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- New Center for Psychoanalysis, Chair Research Committee, Faculty MemberUniversity of Southern California, Psychiatry and Behavioral Sciences, Department MemberUniversity of Washington, Psychiatry, Faculty Memberadd
- Adult and Child Psychiatry Clinical Research Adult and Child Psychoanalysis Psychiatric and Psychoanalytic Educati... moreAdult and Child Psychiatry
Clinical Research
Adult and Child Psychoanalysis
Psychiatric and Psychoanalytic Education
Eating Disorders
Clinical Professor, Dept. of Psychiatry and Human Behavior, School of Medicine, University of California Irvine
Visiting Professor, Keck School of Medicine, Univ. Southern California
Faculty, New Center for Psychoanalysis, Los Angelesedit
Major social political changes over the past decades have stimulated an interest in both individual (i.e., personal) and group narratives as they relate to the decision-making process. In previous contributions, we have proposed the term... more
Major social political changes over the past decades have stimulated an interest in both individual (i.e., personal) and group narratives as they relate to the decision-making process. In previous contributions, we have proposed the term Identity Narrative (IdN) to define a cognitive and emotional framework that serves as an implicit (unconscious) scaffold of human autobiography. IdN is a form of implicit memory, the acquisition of which begins with the first human nonverbal interactions. It serves as a framework for a person’s identity and creates relative stability and constancy for conscious, explicit, autobiographical memory. In this contribution we are presenting a multi-system exploration of the relationship between personal narratives as influenced by IdN and group narratives and their impact on social stability. We are presenting multi-disciplinary data from a variety of fields, including group psychoanalysis, memory research, the neuroscience of error prediction and free en...
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Eight women with bulimia and eight age- and sex-matched normal control subjects were studied with positron emission tomography using [18F]-fluorodeoxyglucose (FDG) as a tracer of brain metabolic rate. Subjects performed a visual vigilance... more
Eight women with bulimia and eight age- and sex-matched normal control subjects were studied with positron emission tomography using [18F]-fluorodeoxyglucose (FDG) as a tracer of brain metabolic rate. Subjects performed a visual vigilance task during FDG uptake. In control subjects, the metabolic rate was higher in the right hemisphere than in the left, but patients with bulimia did not have this normal asymmetry. Lower metabolic rates in the basal ganglia, found in studies of depressed subjects, and higher rates in the basal ganglia, reported in a study of anorexia nervosa, were not found. This is consistent with the suggestion that bulimia is a diagnostic grouping distinct from these disorders.
Research Interests: Psychology, Nuclear medicine, Positron Emission Tomography, Medicine, Bulimia Nervosa, and 15 moreHumans, Cerebral Cortex, Female, American, Basal metabolic rate (BMR), Single Photon Emission Computed Tomography, Adult, Basal ganglia, Pet Scan and Eating Disorders, Brain imaging and eating disorders, Bulimia, American J of Psychiatry, Functional Laterality, Psychology and Cognitive Sciences, and Medical and Health Sciences
Women with bulimia often present with symptoms of depression in addition to bingeing and purging behavior. Brain metabolism in eight women with bulimia nervosa was compared to that in eight women with major affective disorder and eight... more
Women with bulimia often present with symptoms of depression in addition to bingeing and purging behavior. Brain metabolism in eight women with bulimia nervosa was compared to that in eight women with major affective disorder and eight normal women, using positron emission tomography and 18-fluoro-2-deoxyglucose. Normal women have higher right than left cortical metabolic rates and active basal ganglia. Bulimics lost the normal right activation in some areas, but maintained basal ganglia activity. Depressives retained right hemisphere activation, but had decreased metabolism in basal ganglia. This suggests that although women with bulimia frequently present with symptoms of depression, the pathophysiologic changes associated with bulimia differ from major effective disorder.
