scholarly journals Initial self-blame predicts eating disorder remission after 9 years

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Suzanne Petersson ◽  
Andreas Birgegård ◽  
Lars Brudin ◽  
Emma Forsén Mantilla ◽  
Elin Monell ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Psychiatric Symptoms ◽  
English Summary ◽  
Self Report ◽  
Recovery Rates ◽  
Psychological Variables ◽  
Self Blame

Abstract Background Research into predictors of outcome in eating disorders (ED) has shown conflicting results, with few studies of long-term predictors and the possible importance of psychological variables that may act as risk- and maintenance factors. Aim To identify baseline predictors of ED remission nine years after initial clinical assessment using self-report measures of ED psychopathology, psychiatric symptoms, and self-image in a sample of adult ED patients (N = 104) treated at specialist units in Stockholm, Sweden. Sixty patients participated in the follow-up, of whom 41 patients (68%) had achieved remission. Results Results suggested that the only significant predictor of diagnostic remission after nine years was initial levels of self-blame. Conclusion In order to ensure long-term recovery in ED it may be important for clinicians to widen their therapeutic repertoire and utilise techniques that reduce self-blame and increase self-compassion. Plain English summary It is difficult to predict how an eating disorder will develop, and research has found varying factors that affect the outcome of the condition. Recovery rates vary from nearly nil to over 90%. This variation could be explained by different research factors, but are more likely due to varying definitions of ‘recovery’, with less stringent definitions yielding high recovery rates and more stringent definitions yielding lower rates. The present study investigated whether the severity of eating disorder symptoms and other psychiatric symptoms could predict recovery nine years from first admission to specialised eating disorder care. Sixty patients at three eating disorder treatment units participated, and their scores on self-report measures of symptoms were used as predictor variables. Forty-one participants had no eating disorder diagnosis at nine-year follow-up. Most participants with binge-eating disorder had recovered, while the poorest outcome was found for anorexia nervosa with slightly over half of patients recovered after nine years. The only predictor for the nine-year outcome was a higher initial rating of self-blame, measured with the Structural Analysis of the Social Behavior. It was concluded that it may be important for clinicians to detect and address self-blame early in the treatment of eating disorders in order to enhance the possibility of recovery. Treatment should focus on reducing self-blame and increasing self-acceptance.

Evaluation of treatment and intermediate and long-term outcome of adolescent eating disorders

2000 ◽  
Vol 30 (5) ◽  
pp. 1089-1098 ◽  
Author(s):  
H.-C. STEINHAUSEN ◽  
R. SEIDEL ◽  
C. WINKLER METZKE
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Psychosocial Functioning ◽  
The Body ◽  
Patient Treatment ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Adolescent Eating Disorders

Background. A cohort of 60 adolescent eating-disordered patients that was consecutively admitted between 1979 and 1988 to a child and adolescent psychiatric university department in Berlin, Germany was followed up at a mean of 5·0 years and for a second time at a mean of 11·5 years.Methods. Each patient was personally interviewed and findings dealing with eating disorder symptoms and psychosocial functioning were rated on four-point scales. In addition, the duration of both in-patient and out-patient treatment and the Body Mass Index (BMI) were recorded.Results. Patients were in treatment for a mean of 33% of the initial 5-year follow-up period, but this has dropped to a mean of 17% of the entire 11-year follow-up period. No predictors of treatment duration were found. The mortality rate was 8·3% at the second follow-up. The distribution of abnormal BMIs (<17·5) reflected a trend of improvement with increasing duration of follow-up. In comparison to the 5-year follow-up, fewer patients suffered from symptoms of the full clinical picture of an eating disorder at the 11-year follow-up. Among the surviving patients 80% recovered during the long-term course. There were few specific predictors of three different outcome criteria.Conclusion. This outcome study of adolescent eating disorders provides further evidence that the long-term course of the disorders in terms of the eating pathology is better than can be expected after a few years. Very little can be said with regard to individual prognosis.

scholarly journals Temperament-Based Treatment for Young Adults with Eating Disorders: Acceptability and Initial Efficacy of an Intensive, Multi-Family, Parent-Involved Treatment.

