Binge Eating Disorder in the DSM-V

I’ve just been to the DSM-5 website.  Here is their stated rationale for including BED as a diagnosis in the latest version of the Diagnostics and Statistics Manual, which is the manual used for categorizing patients:

Rationale

Binge Eating Disorder is one of the disorders in the DSM-IV appendix. It is recommended that it be formally included as a disorder in DSM-5.

The rationale for recommending inclusion of binge eating disorder (BED) in DSM-5 is based on a comprehensive literature review (Wonderlich, Gordon, Mitchell, Crosby, & Engel, 2009). Below we address several key recommendations offered by Kendler et al. as they apply to BED.

Consistent with Kendler et al’s recommendation for making decisions about diagnoses in the Appendix, the Eating Disorders Work Group addressed the question, “Should the BED diagnosis should be a) deleted from the appendix, b) promoted to the main manual, or c) retained in the appendix.

 

Synopsis of the Review of Validators.

The following comments are organized according to the structure of the table of validators provided by Kendler et al. (2009) and based on a literature review (Wonderlich et al., 2009). BED has been compared to both other eating disorders (i.e., anorexia nervosa, bulimia nervosa) and obesity in validational studies. Overall, BED distinguishes itself from other eating disorders and obesity across a wide range of validators, including high priority validators.

In terms of antecedent validators, there is evidence from family history studies that BED tends to run in families and is not a simple familial variation of obesity. Furthermore, in comparison to other eating disorders, BED shows a relatively distinct demographic profile with a greater likelihood of male cases, older age, and a later age of onset.

Regarding studies of concurrent validators, BED is also differentiated from obesity in terms of greater concerns about shape and weight, more personality disturbance, and a higher likelihood of psychiatric comorbidity in the form of mood disorders and anxiety disorders. Also, BED is associated with lower quality of life than obesity.

Finally, in terms of predictive validators, BED may be differentiated from other eating disorders in terms of its lower level of diagnostic stability and greater likelihood of remission.  In clinical course, BED also shows a greater likelihood of medical morbidities (e.g., self-reported weight gain and metabolic syndrome indicators) than is typically seen in other eating disorders, or in obesity. Finally, in studies of treatment response, there is evidence that individuals with BED have a more positive response to specialty treatments than to generic behavioral weight loss treatments in terms of reduction of eating disorder psychopathology.  These findings suggest some evidence of clinical utility of the BED diagnosis in terms of treatment selection; for example, antidepressant medication is useful in the treatment of BED, but is not generally useful in the treatment of obesity.

 

Comments on the book, “Skinny Bitch” on Amazon – Check out this link

I found the following comments on the book, Skinny Bitch on Amazon.  I do not plan to support these authors by buying their book!  I would like to see a copy to see if I can add to the discussion somehow, but not by making a purchase of any kind.  But would I, skinny bitch, dare be seen checking this book out of the library?  (More anorexic paranoia, I suppose.)

Here’s the link:

http://www.amazon.com/review/R2LVT0WBBC3RU3/ref=cm_cr_dp_cmt?ie=UTF8&ASIN=0762424931&nodeID=283155&tag=&linkCode=#wasThisHelpful

About Chipmunkapublishing (my publisher)

Chipmunkapublishing is the Mental Health Publisher.  Their mental health books give a voice to writers with mental illness around the world. Most of their mental health books are written by people with mental health issues. They also give a voice to family members of people with mental health issues and other disabilities. Titles include autobiographies/memoirs, fiction, poetry, anthologies, stories written by carers, self help books, academic works and much more.

Chipmunkapublishers is a unique social enterprise focused on publishing both factual and creative literature. They  want to reduce the humiliation that people with “mental illness” feel. Chipmunkapublishers gives people with mental illness a voice so that they can have the opportunity and positive mindset to lead better lives and hopefully full recoveries. Do not let your children grow up not understanding people with mental health issues. Let’s improve society so that mental health artists can empower people with mental health issues and be equal in society. Then they can shape their future and help others.

Chipmunkapublishers works with the government, health services, the media, mental health organisations, charities and private businesses to successfully publish and promote literature that brings a positive attitude towards mental health issues. Chipmunkapublishing aims to break down the stigma on mental illness once and for all.

Chipmunkapublishing gratefully acknowledges the support of Arts Council England.

Chipmunkapublishing is creating a new genre of literature to empower the service user and break down the last taboo.

Adding value to people with mental illness helps economies. Enabling them to empower themselves saves lives. That means that by logging on now and purchasing their books or donating, you may have just been able to save a life. Support the humanitarian rights of the “mentally ill” and you will save the lives of people today and even future generations.

–from www.chipmunka.com

You can access my book, This Hunger Is Secret: My Journeys Through Mental Illness and Wellness at Chipmunka’s website here.

