Effectiveness of day treatment for eating disorders: are improvements maintained at 12-month follow-up?

2020 ◽  
Vol 25 (3) ◽  
pp. 255-268
Author(s):  
Zoë Meropi Hepburn ◽  
Emily Rose Rothwell
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Repeated Measures ◽  
Day Treatment ◽  
Content Type ◽  
Psychosocial Impairment ◽  
Eating Disordered ◽  
Eating Disorder Symptoms ◽  
Repeated Measures Analysis

Purpose This study aimed to investigate the effectiveness of a specialist UK day treatment programme (DTP), in terms of whether improvements in eating disorder symptomology and psychosocial impairment achieved at discharge were maintained at 6-month and 12-month follow-ups. Design/methodology/approach A total of 69 patients (aged 16+) with eating disorders who had received treatment in the DTP were reviewed at 6-month and 12-month follow-ups, using demographic, physiological and psychological measures. Quantitative outcomes were analysed using one-way repeated measures analysis of variance. Findings Data analysis revealed that significant improvements in eating disordered attitudes, body mass index (among underweight participants), binge frequency (among participants with those symptoms) and psychosocial impairment achieved at discharge, were also maintained at 6-month and 12-month follow-ups, and with large effect sizes. All hypotheses were supported, with the exception that frequency of vomiting symptoms had deteriorated at the 12-month follow-up and was no longer significantly different from vomiting frequency on admission. Originality/value Results provide support for the sustained effectiveness of DTPs in improving eating disorder symptoms and psychosocial impairment associated with eating disorders. This is the first study to evaluate the effectiveness of a UK DTP for adults at maintaining improvements to eating disorder symptoms and attitudes at follow-up.

scholarly journals Treating the overlooked majority: quantitative outcomes from an NHS adaptation of Interpersonal Group Psychotherapy for binge eating disorder

2021 ◽  
Vol 26 (1) ◽  
pp. 55-70
Author(s):  
Zoë Meropi Hepburn ◽  
Emily Rose Rothwell ◽  
Julia Ann Fox-Clinch
Keyword(s):  
Eating Disorder ◽  
Binge Eating ◽  
Group Psychotherapy ◽  
Binge Eating Disorder ◽  
Repeated Measures ◽  
Attachment Anxiety ◽  
Post Treatment ◽  
Content Type ◽  
Psychosocial Impairment

Purpose To evaluate the effectiveness of an adaptation of Interpersonal Group Psychotherapy (IPT-G), in facilitating short- and longer-term improvements in eating disorder symptomology, psychosocial impairment, anxiety, depression and attachment difficulties among adults living with overweight and diagnosed with binge eating disorder (BED). Design/methodology/approach In total, 24 participants completed measures at the start of IPT-G, mid-treatment, discharge and six-month follow-up. Quantitative outcomes were analysed utilising one-way repeated measures analysis of variance. Findings Treatment retention was 100%. Significant improvements in binge-eating frequency, psychosocial impairment and depression were achieved at mid-treatment and maintained at post-treatment and six-month follow-up, and with large effect sizes. Attachment anxiety had reduced significantly at post-treatment and was maintained at six-month review. Body mass index (BMI) had stabilised by mid-treatment and was maintained at post-treatment and six-month follow-up. All hypotheses were supported, with the exception that attachment avoidance did not improve significantly and following a post-treatment reduction, anxiety symptoms deteriorated slightly by six-month follow-up, such that they were no longer significantly different from pre-treatment levels. Practical implications Despite being the most prevalent of the eating disorders (compared to anorexia nervosa and bulimia nervosa), BED is under-recognised and under-treated in clinical settings. Results indicate the sustained effectiveness of IPT-G in improving eating disorder and comorbid symptomology associated with BED. Originality/value This is the first UK study to investigate the effectiveness of IPT-G at treating BED. Unlike previous studies in the field, this study did not exclude participants based on age, BMI or psychiatric comorbidity.

Negative Self-Beliefs in Relation to Eating Disorder and Depressive Symptoms: Different Themes Are Characteristic of the Two Sets of Symptoms in Those With Eating Disorders and/or Depression

2009 ◽  
Vol 23 (2) ◽  
pp. 147-159 ◽  
Author(s):  
Myra J. Cooper ◽  
Phil Cowen
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Depressive Symptoms ◽  
Depressive Symptomatology ◽  
Self Report ◽  
Control Group ◽  
Core Beliefs ◽  
Regression Analyses ◽  
Eating Disordered ◽  
Eating Disorder Symptoms

