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Biomedical subjects

K A Halmi

Publications and source records attributed to K A Halmi.

At least 109 records · Page 6Linked to original sources

Psychometric validation of the Tridimensional Personality Questionnaire: application to subgroups of eating disorders.

Eating disorder patients show extremes of the personality characteristics measured by the Tridimensional Personality Questionnaire (TPQ). For this reason, the TPQ was tested in four subgroups of eating disorder patients. Patients completed the TPQ and their responses were compared with a normative sample of women. Results indicated that the TPQ is an internally consistent and valid instrument to use with eating disorder patients.

Adolescent↗

Effects of depression and borderline personality traits on psychological state and eating disorder symptomatology.

The incidence of current or lifetime affective disorder and borderline personality characteristics were measured in bulimia nervosa patients. The relationship of these variables to the severity of eating disorder symptomatology (Eating Disorder Inventory [EDI]) and general psychiatric symptoms (Hopkins Symptom Checklist [SCL]) was examined. Categorical diagnostic assessments of affective disorder and borderline personality disorder (BPD) were made by Structured Clinical Interviews for DSM-III-R (SCID-I and -II). Affective disorder diagnosis (both current and lifetime) strongly influenced EDI and SCL profiles, while borderline personality characteristics had little influence. An understanding of the broad psychological symptomatology in bulimics requires the consideration of comorbid psychiatric illnesses, especially affective disorders.

Adult↗

The relationship between psychopathology, eating disorder diagnosis, and clinical outcome at 10-year follow-up in anorexia nervosa.

General psychopathology as measured by the Minnesota Multiphasic Personality Inventory (MMPI), eating disorder diagnostic status (DSM-III-R), and clinical outcome were compared in a sample of 59 women 10 years after their hospital treatment for anorexia nervosa. There was a substantial and orderly relationship between severity of eating disorder symptomatology and severity of comorbid general psychopathology at follow-up evaluation. Those who had no eating disorder at follow-up displayed essentially no general psychopathology on the MMPI. Persons still suffering from a severe eating disorder (anorexia or bulimia nervosa) showed clinically significant levels of comorbid general psychopathology, and had significantly higher mean scores than the no eating disorder diagnosis group on seven MMPI clinical scales. Little general psychopathology was displayed by persons receiving a NOS eating disorder diagnosis at follow-up. Their mean MMPI profile was intermediate between those for the no diagnosis and severe eating disorder groups, but closer to that for the no diagnosis group. Rank order correlations were significant between levels of eating disorder symptom severity and all relevant MMPI clinical scales. Severity of psychopathology on the MMPI was also related to ratings of global outcome assessed by two approaches to categorizing outcome in anorexia nervosa.

Anorexia Nervosa↗

Seasonal patterns in eating disorder subgroups.

Patients with bulimia nervosa (BN) often have seasonal patterns of mood and appetite that compare with patterns seen in seasonal affective disorder (SAD). Seasonal patterns in other eating disorder (ED) subgroups have not been adequately described. We report on seasonal patterns in mood, weight, appetite, sleep, social activity, and energy in 154 consecutive admissions to an outpatient ED program: 60 patients with anorexia nervosa (AN), 31 with BN, 34 with a history of both AN and BN (AN/BN), and 29 with an ED not otherwise specified (ED-NOS). AN patients had significantly less seasonal variation overall than either bulimic subgroup, as measured by the global seasonality score (GSS) on the Seasonal Patterns Assessment Questionnaire (SPAQ). AN patients also showed less seasonal change in mood, weight, and energy than BN patients, and less variation in mood and appetite than AN/BN patients.

Adolescent↗

The Tridimensional Personality Questionnaire: an exploration of personality traits in eating disorders.

The Tridimensional Personality Questionnaire (TPQ) was tested in four subgroups of eating-disorder patients: anorectic-restrictors (AN-R), anorectic-bulimics (AN-B), normal weight bulimics (BN), and bulimics with a past history of anorexia (B-AN). Normal controls and patients were matched for gender and age. All subjects completed the Beck Depression Inventory (BDI) in addition to the TPQ. AN-Rs scored lower on the Novelty Seeking scale than the bulimic groups and controls, and the two normal weight bulimic groups had higher Novelty Seeking scores than the controls. On the Harm Avoidance scale, all eating disorder groups scored significantly higher than the control group. In addition, the AN-Rs scored lower than the AN-Bs and B-ANs. The Harm Avoidance scale and depression scores were positively correlated while the Reward Dependence scale and depression scores were negatively correlated. Differences between diagnostic groups on the Novelty Seeking and Persistence scales remained clearly significant when depression was partialled out. These results are discussed in terms of the Tridimensional Personality Questionnaire as a stable measure of traits with eating disorder subjects.