Research Interests: Psychology, Positron Emission Tomography, Medicine, Bulimia Nervosa, Brain, and 15 moreHumans, Thalamus, Affective Disorders, Blood Glucose, Cerebral Cortex, Female, Depressive Disorder, Adult, Basal ganglia, Limbic System, Bulimia, Affective Disorder, Psychiatric Status Rating Scales, Psychology and Cognitive Sciences, and Medical and Health Sciences
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Our aim was to construct an experimental situation with which we could explore relationships between the looking behavior of the eye and recall of pictures differing in threatening content. Seventeen Ss individually were shown 10 pictures... more
Our aim was to construct an experimental situation with which we could explore relationships between the looking behavior of the eye and recall of pictures differing in threatening content. Seventeen Ss individually were shown 10 pictures for 10 sec. each with concurrent eye fixation photography (Mackworth eye camera) and GSR recording. The main analysis consisted of breaking high and low GSR “Peak” (i.e., the high point of GSR deflection during the ten seconds of looking) against “mean duration of each fixation,” inspection time of “ground” of each picture (rather than “figure”), recall duration, instances of forgetting the picture, and postponement in recall order. Significant differences were found in most of these measures in a direction which seemed consistent with a concept of avoidance—under conditions of high GSR responsivity more than under low GSR responsivity, Ss tended to show avoidance tendencies in both looking and recalling behavior.
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Salivary isoamylase levels were studied in a sample of 35 women with bulimia, anorexia nervosa, or bulimia nervosa. Salivary isoamylase elevation was related to the presence of sham eating, evidenced by elevated isoamylase values in... more
Salivary isoamylase levels were studied in a sample of 35 women with bulimia, anorexia nervosa, or bulimia nervosa. Salivary isoamylase elevation was related to the presence of sham eating, evidenced by elevated isoamylase values in patients with bulimia nervosa or bulimia, and depressed isoamylase values in patients with anorexia nervosa. Salivary isoamylase levels may provide insight and have bearing on the functional interrelationship between appetite regulation and ingestive behavior in patients with eating disorders, as abnormalities may occur during both the cephalic as well as the oral phase of eating.
Research Interests: Adolescent, Medicine, Anorexia Nervosa, Bulimia Nervosa, Humans, and 6 moreInternal Medicine, Female, Pubmed, Saliva, Adult, and Bulimia
Conclusions Pica is a complex disorder with varying prognoses among patients. Epidemiological surveys in different settings and age groups (urban, rural, youth, adults) indicate a greater prevalence of pica than expected by sporadic... more
Conclusions Pica is a complex disorder with varying prognoses among patients. Epidemiological surveys in different settings and age groups (urban, rural, youth, adults) indicate a greater prevalence of pica than expected by sporadic individual clinical reports. The adverse medical, surgical, and developmental consequences mean that early recognition and prevention are imperative.
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Page 1. Rumination: A Benign Disorder? Barton J. Blinder, MD The recent characterization of rumination as a benign disorder deserves further study and reconsideration. The frequency of appearance of rumina-tion in certain ...
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To investigate control and self-control issues for patients with eating disorders, 10 individuals diagnosed with anorexia nervosa or bulimia nervosa were compared to two sex-matched groups of 9 and 50 adults on the Shapiro Control... more
To investigate control and self-control issues for patients with eating disorders, 10 individuals diagnosed with anorexia nervosa or bulimia nervosa were compared to two sex-matched groups of 9 and 50 adults on the Shapiro Control Inventory. Analysis of variance and subsequent planned comparisons showed significant differences indicative of pathology between the eating-disordered group and one or both comparison groups on the general domain sense of control scale and the positive sense of control scale. Three of the four mode scales and the domain-specific sense of control scale were also in the expected direction. Several clinically relevant individual items also supported this trend. The discussion notes the clinical importance of refining how control is measured for eating-disordered populations.