2021 ◽  
Author(s):  
Stephanie Knatz Peck ◽  
Terra Towne ◽  
Christina Wierenga ◽  
Laura Hill ◽  
Ivan Eisler ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Young Adults ◽  
Eating Disorder ◽  
Self Report ◽  
Program Satisfaction ◽  
Full Remission ◽  
Eating Disorder Psychopathology ◽  
Clinical Impairment ◽  
Spectrum Disorders

Abstract Background: Adult eating disorder treatments are hampered by lack of access and limited efficacy. This open-trial study evaluated the acceptability and preliminary efficacy of a novel intervention for adults with eating disorders delivered to young adults and parent-supports in an intensive, multi-family format (Young Adult Temperament-Based Treatment with Supports; YA-TBT-S). Methods: 38 YA-TBT-S participants (m age = 19.58; SD 2.13) with anorexia nervosa (AN)-spectrum disorders, bulimia nervosa (BN)-spectrum disorders, and avoidant/restrictive food intake disorder (ARFID) completed self-report assessments at admission, discharge, and 12-month follow-up. Assessments measured program satisfaction, eating disorder psychopathology and impairment, body mass index (BMI), and trait anxiety. Outcomes were analyzed using linear mixed effects models to examine changes in outcome variables across diagnoses over time. Results: Treatment was rated as highly satisfactory. 53.33% were in partial or full remission at 12-month follow-up. Participants reported reductions in ED symptomatology (AN and BN), increases in BMI (AN and ARFID), and reductions in clinical impairment (AN and ARFID) at 12-month follow-up. Conclusions: YA-TBT-S is a feasible and acceptable treatment that may improve ED outcomes in young adults with a broad range of diagnoses. Further evaluation of efficacy is needed in larger samples, and to compare YA-TBT-S to other ED treatment approaches.

Commentary

2013 ◽  
pp. 393-399
Author(s):  
Carol B. Peterson
Keyword(s):  
Eating Disorders ◽  
Psychiatric Symptoms ◽  
Outcome Data ◽  
Medical Complications ◽  
Evidence Based ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Bulimic Symptoms ◽  
Complications And Mortality

Dr. Cubic’s case presentation eloquently highlights the numerous challenges of using evidence-based interventions in the treatment of eating disorders. As Dr. Cubic emphasizes in her case description, among the different types of eating disorders, anorexia nervosa (AN) (and especially AN accompanied by bulimic symptoms) is particularly difficult to treat effectively, and long-term outcome data indicate high levels of treatment nonresponse, relapse, co-occurring psychiatric symptoms, medical complications, and mortality (...

Psychological Assessment of the Eating Disorders

2017 ◽  
Author(s):  
Drew A. Anderson ◽  
Joseph Donahue ◽  
Lauren E. Ehrlich ◽  
Sasha Gorrell
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Psychological Assessment ◽  
Functional Approach ◽  
Self Report ◽  
Behavioral Measures

Clinicians and researchers have several approaches with which to assess eating disorder and related symptomatology, including interviews, self-report instruments, and behavioral measures. The purpose of this chapter is to describe a process, based on a functional approach, that will help assessors to develop assessments and choose instruments for eating disorders and eating-related problems. This approach takes into account both theoretical and practical concerns and allows assessors to individualize their assessments depending on their particular needs. This process starts with broad considerations about the context in which the assessment is to be given and ends with the choice of specific instruments to be used.

scholarly journals Long-Term Outcomes from a 10-Year Follow-Up of Women Living with a Restrictive Eating Disorder: A Brief Report

Nutrients ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2331
Author(s):  
Enza Speranza ◽  
Lidia Santarpia ◽  
Maurizio Marra ◽  
Emilia De Filippo ◽  
Olivia Di Vincenzo ◽  
...  
Keyword(s):  
Eating Disorder ◽  
Data Collection ◽  
Laboratory Evaluation ◽  
Data Collection Form ◽  
Restrictive Eating ◽  
Outpatient Unit ◽  
General Data ◽  
Collection Form

Background: This study aimed to evaluate several socio-demographic and long-term clinical outcomes in a cohort of women living with a restrictive eating disorder. Methods: Patients were asked to fill in a general data collection form aiming to investigate their current conditions and to attend the outpatient unit for a 10-year follow-up clinical and laboratory evaluation. Results: Forty-four patients completed the follow-up general data collection form and 20 agreed to attend the outpatient unit for the 10 year-follow-up evaluation. In total, 52% of patients were single, 55% had achieved a university degree, and 55% had steady employment. After 10 years, there was a clear improvement in biochemical markers, but cholesterol levels were still slightly high. The prevalence of osteopenia in the whole sample was 70% when measured on the lumbar column and 20% on the total body, while osteoporosis was found in 10% of patients and only on the lumbar column. Conclusion: According to the collected data, women with a history of restrictive eating disorders appear to re-adapt well to social life by obtaining the level of their unaffected peers in terms of education and employment.

