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Background
Case formulation is a core component of cognitive behavioural therapies. Formulation letters provide an opportunity to enhance the therapeutic alliance and may improve treatment outcomes. This workshop focuses on case formulation in the context of the Maudsley Anorexia Nervosa Treatment for Adults (MANTRA), but the content will also be relevant to other psychotherapies for anorexia nervosa (AN). Interactive, practical consideration will be given to the development of case formulations. In addition, new data will be presented on links between MANTRA formulation letters and treatment completion
rates, patient-reported treatment satisfaction, and improvements in eating disorder symptoms over treatment.
Methods
Case examples will be used to illustrate the formulation process. To determine if formulation letters predicted treatment outcomes, data were studied from
46 adult outpatients with AN who received MANTRA at the Maudsley Hospital. A Case Formulation Rating Scheme was used to rate formulation letters for global quality, adherence to the MANTRA model and use of a collaborative, re ective, af rming stance.
Results
Formulation letters that paid attention to the development of the AN predicted greater treatment acceptability ratings (p=.002). More re ective and respectful letters predicted greater reductions in Eating Disorder Examination scores (p=.003).
Conclusions
Results highlight the potential signi cance of a particular style of written formulation as part of treatment for AN. This workshop will illustrate the aspects of case formulation that may be most relevant when working with individuals with AN.
WORKSHOP ABSTRACTS
4.30PM – 6PM > SATURDAY 19 MARCH 2016
WORKSHOP 5.1
Logan Hall
DELIVERING ENHANCED COGNITIVE BEHAVIOUR THERAPY (CBT-E) IN REAL WORLD CLINICAL SETTINGS
> Assoc Prof Susan Byrne1,2, Dr Karina Allen3, 1University of Western Australia (UWA), 2Centre for Clinical Interventions in Perth, Western Australia, 3Eating Disorders Service, South London and Maudsley NHS Foundation Trust, London, UK
Enhanced cognitive behaviour therapy (CBT-E), a revised version of the original cognitive behavioural therapy for bulimia nervosa, was developed by Christopher Fairburn and colleagues at Oxford University. CBT-E stems from the transdiagnostic theory of eating disorders and is intended to be applied to all forms of eating disorders.
It has been investigated as a treatment for anorexia nervosa, bulimia nervosa and in two transdiagnostic samples. CBT-E focuses primarily on core eating disorder features and the mechanisms thought to
maintain them. Thus it employs standard cognitive behaviour procedures to modify eating habits (such as binge eating), extreme weight-control behaviour (particularly dietary restraint), and the over-evaluation of eating, shape and weight. First, an intensive
initial stage focuses on engaging and educating the patient, creating an initial personalised formulation, and obtaining maximal early behaviour change. In stage two, there is a detailed review of progress
and barriers to change. In stage three there is an emphasis on modifying the patient’s eating disorder psychopathology, particularly the dysfunctional scheme for self-evaluation. In the nal stage, the focus turns to maintenance of gains across the various domains addressed during treatment.
In this interactive workshop, the key components of CBT-E will be described and demonstrated, using
role play and real case material. Participants will have the opportunity to observe and practice techniques integral to this evidence-based treatment and to discuss the implications of using CBT-E in “real world” clinical settings.
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WORKSHOP 5.2
Elvin Hall
SPECIALIST SUPPORTIVE CLINICAL MANAGEMENT FOR EATING DISORDERS (SSCM- ED). A FIRST-LINE TREATMENT FOR EATING DISORDERS? A PRACTICAL WORKSHOP
> Dr Paul Robinson, Barnet, En eld and Haringey Mental Health Trust; University College London, London, UK
Background
Specialist supportive clinical management has been found in a number of studies in which it has been
used as a control or comparison treatment, to have approximately the same clinical ef cacy for anorexia nervosa as other treatments such as CBT or MANTRA. In the NOURISHED study, SSCM was modi ed in order to facilitate its use in all eating disorders. This modi ed therapy was called SSCM-ED. It was found to have around the same ef cacy as mentalization-based therapy in that study. SSCM and SSCM-ED can be administered by eating disorders staff without lengthy training as long as expert supervision is available. This evidence suggests that SSCM-ED might have a role in primary and secondary care as an initial response to
a patient referred with an eating disorder, especially if there is a substantial waiting list for more complex treatments.
Workshop structure
1. Lecture (30 mins): The essential features of SSCM-
ED will be described.
2. Workshop (30 mins): Participants will then be
asked to work in pairs in order to practice techniques of SSCM-ED, including:
1. Therapeutic alliance, 2. Target symptom lists, 3. Speci c ED symptoms, 4. Ending.
3. Discussion (30 mins): Feedback and questions.
WORKSHOP 5.3
Drama Studio
OXYTOCIN IN EATING DISORDERS: A NEW TARGET FOR TREATMENT?
> Jenni Leppanen1, Valentina Cardi1, Dr Kah Wee Ng2, Daniel Stein3, Kate Tchanturia1, Prof Janet Treasure1 and Dr Yannis Paloyelis1, 1King’s College London, London, UK, 2Singapore General Hospital, Singapore, 3Sackler Faculty of Medicine, Tel Aviv, Israel
Background
In anorexia nervosa (AN), eating and food are associated with adverse appraisal, leading to compulsive avoidance and rumination. Preclinical animal studies show oxytocin can break the loop of compulsive behaviours. We investigated the effects of
oxytocin on attentional responses to food before and after test meal in AN.
Method
The study used a double blind, placebo-controlled, within subjects crossover design. 30 women with AN completed a fast visual probe task with food and neutral images at 30 (T1) and 45 minutes (T2) after oxytocin/placebo. A test meal was presented between the tasks.
Results
There was a signi cant condition by time interaction. At T1 in the placebo condition, subjects showed attentional avoidance of food stimuli. No such pattern was seen in the oxytocin condition. At T2, there was a signi cant difference between conditions. In placebo condition subjects showed attentional bias towards food stimuli whereas in oxytocin condition subjects showed attentional avoidance.
Discussion
The ndings suggest that oxytocin could reduce food- related avoidance and rumination in AN.
WORKSHOP 5.4
Nunn Hall
COST-EFFECTIVENESS OF MODELS OF CARE FOR YOUNG PEOPLE WITH EATING DISORDERS: THE COST ED STUDY
> Prof Sarah Byford1, Dr Hristina Petkova1,
Prof Ivan Eisler2, Simon Gowers3, Dasha Nicholls4, Geraldine Macdonald5 and Tamsin Ford6
1King’s College London, UK, 2South London and Maudsley NHS Trust, UK, 3University of Liverpool, UK, 4Great Ormond Street Hospital, UK, 5University of Bristol, UK, 6University of Exeter, UK
Background
Anorexia nervosa (AN) often involves lengthy hospital admissions which are disruptive to family, school and social life. Evidence suggests specialist services are better at keeping young people out of hospital, are more effective and more acceptable to users/carers than general CAMHS. Despite this, many areas of the British Isles have little or no specialist eating disorder provision.
Methods
Naturalistic surveillance study to evaluate whether increased investment in specialist services is affordable to the NHS and of bene t to young people with AN.
Objectives
1. To identify all young people in the British Isles
diagnosed by a consultant psychiatrist with DSM5 AN for the rst time.
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2. To classify the model of care provided to cases and map models of care across the British Isles.
3. To assess the cost and cost-effectiveness of
different models of community-based care.
4. To explore the impact on cost-effectiveness of
potential changes to the provision of specialist community-based services using decision modelling.
Results
The study is ongoing. Initial indications of incidence rates for AN will be reported alongside a description of the study population and an outline of the proposed economic analysis.
WORKSHOP 5.5
Clarke Hall
PARENTAL EXPRESSED EMOTION: EXPLANATORY FACTORS IN ANOREXIA NERVOSA
> Jeanne Duclos1, Meritxell Camprecios2, Dr Benjamin Carrot3, Christophe Lalanne4, Evhan
Group clinical trial and Dr Nathalie Godart3, 1Institut Mutualiste Montsouris, Inserm U1178, URCA, France, 2Blanquerna, Universitat Ramon Llull, Barcelona, Spain, 3Institut Mutualiste Montsouris, Inserm U1178, Paris, France, 4AP-HP, Hôpital Saint-Louis, Département de Recherche Clinique, Paris, France
Although literature on expressed emotion (EE) in eating disorders (ED) has recently grown, further
and larger sample studies are needed to deepen understanding of explanatory factors. The aim of this study was to enrich existing ndings focused on non- acute phase with a study on the acute ED phase. Will the factors identi ed as underlying parental EE change between the different phases?
In a sample of 87 patients, 63 fathers and 84 mothers, the contribution of patient clinical characteristics, ED- related symptoms, and both parents’ psychological functioning to EE levels, as measured by the Five Minute Speech Sample, were examined. Multivariate logistic regression analyses were used to identify possible explanatory factors.
Contrary to data collected at discharge from hospitalisation, admission data showed that paternal emotional over-involvement is related to the severity of the offspring’s clinical state. And only maternal psychological functioning explained maternal emotional over-involvement. In the same line, parental critical EE was not explicated by any of the variables considered.
Thus, ED treatment plan should provide individual parental psychological support and psycho-educative group sessions.
WORKSHOP 5.6
Room 728
THE MORGAN-RUSSELL OUTCOME SCHEDULE VS PATIENT-REPORTED QUALITY OF LIFE AND PERCEPTION OF DISEASE
> Laura Al-Dakhiel Winkler1, Jacob S Frølich2, Claire Gudex2, René K Støving2, Niels Bilenberg3 and Kirsten Hørder3
1Centre For Eating Disorders, Department of Edn Odense University Hospital, Denmark, 2Department of Endocrinology, Odense, Denmark, 3Department of Child and Adolescent Psychiatry, Odense, Denmark
Background
Studies have shown that patients suffering from
an eating disorder (ED) have a different opinion of their needs than that of the health professional. This leads to ambivalence towards treatment and great compliance dif culties. This study aimed to associate an outcome measure assessed by the clinician with patient-perceived health related quality of life (HRQoL) and burden of disease.
Methods
We included data from 280 (n=280) patients referred to a specialised ED unit in Denmark between 1994 - 2004. Data included diagnoses, age, BMI, psychiatric co-morbidity, symptom severity (measured by the eating disorder inventory, EDI-2), HRQoL (measured by SF-36) and outcome (measured by MROS).
Results
We found a high association between the MROS, EDI-2 and SF-36 scores. Furthermore, we found this association present regardless of patients’ age, BMI or diagnoses at referral and regardless of a psychiatric co-morbidity being present.
Conclusion
The high association between the clinician-assessed and the patient-perceived is valuable information, as this con rms that the widely used measurement tool MROS re ects the patients’ approach to their own status.
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SHORT PAPER ABSTRACTS
THURSDAY 17 MARCH 2016
SHORT PAPERS ONE: TREATMENT
11.30am, Logan Hall
CHAIR > Dr PAUL ROBINSON
DOES PRACTICAL BODY IMAGE WITH
MIRROR EXPOSURE IMPROVE BODY IMAGE AND ACCEPTANCE OF A HEALTHY WEIGHT
IN ADOLESCENT INPATIENTS WITH AN EATING DISORDER?
> Sarah Astbury1, Amanda Beavan1, Prof Hubert Lacey1 and Prof John Morgan2, 1Newbridge House, Birmingham, UK, 2St George’s University of London, London, UK
Dysfunctional body image in people with an eating disorder (ED) is associated with low self-esteem and relapse, making body image treatment clinically relevant. Practical body image (PBI) is a one-to-one, six-session programme developed at Newbridge House, a child and adolescent eating disorder inpatient unit. PBI utilises cognitive behavioural methods and is followed by seven sessions of mirror exposure (ME) promoting acceptance of a healthy weight. Outcome measures are administered before PBI, after PBI and after ME, including eating disorder examination questionnaire, body image avoidance questionnaire, Rosenberg self-esteem scale, physical appearance state and traits anxiety scale: trait version and the body acceptance scale. A study, awaiting ethical approval, will investigate the following research questions: ‘Does the treatment improve body image and acceptance of a healthy weight in adolescents with an ED?’ and ‘Which part of the treatment is most effective?’. It is hypothesised that the treatment will bene t adolescents with an ED, however it is unknown which part will be most effective. The results of this study will inform a manualised body image treatment to be disseminated across the wider health economy.
11.50am, Logan Hall
A FEASIBILITY RCT OF MENTALIZATION-BASED THERAPY VS SPECIALIST SUPPORTIVE CLINICAL MANAGEMENT IN PATIENTS WITH EATING DISORDERS AND SYMPTOMS OF BPD
> Dr Paul Robinson1,2, Jennifer Hellier3, Daiva Barzdaitiene4, Anthony Bateman1,2, Alexandra Bogaardt1,2, Ajay Clare1, Nadia Somers1, Aine O’Callaghan1, Kimberley Goldsmith3, Nikola Kern5, Prof Ulrike Schmidt3, Sara Morando6, Catherine Ouellet-Courtois1,2 and Peter Fonagy2, 1Barnet, En eld and Haringey Mental Health Trust, UK, 2University
College London, UK, 3King’s College London, UK, 4Kent and Medway NHS Trust, UK, 5South London and the Maudsley NHS Trust, UK, 6Central and North West London NHS Foundation Trust, UK
Background
Patients with eating disorders (ED) and borderline personality disorder (BPD) symptoms are a challenging population. MBT has been effective in borderline personality disorder and SSCM has been proposed as a treatment for anorexia nervosa. In this multi-centre RCT, we compared modi ed mentalization-based therapy (MBT-ED) and specialist supportive clinical management (SSCM-ED) in this patient group.
Methods
68 participants were randomised to either MBT-ED or SSCM-ED.
Results
Both therapies were manualised. There was very signi cant drop-out. 15 patients completed the follow up at 18 months, 20 at 36 months. There were adverse incidents, mostly self-harm, and one death of unknown cause.
At 6, 12, 18 and 36 months, there was a signi cant decline of ED and BPD symptoms and of anxiety and stress symptoms in both arms of the study.
At 12 and 18 months, MBT-ED was associated with
a greater reduction in shape concern (p=.007), and weight concern (p=0.021) in the eating disorder examination compared to SSCM-ED. At 36 months, weight concern fell signi cantly more in the MBT-ED group (p<0.05).
Conclusions
Both therapies appeared to improve ED and BPD symptoms. MBT-ED had more impact on core body image psychopathology.
12.10pm, Logan Hall
A SYSTEMATIC EVALUATION OF COGNITIVE REMEDIATION THERAPY (CRT) FOR THE TREATMENT OF CHILDREN AND ADOLESCENTS WITH ANOREXIA NERVOSA
> Jennifer Moynihan, Dr Lucia Giombini and Sophie Nesbitt, Rhodes Farm, London, UK
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Background
Research suggests that there may be cognitive weaknesses underlying anorexia nervosa (AN), with CRT showing promise in improving these weaknesses in adults. The aim of the study was to evaluate the effectiveness of CRT in children and adolescents.
Methods
A within-subjects design was used to compare 61 females with AN, aged between 11 and 17 (M = 15, SD = 1.4), on several neuropsychological tests before and after a course of CRT. The assessment consisted of: Rey-Osterrieth complex gure test (ROCFT), behaviour rating inventory of executive function - self-report (BRIEF-SR), DKEFS color-word interference test (CWT).
Results
Repeated-measures MANOVAs found a signi cant improvement in central coherence index (p < .001), immediate recall (p < .001), emotional control (p = .002), working memory (p = .001), plan/organise (p
= .004), behavioural shift (p = .004). On the DKEFS CWT, a repeated-measure Wilcoxon Signed-Rank Test revealed a signi cant improvement in Error Rate (p = .019) and a repeated measures T-test revealed a signi cant improvement in Time Taken (p < .001).
Conclusions
Results suggest that the use of CRT in children and adolescents with AN could strengthen speci c cognitive domains.