Research Interests: Psychology, Clinical Psychology, Cognitive Science, Psychometrics, Eating Disorders, and 14 moreAdolescent, Medicine, Anorexia Nervosa, Bulimia Nervosa, Humans, Personality Assessment Inventory, Psychological, Female, Assertiveness, Adult, Bulimia, Psychological Reports, Internal- External Locus of Control, and Personality Inventory
Research Interests: Psychology, Psychotherapy, Adolescent, Medicine, Anorexia Nervosa, and 15 moreHumans, Behavior Therapy, Hospitalization, Female, American Journal of Psychiatry, American, Adult, Operant Conditioning, Anorexia, Body Weight, Hyperkinesis, American J of Psychiatry, Psychology and Cognitive Sciences, Medical and Health Sciences, and physical exertion
Eight women with bulimia and eight age- and sex-matched normal control subjects were studied with positron emission tomography using [18F]-fluorodeoxyglucose (FDG) as a tracer of brain metabolic rate. Subjects performed a visual vigilance... more
Eight women with bulimia and eight age- and sex-matched normal control subjects were studied with positron emission tomography using [18F]-fluorodeoxyglucose (FDG) as a tracer of brain metabolic rate. Subjects performed a visual vigilance task during FDG uptake. In control subjects, the metabolic rate was higher in the right hemisphere than in the left, but patients with bulimia did not have this normal asymmetry. Lower metabolic rates in the basal ganglia, found in studies of depressed subjects, and higher rates in the basal ganglia, reported in a study of anorexia nervosa, were not found. This is consistent with the suggestion that bulimia is a diagnostic grouping distinct from these disorders.
Research Interests: Psychology, Nuclear medicine, Positron Emission Tomography, Medicine, Bulimia Nervosa, and 15 moreHumans, Cerebral Cortex, Female, American, Basal metabolic rate (BMR), Single Photon Emission Computed Tomography, Adult, Basal ganglia, Pet Scan and Eating Disorders, Brain imaging and eating disorders, Bulimia, American J of Psychiatry, Functional Laterality, Psychology and Cognitive Sciences, and Medical and Health Sciences
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SUMMARY Eating disorders show some similar features to substance abuse and dependence, but this does not justify viewing them as an addiction. Neither tolerance nor withdrawal reactions to food have been demonstrated. Evidence for... more
SUMMARY Eating disorders show some similar features to substance abuse and dependence, but this does not justify viewing them as an addiction. Neither tolerance nor withdrawal reactions to food have been demonstrated. Evidence for “carbohydrate craving” is lacking, and other ostensibly common features (e.g., loss of control over eating, preoccupation with food) have biobehavioral explanations that do not invoke addiction. While not an addiction, eating disorders have been reliably linked to substance abuse and dependence in clinical and community samples. However, the association is not a specific one, and the mechanisms that explain it are unknown. Independent familial transmission of eating and substance use disorders indicates that they do not derive from a single, shared etiological mechanism. Clinicians should routinely screen for substance abuse in eating disorder patients and vice versa.
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Research Interests: Psychology, Psychotherapy, Adolescent, Anorexia Nervosa, Humans, and 14 moreBehavior Therapy, Hospitalization, Female, American Journal of Psychiatry, American, Adult, Operant Conditioning, Body Weight, Hyperkinesis, American J of Psychiatry, Psychology and Cognitive Sciences, reinforcement psychology, Medical and Health Sciences, and physical exertion
Research Interests: Eating Disorders, Adolescent, Medicine, Comorbidity, Psychosomatic Medicine, and 14 moreHumans, Child, Female, Regression Analysis, Mental Disorders, Aged, Middle Aged, Psychosomatic, Adult, Retrospective Studies, Eating Disorder, Inpatients, Psychology and Cognitive Sciences, and Medical and Health Sciences
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Over the past years, a multi-disciplinary literature on the significance of personal narratives in autobiography and identity has emerged. This subject has been of interest to authors in the fields of humanities, psychology, and medicine... more
Over the past years, a multi-disciplinary literature on the significance of personal narratives in autobiography and identity has emerged. This subject has been of interest to authors in the fields of humanities, psychology, and medicine alike. In this paper, we are proposing the term Identity Narrative (IdN) to define a cognitive and emotional framework that serves as an implicit (unconscious) scaffolding of memory on which to build human autobiography. The authors first classify narratives into external (universal history, the humanities, culture) and internal (autobiography, based on personal experiences, both directly and indirectly, through identification and education). All philosophy and social commentary has utilized history for the purposes of prediction and meaning-making. Personalities including Aristotle, St. Augustine, Rousseau, Freud, Marx, Spengler, and Benjamin Franklin have reread history to gain insight about human nature. History has inspired the enlightenment and...
