El Objetivo de esta investigación fue evaluar la eficacia de dos tipos de intervenciones—Terapia Familiar Sistèmica (TFS) y Grupo de apoyo apadres + terapia de grupo (GAP + TG)—enfunción de los cambiosproducidos en los perfiles de personalidad del MMPI de pacientes ambulatorios con trastorno alimentario (TA) al año del inicio de la intervención. 46 sujetos con TA, 8 con anorexia restrictiva (ANR), 15 con anorexia bulímica (ANB) y 23 con bulimia nerviosa (BN) {de acuerdo a los criterios del Diagnostic and Statistical Manual of Mental Disorders, 4a edición (American Psychiatric Association, 1994)} fueron distribuidas al azar en uno de los dos grupos de tratamientoy fueron evaluadas a través del MMPI, al comienzo y final de la intervención. Ambos tratamientos muestran disminuciones significativas en las puntuaciones del MMPI en el postratamiento, aunque estas intervenciones breves no fueron suficientes para normalizar todas las escalas. La TFS consiguió mayores disminuciones significativas con respecto al GAP + TG en algunas escalas, especialmente en pacientes con bulimia nerviosa (BN). Los resultados apoyan la eficacia de este tipo de intervenciones en la mejora de los perfiles de personalidad de las pacientes con TA.
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References
1.
AgrassW. S.SchneiderJ. A.ArnowB.RaeburnS. D.TelchC. F. (1989). Cognitive behavioural and response prevention treatment for bulimia nervosa.Journal of Consulting and Clinical Psychology, 57, 215–221.
2.
AMERICAN PSYCHIATRIC ASSOCIATION (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, D.C.: Author.
3.
AMERICAN PSYCHIATRIC ASSOCIATION. (2000). Practice guideline for the treatment of patients with eating disorders (revision).American Journal of Psychiatry, 157 (1), 1–39.
4.
AtwoodN. (1983). Parent' support group for schizophrenia. EnMcFarlane (Ed.), Family Therapy in schizophrenia (pp. 157–169). Nueva York: The Guilford Press.
5.
ChinchillaA. (1995). Guía teórico-práctica de los trastornos de conducta alimentaria: anorexia nerviosa y bulimia nerviosa. Madrid: Masson.
6.
ColahanM. (1995). Being a therapist in eating disorder treatment trials: constraints and creativity.Journal of family Therapy, 17, 79–96.
7.
CrispA. H.NortonK.GowersS.HalekC.BowyerC.YeldamD.LevettG.BhatA. (1991). A controlled study of the effect of therapies aimed at adolescent and family psychopatology in anorexia nervosa.British Journal of Psychiatry, 159, 325–333.
8.
CrispA. H.HsuL. K.StonehillE. (1979). Personality, body weight and ultimate outcome in anorexia nervosa.Journal of Clinical Psychiatry, 40 (8), 332–335.
9.
DareC.EislerI. (1995). Family therapy. EnSzmuklerG.DareC.TreausureJ. (Eds.), Handbook of Eating Disorders: Theory, Treatment and Research (pp. 225–246). Nueva York: John Wiley & sons Ltd.
10.
DareC.EislerI.ColahanM.CrowtherC.SeniorR.AsenE. (1995). The listening heart and the chi square: clinical and empirical perceptions in the family therapy of anorexia nervosa.Journal of Family therapy, 17, 31–57.
11.
DareC.EislerI.RussellG. F. M.SzmuklerG. (1990). The clinical and theoretical impact of a controlled trial of family therapy in anorexia nervosa.Journal of Marital and Family Therapy, 16 (1), 39–57.
12.
DodgeE.HodesM.EislerI.DareC. (1995). Family therapy for bulimia nervosa in adolescents: an exploratory study.Journal of Family Therapy, 17, 59–77.
13.
EhleG. (1992). Experiences with “planned” dynamic group psychotherapy of patients with anorexia nervosa.Group analysis, 25, 43–53.
14.
EislerI.DareC.RussellG. F. M.SzmuklerG.Le GrangeD.DodgeE. (1997). Family and individual therapy in anorexia nervosa.Archives of General Psychiatry, 54, 1025–1030.
15.
EliotA. O. (1990). Group coleadership. A new role for parents of adolescents with anorexia and bulimia nervosa.International Journal of Group Psychotherapy, 40 (3), 339–351.
16.
