scholarly journals The role of embodiment in the treatment of patients with anorexia and bulimia nervosa: a 2-year follow-up study proposing an integration between enhanced cognitive behavioural therapy and a phenomenological model of eating disorders

2021 ◽  
Author(s):  
Eleonora Rossi ◽  
Giovanni Castellini ◽  
Emanuele Cassioli ◽  
Carolina Sensi ◽  
Milena Mancini ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Bulimia Nervosa ◽  
Cognitive Behavioural Therapy ◽  
Indirect Effect ◽  
Phenomenological Model ◽  
Case Series ◽  
Behavioural Therapy ◽  
Cognitive Behavioural ◽  
Body Uneasiness

Abstract Purpose Recent studies demonstrated that the embodiment disorder represents a core feature of eating disorders (EDs). The aim of this study was to evaluate the role of its variation as a possible mediator of the efficacy of enhanced cognitive behavioural therapy (CBT-E) on classic ED symptomatology, including body uneasiness. Methods 73 patients with anorexia nervosa and 68 with bulimia nervosa were treated with a multidisciplinary approach including CBT-E. Psychometric questionnaires were administered at baseline (T0) and after one (T1) and 2 years (T2) to evaluate general and ED-specific psychopathology, body uneasiness and the embodiment disorder. Data regarding diagnostic crossover and remission were also collected. Results Longitudinal analysis showed an improvement of all psychopathological dimensions at T1, which remained stable at T2 (p < 0.05). Remission rate at T2 was 44.7%, and diagnostic crossover occurred in 17.0% of patients. Higher levels of embodiment disorder predicted increased diagnostic instability (OR: 1.80 [1.01–3.20], p = 0.045). The amelioration of the embodiment disorder mediated the decrease in both ED-specific psychopathology (indirect effect: 0.67 [0.46–0.92]) and body uneasiness (indirect effect: 0.43 [0.28–0.59]). Conclusion For the first time, these findings highlighted the role of the embodiment disorder as a maintaining factor of ED symptomatology, supporting the importance of integrating CBT-E with a phenomenological model of EDs. Level of evidence Level IV, longitudinal observational study (case series).

THE ROLE OF COGNITIVE BEHAVIOURAL THERAPY IN FACILITATING ADAPTATION TO ILLNESS IN RHEUMATOID ARTHRITIS: A CASE SERIES

2001 ◽  
Vol 29 (3) ◽  
pp. 303-309 ◽  
Author(s):  
Louise Sharpe ◽  
Tom Sensky ◽  
Natalie Timberlake ◽  
Simon Allard ◽  
Chris R. Brewin
Keyword(s):  
Rheumatoid Arthritis ◽  
Chronic Illness ◽  
Cognitive Behavioural Therapy ◽  
Case Series ◽  
Behavioural Therapy ◽  
Behavioural Intervention ◽  
Disease Course ◽  
Medical Disorders ◽  
Cognitive Behavioural

A considerable literature has developed over the past two decades that has investigated the utility of cognitive behavioural treatments for a variety of medical disorders, including rheumatoid arthritis. Research has consistently found that psychological variables affect the course of the illness and that cognitive behavioural approaches can improve psychological and physical function. However, the literature has focused almost exclusively on chronic illness. There is little literature that has investigated the role of cognitive behavioural therapy in facilitating the adjustment early in the disease course to diagnosis and subsequent illness. The diagnosis of any potentially chronic illness has enormous ramifications for a person's life and it is well documented that many people become depressed even early in the disease course. Theoretical accounts have been put forward that allow a model for understanding the process of adaptation and offer a foundation for the use of cognitive and behavioural strategies with a recently diagnosed group of patients. The present paper reports the use of a cognitive and behavioural intervention to facilitate coping and adjustment to illness.

CBT for adolescent pathological gambling – lessons from adult research

2009 ◽  
Vol 26 (3) ◽  
pp. 140-146 ◽  
Author(s):  
Ciaran Clarke ◽  
Norbertas Skokauskas
Keyword(s):  
Pathological Gambling ◽  
Cognitive Behavioural Therapy ◽  
Case Series ◽  
Behavioural Therapy ◽  
Addictive Behaviors ◽  
Hand Search ◽  
Intention To Treat ◽  
Cognitive Behavioural ◽  
Long Term Follow Up ◽  
Randomised Control Trials

