Pre-occupations and rituals related to food in patients with eating disorders

["Pre-occupations","Rituals","Food","Eating disorders","Yale-Brown-Cornwell Eating-Disorder-Scale Self-Report-Questionnaire","Dissertation (M.Sc. (Nutrition and Dietetics))--University of the Free State, 2014"]

Hambloch, Danielle ; ["Walsh, Corinna"]

University of the Free State

Others  :  http://scholar.ufs.ac.za/xmlui/bitstream/11660/9881/1/HamblochD.pdf

瑞士|英语

来源: University of Iowa

【 摘 要 】

English: Introduction: Course and outcomes of eating disorders are often chronic conditions with lapses and relapses occurring commonly. The high relapse rate as well as the large number of patients' who still suffer from eating disorder symptoms, even years after treatment, is due to the fact that even though weight is within a normal, healthy range and bingeing and purging episodes have ceased. These patients, however, still continue to be preoccupied with thoughts about food, eating, and their bodies and therefore may still participate in ritualised behaviours surrounding eating and their bodies. The Yale-Brown-Cornwell Eating Disorder Scale Self Report Questionnaire (YBC-EDS-SRQ) is a reliable and valid semi-structured questionnaire that assesses these pre-occupations and rituals in a private setting where patients feel comfortable reporting the intensity, as well as frequency of their eating disorder symptoms. This assessment tool can also provide researchers and clinicians with an efficient means of evaluating the severity and impairment of the symptoms associated with the wide range of pre-occupations and rituals experienced by patients struggling with eating disorders, which in turn can motivate treatment options.Main objective: The main objective of the study was to describe the pre- occupations and rituals related to food in patients with eating disorders. In order to achieve the main objective of the study, the following sub-objectives were investigated: the demographic profile of participants; current anthropometric status, including weight and height to calculate Body Mass Index (BMI); and the pre-occupations and rituals related to food.Subjects and methods: The sample included all in-patients (n=5), as well as those who had been discharged but were still being followed up in the outpatient clinic (n=4), from an institution specialising in eating disorders i.e. Tara Hospital in Johannesburg, South Africa. The anthropometric measurements were obtained using standard techniques, while the socio-demographic information was obtained in one-on- one interviews between the resident dietitian and each participant.The YBC-EDS-SRQ was self-administered. The YBC-EDS-SRQ nine questions considers pre-occupations and rituals of participants during their 'Current' and 'Worst period' of experiencing the eating disorder. This showed that in most instances, the pre- occupations and rituals occupied a greater amount of time throughout a day during the participants' 'Worst period' than during the 'Current period'. Pre-occupations and rituals during the 'Worst period', were also absent for a smaller proportion of the day when compared to the 'Current period'.After completion of the questionnaire, scores were determined separately for the 'Current' and 'Worst' period's. The pre-occupations subtotal score was calculated by adding together the scores of four questions (1, 3, 4 and 7) for each period and the rituals subtotal score was calculated by adding together the scores of four questions (10, 12, 13 and 15). The total score was calculated by adding together the subtotals of the pre-occupations and rituals. The experimental change score was calculated by adding together the scores for questions 6, 8, 9, 15, 17 and 19.Results: Nine participants were recruited and included in the research study. Five of the nine participants were in-patients and four of the nine participants were outpatients. All of the nine participants were female. Eight of the nine were Caucasian, while one was Indian. More than half of participants were currently diagnosed with AN-non purging, with one currently diagnosed with AN-purging type and three currently diagnosed with BN-purging type. With regards to previous diagnosis, seven of the nine participants had not been previously diagnosed with an eating disorder. This information is supported by seven of the nine participants who had not been previously admitted to Tara Hospital or any other institution for an eating disorder. Three participants had a BMI <18.5 kg/m2 which indicated that they were underweight, five had a BMI within the normal range and only one had a BMI between 25-30 kg/m2, indicating overweight.Pre-occupations typically occupied a significant proportion of the individuals' time, interfered with daily functioning, caused severe distress and although they are often mildly resisted, the pre-occupations are perceived to be largely out of the individuals' control. Rituals have been identified as somewhat less severe than the pre-occupations, however, individuals still spend a vast majority of their time, performing them and also experienced little control over them.For the pre-occupations sub-total score, the 'Current period' had a mean score of 8.6. The 'Worst period' had a mean score of 10.7. For the rituals sub-total score, the 'Current period' had a mean score of 6.2. The 'Worst period' had a mean score of 9.4. For the total score, the 'Current period' had a mean score of 14.8, while the 'Worst period' had a mean score of 20.1. For the experimental change score, the 'Current period' had a mean score of 8.4 and the 'Worst period' had a mean score of 13.0.When compared with other similar studies, these results indicate a moderate level of eating disorder symptom severity related to pre-occupations and rituals in this sample of participants.Conclusion: The results of this study confirm that the high rate of relapse that occurs in patients who suffer from eating disorder symptoms, despite the fact that treatment is ceased, may be related to the fact that even though weight is within a normal, healthy range and bingeing and purging episodes have ceased, these patients still continue to be preoccupied with thoughts about food, eating, and their bodies and therefore may still participate in ritualised behaviours surrounding eating and their bodies.