of findings to clinical recommendations for primary care providers (PCPs). A next step in this translational work could include a comprehensive approach where PCPs are seen as partners in efforts to improve population health outcomes.

Screening for eating disorders in adolescents with chronic pain: the Eating Attitudes Test-16-Chronic Pain.

Background: Few measures have been validated to screen for eating disorders (ED) in youth with chronic pain. We conducted confirmatory (CFA) of two established factor structures of the Eating Attitudes Test-26 (EAT-26) in a sample of youth with chronic pain attending an intensive interdisciplinary pain treatment (IIPT) program and examined the validity of the best-fitting model in predicting ED diagnoses in this sample.

Methods: Participants were 880 adolescents (M age = 16.

Does embedding pediatric eating disorder treatment in primary care bridge the access gap?

Given the numerous barriers to accessing child and adolescent eating disorder treatment, there is a need for innovation in how this care is delivered. Primary care-based eating disorder treatment has established proof-of-concept, yet it is unclear whether this model can bridge the treatment-access gap. This retrospective chart review study compared demographic and illness characteristics of 106 adolescents (M age = 15.

Disparities in Medical Assessment Practices for Adolescents at Risk for Eating Disorders.

Purpose: The United States Preventative Services Task Force found insufficient evidence to support universal screening for eating disorders (EDs) but did recommend assessing high-risk adolescents through laboratory tests, close follow-up, and referrals to other specialties. Yet, it is unclear whether youth at high risk for EDs receive such assessment and whether patient characteristics influence such practices.

Methods: Using the Rochester Epidemiological Project, we identified adolescents (13-18 years) at risk for EDs (i.

The Role of Primary Care in Bridging Adolescents Awaiting Eating Disorder Treatment.

The striking rise in adolescent eating disorders since the severe acute respiratory coronavirus syndrome 2 pandemic has amplified demands for specialty eating disorders services and contributed to protracted delays in care. In the context of these delays, patients are at risk for increased weight loss, medical instability, escalating disease progression and poor prognosis. Primary care providers (PCPs) are frequently the first point of contact for young patients with eating disorders and are often left to bridge the gap while families struggle to establish specialty care.

Adapting Behavioral Treatments for Primary Care Using a Theory-Based Framework: The Case of Adolescent Eating Disorders.

Evidence-based treatments have been developed for a range of pediatric mental health conditions. These interventions have proven efficacy but require trained pediatric behavioral health specialists for their administration. Unfortunately, the widespread shortage of behavioral health specialists leaves few referral options for primary care providers.

Using session recordings to understand the content of community-based treatment for childhood anxiety disorders and response to technology-based training.

Objective: The goal of the current study is to advance efforts to increase the quality of care for childhood anxiety disorder (CADs) through (1) detailing the content of community-based treatment sessions, (2) exploring the validity of therapist surveys, (3) examining the influence of setting differences, and (4) testing the effects of a technology-based training on use of nonexposure strategies.

Methods: Thirteen therapists were randomly assigned to technology-based training in the use of exposure therapy or treatment as usual (TAU) for CADs. Therapeutic techniques were coded from 125 community-based treatment sessions.

Lifetime Prevalence of Psychiatric Disorders in Adolescents with Unexplained Weight Loss, Underweight, or Poor Appetite.

Background: When adolescents present with symptoms of unexplained weight loss, underweight, or poor appetite, eating disorders (EDs) are commonly on the list of differential diagnoses. However, the relationship of these symptoms to other psychiatric disorders is often less clear.

Methods: Using the Rochester Epidemiology Project database, a retrospective cohort study of adolescents (13-18 years) with billing diagnoses of weight loss, underweight, or loss of appetite was conducted between January 2005 and December 2017.

Study What You Do: Developing a Psychotherapy Tracking Database in a Large-Scale Integrated Behavioral Health Service.

Purpose: Many individuals with behavioral health challenges receive services in primary care, and integrated behavioral health (IBH) programs can help increase access to evidence-based interventions. IBH programs can benefit substantially from integrating standardized tracking databases that allow for the implementation of measurement-based care to evaluate patient-, clinician-, and practice-level outcomes. We describe the development and integration of Mayo Clinic's pediatric and adult primary care psychotherapy tracking database.

Adapting integrative cognitive-affective therapy for adolescents with full and subthreshold bulimia nervosa: A feasibility study.

Background: Integrative Cognitive Affective Therapy (ICAT) is an empirically supported treatment for bulimia nervosa (BN) in adults. However, it is unclear whether a modified version, Integrative Cognitive Affective Therapy-Adolescent (ICAT-A) is feasible and beneficial for adolescents. This study evaluated the feasibility of ICAT-A for adolescents with BN or subthreshold BN.

