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Your Adolescent's Eating Habits: From Soup to Nuts

1/20/2019

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Heather Corazzini, MA
Psychology Intern
Copernican Clinical Services

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"There isn’t one single reason eating disorders begin or are maintained"

"For some kids certain food textures make them feel like someone is dragging their nails across a blackboard"

“perfectionistic language” is a common trait shared
between parents and adolescents with disordered eating

Does your adolescent’s eating behavior, weight, or exercise ever appear abnormal to you? Do they seem preoccupied with their physical appearance? Have you considered asking them about it, but weren’t sure how to approach them? Not all eating patterns or behaviors would constitute an eating disorder diagnosis; however, disordered eating patterns and behaviors are real, require careful consideration, and can have serious health implications.

Trust Your Intuition:
Eating disorders are often disguised in ways that minimize their significance. At times they can be difficult to assess and are often overlooked by adults. If your intuition as a parent tells you something might be “off,” with your child’s eating, listen to it, and consult a professional for guidance. It’s okay to be unsure about what you have noticed.  Speaking with a mental health professional who has experience in this area can help you develop language that will allow you to express your intuitions to your child in a clear and supportive way.

Eating Disorders can be Deadly:
The prevalence of adolescent eating disorders has gained significant attention in the mental health field over the last decade. Some researchers have claimed anorexia nervosa has the highest mortality rate of all psychological disorders (NEDA, 2018).

See: https://www.nationaleatingdisorders.org
for more information.

How does it Start?
Many parents ask, “How did this start? Why and when did my child become so obsessed with what they’re eating?”

Studies offer arguments for why and how eating disorders are developed and maintained. In 2016, a team of researchers examined risk factors they believed to predict onset of eating disorders in adolescent females.  According to their study, adolescent females were most at risk to develop eating disorders if they dieted, idealized thinness, had body dissatisfaction, and displayed unhealthy weight control behaviors (Stice et al., 2016).

Despite research supporting specific reasons for ED development and maintenance, it can be argued such reasons are multifactorial;there isn’t one single reason eating disorders begin or are maintained. Eating disorders may also function as a form of self-punishment, manifestation of anxiety, or addiction—with little to no emphasis on weight loss as a central goal.

Sensory Integration Issues:
Not all eating disorders develop from preoccupation with fear of weight gain. Aversion to texture, fear of choking, fear of swallowing, etc., can also develop into ED (see Avoidant Restrictive Food Intake Disorder, DSM-5 criteria that are listed below).
·       An eating or feeding disturbance (e.g., apparent lack of interest in eating or food; avoidance based on the sensory characteristics of food; concern about aversive consequences of eating) as manifested by persistent failure to meet appropriate nutritional and/or energy needs associated with one (or more) of the following:

Significant weight loss (or failure to achieve expected weight gain or faltering growth in children).
Significant nutritional deficiency.
Dependence on enteral feeding or oral nutritional supplements.
Marked interference with psychosocial functioning.

See:
https://www.nationaleatingdisorders.org/learn/by-eating-disorder/arfid

Many children who struggle with sensory integration disorders have difficulties with their eating, due to their reactivity to strong odors/tastes and certain textures of food. Their eating issues can often be compounded by the presence of muscular weaknesses in their mouth, tongue, and throat that impair their ability to swallow food.

One researcher stated…
“Often when kids display picky eating, especially those with food aversions/extreme picky eating, the touch, taste, or smell of a food is being processed in their brain as dis-pleasurable in some way. And, by dis-pleasurable, I mean down-right uncomfortable. Think of something that makes you shutter… nails on chalkboard or touching a slug?” (Grogan, 2018)

See: https://yourkidstable.com/sensory-processing-and-picky-eating/

What about Boys?
According to the National Eating Disorders Association (NEDA), approximately 0.3 – 0.4% of young women and 0.1% of young men will suffer from anorexia nervosa. Despite the common assumption eating disorders are exclusive to women, NEDA claims 25% of individuals with anorexia nervosa are male. Additionally, NEDA claims disordered eating behaviors (binge-eating, purging, laxative abuse, fasting) are nearly equal across male/female genders. For example, many boys who wrestle in high school manage their calories and exercise level so they can “cut weight” before a wrestling match. Additionally, dehydration can cause poorer performance in these athletes and places them at risk for more serious health concerns.

See: http://pediatrics.aappublications.org/content/140/3/e20171871

Regardless of the severity of source of the ED, the way you communicate about this with your child matters!

Researchers in 2011 conducted a study addressing the relationship between adolescent disordered eating and parent-child communication dynamics. The researchers concluded individuals’ thoughts of defectiveness, failure, and unrelenting standards from their parents contributed to their eating disorder. Findings suggest “perfectionistic language” is a common trait shared between parents and adolescents with disordered eating (Deas et al., 2011). “Perfectionistic language,” looks different within each family.

