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.

scholarly journals Temperament-based treatment for young adults with eating disorders: acceptability and initial efficacy of an intensive, multi-family, parent-involved treatment

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Stephanie Knatz Peck ◽  
Terra Towne ◽  
Christina E. Wierenga ◽  
Laura Hill ◽  
Ivan Eisler ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Young Adults ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Young Adult ◽  
Food Intake ◽  
Adjunctive Treatment ◽  
Spectrum Disorders ◽  
Over Time

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 over time. Results Treatment was rated as highly satisfactory. 53.33% were in partial or full remission at 12-month follow-up. 56% of participants received other treatment within the 12-month follow-up period, suggesting that YA-TBT-S may be an adjunctive treatment. 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 adjunctive treatment for young adults with a broad range of ED diagnoses and may be a method for involving parents in ED treatment in ways that are acceptable to both parents and YA. Further evaluation of efficacy is needed in larger samples, and to compare YA-TBT-S to other ED treatment approaches. Plain English summary Eating disorders are costly and dangerous psychiatric disorders that affect millions of individuals each year. Despite their risks and societal costs, currently available treatments are limited. This study examined the acceptability and efficacy of Young Adult, Temperament-Based Treatment with Supports (YA-TBT-S), a new treatment program for adults with eating disorders. YA-TBT-S was rated highly, and a significant portion of participants improved based on ratings collected 12 months after program participation. Those with anorexia nervosa (AN) and bulimia nervosa (BN) showed significant reductions in eating disorder pathology, and those with AN and avoidant/restrictive food intake disorder (ARFID) showed increases in BMI over time.

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.

Examination of a day programme for eating disorders: impact on 3-month follow-up by psychiatric comorbidity

2019 ◽  
Vol 28 (2) ◽  
pp. 148-152 ◽  
Author(s):  
Tracey D Wade ◽  
Ertimiss Eshkevari ◽  
Corree Guerin ◽  
Jasmine Smith ◽  
Daniela Hoskin
Keyword(s):  
Eating Disorders ◽  
Psychiatric Comorbidity ◽  
Preliminary Investigation ◽  
Case Series ◽  
Series Design ◽  
Eating Disorder Psychopathology ◽  
Clinical Impairment ◽  
Changes Over Time ◽  
Mixed Modelling

Objective: The two aims of this preliminary investigation were to use a case series design to examine outcomes of a day programme (DP) for eating disorders and to investigate whether the presence of baseline psychiatric comorbidities moderated outcomes 3 months after discharge. Method: Linear mixed modelling was used to investigate changes over time in the 91 participants who had commenced the DP by April 2019; 87 (96%) female, 61 (67%) with a DSM-5 diagnosis of anorexia nervosa. Results: Six of our seven outcome variables (dietary restraint; concern over weight, eating and shape; clinical impairment; and psychological distress) showed moderate to large effect size improvements from baseline to follow-up. Generally, improvement declined somewhat at follow-up from discharge, with a pattern of results suggesting this decline was less where there was comorbidity at baseline. Conclusions: These results suggest that a DP effectively reduces eating disorder psychopathology regardless of the presence of psychiatric comorbidity.

scholarly journals Predictors of illness course and health maintenance following inpatient treatment among patients with anorexia nervosa

2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Deborah R. Glasofer ◽  
Alexandra F. Muratore ◽  
Evelyn Attia ◽  
Peng Wu ◽  
Yuanjia Wang ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Inpatient Treatment ◽  
Weight Status ◽  
Self Report ◽  
Healthy Weight ◽  
Health Maintenance ◽  
Duration Of Illness ◽  
Clinical Impairment

