scholarly journals Early Improvement in Eating Attitudes during Cognitive Behavioural Therapy for Eating Disorders: The Impact of Personality Disorder Cognitions

2013 ◽  
Vol 42 (2) ◽  
pp. 224-237 ◽  
Author(s):  
Emma C. Park ◽  
Glenn Waller ◽  
Kenneth Gannon
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Eating Attitudes ◽  
Drop Out ◽  
Cognitive Behavioural ◽  
The Impact

Background: The personality disorders are commonly comorbid with the eating disorders. Personality disorder pathology is often suggested to impair the treatment of axis 1 disorders, including the eating disorders. Aims: This study examined whether personality disorder cognitions reduce the impact of cognitive behavioural therapy (CBT) for eating disorders, in terms of treatment dropout and change in eating disorder attitudes in the early stages of treatment. Method: Participants were individuals with a diagnosed eating disorder, presenting for individual outpatient CBT. They completed measures of personality disorder cognitions and eating disorder attitudes at sessions one and six of CBT. Drop-out rates prior to session six were recorded. Results: CBT had a relatively rapid onset of action, with a significant reduction in eating disorder attitudes over the first six sessions. Eating disorder attitudes were most strongly associated with cognitions related to anxiety-based personality disorders (avoidant, obsessive-compulsive and dependent). Individuals who dropped out of treatment prematurely had significantly higher levels of dependent personality disorder cognitions than those who remained in treatment. For those who remained in treatment, higher levels of avoidant, histrionic and borderline personality disorder cognitions were associated with a greater change in global eating disorder attitudes. Conclusions: CBT's action and retention of patients might be improved by consideration of such personality disorder cognitions when formulating and treating the eating disorders.

The Effectiveness of Enhanced Cognitive Behavioural Therapy (CBT-E): A Naturalistic Study within an Out-Patient Eating Disorder Service

2017 ◽  
Vol 46 (1) ◽  
pp. 21-34 ◽  
Author(s):  
Rachel Signorini ◽  
Jeanie Sheffield ◽  
Natalie Rhodes ◽  
Carmel Fleming ◽  
Warren Ward
Keyword(s):  
Eating Disorder ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Post Treatment ◽  
Drop Out ◽  
Clinical Settings ◽  
General Psychopathology ◽  
Cognitive Behavioural ◽  
Assessment Period

Background: The effectiveness of enhanced cognitive behavioural Therapy (CBT-E) for adults with a range of eating disorder presentations within routine clinical settings has been examined in only two known published studies, neither of which included a follow-up assessment period. Aim: The current study aimed to evaluate the effectiveness of CBT-E within an out-patient eating disorder service in Brisbane, Queensland, Australia, and incorporated a follow-up assessment period of approximately 20 weeks post-treatment. Method: The study involved 114 adult females with a diagnosed eating disorder, who attended an average of 20–40 individual CBT-E sessions with a psychologist or a psychiatry registrar between 2009 and 2013. Results: Of those who began treatment, 50% did not complete treatment, and the presence of psychosocial and environmental problems predicted drop-out. Amongst treatment completers, statistically and clinically significant improvements in eating disorder and general psychopathology were observed at post-treatment, which were generally maintained at the 20-week follow-up. Statistically significant improvements in eating disorder and general psychopathology were observed amongst the total sample. Conclusions: The findings, which were comparable to the previous Australian effectiveness study of CBT-E, indicate that CBT-E is an effective treatment for adults with all eating disorders within out-patient settings. Given the high attrition rate, however, minimizing drop-out appears to be an important consideration when implementing CBT-E within clinical settings.

scholarly journals Impact of personality status on the outcomes and cost of cognitive–behavioural therapy for health anxiety

2016 ◽  
Vol 209 (3) ◽  
pp. 244-250 ◽  
Author(s):  
Rahil Sanatinia ◽  
Duolao Wang ◽  
Peter Tyrer ◽  
Helen Tyrer ◽  
Mike Crawford ◽  
...  
Keyword(s):  
Personality Disorder ◽  
Cognitive Behavioural Therapy ◽  
Standard Care ◽  
Controlled Trial ◽  
Health Anxiety ◽  
Behavioural Therapy ◽  
Cognitive Behavioural ◽  
Personality Dysfunction ◽  
The Impact ◽  
Severe Personality Disorder

