Citations

Background This goal of this study was to understand the patterns of expressed emotions (EEs) in adolescent eating disorders. As such, this study compared EE among families of adolescents with anorexia nervosa ( AN ), bulimia nervosa ( BN ), and a psychiatric control group, major depressive disorder ( MDD ). This study also examined the influence of family status (intact vs. nonintact) and the presence of siblings on EE . Methods Two‐hundred and fifteen adolescents (ages 12–19) and their families were recruited for this study including 121 adolescents with AN , 54 adolescents with BN , and 40 adolescents with MDD . Adolescents with at least one parent completed the Standardized Clinical Family Interview. Adolescents completed structured diagnostic interviews to assess eligibility for the study, as well as a standardized questionnaire to assess depression. Results Analyses revealed that fathers showed higher levels of critical comments to adolescents with BN or MDD than those with AN , whereas mothers made more critical comments toward patients with BN . Mothers made the least number of positive remarks toward patients with MDD . In terms of the influence of family status, fathers from intact families showed more expressions of warmth and were less critical than fathers from nonintact families, whereas mothers from intact families were less critical but also made fewer positive remarks than mothers from nonintact families. The presence of siblings appeared to reduce mothers’ expression of warmth and emotional overinvolvement. Conclusions Unique patterns of EE were found to characterize AN , BN , and MDD . Family status and the presence of siblings exert an influence on EE that should be taken into consideration in future research.

The Food and Drug Administration recently approved topiramate for migraine prevention in adolescents. Given the well-established appetite-suppressant side effects of topiramate, as well as data suggesting a potential comorbidity between migraine and eating disorders, susceptible young migraine patients may be at a greater risk for the development or worsening of eating disorder symptoms with topiramate therapy. This case series comprises 7 adolescent patients in whom serious eating disorders developed or were exacerbated after the initiation of topiramate therapy. Clinical characteristics of these patients are highlighted. In addition, this case series provides guidelines for providers to use in assessing eating disorders before prescribing topiramate for migraine prevention in adolescents.

Adolescent patients with obesity are at significant risk of developing an eating disorder (ED), yet due to their higher weight status their symptoms often go unrecognized and untreated. Although not widely known, individuals with a weight history in the overweight (BMI-for-age ≥85th percentile but <95th percentile, as defined by Centers for Disease Control and Prevention growth charts) or obese (BMI-for-age ≥95th percentile, as defined by the Centers for Disease Control and Prevention growth charts) range, represent a substantial portion of adolescents presenting for ED treatment. Given research that suggests that early intervention promotes the best chance of recovery, it is imperative that these children’s and adolescents’ ED symptoms are identified and that intervention is offered before the disease progresses. This report presents 2 examples of EDs that developed in the context of obese adolescents’ efforts to reduce their weight. Each case shows specific challenges in the identification of ED behaviors in adolescents with this weight history and the corresponding delay such teenagers experience accessing appropriate treatment.

Research suggests that negative affect is an important mediator in the relationship between body dissatisfaction and bulimic symptoms. This study examines the mediational role of specific emotion regulation processes (i.e., negative emotionality, poor awareness of emotion, nonconstructive coping with negative emotion) in bulimic symptoms. In addition to these emotion regulation variables, body dissatisfaction and bulimic symptoms were assessed in 234 girls in Grades 6 to 8 (mean age = 12 years, 11 months). The results indicated that negative affect, poor awareness of emotion, and nonconstructive coping with negative emotion partially mediated the relationship between body dissatisfaction and bulimic behaviors. The findings are discussed in light of previous research that suggests emotion regulation needs to be viewed as a multidimensional construct.

This study examined the reliability and validity of the Adolescent Clinical Sexual Behavior Inventory (ACSBI), a new 45-item measure, designed to elicit parent-and self-report regarding a range of sexual behaviors in high-risk adolescents. Using this measure, this study also investigated predictors of adolescent sexual behavior. Participants were 174 adolescents and their parents consecutively admitted to one of three clinical settings (i.e., inpatient treatment, partial hospital program, and outpatient clinic). Parent-and self-reports of adolescent sexual behavior were moderately correlated, and there was a strong relationship between high-risk sexual behavior and adolescent emotional and behavioral problems, as well as sexual concerns, distress, and preoccupation. In addition to sexual abuse, physical abuse, life stress, and impaired family relationships also significantly predicted sexual behavior in adolescents.