Abstract Background Anorexia nervosa (AN) is a life-threatening psychiatric disorder associated with significant medical and psychosocial impairment. Hospital-based behavioral treatment is an effective intervention in the short-term. However, relapse rates following discharge are high and thus, there is a need to identify predictors of longitudinal outcome. The current study provides information regarding illness course and health maintenance among patients with AN over 5 years following discharge from an eating disorder inpatient unit. Methods Participants were individuals with AN who were discharged from a specialized, inpatient behaviorally-based unit. Prior to discharge, height and weight were measured and participants completed self-report measures of eating disorder severity and general psychopathology (depression, anxiety, harm avoidance). Participants were contacted annually for self-report measures of weight, eating disorder severity and clinical impairment. Outcome was defined by illness course (body mass index (BMI) and clinical impairment during the 5 years) and health maintenance (categories of weight and eating disorder symptom severity) across follow-up, using all available data. Linear mixed models were used to examine whether demographic and clinical parameters at discharge predicted BMI and clinical impairment over time. Additional analyses examined whether these variables significantly influenced an individual’s likelihood of maintaining inpatient treatment gains. Results One-hundred and sixty-eight individuals contributed data. Higher trait anxiety at discharge was associated with a lower BMI during follow-up (p = 0.012). There was a significant interaction between duration of illness and time, whereby duration of illness was associated with a faster rate of weight loss (p = 0.003) during follow-up. As duration of illness increased, there was a greater increase in self-reported clinical impairment (p = 0.011). Increased eating disorder severity at discharge was also associated with greater clinical impairment at follow-up (p = 0.004). Higher BMI at discharge was significantly associated with maintaining healthy weight across a priori BMI-based definitions of health maintenance. Conclusions Weight status (higher BMI) and duration of illness are key factors in the prognosis of AN. Higher weight targets in intensive treatments may be of value in improving outcomes.

scholarly journals Eating habits and attitudes among 10-year-old children of mothers with eating disorders

2006 ◽  
Vol 189 (4) ◽  
pp. 324-329 ◽  
Author(s):  
Alan Stein ◽  
Helen Woolley ◽  
Sandra Cooper ◽  
Jonathan Winterbottom ◽  
Christopher G. Fairburn ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Middle Childhood ◽  
Eating Habits ◽  
Eating Disturbance ◽  
Disturbed Eating ◽  
Eating Disorder Psychopathology ◽  
Increased Risk ◽  
Developmental Disturbance

BackgroundChildren of mothers with eating disorders are at increased risk of developmental disturbance, but there has been little research in middle childhood, when disturbed eating habits tend to emerge.AimsTo examine whether maternal eating disorders identified in the postnatal year are associated with the development of disturbed eating habits and attitudes in children at 10 years of age.MethodFollow-up comparative study of 56 families (33 mothers with eating disorders and 23 controls). Psychopathology of children, mothers and fathers was assessed by interview, and mother-child interaction observed.ResultsThe index group of children scored higher than controls on three of four domains of eating disorder psychopathology and on a global score. Children's eating disturbance was associated with length of exposure to mothers' eating disorder and mother-child mealtime conflict at 5 years. There was some evidence of increased emotional problems in index children.ConclusionsThe children of mothers with eating disorders manifested disturbed eating habits and attitudes compared with controls, and may be at heightened risk of developing frank eating disorder psychopathology.

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 0919 Health Disparities in the Persistence of Childhood Insomnia Symptoms in the Transition to Adolescence: The Penn State Child Cohort

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A349-A349
Author(s):  
E Bourchtein ◽  
K Puzino ◽  
S L Calhoun ◽  
C Criley ◽  
F He ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Ethnic Minorities ◽  
Remission Rate ◽  
Self Report ◽  
Full Remission ◽  
Penn State ◽  
State Child ◽  
Racial Ethnic ◽  
Insomnia Symptoms

Abstract Introduction A strong body of cross-sectional evidence indicates that social determinants of health (SDH), such as race, ethnicity, socioeconomic status, and sex/gender, are linked to sleep problems, including insomnia symptoms. Few studies have examined the longitudinal association between SDH and the persistence and remission of insomnia symptoms in the transition between childhood and adolescence, a critical period for sleep health. Methods The Penn State Child Cohort is a random, population-based sample of 700 children (5-12y at baseline), of whom 421 were followed up as adolescents (12-23y at follow-up). All subjects underwent polysomnography, clinical history, physical exam, and parent- and self-reported scales at baseline and follow-up. Childhood insomnia symptoms were defined as a parent- and/or self-report of difficulty falling and/or staying asleep. All subjects or their parents identified the subject’s sex, race, and ethnicity, and reported on socioeconomic status (SES) of the household. Results Females (32.7%) and racial/ethnic minorities (25.0%) were associated with a significantly lower remission rate as compared to males (53.3%) and non-Hispanic whites (48.3%), respectively. Non-Hispanic whites of low SES were associated with a significantly lower full remission rate (26.3%) as compared to non-Hispanic whites of higher SES (42.0%), while racial/ethnic minorities were associated with the lowest full remission rates regardless of whether they were of low (9.1%) or higher (11.1%) SES. Conclusion Our novel data indicate that gender-, racial/ethnic- and socioeconomic-related disparities in insomnia not only occur as early as childhood but are important determinants of insomnia’s chronic course throughout development. Support National Institutes of Health (R01HL136587, R01HL97165, R01HL63772, UL1TR000127)

