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Resistance to treatment in eating disorders: a critical challenge.

Fassino S, Abbate-Daga G - BMC Psychiatry (2013)

Bottom Line: The Special Issue "Treatment resistance in Eating Disorders" gathers together the contributions provided by several experienced groups of researchers in the field of Eating Disorders (EDs).The main topic is addressed from multiple perspectives ranging from pathogenesis (including developmental and maintaining factors) to treatment.An explicative model of resistance in EDs is also proposed.

View Article: PubMed Central - HTML - PubMed

Affiliation: Eating Disorders Center for Treatment and Research, Department of Neuroscience, University of Turin, Via Cherasco 15, Turin 10126, Italy. secondo.fassino@unito.it.

ABSTRACT
The Special Issue "Treatment resistance in Eating Disorders" gathers together the contributions provided by several experienced groups of researchers in the field of Eating Disorders (EDs). The main topic is addressed from multiple perspectives ranging from pathogenesis (including developmental and maintaining factors) to treatment. An explicative model of resistance in EDs is also proposed.

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Related in: MedlinePlus

The vicious cycle of treatment resistance in eating disorders.
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Figure 1: The vicious cycle of treatment resistance in eating disorders.

Mentions: Figure 1 illustrates the EDs as developmental disorders and the vicious cycle that is elicited and maintained by the “ED identity”, potentially a crucial issue in generating resistance. Disorientation and distress that characterize patients since childhood and that are then triggered during adolescence have been graphically emphasized. The biopsychosocial factors that interfere with a mature development of the Self and those aspects that hamper an adaptive personality development are also highlighted. This approach suggests a distinction between mere eating symptomatology (as conceptualized by the Diagnostic and Statistical Manual criteria) and the profound nature and meaning of these disorders. In line with this approach, the ED symptomatology can be severe and overwhelming but the triggering core of the disorder could be represented instead by a primary and multifaceted deficit of personality development. During adolescence, such a deficit could be involved in generating eating symptomatology as both signal of suffering and harmful attempt to self-cure. The process/vicious cycle is graphically represented as reinforced by contaminant emotions [15]: conscious and unconscious meanings, family dynamics, starvation, countertransference and therapist’s reactions, anger, and aggressiveness; all these factors can lead to a chronic course of the disorder.


Resistance to treatment in eating disorders: a critical challenge.

Fassino S, Abbate-Daga G - BMC Psychiatry (2013)

The vicious cycle of treatment resistance in eating disorders.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4225668&req=5

Figure 1: The vicious cycle of treatment resistance in eating disorders.
Mentions: Figure 1 illustrates the EDs as developmental disorders and the vicious cycle that is elicited and maintained by the “ED identity”, potentially a crucial issue in generating resistance. Disorientation and distress that characterize patients since childhood and that are then triggered during adolescence have been graphically emphasized. The biopsychosocial factors that interfere with a mature development of the Self and those aspects that hamper an adaptive personality development are also highlighted. This approach suggests a distinction between mere eating symptomatology (as conceptualized by the Diagnostic and Statistical Manual criteria) and the profound nature and meaning of these disorders. In line with this approach, the ED symptomatology can be severe and overwhelming but the triggering core of the disorder could be represented instead by a primary and multifaceted deficit of personality development. During adolescence, such a deficit could be involved in generating eating symptomatology as both signal of suffering and harmful attempt to self-cure. The process/vicious cycle is graphically represented as reinforced by contaminant emotions [15]: conscious and unconscious meanings, family dynamics, starvation, countertransference and therapist’s reactions, anger, and aggressiveness; all these factors can lead to a chronic course of the disorder.

Bottom Line: The Special Issue "Treatment resistance in Eating Disorders" gathers together the contributions provided by several experienced groups of researchers in the field of Eating Disorders (EDs).The main topic is addressed from multiple perspectives ranging from pathogenesis (including developmental and maintaining factors) to treatment.An explicative model of resistance in EDs is also proposed.

View Article: PubMed Central - HTML - PubMed

Affiliation: Eating Disorders Center for Treatment and Research, Department of Neuroscience, University of Turin, Via Cherasco 15, Turin 10126, Italy. secondo.fassino@unito.it.

ABSTRACT
The Special Issue "Treatment resistance in Eating Disorders" gathers together the contributions provided by several experienced groups of researchers in the field of Eating Disorders (EDs). The main topic is addressed from multiple perspectives ranging from pathogenesis (including developmental and maintaining factors) to treatment. An explicative model of resistance in EDs is also proposed.

Show MeSH
Related in: MedlinePlus