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The IRobot Roomba 510 vacuum cleaner–my review

I had to replace my vacuum cleaner and this one was on sale for less than a human-powered vacuum, so I went for it!  Ever since then, vacuuming has been a snap, and I’ve been super fussy about my floor!  Here’s are the details:

I have hardwood parquet floors that aren’t perfectly smooth, and they’re very, very difficult to get perfectly clean, so I wasn’t too confident that any vacuum would do a decent job.  My OLD vacuum’s rug attachment had long since died, and of course I no longer needed it, not having carpets anymore anyway.  I relied on crummy attachments, and I mean crummy!  The larger one was a brush-type.  Now, brush-type attachments do nothing but push the dirt around instead of pulling the dirt into the vacuum.  The other, more effective attachments were so tiny that vacuuming with them was just plain fruitless, that plus they didn’t rotate.  No way could I get under the futon couch, so I just ignored this area.  So this was why I had to replace my old vacuum cleaner.

So, I bought the IRobot.  I read reviews carefully.  Would a lower-end model, with fewer features work as well as a higher-end model?  Apparently so.  No way did I need luxury features in my tiny, tiny apartment.  The 510 was definitely the appropriate model for me, and it was the one on sale.  I purchased it from Newegg.  I’m certain you can’t get it from them on sale anymore, but probably it’s cheaper from them than from many other websites.  Shop around.

The IRobot works on rechargeable battery.  It will do three rooms on one charge.  I mean three bedroom-sized rooms, or dining rooms, not large rooms, from what I can tell.  I believe this is true of all models.  It supposedly takes an average of 25 minutes to do a room, depending on many factors.  I find that this really, really varies.  Today it took about 20 minutes to do my bedroom, but usually it’s about 35, even when the room is already rather clean.  Once, it took about 50 minutes to do my living room, again when it was already not very dirty.  Today it took about 40.  Of course, the IRobot is very, very fussy and does a thorough job.  More about this in a minute.

There are two cleaning modes: spot clean and regular clean.  During regular clean, the IRobot will criss-cross the room, going in what appears to be random lines, turning when it hits something, though sometimes it turns mid-room.  Sometimes, it will follow along a wall and try to get into the nooks and crannies of the corners.  It does a fair job of getting into corners.  I notice it sometimes misses certain out-0f-the-way corners that I would say are not all that reachable–by me, either, and not easily visible, but still, the fact that the IRobot misses any corners is annoying.

During spot clean, the IRobot is supposed to circle a three-foot circumference area, around and around. inside and out, until clean, and then stop.  I find that first of all, it’s more like a four-foot area, and secondly, it frequently doesn’t get the area totally clean, and stops prematurely.  I’m guessing that rather than gauging the cleanliness of an area, it’s on a timer.

Regarding the effectiveness of this machine–well, extremely.  Better than a human-powered machine, that’s for sure.  Wicked good.  Spectacular.  Tech support told me to empty the bin after each room the first room I use it on because it’s going to pick up so much stuff.  Yeah, I was amazed at what my old vacuum had missed–that plus my old vacuum was so freaking annoying that I rarely used it, and hadn’t vacuumed–okay, I admit–for about a month.  Giggle giggle.  Actually, the IRobot got the floor perfectly clean the first time it vacuumed my filthy floor.  I didn’t have to run it a second time even though my floor was a disgrace from the start.  Hey, no more wiping my feet off before putting my socks on.  Those days are gone.

Once, I had a terrible spill–I spilled baking powder in my kitchen, and swept it up with a broom, then tried to get the IRobot to clean the rest.  No way did it pick up any of it.  Why this was I don’t know.  But this was highly unusual of this machine, and it was the only time this happened.

IRobot will not do a tiny room.  I found this out.  I have what might be called a half-kitchen.  It’s like the size of a large closet.  Don’t bother.  I sweep it thoroughly and then mop on my hands and knees it with an old towel.  It’s quicker and more thorough than trying to use the spot clean feature over and over on the kitchen floor.  Actually, the IRobot cleans so deeply that it will pick up coffee stains!  But a wet towel will do this as well.  And quicker.

Another thing I learned was to sweep and mop under my main desk before doing anything else.  My desk is in the living room, and it always gets filthy under there.  This necessary cleaning has nothing to do with the IRobot’s capacities, but the fact that if I don’t do this job, I will track the under-desk dirt into my clean bedroom after the machine is done with it, and dirty the room.

Proper battery care is crucial.  Keep it on its charger when you’re not using it, and use the vacuum frequently.  That is, don’t be lazy like I used to be with my old vacuum.  You won’t want to be lazy anymore.  You’re going to love your new floor and want to keep it wicked squeaky clean.