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O ne of the annual pleasures brought by the New Year is the opportunity it affords the Editor to express publicly the perdurable private gratitude he feels toward his myriad colleagues for their thoughtful reviews of the ceaseless flow of... more
O ne of the annual pleasures brought by the New Year is the opportunity it affords the Editor to express publicly the perdurable private gratitude he feels toward his myriad colleagues for their thoughtful reviews of the ceaseless flow of manuscripts submitted to the Journal. From the letters he receives from the Journal's authors, he knows how valuable they find the reviewers' comments in the task of revising their papers. At a time when medicine as a whole is infected with the spreading plague of cost consciousness and fiscal accountability, it is ...
... This article is not included in your organization's subscription. However, you may be able to access this article under your organization's agreement with Elsevier. Lester Luborsky a , Barton Blinder a and Jean Schimek a. a... more
... This article is not included in your organization's subscription. However, you may be able to access this article under your organization's agreement with Elsevier. Lester Luborsky a , Barton Blinder a and Jean Schimek a. a U. Pennsylvania. Available online 6 May 2007. ...
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Page 1. Rumination: A Benign Disorder? Barton J. Blinder, MD The recent characterization of rumination as a benign disorder deserves further study and reconsideration. The frequency of appearance of rumina-tion in certain ...
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... The third piece, "Psychodynamic Neurobiology," written by Barton Blinder, provides many seeds for the growth of our understanding of the relationship between psychotherapy and the brain. Debra Safer contributed... more
... The third piece, "Psychodynamic Neurobiology," written by Barton Blinder, provides many seeds for the growth of our understanding of the relationship between psychotherapy and the brain. Debra Safer contributed excellent editorial details and several useful cases. ...
To investigate control and self-control issues for patients with eating disorders, 10 individuals diagnosed with anorexia nervosa or bulimia nervosa were compared to two sex-matched groups of 9 and 50 adults on the Shapiro Control... more
To investigate control and self-control issues for patients with eating disorders, 10 individuals diagnosed with anorexia nervosa or bulimia nervosa were compared to two sex-matched groups of 9 and 50 adults on the Shapiro Control Inventory. Analysis of variance and subsequent planned comparisons showed significant differences indicative of pathology between the eating-disordered group and one or both comparison groups on the general domain sense of control scale and the positive sense of control scale. Three of the four mode scales and the domain-specific sense of control scale were also in the expected direction. Several clinically relevant individual items also supported this trend. The discussion notes the clinical importance of refining how control is measured for eating-disordered populations.
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Page 1. 1093 A mer. J. Psychiat. 126.8, February /970 [77] Behavior Therapy of Anorexia Nervosa: Effectiveness of Activity as a Reinforcer of Weight Gain BY BARTON J. BLINDER, MD, DANIEL MA FREEMAN, MD, AND ALBERT J. STUNKARD. MD ...
Research Interests: Psychotherapy, Adolescent, Anorexia Nervosa, Humans, Behavior Therapy, and 12 moreHospitalization, Female, American Journal of Psychiatry, American, Adult, Operant Conditioning, Body Weight, Hyperkinesis, Psychology and Cognitive Sciences, reinforcement psychology, Medical and Health Sciences, and physical exertion
... This article is not included in your organization's subscription. However, you may be able to access this article under your organization's agreement with Elsevier. Lester Luborsky a , Barton Blinder a and Jean Schimek a. a... more
... This article is not included in your organization's subscription. However, you may be able to access this article under your organization's agreement with Elsevier. Lester Luborsky a , Barton Blinder a and Jean Schimek a. a U. Pennsylvania. Available online 6 May 2007. ...