12.30pm, Logan Hall
TRAINING COURSES BASED ON THE NEW MAUDSLEY MODEL, FOR SPECIALISED TEAMS IN EMILIA ROMAGNA, ITALY
> Dr Maria Cristina Stefanini1, Dr Maria Rita Troiani2, Carlotta Gentili3 and Marinella Di Stani4
1University of Florence, Florence, Italy, 2Child and Adolescence Psychiatry Meyer Hospital, Florence, Italy, 3Child and adolescence Psychiatry Unit, Bologna, Italy, 4Eating Disorders and Mental Health Service, Ravenna, Italy
Background
Emilia Romagna (Italy) is organised in a network system for eating disorders (ED) in each local health services, with specialised teams and speci c training on ED during each year. In 2015, in Bologna and Ravenna, the training was “Parents’ support based on the New Maudsley Model”, conducted by a team with experience on the model, working in Child and Adolescence Psychiatry Meyer Hospital, University of Florence.
Methods
Two courses of 16 hours each. The content included lectures with slides, operational experience and role playing, videos, etc. Material utilised was: speci c tests, books and worksheets for operators.
Results
There were 63 participants. Profession: Child and Adolescent Psychiatrists 9, Psychologists 31, Educators 3, Psychiatrists 6, Paediatricians 3, Dietitians 8, Parents (associations) 3. Questionnaires rating: 63.9% the highest, 30% high, 5.5% medium.
Discussions
The training gave good results for the active involvement of operators. Several teams plan family groups conducted with this model. The project includes a follow-up in 3 months to assess the results with the operators who have applied the model.
12.50pm, Logan Hall
RECOGNISING AND MANAGING PHYSICAL PROBLEMS ON A SPECIALIST EATING DISORDER UNIT
> Dr Agnes Ayton, Christopher Periera and Dr Christopher Hopkins, Oxford Health NHS Foundation Trust, UK
Background
Severe eating disorders are associated with signi cant physiological dysfunction and ensuing physical problems. We aimed to investigate the frequency and nature of these in a UK specialist eating disorder unit.
Methods
A cross-sectional study of 55 consecutive patients admitted to the Cotswold House, Oxford, was undertaken. ICD-10-coded psychiatric co-morbidities were systematically identi ed and triangulated using patients’ electronic health records and GP records.
Results
Signi cant and common co-morbidities included:
■ Amenorrhoea (93%)
■ Osteoporosis and osteopenia (67.2%)
■ Electrolyte abnormalities
■ Hypokalaemia (20%)
■ Hypomagnesaemia (3.6%)
■ Hyponatraemia (1.8%)
■ Vitamin de ciencies
■ Vitamin D de ciency (18.2%)
■ Pellagra (3.6%)
■ Wet beri beri (3.6%)
■ Organ failure
- Renal failure (3.6%)
- Multi-organ failure (1.8%)
■ Immune disorders (20%)
■ Malignancy (3.6%)
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Conclusions
Healthcare professionals need to be alert to recognise and treat severe and potentially dangerous physical consequences of eating disorders. Consideration has to be given about how best to provide diagnostic
and treatment of physical illnesses in severe eating disorder patients between different specialist services.
SHORT PAPERS TWO: PSYCHOLOGY ONE
11.30am, Elvin Hall
CHAIR > Prof JANET TREASURE
‘THE SEARCH FOR IDENTITY’: THE NARRATIVE ANALYSIS APPROACH TO EXPLORING THE SELF-CONCEPT OF INDIVIDUALS WITH BULIMIA NERVOSA
> Anna M Turek and Dora Brown, University of Surrey, Guildford, Surrey, UK
Background
Individuals with bulimia nervosa often keep their illness a secret in fear of being perceived as repulsive and being rejected. There is little known about how these individuals, once their bulimia is revealed, integrate their sense of identity within their social contexts. Understanding this might help to improve ways of supporting recovery from bulimia nervosa.
Methods
Life-story interviews were conducted with six participants. Data was analysed using narrative analysis (Murray, 2008). The ethical approval was granted by the University of Surrey Ethics Committee.
Results
Participants thought of their bulimia as their ‘imperfect self’ which counterbalanced social tensions present in their environment, demands for perfection and a sense of responsibility. The common patterns in narratives were: the family context – a formative ground, developing a mask, and rede ning the self. After recovery, few participants thought of ‘being a different person’, whereas others talked about ‘returning back to the person they were before bulimia’ or seeing ‘bulimia as part of their identity’.
Conclusions
Understanding bulimia as an integral part of identity sheds some light on the challenging and resistant aspects of bulimia.
11.50am, Elvin Hall
UNDERSTANDING THE THERAPEUTIC RELATIONSHIP BETWEEN PEOPLE WITH ANOREXIA NERVOSA AND THEIR THERAPISTS > Alison Seymour, Tina Gambling and Gail Boniface, Cardiff University, Cardiff, UK
Background
Users of eating disorder services suggest that the therapeutic relationship is essential in the quality
of any treatment received. However, for people
with anorexia nervosa (AN) the development of this relationship can be challenging due to interpersonal dif culties that may be experienced. This project aimed to develop an in-depth understanding of
this aspect of treatment from the perspective of service users.
Methods
Purposive sampling was used to recruit adults
with AN through the eating disorder charity Beat. Written accounts of participants’ experiences have been gathered through a con dential website. Data collection and analysis has been carried out over two phases using grounded theory methods.
Results
Four themes describing key aspects of a positive therapeutic relationship have been developed: paradoxical control, trust, feeling understood and being seen as an individual.
Discussion
The ndings suggest that the aspects of the relationship that participants view as helpful are akin to person-centred therapy approaches. Using an online focus group discussion, the nal phase of this project will explore with participants how this approach to treatment could be applied in practice.
12.10pm, Elvin Hall
A WISH TO BE THINNER INCREASES THE ODDS FOR DISTURBED EATING 20 YEARS LATER
> Dr Jose n Westerberg Jacobson1, Marie Bjuhr2, Mikaela Willmer2 and Magnus Lindberg2, 1Department of Health and Occupational Studies, Gävle, Sweden, 2Department of Health and Caring Sciences, Gävle, Sweden
Background
Studies from various cultures show that a large number of adolescent girls have a wish to be thinner, and thus more often go on diets. The purpose of
this longitudinal study was to examine if a wish to
be thinner among Swedish girls contributes to the development of disturbed eating (DE), and to describe motives for wishing to be thinner.
Methods
Following ethical approval (reg no: 258/94; 2014/401) the Demographic and Dieting Questionnaire and the Eating Disorder Examination Questionnaire were used in a general population cohort of 7 to 11-year old girls (n=462), 20 years later in October 2015.
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Threshold for DE was 1 SD above general population mean. Chi-square tests providing OR were used.
Results
A wish to be thinner during adolescence increases the likelihood 3 - 5 times to develop DE during the following 20-year period. Self-described motives for the wish to be thinner were to “correspond to the societal ideal” and to “deal with dif culties”.
Conclusions
For prevention, it is of importance to detect girls who wish to be thinner as early as possible. By considering the girls’ motives, preventive efforts might be perceived as more meaningful and relevant to the girls at risk of developing eating disorders.
12.30pm, Elvin Hall
TO FAST OR NOT TO FAST: EXAMINING
THE IMPACT OF THE 5:2 DIET ON A SERIES
OF EXECUTIVE FUNCTION TASKS IN
HEALTHY ADULTS
> Kate Mahony, Jasmin Langdon-Daly, Lucy Serpell and Sam Gilbert, University College London, London, UK
Background
Evidence suggests speci c cognitive de cits are linked with eating disorders (ED), but whether these are pre-morbid vulnerabilities or whether malnutrition contributes is unclear. Examining the impact of intermittent fasting (IF) on cognition in healthy adults helps clarify the evidence for executive function de cits in ED as state or trait.
Method
This within-subjects prospective study examined the in uence of IF on executive functioning, using the 5:2 diet. Healthy adults’ performances on online tasks were compared on fasting versus non-fasting days, examining their prospective memory, impulsivity, set- shifting and psychomotor abilities (n = 74).
Results
Results from mixed between-within linear models showed no signi cant differences on fasting over non- fasting days on any task (p > 0.05), suggesting that restricting calorie intake did not in uence executive function abilities.
Conclusion
This study does not support the view that intermittent fasting leads to cognitive de cits on fasting days. Results differ from previous studies which have found cognitive de cits in healthy adults when fully fasted, suggesting that even minimal calorie intake may have a positive impact on performance in the short term.
12.50pm, Elvin Hall
NOVEL METHODS TO HELP DEVELOP HEALTHIER EATING HABITS: A SYSTEMATIC REVIEW AND META-ANALYSIS
> Robert Turton, Kiki Bruidegom, Valentina Cardi, Colette Hirsch and Prof Janet Treasure, King’s College London, London, UK
Background
Excessive habit formation has been proposed as
a maintenance mechanism across the spectrum of eating and weight disorders. This review covers novel interventions developed and tested in healthy controls that may be able to change compulsive/ impulsive eating behaviours in eating and weight disorders.
Methods
Databases were searched for interventions targeting habits related to eating behaviours (ie, implementation intentions, food-speci c inhibition training and attention bias modi cation). These were assessed
in accordance with the preferred reporting items for systematic reviews and meta-analyses guidelines.
Results
In healthy controls the implementation intention approach produces a small increase in healthy food intake and reduction in unhealthy food intake post- intervention. The size of these effects decreases over time and no change in weight was found. More promisingly, unhealthy food intake was moderately reduced by food-speci c inhibition training and attention bias modi cation post-intervention.
Conclusions
This work has implications for the development of novel treatment enhancers for eating and weight disorders.
SHORT PAPERS THREE: PSYCHOLOGY TWO
11.30am, Drama Studio
CHAIR > Dr VALENTINA CARDI
BINGE EATING AS MALADAPTIVE COPING STRATEGY AMONG STUDENTS IN THE UAE
> Dr Sabrina Tahboub-Schulte, American University of Sharjah, Sharjah, United Arab Emirates
Background
While the DSM-5 recognition of binge eating disorder is an important step towards better diagnostic procedures and treatment development, research
in this area remains narrow. This is especially true for Arab countries where overweight and obesity are primary health issues but studies on psychological factors of overeating are rare.
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Methods
Binge eating was assessed together with stress levels, body-related shame and guilt, obsessive-compulsive behaviours, depression and emotional eating in 254 UAE students. The study comprised three assessment points over four months in 2015. Standardised self- report questionnaires were electronically administered to participants. Ethical approval was obtained by the American University of Sharjah (IRB290).
Results
Moderate to high levels of binge eating were found in 17 to 26% of the sample across assessment
points. Severe binge eating was indicated by 7 to 14%. As hypothesised, stress levels were positively and signi cantly correlated with binge eating. The same applied to binge eating and all other above- mentioned key variables. Linear regression analyses showed obsessive-compulsive behaviour as the most powerful and statistically signi cant predictor of binge eating after adjustment for binge eating at baseline (R2=55.6%, F=27.67, p=.000).
Discussion
Findings emphasise binge eating as a concern among adolescents in the UAE. One-third con rmed moderate to severe levels of binge eating, which
was associated with high stress levels. Furthermore, obsessive-compulsive behaviour was identi ed as a key predictor of binge eating. Although analyses are not nalised yet, the emerging patterns suggest that binge eating operates as a common maladaptive coping strategy, which mirrors ndings internationally.
11.50am, Drama Studio
EXPLORING THE AETIOLOGY OF EARLY-ONSET EATING DISORDERS WITH A FOCUS ON HEALTH EDUCATION, PUBERTY AND GENDER
> Cathaline Tangau1 and Dasha Nicholls2, 1University College London, London, UK, 2Great Ormond Street Hospital, London, UK
Background
Research on the causes of eating disorders (ED) have focused on adult females with few looking at early- onset cases. This paper explores possible triggers in early-onset cases with an emphasis on the relationship between health education (HE) and ED.
Method
A retrospective casenote review of a substantial amount patients from Great Ormond Street Hospital was performed. Triggers in the development of ED were identi ed from casenotes and online records grouped into six clusters: social, loss, change, pudicity, nutrition and infection. A chi-square test was executed between these triggers and pubertal status (PS) and gender respectively.
Results
There was no relationship between HE and PS, X2 (1, N=47) =2.013, p>0.05 or gender, X2 (1, N=47) =1.069, p>0.05. However, a signi cant correlation was found between PS and distress at early-onset of puberty, X2 (1, N=46) = 6.151, p<0.05.
Discussion
Despite nding no relationship between HE and PS, a substantial amount of patients from our sample cited HE as a trigger. We postulate that con icting messages in HE could cause vulnerable pre-pubertal children and post-pubertal children with sociotropic thinking styles to engage in unhealthy weight control behaviours.
12.10pm, Drama Studio
UNRAVELING THE ASSOCIATION BETWEEN THIN IDEAL INTERNALISATION AND EATING PATHOLOGY: DOES INSECURE ATTACHMENT INCREASE VULNERABILITY IN ADOLESCENTS? > Prof Lien Goossens1, Kim Van Durme1 and Guy Bosmans2, 1Ghent University, Ghent, Belgium, 2University of Leuven, Leuven, Belgium
Background
The present study aims to investigate whether insecure attachment dimensions moderate the association between thin ideal internalisation and eating pathology in adolescent girls.
Methods
Self-report scales on attachment anxiety and attachment avoidance towards both mother and father, thin ideal internalisation, body dissatisfaction and bulimic symptoms were administered to a community-based sample of 161 girls (11-18 years).
Results
After controlling for age and weight status, signi cant interactions were found between attachment anxiety towards mother and thin ideal internalisation, and between attachment avoidance towards father
and thin ideal internalisation for explaining body dissatisfaction. Also, a signi cant interaction between attachment avoidance towards mother and thin
ideal internalisation was found for explaining bulimic symptoms.
Conclusions
Both attachment anxiety (towards mother) as well as attachment avoidance (towards both parents) play a moderating role in explaining the relationship between thin ideal internalisation and eating pathology in female adolescents. Longitudinal studies are needed to further unravel the role of insecure attachment as a vulnerability for eating pathology in youth.
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12.30pm, Drama Studio
THE ROLE OF ATTACHMENT AND SECONDARY EMOTION REGULATION STRATEGIES IN THE DEVELOPMENT OF BULIMIC SYMPTOMS IN ADOLESCENTS
> Prof Caroline Braet1, Kim Van Durme1, Prof Lien Goossens1 and Guy Bosmans2, 1Ghent University, Ghent, Belgium, 2University of Leuven, Leuven, Belgium
Background
Following the theoretical propositions of the Interpersonal Vulnerability Model (IPV-model) and the Emotion Regulation Model (ER-model) of attachment, the current study wants to investigate whether two attachment dimensions might play a differential contributing role in the development of bulimic symptoms through assumed differences in adopting speci c maladaptive emotion regulation strategies in a sample of adolescents.
Methods
Developmentally appropriate self-report questionnaires were administered to a community sample of 397 adolescents (mean age: 14.02) at two points with a one-year time lag.
Results
Results provided longitudinal evidence for both the IPV-model and ER-model of attachment in con rming the differential contributing role of the attachment dimensions on the development of bulimic symptoms in a sample of adolescents. More speci cally, attachment anxiety seemed to be related to bulimic symptoms through rumination, while attachment avoidance through emotional control.
Discussion
These results may have clinical implications for both the prevention and intervention of bulimic symptoms in adolescents.
12.50pm, Drama Studio
INCREASED TOP-DOWN CONTROL IN WOMEN WITH ANOREXIA NERVOSA WHEN VIEWING EMOTIONAL INFANT FACES
> Jenni Leppanen, Valentina Cardi, Owen O’Daly, Andy Simmons and Kate Tchanturia, Prof Janet Treasure, King’s College London, London, UK
Background
Emotional infant faces are salient and arousing stimuli for adults. People with anorexia nervosa (AN) have dif culties regulating and accepting their emotions. The current study aimed to investigate neural mechanisms that underlie maladaptive emotion regulation strategies in AN.
Method
Twenty women with AN and twenty six comparison women took part in the study. Subjects were presented with positively valenced, negatively valenced, and neutral infant faces during an fMRI scan.
