scholarly journals Lifetime Weight Characteristics of Adult Inpatients With Severe Anorexia Nervosa: Maximal Lifetime BMI Predicts Treatment Outcome

2021 ◽  
Vol 12 ◽  
Author(s):  
Lisa-Katrin Kaufmann ◽  
Hanspeter Moergeli ◽  
Gabriella Franca Milos
Keyword(s):  
Anorexia Nervosa ◽  
Treatment Outcome ◽  
Strong Predictor ◽  
Negative Influence ◽  
Positive Influence ◽  
The Body ◽  
Linear Regression Models ◽  
Weight Suppression ◽  
Positive Treatment

Background: The body mass index is a key predictor of treatment outcome in patients with anorexia nervosa. In adolescents, higher premorbid BMI is a strong predictor of a favorable treatment outcome. It is unclear whether this relationship holds true for adults with anorexia nervosa. Here, we examine adult patients with AN and investigate the lowest and highest lifetime BMI and weight suppression as predisposing factors for treatment outcome.Methods: We included 107 patients aged 17–56 with anorexia nervosa and tracked their BMI from admission to inpatient treatment, through discharge, to follow-up at 1–6 years. Illness history, including lowest and highest lifetime BMI were assessed prior to admission. We used multiple linear regression models with minimal or maximal lifetime BMI or weight suppression at admission as independent variables to predict BMI at admission, discharge and follow-up, while controlling for patients' age, sex, and duration of illness.Results: Low minimal BMI had a negative influence on the weight at admission, which in turn resulted in a lower BMI at discharge. Higher maximal BMI had a substantial positive influence on BMI at discharge and follow-up. Weight suppression was highly correlated with maximal BMI and showed similar effects to maximal BMI.Conclusion: Our findings strongly support a relationship between low minimal lifetime BMI and lower BMI at admission, and between higher maximal lifetime BMI or weight suppression and a positive treatment outcome, even years after discharge. Overall, maximal BMI emerged as the most important factor in predicting the weight course in adults with AN.

scholarly journals manuscript

2021 ◽  
Author(s):  
Lisa-Katrin Kaufmann
Keyword(s):  
Anorexia Nervosa ◽  
Treatment Outcome ◽  
Strong Predictor ◽  
Negative Influence ◽  
Positive Influence ◽  
The Body ◽  
Linear Regression Models ◽  
Weight Suppression ◽  
Positive Treatment

Background: The body mass index is a key predictor of treatment outcome in patients with anorexia nervosa. In adolescents, higher premorbid BMI is a strong predictor of a favourable treatment outcome. It is unclear whether this relationship holds true for adults with anorexia nervosa. Here, we examine adult patients with AN and investigate the lowest and highest lifetime BMI and weight suppression as predisposing factors for treatment outcome.Methods: We included 107 patients aged 17-56 with anorexia nervosa and tracked their BMI from admission to inpatient treatment, through discharge, to follow-up at 1-6 years. Illness history, including lowest and highest lifetime BMI were assessed prior to admission. We used multiple linear regression models with minimal or maximal lifetime BMI or weight suppression at admission as independent variables to predict BMI at admission, discharge and follow-up, while controlling for patients’ age, sex, and duration of illness. Results: Low minimal BMI had a negative influence on the weight at admission, which in turn resulted in a lower BMI at discharge. Higher maximal BMI had a substantial positive influence on BMI at discharge and follow-up. Weight suppression was highly correlated with maximal BMI and showed similar effects to maximal BMI.Conclusion: Our findings strongly support a relationship between low minimal lifetime BMI and lower BMI at admission, and between higher maximal lifetime BMI or weight suppression and a positive treatment outcome, even years after discharge. Overall, maximal BMI emerged as the most important factor in predicting the weight course in adults with AN.

Factors affecting tender price in the Ghanaian construction industry

2017 ◽  
Vol 22 (3) ◽  
pp. 252-268 ◽  
Author(s):  
Ernest Kissi ◽  
Theophilus Adjei-Kumi ◽  
Edward Badu ◽  
Emmanuel Bannor Boateng
Keyword(s):  
Construction Industry ◽  
Structural Equation ◽  
Construction Projects ◽  
Negative Influence ◽  
Positive Influence ◽  
The Body ◽  
Content Type ◽  
Factors Affecting ◽  
Practical Implications ◽  
Structured Questionnaire