This study aimed to identify differences in the personal themes in negative self or core beliefs that might be characteristic of high levels of eating disorder symptoms when compared to high levels of depressive symptoms in those with an eating disorder and/or depression. Differences between putative diagnostic subgroups were also examined. One hundred and ninety-three participants completed self-report measures of negative self-beliefs, eating, and depressive symptoms. Putative diagnostic subgroups were also identified, including an eating disorder group that also had high levels of depressive symptomatology and in most cases a diagnosis of depression. Six themes descriptive of the self corresponding to 6 robust factors were identified and provisionally labeled isolated, repelled by self, self-dislike, lacking in warmth, childlike, and highly organized. Multiple regression analyses indicated that, in the whole sample, eating disorder symptoms were uniquely predicted by subscales reflective of repelled by self and lacking in warmth, though depressive symptoms were uniquely predicted by subscales measuring isolation and self-dislike. Between-group analyses indicated that high scores on isolation, self-dislike, and lacking in warmth were typical of both eating-disordered and depressed-only diagnostic groups when compared to the control group, though only the eating-disordered group (also high in depressive symptoms and “diagnosis” of depression) also had high scores on repelled by self. The findings indicate that eating disorder and depressive symptoms are associated with some potentially important differences in self-beliefs. Putative diagnostic subgroups may also differ in these beliefs. The findings further indicate that psychometrically sound themes exist in the core or negative self-beliefs associated with eating disorder and depressive symptoms. Implications of the findings for cognitive therapy with eating disorders and depression are briefly considered, and the limitations and implications of the diagnostic subgroups identified here are discussed.

The short term effectiveness of day treatment for eating disorders in reducing psychosocial impairment: utilizing the clinical impairment assessment in routine practice

2016 ◽  
Vol 21 (1) ◽  
pp. 11-22 ◽  
Author(s):  
Zoe Meropi Hepburn ◽  
Sam Clark-Stone
Keyword(s):  
Eating Disorders ◽  
Day Treatment ◽  
Effect Sizes ◽  
Future Research ◽  
Routine Practice ◽  
Content Type ◽  
Psychosocial Impairment ◽  
Adequate Dose ◽  
Clinical Impairment ◽  
The Uk

Purpose – The purpose of this paper is to investigate the effectiveness of a day treatment programme (DTP) in reducing psychosocial impairment, changing attitudes, restoring body-weight and decreasing binge/vomit symptoms among 52 individuals (aged 16+) with eating disorders. It was hypothesized that day treatment would result in improvements across all variables measured. Design/methodology/approach – In a within-participants design, demographic, physiological and psychological measures were taken on admission to and at discharge from a DTP in the UK. Quantitative outcomes were analysed. Findings – In total, 40 participants were considered to have received an adequate dose of the DTP, having completed at least four weeks on the programme. Analyses supported all hypotheses, with all improvements being statistically significant. Large effect sizes were evident for all outcomes across the whole sample other than shape concern attitudes and weight concern attitudes, which reduced with moderate and moderate-to-large effect sizes, respectively. Originality/value – This study provides new evidence of the effectiveness of day treatment in reducing psychosocial impairment resulting from eating disorder psychopathology. It remains for future research to determine whether these outcomes can be sustained over the longer term.

scholarly journals The outcome at follow-up after inpatient eating disorder treatment: a naturalistic study

2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Marit Danielsen ◽  
Sigrid Bjørnelv ◽  
Siri Weider ◽  
Tor Åge Myklebust ◽  
Henrik Lundh ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Eating Disorders ◽  
Treatment Outcome ◽  
Eating Disorder ◽  
Body Mass ◽  
Inpatient Treatment ◽  
Symptom Improvement ◽  
Eating Disorder Symptoms ◽  
Significant Symptom

Abstract Background Patients with eating disorders may experience a severe and enduring course of illness. Treatment outcome for patients provided with inpatient treatment is reported as poor. Research to date has not provided consistent results for predictors of treatment outcome. The aims of the study were to investigate rates of remission at follow-up after inpatient treatment, symptom change from admission to follow-up, and predictors of treatment outcome. Methods The follow-up sample consisted of 150 female adult former patients (69.4% of all eligible female patients) with eating disorders. Mean age at admission was 21.7 (SD = 4.9) years. Diagnostic distribution: 66% (n = 99) anorexia nervosa, 21.3% (n = 32) bulimia nervosa and 12.7% (n = 19) other specified feeding or eating disorder, including binge eating. Data were collected at admission, discharge and follow-up (mean 2.7 (SD = 1.9) years). Definition of remission was based on the EDE-Q Global score, body mass index and binge/purge behavior. Paired T-tests were performed to investigate change over time. Univariate and multivariate logistic regressions were estimated to investigate predictors of remission. Results At follow-up, 35.2% of the participants were classified as in remission. Significant symptom reduction (in all patients) (p <  0.001) and significant increase in body mass index (BMI) (in underweight participants at admission) (p <  0.001) was found. Increased BMI (p <  0.05), the level of core eating disorder symptoms at admission (p <  0.01) and reduced core eating disorder symptoms (p <  0.01) during inpatient treatment were found significant predictors of outcome in the multivariate model. Conclusions All participants had an eating disorder requiring inpatient treatment. Approximately one-third of all participants could be classified as in remission at follow-up. However, most participants experienced significant symptom improvement during inpatient treatment and the improvements were sustained at follow-up. Increased probability of remission at follow-up was indicated by lower core ED symptoms at admission for all patients, raised BMI during admission for patients with AN, and reduced core ED symptoms during inpatient treatment for all patients. This finding contributes important information and highlights the importance of targeting these core symptoms in transdiagnostic treatment programs.