Results
The whole brain ndings revealed signi cantly increased medial prefrontal and superior temporal activation in the AN women relative to HC women when viewing emotional infant faces. The region
of interest ndings revealed a similar pattern of increased recruitment of the medial prefrontal cortex in AN women relative to HC women when viewing positively valenced infant faces. Additionally, increased recruitment of the insula was observed in the AN women relative to HC women when viewing negatively valenced infant faces.
Discussion
The present ndings suggest that women with
AN employ more maladaptive emotion regulation strategies based on suppression and rumination when presented with highly arousing emotional infant faces.
SHORT PAPERS FOUR: PSYCHOSOCIAL ONE
11.30am, Nunn Hall
CHAIR > Dr NATHALIE GODART
THE IMPACT OF EATING DISORDERS ON CARER- PATIENT RELATIONSHIP: ACCOMMODATION AND ENABLING
> Dr Maria Cristina Stefanini1, Michela Caselli1,
Dr Maria Rita Troiani2, Paolo Dirindelli3 and
Saverio Caini1, 1University of Florence, Florence, Italy, 2Child and Adolescence Psychiatry Meyer Hospital, Florence, Italy, 3Child and Adolescence Psychiatry Unit, Empoli, Italy
Background
We know the impact of eating disorders (ED) on the quality of life and family relationships. The aim of this study is to analyse if there are signi cant differences
in accommodation and enabling behaviours between primary and secondary carers, and/or carers who spend more or less than 21 hour per week with the patient.
Method
The sample consists of 97 carers (94.8% parents, 5.2% partners) of patients with diagnosis of ED (AN: 86,1%, BN: 13,9%), who received the questionnaire AESED (Accommodation and Enabling Scale for Eating Disorders).
Results
Primary carer 84%, secondary carer 19.6%; spend > 21 h/w with the patient 64.5%, spend < 21h/w 35.5%. There are signi cant differences between primary and secondary carers in the AESED Overall score (p
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0.02), avoidance and modifying routine (p 0,05) and reassurance seeking ( p 0,05), no signi cant differences between carers who spend more or less than 21 h/w with the loved one with ED.
Conclusions
We believe that interventions focalised on ED maintenance factors have to show particular attention to primary carers to support them and to improve skills to care for their loved one with an ED.
11.50am, Nunn Hall
AN EXAMINATION OF FACTORS ASSOCIATED WITH EXPRESSED EMOTION IN CARERS OF PEOPLE WITH EATING DISORDERS
> Dr Yolanda Quiles1, Brígida Pérez2, Marta Escolano2 and María José Quiles1
1University Miguel Hernández, Elche, Spain, 2Centro de Recuperación Emocional (CREA), Elche, Spain
Background
In the last decade, there has been an increase
in the scienti c literature on expressed emotion, psychological distress, accommodation and negative experience of care in relatives caring for patients with an eating disorder (ED). The purpose of this study was to assess the relationships between expressed emotion, psychological distress, burden and accommodation in caregivers of people with ED.
Methods
A cross-sectional study of 90 relatives, was conducted to examine these relationships. The average sample age was 47.8 years (SD =8.1). Out of the total participants, 38.9% were male and 61.1% female. They completed the Family Questionnaire (FQ),
The Scale Hospital Anxiety and Depression (HADS), The Experience of Caregiving Inventory (ECI) and the Accommodation and Enabling Scale for Eating Disorders (AESED).
Results
Carers showed high emotional over-involvement and criticism. Signi cant and positive correlations were found between criticism and emotional over- involvement with the subscales from the ECI, depression, anxiety, and with accommodation subscales.
Conclusions
Interventions aimed at reducing expressed emotion may need to focus on decreasing carers’ anxiety, depression and teaching skills.
12.10pm, Nunn Hall
CAN MEAL SUPPORT TRAINING IN COMMUNITY ADOLESCENT SERVICES IMPROVE RECOVERY TIME AND PREVENT ADMISSION TO HOSPITAL? > Dr Xanthe Barkla1 and Dr Sabia Chaudhry2 1Northumberland Children and Young People’s Service (CYPS), Northumberland, UK, 2Eating Disorder Intensive Community Treatment Team (EDICT), Northumberland, UK
Background
Meal support is the mainstay of treatment for anorexia nervosa. The Eating Disorder Intensive Community Treatment (EDICT) team provided meal support training (MST) to parents and carers in the home. It is resource intensive. The aim of the study was to assess whether meal support training affected recovery and prevented admission to inpatient services.
Methods
A retrospective case analysis was carried out, reviewing 34 cases. This looked at pre and post-treatment physical parameters, demographic factors (age, family composition, siblings) and outcomes. Three groups were identi ed: short-term MST (<4weeks), long-term (>4 weeks) or no MST.
Results
The study showed that the short-term group gained the most weight. Admission to hospital was the same across all groups.
Conclusions
MST is resource intensive. Those who responded to MST did not require lengthy support as were able to implement the strategies quickly. The team no longer adopt this approach. Those who are going to respond to meal support do so quickly (in rst four weeks). Those who did not receive meal support or required >4 weeks support did not do signi cantly worse, and were not admitted to hospital more often.
12.30pm, Nunn Hall
THE IMPORTANCE OF THERAPISTS’ PHYSICAL APPEARANCE IN THE ESTABLISHMENT OF A THERAPEUTIC RELATIONSHIP WITH CLIENTS WITH EATING DISORDERS
> Dr Liz Lawson, The Tuke Centre, York, UK
Given that clients’ preference for certain therapist physical characteristics has been shown to impact on their engagement (Arnkoff et al, 2002), the effect of therapists’ physical appearance on individuals with eating disorders who have an attentional bias towards gure-related stimuli seems particularly important. This study attempts to gain an understanding of
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clients’ preferences for certain therapist characteristics considering both how and why they impact on therapy. Interpretative phenomenological analysis was used to analyse the transcripts of semi-structured interviews with a sample of six clients of both genders with a range of eating disorders. Five themes were identi ed including credibility, participants’ experiences, identi cation, impact on therapy and overcoming
the impact of therapists’ physical appearance. Exploration of these themes highlights the importance of therapists’ gender, age, body shape, attire and attractiveness to this population group and their impact on engagement, motivation, disclosure and adherence to therapy. The importance of physical characteristics highlight the extent to which role modelling, credibility and trust are critical within therapy with clients with eating disorders.
12.50pm, Nunn Hall
A MODEL FOR EARLY DETECTION AND PREVENTION OF DEVELOPMENT OF EATING AND FEEDING DISORDERS IN CHILDHOOD
> Mirta David1 and Dr Tova Yedidia2
1Safra Children’s Hospital Israel, 2School of Social Work, Bar Ilan University Ramat Gan, Israel
This lecture will present a model for the early detection, prevention and treatment of eating disorders in the entire population. The model was built in collaboration with The Eating and Feeding Disorder Clinic in Childhood in the Safra Children’s Sheba Hospital and Bar-Ilan University Social Work Department.
“For most infants, feeding appears to be a natural process. However, approximately 25% of otherwise normally developing infants and up to 80% of
those with developmental handicaps have been reported to have feeding problems. In addition, 1% to 2% of infants have been found to have serious feeding dif culties associated with poor weight gain. Feeding disorder not only disrupts the infant’s early development but has been linked to later de cits in cognitive development, behavioural problems, as well as anxiety disorders and eating disorders during childhood, adolescence, and young adulthood. Consequently, it is extremely important to identify, understand, and treat early feeding problems (ages 0-5).” Chatoor, I (2009)
In recent years, Israel has opened a number of units for diagnosis and treatment of eating and feeding disorders in infants. But awareness of eating disorders in this age group is still low.
This lecture includes theoretical section and demonstration of several cases.
SHORT PAPERS FIVE: PSYCHOSOCIAL TWO
11.30am, Clarke Hall
CHAIR > Dr BEATE HERPERTZ-DAHLMANN
EATING DISORDERS IN SCHOOLS: THE ROLE OF PASTORAL CARE IN REDUCING INCIDENCE
> Dr Amy Harrison and Stephanie Watterson, Regent’s University London, UK
Eating disorders (ED) are associated with an adolescent onset and school is a key part of the system at this point in the lifespan. Previous studies indicate teachers are aware of ED in students, but like carers, they report a lack of understanding and skills. Psycho- educational and skills-based initiatives have been developed, alongside sample policies to improve practice around EDs in schools. This study aimed to measure ED symptoms using the Eating Disorders Examination Questionnaire (EDEQ) in ve UK secondary schools with differing levels of ED-related pastoral care. Four hundred and twenty ve students (N=221 female; 52%; mean age=17.14; SD =0.76) took part and the data suggest a signi cant and large-sized reduction (d=0.9) in ED symptoms (EDEQ global score) in schools with higher quality pastoral care compared to schools with lower pastoral care (F(4, 420) = 6.51
, p < .01), with signi cantly fewer likely cases of ED
in settings with higher pastoral care relative to lower pastoral care (F(4, 384) = 3.14, p = .02). These ndings imply that pastoral care may play a role in reducing incidence of ED.
11.50am, Clarke Hall
THE NEED FOR COMMUNITY RESOURCES AND SEAMLESS TREATMENT
> Amanda Beavan, Sarah Astbury, Prof Hubert Lacey and Rachel Matthews, Newbridge House, Birmingham, UK
The Health and Social Care Information Centre report a major increase in child and adolescent inpatient admissions and readmissions for eating disorders in England.
A service evaluation (N=110) was conducted at Newbridge House (NH) (a child and adolescent eating disorder inpatient unit) to examine the outcomes of 11-18 year olds discharged from NH between August 2012 - August 2015 with a mean length of stay of 6 months.
Results show signi cant improvements between admission and discharge as measured by BMI, Eating Disorder Examination Questionnaire (EDE-Q) and the Eating Disorders Symptom Impact Scale (EDSIS). This shows that inpatients of NH reach a healthy weight by discharge along with reduced eating disorder psychopathology and impact on the family system. However, one year follow-up outcomes of those discharged between August 2012 - August
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2014 show a signi cant weight loss in the community and non-signi cant deterioration on the EDE-Q and EDSIS. Only 72% received outpatient treatment in the community and two- fths required readmission.
These concerning results highlight the need to investigate why progress made from inpatient treatment is not maintained in the community and the importance of a continuity of care.
12.10pm, Clarke Hall
PREDICTORS OF INTOLERANCE OF UNCERTAINTY IN WOMEN WITH EATING DISORDER SYMPTOMS
> Martin Fisher1, Dr Amy Harrison1,2, Dr Lot Sternheim3 and Dr Rosamond Watling1, 1Regent’s University London, UK, 2Ellern Mede Centre for Eating Disorders, UK, 3Ultrech University, The Netherlands
Intolerance of uncertainty (IU), fear or worry of
the unknown, is an important part of the clinical presentation in eating disorders (ED). IU is observed in people with ED regardless of the presence of co- morbid anxiety disorders. Little is known about the predictors of IU and this study aimed to explore, in
a community sample of women with ED symptoms, whether attachment insecurity, openness to experience and extraversion predict IU. Extraversion and openness to experience were measured using the NEO-PR (Costa & McCrae 1992), attachment insecurity was assessed using the Experiences in Close Relationships Scale (Wei et al., 2007) and ED symptoms were measured using the Eating Disorder Examination Questionnaire (EDEQ; Fairburn & Beglin, 1994) in 563 women via an online weblink. From this, 349 women scored above the EDEQ community norm, indicating high ED symptomatology and
they reported signi cantly higher IU than those with minimal ED symptoms (n=214), mirroring clinical groups and highlighting IU as a prevention target. Within the ED symptom group, insecure attachment and low extraversion were signi cant predictors of
IU, explaining 60% of the variance. Addressing these factors in treatment may reduce IU.
12.30pm, Clarke Hall
BUT WHY DO WE CONTINUE TO FAT TALK?
AN EXPERIMENTAL INVESTIGATION OF WOMEN’S REACTIONS TO BODY DISPARAGING CONVERSATIONS
> Megan Baumgardner1, Cai Guo2, Lea Simms2,
Dr Suman Ambwani2, 1Bucknell University,
Lewisburg, PA, USA, 2Dickinson College, Carlisle, USA
Although research suggests that “fat talk,” a social ritual that involves degrading the body shape/ weight of oneself or others, is associated with
negative health outcomes, the speci c reasons for engagement in these conversations remain unclear. The current experimental study employs a vignette paradigm to examine individual and social factors underlying women’s responses to fat talk and (feminist theory-inspired) opposition to fat talk scenarios. Undergraduate women (current n = 84; target N
by February 2016 = 250) complete questionnaires assessing body dissatisfaction, tendencies to engage in fat talk, and personality characteristics. After a one-week delay, they are randomly assigned to read pilot-tested fat talk or challenging fat talk vignettes, and then assessed on subsequent engagement in fat talk, social perceptions, and emotional experiences. Results are expected to indicate a signi cant effect of experimental condition on participants’ subsequent engagement in fat talk, social perceptions, and emotional experiences and to identify predictors of fat talk. Findings are expected to reveal factors that maintain engagement in fat talk and clarify the impact of feminism-based education in eating disorder prevention efforts.
12.50pm, Clarke Hall
PERCEPTIONS OF EATING DISORDERS HELD BY THE PUBLIC: A QUALITATIVE INVESTIGATION OF THE ROLE OF EXPERIENCE
> Dr Amy Harrison and Sophie Bertrand, Regent’s University London, UK
Although campaigns to improve awareness of
mental illness may reduce negative perceptions, negative attitudes towards eating disorders (ED), poor understanding of the causes, severity and nature of the illness have been reported. This may reduce opportunities for help-seeking. Less is known about how experience of an ED might increase understanding. This qualitative study used thematic analysis to analyse individual, semi-structured interviews conducted with 10 women with experience of an ED attained through a close loved one’s illness and 10 women with minimal experience of ED. Four themes were endorsed by both groups:
1. the understanding of stakeholders (individuals, society, health professions),
2. the nature of the illness (role of food, addiction, severity, impact),
3. triggers (biological and social factors, self-esteem and the media), and
4. hope and the future (duration, sympathy and positive outcomes).
Contrary to previous work, strong negative views were not expressed and both groups expressed sympathy towards patients and group differences were present in the content of subordinate themes, highlighting different levels of knowledge. Educational campaigns are required, as learning through experience is not always possible.
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SHORT PAPERS SIX: CLINICAL FEATURES
11.30am, Room 728
CHAIR > Prof ULRIKE SCHMIDT
EVOLUTION OF DEPRESSION 13 YEARS
AFTER AN HOSPITALISATION FOR ANOREXIA NERVOSA: LINKS WITH CLINICAL STATE AND FAMILY HISTORY OF DEPRESSION
> Leslie Radon1, Christophe Lalanne2, Florence Curt1, Jeanne Duclos1 and Dr Nathalie Godart1, 1Institut Mutualiste Montsouris, Paris, France, 2AP-HP, Hôpital Saint-Louis, Recherche Clinique, Paris, France
Background
Depression is one of the most frequently associated co-morbidities with anorexia nervosa (AN) but only few studied its link to AN in a long-term follow-up (FU).
Aims
To evaluate the prevalence of depressive disorder in
a sample of individuals with teenage-onset AN. To determine the link between depression and nutritional status, AN and family history and depression.
Method
60 patients hospitalised for AN, and their families, was included and followed at 6, 12, 18, 54 and 156 months. The prevalence of AN and depression was evaluated with the MINI. Depression was assessed through the Beck Depression Inventory; AN symptomatology via the Eating Disorder Inventory. The nutritional status was recorded with the body mass index.
Results
We found that lifetime prevalence of depression signi cantly increased during FU, whereas the current one decreased. There was a signi cant link between depression and the eating symptoms. There was no link between depression and nutritional status, AN diagnosis and family co-morbidity.
Conclusion
We propose to integrate our results and data from the literature in an explaining model attempt of the relationship between depression and AN in order to identify therapeutic perspective.