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

Mixture Modeling to Characterize Anorexia Nervosa: Integrating Personality and Eating Disorder Psychopathology

2019 ◽  
pp. 107839031986202
Author(s):  
Karen M. Jennings ◽  
Lindsay P. Bodell ◽  
Ross D. Crosby ◽  
Ann F. Haynos ◽  
Jennifer E. Wildes
Keyword(s):  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Latent Class ◽  
Clinical Presentation ◽  
Mixture Modeling ◽  
Eating Disorder Psychopathology ◽  
Personality Psychopathology ◽  
Latent Dimension ◽  
Eating Disorder Behaviors

BACKGROUND: Efforts to examine alternative classifications (e.g., personality) of anorexia nervosa (AN) using empirical techniques are crucial to elucidate diverse symptom presentations, personality traits, and psychiatric comorbidities. AIM: The purpose of this study was to use an empirical approach (mixture modeling) to test an alternative classification of AN as categorical, dimensional, or hybrid categorical–dimensional construct based on the co-occurrence of personality psychopathology and eating disorder clinical presentation. METHOD: Patients with AN ( N = 194) completed interviews and questionnaires at treatment admission and 3-month follow-up. Mixture modeling was used to test whether indicators best classified AN as categorical, dimensional, or hybrid. RESULTS: A four-latent class, one-latent dimension mixture model that was variant across groups provided the best fit to the data. Results suggest that all classes were characterized by low self-esteem and self-harming and suicidality tendencies. Individuals assigned to Latent Class 2 (LC2; n = 21) had a greater tendency toward being impulsive and easily angered and having difficulties controlling anger compared with those in LC1 ( n = 84) and LC3 ( n = 66). Moreover, individuals assigned to LC1 and LC3 were more likely to have a poor outcome from intensive treatment compared with those in LC4 ( n = 21). Findings indicate that the dimensional aspect within each class measured frequency of specific eating disorder behaviors but did not predict treatment outcomes. CONCLUSION: These results emphasize the complexity of AN and the importance of considering how facets of clinical presentation beyond eating disorder behaviors may have different treatment and prognostic implications.

scholarly journals Emotion regulation group skills training: a pilot study of an add-on treatment for eating disorders in a clinical setting

2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Kristina Holmqvist Larsson ◽  
Anna Lowén ◽  
Linda Hellerstedt ◽  
Linn Bergcrona ◽  
Mimmi Salerud ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Emotion Regulation ◽  
Eating Disorder ◽  
Pilot Study ◽  
Clinical Setting ◽  
Skills Training ◽  
Adjunctive Treatment ◽  
Paired Samples ◽  
Clinical Impairment ◽  
Group Skills

Abstract Background Emotion regulation difficulties appear to play a role in the development and maintenance of several eating disorders. This pilot study aimed at examining whether a short add-on group skills training in emotion regulation for young adults with different eating disorders was feasible in a psychiatric clinical setting. We also investigated if the treatment increased knowledge of emotions, and decreased self-reported difficulties with emotion regulation, alexithymia, symptoms of eating disorder, anxiety and depression, as well as clinical impairment. Methods Six skills training groups were piloted with a total of 29 participants (M = 21.41 years, SD = 1.92). The treatment consisted of five sessions dealing with psychoeducation about emotions and emotion regulation skills training. Paired samples t-test was used to compare differences between before-and-after measures. Results The primary outcomes measures difficulties in emotion regulation (p <  0.001) and alexithymia (p <  0.001) showed significant improvement after treatment. The total eating disorder score (p = 0.009) was also significantly reduced, as was clinical impairment (p <  0.001). Acceptance/valued direction, identifying primary emotions and learning about secondary emotions was rated as especially helpful. Conclusions This preliminary pilot study showed that group training targeting emotion regulation skills was feasible and appreciated by participants, as well as being potentially promising as an adjunctive treatment for different eating disorders. Further controlled studies are needed. Trial registration The study was retrospectively registered NCT04148014 on October 30th 2019.

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