Adult↗

The Yale-Brown-Cornell Eating Disorder Scale: development, use, reliability and validity.

Patients with eating disorders present with a wide range of eating-related preoccupations and or rituals. Yet, eating disorder assessments traditionally have measured a finite number of specific eating-disordered thoughts or actions. The current work presents a new instrument, the Yale-Brown-Cornell Eating Disorder Scale (YBC-EDS), that does not limit assessment to a particular set of eating-related concerns or behaviors. Rather, it assesses the severity of illness associated with an individual's unique symptomatology. Reliability and validity of this new, clinician-rated instrument was tested in two independent samples of DSM-III-R eating disorder patients. The YBC-EDS eight-item scale assessing severity of preoccupations and rituals, and a set of six provisional items for assessing motivation for change were both frequently endorsed and found to have excellent interrater reliability. Internal consistency was shown to be good for the set of eight core items and the set of six items related to motivation for change. The eight-item scale demonstrated aspects of convergent validity with other assessments of eating disorder symptomatology. The set of six provisional items for assessing motivation for change was inversely related to measures to diet restriction, drive for thinness, and body dissatisfaction. This paper presents the eight-item Yale-Brown-Cornell Eating Disorder Scale for assessing illness severity in eating-disordered patients with an extensive range of symptomatology. An accompanying set of six provisional items for assessing motivation for change are also presented. Initial findings showed excellent reliability and indications of validity for both the eight-item YBC-EDS and the set of six provisional items.

Adolescent↗

A comparative analysis of Minnesota Multiphasic Personality Inventory profiles of anorexia nervosa at hospital admission, discharge, and 10-year follow-up.

The assessment of personality variables measured by the Minnesota Multiphasic Personality Inventory (MMPI), was compared in a sample of 52 female inpatients with anorexia nervosa at the time of hospitalization, discharge from hospital, and 10 years after treatment. Admission MMPI scores were significantly higher than scores both at discharge and 10 years later. There were no significant overall differences between discharge and follow-up evaluation. Discharge, but not admission, MMPI scores were positively correlated with 10-year follow-up study on seven of 10 clinical MMPI scales (all but hypochondriasis, masculinity/femininity, and hypomania). At follow-up evaluation, eating disorder poor outcome was associated with higher MMPI scores. There was no significant difference on admission MMPI scores between the four outcome groups; however, patients who recovered had a greater decrease in MMPI scores at the 10-year follow-up study compared with poor outcome patients. The long-term outcome of anorexia nervosa was largely unrelated to the severity of psychopathology during the acute phase of the illness. These results suggest that persistent personality features are best measured following treatment of acute symptomatology of anorexia nervosa.

Adult↗

Bright light therapy decreases winter binge frequency in women with bulimia nervosa: a double-blind, placebo-controlled study.

The study objective was to determine the effect of winter bright light therapy on binge and purge frequencies and depressive symptoms in subjects with bulimia nervosa. Thirty-four female bulimic outpatients were treated with either 10,000 lux bright white light or 50 lux dim red light (placebo control) during the winter months. In this double-blind study, the placebo group (n = 18) and the bright light group (n = 16) were matched for age, degree of seasonality (measured by the Seasonal Patterns Assessment Questionnaire [SPAQ]), and concurrent depression (measured by Structured Clinical Interview for DSM-IV [SCID]). Three weeks of baseline data collection were followed by 3 weeks of half-hour daily morning light treatment and 2 weeks of follow-up evaluation. There was a significant light-treatment by time interaction (Wilks' lambda = .81, F(2,28) = 3.31, P = .05). The mean binge frequency decreased significantly more from baseline to the end of treatment for the bright light group (F(1,29) = 6.41, P = .017) than for the placebo group. The level of depression (measured by daily Beck Depression Inventory [BDI] scores) did not significantly differ between the groups during any phase, and neither depression nor seasonality affected the response to light treatment. In this double-blind study, bulimic women who received 3 weeks of winter bright light treatment reported a reduced binge frequency between baseline and the active treatment period in comparison to subjects receiving dim red light.

Adolescent↗