11.50am, Room 728
THE IMPEDING ROLE OF SELF-CRITICAL PERFECTIONISM ON THERAPEUTIC ALLIANCE DURING TREATMENT AND EATING DISORDER SYMPTOMS AT FOLLOW-UP IN PATIENTS WITH AN EATING DISORDER
> Dr Liesbet Boone and Jolene van der Kaap-Deeder, Ghent University, Belgium
This is the rst study to examine the impeding role of self-critical perfectionism at onset of treatment on therapeutic alliance during treatment and eating disorder symptoms at follow-up in patients with an
eating disorder. Participants were 53 female patients with a mean age of 21.1 years treated for an eating disorder in a specialised inpatient treatment unit. Self-critical perfectionism was assessed at admission, therapeutic alliance was assessed during treatment (after three months of treatment), and eating disorder symptoms were assessed at admission and follow-
up (one year later). Self-critical perfectionism was predictive of a less bene cial treatment alliance with the therapist. Although self-critical perfectionism was not directly predictive of subsequent changes in eating disorder symptoms, it was indirectly related to less reductions in body dissatisfaction through the therapeutic alliance. These results point to
the importance of self-critical perfectionism in the therapeutic alliance and in changes in eating disorder symptoms. Treatment implications are discussed.
12.10pm, Room 728
PERFECTIONISM: A PREDICTOR FOR DIETARY THERAPY EFFICACY IN OVERWEIGHT AND OBESE WOMEN
> Carolina Roque1,2, Mariana Briote1, Ana Telma Pereira1 and António Macedo1,2, 1Department
of Psychological Medicine, Faculty of Medicine, University of Coimbra, Portugal, 2Department of Psychiatry, Coimbra University Hospital, Portugal
Background
Although disordered eating is common in overweight individuals, perfectionism, a proposed risk factor for eating disorders, might confer advantage when dietary interventions are required.
Objective
To prospectively explore the role of perfectionism on dietary ef cacy [% of weight loss (%WL)] in overweight/ obese females.
Methods
78 girls (age=21±3) were assessed at the rst nutrition consultation (T0) and 18 at 6 months (T6) regarding body mass index (BMI) and lled in the Eating Attitudes Test-25 (EAT), the Multidimensional Perfectionism Scale and the Almost Perfect Scale.
Results
BMI declined (29.7±4.2;26.6±4.6), EAT increased (11±11;19±10) and perfectionism scores remained stable over T0/T6 groups except for self-oriented perfectionism (SOP/83±17;94±14) and perfectionism discrepancy (PD/47±16;39±15) (all p<.05). T0 EAT correlated to T0 BMI, SOP, socially prescribed perfectionism (SPP), order and PD; T6 %WL to T6/T0 personal high standards (PHS) and to T0 order and PD (all p<0.05). T6 BMI (ß=.411) and PHS (ß=.667) predicted T6 %WL (all p<.05). Controlling for BMI, PHS incremented %WL variance from 3.8% to 46.6% [F(1,15)=13.8, p=.002].
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Conclusion
PHS predicted the %WL in overweight/obese women endorsing dietary therapy.
12.30pm, Room 728
SELF-DISGUST WITHIN EATING PSYCHOPATHOLOGY: ASSOCIATIONS WITH DISGUST SENSITIVITY, DEPRESSION, ANXIETY AND LEVELS OF SENSORY PROCESSING
> Katie Bell, Dr Helen Coulthard and Dr Diane Wildbur, De Montfort University, Leicester, UK
The factors that may contribute to the emergence
of self-disgust have not yet been established
(Power, Overton & Simpson, 2015) however there
is an increasing interest into the physiological and inherent contributors to the onset of disordered eating. It remains unclear whether sensory de cits
are associated with self-disgust within disordered eating, but it can be argued that understanding the motivation to change the subjective body experience within disordered eating is critical to understanding and altering the pathophysiology of this illness (Zucker et al., 2013).
12.50pm, Room 728
BODY IMAGE DURING PREGNANCY: DEVELOPING A VALID MEASURE OF BODY IMAGE FOR PREGNANT WOMEN
> Brittany Watson, Matthew Fuller-Tyszkiewicz, Helen Skouteris and Jaclyn Broadbent, Deakin University, Burwood, Australia
Background
Whilst considerable research has been dedicated
to examining body image (BI) in non-pregnant populations, further research needs to explore how BI is assessed during pregnancy and ensure measures of BI are appropriate for this population. This project developed a valid measure of BI disturbances for pregnant women.
Method
A mixed-methods approach was used to rst determine via qualitative study design salient BI experiences during pregnancy. A quantitative study design was then used to validate a new measure of BI for pregnant women, the Body Image in Pregnancy Scale (BIPS), based on the qualitative ndings.
Results
The qualitative study highlighted that women’s BI experiences during pregnancy were complex, and shaped by the women’s expectations for their body changes, salience of speci c body parts, and the
body functionality. The psychometric properties of
the BIPS were tested. All subscales of the BIPS had acceptable internal consistency, except the BI ideals subscale. Test-retest reliabilities were acceptable for all subscales.
Discussion
The BIPS as a measure is an improvement on measures of BI developed in non-pregnant populations but utilised in studies sampling pregnant women.
The present study aimed to identify whether measures of sensory processing could predict levels of self- disgust within a sample of 591 females with either
a diagnosis of anorexia nervosa (n=270), bulimia nervosa (n=104) or had no previous history of an eating disorder (n=217). Participants completed an online battery of questionnaires.
Tests of difference showed that both clinical groups (anorexia and bulimia) had higher levels of eating disorder symptomology, disgust sensitivity, anger, depression, anxiety, self-disgust, poor registration, sensory sensitivity and sensation avoiding than the non-clinical group. Both clinical groups had lower levels of sensation-seeking than the non-clinical group. Hierarchical regressions revealed that within the bulimia group, levels of self-disgust were most strongly associated with depression. In the clinical group with anorexia nervosa, self-disgust was associated with levels of depression, anxiety and lower sensation-seeking.
These ndings suggest that sensory processing may be implicated in levels of self-disgust in clinical groups with anorexia but not bulimia, however more research would be needed to replicate this nding. The role of sensory processing in the expression of self-disgust is a novel area of investigation, and how it may relate to the understanding and treatment of individuals with eating disorders warrants further investigation.
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POSTER ABSTRACTS
POSTER STROLLS > THURSDAY 17 MARCH 2016
POSTER STROLL GROUP ONE
Thursday 17 March 2016
1.30pm – 2pm, Crush Hall NU2
THEME > EXPLANATORY MODELS
LEAD STROLLER > Prof JANET TREASURE
POSTER NU1MBER
‘BLINDNESS TO THE OBVIOUS’: BRINGING CRITICAL FEMINIST APPROACHES TO EATING DISORDERS INTO TREATMENT
> Dr Su Holmes, University of East Anglia, Norwich, UK
Background
There is a long heritage of feminist writing on eating disorders (ED) which has been marginalised at the level of treatment. ED are now widely perceived to be biopsychosocial in nature, but the ‘social’ aspect of the equation is frequently relegated to a ‘contextual’/ subsidiary factor.
Methods
Drawing on the results of a pilot study (approved by the ethics committee at UEA) comprised of 15 semi- structured interviews, this research engaged women in debate about their treatment, and the role of ‘the social’ within this context. The women were asked
to talk about how they had understood (and were encouraged to understand) the aetiology of their ED within treatment contexts.
Results
All the women explained the aetiology of their eating problems in ways which spoke to questions of gender and the social/cultural construction of femininity. None of them had received treatment which dealt with these issues in any depth, and all felt that such perspectives would have been crucial in enabling them to understand the signi cance of their ED, as well as the process of recovery.
Discussion
Should questions of gender/identity (potentially signi cant for male sufferers too) be better integrated into treatment?
POSTER MBER
EDIC 2016
BELIEVE THE HYPE? AN EXPLORATION OF THE IMPACT OF INTERMITTENT FASTING (5:2) DIETS ON EATING PSYCHOPATHOLOGY AND BINGE EATING IN HEALTHY PARTICIPANTS
> Jasmin Langdon-Daly, Kate Mahony, Sam Gilbert and Lucy Serpell, University College London, London, UK
Intermittent fasting (IF) diets such as ‘5:2’ dieting have recently been popularised in the media as an easy and effective way to lose weight and improve health, leading to wide uptake globally. The eating disorder (ED) eld has been sceptical of calorie restriction
and fasting, citing research and clinical experience to suggest that restriction and fasting may lead to rises in eating psychopathology, preoccupation with food and bingeing.
While some studies have explored the effect of IF
on a range of health biomarkers, none have yet investigated the psychological and behavioural impact of eating in this way. This prospective study explored the impact of starting a 5:2 IF diet on symptoms of ED, binge eating, food craving and mood, and looked for interactions with risk factors for the development of disordered eating behaviours such as dieting history, low self-esteem, dichotomous thinking, and weight suppression and dissatisfaction. Using online media, healthy individuals about to start 5:2 IF were recruited globally. Participants completed food diaries and online self-report measures prior to starting IF (N=144), and again after four weeks of IF (N=81).
After four weeks of IF, participants reported reduced ED symptoms on the EDEQ, binge frequency, binge eating disorder symptoms on the BEDT (all p>.001 with medium effects sizes), food craving and mood symptoms on the DASS (p>.05).
Exploration of risk factors showed an interaction
with dieting history, such that only those who had dieted in the past showed signi cant reductions
on EDEQ score, binge frequency and food craving. Reductions in ED symptoms on some measures were positively correlated with weight dissatisfaction and dichotomous thinking, and negatively correlated with self-esteem. These ndings, which could suggest that IF can bring about reductions in disordered and binge eating in healthy people, should be interpreted with
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care due to the high drop-out rate and lack of other weight loss diet control.
POSTER
Methods
80 men and 409 women, all apparently healthy, answered the Bulemic Investigatory Test Edinburgh (BITE), which has a symptom (BITE A) and a severity (BITE B) score. Values for body mass index (BMI) of the subject and his/her parents were compared with BITE scores in single or multiple regression analysis.
Results
Subject BMI was strongly correlated with BITE A and B (r = 0.3-0.5; p<0.0001). Parental BMI and BITE were compared adjusting for subject BMI. No correlation with BITE B was observed (partial r = 0.017-0.020; p= 0.65-0.73). Maternal BMI did not correlate with BITE A (partial r = 0.01; p= 0.76). Paternal BMI was strongly correlated with BITE A among women (partial r= 0.16; p=0.0008) but not correlated among men (partial r=- 0.09; p=0.35).
Conclusion
Epigenetic paternal effects link BMI to bulimic symptoms in women.
POSTER NU5MBER
DAILY FOOD CRAVING AND ITS RELATIONSHIP WITH DIFFERENT STRESSOR TYPES
> Julia Reichenberger1, Michael Liedlgruber1, Martin Tiefengrabner2, Simon Ginzinger2, Frank Wilhelm1 and Jens Blechert1, 1University of Salzburg, Salzburg, Austria, 2University of Applied Science, Salzburg, Austria
Background
Acute stress in uences eating behaviour, however this in uence varies by stressor type. Whereas the stress-eating relationship is widely studied, the relationship of stress and food craving, de ned as
an intense desire to consume a speci c food, remains unclear. Moreover, laboratory studies fall short of capturing naturalistic eating patterns, making studies with ecological momentary assessment an important goal.
Method
The present study measured daily food cravings and intensity of different stressor types for seven days in a student sample. Data were obtained through signal- and interval-contingent sampling and analysed with hierarchical multilevel modelling.
Results
Results showed that higher daily craving was signi cantly predicted by higher intensities of work- related stressors during the day. However, neither social stressors nor daily hassles in uenced daily craving.
NU3
MBER
EMOTIONS BEFORE AND AFTER LOSS-OF- CONTROL EATING
> Brittany L Stevenson, Robert Dvorak and Matthew Kramerv, North Dakota State University, Fargo, North Dakota, USA
Background
Support for the post-binge component of the affect regulation model is mixed and there is limited research testing the affect regulation model with loss-of-control (LOC) eating. Our study examined momentary mood and emotional instability (EI) pre and post-LOC eating using randomly timed assessments.
Methods
Participants were 48 adults from the community and college students. Participants completed two weeks of Ecological Momentary Assessment (EMA) examining mood and LOC eating up to 9 times per day.
Results
Anger, sadness, guilt, and emotional instability are higher following one or more LOC episodes, stress decreases later in the day on non-LOC days but not on LOC days, positive mood is generally lower on multiple-LOC days than single-LOC days, and anxiety decreases following one LOC episode, but maintains on multiple-LOC days.
Conclusion
Most moods were not effectively regulated in this sample, with the exceptions of anxiety for single-LOC episode days only and possibly positive mood on multiple-LOC days.
POSTER
NU4
MBER
EPIGENETIC FACTORS AND
BULIMIC SYMPTOMS
> Prof Peter Arner and Ingrid Dahlman, Karolinska Institutet, Stockholm, Sweden
Background
Bulemia is strongly linked to development of obesity. Our study investigated whether this involves epigenetic factors.
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Discussion
Results further support previous research on the
relationship between stress and eating behaviour, NU7
whereas unlike earlier studies, social stressors did not affect food craving. Future research should consider the distinct role of different stressors on food craving and food consumption as well as their interplay.
POSTER STROLL GROUP TWO
Thursday 17 March 2016
1.30pm – 2pm, Crush Hall
THEME > PSYCHOPATHOLOGY
LEAD STROLLER > STEPHEN WONDERLICH PhD
POSTER NU6MBER
NOT MEETING THE CRITERIA: A QUALITATIVE INVESTIGATION INTO A PATIENT’S INTERPRETATION AND EXPERIENCE OF
AN EDNOS DIAGNOSIS
> Cecilia MacDougald, London South Bank University, London, UK
Background
POSTER MBER
EDNOS (eating disorder not otherwise speci ed) is a residual category of eating disorders (ED) that don’t meet criteria for typical diagnosis. It is a diagnosis of ‘exclusion’ that provides little information for patients and is frequently omitted from research, making it poorly understood. The impacts of NOS diagnoses are rarely documented. This qualitative study explored interpretations of ‘not meeting the criteria’ and the experiential impact of EDNOS diagnosis/treatment.
Method
Following ethical approval from LSBU, seven one-to- one interviews with women aged 18-25 with EDNOS were conducted. Thematic analysis generated two themes: ‘the agentic power of a diagnostic label
and the powerlessness of EDNOS’ and ‘weight’s paradoxical signi cance as an indicator of illness and recovery’.
Results
Perceived powerlessness and inauthenticity of ‘EDNOS’ compounded feelings of failure/shame, implicating it in the exacerbation of participant’s ED and low self-esteem.
Discussion
The connotations/impacts of EDNOS’s ‘mildness’ are discussed. Recommendations are made to change how EDNOS is communicated to a patient, include it in future ED research, and increase public awareness about its seriousness and prevalence.
THE INDIVIDUAL EXPERIENCE OF SEEKING HELP FOR BULIMIA NERVOSA: A QUALITATIVE RESEARCH REPORT
> Anna M Turek and Dora Brown, University of Surrey, Guildford, UK
Background
To seek help is the rst step on the way to recovery. Many individuals with bulimia nervosa do not seek help or they drop out from treatments. Developing a greater understanding of the experience of seeking help might allow for more meaningful and successful ways of helping these individuals.
Method
Eight semi-structured interviews were conducted. Interpretative Phenomenological Analysis (IPA) was used to analyse data. Ethical approval was granted by the University of Surrey Ethics Committee.
Results
Three superordinate themes were identi ed: ‘wrestling with control’, ‘the readiness to let go of bulimia’
and ‘changes within self’. Seeking help was a long, ongoing process of individuals accessing different types of help and moving between denial and awareness of their bulimia. These individuals, utilised help from a variety of sources and valued feeling listened to and that help was used exibly in response to their changing needs. The negative experiences had adverse effects.
Conclusions
Seeking help was a process which oscillated between awareness and denial of bulimia. It led to gradual, internal transformation and recovery. It is important for professionals to stay aware and sensitive to this internal dynamic.
