The aim of this 5-year longitudinal study of 593 girls (9-20-year-old) was to examine whether the internalization of the thinness ideal in terms of 'a wish to be thinner' might be related to lifestyle factors and longitudinally increase the risk of disturbed eating over time. Results showed that a wish to be thinner was related to lifestyle factors, eating attitudes and body mass index (BMI) longitudinally. Girls who wished to be thinner dieted more often, thought that they would be more popular if they were thinner, skipped meals, were eating breakfast more often alone and had a higher BMI compared to the girls without such a wish. Girls who wished to be thinner were 4 times more likely to develop disturbed eating attitudes over a 5-year period. These findings point to the importance of helping adolescents to establish regular eating habits, to avoid unhealthy dieting practices and to prevent sedentary behaviours that might lead to overweight and or obesity in early childhood.
Acquiring proficiency in motivational interviewing (MI) may be more difficult than generally believed, and training research suggests that the standard one-time workshop format may be insufficient. Although nurses represent one of the professions that have received most training in MI, training in this group has rarely been systematically evaluated using objective behavioral measures.
To evaluate an enhanced MI training program, comprising a 3.5-day workshop, systematic feedback on MI performance, and four sessions of supervision on practice samples.
Nurses (n = 36) in Swedish child health services were trained in MI. Skillfulness in MI was assessed using the Motivational Interviewing Treatment Integrity (MITI) Code. Effects of training were compared to beginning proficiency thresholds.
Participants did not reach beginning proficiency thresholds on any of the indicators of proficiency and effect sizes were small.
The present study adds to a growing body of literature suggesting that the current standard MI training format may not provide practitioners with enough skillfulness. Moreover, the results indicate that even enhanced training, including systematic feedback and supervision, may not be sufficient. Suggestions for improved MI training are made.
There is a need for brief, sensitive, and reliable instruments for contextual assessment of body dissatisfaction. Suitable selection and optimal use of psychological assessment instruments requires appropriate psychometric as well as normative data. Two studies were conducted to investigate the psychometric properties and collect general population norms for a short, eight item version of the body shape questionnaire (BSQ-8C). In the first study, a sample of undergraduate students (N=182) was recruited to investigate the psychometric properties of the BSQ-8C, while in the second study a sample from the general population of Swedish women aged 18-30 years (N=747) was used to collect norms. The test-retest reliability, internal consistency, and convergent validity for BSQ-8C were high. Given the questionnaire's briefness and good psychometric properties, particularly when used in conjunction with norms, the BSQ-8C is considered a valuable instrument for measuring body shape dissatisfaction among young adult women.
There is very little research exploring the effects of Roux-en-Y gastric bypass surgery (RYGB) on the patient's partner. The aim of the present study was to investigate longitudinally whether male partners of female RYGB patients were affected in terms of BMI, sleep quality, body dissatisfaction, depression, and anxiety.
Thirty-seven women, with partners who were willing to participate, were recruited from RYGB waiting lists at five Swedish hospitals. Data collection took place during two home visits, 3 months before and 9 months after RYGB surgery. Anthropometrical data were documented, and both women and men completed the Hospital Anxiety and Depression Scale (HADS) and the Karolinska Sleep Questionnaire (KSQ). The men also completed the Male Body Dissatisfaction Scale (MBDS).
The men's BMI changes between the two time points that were analysed using general estimating equation (GEE) regression. Their BMI decreased significantly (ß?=?-0.9, p?=?0.004). The change was more pronounced in the 26 men who had a baseline BMI of =25 (ß?=?-1.4, p?
Eating disorders (ED) are serious disorders that have a negative impact on both the psychological and the physiological well-being of the afflicted. Despite the fact that ED affect both genders, males are often underrepresented in research and when included the sample sizes are often too small for separate analyses. Consequently we have an unclear and sometimes contradictory picture of the clinical characteristics of males with ED. The aim of the present study was to improve our understanding of the clinical features of adolescent males with eating disorders.
We compared age at presentation, weight at presentation, history of significantly different premorbid weight and psychiatric (Attention Deficit Hyperactivity Disorder (ADHD)) and somatic comorbidity (celiac disease and diabetes) of 58 males to 606 females seeking medical care for eating disorders at the Children's Hospital in Uppsala, Sweden during the years 1999-2012. As all boys were diagnosed with either AN or Other Specified Feeding or Eating Disorder (OSFED) atypical AN, the age and weight comparisons were limited to those girls fulfilling the diagnostic criteria for AN or OSFED atypical AN.
There was no significant difference in age at presentation. Differences in weight at presentation and premorbid weight history were mixed. A significantly higher percentage of males had a history of a BMI greater than two standard deviations above the mean for their corresponding age group. As well, there was a higher prevalence of ADHD among the males whereas celiac disease and diabetes only was found among the females.
A better understanding of the clinical characteristics of males with ED at presentation should improve our ability to identify males with ED and thereby aid in tailoring the best treatment alternatives.
Cites: Am J Psychiatry. 2001 Apr;158(4):570-411282690
Cites: Int J Eat Disord. 2012 Nov;45(7):883-9022570093
A significant number of Swedish practitioners are offered workshop trainings in motivational interviewing through community-based implementation programs. The objective of this randomized controlled trial was to evaluate to what extent the practitioners acquire and retain skills from additional supervision consisting of feedback based on monitoring of practice.
A total of 174 practitioners in five county councils across Sweden were randomized to one of the study's two groups: 1) Regular county council workshop training, 2) Regular county council workshop training followed by six sessions of supervision. The participant's mean age was 43.3 years, and the majority were females (88.1%).
