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Despite availability of evidence-based treatments for eating disorders (EDs), individuals with EDs often do not receive informed treatment. Training of non-specialized clinicians by experienced professionals through knowledge exchange (KE) programs is an effective way to enhance accessibility to evidence-based treatments for EDs. The authors conducted a qualitative analysis of factors that facilitated or impeded the uptake of an ED-focused KE program. Semi-structured interviews were conducted with mental health professionals (n = 43) and managers (n = 11) at 13 community mental-health sites at which the KE program was offered. Data were analyzed using a qualitative content analysis. Key facilitators identified were management support for the program and building competence through ongoing supervision of clinicians. Main barriers were limited access to ED patients to treat and having insufficient time to apply ED interventions in front-line settings. The results provide insights into the practical imperatives involved in implementing a KE initiative for ED treatment. [ABSTRACT FROM AUTHOR]

We describe the implementation and impact of a province-wide program of knowledge exchange (KE), aimed at developing capacity for the treatment of people with eating disorders (EDs). The program is designed to equip clinicians working in nonspecialized health-care installations with skills to evaluate and treat people with EDs. Trainings were conducted at 21 institutions. The majority of clinicians reported satisfaction with the KE program and indicated that the trainings enhanced their confidence and ability to treat patients with EDs. A subset of clinicians received case supervision with a specialist ED therapist and followed patients with EDs (n = 119). Treated patients showed significant improvements on eating and depressive symptoms, and reported satisfaction with the treatments they received. [ABSTRACT FROM AUTHOR]

Thought-shape fusion (TSF) is a belief that entails perceptions of weight gain, moral transgression, and body dissatisfaction when thinking about food consumption. The objectives of the current study were to (1) investigate whether high TSF endorsement is associated with differences in cognitive, affective and behavioural reactions to a TSF induction in comparison to those who are low in TSF, and (2) evaluate whether TSF shows temporal stability. TSF was assessed in 32 individuals with eating disorders over a 1-month period. Participants were classified as either low ( n = 16) or high ( n = 16) in trait TSF. Participants attended three sessions (baseline, experimental session, and follow-up), and were exposed to a TSF induction during the experimental session. High correlations were found for trait TSF scores between baseline and follow-up appointments. Furthermore, high TSF individuals were more vulnerable to the induction, with higher negative affect and state TSF, and more food-related thoughts at follow-up in comparison to those low in TSF. These findings indicate that TSF is a stable belief holding clinical relevance. [ABSTRACT FROM AUTHOR]

Reduced brain serotonin (5-hydroxytryptamine: 5-HT) transporter activity has been associated with susceptibility to various forms of psychopathology, including bulimia nervosa (BN) and related syndromes characterized by appetitive or behavioural dysregulation. We applied density (Bmax) of platelet [3H-]paroxetine binding as a proxy for central 5-HT reuptake activity in two groups of women (33 with BN-spectrum disorders and 19 with no apparent eating or psychiatric disorders), most of these individuals' mothers (31 and 18, respectively), and a small sampling of their sisters (seven and eight, respectively). Hierarchical linear modeling techniques were used to account for nesting of individuals within families and diagnostic groupings. Bulimic probands, their mothers, and their sisters all displayed significantly lower density (Bmax) of platelet-paroxetine binding than did ‘control’ probands, mothers, or sisters—even when relatives showing apparent eating or psychiatric disturbances were excluded. In addition, in bulimic probands and mothers, significant within-family correlations were obtained on Bmax. These findings imply a heritable trait (or endophenotype), linked to 5-HT activity, and carried by BN sufferers and their first-degree relatives (even when asymptomatic). We propose that, under conducive circumstances, such a trait may increase risk of binge-eating behavior, or associated symptoms of affective or behavioral dysregulation.Neuropsychopharmacology (2006) 31, 1785–1792. doi:10.1038/sj.npp.1301011; published online 11 January 2006 [ABSTRACT FROM AUTHOR]

Rationale: There have been few studies of platelet paroxetine binding in borderline personality disorder (BPD). Objective: Our aim was to determine whether female BPD subjects show abnormalities in platelet paroxetine binding. Methods: Twenty-one female BPD subjects and 16 age- and gender-matched normal control subjects were assessed using the following: (1) Diagnostic Interview for Borderlines, Revised, (2) Diagnostic Assessment for Personality Pathology: Brief Questionnaire, and (3) Barratt Impulsivity Scale. Platelets were collected and assayed for platelet paroxetine binding. Results: Bmax was lower in the BPD group (p<0.0001), but differences in Kd only reached a trend level. There were no associations with trait dimensions independent of diagnosis. Conclusions: Reduced platelet paroxetine binding in female BPD patients may reflect presynaptic serotonin dysfunction. [ABSTRACT FROM AUTHOR]

Findings show brain serotonin (5-hydroxytryptamine (5-HT)) activity to be altered in individuals who have had bulimia nervosa (BN), even after substantial remission of symptoms. Such findings could reflect persistent sequelae due to BN, or a vulnerability 'trait' that exists independently of active eating-disorder manifestations. We compared women with full-blown BN (BN; n = 22), BN in remission (BN-R; n = 11), and no eating or psychiatric disturbances (n = 22) on measures of platelet [³H]paroxetine binding, eating symptoms and psychopathology. The BN-R group showed normal-range scores on eating and psychopathological symptoms, but reductions in density (Bmax) of binding sites for paroxetine similar to those obtained in the actively ill women. Both BN groups had substantially lower Bmax than did healthy controls. Our results corroborate other findings indicating recovered BN patients to have anomalous 5-HT functioning. While such effects could represent a lasting 'injury' to the system, reported covariations between personality traits and 5-HT indices in BN encourage us to favor the argument that some alterations of 5-HT activity (in this case, consistent with reduced transporter activity) represent a 'trait' associated with the risk of developing BN and/or associated psychopathology. [ABSTRACT FROM AUTHOR]

The original version of this article unfortunately contained a mistake in EAT-26 values under “Patients Receiving Treatment for an ED in their Sector” section. [ABSTRACT FROM AUTHOR]