POSTER
EDIC 2016
NU8
MBER
SOCIAL COGNITION AND INTERPERSONAL BEHAVIOUR IN ANOREXIA NERVOSA: AN EXPERIMENTAL INVESTIGATION.
> Dr Suman Ambwani1, Lea Simms1, Kathy R Berenson2, Amanda Wai Yin Li3, Freya Cor eld3 and Prof Janet Treasure3, 1Dickinson College, Carlisle, USA, 2Gettysburg College, Gettysburg, USA, 3King’s College London, London, UK
67


The current study investigated social functioning by comparing interpersonal self-ef cacy, perceptions of dominance/submission (agency) and coldness/warmth (communion), and hypothetical behavioural reactions among individuals with and without anorexia nervosa (AN). Seventy-seven women (clinical n = 41, nonclinical controls n = 36) completed questionnaires assessing mood symptoms and interpersonal self-ef cacy, followed by an experimental video-rating task in which they received critical feedback from job supervisors varying in agency and communion.
Results
The research is work in progress. Three interviews have been carried out so far. The ndings will be written up as part of a doctoral thesis.
Conclusions
The ndings will provide more insight into what makes therapy effective and enable practitioners to evaluate the current treatment guidelines for bulimia nervosa.
AN respondents perceived more coldness even after controlling for differences in depression and anxiety and tended to respond with coldness even to videos that they perceived as being warm. Interpersonal self-ef cacy moderated the relationship between diagnostic status and behavioural responses: among those who felt competent being cold-submissive, AN respondents selected cold-submissive responses more frequently than the controls.
Among those with AN symptoms, there may be
a tendency toward social perceptual inaccuracies regarding communion and non-complementary cold behavioural responses; targeted efforts to improve social perception may thus facilitate interpersonal functioning in AN.
POSTER NU9MBER
AN EXPLORATION OF WOMEN’S EXPERIENCES OF CBT FOR BULIMIA NERVOSA
> Kati Hallikainen and Dr Angela Loulopoulou, London Metropolitan University, London, UK
Background
Cognitive behaviour therapy (CBT) is considered to have the most robust evidence-base for the treatment of bulimia nervosa, yet little is known about the factors that may contribute to treatment outcomes. The study aims to gain a deeper understanding of the process of engaging in CBT for bulimia nervosa.
Methods
Data will be gathered through semi-structured interviews and analysed by following the principles of Interpretative Phenomenological Analysis (IPA).
Six women aged 18 to 35, who have received one- to-one CBT for bulimia will be recruited. They should have been diagnosed with bulimia nervosa (BN) or EDNOS (bulimia subtype) in the past and completed therapy at least one month prior to the interview. The study has received ethical approval from the London Metropolitan University Research Ethics Review Panel and an NHS Ethics Committee.
POSTER NUMBER
10
WOMEN WITH DISTURBED EATING BEHAVIOUR RATE LESS WORK ENGAGEMENT
> Dr Magnus Lindberg, Dr Jose n Jacobson, Marie Bjuhr and Dr Mikaela Willmer, Department of Health and Caring Sciences, Gävle, Sweden
There is a lack of research exploring emotional commitment to work in relation to eating attitudes. Since eating disorders are associated with adverse psychological and social consequences, work engagement could be affected.
The purpose was to compare work engagement among women with and without disturbed eating (DE). A cross-sectional survey using the Utrecht
Work Engagement Scale and the Eating Disorder Examination Questionnaire in a general population cohort of 26 to 36-year-old women (n=847). Threshold for DE was 1 SD above general population mean. Independent t-test was used to compare work engagement. Ethical approval (reg no:2014/401).
The level of work engagement was lower (p=0.02) among women with DE (mean 3.69+-1.43) than women without DE (mean 4.06+-1.18). The score
for dedication was also lower (p=0.02) within the DE Group (mean 3.74+-1.57 vs 4.22+-1.26). However, vigour and absorption were not different. The work engagement in the cohort was within the average range although women with DE had signi cantly lower emotional commitment to work.
As work engagement is linked to business success, workplace growth and sustainability, it seems important to explore tailored strategies to improve work engagement among women with DE.
POSTER STROLL GROUP THREE
Thursday 17 March 2016
1.30pm – 2pm, Crush Hall
THEME > PSYCHOPATHOLOGY
LEAD STROLLER > Dr PAUL ROBINSON
EDIC 2016
68


POSTER NUMBER
Background
The purpose of this study was to compare the clinical and socio-demographic pro les of patients diagnosed of an eating disorder (ED), bulimia nervosa or anorexia nervosa. All of them were treated in a specialised inpatient unit.
Methods
This is a cross-sectional study in which 87 medical records of patients were analysed. All of them were women, whose average age was 22.8 (dt=5.1). They completed a socio-demographic scale, the scale hospital anxiety and depression (HADS) and the self- concept scale (AF-5).
Results
With respect to socio-demographic variables, the anorexic patients had a lower age (t= -2.92, p≤0.01), and fewer were in a couple (t2=10.83, p ≤ 0.05). With respect to the illness course, anorexic patients had less evolution years (t= -2.08, p ≤ 0.05) and they started younger (t= -2.12, p ≤ 0.05). If we attend to the type
of treatment, the pharmacologic approach was more frequent in the group of bulimic patients (t2=6.4, p ≤ 0.05) also the personality disorder (t2=5.87, p ≤ 0.05). Finally, the family self-concept was higher in anorexic patients (t=2.58, p ≤ 0.01).
Conclusions
Speci c units for ED should be included in the combined resources, which not only allow for treatment of the ED but also for their psychopathological co-morbidity.
11
ATTENTIONAL BIASES IN PATIENTS WITH EATING DISORDERS
> Dr Katarzyna Kucharska1 and Malgorzata Starzomska2, 1The Institute of Psychiatry and Neurology, Warsaw, Poland, 2Department of Psychology, Uniwersytet Kardynala Wyszynskiego, Warsaw, Poland
Recently, there has been an increasing interest
in the cognitive approach to eating disorders,
which postulates that patients selectively attend to information associated with eating, body shape, and body weight. Along with the Stroop test and the Posner paradigm, one of the most frequently used methods of attentional bias measurement is the dot probe task. The aim of the study was to compare attentional biases among patients with eating disorders and healthy controls and to investigate the relationship between attentional biases and eating disorder psychopathology.
Methods
The study comprised 30 female patients diagnosed with eating disorders (ICD-10 and DSM-V) and 30 female controls. All participants completed the Hunger Scale, the Eating Disorder Examination and the modi ed pictorial dot-probe task.
Results
In the study, statistically signi cant biases were found for negative and positive eating and body shape images, and they were greater than those found in healthy controls. The strength of attentional biases was associated with eating disorder psychopathology.
Discussion/Conclusion
The obtained results were interpreted in light of previous studies and practical treatment implications were formulated.
POSTER NUMBER
13
POSTER NUMBER
ASPECTS OF PARENTAL EXPERIENCES IN EATING DISORDERS: COMPARISON BETWEEN GREECE AND BRITAIN
> Maria Tsiaka, Prof Janet Treasure and Prof Ulrike Schmidt, Institute of Psychiatry, King’s College London, UK
Background
Eating disorders have a great impact on family members, experiencing high levels of psychological distress. Carers’ emotional reactions, accommodation and enabling behaviors contribute to the maintenance of the illness.
Aim
To examine any differences in caregiving experience between Greek and British parents of people with anorexia nervosa and bulimia nervosa.
12
COMPARISON OF ANOREXIC AND BULIMIC PATIENTS’ PROFILES ATTENDED IN AN INPATIENT UNIT
> Prof Maria-Jose Quiles1, Cristina Romero2, Maria- Jose Serralta3 and Dr Yolanda Quiles1, 1Miguel Hernández University, Elche, Spain, 2Unit Disorders Eating, San Juan Hospital, Alicante, Spain, 3Centro de Recuperación Emocional (CREA), Outpatient Unit, Elche, Spain
EDIC 2016
69


Method
Parents of people with eating disorders from Greece (n=89) and Britain (n=89) were assessed on psychological distress (Depression Anxiety Stress Scale), expressed emotions (Family Questionnaire) and accommodating and enabling behaviours (The Accommodation and Enabling Scale for Eating Disorder).
Results
Greek and British parents did not differ in terms of psychological distress. Criticism (CC) from the Family Questionnaire, total AESED score and the Avoidance , Modifying Routine, Reassurance Seeking and Control of Family subscales were higher in the Greek parents regardless the type of diagnosis.
Discussions/Conclusions
The ndings highlighted the need for developing and re ning psychological therapies to address
the experience of feeling fat for people with eating disorders. This will be discussed further and areas for research will be highlighted.
Conclusion
These differences in emotional reactions and accommodating behaviours between Greek and English parents may represent cultural factors that may need to be targeted in order to make family interventions more effective.
REMEDIATION OF SOCIAL COGNITIVE DEFICITS IN ANOREXIA NERVOSA AFTER
12 WEEKS OF SOCIAL COGNITIVE AND NEUROCOGNITIVE TRAINING
> Dr Katarzyna Kucharska1, Dorota Kulakowska1, Ewelina Wilkos1, Katarzyna Biernacka1, Malgorzata Starzomska2 and Filip Rybakowski1, 1The Institute of Psychiatry and Neurology, Warsaw, Poland, 2Uniwersytet Kardynala Stefana Wyszynskiego, Warsaw, Poland
Aim
To remediate the de cits in social cognitive functioning in inpatients diagnosed with anorexia nervosa who underwent a 12-week therapeutic programme of social cognitive and neurocognitive training (SCNT).
Method
30 adolescent female inpatients diagnosed with anorexia nervosa according to ICD-10 and DSM V criteria were evaluated at the time of admission and after completion of SCNT using various psychological measures (Penn CNP- computerised emotion recognition/face memory battery; ‘Reading the mind in the eyes’ test; Toronto Alexithymia Scale, TAS;
and Right Hemisphere Language Battery, RHLB) and clinical scales (EAT-26, Y-BOCS, and BDI). Additionally, 30 healthy females were recruited to the study as a comparison group.
Results
After therapy, patients presented with reduced clinical symptoms compared to the pre-treatment group. Patients showed statistically signi cant improvement in their perception of facial affect and emotional prosody. Furthermore, after therapy, signi cant improvement was documented in empathy, mentalising, and gurative language processing.
Conclusions
SCNT appeared a promising therapeutic intervention aimed at improvement of emotional regulation and social skills in AN.
POSTER NUMBER
14
THE EXPERIENCE OF FEELING FAT FOR WOMEN WITH ANOREXIA NERVOSA
> Dr David Viljoen1, Pieter Nel2 and Laura Major2 1Cotswold House, Oxford Eating Disorders Service, Oxford, UK, 2University of Hertfordshire, Hat eld, UK
Background
This qualitative study explored the lived experience of feeling fat for women diagnosed with anorexia nervosa.
Method
Seven UK women who received treatment for anorexia nervosa completed semi-structured interviews. Interview transcripts were qualitatively analysed using Interpretative Phenomenological Analysis (IPA).
Results
Four main themes emerged from the accounts. Feeling fat was associated with a negative sense of self (eg a negative hyperawareness of their bodies, a perceived sense of inadequacy and a fear of being judged). Participants used the term ‘feeling fat’
to describe a sense of feeling out of control. They described unhelpful (eg eating disorder behaviours) and helpful (eg distraction and nding self-worth outside of weight and shape) methods of coping with feeling fat. Finally, making sense of feeling fat was complex as participants found it dif cult to verbalise the experience and felt misunderstood by others.
EDIC 2016
POSTER NUMBER
15
70


POSTER ABSTRACTS
POSTER STROLLS > FRIDAY 18 MARCH 2016
POSTER STROLL GROUP FOUR
Thursday 17 March 2016
4pm – 4.30pm, Crush Hall
THEME > PHYSICAL ASPECTS AND SEED LEAD STROLLER > Dr ERIC JOHNSON-SABINE
POSTER NUMBER
NEUTROPAENIA IN ADULT ANOREXIA NERVOSA INPATIENTS
> Dr Christopher Hopkins, Alessandro Bruno,
Paul Jenkins and Agnes Ayton, Oxford Health NHS Foundation Trust, UK
Background
Literature regarding neutropaenia in anorexia nervosa (AN) is highly limited, with past studies being small or cross-sectional in design. As such, this study sought to further examine the prevalence and course of neutropaenia in AN inpatients.
Methods
All adult AN patients admitted to the Cotswold House Eating Disorders Unit between November 2013 and December 2014 were included in this study. Blood specimens were drawn throughout admission, neutrophil counts (N ) recorded, and neutrophilia prevalence and severity determined.
Results
37 patients (92% female; mean age: 25 years; mean BMI: 13.7kg/m2) were enrolled. 43.2% and 10.8% of patients suffered from mild (N : 1.0-2.0 x10^9/L) and moderate (N : 0.5-0.9 x10^9/L) neutropaenia, respectively, with no cases of severe neutropaenia (N : <0.5 x10^9/L). The median nadir N for all patients was 1.7 x10^9/L and occurred at a median of 10 days after admission. 76% of cases resolved by the time of discharge, with a median duration of neutropaenia of 30 days.
Discussion
Neutropaenia was highly prevalent and most severe during the refeeding period. Further study is warranted to examine the aetiology underlying neutropaenia in AN and its clinical signi cance in this population.
16
SEVERE AND ENDURING BULIMIA NERVOSA (SEED-BN): A QUALITATIVE STUDY
> Dr Paul Robinson1,2, Giulia Guidetti1, Jessica Jackson2 and Gerard Leavey3, 1Barnet, En eld and Haringey Mental Health Trust, London, UK, 2University College London, London, UK, 3University of Ulster, Coleraine, Northern Ireland, UK
Background
Qualitative studies of bulimia nervosa are few. In this study we aimed to describe the way longstanding BN affects diverse realms of life using qualitative methodology.
Methods
In-depth interviews were conducted to assess eight women with an 8 - 29 year history of BN. Open questions were used to explore the social (family, friendships, relationships), occupational, nancial, psychological and physical domains of participants’ lives. The interviews were studied using thematic analysis and common themes identi ed.
Results
POSTER NUMBER
17
A proportion of participants described serious physical sequelae. However, the social impact was signi cant
in all. Financial problems were common. Relationships were avoided, especially if they led to cohabitation. Family attitudes were problematic, with denial of the sufferers’ dif culties and unwillingness to discuss them. Participants were often socially isolated, even though they did engage in social activities, because of the secret behaviour they were unable to talk about.
Conclusions
Long-standing bulimia nervosa is associated with very signi cant dif culties in diverse, especially social, realms and reduced quality of life. These problems should be addressed during treatment.
EDIC 2016
71


POSTER NUMBER
Background
The lifetime prevalence of anorexia nervosa is around is 0.9-2.2%, and mortality is 5-7%. Patients with severe and enduring anorexia nervosa (SEED- AN) may develop health problems associated with micronutrients de ciencies.
Objective
We wished to ascertain if routine supplementation is justi ed, based on serum levels of micronutrients, symptoms reported and dietary diary evidence.
Method
Plasma levels of vitamins A, B9, B12, D, calcium, zinc, magnesium, phosphorus and ferritin alongside a 3-day diet diary and a symptom of de ciency questionnaire were assessed in six patients from a large eating disorders service. Daily intake was estimated with Diet Plan 7 software.
Results
Not all participants reached their dietary reference values of micronutrients intake (5/6). All subjects reported at least ve symptoms of micronutrients de ciencies. Plasma levels of micronutrients showed abnormal values in folates (5/6) and borderline values for calcium (3/6) and zinc (1/3).
Conclusion
Symptoms of micronutrient de ciency and low serum levels were found in this pilot study, which provides preliminary evidence justifying routine micronutrient supplementation in SEED-AN.
18
EHLERS-DANLOS SYNDROME: A POSSIBLE PHENOTYPE OF ANOREXIA NERVOSA?