Recruiting participants proved difficult, which may have led to a biased sample of practitioners highly motivated to learn the method. Although slightly different in form and content, all the workshop trainings increased the participants' skills to the same level. Also, consistent with previous research, the additional supervision group showed larger gains in proficiency compared to the group who received workshop training only at the six-month follow-up. However, analyses showed generally maintained levels of skills for all the participants at the follow-up assessment, and the majority of participants did not attain beginning proficiency levels at either post-workshop or follow-up.
The results of this study address the real-life implications of dissemination of evidence-based practices. The maintained level of elevated skills for all participants is a promising finding. However, the low interest for obtaining additional supervision among the Swedish practitioners is problematic. In addition, neither the workshop trainings nor the additional supervision, although improving skills, were sufficient for most of the participants to reach beginning proficiency levels. This raises questions regarding the most efficient form of training to attain and sustain adequate practice standards, and how to create incentive and interest among practitioners to participate in such training.
Cites: Behav Res Ther. 2009 Nov;47(11):931-719632667
Cites: Med Care Res Rev. 2012 Apr;69(2):123-5722203646
Optimal use of assessment instruments for the detection and diagnosis of eating disorders (ED) depends on the availability of normative data. The aim of this work was to, for the first time, collect norms for both the Eating Disorder Examination Questionnaire (EDE-Q) and the newly developed Clinical Impairment Assessment (CIA) Scale from a general population of young women in Sweden, as well as from a clinical population of ED patients in Sweden. Participants were composed of both a randomized sample from the general population of women aged 18-30 years (N = 760) as well as from a clinical population aged 18-66 years (N = 2383). Data for the clinical population was extracted from the Stepwise database. Mean scores, standard deviations and percentile ranks for the global for the EDE-Q (as well as its subscales) and the CIA are presented. Prevalence figures of key eating disorder behaviors are also reported. Comparisons are made between the results in the present study with other existing normative studies on the EDE-Q and the CIA. The present study contributes to improving the accuracy of the interpretation of scores of the widely used self-report measure of ED, the EDE-Q, and the CIA, both of which play important roles in for diagnosis, prevention and intervention of ED.
The aim of this cross-sectional descriptive study of 194 Swedish men and women seeking non-surgical weight-loss treatment was to investigate the presence of eating disorders and binge eating symptoms and to compare these two groups of patients with a group without eating disorder- or binge eating symptoms. The groups were compared in regard to co-morbid psychopathology, Health Related Quality of Life (HRQL) and anthropometric data. Of the total sample, 9.8% fulfilled criteria for any eating disorder. An additional 7.2% indicated binge eating symptoms without having an eating disorder. The three groups were significantly different in regard to psychopathology scales and most HRQL items. Eating disorders and binge eating symptoms are common among patients seeking non-surgical weight-loss treatments in Sweden and both groups showed elevated levels of co-morbid psychopathology and lower HRQL compared to patients without disordered eating. These findings point to the importance of assessing the full range of eating disorder symptoms and disorders as well as HRQL and co-morbid psychopathology before weight-loss treatment, as these factors might affect treatment outcome.
The number of refugees is the highest ever worldwide. Many have experienced trauma in home countries or on their escape which has mental health sequelae. Intrusive memories comprise distressing scenes of trauma which spring to mind unbidden. Development of novel scalable psychological interventions is needed urgently.
We propose that brief cognitive science-driven interventions should be developed which pinpoint a focal symptom alongside a means to monitor it using behavioural techniques. The aim of the current study was to assess the feasibility and acceptability of the methodology required to develop such an intervention.
In this study we recruited 22 refugees (16-25 years), predominantly from Syria and residing in Sweden. Participants were asked to monitor the frequency of intrusive memories of trauma using a daily diary; rate intrusions and concentration; and complete a 1-session behavioural intervention involving Tetris game-play via smartphone.
Frequency of intrusive memories was high, and associated with high levels of distress and impaired concentration. Levels of engagement with study procedures were highly promising.
The current work opens the way for developing novel cognitive behavioural approaches for traumatized refugees that are mechanistically derived, freely available and internationally scalable.
The main aim of this seven-year longitudinal study, of 411 Swedish pre-adolescent girls (aged 7-11 years, Year 1), was to examine a wish to be thinner, dieting attempts, described motives for wishing to be thinner and weight-control practices. A further aim was to examine to what extent body mass index (BMI) accounted for motives for wishing to be thinner and weight-control practices. A wish to be thinner and dieting attempts increased significantly with increasing age between the ages of 9 and 18. The most frequently reported motive for wishing to be thinner was to 'feel better about yourself'. Categories that emerged from the qualitative analysis of self-described motives for the wish to be thinner were, for example, to 'correspond to the societal ideal' and to 'wear particular clothes'. A majority of the girls adopted weight-control practices that would be considered as healthy, but extreme weight-control practices increased with age. Girls with BMIs over the 75th percentile reported a greater number of motives for wishing to be thinner and used extreme weight-control practices significantly more often than the other girls. However, of the girls who changed BMI from above the 75th percentile to under the 75th percentile, 34.1% reported that they had not used any weight-control practices at all. Our results show that girls at a very early age are aware of the 'thin' ideal in our society, wish to be thinner and try to lose weight. The results point to the importance of detecting girls who wish to be thinner as early as possible. If we can employ preventive action in time, it is possible that dieting behaviour will never develop.