Prevalence and Clinician Recognition of Avoidant/Restrictive Food Intake Disorder in Patients With Inflammatory Bowel Disease.

Background: Avoidant/restrictive food intake disorder (ARFID) is a newly described eating disorder. The aims of this study were to evaluate the prevalence of ARFID in patients with inflammatory bowel disease (IBD) and assess provider recognition of an eating disorder in these patients.

Methods: One hundred patients with IBD seen at the Mayo Clinic subspecialty IBD practice in Jacksonville, Florida were screened for ARFID.

First, Do No Harm: Understanding Primary Care Providers' Perception of Risks Associated With Discussing Weight With Pediatric Patients.

Many health care providers struggle with if- and how-to discuss weight with their pediatric patients. This study used one-on-one interviews with primary care providers (n = 20) to better understand their: (1) perception of risks associated with talking about weight with pediatric patients, (2) commitment to adhering to best practices of pediatric weight management, and (3) approaches to mitigate perceived risks. Providers felt concerned that discussing weight with children during clinic visits may have unintended negative impacts.

Insufficient Assessment and Treatment of Vitamin D in the Medical Management of Adolescents with Anorexia Nervosa.

Purpose: Suboptimal vitamin D levels are implicated in low bone mineral density, a common medical complication of anorexia nervosa. This study aimed to examine the frequency of vitamin D assessment and treatment for adolescents with anorexia nervosa in outpatient medical management.

Design And Methods: Retrospective chart review was used to examine 179 adolescents (M age = 15.

Can adolescents with eating disorders be treated in primary care? A retrospective clinical cohort study.

Background: Family-Based Treatment (FBT) is considered the first-line intervention for adolescent anorexia nervosa. However, access to this treatment is limited. Treatment programs for other pediatric mental health conditions have successfully overcome barriers to accessing evidence-based intervention by integrating mental health services into primary care.

Identifying Opportunities to Promote Physical Activity in a Diverse Low-Income Population: A Mixed-Method Study at a Boys & Girls Club Site.

Background: Prevalence and consequences of obesity and sedentary lifestyle are well-documented public health concerns for youth in the United State of America (U.S.A) that disproportionally affect children from low income and minority families.

Addressing Disparities in Adolescent Eating Disorders: A Case Report of Family-Based Treatment in Primary Care.

Eating disorders typically have a protracted course, marked by significant morbidity. Male adolescents and adolescents of color are at risk of delayed care. Primary care providers are well-positioned to identify eating disorders early and initiate treatment.

Engaging primary care providers in managing pediatric eating disorders: a mixed methods study.

Background: The primary care setting offers an attractive opportunity for, not only the identification of pediatric eating disorders, but also the delivery of evidence-based treatment. However, constraints of this setting pose barriers for implementing treatment. For interventions to be successful, they need to take into consideration the perspectives of stakeholders.

Assessing for Eating Disorders: A Primer for Gastroenterologists.

Eating disorders involve irregularities in eating behavior that may cause gastrointestinal (GI) symptoms. Consequently, many patients with eating disorders seek gastroenterological healthcare at some point in their illness, with many seeking this care even before they seek treatment for and/or diagnosed with their eating disorder. As such, the gastroenterology provider is in a unique position to identify, manage, and facilitate treatment for an eating disorder early in the course of the illness.

A qualitative examination of adolescent and parent perspectives on early identification and early response to eating disorders.

This qualitative study examined adolescent and caregiver perspectives on identification and early response in emerging eating disorders. Fifteen female-identified adolescents with an eating disorder diagnosis ( age = 15.20 years; 93% White; 20% Hispanic) and 12 caregivers (all biological parents: 1 father, 11 mothers; age = 51.

Psychotropic medication use in treatment-seeking youth with eating disorders.

Objective: Psychotropic medication use in youth with eating disorders (EDs) is poorly understood despite high co-occurrence of psychiatric disorders. This study examined characteristics associated with medication use in treatment-seeking youth with EDs.

Method: Youth up to age 18 reported on medication use when presenting to an academic medical center outpatient ED service in the United States.

Parents know best: Caregiver perspectives on eating disorder recovery.

Objective: This study used mixed methods to evaluate caregiver perspectives on recovery from an eating disorder.

Method: Caregivers (N = 387) completed an online survey about their child's weight history, treatment history, illness trajectory, and recovery.

Results: Children were predominantly females with adolescent onset anorexia nervosa and currently 18.