> Dr Lauren Gavaghan1, Gemma Peachey1, Bruno Nazar2 and Prof Janet Treasure1, 1South London
and Maudsley NHS Trust, UK, 2Kings’ College London, London, UK
Background
Many psychiatric disorders, including eating disorders (ED) are associated with polygenic pro les. We describe a female with Ehlers-Danlos syndrome
(Type 3), co-morbid with anorexia nervosa (AN), emetophobia and paroxsysmal orthostatic tachycardia and consider links between the phenotype of hypermobility, anxiety and AN.
Methods
The patient developed a fear of vomiting in childhood. This precipitated development of safety behaviours
to avoid vomiting, along with rituals around food and contamination fears. She was diagnosed with Ehlers- Danlos syndrome (Type 3).
Results
She was admitted as an inpatient in 2014. A pan- systolic murmur was detected, as were shortness of breath and palpitations. ECG demonstrated normal sinus rhythm with borderline right atrium abnormality. A spontaneous episode of supraventricular tachycardia (SVT) occurred, failing to respond rapidly to treatment.
Discussions/Conclusions
Ehlers-Danlos syndrome (Type 3) is linked to TNXB genetic abnormalities. TNXB encodes an extracellular matrix glycoprotein with anti-adhesive effects and
is reported as a hypermethylation site in AN. We examine how common hypermobility and associated phenotypes (paroxysmal SVT) and a similar genotype are to AN.
POSTER NUMBER
20
POSTER NUMBER
WHAT IS INFLUENCING BODY COMPOSITION IN ACUTE ANOREXIA NERVOSA?
> Melissa Rizk1, Dr Nathalie Godart2, Laurence Kern3, Christophe Lalanne4, Jean-Claude Melchior5, Sylvie Berthoz1 and Claude Pichard6, 1INSERM U1178, Paris, France, 2Institut Mutualiste Montsouris, Paris, France, 3Laboratoire EA 2931, Nanterre, France, 4Laboratoire EA 7334, Paris, France, 5Hôpital Raymond Poincaré, Garches, France, 6Geneva University Hospital, Geneva, Switzerland
Background/Aims
To determine potential predictive factors of nutritional status (body mass, fat-free mass and fat mass indexes) in acute anorexia nervosa. We took into account factors that are speci cally linked to anorexia nervosa (age at illness onset, illness duration, anorexia nervosa subtype, and premenarchal status) and those found in the general population (birth weight, physical activity, age and presence of amenorrhea).
19
LEVELS OF MICRONUTRIENTS IN PATIENTS WITH SEVERE AND ENDURING ANOREXIA NERVOSA (SEED-AN)
> Maria Jose Vasquez Gonzalez1 and Dr Paul Robinson1,2, 1University College London, London, UK, 2Barnet, En eld and Haringey Mental Health Trust, UK
EDIC 2016
72


Methods
The study recruited 191 hospitalised women suffering from acute anorexia nervosa. Body mass index was calculated. Body composition (fat-free mass and fat mass) were measured using the Bioelectrical Analyser (FORANA, Helios, Frankfurt, Germany). Physical activity was evaluated in terms of duration, intensity and type. Other factors such as age, age at illness onset, illness duration, anorexia nervosa subtype, birth weight, premenarchal anorexia nervosa and presence of amenorrhea were assessed using self-reports and questionnaires. Multivariate analyses were conducted.
Results
When considering all models and predictors, the three components of nutritional status were explained by both factors that are linked to AN characteristics and factors described in the general population,
with number and type of factors varying for each component. Restricting type of anorexia nervosa was the only factor linked to a worse nutritional status in all three components. Mean intensity of all physical activities was associated with higher body mass and fat mass indexes independently of other factors considered. Conclusions: A worse nutritional status
in the acute phase of anorexia nervosa is one of the most pejorative predictive factor of outcome, further researches on this topic are strongly needed.
POSTER STROLL GROUP FIVE
Friday 18 March 2016
4pm – 4.30pm, Crush Hall
THEME > POPULATION STUDIES AND MALES LEAD STROLLER > Dr VALENTINA CARDI
Methods
The Bem Sex Role Inventory, Bulimic Investigatory Test, Edinburgh, Eating Disorder Examination Questionnaire, and Body Shape Questionnaire were used to assess sexuality, their eating behaviours and body shape satisfaction in an online study of 104 male volunteers. Sex object choice was not investigated.
Results
14 men were diagnosed as having ED. Femininity and androgyny were not risk factors for ED traits in men. However, masculinity was predictive of restrained eating (p<0.005). Masculinity and high BMI were positively correlated.
Conclusions
Femininity is not a risk factor for ED in men. However, masculinity was found to predict dietary restraint perhaps due to perfectionistic qualities in those with high masculinity. The role of intermediate gender role orientation as a possible protective factor requires investigation.
POSTER NUMBER
A QUALITATIVE STUDY OF MALES’ EXPERIENCE OF EATING DISORDERS AND THEIR TREATMENT > Dr Paul Frith1,2, Ryan Branson1,2 and Dr Paul Robinson1,2, 1University College London, UK, 2Barnet, En eld and Haringey Mental Health Trust, UK
Background
Eating disorders have the highest mortality of psychiatric disorders. The female to male ratio is 10:1, but studies suggest a higher proportion of males. Presently most research and so treatment recommendation comes from female studies so information speci c to the male experience is not recognised.
Methods
Semi-structured, interviews were audio-recorded and transcribed with eight male patients from St Ann’s Hospital, London. Thematic analysis was used to explore emerging themes
Results
Men feel pressure from peers and society to conform to a lean body ideal. Obstacles to diagnosis include stigma leading to shame and poor knowledge that males can have ED. Symptoms include restriction, binging, purging and exercise and it may be a coping strategy for pressures experienced in life. Other impacts include social isolation, strained relationships
21
DOES SEXUALITY AND GENDER ROLE AFFECT EATING DISORDERS IN MEN?
> Emily Homma1 and Dr Paul Robinson1,2, 1University College London, London, UK, 2Barnet, En eld and Haringey Mental Health Trust, London, UK
Background
Eating disorders (ED) predominantly affect women. Although females have proven more susceptible to ED, gender may not be the only factor. Gender role orientation may contribute to sex differences but there is little agreement on how this occurs.
Objective
The aim was to assess whether levels of masculinity or femininity were predictive of ED traits in men.
EDIC 2016
POSTER NUMBER
22
73


and time out of employment. Therapeutic relationship is highly valued. Male speci c treatment could be bene cial, particularly in group therapy.
Discussion
Males feel pressure regarding body image. Increased public awareness could help remove stigma of this diagnosis to improve recognition and early treatment. The alienation associated with being male in treatment for an ED should be considered.
POSTER NUMBER
23
PREVALENCE OF EATING DISORDERS IN LATIN AMERICA – A SYSTEMATIC REVIEW
> David R Kolar1, Moises Mebarak Chams2 and Dania L Mejía Rodriguez2, 1Department of Child and Adolescent Psychiatry and Psychotherapy of Johannes Gutenberg-University, Mainz, Germany, 2Psychology Institute of Universidad del Norte, Barranquilla, Colombia
Background
Eating disorders (ED) are nowadays considered as disorders not limited to Western culture. Recent international research on ED outside of the Western hemisphere was mainly focused on Asian and Arab countries. Therefore, this study assesses the existing literature on prevalence rates of ED in Latin America.
Methods
A systematic review of the English, Spanish and Portuguese literature on prevalence rates of anorexia nervosa (AN), bulimia nervosa (BN), and binge-eating disorder (BED) was conducted. Of initially 2,042 identi ed records, 1,366 records were screened, 182 articles reviewed in full, and 17 articles included in qualitative analysis. Meta-analyses were conducted disorder-wise for point prevalence of ED. Heterogeneity was analysed.
Results
Most of the relevant studies were conducted in Brazil or Colombia. Mean point-prevalence rates were 0.1% for AN (range 0 - 1.6%), 1.7% for BN (0.1 - 6.1%), and 3.3% for BED (0.7 - 6.6%). Heterogeneity was large (72.5 < I2 < 96.2).
Discussions
Point prevalence of BN and BED in Latin America seems similar or higher compared to Western countries, and lower regarding AN. However, results have to be reviewed carefully due to the heterogeneity of the studies included.
EDIC 2016
24
POSTER NUMBER
DISORDERED EATING AND BODY DISSATISFACTION AMONG UNIVERSITY STUDENTS IN LEBANON
> Rayane Chami1, Dr Alaa M Hijazi2 and Dr Nadia Micali3, 1University College London, London,
UK, 2American University of Beirut, Beirut, Lebanon, 3Institute of Child Health, London, UK
Trends of eating disorders in the Middle East are increasingly similar to those of the West and there is a need to extend research to non-Western countries. This cross-sectional study recruited 187 students from two universities in Lebanon and analysed the relationship between seven predictors (gender, femininity, masculinity, gender role conformity, westernisation, difference between current/ideal weight, and BMI) and disordered eating (DE) and body dissatisfaction (BD). Participants completed a demographic survey, the body image states scale (BISS), the eating attitudes test (EAT-26), the BEM sex role inventory (BSRI), and a national/psychosocial survey.
The results indicated that pro ciency in French
and difference between current/ideal weight were positively associated to BD (p = .011; p < .001), while only the latter was positively associated to DE (p = .001). BD was signi cantly higher among participants with overweight, as compared to underweight (p < .001) and healthy (p < .001) BMI. DE was signi cantly higher among participants with unhealthy BMI (p = .032). Conformity to male gender roles was negatively associated with BD (p = .016) and marginally associated to DE (p = .051). Implications and limitations will be discussed.
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POSTER ABSTRACTS
POSTER STROLLS > SATURDAY 19 MARCH 2016
POSTER STROLL GROUP SIX
Saturday 19 March 2016
10.30am – 11am, Crush Hall
THEME > TREATMENT
LEAD STROLLER > Prof BEATE HERPERTZ- DAHLMANN
POSTER NUMBER
26
POSTER NUMBER
REDUCING INTOLERANCE OF UNCERTAINTY
IN ADOLESCENTS WITH EATING DISORDERS
THROUGH GROUP TREATMENT
25
> Dr Amy Harrison1 and Dr Lot Sternheim2 12
AN EXPLORATION OF EXPERIENCES OF YOGA PRACTICE AND EATING DISORDERS FROM
THE PERSPECTIVE OF WOMEN WITH A HISTORY OF EATING DISORDERS
> Anna Lose, University of East London, London, UK
Background
Eating disorder (ED) literature shows a need for
more effective treatments and support for people diagnosed with ED. The limited research on alternative treatments reports bene ts of yoga for various mental health dif culties, including ED. However, only one study investigated people’s experiences of yoga and EDs, and none examined the aspects of yoga that people may nd more or less helpful. This study aims to explore women’s experiences of yoga practice in relation to their ED.
Methods
Background
Intolerance of uncertainty (IU) is a key clinical feature in eating disorders (ED) and is referred to as future- related fear or worry of the unknown. High levels have been identi ed in children and adults with ED regardless of co-morbid anxiety disorders.
Methods
This pilot aimed to develop and implement a 10-session IU group for adolescent ED inpatients, assessing feasibility, acceptability and possible bene t. The treatment protocol was adapted for adolescents from Dugas (2000). IU was measured using the IU Scale (Freeston, 1994) before, after and at three-month follow-up.
Results
Eight patients attended the group and there was no drop-out. Small to medium-sized improvements in IU were reported and sustained at follow-up. Patients found the group acceptable, reporting high levels
of satisfaction. Service user feedback also noted the relevance of the topic, the usefulness of discussing it with understanding others, challenging IU through experiments and developing new coping strategies.
Discussion
IU in EDs can be targeted through group treatments. Feasibility may increase through greater MDT and family involvement to support homework. Future replications could develop the group in other clinical contexts.
Ethical approval was granted by the Ethics Committee of the University of East London. 12 semi-structured interviews were conducted with women with a history of EDs, eight of whom trained as yoga teachers,
and all practiced yoga regularly while experiencing dif culties with eating. The transcripts will be analysed thematically.
Results
The analysis (to be completed in January 2016) will shed light onto the perceived bene ts of yoga for ED and will help to identify components that could be bene cial or detrimental to recovery.
Discussion
It is hoped that this research will contribute to the development of more effective and client-accepted ways of supporting people with ED, thereby increasing the variety of treatments offered.
EDIC 2016
Regent’sUniversityLondon,UK, Universityof Ultrech, Netherlands
75


POSTER NUMBER
POSTER NUMBER
27
28
DANCE MOVEMENT PSYCHOTHERAPIST’S EXPERIENCE OF THEIR BODY IMAGE WHEN WORKING WITH AN EATING DISORDER CLIENT GROUP: A FEMINIST AUTO-ETHNOGRAPHIC EXPLORATION
> Hannah Mcilveen, Nottinghamshire Eating Disorder Service, Nottinghamshire Healthcare, Nottingham, UK
Background
My study explores the unique experience of the female dance movement psychotherapist regarding her relationship with her body image when working with people with an eating disorder, who often experience distorted body image and associated low self-esteem and depression.
Methods
Throughout the study I draw from a range of feminisms: biological, psychodynamic, social constructionist. The study used a qualitative design. My literature review highlighted Allegranti’s work (2011, 2013) as a feminist DMP researcher, valuing thinking through the body as part of knowledge production. I took an auto-ethnographic stance to build on my existing experience of my body image and 1:1 semi-structured interviews, inviting others to share and explore theirs via interactive interviewing and movement exploration.
The research proposal was assessed by the MA DMP programme at the University of Roehampton and comments for any required adaptions were employed. Speci c ethical approval was sought from the MA programme Ethics Committee prior to any participant recruitment.
Results
The themes that occurred were changing body and the embodied ‘I’; envy, competition and control and public/private.
Discussion/Conclusion
The ndings suggest that female dance movement psychotherapists may experience changes in their relationship with their body image during and post- therapeutic engagement with clients with eating disorders. However, due to training, supervision and personal therapy they are able to translate the body counter/transferences and use these as important data to positively in uence the client’s journey through therapy.
A REVIEW OF CASE NOTES OF PATIENTS DISCHARGED FROM INPATIENT SERVICES AT LEAST TWO YEARS BEFORE
> Dr Paul Robinson and Amelia Durcan, University College London, London, UK
Eating disorders are characterised by an abnormal attitude towards food that causes someone to change their eating and behaviours (Fairburn & Harrison,2003).
Objective
To establish the readmission rate in patients discharged from inpatient and day care in a single eating disorders unit between January 2011 and June 2015.
Case-notes of 40 patients treated as inpatients at a large eating disorder service over the past four years were studied. There were 35 women and 5 men, and average age was 37 years. For each patient an audit form was completed, and the data was analysed in Microsoft Excel. Death rate was 10%. Readmission rates, 77%, were high. SEED patients have more admissions (5.15 compared to 1.17) which were long (33% longer than 6 months) when compared to shorter history patients. 7% of the original sample were current inpatients, while 68% had not been readmitted for two years. Those who were NG/PEG fed had a signi cantly shorter average length of stay in hospital compared to those who were solely orally fed. The results suggest that prolonged inpatient care is being used in a proportion of this very disabled group of patients. We suggest that enhanced community care for SEED patients might have reduced the time spent in hospital.
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AN INTERPRETATIVE PHENOMENOLOGICAL ANALYSIS OF THE CLINICIANS’ EXPERIENCE OF CHANGE DURING A MULTIPLE FAMILY THERAPY FOR ADOLESCENTS WITH ANOREXIA NERVOSA > Zoé Gelin1, Jan De Mol2, Yves Simon3 and Stéphan Hendrick1, 1University of Mons, Mons, Belgium, 2University of Louvain-la-Neuve, Louvain-la-Neuve, Belgium, 3Centre Hospitalier Le Domaine, Braine l’Alleud, Belgium
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Multiple family therapy (MFT) is a therapeutic method that brings together several families affected by
the same pathology. MFT is dif cult to de ne with precision, a weakness which may in turn hinder research on therapeutic effectiveness. This is most notable in the eld of eating disorders (ED) where,
in spite of MFT’s great popularity, research evidence remains limited.
