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Biomedical subjects

C M Bulik

Publications and source records attributed to C M Bulik.

At least 91 records · Page 5Linked to original sources
PubMed1993

The effect of food deprivation on alcohol consumption in bulimic and control women.

The effect of food deprivation on alcohol self-administration was examined in five women with bulimia nervosa and five healthy controls in a semi-naturalistic experimental design. In this within-subjects study, each individual underwent two food-deprived and two non-deprived sessions. The deprivation condition consisted of no food or caloric beverages for 19 hours prior to the experimental procedure. On each of the 4 days, subjects watched a 2-hour segment of an epic movie and were permitted to drink ad libitum. No differences were observed in the number of grams of alcohol consumed under deprived and non-deprived conditions for either group. Breath alcohol levels were significantly higher under the non-deprived condition despite equivalent amounts of alcohol consumed and similar ratings of the subjective sense of tipsiness. Bulimic women consumed equivalent calories due to alcohol as control women but significantly fewer calories due to non-alcoholic beverages. These results do not support the hypothesis that food deprivation leads to increased self-administration of alcohol in women.

Adult↗
PubMed1993

Characteristics of repeat users of a psychiatric emergency service.

OBJECTIVE: Patients who visited a psychiatric emergency service were studied to determine whether repeat visitors, who consume a disproportionate share of services, could be identified by demographic and diagnostic characteristics. METHODS: Data were obtained from a semistructured diagnostic interview given to all 16,257 persons who made 29,214 visits to an urban psychiatric emergency service in Pittsburgh, Pennsylvania, from 1985 to 1989. Patients were categorized into four groups based on the number of visits in the five-year period. Patients in group 1 made a single visit, while those in group 2 averaged less than one visit per year; those in group 3 made one or two visits per year, and those in group 4, more than two visits per year. RESULTS: Groups 3 and 4 constituted 5.1 percent of the sample but made 27.1 percent of the total visits. Repeat users were significantly more likely to be male, younger, unmarried, unemployed, and nonwhite and to have diagnoses of schizophrenia, other psychotic disorders, and personality disorders. CONCLUSIONS: Repeat users of psychiatric emergency services appear to have demographic and diagnostic characteristics that may permit their early identification. For such patients, implementation of alternative management strategies, such as intensive case management, may reduce their use of services.

Adolescent↗
PubMed1992

Abuse of drugs associated with eating disorders.

Concomitant bulimia nervosa and drug abuse are common in women. Drugs used by this group include diuretics, emetics, laxatives, and diet pills, as well as alcohol, cigarettes, and illicit street drugs. This paper applies principles from behavioral pharmacology to the problem of drug use by women with bulimia nervosa. The prevalence of use, primary effects, toxicity, detection, tolerance, withdrawal, and effects on appetite and weight are discussed for drugs used by bulimic women to reduce appetite or weight or to induce purging (e.g., diuretics, emetics, laxatives, and diet aids). Alternatives in the diagnosis and treatment of drug use in women with eating disorders are discussed.

Adult↗
PubMed1991

Behavioral economic analysis of smoking: money and food as alternatives.

The relative reinforcing value of smoking versus two nonpharmacological reinforcers, money and food, was evaluated in young female smokers in two experiments. In Experiment 1 eight smokers worked for access to smoking or money on concurrent progressive variable ratio schedules of reinforcement (VR4 to VR50) across two days of Smoking Deprivation or No Deprivation. During No Deprivation money was reliably chosen over smoking. During Deprivation subjects initially (VR4) chose smoking over money, but at subsequent comparisons allocated equal time to work for smoking or money. In Experiment 2 eight smokers were provided access to smoking or food across four conditions: No Deprivation, Smoking Deprivation, Food Deprivation and Smoking + Food Deprivation, using the same progressive variable ratio schedules as in Experiment 1. Results showed an increase in the reinforcing value of food after Food Deprivation and smoking after Smoking Deprivation. On the dual deprivation day, subjects initially (VR4) chose to work for food, showed equal preferences over the next three schedule comparisons (VR8-VR20), and from VR25-VR50 shifted their choice to smoking. An increase in percent of calories as fat was observed during all deprivation conditions. The results demonstrate the use of the concurrent schedule paradigm for assessing choice among pharmacological and nonpharmacological reinforcers, and shows the relative reinforcing value of smoking depends on recent deprivation, response demands to obtain the reinforcer and availability of alternative reinforcers.

Adolescent↗
PubMed1991

An open trial of fluoxetine in patients with anorexia nervosa.

BACKGROUND: Anorexia nervosa is a disorder of unknown etiology with a high rate of relapse and no known treatment. Because anorexia nervosa shares some similarities with obsessive compulsive disorder, we hypothesized that a serotonin-specific medication might be useful in the treatment of this illness. METHOD: We administered an open trial of fluoxetine to 31 patients with DSM-III-R anorexia nervosa. Most anorexics were started on fluoxetine treatment after inpatient weight restoration and then discharged from the hospital and followed up as outpatients. RESULTS: At the time of follow-up (11 +/- 6 months on fluoxetine), 29 of the 31 patients had maintained their weight at or above 85% average body weight (97% +/- 13% average body weight for the group). We judged response as good in 10, partial in 17, and poor in 4 anorexics as measured by improvements in eating behavior, mood, and obsessional symptoms. Restrictor anorexics responded significantly better than bulimic and/or purging-type anorexics. CONCLUSION: This open trial suggests that fluoxetine may help patients with anorexia nervosa maintain a healthy body weight as outpatients. The reasons for the positive effects of fluoxetine are uncertain, but the agent may help by improving eating behavior and/or reducing obsessionality, depression, and anxiety. It is important to emphasize that this was not a double-blind, placebo-controlled study. Thus we can not be certain of the efficacy of fluoxetine and caution that fluoxetine should not be used as the sole treatment of anorexia nervosa at this time.

