Readiness to change mediates the impact of eating disorder symptomatology on treatment outcome in anorexia nervosa

2008 ◽  
Vol 41 (4) ◽  
pp. 368-371 ◽  
Author(s):  
Carmen V. Bewell ◽  
Jacqueline C. Carter
Keyword(s):  
Anorexia Nervosa ◽  
Treatment Outcome ◽  
Eating Disorder ◽  
Readiness To Change ◽  
Eating Disorder Symptomatology ◽  
The Impact

Cardiac changes in anorexia nervosa

2016 ◽  
Vol 26 (4) ◽  
pp. 623-628 ◽  
Author(s):  
Michael A. Spaulding-Barclay ◽  
Jessica Stern ◽  
Philip S. Mehler
Keyword(s):  
Weight Loss ◽  
Anorexia Nervosa ◽  
Treatment Outcome ◽  
Eating Disorder ◽  
Medical Complications ◽  
Cardiac Complications ◽  
Successful Treatment Outcome ◽  
Comprehensive Literature Review ◽  
Life Threatening ◽  
Weight Restoration

AbstractIntroductionAnorexia nervosa is an eating disorder, which is associated with many different medical complications as a result of the weight loss and malnutrition that characterise this illness. It has the highest mortality rate of any psychiatric disorder. A large portion of deaths are attributable to the cardiac abnormalities that ensue as a result of the malnutrition associated with anorexia nervosa. In this review, the cardiac complications of anorexia nervosa will be discussed.MethodsA comprehensive literature review on cardiac changes in anorexia nervosa was carried out.ResultsThere are structural, functional, and rhythm-type changes that occur in patients with anorexia nervosa. These become progressively significant as ongoing weight loss occurs.ConclusionCardiac changes are inherent to anorexia nervosa and they become more life-threatening and serious as the anorexia nervosa becomes increasingly severe. Weight restoration and attention to these cardiac changes are crucial for a successful treatment outcome.

Prevention of Eating Disorders

2017 ◽  
pp. 335-362
Author(s):  
Evelyn Attia ◽  
Anne E. Becker ◽  
Cynthia M. Bulik ◽  
Alison E. Field ◽  
Neville H. Golden ◽  
...  
Keyword(s):  
Risk Factors ◽  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Weight Maintenance ◽  
Eating Disorder Prevention ◽  
Effectiveness Trials ◽  
Low Prevalence ◽  
The Impact ◽  
Disorder Prevention

This chapter examines risk factors for the development of eating disorders and efforts to prevent them. A number of variables are considered to be risk factors; however, extant research has notable limitations, including the low prevalence of these conditions within the general population, which complicates the identification of reliable risk factors. The impact of culture on eating disorders is reviewed, as well as social and biological factors thought to exert complementary impact and to contribute synergistically to risk. Considerable progress has been made in developing and evaluating models for prevention since the publication of the prior edition of this book. These advances include the publication of several large effectiveness trials, the development of models to prevent the onset of anorexia nervosa and combined eating disorder prevention and weight maintenance/loss programs, and the availability of interventions for both boys and girls.

Physical activity in anorexia nervosa: How relevant is it to therapy response?

2015 ◽  
Vol 30 (8) ◽  
pp. 924-931 ◽  
Author(s):  
S. Sauchelli ◽  
J. Arcelus ◽  
I. Sánchez ◽  
N. Riesco ◽  
S. Jiménez-Murcia ◽  
...  
Keyword(s):  
Physical Activity ◽  
Anorexia Nervosa ◽  
Treatment Outcome ◽  
Eating Disorder ◽  
Treatment Program ◽  
Therapy Response ◽  
Hospital Treatment ◽  
Depression Symptoms ◽  
Healthy Weight ◽  
Activity Profile