Do NOT:

Make critical comments about your child’s physical appearance.
Encourage your child to “watch their weight,” or warn them of gaining weight.
Praise your child for appearing as if they lost weight.

Make negative comments about your own appearance/weight in front of your child.

Parents are encouraged to alter their communication style in ways that may discourage the onset or maintenance of an eating disorder.

Do try to:

Praise your child based upon their achievements to enhance their self-esteem
Encourage healthy eating without rigidity; everything in moderation!
Work hard to make your child feel their weight/physical appearance is not everything. Instead, try to focus on their uniqueness in ways that will strengthen their mental health.
Consult with professionals about rising concerns, so you can feel equipped with positive and effective language to use with your child

Try not to forget:
It is your child, so it’s up to you.-Notice, listen, and speak up.

References:
Deas, S., Power, K., Collin, P., Yellowlees, A., & Grierson, D. (2011). The relationship between disordered eating, perceived parenting, and perfectionistic schemas. Cognitive Therapy And Research, 35(5), 414-424.

Stice, E., Gau, J. M., Rohde, P., & Shaw, H. (2017). Risk factors that predict future onset of each DSM-5 eating disorder: Predictive specificity in high-risk adolescent females. Journal Of Abnormal Psychology, 126(1), 38–51.

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Anger Research: Staff at the Yale Child Study Center Provide a Helpful Summary Article

1/19/2019

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David A. Perna, PhD
Licensed Psychologist
Lecturer in Psychiatry
Harvard Medical School

Categories

"Anger Follows a Developmental
Trajectory"

"We use the CBT framework for our anger
management
groups "

Dr. Perna

Staff at the Yale Child Study Center have provided a helpful summary Article on how to differentiate between anger, irritability, and aggression. I think that it is one of the better summary articles that I have come across in the last year. While it covers a variety of topics that have been discussed in the past, it does so with a sense of clarity that fellow authors seem to lack.

Here are a list of the points that I think were helpful:

Anger follows a Developmental Trajectory
Oppositional Defiant Disorder has three symptoms:
- Angry/irritable mood
- Argumentativeness/defiant behavior
- Vindictiveness
ODD has two primary trajectories, one that predicts future mood lability and one that predicts conduct disorder.
Parent Management Training (PMT): Focuses on the antecedents to aggression as well as the consequences. The goal is to break the link between the two by focusing on the parent impact on the child.
Cognitive Behavioral Therapy (CBT) : Focuses on the interaction between cognitions, feelings, and behaviors.

Sukhodolsky offers his version of treatment which has proven to be clinically effective in a research environment. It is a sophisticated treatment model that is thoughtful and has withstood randomized treatment trials. However, like many of these manual-based, highly structured research protocols one can easily ask, "What is the clinical relevance of this research, when one applies it to a typical outpatient treatment environment?"

I do think that reading this type of research can be helpful in guiding clinicians to adopt "best practices" that help with anger management treatment. However, out-patient treatment of anger is complicated and at times sequentially confusing for both the patient and the inexperienced clinician.

I do find it surprising that Sukhodolsky comments that CBT is generally implemented on a one-on-one basis. He seems to miss the fact that many models of anger management are based on group models that rely on CBT frameworks. We use the CBT framework for our anger management groups.

Overall I give the article two thumbs up. Kudos to the staff at Yale!

Dr. Perna

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Your Adolescent's Eating Habits: From Soup to Nuts

Heather Corazzini, MA
Psychology Intern
Copernican Clinical Services

Categories

Anger Research: Staff at the Yale Child Study Center Provide a Helpful Summary Article

David A. Perna, PhD
Licensed Psychologist
Lecturer in Psychiatry
Harvard Medical School

Categories

COPERNICAN CLINICAL SERVICES

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Your Adolescent's Eating Habits: From Soup to Nuts

Heather Corazzini, MAPsychology InternCopernican Clinical Services

Categories

Anger Research: Staff at the Yale Child Study Center Provide a Helpful Summary Article

David A. Perna, PhDLicensed PsychologistLecturer in PsychiatryHarvard Medical School

Categories

COPERNICAN CLINICAL SERVICES​Welcome To Our Posts

Archives

Categories

Copernican Clinical Services:"We Help People Change"

Reach Out To Us At:Ph: 617-244-2700Fx: 617-244-2774E-mail: admin.help@copernican.solutions

Heather Corazzini, MA
Psychology Intern
Copernican Clinical Services

David A. Perna, PhD
Licensed Psychologist
Lecturer in Psychiatry
Harvard Medical School

COPERNICAN CLINICAL SERVICES

Welcome To Our Posts

Copernican Clinical Services:
"We Help People Change"

Reach Out To Us At:
Ph: 617-244-2700
Fx: 617-244-2774
E-mail: admin.help@copernican.solutions