Mental health articles
OF mental health care and mentally ill
Matching treatment of anorexia nervosa to need and acceptability
In spite of what we know about the effectiveness of treatments for eating disorders overall, there remain many questions of what is cost effective and/or acceptable for individual patients. The broad clinical presentation of anorexia nervosa over age and severity, and the paucity of evidence, means that there is great uncertainty whether any of the […]
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bulimia nervosa about getting help
In bulimia nervosa there may also be ambivalence about getting help but the source of these mixed feelings differs. It is less usual for the person with bulimia nervosa to be encouraged to seek help by others. This is because the symptoms can be less overt and the most common time of onset is after […]
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The primary-care hurdle of eating disorders
The primary-care hurdle of eating disorders Epidemiological research from different European countries highlights how eating disorders are under-diagnosed in primary care. A number of different reasons seem to present potent barriers to early diagnosis and intervention. These include: •patient delay in presenting their eating problems; •doctor delay in diagnosing eating disorders at an early stage; […]
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What should be the focus of any prevention work on eating disorders?
Many risk factors are not modifiable and so they cannot be targets of any health promotion programme. Moreover there is controversy as to the effectiveness of prevention packages which have had eating disorders as their focus as some have appeared to be ineffective (irrelevant to the majority) or dangerous as there is a risk that […]
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Perinatal complications and stress during pregnancy: anorexia nervosa (AN)
A quarter of parents had experienced severe obstetric difficulty and loss, compared to only 7.5 per cent of matched comparison parents. The incidence of prematurity and birth trauma is elevated by 2–3 fold in the birth histories of those with AN. Pregnancy complications were noted more often. There is a trend for people with anorexia […]
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Predisposing factors of anorexia nervosa
There is increased number of cases of eating disorders within families. Twin studies suggest that over 50 per cent of the variance is attributed to genetic factors. There is an increased risk of perinatal stress or trauma in anorexia nervosa. There is insecure attachment: avoidant in anorexia nervosa and ambivalent in bulimia nervosa. There is […]
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To whom and where should prevention work for bulimia nervosa be targeted?
The incidence and prevalence and demographic features associated with eating disorders are shown in Tables 16.2, 16.3 and 16.4. These show that for maximum impact primary prevention work for bulimia nervosa should be focused on adolescent females in urban settings. The most effective strategy for prevention in anorexia nervosa would be early intervention (secondary prevention) […]
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Behavioural experiments of generalized anxiety disorder
Behavioural experiments generally involve testing predictions about physical, social or psychological danger that involve a combination of exposure plus disconfirmatory manoeuvres or survey-based techniques. As with all cognitive techniques the principal focus is belief change, so experiments should be designed that specify a clear hypothesis from the client, followed by a task that tests out […]
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Manipulation of safety behaviours in panic disorder
Safety behaviours are the acts that people carry out which are designed to prevent a feared catastrophe or outcome. The client may also see them as things that help them cope in a situation. Salkovskis et al. conducted a survey of the types of safety behaviours people employed. Examples of safety behaviours in panic disorder […]
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Exposure to feared stimuli in panic disorder
Exposure may be practised as detailed above. However, in cognitive therapy exposure is used in the context of helping to modify thoughts and beliefs. For example, in panic disorder with agoraphobia a client may be asked to enter an avoided situation and remain until anxiety has reduced by 50 per cent. The therapist’s focus at […]
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