EspinaA. (1996). Terapia familiar sistèmica en la anorexia nerviosa. EnEspinaA.PumarB. (Eds), Terapia Familiar Sistèmica. Teoría, Clínica e Investigación (pp. 153–184). Madrid: Fundamentos.
17.
EspinaA. (1997). Evaluación y proceso terapéutico en un caso de anorexia nerviosa.Systémica, 3, 67–98.
18.
EspinaA.OrtegoA. (1998). Grupo de apoyo a familiares en los trastornos alimentarios.Cuadernos de terapia familiar, 37, 39–49.
19.
EspinaA.OrtegoA.Ochoa De AldaI. (2000). Un ensayo controlado de intervenciones familiares en trastornos alimentarios.Anales de Psiquiatría, 16 (8), 322–336.
20.
EspinaA.OrtegoA.Ochoa De AldaI. (2001). Un ensayo controlado de intervenciones familiares en los trastornos alimentarios. Cambios en alexitimia.Anales de Psiquiatría, 17 (2), 64–72.
21.
EspinaA.OrtegoA.Ochoa De AldaI.AlemánA. (2001). Intervenciones familiares e imagen corporal en los trastornos alimentarios.Cuadernos de Medicina Psicosomatica y Psiquiatría de Enlace, 58/59, 29–40.
22.
Fernández-arandaF.BelM.JiménezA.ViñualesM.TurónJ.VallejoJ. (1998). Outpatient group therapy for anorexia nervosa. A preliminary study.Eating Weight Disorders, 3, 1–6.
23.
FischR.WeaklandJ. H.SegalL. (1982). The tactics of change.San Francisco: Jossey-Bass Publishers.
24.
FreemanC. P.BarryF.Dunkeld-TurnbullJ.HendersonA. (1988). A controlled trial of psychotherapy for bulimia nervosa.British Medical Journal, 296, 521–525.
25.
FreemanM. S.AmesJ. R.Dunkfeld-TurnbullJ.HendersonA. (1988). Controlled trials of psychotherapy for bulimia nervosa.British Medical Journal, 296, 521–525.
26.
HaleyJ. (1980). Leaving Home. Nueva York. McGraw-Hill.
27.
Harper-GiuffreH.MackenzieK. R. (1992). Group psychotherapy for eating disorders.Washington, D.C.: American Psychiatric Press.
28.
HathawayS. R.MckinleyJ. C. (1967). The Minnesota Multiphasic Personality Manual revised.Nueva York: The Psychological corporation.
29.
JohnsonJ. (1990). Why group therapy for bulimia?International Group Psychotherapy, 40, (2), 169–187.
30.
KennedyS. H.KatzR.RockertW.MendlowitzS.RalevskyE.ClevesJ. (1995). Assessment of personality in anorexia nervosa and bulimia nervosa: a comparison of self-report and structured interview methods.Journal of Nervous and Mental Disease, 183, 358–364.
31.
KeysA.BrozekJ.HenschelA.MickelsenO.TaylorH. L. (1950). The biology of human starvation.Minneapolis: University of Minnesota Press.
32.
LaceyJ. H. (1983). Bulimia nervosa, binge eating and psychogenic vomiting: a controlled treatment study and log-term out come.British Medical Journal, 2, 1609–1613.
33.
LaessleR. G.BeaumontP. J. V.ButowP.LennertsW.O'connorM.PirkeK. M.TouyzS. W.WaadtS. (1991). A comparison of nutritional management with stress management in the treatment of bulimia nervosa.British Journal of Psychiatry, 159, 250–261.
34.
Le GrangeD.EislerI.DareC.RussellG. (1992). Evaluation of family treatments in adolescent anorexia nervosa: a pilot study.International Journal of Eating Disorders, 12, 347–357.
35.
MadanesC. (1981). Strategic Family Therapy.San Francisco: Jossey Bass.
36.
MalanD. H. (1976). Toward the validation of dynamic psychotherapy.Nueva York: Plenum.
37.
MarnerT.WesternbergC. (1987). Concomitant group therapy with anorectics and their parents as a supplement to family therapy.Journal of Family Therapy, 9, 255–263.
38.
MatsunagaH.KiriikeNNagataT.YamagamisS. (1998). Personality disorders in patients with eating disorders in Japan.International Journal of Eating Disorders, 23, 399–408.
39.
McintoshV. V.BulikC. M.MckenzieJ. M.LutyS. E.JordanJ. (2000). Interpersonal psychotherapy for anorexia nervosa.International Journal of Eating Disorders, 27, 125–139.
40.