COGNITIVE BEHAVIOUR THERAPY AND ASSERTION TRAINING GROUPS FOR PATIENTS WITH DEPRESSION AND COMORBID PERSONALITY DISORDERS

2000 ◽  
Vol 28 (1) ◽  
pp. 71-85 ◽  
Author(s):  
Jillian Ball ◽  
Brian Kearney ◽  
Kay Wilhelm ◽  
Jodie Dewhurst-Savellis ◽  
Belinda Barton
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Depressive Symptomatology ◽  
Therapy Group ◽  
Self Report ◽  
Cognitive Behaviour ◽  
Long Term Follow Up ◽  
Assertion Training

Longitudinal evaluations were conducted on 61 adults who were referred to a Mood Disorders Unit with a history of depression (all index episodes reached criteria for DSM-III-R major depression or dysthymia) and who had completed a cognitive behavioural therapy group either on its own or in combination with an assertion training group. Assessment of personality was made using DSM-III-R Axis II personality disorder categories. These categories were aggregated to form three groups: (i) no personality disorder; (ii) Cluster B (dramatic-erratic); and (iii) Cluster C (anxious-fearful), and were used to identify responsiveness to treatment and outcome at long-term follow-up. A battery of self-report measures were administered pretreatment, posttreatment and at long-term follow-up (1–3 years later). Both groups showed significant improvements in mean scores during treatment and these gains were maintained over the follow-up period. However, improvement in those patients without personality disorders was greater at posttreatment and at long-term follow-up, both in level of depressive symptomatology and proportion of cases meeting criteria for recovery. The treatment implications of these results are discussed.

scholarly journals Developing Predictors of Long-Term Adherence to Exercise Among Older Veterans and Spouses

2019 ◽  
Vol 39 (10) ◽  
pp. 1159-1162
Author(s):  
Candace S. Brown ◽  
Richard Sloane ◽  
Miriam C. Morey
Keyword(s):  
Older Adults ◽  
Body Mass Index ◽  
Self Efficacy ◽  
Change Theory ◽  
Self Report ◽  
Social Barriers ◽  
Inclement Weather ◽  
Behavior Change Theory

Behavior change theory was used to explore predictors of long-term adherence (≥2 years) to exercise. A retrospective analysis of data from participants ( N = 97) who reached a 6-month follow-up, which served as the baseline, was evaluated for completion of yearly follow-up surveys. Variables examined at baseline, which included age, race, gender, body mass index (BMI), and self-report of comorbidities, symptoms, physical function, and a Barriers Specific Self-Efficacy Scale, were examined with significance set at p < .05. Lower BMI (29.1 ± 5.1 vs. 31.6 ± 6.5, p = .047) and higher self-efficacy to overcome environmental barriers ( p = .016) and social isolation ( p = .05) were associated with long-term adherence. Self-efficacy to overcome environmental and social barriers, such as inclement weather, access to exercise site, and opportunities for group-based exercise, should be addressed to promote long-term adherence to exercise among older adults.

scholarly journals Suicide attempts and mortality in eating disorders: a follow-up study of eating disorder patients

2014 ◽  
Vol 36 (3) ◽  
pp. 355-357 ◽  
Author(s):  
Jaana T. Suokas ◽  
Jaana M. Suvisaari ◽  
Marjut Grainger ◽  
Anu Raevuori ◽  
Mika Gissler ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Suicide Attempts ◽  
Follow Up Study

scholarly journals Long-Term Efficacy of the Workshop Vs. Online SUCCEAT (Supporting Carers of Children and Adolescents with Eating Disorders) Intervention for Parents: A Quasi-Randomised Feasibility Trial