AbstractObjectives:Features of gambling, particularly among young people have changed over the past decade and, while there are no data from Ireland, there are suggestions from those working in the field that pathological gambling is increasing among adolescents. Relatively little is known about the effective treatment of pathological gambling in adolescents. This paper aims to review research in cognitive behavioural treatments with a view to their application in adolescents. Research among adolescence is given prominence when this is available.Methods:The methodology comprised a literature search of Medline, Psycinfo, and EMBASE databases, using the search terms: ‘cognitive behavioural therapy’; ‘gambling; ‘psychology’; ‘epidemiology’; ‘adolescent’; ‘motivation’; ‘effectiveness’; ‘outcome’; ‘relapse’; and ‘internet’. In addition, a hand search ofClinical Psychological Reviews, Journal of Gambling Studies, Addiction, Psychology of Addictive Behaviors, and International Gambling Studies(1997-2007) was performed.Results:A total of 23 studies comprising various cognitive and behavioural approaches were identified, all but three of them confined to adult subjects. Study methodology and quality varied greatly, with many case studies or small case series, and only three randomised control trials. None used an intention-to-treat analysis, and there was little long-term follow-up. Almost ail indicated, with more or less evidence, that cognitive behavioural strategies might be beneficial.Conclusions:Many varieties and modifications of cognitive behavioural therapy have been applied to pathological gambling, though there are few studies of any psychological treatments for adolescent gamblers. Methodological problems surround much of the research. Notwithstanding these reservations cognitive behavioural approaches seem to offer promise in managing this serious problem.

scholarly journals Stepped care and cognitive–behavioural therapy for bulimia nervosa: randomised trial

2011 ◽  
Vol 198 (5) ◽  
pp. 391-397 ◽  
Author(s):  
James E. Mitchell ◽  
Stewart Agras ◽  
Scott Crow ◽  
Katherine Halmi ◽  
Christopher G. Fairburn ◽  
...  
Keyword(s):  
Bulimia Nervosa ◽  
Cognitive Behavioural Therapy ◽  
Relative Effectiveness ◽  
Randomised Trial ◽  
Behavioural Therapy ◽  
Individual Therapy ◽  
Stepped Care ◽  
Self Help ◽  
Treatment Conditions ◽  
Cognitive Behavioural

BackgroundThis study compared the best available treatment for bulimia nervosa, cognitive–behavioural therapy (CBT) augmented by fluoxetine if indicated, with a stepped-care treatment approach in order to enhance treatment effectiveness.AimsTo establish the relative effectiveness of these two approaches.MethodThis was a randomised trial conducted at four clinical centres (Clinicaltrials.gov registration number: NCT00733525). A total of 293 participants with bulimia nervosa were randomised to one of two treatment conditions: manual-based CBT delivered in an individual therapy format involving 20 sessions over 18 weeks and participants who were predicted to be non-responders after 6 sessions of CBT had fluoxetine added to treatment; or a stepped-care approach that began with supervised self-help, with the addition of fluoxetine in participants who were predicted to be non-responders after six sessions, followed by CBT for those who failed to achieve abstinence with self-help and medication management.ResultsBoth in the intent-to-treat and completer samples, there were no differences between the two treatment conditions in inducing recovery (no binge eating or purging behaviours for 28 days) or remission (no longer meeting DSM–IV criteria). At the end of 1-year follow-up, the stepped-care condition was significantly superior to CBT.ConclusionsTherapist-assisted self-help was an effective first-level treatment in the stepped-care sequence, and the full sequence was more effective than CBT suggesting that treatment is enhanced with a more individualised approach.

scholarly journals A case series to examine whether people with learning disabilities can learn prerequisite skills for cognitive behavioural therapy

2018 ◽  
Vol 11 ◽  
Author(s):  
Ioanna Tsimopoulou ◽  
Biza Stenfert Kroese ◽  
Gemma Unwin ◽  
Sabiha Azmi ◽  
Christopher Jones
Keyword(s):  
Learning Disabilities ◽  
Cognitive Behavioural Therapy ◽  
Case Series ◽  
Behavioural Therapy ◽  
Task Demands ◽  
Cognitive Mediation ◽  
Qualitative Feedback ◽  
Cognitive Behavioural ◽  
Prerequisite Skills

AbstractAlthough cognitive behavioural therapy (CBT) is recommended for the treatment of a number of mental disorders among the general population, the ability of individuals with learning disabilities (LD) to understand CBT concepts and engage in CBT has been questioned. Aims: To examine whether specific prerequisite skills for CBT can be taught to people with LD using a newly developed training intervention and to investigate the acceptability of the intervention. Method: The study adopted a within-subjects case series research design. Quantitative assessment methods were used to evaluate the CBT skills of six adults with mild to moderate LD pre-intervention, following intervention and at 1-week follow-up. Participants were also asked to provide some qualitative feedback about how they had experienced the intervention. Results: The cognitive mediation skills and the ability of most participants to link activating events to emotions increased following intervention training and this improvement was maintained for four of them at follow-up. The feedback of participants regarding the process and content of the task demands was positive. Conclusions: The findings suggest that people with LD can learn some of the skills considered necessary to participate in CBT, such as cognitive mediation. However, further and more robust research is required to substantiate these findings.

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