Proper p0st-vacuum care is also crucial.  You need to empty the bin after every vacuuming, which takes a couple of seconds.  You also need to clean the brushes.  This takes about two minutes, but it involves some assembly work that you have to learn.  The instructions in the manual are extremely helpful and clear about this.  Now and then you have to remove the front wheel and clean it.  I did this for the first time today and it was a snap.  Again, the instructions were a cinch to follow and the task took about a minute.  I could be wrong, but I don’t think the manual explains how to clean the tiny rotary brush.  You have to remove it with a Phillips-head screwdriver.  I had to call tech support on this one.  The rotary brush stopped will stop moving if you don’t clean the hair and grit out of it now and then.  Again, all this dis-assembly work is very easy and quick, but you have to do a bit of it–cleaning the brushes and emptying the bin–every time you vacuum.  Plan on four or five extra minutes, and putting down a drop cloth (I use a large, old, junky towel) so that you won’t get dust and hair on your nice clean floor.

Error messages: Occasionally, and especially on your first vacuum, the machine will stop vacuuming, make a special sound, and “announce” that something is amiss.  Often, it’s “Clean the brushes!”  Usually, this is because it has rolled over something that’s stuck in the brushes, and the brushes can’t rotate.  Take the object out.  There are other messages.  Refer to the owner’s manual.  After a few vacuums, it won’t happen often.

Okay, say you get an error message, and the vacuum stops running.  Does it “remember” where it left off?  No, it doesn’t.  It’ll start the room all over again.  How annoying.  Good idea to stop it after the total is the number of minutes it usually takes to do that room.  Otherwise, the battery will run out prematurely.  Just my opinion.

Regarding tech support: Excellent.  Totally.  I haven’t had a problem with them, except that they aren’t open Sundays.  There is no wait to talk to them.  They understand my problem right away.  Their instructions are clear, and the suggestions they make work right away.  I have only had to call them twice for problems.  The first was when I turned on the machine and it wouldn’t go.  They told me to push the on/off switch again.  Voila.  The other time was–as I described before–the rotary brush stopped rotating–they described how to remove it, and I did so.  I cleaned it, and then all was fine.  The other time I called them was to ask a simple question about the machine.  They understood my question and answered it.  All three times, they sent a follow-up e-mail immediately with the instructions in writing, and they took care of product registration over the phone.

One more thing and I’ll shut up: This machine is fascinating to watch.  So don’t be surprised if the first, second, and third time you vacuum, you don’t get anything else done.  Regarding pets and your machine, well, Puzzle (my dog) adjusted right away.  The Roomba 510 is a very quiet machine as vacuums go.  She never once barked at it.  She just accepts it as it is.  (I can’t say anything about pet hair and this vacuum as Puzzle doesn’t shed.)

My overall rating of the IRobot Roomba 510: five stars.

If you are just dropping in out of cyberspace, feel free to check out the rest of my blog.  I actually have some interesting things to say besides reviewing this vacuum cleaner.  Also check out my home site, www.juliegreene.name.  I have a book coming out soon, This Hunger Is Secret: My Journeys Through Mental Illness and Wellness, late in 2010, in e-book form first, then in paperback in 2011, from Chipmunkapublishing.

August 25, 2010

Desiderata

Go placidly amid the noise and haste, and remember what peace there may be in silence.
As far as possible without surrender be on good terms with all persons.
Speak your truth quietly and clearly; and listen to others, even the dull and ignorant; they too have their story.
Avoid loud and aggressive persons, they are vexations to the spirit.
If you compare yourself with others, you may become vain and bitter;
for always there will be greater and lesser persons than yourself.

Enjoy your achievements as well as your plans.
Keep interested in your career, however humble; it is a real possession in the changing fortunes of time.
Exercise caution in your business affairs; for the world is full of trickery.
But let this not blind you to what virtue there is; many persons strive for high ideals;
and everywhere life is full of heroism.

Be yourself.
Especially, do not feign affection.
Neither be critical about love; for in the face of all aridity and disenchantment it is as perennial as the grass.

Take kindly the counsel of the years, gracefully surrendering the things of youth.
Nurture strength of spirit to shield you in sudden misfortune. But do not distress yourself with imaginings.
Many fears are born of fatigue and loneliness. Beyond a wholesome discipline, be gentle with yourself.

You are a child of the universe, no less than the trees and the stars;
you have a right to be here.
And whether or not it is clear to you, no doubt the universe is unfolding as it should.

Therefore be at peace with God, whatever you conceive Him to be,
and whatever your labors and aspirations, in the noisy confusion of life keep peace with your soul.
With all its sham, drudgery and broken dreams, it is still a beautiful world. Be careful. Strive to be happy.

© Max Ehrmann 1927