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Abstract Background In eating disorders (EDs), treatment outcome measurement has traditionally focused on symptom reduction rather than functioning or quality of life (QoL). The Eating Disorders Quality of Life Scale (EDQLS) was recently developed to allow for measurement of broader outcomes. We examined responsiveness of the EDQLS in a longitudinal multi-site study. Methods The EDQLS and comparator generic QoL scales were collected in person at baseline, and 3 and 6 months from 130 participants (mean age 25.6 years; range 14-60) in 12 treatment programs in four Canadian provinces. Total score differences across the time points and responsiveness were examined using both anchor- and distribution-based methods. Results 98 (75%) and 85 (65%) responses were received at 3 and 6 months respectively. No statistically significant differences were found between the baseline sample and those lost to follow-up on any measured characteristic. Mean EDQLS total scores increased from 110 (SD = 24) to 124.5 (SD = 29) at 3 months and 129 (SD = 28) at 6 months, and the difference by time was tested using a general linear model (GLM) to account for repeated measurement (p < .001). Responsiveness was good overall (Cohen's d = .61 and .80), and confirmed using anchor methods across 5 levels of self-reported improvement in health status (p < .001). Effect sizes across time were moderate or large for for all age groups. Internal consistency (Chronbach's alpha=.96) held across measurement points and patterns of responsiveness held across subscales. EDQLS responsiveness exceeded that of the Quality of Life Inventory, the Short Form-12 (mental and physical subscales) and was similar to the 16-dimension quality of life scale. Conclusions The EDQLS is responsive to change in geographically diverse and clinically heterogeneous programs over a relatively short time period in adolescents and adults. It shows promise as an outcome measure for both research and clinical practice.

Abstract Background In eating disorders (EDs) treatment, outcome measurement has traditionally focused on symptom reduction rather than functioning or quality of life (QoL). Generic QoL measures lack sensitivity for some diagnoses and many not be responsive in eating disorder patients. This article describes the development and validation of a condition-specific QoL measure for adolescents and adults with eating disorders – the Eating Disorders Quality of Life Scale (EDQLS). Methods Multi-source and multi-stage methods were used to develop the EDQLS, with participation of patients with EDs, their family members and ED treatment providers. Sources for domain and item development included 39 articles, 12 patient and 10 treatment provider interviews, and 31 first person narratives from the internet. Four stages of validation and pre-testing involving 17 patients, 10 family members and 18 providers reduced 233 items to 40 items in 12 domains. These items were pilot tested in 41 ED patients. Results The final instrument was then validated in a 12 site sample of 171 individuals aged 14–60 with EDs. All items showed good dispersion. The total raw mean score was 110 out of 200 (SD 27.6) with higher scores indicating better QoL. Internal consistency was excellent (Cronbach's alpha = .96) and subscale internal consistency ranged from alpha .36 to .79 providing evidence for a strong overall construct and some multi-dimensionality. Validity was supported by significant differences in mean EDQLS according to severity levels on the EDI-2 (F = 95.3, p Conclusion The EDQLS has promising psychometric characteristics and may be useful for evaluating ED treatment effectiveness.

Examined the "still-face" paradigm in which mothers stared at their three- or six-month-old infants with a still face for brief periods interposed between two periods of normal face-to-face interaction. Six-month-old infants decreased smiling and gazing at their mothers and grimaced more during the still-face period than in other periods. (RJC)

The effectiveness of a web-based prevention program designed for elementary school teachers was examined in 78 elementary school teachers and 89 local public health practitioners (who provide support to schools). Participants were assigned to either the intervention (n = 95) or comparison (n = 72) study groups. All participants completed self-report online measures prior to, and following, the 60-day study period assessing knowledge about various factors that influence body image in children and efficacy to fight weight bias in the school. Information was also solicited on the feasibility of, and on the perceived benefit of the web-based program as a knowledge translation tool, in terms of layout and content. The Student Body program was found to be successful in improving knowledge concerning facts about dieting among the teacher participants, and in increasing efficacy to fight weight bias among the public health participants. Overall, the feedback was very positive concerning the layout and content of the Student Body. Participants reported an overall improvement in their awareness about how weight bias can be present in their teaching practices, and how this can trigger body image concerns among their students. Findings have implications for using the web to engage teachers in the prevention of disordered eating among school age children. [ABSTRACT FROM AUTHOR]