Effectiveness of adult day treatment for eating disorders

2014 ◽  
Vol 19 (2) ◽  
pp. 131-144 ◽  
Author(s):  
Zoë Hepburn ◽  
Kim Wilson
Keyword(s):  
Systematic Review ◽  
Eating Disorders ◽  
Eating Disorder ◽  
Treatment Outcomes ◽  
Psychological Functioning ◽  
Day Treatment ◽  
Effect Sizes ◽  
Content Type ◽  
Eating Disorder Psychopathology ◽  
Underweight Patients

Purpose – The purpose of this paper is to assess the effectiveness of day treatment programmes for adults with eating disorders by comparing, evaluating and synthesizing published pre- and post-treatment outcomes. Design/methodology/approach – A systematic review was undertaken of publications containing quantitative outcome data relating to weight restoration among underweight patients, reduction in binge and purge/vomit symptoms, decrease in eating disorder psychopathology and improvement in psychological functioning. Findings – This systematic review of pre- and post- treatment outcomes from 15 studies revealed large effect sizes relating to increase in Body Mass Index (BMI), reduction in symptoms and decrease in depression. Medium effect sizes were observed for improvement in self-esteem and reduction in anxiety and medium-large effect sizes were generally observed for attitude-change, although a small effect size was identified for perfectionism. Practical implications – This systematic review indicates that day treatment for adults is effective in increasing BMI among underweight patients, reducing binge, purge/vomit symptoms and eating disorder psychopathology and improving psychological functioning. Further research is required to investigate whether gains are cost-effective and sustainable over the longer term, and how day treatment programmes can improve outcomes for patients who are vulnerable to non-response and drop-out. Originality/value To date, reviews of day treatment for adults with eating disorders have focused upon comparisons of treatment approach and structure and neglected to assess outcomes. Therefore this review fills a gap in existing literature

scholarly journals Comparison of Two Novel Methods for Sink Drain Disinfection

2020 ◽  
Vol 41 (S1) ◽  
pp. s180-s180
Author(s):  
Muhammed Fawwaz Haq ◽  
Lucas Jones ◽  
Natalia Pinto Herrera ◽  
Jennifer Cadnum ◽  
Philip Carling ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Contact Time ◽  
Healthcare Facility ◽  
Gram Negative ◽  
Disinfection Methods ◽  
Initial Reduction ◽  
Repeated Measures Analysis ◽  
Potential Reservoir ◽  
Cleaning And Disinfection

Background: Sink drainage systems are a potential reservoir for the dissemination of gram-negative bacilli but are not amenable to standard methods of cleaning and disinfection. Pouring liquid disinfectants down drains has only a limited and transient effect on drain colonization, presumably due to inadequate disinfectant contact time and suboptimal penetration into areas harboring biofilm-associated organisms. Methods: We compared the antimicrobial efficacy of 2 novel sink disinfection methods intended to enhance disinfectant contact time and penetration. Healthcare facility sinks were randomly assigned to disinfection with 300 mL hydrogen peroxide-based disinfectant applied either as a foam (N = 13 sinks) or instilled for 30 minutes behind a temporary obstruction created by an inflated urinary catheter balloon (N = 12 sinks). Swabs were used to collect quantitative cultures from the proximal sink drain to depth of 2.5 cm (1 inch) below the strainer before treatment and at 15 minutes and 1, 2, 3, 5, and 7 days after treatment. Repeated measures analysis of variance was performed to compare the efficacy of the 2 treatments. Results: As shown in Fig. 1, both methods yielded an initial reduction of >3 log10 CFU of gram-negative bacilli. Over the 7-day follow-up period, disinfectant instillation resulted in significantly greater reduction than the foam application (P < .01). Recovery of sink colonization to >2 log per swab occurred at day 3 for both treatments, whereas recovery to >3 log per swab occurred on day 3 for the foam treatment versus day 7 for disinfectant instillation. Conclusions: Two novel disinfection methods were effective in reducing sink drain colonization for several days. The instillation method was more effective than the foam method in maintaining reductions over 7 days.Funding: NoneDisclosures: NoneDisclosures: NoneFunding: None