Purpose Tender price remains an imperative parameter for clients in deciding whether to invest in a construction project, and it serves as a basis for tender price index (TPI) manipulations. This paper aims to examine the factors affecting tender price in the construction industry. Design/methodology/approach Based on the literature review, nine independent constructs and one dependent construct relating to tender pricing were identified. A structured questionnaire survey was conducted among quantity surveyors in Ghana. Partial least squares structural equation modelling (PLS-SEM) examined the influences of various constructs on tender price development (TPD) and the relationships among TPD and TPI. Findings Results showed that cultural attributes, client attributes, contractor attributes; contract procedures and procurement methods; consultant and design team; external factors and market conditions; project attributes; sustainable and technological attributes; and TPI have a positive influence on tender price, whereas fraudulent attributes exert a negative influence. Practical implications The findings offer construction professionals broader understanding of factors that affect tender pricing. The results may be used in professional decision-making in the pricing of construction projects, as they offer clearer causal relations between how each construct will influence pricing. Originality/value This study adds to the body of construction pricing knowledge by establishing the relationships and degree of influences of various factors on tender price. These findings provide a valuable reference for practitioners.

Factors Affecting the Price of Luxury Suites in Major North American Sports Facilities

2012 ◽  
Vol 26 (3) ◽  
pp. 249-257 ◽  
Author(s):  
Stephen L. Shapiro ◽  
Tim DeSchriver ◽  
Daniel A. Rascher
Keyword(s):  
North American ◽  
Negative Influence ◽  
Positive Influence ◽  
The Body ◽  
Professional Sport ◽  
Sports Facilities ◽  
Sporting Events ◽  
Empirical Examination ◽  
Factors Affecting ◽  
Explanatory Variables

Luxury suites have become a key revenue source and an important element of sport facility design for professional sport organizations. There are a variety of factors influencing the pricing of luxury suites; however, the recent recession has impacted the premium seat sales market significantly. The current investigation was the first empirical examination of luxury suite pricing determinants for professional sport facilities. An economic model, utilizing multiple regression analysis, was constructed to examine the relationship between the current price of luxury suites for major North American professional sports facilities and selected demographic, economic, and team/facility/league-specific explanatory variables, in a uncertain economic climate. The final economic models were found to be significant, explaining 57% and 60% of the variability in luxury suite prices, respectively. Significant variables of interest included team performance and league affiliation, which had a positive influence and the number of competing venues, which had a negative influence on luxury suite prices. The current findings further the body of knowledge in the pricing of admissions to sporting events though the development of the first pricing determinants models for luxury suites, which take into consideration the tenuous economic environment.

scholarly journals An evaluation of a manualised group self-esteem programme for Anorexia Nervosa patients regaining weight

2019 ◽  
Vol 3 (3) ◽  
Author(s):  
Hannah Biney ◽  
Matt Hutt ◽  
Rachel Matthews ◽  
Hubert Lacey
Keyword(s):  
Anorexia Nervosa ◽  
Strong Predictor ◽  
Self Esteem ◽  
Service Evaluation ◽  
Behavioural Therapy ◽  
Primary Diagnosis ◽  
Paired Samples ◽  
Cognitive Behavioural ◽  
The Uk

Low self-esteem has been identified as a strong predictor of onset, maintenance and relapse in eating disorders. This suggests that treatment directly addressing low self-esteem might improve recovery. The Cognitive Behavioural Therapy (CBT) based group for low self-esteem is a six session manualised programme based on Melanie Fennel’s model for low self-esteem. It was developed at Newbridge House, a child and adolescent eating disorder inpatient unit in the UK. Although the use of CBT for low self-esteem is established in adult services, the Newbridge programme, adapting the same principles for children and adolescents, is to our knowledge, the first of its kind. This paper reports a service evaluation (N=63) which examines the efficacy of this group in improving low self-esteem for 12-17 year olds with a primary diagnosis of Anorexia Nervosa (AN). Paired-samples t-tests compared the differences in pre- to post-group and post-group to follow-up. Results indicate significant improvements in self-esteem as shown by improvements on the Rosenberg Self-Esteem scale, which are maintained at follow-up. This highlights that group manualised CBT for low self-esteem is effective for young people with AN and indicates the need for future controlled studies.

scholarly journals Motivation to Change in the Course of a Pilot Study of a Step-Down Treatment Approach of Inpatient and Anorexia Nervosa-Specific Home Treatment and Its Effects on Treatment Outcome

2021 ◽  
Vol 12 ◽  
Author(s):  
Kathrin Sophie Heider ◽  
Astrid Dempfle ◽  
Sophie Altdorf ◽  
Beate Herpertz-Dahlmann ◽  
Brigitte Dahmen
Keyword(s):  
Anorexia Nervosa ◽  
Treatment Outcome ◽  
Inpatient Treatment ◽  
Treatment Approach ◽  
Illness Severity ◽  
Home Treatment ◽  
Motivation To Change ◽  
Sum Score ◽  
Step Down