Our objective is to contribute to the development of a better-de ned identity for MFT through the examination of the subjective experience of six MFT clinicians interviewed using interpretative phenomenological analysis.
Three master themes were identi ed as potential therapeutic factors: 1. prede ned therapeutic model, 2. transmission process, and 3. focus on the group.
The process of differentiation within the security of the af liation to the group ‘teaches’ the family that individuation of family members enhances its identity rather than destroys it. While this MFT seems to be strongly in uenced by integrative research focused on common factors, the dialectical dynamic between af liation and differentiation within the group, operating as a mirror for the family, may constitute a speci c mechanism of change involved in MFT.
POSTER STROLL GROUP SEVEN
Saturday 19 March 2016
10.30am – 11am, Crush Hall
THEME > TREATMENT
LEAD STROLLER > Prof ULRIKE SCHMIDT
Methods
We critique processes and products related to experiences of co-operating within the Avalon Ward community and treat dif culties working together and instances where no ‘product’ emerged as of equal importance.
Results
We detail co-operative processes that suggest creative forces are being mobilised. However, there may be a tendency to take a rosy view of co-production that risks glossing painful ambiguities and tensions: destructive forces mobilised on/by ‘both sides’. Co-production in times of austerity may ‘excuse’ a reluctance to provide basics of care and/or to engage in the give and take of authentic co-operation.
Conclusions
Perhaps we work together more effectively when we don’t begin by assuming the wish to do so. We outline an approach in which the tensions in processes of co- operation are not owned by any particular sub-group but form a kind of ‘commons’. We aspire to avoid ‘enclosing’ these shared spaces.
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THE VALUE OF VALUES: USING CLINICAL VALUES AND PHILOSOPHY OF PRACTICE TO GUIDE WORKING WITH PEOPLE WHO ARE EXPERIENCING SEVERE EATING DISORDERS > Dr Menna Jones, Cardiff and Vale University Health Board, UK
Background
Values and philosophy play key roles in steering a clinician’s work with individual clients, and also in how services are developed over time. However, focus on those values and philosophies can become diminished by the complex challenges of daily clinical practice, causing clinicians and services to nd themselves adrift without a clear compass.
Methods
The Service for High-risk Eating Disorders is a multi- disciplinary team that undertook to explore and capture a shared set of values to form a philosophy that guides their activity and ongoing service development. This involved collaborative re ection on the team members’ clinical experiences and aspirations that indicate the values that guide how they seek to provide the optimum service for their clients.
30
‘FINE WORDS IN THEORY BUTTER NO PARSNIPS IN PRACTICE’: CRITICAL APPROACHES TO ‘CO-PRODUCTION’ ON AN INPATIENT EATING DISORDERS WARD
> John Adlam1, Helen Hewitt2, Katharine Lazenby2, Caroline Plumb1 and Rebecca Hursey2, 1Avalon Ward, South West London and St George’s Mental Health NHS Trust, UK, 2Expert by Experience
Background
‘Co-production’ is an idea arising out of diverse narratives but the values underlying the term may be obscure or ambiguous. The noun of product is privileged over the verb of process. The term also exempli es the colonisation of the language of humane care by more ‘corporate’ discourses.
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Results
The team were invited 10 months later to re ect on their experiences of identifying key service values, and discussed the difference that a focus on these values was making in their work.
Discussions/Conclusions
The workshop will provide attendees with the opportunity to explore their own values and philosophy of practice, as well as understand the role and bene ts of clear values and philosophy in working with people with severe eating disorders.
exion/rotation and hip abduction. Modi cations to exercises were identi ed where possible. A table of exercises and positions to avoid was produced to inform and guide practice. A patient-friendly version was also produced for use in community Pilates studios and for educational purposes.
Conclusion
A modi ed Pilates exercise guide was produced that should make Pilates safer for this client group.
32
GETTING GOOD OUTCOMES: TOWARDS MEANINGFUL DATA COLLECTION IN AN INPATIENT SERVICE
> Dr Caroline Plumb, John Adlam, Georgina Heath and Nadia Daer, Spring eld University Hospital National Inpatient Eating Disorder Service,
London, UK
Background
Against a background of austerity, there is an ever clearer need for health services to justify activity and effectiveness to commissioners. However, as clinicians we are concerned not to harm our patients by the ways and means of measurement. At present, we see very low rates of outcome questionnaire completion by our patients, and they raise valid objections to our measures. This is perhaps unsurprising, given that the dataset was not designed speci cally for inpatients, especially not for those detained under the Mental Health Act.
Method
We contacted other specialist ED services (directly and via SIGs) to ascertain their experiences with outcome measuring. We held conversations with our patients to collect their views of the current measures.
Results
Our intention is to present percentage completion rates from specialist inpatient EDUs, as well as clinical narratives about collection processes. We also intend to present themes arising from patients regarding potential improvements to processes and measures.
Discussion
For ED services to deliver useful and accurate outcome data to commissioners, we need to use measures which are sensitive and acceptable in this population. From the ideas conveyed by patients and clinicians, we can plan for the development of better specialist inpatient measures and more acceptable methods of delivery.
PILATES: AN EFFECTIVE EXERCISE INTERVENTION FOR EATING DISORDER PATIENTS WITH OSTEOPOROSIS?
> Jody Phillips1, Lynn Hammond2, Yvonne Hull3 and Kate Brown4, 1St John’s Hospital, Edinburgh, UK, 2St Vincents Square, London, UK, 3Southmead Hospital, Bristol, UK, 4Fulbourn Hospital, Cambridgeshire and Peterborough Foundation Trust, Cambridge, UK
Background
Osteoporosis is a common complication of eating disorders, especially anorexia nervosa and can lead to reduced bone mass and strength, increasing susceptibility to fractures. There are many risk factors for osteoporosis related to eating disorders, including amenorrhoea, excessive exercise and hormonal changes.
Pilates is a type of exercise that physiotherapists
use to aid rehabilitation. Pilates aims to build core strength around the spine, improve joint stability
and strength and improve posture. The principles of Pilates can be adapted to most rehabilitation settings. The aim of this study was to identify whether Pilates would be a safe and effective exercise intervention for patients with a body mass index below 18.5 and with a diagnosis of osteoporosis.
Method
The most common fracture sites with osteoporosis are the spine, wrists and hips. Exercises from Levels 1-3 Pilates training were screened for risk positions known to increase likelihood of osteoporitic fractures by quali ed Pilates instructors and physiotherapists.
Results
Speci c positions and exercises to avoid were highlighted within Pilates techniques to reduce the risk of osteoporitic fracture in patients with eating disorders. These include forced neck exion, spinal
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POSTER STROLL GROUP EIGHT
Saturday 19 March 2016
10.30am – 11am, Crush Hall
THEME > TREATMENT
LEAD STROLLER > Dr NATHALIE GODART
34
BRIDGING THE GAP: SMARTPHONE-BASED SUPPORT BETWEEN SESSIONS FOR ADOLESCENT OUTPATIENTS WITH ANOREXIA NERVOSA – A RANDOMISED CONTROLLED TRIAL PROTOCOL
> David R Kolar1, Florian Hammerle1 Ekkehart Jenetzky1, Michael Huss1 and Ekaterina Karabasheva2, 1Department of Child and Adolescent Psychiatry and Psychotherapy of Johannes Gutenberg-University, Mainz, Germany, 2Jourvie gUG, Berlin, Germany
Background
Most adolescents nowadays possess smartphones, and self-help applications (apps) for various disorders exist. However, to this day no evidence-based app
for anorexia nervosa (AN) is available. This study protocol presents a randomised, controlled, three- month intervention supported by a smartphone app to bridge the gap between psychiatric consultations.
Methods
In an adaptive study design, initially 30 female patients with AN aged 12 to 19 years will be randomly distributed to intervention (app + consultations) vs control group (consultations only). Participants will receive six 50-minute consultations. In the intervention group, electronic meal protocols will be lled out, and individual emotion regulation skills for momentary aversive tension are given by the app.
POSTER NUMBER
Outcomes
Primary outcome: baseline-relative weight gain. Co- primary: overall symptom burden at follow up.
Discussions
TO GO OR NOT TO GO: BRAIN TRAINING IN EATING AND WEIGHT DISORDERS
> Robert Turton, Bruno Nazar, Emilee Burgess, Colette Hirsch and Prof Janet Treasure, King’s College London, London, UK
Background
Impulsivity has been indicated as a predisposing
and maintenance factor across disorders of under control and over eating. This experimental study examines whether food-speci c go/no go training can increase control over eating habits in disorders across the spectrum of binge-eating relative to a control condition, and whether any effects are moderated by ADHD status.
Methods
Participants are given one session of food-speci c go/ no go training and one control session in a within- subjects design. The primary outcome measures are: food consumption on a taste test and food diaries for the 24 hours post-training. Diagnostic measures of ADHD are included to examine whether symptoms relating to impulsivity/inattention moderate the outcome of this cognitive training approach. The ethics reference number for the study is 14/L0/2166.
Results
Although data collection is still under way, preliminary results will be discussed.
Conclusions
Following promising ndings in healthy populations, this proof of concept study will help to further elucidate whether food-speci c inhibition training approaches are also useful in clinical populations.
This innovative protocol presents a randomised controlled trial to assess the effect of a low-threshold intervention with a smartphone app for adolescents with AN waiting for outpatient psychotherapy. If effects are found, clinicians should consider the use of smartphone apps in the treatment of AN.
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POSTER NUMBER
Background
Previous research suggests that partners of patients with anorexia nervosa (AN) receive less social and emotional support than parent caregivers. This study investigated differences in the ef cacy of a carer’s skills intervention across all groups.
Methods
This study compared well-being and clinical outcomes from a carer’s skills intervention across partners (n=28), mothers (n=144), and fathers (n=81) of patients with AN (n=178) admitted to inpatient units within the UK. Well-being measures included quality of life (QOL), and depression, anxiety, and stress scores (DASS-
21). Caregiving behaviours were assessed with the family questionnaire (FQ) and accommodating and enabling scale for eating disorders (AESED). Ethical approval was granted by the Royal Free Hospital Ethics Committee (COREC ref. no. 08/H0720/41).
Results
Parents improved on all measures of caregiving behaviours and well-being. In contrast, partners showed no improvement on accommodating and enabling behaviours by 12 months, with marginal improvement by 24 months. Partners’ depression, anxiety, and stress also deteriorated by 24 months.
Conclusions
More carer interventions speci cally targeting well- being and caregiving behaviours of partners are needed.
36
EVALUATING THE EFFECTIVENESS OF ‘TEEN BODYWISE’ AT NEWBRIDGE HOUSE: A PSYCHO- EDUCATIONAL BODY IMAGE GROUP FOR ADOLESCENTS WITH ANOREXIA NERVOSA
> Amanda Beavan1, Sophie Bates1, Dr Juliet Rosewall2, Catherine Houlihan3 and Prof Hubert Lacey1, 1Newbridge House, Birmingham, UK,
2St George’s University of London, London, UK, 3University of Oxford, Oxford, UK
Body image disturbance is a core feature of anorexia nervosa (AN) and has been shown to be a predictor of relapse. A psycho-educational group ‘BodyWise’ has shown promising results in reducing body image disturbance in adults with AN, however similar research with young people is limited.
The adapted ‘Teen BodyWise’ group for adolescents with AN has been facilitated at Newbridge House, a child and adolescent eating disorder inpatient unit. A service evaluation (N=32) examined the effectiveness of this group in reducing body image disturbance for 13 to 17-year-olds with AN.
Paired-samples t-tests and non-parametric Wilcoxon signed rank tests compared the differences in pre and post-group measures. Results indicate signi cant reductions in body image disturbance as shown by improvements on the Eating Disorder Examination Questionnaire Weight and Shape Concern subscales, Body Image Communication and Understanding Questionnaire, Sociocultural Attitudes Towards Appearance Questionnaire, and Body Checking Questionnaire.
This shows that ‘Teen BodyWise’ is a valuable group for young people with AN and highlights the need for future controlled studies.
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38
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COGNITIVE BEHAVIOUR THERAPY FOR ANOREXIA NERVOSA: OUTCOMES IN ROUTINE CLINICAL PRACTICE
> Prof Glenn Waller1 and Jonathan Kelly2, 1University of Shef eld, Shef eld, United Kingdom, 2Beat, Norwich, UK
Background
While not the most common of the eating disorders, anorexia nervosa among adults is the most resistant to treatment. While psychological therapies have demonstrated some bene ts in clinical trials, those effects are relatively weak, with recovery rates of 0-30%. It is not known whether those effects replicate in routine clinical practice. This paper will report on the preliminary outcomes of a naturalistic study of outcomes in patients with anorexia nervosa, over the course of up to 30 sessions of cognitive behavioural therapy (CBT).
37
CLINICAL OUTCOMES OF PARTNERS WITH ANOREXIA NERVOSA COMPARED TO PARENT CAREGIVERS
> Emilee Burgess, Nicholas Magill, Charlotte Rhind, Rebecca Hibbs, Elizabeth Goddard and Prof Janet Treasure, King’s College London, London, UK
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Methods
Entry to the case series was closed in December 2015, with an expected N of c.40 patients who have entered outpatient CBT for anorexia nervosa, undertaken in two NHS clinics in the UK from 2012-2015. Sessional symptom data (particularly BMI) and psychometric measures have been collected routinely across therapy.
Results
Attrition rates will be reported. Outcomes (completer and intention to treat analyses) will be presented in terms of clinical change and remission rates.
Discussion
The outcomes will be compared to those from recent randomised controlled trials, to determine whether the results of more tightly controlled studies are generalisable to routine clinical practice.
POSTER STROLL GROUP NINE
Saturday 19 March 2016
10.30am – 11am, Crush Hall
THEME > TREATMENT
LEAD STROLLER > Dr JOANNA STEINGLASS
POSTER NUMBER
40
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COMPULSIVE BOWEL EMPTYING AND RECTAL PROLAPSE IN EATING DISORDERS
> Dr Fragiskos Gonidakis, Georgios Georgantopoulos and Eleftheria Varsou, Eating Disorders Unit, 1st Department of Psychiatry, Athens University, Medical School, Athens, Greece
In many cases of eating disorders (ED) food consumption is considered a “failure” and its presence in the body “harmful” and even “toxic” leading
the individual to adopt a wide variety of purging behaviours in order to achieve a state of mental and physical “cleanliness”.
Compulsive bowel emptying behaviour compromised of repeated and/or prolonged voluntary tension of
the abdominal and pelvic muscles as well as insertion of the gure in the rectum to “check” if the bowel has been completely emptied of its content. The purpose of this behaviour is to alleviate intense anxiety caused by obsessive thoughts that the individual would get “fat” and/or “dirty/intoxicated” if the bowel is not completely vacated of the stools. In many cases the compulsive behaviour facilitates the manifestation of rectum prolapse that reinforces the vicious circle of the obsessive-compulsive symptomatology.
Three cases of compulsive bowel emptying, two suffering from anorexia nervosa and one suffering from bulimia nervosa, are presented.
39
THE EFFECT OF TRANSCRANIAL DIRECT CURRENT STIMULATION (TDCS) ON BODY IMAGE PERCEPTION IN ANOREXIA AND BULIMIA SPECTRUM DISORDERS
> Sarah Trufhitt, Dr Igor Schindler and Natalia Szostak, University of Hull, UK
Body image distortion in eating disorders (ED) leads to a bias in perceiving their body as overly sized. Thus, determination to obtain an ideal body shape and weight is maintained by a cycle of food restrictive and purging behaviours, subsequently driving their distortion towards thinness.
Findings of right dorsolateral prefrontal cortex (DLPFC) hyperactivity in ED, may potentially effect body size perception. To evaluate whether stimulation of this area can modulate body image distortions in ED, tDCS over the right DLPFC will be applied. Three stimulation conditions will be carried-out using of ine tDCS in a within subject-design. Participants will receive a weekly 20-minute session of anodal, cathodal and sham stimulation in counterbalanced order followed by a computerised body-image task.
