An examination of the role of autonomous versus controlled motivation in predicting inpatient treatment outcome for anorexia nervosa

2016 ◽  
Vol 49 (6) ◽  
pp. 626-629 ◽  
Author(s):  
Lea Thaler ◽  
Mimi Israel ◽  
Juliana Mazanek Antunes ◽  
Sabina Sarin ◽  
David C. Zuroff ◽  
...  
2021 ◽  
Author(s):  
David R. Kolar ◽  
Adrian Meule ◽  
Silke Naab ◽  
Ulrich Voderholzer

Background: Early weight gain during inpatient treatment for anorexia nervosa (AN) is an important predictor of overall treatment outcome. However, weight gain is a dynamic process characterized by within-person variability that may also be age-dependent. Therefore, we examined whether age moderates the effect of within-person weight gain and variability on treatment outcome.Methods: Within-person level estimates of N = 2881 underweight adolescents and adults with AN for daily average weight gain (linear slope) and variability (root mean squared errors) were obtained using random-effects modelling. Linear and logistic regression analyses at the between-person level were calculated to assess their effects on weight, core eating disorder psychopathology and weight restoration. Results: Higher weight gain during the first two weeks of inpatient treatment predicted higher discharge weight, lower drive for thinness and lower body dissatisfaction at discharge, but was not associated with changes in bulimic symptoms. Moreover, higher early weight gain predicted a higher probability of weight restoration at discharge. Moderation analyses revealed that younger age was significantly associated with a stronger effect of early weight gain on weight, drive for thinness and body dissatisfaction at discharge, but was not associated with a higher likelihood of weight restoration. Weight variability was not associated with any treatment outcome. Conclusion: Age moderated the effect of early weight gain on treatment outcome, with larger effects for younger patients. Weight variability did not substantially influence treatment outcome across age and should be of lesser clinical concern during early inpatient treatment when patients gain weight on average.


2015 ◽  
Vol 24 (3) ◽  
pp. 214-222 ◽  
Author(s):  
Sandra Schlegl ◽  
Alice Diedrich ◽  
Christina Neumayr ◽  
Markus Fumi ◽  
Silke Naab ◽  
...  

2021 ◽  
Vol 29 (1) ◽  
pp. 184-191

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)


2021 ◽  
Vol 12 ◽  
Author(s):  
Kathrin Sophie Heider ◽  
Astrid Dempfle ◽  
Sophie Altdorf ◽  
Beate Herpertz-Dahlmann ◽  
Brigitte Dahmen

Introduction: Anorexia nervosa (AN) is a serious mental disorder that typically manifests in adolescence. Motivation to change is an important predictor for treatment outcome in adolescent AN, even though its development over the often long therapeutic process, with transitions between treatment settings, has not yet been studied. In this pilot study, the course of motivation to change and its effect on treatment outcome were investigated over the course of a step-down treatment approach during a 12-month observation period.Methods: Twenty-one adolescents admitted to inpatient treatment because of AN received multidisciplinary home treatment (HoT) with several weekly visits after short inpatient stabilization. Eating disorder (ED-)specific cognitive [Eating Disorder Inventory 2 (EDI-2) subscales] and physical [% expected body weight (%EBW)] illness severity and motivation to change [Anorexia Nervosa Stages of Change Questionnaire (ANSOCQ)] were assessed at the time of admission, discharge from hospital, at the end of HoT, and at a 12-month follow-up. Changes in motivation over time and its relationship with treatment outcome were investigated.Results: Mean motivation to change improved significantly over the course of treatment from the contemplation stage [2nd stage, mean ANSOCQ sum score 47.26 (SD 17.60)] at admission to the action stage [4th stage, mean ANSOCQ sum score 77.64 (SD 18.97)] at the end of HoT (p < 0.001) and remained stable during the follow-up period. At each assessment, higher motivation to change was significantly correlated with lower ED-specific cognitive illness severity (Spearman ρs: −0.53 to −0.77, all p < 0.05). Only pretreatment motivation to change significantly predicted ED-specific cognitive illness severity after the first inpatient treatment phase when taking prior illness severity into account.Conclusions: Motivation to change is an important aspect of treatment success in adolescent AN, especially in the early phase of treatment. In addition, home treatment contributed significantly to a higher motivation. Further longitudinal research into how motivation to change in adolescent patients with AN is related to outcome in this often severe and enduring disease and into targeted therapeutic strategies and interventions that reliably enhance the motivation to change in adolescent patients with AN seems promising.


2016 ◽  
Vol 24 (5) ◽  
pp. 417-424 ◽  
Author(s):  
Jackie Wales ◽  
Nicola Brewin ◽  
Rebecca Cashmore ◽  
Emma Haycraft ◽  
Jonathan Baggott ◽  
...  

Author(s):  
Marian Tanofsky-Kraff ◽  
Denise E. Wilfley

Interpersonal psychotherapy (IPT) is a focused, time-limited treatment that targets interpersonal problem(s) associated with the onset and/or maintenance of EDs. IPT is supported by substantial empirical evidence documenting the role of interpersonal factors in the onset and maintenance of EDs. IPT is a viable alternative to cognitive behavior therapy for the treatment of bulimia nervosa and binge eating disorder. The effectiveness of IPT for the treatment of anorexia nervosa requires further investigation. The utility of IPT for the prevention of obesity is currently being explored. Future research directions include enhancing the delivery of IPT for EDs, increasing the availability of IPT in routine clinical care settings, exploring IPT adolescent and parent–child adaptations, and developing IPT for the prevention of eating and weight-related problems that may promote full-syndrome EDs or obesity.


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