Even though we know that anorexia nervosa carries the highest mortality rate of all mental disorders, it is easy to distance ourselves from this fact. Cold hard statistics did not help me to understand what I was likely to experience as a therapist with a dying patient. Putting a face to these statistic,s; brings the grim reality closer to home for all of us. [ABSTRACT FROM AUTHOR]

There has been little attention paid to the motivation of adolescents entering treatment for an eating disorder. The present study investigates a questionnaire designed to assess readiness to change based on Prochaska and DiClemente's model. The Motivational Stages of Change for Adolescents Recovering from an Eating Disorder (MSCARED) was examined with 34 adolescent girls attending one of six eating disorder treatment groups. The assessment prior to, and at the termination of the groups, included the MSCARED; Children's Depression Inventory (CDI); Perceived Body Image Scale (PBIS); Eating Disorders Inventory (EDI-2—pre-only); and, the Group Evaluation Form (post-only). The MSCARED proved to be easy for youth to complete, reliable, and demonstrated concurrent and predictive validity. While the group was beneficial to girls at each stage of change, greater gains were reported by those who started at a more advanced stage. The clinical and research implications of measuring motivation to change are discussed. Copyright © 2002 John Wiley & Sons, Ltd and Eating Disorders Association. [ABSTRACT FROM AUTHOR]

Chronicles therapists' experience with the practice of treating adolescent girls afflicted with eating disorders. Use of imagery, analogies and metaphors as tools; Recovery Mountain analogy; Stages of change.

We surveyed the opinions and satisfaction levels of 69 adolescents hospitalized at the Izaak Walton Killam Children's Hospital using a computerized questionnaire. Participation rate using the computer format was high (97%). The adolescents reported that privacy, visitation, mobility, independence, and education are all important needs during a hospital stay. Although 90% reported overall satisfaction with their hospital experience, 91% of the adolescents also made reasonable suggestions for improvement. Those with chronic conditions made more suggestions for change than those with acute conditions. Older adolescents cited more disadvantages of hospitalization than younger ones, and girls reported more advantages than did boys. The benefits of asking adolescents how they would improve specific aspects of their care are discussed. [ABSTRACT FROM AUTHOR]

Objective: To explore and describe philosophies and characteristics of intensive eating disorder (ED) treatment programs based in tertiary care institutions across Canada. Method: A ninety-item survey examining ED services for adolescents was developed, piloted, and completed by 11 programs across Canada. Information pertaining to program characteristics and components, governance, staffing, referrals, assessments, therapeutic modalities in place, nutritional practices, and treatment protocols were collected. Results: The results highlight the diversity of programming available but also the lack of a unified approach to intensive eating disorder treatment in youth. Conclusions: This report provides important baseline data that offers a framework that programs can use to come together to establish assessment and treatment protocols as well as a process for outcome evaluation. Continued collaboration will be essential moving forward to ensure Canadian youth, regardless of geographic location, receive the necessary treatment required to attain and sustain recovery. [ABSTRACT FROM AUTHOR]

This study of a Cognitive Behavior Therapy group examined the process of self-monitoring by adolescent females with eating disorders in group treatment. Five females, aged 17-18 with Anorexia Nervosa (n = 2) and Bulimia Nervosa (n = 3), participated in an 8-week treatment group. Self-monitoring occurred on 50% of the days and was highest during the first 3 weeks of treatment. Commitment to monitoring was related to the girls' self-reported readiness to change. Girls with Anorexia self-monitored as frequently as those with Bulimia. The clinical usefulness of self-monitoring with adolescents is discussed.