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Summary.-Our aim was to illustrate an eye-fixation photographic method of studying cognition both with and without awareness. We focused upon (a) the rime of inspection of a part of the visual field in relation to (b) the recall of that... more
Summary.-Our aim was to illustrate an eye-fixation photographic method of studying cognition both with and without awareness. We focused upon (a) the rime of inspection of a part of the visual field in relation to (b) the recall of that part of the stimulus and (c) the relationships of (a) and (b) as a function of heart rate. Recall was defined in two ways: direct and unintentional, ie, recovery in the content of waking images of picture content which had not appeared in direcr recall. Eighteen Ss were overloaded with information by a 6-sec. ...
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Either your web browser doesn't support Javascript or it is currently turned off. In the latter case, please turn on Javascript support in your web browser and reload this page. ... American Psychiatric Association practice guideline for the treatment of patients with Alzheimer's disease and other dementias. Second edition. ... Find all citations by this author (default). ... Find all citations by this author (default). ... Find all citations by this author (default). ... Find all citations by this author (default). ... Find all citations by this author (default). ... Find all citations by this ...
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Our aim was to construct an experimental situation with which we could explore relationships between the looking behavior of the eye and recall of pictures differing in threatening content. Seventeen Ss individually were shown 10 pictures... more
Our aim was to construct an experimental situation with which we could explore relationships between the looking behavior of the eye and recall of pictures differing in threatening content. Seventeen Ss individually were shown 10 pictures for 10 sec. each with concurrent eye fixation photography (Mackworth eye camera) and GSR recording. The main analysis consisted of breaking high and low GSR “Peak” (i.e., the high point of GSR deflection during the ten seconds of looking) against “mean duration of each fixation,” inspection time of “ground” of each picture (rather than “figure”), recall duration, instances of forgetting the picture, and postponement in recall order. Significant differences were found in most of these measures in a direction which seemed consistent with a concept of avoidance—under conditions of high GSR responsivity more than under low GSR responsivity, Ss tended to show avoidance tendencies in both looking and recalling behavior.
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Major social political changes over the past decades have stimulated an interest in both individual (i.e., personal) and group narratives as they relate to the decision-making process. In previous ...
Research Interests:
Free association is still widely accepted as a fundamental component of psychoanalysis. However, despite notable advances in cognitive science, only a limited number of studies of free association by means of neurological methods exist.... more
Free association is still widely accepted as a fundamental component of psychoanalysis. However, despite notable advances in cognitive science, only a limited number of studies of free association by means of neurological methods exist. This review surveys a representative sample of neuroimaging studies on free association available to this date. Neuroimaging findings on free association, mind wandering, meditation, and other forms of spontaneous thought process seem to share significant commonalities. Free association is also examined in view of the literature on free energy, predictive coding, error prediction, and down-regulation of the default mode network. In this sense, the authors propose that free association and the role of the default mode network and the executive network are part of a complex process of adaptive reshaping of thought and autobiographical memory. The authors further propose that FA is an internally energized emotional cognitive mobility that taps into all forms of memory (episodic, implicit, embodied unformulated) and facilitates memory reconsolidation and simulation of future possibilities. In addition, creativity, as an evolutionary potential to form predictions and paradigm shifts, is presented in the context of adaptation and survival. Seen in this context, free association can lead to a creative therapeutic change in treatment that favors introspective, ontoethical, and social adaptation. Further investigation of free association by means of neuroscientific studies will need to include more specific parameters that closely mimic the experience of free association during psychoanalysis.
Objective: We analyze 27 point-prevalent DSM-IV Axis I comorbidities for eating disorder inpatients. Methods: The sample included 2436 female inpatients treated between January 1, 1995, and December 31, 2000, for primary DSM-IV diagnoses... more
Objective: We analyze 27 point-prevalent DSM-IV Axis I comorbidities for eating disorder inpatients. Methods: The sample included 2436 female inpatients treated between January 1, 1995, and December 31, 2000, for primary DSM-IV diagnoses of anorexia, bulimia, and eating disorder not otherwise specified. Analyses were multivariate analysis of variance and multinomial logistic regression; sociodemographics and severity-of-illness measures were controlled. Results: Ninety-seven percent of patients evidenced 1 comorbid diagnoses; 94% evidenced comorbid mood disorders, largely unipolar depression, with no differences across eating disorders; 56% evidenced anxiety disorders, with no differences across eating disorders; and 22% evidenced substance use disorders, with significant differences across eating disorders (p .0001). Five specific diagnoses differed across eating disorders. Alcohol abuse/dependence was twice as likely with bulimia (p .0001); polysubstance abuse/dependence three tim...
