Please excuse me while I nerd out all over your computer screen. I recently turned a corner on my appreciation of the value of quantitative social science, having taken a structural equation modelling class last winter, and today I’m going to share a little of that with you. While I’m still a qualitative researcher through and through, this course taught me that there is great value in understanding how scales are constructed and what that means about how we can interpret results from survey-takers.
What, you might ask, does any of this have to do with eating disorders? Plenty. A while back, Shiran wrote a post about the issues with the Eating Disorders Examination Questionnaire. Her post didn’t focus on the scale psychometrics – that is, how well the scale measures what it is supposed to measure and how consistent it is – but still reveals how questionnaires … Continue reading →
Something I have come across several times when reading ED research studies is a disclaimer that research has been dutifully carried out, but the findings have to be viewed with some scepticism because the participants (and – more specifically – the participants with AN-R) were in denial when completing the self-report questionnaires.
In this post, I will to look at a couple of recent studies that flag-up this issue, to examine what is behind this disclaimer.
The first paper I will explore was published very recently by Gailledrat et al. and touches on body shape concerns in women with eating disorders. Participants were women with a diagnosis of AN or BN selected from a clinic in France. The researchers inform us that, “patients with an ED are much more concerned with their body image and weight than the rest of the population”. The authors do not provide any support for … Continue reading →
I find the idea of treatment retention for eating disorders to be quite interesting. Mostly, I find it intriguing to dissect the way that authors write about treatment retention – that is, how they tend to look at factors within people that make them more or less able to complete treatment, rather than things about the treatment that serve or don’t serve people’s needs. I’ve been reading a lot more about adolescent eating disorder treatment these days, given that I’m doing a practicum at an adolescent treatment centre that does things a bit differently. Resultantly, I’ve become more interested than ever in how we can better meet people’s different treatment needs and provide a more comprehensive treatment continuum.
The stark reality of treatment is that people don’t always finish it. That statement sounds fairly banal, but it’s a loaded one. Too often, I see this framed as people failing … Continue reading →
Have I mentioned that I go to too many conferences? This week I attended the Eating Disorders Association of Canada (EDAC) conference in Winnipeg, Manitoba. If you follow me on Twitter, this post might be a bit repetitive, as I seem to think that live-tweeting conferences is my single handed responsibility (that and convincing everyone and their dog to join Twitter). However, I wanted to take the opportunity to provide a bit more context around some of my Tweets and give my overall impressions about the conference and next steps that we might take to move from discussion to action around eating disorders in Canada.
Before getting into the conference, it is worth commenting on the pre-conference session hosted by the National Initiative for Eating Disorders (NIED). In case you don’t know, NIED is a not for profit group founded by Wendy Preskow and Lynne Koss and comprised of professionals … Continue reading →
It’s no secret that I am not a fan of primarily psychoeducational interventions for people with eating disorders (EDs). It irks me that the overall theory in implementing this kind of intervention seems to be: if they only knew what they were doing to their bodies, people with EDs would take better care of themselves. Of course I take issue with this idea – if knowing that EDs were harmful to one’s health was enough to make the changes needed to not have an ED anymore, far fewer people would be struggling.
In case you don’t know what I’m talking about, a psychoeducational program is one that focuses on educating people about a mental illness, including what qualifies as pathology, what the behaviours look like, what the harms are, and what possible interventions exist. To be fair, there are not that many examples of purely psychoeducational interventions for … Continue reading →
Identifying risk factors for eating disorder symptoms may help us develop more evidence-based prevention mentions. Personally not convinced that prevention is really possible with the types of individual-focused programs we have today, I would argue that identifying risk factors may at least help us determine which individuals should be screened in subsequent years. If they do develop eating disorders, they will hopefully be more likely to receive early intervention and treatment.
To identify predictors of eating disorder symptoms, Elizabeth Evans and colleagues (2016) conducted a longitudinal study that measured various putative risk factors at ages 7, 9, and 12 in a group of boys and girls. The authors also wanted to identify correlates of eating disorder symptoms at 12 years of age. They measured eating attitudes and dietary restraint, BMI, body dissatisfaction, and depressive symptoms.
- 516 participants; 262 girls and 254 boys
- all individuals were residents of Gateshead, located
… Continue reading →
This is part II of posts on why I am highly skeptical of the argument that we need to understand the genetic basis of eating disorders in order to improve outcomes. If you would like to leave a comment, please read Part I as well.
I worry about the implications of focusing on genetics and neurobiology in identifying causes of and solutions to eating disorders in the context of a neoliberal society.
When I was an adolescent, finding out that eating disorders have a genetic component alleviated my guilt. Coming across Dr. Walter Kaye’s research into the neurobiology of eating disorders — the hypothesis that the drive to restrict may be linked to and reinforced by serotonin systems in the brain (here, here, and here) — provided me with a plausible biological explanation for why restricting made me feel calmer. It meant my eating disorder was … Continue reading →
I no longer support genetics research into eating disorders. Okay, that’s not quite right: I no longer support genetics research into eating disorders under the pretense that it will improve treatment outcomes or prevent eating disorders. I just don’t believe it. Moreover, I think emphasizing the need for a genetic understanding of eating disorders shifts focus away from research and, more importantly, from actions, that can yield much greater benefits much quicker.
It wasn’t always like this. In my third (junior) year of university, I wrote a mini-review on the genetic and neurobiological etiology (cause) of anorexia nervosa. In it, I argued that “in order to improve recovery outcomes, more specific treatments based on genetic and neurobiological evidence need to be developed.” I concluded by writing,
However, with the advent of large-scale genetic databases and worldwide collaboration among researchers resulting in larger sample sizes, the future of AN research
… Continue reading →
I can’t help but think I often write more about the issues surrounding the general lack of treatment options for eating disorders that I sometimes neglect to comment on what is available. A part of this is that I would refer to myself as somewhat of a treatment modality atheist – I have the luxury of being someone who does eating disorder research but is not involved in directly treating those with eating disorders, and so I don’t need to specialize in one type of treatment. My bottom line tends to be that no one-size-fits-all, and that the type of treatment that works for someone will depend on so many factors (like their gender, ethnicity, socioeconomic status, body size, ability, even their politics to a certain extent) that I wouldn’t want to proclaim one type of treatment as king.
In spite of this treatment modality atheism (or perhaps because of … Continue reading →
I write a lot about systems-level change for eating disorders, and about how the services that we have available for eating disorders are severely lacking. What I tend to struggle with – though it’s something I’m working on – is how to actually MAKE the changes I’m advocating for. I always fear the tendency to get caught up in saying “this is how things should be,” when I know that eating disorders are so complex and multifaceted and that one size does not fit all when it comes to support. I also fear my experience and my story becoming “the” story about eating disorders and recovery; just because something worked for me does not mean it will work for others.
Surprisingly, despite a general discontent in the ED field with the service continuum, there are few studies that explore what kinds of changes might be made to eating disorder services … Continue reading →