2020 ◽  
Vol 9 (6) ◽  
pp. 1912 ◽  
Author(s):  
Stefanie Truttmann ◽  
Julia Philipp ◽  
Michael Zeiler ◽  
Claudia Franta ◽  
Tanja Wittek ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Children And Adolescents ◽  
Comparison Group ◽  
General Health Questionnaire ◽  
Parental Psychopathology ◽  
Feasibility Trial ◽  
Significant Group ◽  
Adolescent Patients

Interventions for main carers of adult patients with anorexia nervosa (AN) can reduce the caregiving burden and increase caregiver skills. However, the effectiveness and feasibility for carers of adolescent patients, the optimal form of the intervention and long-term outcomes are largely unknown. We evaluated the efficacy and feasibility of the “Supporting Carers of Children and Adolescents with Eating Disorders in Austria” (SUCCEAT) workshop vs. online intervention. Main caregivers (parents) of adolescent patients with AN were randomly allocated to a workshop (n = 50) or online version (n = 50). Participants were compared to a non-randomised comparison group (n = 49) receiving multi-family or systemic family therapy. Primary (General Health Questionnaire) and secondary outcomes were obtained at baseline, three-month and 12-month follow-up. Adherence was high for workshop and online participants (6.2 and 6.7 sessions completed out of 8). Intention-to-treat analyses revealed significant pre–post reductions in the primary outcome for the workshop (d = 0.87 (95%conficence interval (CI): 0.48; 1.26)) and online (d = 0.65 (95%CI: 0.31; 0.98)) intervention that were sustained at the 12-month follow-up. There was no significant group difference (p = 0.473). Parental psychopathology and burden decreased and caregiver skills increased in all groups; the improvement of caregiver skills was significantly higher in SUCCEAT participants than in the comparison group. Online interventions for parents of adolescents with AN were equally effective as workshops. The improvements remained stable over time.

Binge/Purge Symptoms and Comorbidity in Adolescents with Eating Disorders

1998 ◽  
Vol 43 (5) ◽  
pp. 507-512 ◽  
Author(s):  
Rose Geist ◽  
Ron Davis ◽  
Margus Heinmaa
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Depressive Disorders ◽  
Early Stage ◽  
Diagnostic Interview ◽  
Brief Symptom Inventory ◽  
Self Report ◽  
Oppositional Defiant ◽  
Assessment Measure ◽  
Axis I

Objective: To identify the diagnostic subtypes of eating disorders (EDs), the psychiatric comorbid diagnoses, and associated specific and nonspecific psychopathology in a series of 120 adolescents undergoing standardized assessment for an ED. Method: Consecutive patients referred to our large pediatric hospital for ED assessment completed a semistructured diagnostic interview for children and adolescents. The following self-report scales were administered to assess specific and nonspecific psychopathology: the Children's Depression Inventory (CDI), the Brief Symptom Inventory (BSI), the Eating Disorder Inventory 2 (EDI-2), and the Family Assessment Measure (FAM-III) of family functioning. Results: Female subjects with a mean age of 14.5 years and a mean body mass index (BMI) of 18.1 comprised 93% of the sample. The restrictive subtypes of anorexia nervosa (AN) (43%) and eating disorder not otherwise specified (EDNOS) (16%) were the most common diagnoses. Patients with restricting symptoms (R) could be grouped together because they were more similar to each other with respect to self-report symptoms of psychopathology than they were to patients with binge/purge (B/P) symptoms and vice versa. Patients with R endorsed significantly fewer subjective symptoms, both ED-specific and nonspecific, and rated their families' functioning better than did B/P patients. Comorbid, current major depressive disorders and dysthymic disorders occurred in 66% of subjects, but depressive, dysthymic, and oppositional disorders occurred in 96% of those with B/P symptoms. Severity of the CDI was the best single discriminator between R and B/P subjects. Conclusions: Adolescents with EDs in the early stage of their illness are similar to adults with EDs in the following ways: they meet the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria for subtypes of EDs (excluding amenorrhea) and commonly have comorbid psychiatric disorders, especially depressive disorders. Patients with B/P symptoms can be distinguished from restricting subjects because they endorse significantly more ED-specific and nonspecific psychopathology and have a higher frequency of comorbid Axis I diagnoses (especially depressive disorders) than restricting patients. Oppositional defiant disorder (ODD) occurs more commonly in adolescents with EDs associated with B/P symptoms.

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