Effectiveness of self-esteem and social skills group therapy in adolescent eating disorder patients attending a day hospital treatment programme

OBJECTIVE

To evaluate self-esteem and social skills in adolescent eating disorder patients before and after specific group therapy as part of a Day Hospital Programme.

METHOD

One hundred and sixty adolescent eating disorder patients, classified as anorexia nervosa and related disorders (AN-rd) (N = 116) or bulimia nervosa and related disorders (BN-rd) (N = 44) received structured group therapy for developing self-esteem and social skills.

RESULTS

BN-rd patients had poorer perceptions of some self-esteem and social skills variables. After group therapy, both groups presented significant improvements in their perceptions of physical appearance, their self-concept related to weight and shape and to others, happiness and satisfaction, social withdrawal and leadership. BN-rd patients presented more changes on many of the variables.

DISCUSSION

Specific self-esteem and social skills group therapy in patients with eating disorders can be useful in improving certain core features.

Phobic anxiety in 11 nations. Part I: Dimensional constancy of the five-factor model

The Fear Survey Schedule-III (FSS-III) was administered to a total of 5491 students in Australia, East Germany, Great Britain, Greece, Guatemala, Hungary, Italy, Japan, Spain, Sweden, and Venezuela, and submitted to the multiple group method of confirmatory analysis (MGM) in order to determine the cross-national dimensional constancy of the five-factor model of self-assessed fears originally established in Dutch, British, and Canadian samples. The model comprises fears of bodily injury-illness-death, agoraphobic fears, social fears, fears of sexual and aggressive scenes, and harmless animals fears. Close correspondence between the factors was demonstrated across national samples. In each country, the corresponding scales were internally consistent, were intercorrelated at magnitudes comparable to those yielded in the original samples, and yielded (in 93% of the total number of 55 comparisons) sex differences in line with the usual finding (higher scores for females). In each country, the relatively largest sex differences were obtained on harmless animals fears. The organization of self-assessed fears is sufficiently similar across nations to warrant the use of the same weight matrix (scoring key) for the FSS-III in the different countries and to make cross-national comparisons feasible. This opens the way to further studies that attempt to predict (on an a priori basis) cross-national variations in fear levels with dimensions of national cultures.

[Clinical, psychological and biological variables in a group of 108 adolescent patients with anorexia nervosa]

BACKGROUND

To assess the clinical and psychological characteristics, hormonal changes derived from malnutrition and the prognostic factors in an adolescent group of patients with anorexia nervosa.

PATIENTS AND METHODS

In this retrospective study specific case-history medical record for this disorder was used first with the parents and later with the patients. Depression questionnaires (BDI or CDI) and eating disorders questionnaires (EAT and CIMEC) were also administered, and hormonal tests were carried out.

RESULTS

98 out of 108 patients (90.7%) were females. Mean age was 15 years, 23 patients (21.1%) showed major depressive disorders or obsessive-compulsive disorders besides anorexia nervosa. The duration of the disorder was 12.0 +/- 9.0 months. The age at onset of the disorder was 15.1 +/- 1.5 (10-17 years), and the percentage of weight loss ranged between 15.53%. In relation to the hormonal findings the low levels of T3, insulin, somatomedin, prolactin, LH and 17 B estradiol were shown up. There were no differences between inpatients and outpatients in relation to the age of onset of the disorder onset, duration of the disorder, percentage of weight loss, psychological variables or applied hormonal findings. There were differences in relation to the used psychometric tests, which differentiated between patients with a good and bad outcome.

CONCLUSIONS

Major depressive disorders and obsessive-compulsive disorders are the most frequent comorbid psychiatric disorders in the anorexia nervosa. The age at onset of the disorder, duration of the disorder, percentage of weight loss and hormonal changes do not seem to influence in outcome, whereas initial affective and eating symptomatology tend to predict disorder outcome.