BackgroundHealth anxiety, hypochondriasis and personality disturbance commonly coexist. The impact of personality status was assessed in a secondary analysis of a randomised controlled trial (RCT).AimsTo test the impact of personality status using ICD-11 criteria on the clinical and cost outcomes of treatment with cognitive–behavioural therapy for health anxiety (CBT-HA) and standard care over 2 years.MethodPersonality dysfunction was assessed at baseline in 444 patients before randomisation and independent assessment of costs and outcomes made on four occasions over 2 years.ResultsIn total, 381 patients (86%) had some personality dysfunction with 184 (41%) satisfying the ICD criteria for personality disorder. Those with no personality dysfunction showed no treatment differences (P= 0.90) and worse social function with CBT-HA compared with standard care (P<0.03) whereas all other personality groups showed greater improvement with CBT-HA maintained over 2 years (P<0.001). Less benefit was shown in those with more severe personality disorder (P<0.05). Costs were less with CBT-HA except for non-significant greater differences in those with moderate or severe personality disorder.ConclusionsThe results contradict the hypothesis that personality disorder impairs response to CBT in health anxiety in both the short and medium term.

scholarly journals Brief cognitive behavioural therapy for binge-eating disorder: clinical effectiveness in a routine clinical setting

2021 ◽  
Vol 14 ◽  
Author(s):  
Elana Moore ◽  
Michelle Hinde ◽  
Glenn Waller
Keyword(s):  
Eating Disorder ◽  
Binge Eating ◽  
Cognitive Behavioural Therapy ◽  
Binge Eating Disorder ◽  
Case Series ◽  
Behavioural Therapy ◽  
Eating Attitudes ◽  
Clinical Group ◽  
List Type ◽  
Cognitive Behavioural

Abstract Brief cognitive behavioural therapy (CBT) is effective in working with non-underweight eating disorder patients across transdiagnostic groups. However, it is not clear whether it will be as effective in the treatment of binge-eating disorder, where emotional eating is likely to play a larger role than starvation-driven eating. This case series tested whether brief, 10-session CBT (CBT-T) would be effective in a case series of 53 patients with binge-eating disorder. Attrition rates were comparable to previous research. Eating attitudes, binge frequency, anxiety and depression were measured. Remission was measured comparing different categorical methods: ‘cut-off’; reliable change index (RCI); and clinically significant change (CSC). CBT-T was effective for binge-eating disorder patients, at comparable levels to other non-underweight patients. All measures of pathology were significantly reduced, with large to moderate effect sizes. When categorical changes were used to indicate remission, RCI and CSC levels were more appropriate than existing cut-off methods, potentially because of the lower levels of initial restrained eating in this clinical group. CBT-T’s effectiveness in transdiagnostic groups is replicated in binge-eating disorder patients, despite their greater level of emotionally driven eating. More stringent definitions of remission (CSC and RCI) should be used more widely, to ensure realistic estimates. Key learning aims (1) What is necessary for brief CBT to be effective for binge-eating disorder (BED)? (2) Is CBT for BED effective in the absence of purging behaviours? (3) What is the most appropriate way to measure remission in CBT for BED?

The Efficacy of Traditional Cognitive Behavioural Therapy for Depressed Adults with Anhedonia: A Systematic Review

2021 ◽  
Vol 7 (5) ◽  
pp. 520-544
Keyword(s):  
Systematic Review ◽  
Cognitive Behavioural Therapy ◽  
Primary Outcome ◽  
Behavioural Therapy ◽  
Major Depressive ◽  
Eligibility Criteria ◽  
Cognitive Behavioural ◽  
System Therapy ◽  
Randomised Controlled ◽  
The Impact

To date, the impact of traditional cognitive behavioural therapy (CBT) on anhedonia in major depressive disorder (MDD) has yet been systematically evaluated. This systematic review aims to examine the efficacy of traditional CBT for depressed adults with anhedonia. A literature search for randomised controlled trials of traditional CBT in adults with MDD from inception to July 2020 was conducted in 8 databases. The primary outcome was the levels of anhedonia. Ten studies with adults with MDD met the eligibility criteria. Our results indicate that traditional CBT is as effective as euthymic therapy, positive psychology therapy, self-system therapy,and medications for anhedonia in depression. Besides, our data provide further support for the development of augmented CBT to optimise treatment outcome for depressed adults with anhedonia. Received 11th June 2021; Revised 2nd September 2021; Accepted 20th September 2021

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