AbstractObjectiveElevated physical activity has been observed in some patients with anorexia nervosa (AN) despite their emaciated condition. However, its effects on treatment outcome remain unclear. This study aimed to examine objectively measured physical activity in this clinical population and how it might be related to a partial hospitalization therapy response, after considering potential confounders.MethodThe sample comprised 88 AN patients consecutively enrolled in a day hospital treatment program, and 116 healthy-weight controls. All participants were female and a baseline assessment took place using an accelerometer (Actiwatch AW7) to measure physical activity, the Eating Disorders Inventory-2 and the Depression subscale of the Symptom Checklist-Revised. Outcome was evaluated upon the termination of the treatment program by expert clinicians.ResultsAlthough AN patients and controls did not differ in the average time spent in moderate-to-vigorous physical activity (MVPA) (P = .21), nor daytime physical activity (P = .34), fewer AN patients presented a high physical activity profile compared to the controls (37% vs. 61%, respectively; P = .014). Both lower levels of MVPA and greater eating disorder severity had a direct effect on a poor treatment outcome. Depression symptoms in the patients were associated with lower MVPA, as well as with an older age, a shorter duration of the disorder and greater eating disorder psychopathology.ConclusionsThere is a notable variation in the physical activity profile of AN patients, characterized by either low or very high patterns. Physical activity is a highly relevant issue in AN that must be taken into account during the treatment process.

scholarly journals Psychological Interventions for Anorexia: Current Challenges

2021 ◽  
Vol 29 (1) ◽  
pp. 184-191
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Treatment Outcome ◽  
Outcome Assessment ◽  
Psychological Aspects ◽  
Psychological Interventions ◽  
Psychological Variables ◽  
Novel Methods ◽  
The Impact

The current digest focuses on the psychological aspects of therapy in anorexia nervosa. It reviews publications considering both recognized and novel methods of psychotherapy for anorexia, the role of psychological variables in treatment outcome assessment, the issue of exhausting physical exercising in eating disorders, and the impact of COVID-19 on vulnerable individuals. (Translated by Elena Mozhaeva)

scholarly journals Carers’ views on autism and eating disorders comorbidity: qualitative study

BJPsych Open ◽  
2020 ◽  
Vol 6 (3) ◽  
Author(s):  
James Adamson ◽  
Emma Kinnaird ◽  
Danielle Glennon ◽  
Madeleine Oakley ◽  
Kate Tchanturia
Keyword(s):  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Structured Interview ◽  
Autism Spectrum ◽  
Current Treatment ◽  
Autism Diagnosis ◽  
Interview Schedule ◽  
Loved One ◽  
The Impact

Background Patients with co-occurring anorexia nervosa and autism respond differently to eating disorder treatments. Previous interviews with patients with both conditions and clinicians working in eating disorder services has highlighted service and treatment adaptations might be beneficial and could improve outcomes for these individuals. Aims The aim of this study was to explore carers’ experiences of current treatment approaches for people with autism who have anorexia nervosa, and their views on how these can be improved. Method Ten carers of a loved one diagnosed with autism and anorexia nervosa were interviewed using a semi-structured interview schedule and the transcripts were analysed with thematic analysis. Results Four key themes emerged from the interviews: the role of autism in anorexia nervosa, carers’ problems with clinical services, the impact on carers and suggestions for future improvements. Conclusions Carers agreed that autism played a significant role in the development and maintenance of their daughters’ anorexia nervosa. However, this comorbidity does not appear to be appropriately addressed in current treatment provisions. They described several difficulties, including problems getting an autism diagnosis and the perception that eating disorder services did not accept or adapt around the condition. This resulted in feelings of frustration and isolation for families, a scenario exacerbated by a perceived lack of support or specific resources for carers of individuals on the autism spectrum. Clinical recommendations on the basis of the current and previous studies are outlined.

scholarly journals Clinical effectiveness of a skills training intervention for caregivers in improving patient and caregiver health following in-patient treatment for severe anorexia nervosa: pragmatic randomised controlled trial