Adolescent↗
PubMed1990

Features associated with suicide attempts in recurrent major depression.

Sixty-seven individuals with recurrent major depression and a history of suicide attempts are compared with 163 individuals with recurrent major depression and no history of suicide attempts. The groups are contrasted on demographic features, clinical course, severity of depression, co-morbidity, and acute symptom profiles. Patients with a history of attempts are distinguished from non-attempters by suicidal ideation, marital isolation, neurovegetative signs, feelings of failure, and co-morbid alcoholism or bipolar II disorder. Logistic regression analysis using a model which included a portion of the significant variables correctly classified 77% of the cases. These findings are discussed with reference to prediction of suicide attempts in individuals with major affective disorder.

Adult↗
PubMed1990

Imipramine and weight gain during the treatment of recurrent depression.

Weight change was examined in 128 depressed outpatients treated successfully with an average dose of 215 mg imipramine and then continued on that treatment regimen for 5 additional months, an average duration of over 33 weeks. More than half the patients experienced a change in weight of 5% or less and only 13.3% experienced a gain of greater than 10%. While males and females did not differ in their pattern of change during acute treatment, females experienced a greater percent change (P less than 0.06) and change in body mass index (P = 0.05) during continuation treatment. The clinical implications of these findings are discussed, especially with respect to the extreme group.

Adult↗
PubMed1990

Treatment of laxative abuse in a female with bulimia nervosa using an operant extinction paradigm.

Chronic laxative abuse was treated using an operant extinction paradigm in a 29-year-old woman with bulimia nervosa. Access to self-administration of laxative and placebo were alternated in an ABAB design. Outcome was measured by self-reported craving for laxatives and rates of drug self-administration. During baseline, the subject exhibited high rates of both craving and self-administration. During placebo phases, cravings and drug self-administration declined. Both measures increased when active drug was reinstated. The final return to placebo led to a decrease in craving and extinction of drug self-administration to zero doses per day. This paper introduces the concept of laxatives as reinforcers and provides a new approach to the treatment of laxative abuse in women with bulimia nervosa.

Adult↗
PubMed1989

Childhood sexual abuse in women with bulimia.

In a study of the family environments and psychiatric histories of 35 bulimic women, the authors found that 12 (34.3%) of the 35 women had been sexually abused or had a sister who had been sexually abused. That rate is comparable to estimates from other studies of women with eating disorders and of female psychiatric patients, but is apparently higher than the rate found in the general population. Bulimic women from families in which sexual abuse occurred were more likely than bulimic women with no personal or family history of sexual abuse to have a personal history of major depression, relatives who abused drugs, and a disturbed family environment. The presence of bulimia should alert clinicians to screen for concomitant depression, suicidality, and substance abuse as well as the possibility of severe, if hidden, familial pathology and environmental disruption including sexual abuse, parental psychopathology, and character deficits.

Age Factors↗
PubMed1987

Drug and alcohol abuse by bulimic women and their families.

The author studied patterns of drug and alcohol abuse in 35 bulimic women, 35 healthy control subjects, and their first- and second-degree relatives. The bulimic women and their families had significantly higher rates of substance abuse disorders.

Adult↗
PubMed1987

Alcohol use and depression in women with bulimia.

In a preliminary study examining affective and addictive components of the bulimia syndrome, individual tendencies toward alcohol abuse and depression as well as family histories of alcoholism and affective disorder were examined. Twelve women meeting DSM-III criteria for bulimia and 12 matched controls participated in the investigation. Bulimic women were significantly more depressed than controls. Although there were no significant differences in global alcoholism scores, a subgroup of bulimics emerged for whom bulimia was one of multiple and debilitating addictions. In addition, bulimic women evidenced a significantly greater family history of alcoholism than controls. Bulimia is described as a disorder with salient disruptions in eating behavior yet strongly influenced by affective and addictive components.

Adolescent↗
PubMed1986

The effect of exercise on non-restricted caloric intake in male joggers.

This study examined the effects of both increasing and decreasing normal energy expenditure over periods of one week on the self-reported caloric intake of seven male joggers (22-27 years). The three levels of energy expenditure were: no exercise, regular exercise and double exercise. Despite significant difference in energy expenditure across conditions, self-reported caloric intake did not differ significantly, suggesting that energy intake was not affected by short-term changes in energy expenditure.

Adult↗
PubMed1984

Relationship between EEG sleep measures and clinical ratings of depression. A revisit.

The relationship between clinical and behavioral ratings and EEG sleep variables has been controversial, leading to a possible premature abandonment of the possible significance for these interrelationships. Instead, our reexamination of this issue in 62 depressed patients suggests that while the strength of these relationships do not account for the majority of variance, correlations between EEG sleep and behavioral measures should not be disregarded as trivial, for the degree of these relationships is commensurate with other behavioral-biological relationships.

Adult↗
PubMed1983

Nighttime plasma cortisol secretion and EEG sleep--are they associated?

Since the initial rise in plasma cortisol during sleep usually occurs near the second period of rapid eye movement (REM) sleep, a more precise association between the initial cortisol rise and electroencephalographic (EEG) sleep was examined in 22 normal control subjects. Our results indicate that the length of the total non-REM sleep period between the first and second REM period including awake time was significantly correlated to the cortisol rise time. However, the timing of the initial cortisol rise was not significantly related to the overall plasma cortisol levels during the night. But the second non-REM sleep period (minus awake time) is inversely related to overall cortisol levels during the night.

Adolescent↗