Self-Injurious Behavior And Its Relationship To Eating Disorder Symptom Severity

Widely held clinical assumptions about self-harming eating disorder patients were tested in this project. Specifically, the present study had two aims: (1) to confirm research that suggests patients with self-injurious behavior exhibit greater severity in eating disorder symptomology; and (2) to document the treatment course for these patients (e.g. reported change in eating disorder attitudes, beliefs, and behaviors) from admission to discharge. Data from 43 participants who received treatment at a Partial Hospitalization Program (PHP) for Eating Disorders were used in the current study. The length of treatment required for study inclusion reflected mean lengths of stay (Williamson, Thaw, & Varnardo-Sullivan, 2001) and meaningful treatment lengths in prior research (McFarlane et al., 2013; McFarlane, Olmsted, & Trottier, 2008): five to eight weeks. Scores on the Eating Disorder Inventory-III (Garner, 2004) at the time of admission and discharge were compared. These results suggest that there are no significant differences between eating disordered patients who engage in self-injury and those who do not in terms of symptom severity or pathology at admission. The results further suggest that patients in both groups see equivalent reductions in symptoms from admission to discharge across domains and also share non-significant changes in emotional dysregulation over the course of treatment. Importantly, these results also suggest that general psychological maladjustment is higher at discharge for eating disordered patients who engage in self-injury.

Treatment Outcomes for Eating Disorder Patients With and Without Comorbid Substance Abuse Diagnoses

The impact of comorbid substance abuse and eating disorder diagnoses in an eating disorder treatment facility remains uncertain. Recent data suggest that in a substance abuse treatment setting, patients with comorbid eating disorders fared less favorably than patients without a comorbid diagnosis (Cohen et al., 2010; Glasner-Edwards et al., 2011). The purpose of this study is to compare eating disorder symptoms over the course of treatment for patients with and without comorbid substance abuse diagnoses in an eating disorder treatment facility. Archival data from an eating disorder treatment facility was used. Twenty-seven women with comorbid eating disorder and substance abuse diagnoses (EDSUD) were compared to twenty-seven women with an eating disorder diagnosis (ED) only. The subjects were compared on three scales from the Eating Disorder Inventory-III (EDI-3) by group, and pre- and post-treatment. The scales were Personal Alienation (PA), Interoceptive Deficits (ID), and Emotional Dysregulation (EmD). There was a significant decrease in symptoms post-treatment for all subjects on the PA and ID scales, and there was a significant difference between the EDSUD subjects and ED subjects on two scales. EDSUD subjects fared significantly less favorably on the ID and EmD scales. Women with EDSUD report more symptoms of Interoceptive Deficits and Emotional Dysregulation when compared to women with an ED diagnosis and no comorbid substance use. Subjects benefited from treatment in terms of less Personal Alienation and Interoceptive Deficits.

Gay Couples Who Adopt Children Who Have Been Abused: Ideas and Interventions From a Self Psychological Perspective to Facilitate the Adoption Process

here are currently hundreds of thousands of children in the US foster care system who are all in need of a stable and predictable home with parents on whom they can depend. Recently, there has been an increased interest in adoption from gay couples who want to start a family. Because the majority of children in the foster care system have some sort of abuse or neglect history, a large number of them present with difficulties such as oppositional behavior, mood dysregulation, and other kinds of mental health problems. This paper addresses the unique situation of gay couples who adopt children who have been abused. Kohut's self psychology theory is utilized to help identify strengths and potential problems that could arise from this type of situation. Particular attention is given to the three selfobject needs that are central in self psychology: mirroring, idealization, and twinship. Additionally, ideas for interventions are posed for potential adoptive parents and mental health professionals to use to help the adoption process progress more smoothly and to hopefully lead to long-term, healthy placements.