BJPsych Open ◽  
2015 ◽  
Vol 1 (1) ◽  
pp. 56-66 ◽  
Author(s):  
Rebecca Hibbs ◽  
Nicholas Magill ◽  
Elizabeth Goddard ◽  
Charlotte Rhind ◽  
Simone Raenker ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Intervention Group ◽  
Skills Training ◽  
Patient Treatment ◽  
Training Intervention ◽  
Randomised Controlled ◽  
The Impact

BackgroundFamilies express a need for information to support people with severe anorexia nervosa.AimsTo examine the impact of the addition of a skills training intervention for caregivers (Experienced Caregivers Helping Others, ECHO) to standard care.MethodPatients over the age of 12 (mean age 26 years, duration 72 months illness) with a primary diagnosis of anorexia nervosa and their caregivers were recruited from 15 in-patient services in the UK. Families were randomised to ECHO (a book, DVDs and five coaching sessions per caregiver) or treatment as usual. Patient (n=178) and caregiver (n=268) outcomes were measured at discharge and 6 and 12 months after discharge.ResultsPatients with caregivers in the ECHO group had reduced eating disorder psychopathology (EDE-Q) and improved quality of life (WHO-Quol; both effects small) and reduced in-patient bed days (7–12 months post-discharge). Caregivers in the ECHO group had reduced burden (Eating Disorder Symptom Impact Scale, EDSIS), expressed emotion (Family Questionnaire, FQ) and time spent caregiving at 6 months but these effects were diminished at 12 months.ConclusionsSmall but sustained improvements in symptoms and bed use are seen in the intervention group. Moreover, caregivers were less burdened and spent less time providing care. Caregivers had most benefit at 6 months suggesting that booster sessions, perhaps jointly with the patients, may be needed to maintain the effect. Sharing skills and information with caregivers may be an effective way to improve outcomes. This randomised controlled trial (RCT) was registered with Current Controlled Trials ISRCTN06149665.

scholarly journals Anomalous self-experience, body image disturbance, and eating disorder symptomatology in first-onset anorexia nervosa

2021 ◽  
Author(s):  
Lorenzo Moccia ◽  
Eliana Conte ◽  
Marianna Ambrosecchia ◽  
Delfina Janiri ◽  
Salvatore Di Pietro ◽  
...  
Keyword(s):  
Body Image ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Distribution Patterns ◽  
The Body ◽  
Body Image Disturbance ◽  
Level Of Evidence ◽  
Eating Disorder Examination ◽  
First Onset ◽  
The Impact

Abstract Purpose Anorexia nervosa-restrictive subtype (AN-R) is a life-threatening disorder relying on behavioural abnormalities, such as excessive food restriction or exercise. Such abnormalities may be secondary to an “objectified” attitude toward body image and self. This is the first study exploring the impact of anomalous self-experience (ASEs) on abnormal body image attitude and eating disorder (ED) symptomatology in individuals with AN-R at onset. Methods We recruited Italian female participants, 40 with AN-R (mean age 18.3 ± 2.3) and 45 age and educational level-matched healthy controls (HCs) (mean age 18.2 ± 2.6). ASEs, body image attitude, and ED symptom severity were assessed through the examination of anomalous self-experience (EASE), the body uneasiness test (BUT), and the eating disorder examination questionnaire (EDE-Q), respectively. We conducted multivariate analysis of variance to investigate distribution patterns of variables of interest, and mediation analysis to test the effect of ASEs and body image on ED symptomatology. Results Individuals with AN-R scored higher than HCs on the EASE (p < .0001). A direct effect of ASEs on ED severity (p = 0.009; bootstrapped LLCI = 0.067, ULCI = 0.240) was found in AN-R. After modelling the effect of abnormal body image attitude, the relationship between EASE total score and ED symptomatology was significantly mediated by BUT (p = 0.002; bootstrapped LLCI = 0.001, ULCI = 0.172). Conclusion Although the exact pathways linking AN-R to self-disorder remain to be identified, a broader exploration of transdiagnostic features in AN, including explorations of different dimensions of self-experience and intersubjectivity, may shed further light on the clinical phenomenology of the disorder. Level of evidence Level III, case–control analytic study.

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