Dialectical Behavioural Therapy for the “Difficult to Treat” Eating Disorder Patients

If there is anything we’ve learned over the  many years of eating disorder research, it is that eating disorders are extremely complex. Often, this complexity is intensified by comorbidities, including post-traumatic stress disorder, depression, and “personality disorders.” Unfortunately, individuals whose disorders are labeled persistent, chronic, or “difficult to treat” may be even less likely to receive the treatment and support they require, deserve, and desire.

“Standard” approaches to eating disorder treatment, such as cognitive behaviour therapy (CBT), may prove ineffectual for these individuals. In a recent article, Federici & Wisniewski (2013) reflected on the difficulty of treating patients whose eating disorders are accompanied by other mental health issues. They noted that focusing on ED symptoms alone generally fails to achieve treatment goals, as behaviours associated with other disorders often decrease ED treatment effectiveness. This situation may leave both patients and clinicians feeling burnt out and unsatisfied (to say … Continue reading →

Self-Harm is Common Among Adolescents With Eating Disorders

Self-harm or non-suicidal self-injury (SI) are common among adolescents, particularly among adolescents with eating disorders. Previous studies have shown that SI seems to be associated with sexual trauma, mood disorders, and substance abuse. The present study aimed to find out whether (1) SI is associated with any specific eating disorder symptoms, such as bingeing, or purging, and (2) how often clinicians screen for SI behaviours (and whether particular patients are more likely to be screened than others).

Dr. Rebecka Peebles and colleagues looked retrospectively at intake evaluations of 1,432 patients between the ages of 10-21 (mean age 15). Three quarters of the patients were Caucasian, and slightly over 9% were male.  Sixty-three percent had an intake diagnosis of eating disorder not otherwise specified (EDNOS).

MAIN FINDINGS FOR AIM 1

  • Of those screened for SI behaviours, 40.8% engaged in SI
  • Cutting was the most common SI behaviour reported (85%)
  • Bingeing/purging was
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