In this overview of pica, we review its causes and prevalence. In addition, we discuss some of the associated complications as well as current treatment strategies.
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What we sense as a “self” emerges from stimuli both from within and without our body through complex levels of neural integration. The integration of memory and self is not a one-time occurrence but involves lifelong development. The... more
What we sense as a “self” emerges from stimuli both from within and without our body through complex levels of neural integration. The integration of memory and self is not a one-time occurrence but involves lifelong development. The autobiography of self is the accumulated unique mental narrative that emerges from our experiencing and participating in the fl ow of events and interpersonal encounters that reach a level of awareness critically facilitated by emotional tone. 1-6 Autobiographical memory plays an important role in the construction of personal identity. An individual’s construction of themselves through time serves the function of creating a coherent and largely favorable view of their present selves and circumstances. 7-11 The autobiographical self is a product of an extended consciousness that places a person in an individual history over time, aware of a lived past and anticipated future. From a multilevel coalescence of
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p ica is defined as a pathological craving for either a food item or its constituents or for substances not commonly regarded as food [1]. DSM-III emphasizes repeated nonnutritive ingestion for a period of time as a habitual mode of... more
p ica is defined as a pathological craving for either a food item or its constituents or for substances not commonly regarded as food [1]. DSM-III emphasizes repeated nonnutritive ingestion for a period of time as a habitual mode of response [2]. Pica must be viewed in a developmental context (age level, physiologic state, level of cognitive and intellectual development) and also related to sociocultural and historical patterns that may determine the food selection of a people or a region [1,3,4]. Animal studies suggest that pica may result from specific deficiencies or be part of a nutrient-specific appetite [1]. A similar pattern has been inferred in humans [5-12]. Nutrient deficiencies and medical consequences such as iron deficiency, lead intoxication, growth and cognitive impairment, and intestinal obstruction are freqently associated with the idiosyncratic dietary habits [13,14]. Pica has been reported in certain schizophrenic patients [15-18] and is frequently observed in the...
umination, an uncommon disorder occurring from infancy throughout adulthood, is derived rom the Latin ruminare, "to chew the cud." Merycism, derived from the Helenic, is the act of postingestive regurgitation of food from the... more
umination, an uncommon disorder occurring from infancy throughout adulthood, is derived rom the Latin ruminare, "to chew the cud." Merycism, derived from the Helenic, is the act of postingestive regurgitation of food from the stomach back into the mouth, followed by chewing and reswallowing [1]. The two terms are often used interchangeably. Rumination is associated with medical complications such as aspiration pneumonia, electrolyte abnormalities, and dehydration [2] and is considered in the differential diagnosis of vomiting [3] and failure to thrive [4] in infants and young children. From latency through adulthood, rumination frequently has a benign course [5]. Recently it has been associated with bulimia [6,7], anorexia nervosa, and depression [5,105,109]. Past studies have ascribed the disorder to lack of emotional reciprocity and attunement between mother and child stemming primarily from maternal depression and anxiety [8-10]. Medical disorders such as gastroesophage...
Textbook
42 chapters
Eating Disorders: Medical and Psychological Bases of Diagnosis and Treatment
42 chapters
Eating Disorders: Medical and Psychological Bases of Diagnosis and Treatment
Textbook
42 Chapters
Neurobiology
Diagnosis
Special sections
Treatment
42 Chapters
Neurobiology
Diagnosis
Special sections
Treatment
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Text 42 chapters
Diagnosis and Treatment
Medical and Psychological Bases
Diagnosis and Treatment
Medical and Psychological Bases