Introduction: Anorexia nervosa (AN) is a serious mental disorder that typically manifests in adolescence. Motivation to change is an important predictor for treatment outcome in adolescent AN, even though its development over the often long therapeutic process, with transitions between treatment settings, has not yet been studied. In this pilot study, the course of motivation to change and its effect on treatment outcome were investigated over the course of a step-down treatment approach during a 12-month observation period.Methods: Twenty-one adolescents admitted to inpatient treatment because of AN received multidisciplinary home treatment (HoT) with several weekly visits after short inpatient stabilization. Eating disorder (ED-)specific cognitive [Eating Disorder Inventory 2 (EDI-2) subscales] and physical [% expected body weight (%EBW)] illness severity and motivation to change [Anorexia Nervosa Stages of Change Questionnaire (ANSOCQ)] were assessed at the time of admission, discharge from hospital, at the end of HoT, and at a 12-month follow-up. Changes in motivation over time and its relationship with treatment outcome were investigated.Results: Mean motivation to change improved significantly over the course of treatment from the contemplation stage [2nd stage, mean ANSOCQ sum score 47.26 (SD 17.60)] at admission to the action stage [4th stage, mean ANSOCQ sum score 77.64 (SD 18.97)] at the end of HoT (p < 0.001) and remained stable during the follow-up period. At each assessment, higher motivation to change was significantly correlated with lower ED-specific cognitive illness severity (Spearman ρs: −0.53 to −0.77, all p < 0.05). Only pretreatment motivation to change significantly predicted ED-specific cognitive illness severity after the first inpatient treatment phase when taking prior illness severity into account.Conclusions: Motivation to change is an important aspect of treatment success in adolescent AN, especially in the early phase of treatment. In addition, home treatment contributed significantly to a higher motivation. Further longitudinal research into how motivation to change in adolescent patients with AN is related to outcome in this often severe and enduring disease and into targeted therapeutic strategies and interventions that reliably enhance the motivation to change in adolescent patients with AN seems promising.

scholarly journals Predictors of Positive Treatment Outcome in People With Anorexia Nervosa Treated in a Specialized Inpatient Unit: The Role of Early Response to Treatment

2016 ◽  
Vol 24 (5) ◽  
pp. 417-424 ◽  
Author(s):  
Jackie Wales ◽  
Nicola Brewin ◽  
Rebecca Cashmore ◽  
Emma Haycraft ◽  
Jonathan Baggott ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Treatment Outcome ◽  
Early Response ◽  
Inpatient Unit ◽  
Response To Treatment ◽  
Positive Treatment

Long Term Outcome of Anorexia Nervosa

1993 ◽  
Vol 10 (2) ◽  
pp. 93-102 ◽  
Author(s):  
Lyndall M. Jones ◽  
W.K. Halford ◽  
Roger T. Dooley
Keyword(s):  
Anorexia Nervosa ◽  
Strong Predictor ◽  
Significant Degree ◽  
Self Report ◽  
Social Maladjustment ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Clinically Significant

The long-term outcome (mean follow-up period 5.7 years) for 20 patients with anorexia nervosa was assessed on a comprehensive battery of self-report inventories and a structured clinical interview. Two thirds of the cohort were improved to a clinically significant degree at follow-up, but the majority still showed higher than normal scores on inventories of anorexic symptomatology, social maladjustment, anxiety, and hostility. The remaining one third were unimproved and demonstrated a broad range of impairment including distorted attitudes toward eating, overconcern about body shape, poor social functioning, high levels of anxiety, hostility, depression, and external locus of control. Moderate to strong correlations were found across outcome measures. Longer duration of eating difficulties before presentation was a strong predictor of poor long-term outcome, suggesting a chronic relapsing form of the disorder occurred in a subgroup of patients.

scholarly journals Reduction of High Expressed Emotion and Treatment Outcomes in Anorexia Nervosa—Caregivers’ and Adolescents’ Perspective

2020 ◽  
Vol 9 (7) ◽  
pp. 2021 ◽  
Author(s):  
Julia Philipp ◽  
Stefanie Truttmann ◽  
Michael Zeiler ◽  
Claudia Franta ◽  
Tanja Wittek ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Mixed Models ◽  
Regression Models ◽  
Expressed Emotion ◽  
Comparison Group ◽  
Linear Regression Models ◽  
Motivation To Change ◽  
Post Intervention ◽  
Patients Perspective