Adolescents newly diagnosed with eating disorders have structural differences in brain regions linked with eating disorder symptoms

2016 ◽  
Vol 71 (3) ◽  
pp. 188-196 ◽  
Author(s):  
Linda Solstrand Dahlberg ◽  
Lyle Wiemerslage ◽  
Ingemar Swenne ◽  
Anna Larsen ◽  
Julia Stark ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Brain Regions ◽  
Newly Diagnosed ◽  
Eating Disorder Symptoms ◽  
Structural Differences

Occurrence of rating distortions and ratees’ fairness perceptions per raters’ mood and affect

2016 ◽  
Vol 21 (7) ◽  
pp. 726-743 ◽  
Author(s):  
Sumrina Razzaq ◽  
Muhammad Zahid Iqbal ◽  
Malik Ikramullah ◽  
Jan-Willem van Prooijen
Keyword(s):  
Undergraduate Students ◽  
Repeated Measures ◽  
Content Type ◽  
Fairness Perceptions ◽  
Repeated Measures Analysis ◽  
Negotiation Performance ◽  
Fairness Theory ◽  
Affect Infusion Model ◽  
Analyse Data ◽  
Different Levels

Purpose The purpose of this paper is to investigate the occurrence of rating distortions under raters’ different mood conditions and at different levels of interpersonal affect of raters towards ratees, and further its association with ratees’ perceptions of distributive and interpersonal fairness. Design/methodology/approach For the scenario-based experiment, the study recruited 110 undergraduate students as participants. Of them, 22 raters appraised the video-taped buyer-seller negotiation performance of 88 ratees. Repeated measures analysis was employed to analyse data. Findings Results revealed that under different mood conditions (pleasant and sad) and at different levels of interpersonal affect towards ratees (high and low), raters distorted ratings (inflated and deflated, respectively). These rating distortions shaped ratees fairness perceptions in such a way that ratees who received inflated ratings due to raters’ pleasant mood and high interpersonal affect perceived more distributive and interpersonal fairness than ratees who received deflated ratings due to raters’ sad mood and low interpersonal affect. Originality/value The paper is a step towards integrating the affect infusion model with distributive and interpersonal fairness theory. This integration can be of value for enhancing our understanding of how rater-centric rating errors take place, which subsequently shape ratees’ fairness perceptions.

Cerebral blood flow and vasoresponsivity within and around cerebral contusions

1996 ◽  
Vol 85 (5) ◽  
pp. 871-876 ◽  
Author(s):  
Mark R. McLaughlin ◽  
Donald W. Marion
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Repeated Measures ◽  
Closed Head Injury ◽  
Ct Scanning ◽  
Brain Parenchyma ◽  
Secondary Brain Injury ◽  
Content Type ◽  
Repeated Measures Analysis ◽  
Surrounding Parenchyma

✓ There is increasing evidence that regional ischemia plays a major role in secondary brain injury. Although the cortex underlying subdural hematomas seems particularly vulnerable to ischemia, little is known about the adequacy of cerebral blood flow (CBF) or the vasoresponsivity within the vascular bed of contusions. The authors used the xenon-enhanced computerized tomography (CT) CBF technique to define the CBF and vasoresponsivity of contusions, pericontusional parenchyma, and the remainder of the brain 24 to 48 hours after severe closed head injury in 10 patients: six patients with one contusion and four with two contusions, defined as mixed or high-density lesions on CT scanning. The CBF within the contusions (29.3 ± 16.4 ml/100 g/minute, mean ± standard deviation) was significantly lower than both that found in the adjacent 1-cm perimeter of normal-appearing tissue (42.5 ± 15.8 ml/100 g/minute) and the mean global CBF (52.5 ± 17.5 ml/100 g/minute) (p < 0.004, repeated-measures analysis of variance). A subset of seven patients (10 contusions) also underwent a second Xe-CT CBF study during mild hyperventilation (a PaCO of 24–32 mm Hg). In only two of these 10 contusions was vasoresponsivity less than 1% (range 0%–7.6%); in the rim of normal-appearing pericontusional tissue, it was 0.4% to 9.1%. The authors conclude that CBF within intracerebral contusions is highly variable and is often above 18 ml/100 g/minute, the reported threshold for irreversible ischemia. Intracontusional CBF is significantly reduced relative to surrounding brain parenchyma, and CO2 vasoresponsivity is usually present. In the contusion and the surrounding parenchyma, vasoresponsivity may be nearly three times normal, suggesting hypersensitivity to hyperventilation therapy. Given this possible hypersensitivity and relative hypoperfusion within and around cerebral contusions, these lesions are particularly vulnerable to secondary injury such as that which may be caused by hypotension or aggressive hyperventilation.

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