Psychophysical thresholds for self and ideal body size will be calculated by presenting morphs of relative body mass index (BMI).
Signi cantly increased accuracy of body image perception ratings of BMI stimuli are expected in either the cathodal or anodal condition compared
to sham stimulation. Participants in the baseline condition are expected to overestimate their actual body size and prefer a lower than normal body size as their ideal.
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EDIC 2016
41
TREATMENT SEEKING FOR BINGE
EATING DISORDER: AN INTERPRETATIVE PHENOMENOLOGICAL ANALYSIS
> Charlotte Evans1,2,3, Bryony Bamford4, Kierron Worley1, 1South Staffordshire and Shropshire Healthcare NHS Foundation Trust, UK, 2Staffordshire University, UK, 3Keele University, UK, 4The London Centre for Eating Disorders and Body Image, London, UK
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Background
It has been well documented that only a minority of individuals suffering from eating disorders receive appropriate specialist treatment. Research has primarily focused on investigating factors which promote or impede individuals’ help-seeking behaviours. More recently there have been qualitative studies, which have begun to explore the experiences of individuals seeking help for an eating disorder, however the exploration of the process of the help- seeking experience is in its infancy and has not been researched for binge eating disorder.
Aim
This research aimed to explore individuals’ treatment-seeking experiences, in order to increase understanding about the treatment-seeking process, in particular regarding possible barriers and facilitating factors, and to optimise the likelihood of individuals being able to seek treatment.
Method
Participants were recruited from specialist eating disorder services across two different NHS trusts
(n=5 NB: recruitment active until Feb 2016). All participants were actively involved within the services and were either awaiting treatment or currently receiving treatment. Data were collected using semi- structured interviews and transcribed verbatim; data analysis was then carried out using interpretative phenomenological analysis (IPA) (Smith, 2009).
Service user consultation was sought for both the development of the research design and the interview schedule.
Results/Discussion
Data analysis is ongoing, however tentatively the following super-ordinate themes have emerged: lack of understanding and recognition; feeling inadequate vs feeling accepted; fear of stigma and feelings of shame. The clinical implications of these ndings will be considered in relation to existing research and theory.
rst assessment appointment. Although a variety of strategies may be used to engage patients, little is known about their current impact.
Methods
We surveyed four different services across the UK about their attendance rates (collected from routinely collected audit data) and their current referral processes.
Results
The number of patients who did not attend a rst appointment ranged from 10-32% across the four services. This gure was higher in services that used an opt-in process (patient asked to contact the service to make an appointment) rather than an invitation
to a pre-arranged appointment. Services also varied in waiting times and the resources they provided before the rst appointment and this may also impact attendance rates.
Discussion
This is a small exploratory study of service processes and attendance and more research is required. However, in this small sample the use of opt-in processes reduced the number of patients attending for an appointment. Although opt-in processes may reduce service costs related to missed appointments, they also appear to deter patients who are more dif cult to engage.
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UNDERSTANDING ADOLESCENT’S EXPERIENCE OF SUPPORTIVE OBSERVATION WITHIN A SPECIALIST INPATIENT UNIT FOR EATING DISORDER TREATMENT
> Angella Fosuaah and Dr Lucia Giombini, Rhodes Farm Eating Disorder Service, London, UK
Background
Research has explored the experience of adult inpatients receiving supportive nursing observation from an arms-distance away, 24-hours a day in psychiatric hospitals (Stewart & Bower, 2009). Experiences of inpatient adolescents receiving supportive observation have not been explored, speci cally receiving inpatient treatment for eating disorders. The aim of this study was to understand adolescents’ experience of this intervention.
Method
Qualitative methods were used. An opportunity sample of 11 adolescents between 13 and 17 years old, who were nursed on supportive observation, were interviewed. Results were interpreted using thematic analysis.
42
THE PROBLEM OF SERVICE NON-ATTENDANCE AT ADULT EATING DISORDER SERVICES IN THE UK: A PRELIMINARY STUDY
> Sarah Muir1, Dr Ciaran Newell2, Katherine Appleton1, Holly Hooper1 and Jess Grif ths1 1Bournemouth University, UK, 2Dorset HealthCare University NHS Foundation Trust, UK
Background
Roughly a quarter of adults referred to an eating disorder service drop out before they attend their
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Results
Four main themes were identi ed: understanding
the need for supportive observation, isolation, self- perceived helpfulness of supportive observation and staff interaction. Staff interaction was split into two sub- themes: verbal interaction and physical boundaries.
Discussion/Conclusion
As the researcher, I was on an academic placement and took part in conducting some supportive observations and potential drawbacks. This research offered the adolescents a chance to discuss a dif cult experience in their treatment. It is useful to continue to explore young people’s inpatient experience.
recovery. A central question is how we can better capitalise on the principles of the recovery model, open to new treatment approaches, which values the ‘whole’ experience of individuals. These models offer an accessible way of understanding recovery and accepting nurture in general. Further research will determine their effectiveness as an emerging developmental treatment model.
POSTER NUMBER
COGNITIVE BEHAVIOURAL THERAPY AS A TREATMENT FOR ANOREXIA NERVOSA: A CRITICAL APPRAISAL
> Anu Perumbalath, University of Liverpool, Liverpool, UK
Background
Mortality rates in anorexia nervosa (AN) are the highest in all of the psychiatric disorders and with
an estimated yearly incidence of 0.4 in 1,000, these statistics highlight the importance in developing an effective treatment for AN. The aim of this paper is to review and appraise recent evidence for cognitive behavioural therapy (CBT) as a treatment for anorexia nervosa.
Methods
A literature search was conducted on Pubmed with
the search terms: “anorexia nervosa”, “CBT” and “cognitive behavioural therapy”. Search results were condensed to four relevant articles that focused on the use of CBT as a treatment for AN. Two papers evaluate CBT alone, whereas, the other two papers compare the use of CBT with other psychotherapies.
Results
The evidence collected from the four studies
showed improvement in treatment outcomes, thus suggesting effectiveness in the use of CBT. However, when compared to other psychotherapies, there was no signi cant difference between the treatments. Therefore, it is unclear if CBT is the most superior of the psychotherapies and its long-term effects are also unknown. There are methodological limitations to these studies which have been discussed in this paper.
Conclusion
Further research and critical appraisals are needed
to gather and analyse evidence for CBT. Research needs to focus on a lengthened follow-up period to measure the long-term effectiveness of the therapy as the risk of relapse in AN patients is present long after termination of therapy.
44
THE ROLE OF ‘THE HEART’ IN RECOVERY FROM EATING DISORDERS: RECLAIMING AND RESTORING THE HEART’S COURAGE AND IMAGINATIVE POWER
> Melanie Oliver, University of Northampton, UK
Background
This qualitative study investigated the role of ‘the heart’ during the painful journey of recovery from an eating disorder. The de nition of ‘the heart’ is not the physical organ of the body, but rather our humanity, courage to live, desire, compassion, the essence of our real self.
Method
Four women, who struggled with an eating disorder for between 10 and 30 years and achieved full recovery, were interviewed using semi-structured and open-ended questions. Grounded theory was used to analyse the data, revealing ve discrete themes and two core concepts.
Results
First, ‘the heart’, atrophied during an eating disorder, is identi ed through an experience with ‘Other’, igniting a heartfelt desire to recover. Second, learning to receive love is a vital component in self-acceptance, becoming vulnerable, known. Based on participants’ experience, two potential models of recovery emerged from the ndings: ‘Six stages of the heart’ and ‘Healing from the inside, out’, which provide food for thought on new approaches to working with eating disorders.
Discussion/Conclusion
Grounded in psychoanalytic and transpersonal theories on eating disorders, this research suggests that the reclaimed ‘thinking heart’ provides the true compass through the rite of passage into full
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NOTES
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Life beyond an ea ng disorder.
• Our highly experienced and caring clinical teams treat children and young people in a variety of se ngs
• Our treatment goes beyond the physical aspects of ea ng disorders and focuses on psychological and emo onal wellbeing
• All our residents work with the clinical teams to build coping strategies for their futures
• Children and young people con nue their educa on in our Ofsted approved schools
Our units:
Althea Park/Ashleigh House, Stroud, Gloucestershire
Residen al treatment and care for young people
aged 15-25 with severe and enduring ea ng disorders
Rhodes Farm, North London*
Inpa ent care for children and young people (6–19 years) with acute ea ng disorders
Living beyond ea ng disorders: Progressive pathways: Sustainable recovery. Talk to us how we can help people in your care
Call us 0800 218 2398 Email [email protected] Research us: www.partnershipsincare.co.uk
*This service will be reloca ng to new larger premises in South Her ordshire in April 2016.
A centre for the treatment of eating disorders
153 Newmarket Road
Norwich
Norfolk NR4 6SY
Telephone 01603 452226 Fax 01603 452229 [email protected] newmarket-house.co.uk
Founded in 1996, Newmarket House is an independent residential hospital dedicated solely to the
treatment of eating disorders. It continues to be a dynamic, developing service, maintaining the
highest standards. We work closely with the NHS as a provider of a 'niche' resource to both local and
national referrers.
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AT A GLANCE
THURSDAY 17 MARCH 2016
8.45am – 9am
Welcome > Andrew Radford, Chief Executive, Beat and Chris Outram, Chair of Trustees, Beat > Logan Hall
9am – 9.45am
Keynote lecture one > Prof Jennifer Beecham > Logan Hall
9.45am – 10.30am
Keynote lecture two > Prof Peter Fonagy > Logan Hall
10.30am – 11am
Discussion of keynotes > Logan Hall
11am – 11.30am
Coffee > Jeffery Hall
11.30am – 1.10pm
Short papers one: Treatment
> Logan Hall
Short papers two: Psychology one
> Elvin Hall
Short papers three: Psychology two
> Drama Studio
Short papers four: Psychosocial one > Nunn Hall
Short papers ve: Psychosocial two > Clarke Hall
Short papers six: Clinical Features > Room 728
1.10pm – 2pm
Lunch > Jeffery Hall
1.30pm – 2pm
Poster strolls: Groups one, two and three > Crush Hall
2pm – 3.30pm
Plenary one: Speci c groups of patients > Logan Hall
> Beat Young Ambassadors > Catherine Doyen > Dr Nadia Micali
3.30pm – 4pm
Coffee > Jeffery Hall
4pm – 5.30pm
Workshop 1.1
> Prof Janet Treasure and Jenny Langley
> Logan Hall
Workshop 1.2
> Stephen Wonderlich PhD > Elvin Hall
Workshop 1.3
> Lorraine Ricks and Dawn Saunders
> Drama Studio
Workshop 1.4
> Susan Ringwood > Nunn Hall
Workshop 1.5
> Dr Matthew Pugh and Dr Jane Evans > Clarke Hall
Workshop 1.6
> Valentina Cardi, Dr Suman Ambwani and Gill Todd > Room 728
5.30pm – 6.30pm
Eating disorder services: then and now > The Rt Hon Alistair Burt MP > Logan Hall
FRIDAY 18 MARCH 2016
9am – 10.30am
Plenary two: Severe and complicated eating disorders > Logan Hall > Stephen Wonderlich PhD > Dr Paul Robinson > Linda Bates
10.30am – 11am
Coffee > Jeffery Hall
11am – 12.30pm
Workshop 2.1
> Dr Nathalie Godart, Dr Irene Kaganski, Zorica Jeremic and Jean-François Mangin > Logan Hall
Workshop 2.2
> Greg Dring > Elvin Hall
Workshop 2.3
> Prof Hubert Lacey > Drama Studio
Workshop 2.4
> Amanda Bye, Manuela Barona and Dr Nadia Micali
> Nunn Hall
Workshop 2.5
> Chandanee Kotecha, Marian Titley and Hayley Smith > Clarke Hall
Workshop 2.6
> Marilyn Conroy and Karen Jeffereys > Room 728
12.30pm – 1.30pm
Lunch > Jeffery Hall
1.30pm – 2.30pm
Keynote lecture three > Prof Janet Treasure and Jenny Langley > Logan Hall
2.30pm – 4pm
Plenary three: Talking therapies for adults across the weight range > Logan Hall > Assoc Prof Susan Byrne > Prof Ulrike Schmidt > Prof Dr med Martina de Zwaan
4pm – 4.30pm
Coffee > Jeffery Hall
4pm – 4.30pm
Poster strolls: Groups four and ve > Crush Hall
4.30pm – 6pm
Workshop 3.1
> Dr Joanna Steinglass, Valentina Cardi and Stephen Wonderlich PhD
> Logan Hall
Workshop 3.2
> Dr Blake Woodside > Elvin Hall
Workshop 3.3
> Jenny Langley > Drama Studio
Workshop 3.4
> Dr Anna Hall and Dr Janet Feigenbaum > Nunn Hall
Workshop 3.5
> Ana Ribeiro > Clarke Hall
Workshop 3.6
> Charles Baily > Room 728
6.15pm - 7.15pm
Theatrical performance: ‘Enoughness’ > Logan Hall
SATURDAY 19 MARCH 2016
8.45am – 9am
Welcome > Andrew Radford, Chief Executive, Beat > Logan Hall
9am – 10.30am
Plenary four: Biological factors > Logan Hall
> Prof Anke Hinney > Dr Blake Woodside > Prof Guido Frank
10.30am – 11am
Coffee > Jeffery Hall
10.30am – 11am
Poster strolls: Groups six, seven, eight and nine > Crush Hall
11am – 12.30pm
Workshop 4.1
> Prof Ulrike Schmidt, Dr Amy Brown and Danielle Glennon
> Logan Hall
Workshop 4.2
> Prof Glenn Waller > Elvin Hall
Workshop 4.3
> Eva Musby
> Drama Studio
Workshop 4.4
> Dr Fragiskos Gonidakis and Dafni Karapavlou
> Nunn Hall
Workshop 4.5
> Inbar Sharav-Ifergan > Clarke Hall
Workshop 4.6
> Dr Karina Allen and Dr Claire Baillie > Room 728
12.30pm – 1.30pm
Lunch > Jeffery Hall
12.45pm – 1.30pm
Academy for Eating Disorders lunchtime seminar > Logan Hall
1.30pm – 2.30pm
Keynote lecture four > Dr Joanna Steinglass > Logan Hall
2.30pm – 4pm
Plenary ve: Family and community > Logan Hall
> Dr Nathalie Godart > Prof Ivan Eisler > Prof Beate Herpertz-Dahlmann
4pm – 4.30pm
Coffee > Jeffery Hall
4.30pm – 6pm
Workshop 5.1
> Assoc Prof Susan Byrne and Dr Karina Allen > Logan Hall
Workshop 5.2
> Dr Paul Robinson > Elvin Hall
Workshop 5.3
> Jenni leppanen, Dr Yannis Paloyelis and Dr Kah Wee Ng > Drama Studio
Workshop 5.4
> Prof Sarah Byford and Dr Hristina Petkova > Nunn Hall
Workshop 5.5
> Jeanne Duclos, Meritxell Campreciòis and Dr Benjamin Carrot > Clarke Hall
Workshop 5.6
> Laura Al-Dakhiel Winkler > Room 728
EDIC 2016
87


SEE YOU IN 2018!
SAME TIME, SAME PLACE
EATING DISORDERS INTERNATIONAL CONFERENCE 2018
If you’re interested in receiving updates about EDIC 2018 or nding out more about Beat’s conferences, please email [email protected]
Beat is the UK’s charity supporting anyone affected by an eating disorder. We exist to provide hope and improve life for the 725,000 individuals in the UK diagnosed with an eating disorder, as well as their friends, families, colleagues and professionals.
We provide information and reassurance through our Helpline, which people can call or email, peer self-help support on our website, where people can engage with our message boards or online support groups, and HelpFinder, an online directory of eating disorder services.
HELPLINE
Call 0345 634 1414 Email [email protected] Visit www.b-eat.co.uk
A charity registered in England and Wales (801343) and Scotland (SC039309). Company limited by guarantee no 2368495