High expressed emotion (EE) is common in caregivers of patients with anorexia nervosa (AN) and associated with poorer outcome for patients. In this study, we examined the prevalence of high EE in caregivers of adolescents with AN and analyzed predictors for EE using multivariate linear regression models. We further analyzed whether EE is reduced by the “Supporting Carers of Children and Adolescents with Eating Disorders in Austria” (SUCCEAT) intervention using general linear mixed models and whether a reduction of EE predicts patients’ outcomes. Caregivers were randomly allocated to the SUCCEAT workshop (N = 50) or online intervention (N = 50) and compared to a comparison group (N = 49). EE and patients’ outcomes were assessed at the baseline, post-intervention, and at the 12-month follow-up. Up to 47% of caregivers showed high EE. Lower caregiver skills, higher AN symptom impact, higher levels of depression and motivation to change in caregivers were significant predictors for high EE. EE significantly decreased in the SUCCEAT groups and the comparison group according to the caregivers’, but not the patients’ perspective. The level of reduction could partially predict subjective improvement and improvement in clinically assessed AN symptoms and body mass index of patients. Implementing interventions for caregivers addressing EE in the treatment of adolescents with AN is strongly recommended.

scholarly journals A dual perspective on first-session therapeutic alliance: strong predictor of youth mental health and addiction treatment outcome

2020 ◽  
Vol 29 (11) ◽  
pp. 1593-1601 ◽  
Author(s):  
Patty van Benthem ◽  
Renske Spijkerman ◽  
Peter Blanken ◽  
Marloes Kleinjan ◽  
Robert R. J. M. Vermeiren ◽  
...  
Keyword(s):  
Mental Health ◽  
Treatment Outcome ◽  
Therapeutic Alliance ◽  
Addiction Treatment ◽  
Strong Predictor ◽  
Youth Mental Health ◽  
Dual Perspective ◽  
First Session

Abstract We investigated the potential role of first-session therapeutic alliance ratings to serve as an early marker of treatment outcome in youth mental health and addiction treatment. The present study is among the first to incorporate both a youths’ and a therapists’ perspective of the therapeutic alliance in order to maximize predictive value of the alliance for treatment outcome. One hundred and twenty-seven adolescents participated in a multi-site prospective naturalistic clinical cohort study, with assessments at baseline and at 4 months post-baseline. Main outcome measure was favorable or unfavorable treatment outcome status at 4-month follow-up. Early therapeutic alliance had a medium and robust association with treatment outcome for youth’ (b = 1.29) and therapist’ (b = 1.12) perspectives and treatment setting. Based on the two alliance perspectives four subgroups were distinguished. Incorporating the alliance-ratings from both perspectives provided a stronger predictor of treatment outcome than using one perspective. Youth with a strong alliance according to both perspectives had an eightfold odds of favorable treatment outcome compared with youth with a weak alliance according to both perspectives. The association between therapeutic alliance and treatment outcome in youth mental health and addiction treatment may be substantially stronger than earlier assumed when both a youths’ and therapists’ perspective on alliance is considered.

scholarly journals Attachment and mentalization as predictors of outcome in family therapy for adolescent anorexia nervosa

2020 ◽  
Author(s):  
Tom Jewell ◽  
Moritz Herle ◽  
Lucy Serpell ◽  
Alison Eivors ◽  
Mima Simic ◽  
...  
Keyword(s):  
Emotion Regulation ◽  
Anorexia Nervosa ◽  
Treatment Outcome ◽  
Family Therapy ◽  
Mental States ◽  
Self Report ◽  
Mediating Role ◽  
Poor Outcome ◽  
Positive Treatment ◽  
Adolescent Anorexia Nervosa

Objective: Anorexia nervosa focussed family therapy (FT-AN) is the first-line treatment for adolescent anorexia nervosa (AN), but the predictors of poor treatment response are not well-understood. The main aim of this study was to investigate the role of attachment and mentalization in predicting treatment outcome at nine months. Therapeutic alliance at one month was tested as a potential mediator of the effect of attachment and mentalization at baseline on outcome at nine months.Method: 192 adolescents with AN and their parents were recruited as they began family therapy in out-patient specialist eating disorder services. Self-report measures of attachment, mentalization and emotion regulation were completed at the start of treatment by adolescent patients and one of their parents. Self-reported alliance scores were collected at one month. Results: Higher scores on the Certainty Scale of the Reflective Functioning Questionnaire, completed by parents, which indicate over-certainty about mental states, were the strongest predictor of poor outcome (Odds Ratio: .42, CI: .20 to .87). Similarly, for adolescents, higher Lack of Clarity scores on the Difficulties in Emotion Regulation Scale, representing being unclear about one’s feelings, were predictive of positive treatment outcome (OR: 1.10, CI: 1.00 - 1.21). Alliance scores at one month were predictive of success but did not play a mediating role in relation to baseline predictors.Conclusion: These novel findings suggest that, particularly in parents, a tendency towards inappropriate certainty about mental states in others may predict poor outcome in family therapy for adolescent AN. Further research is warranted to replicate the finding and characterise families at risk of poor outcome.

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