MckisackC.WallerG. (1997). Factors influencing the outcome of group psychotherapy for bulimia.International Journal of Eating Disorders, 22, 1–13.
41.
MinuchinS. (1974). Familias y terapia familiar.Buenos Aires: Gedisa.
42.
MinuchinS.RosmanB. L.BakerL. (1978). Psychosomatic Families: Anorexia Nervosa in Contexte.Londres: Harvard University Press.
43.
OsterheldJ. R.MckennaM. S.GouldN. B. (1987). Group psychotherapy of bulimia: a critical review.International Journal of Group Psychotherapy, 37, 163–184.
44.
RogebergK. (1990). Eating disorders and the family experiences gathered in a parent support group.Acta Psychiatrica Scandinavica, Suppl.361 (82), 50–51.
45.
RosenvingeJ. H. (1990). Group therapy for anorexic and bulimic patients. Some aspects on the conduction of group therapy and a critical review of some recent studies.Acta Psychiatrica Scandinavica, Suppl.361 (82), 38–43.
46.
RussellG. F. M.DareC.EislerI.Le GrangeP. D. F. (1993). Controlled trials of family interventions in anorexia nervosa. EnHalmiA. H. (Ed.), Psychobiology and treatment of anorexia nervosa and bulimia nervosa (pp. 332–357). Washington: American Psychopathological Association Series.
47.
RussellG. F. M.SzmuklerG. I.DareC.EislerI. (1987). An evaluation of family therapy in anorexia nervosa and bulimia nervosa.Archives of General Psychiatry, 44, 1047–1056.
48.
RussellG. F. M.SzmuklerG. I.DareC.EislerI. (1987). An evaluation of family therapy in anorexia nervosa and bulimia nervosa.Archives of General Psychiatry, 44, 1047–1056.
49.
SkoogD. K.AndersenA. E.LauferW. S. (1984). Personality and treatment effectiveness in anorexia nervosa.Journal of Clinical Psychology, 40, 955–961.
50.
SluzkiC. (1983). Process, structure and world views: an integrated view of systemic models in family therapy.Family Process, 22, 469–476.
51.
SohlbergS.StroberM. (1994). Personality in anorexia nervosa: an update and a theoretical integration.Acta Psychiatrica Scandinavica, 378 (supl.), 1–15.
52.
SzmuklerG. I.EislerI.RussellG. F. M.DareC. (1985). Anorexia nervosa, parental “Expressed Emotion” and dropping out of treatment.British Journal of Psychiatry, 147, 265–271.
53.
SzmuklerG. I.DareC. (1991). The Maudsley Hospital study of family therapy in anorexia nervosa and bulimia nervosa. EnWoodsideD. B.Shekter-WolfsonL. (Eds.), Family approaches to eating disorders (pp. 157–171). Washington D.C. American Psychiatric Press.
54.
VandereyckenW. (1987). The constructive family approach to eating disorders: critical remarks on the use of family therapy in anorexia nervosa and bulimia.International Journal of Eating Disorders, 6, 4, 455–467.
55.
VandereyckenW.CastroJ.VanderlindenJ. (1991). Anorexia y bulimia. La familia en su génesis y tratamiento.Barcelona: Martinez Roca.
56.
VandereyckenW.KogE.VanderlindenJ. (1989). The family approach to eating disorders.Nueva York: PMA Publishing Corp.
57.
VanderlindenJ.VandereyckenW. (1988). Perception of changes in eating disorder patients during group treatment.Psychotherapy psychosomatic, 49, 160–163.
58.
VitousekK.MankeF. (1994). Personality variables and disorders in anorexia nervosa an bulimia nervosa.Journal of Abnormal Psychology, 103 (1), 137–147.
59.
WhiteM. (1983). Anorexia nervosa: a transgenerational system perspective.Family Process, 22 (3), 255–273.
60.
WhiteM. (1986). Anorexia nervosa. A cybernetic perspective. EnElka-HarkawayJ. (Ed.), Eating Disorders and Family Therapy (pp. 56–65). Nueva York: Aspen.
61.
WilsonG. T. (1998). The clinical utility of randomised controlled trials.International Journal of Eating Disorders, 24, 13–29.
62.
WonderlichS. A. (1995). Personality and eating disorders. EnBrownellK. D.FairburnC. G. (Eds.), Eating disorders and obesity (171–176). Nueva York: The Guilford Press.
63.
YagerJ. (1994). Psychosocial treatments for eating disorders.Psychiatry, 57, 153–164.
