Search results for ‘Subject term:"eating disorders"’ Sort:
Results 1 - 10 of 31
The effects of a multiple family therapy on adolescents with eating disorders: an outcome study
- Authors:
- GELIN Zoe, et al
- Journal article citation:
- Family Process, 54(1), 2015, pp.160-172.
- Publisher:
- Wiley
Multiple Family Therapy (MFT) has gained increasing popularity in the treatment of eating disorders but there is little evidence in the literature on the effectiveness on MFT for treating eating disorders. The study examines the effects of a particular model of Multiple Family Therapy on eating disorder symptoms, quality of life, and percentage of Expected Body Weight (%EBW) in adolescents with eating disorders (ED). Eighty-two adolescents with ED, aged between 11 and 19 years, were assessed before and after treatment using the Eating Disorders Inventory 2 (EDI-2), the Outcome Questionnaire 45 (OQ-45) and %EBW. Results showed a significant increase in %EBW between the beginning and end of treatment, with a large effect size. 52.4% of patients achieved an EBW above 85%. Symptoms relative to all EDI dimensions (except for bulimia) significantly decreased during treatment. The three dimensions related to quality of life assessment also improved over the course of MFT. At the end of treatment, 70.7% of patients had a total OQ-45 score below clinical significance. This study suggests that Multiple Family Therapy may benefit adolescents with eating disorders, with improvement on several outcome measures (%EBW, ED symptoms, and quality of life). However, the lack of a comparison group entails caution when drawing conclusions. (Edited publisher abstract)
Out-patient psychological therapies for adults with anorexia nervosa: randomised controlled trial
- Authors:
- SCHMIDT Ulrike, et al
- Journal article citation:
- British Journal of Psychiatry, 201(5), November 2012, pp.392-399.
- Publisher:
- Cambridge University Press
Psychotherapy is the treatment of choice for anorexia nervosa but outcomes are often poor and drop-out rates high. This randomised controlled trial evaluated the efficacy and acceptability of a novel psychological therapy, the Maudsley Model of Anorexia Nervosa Treatment for Adults, (MANTRA) and compared it with specialist supportive clinical management (SSCM). Seventy-two adult out-patients with anorexia nervosa (or other non-specified eating disorder) were recruited from a specialist centre in London. Participants were allocated to 20 weekly sessions of MANTRA or SSCM and optional additional sessions depending on clinical need. Primary outcomes were body mass index, weight and global score on the Eating Disorders Examination at end of treatment (6 months) and follow-up (12 months). Secondary outcomes included: depression, anxiety and clinical impairment; neuropsychological outcomes; recovery rates; and additional service utilisation. At baseline, patients randomised to MANTRA were significantly less likely to be in a partner relationship than those receiving SSCM. Patients in both group improved equally in terms of eating disorder and other outcomes. Strictly defined recovery rates were low. MANTRA patients were significantly more likely to require additional in-patient or day-care treatment. The imbalance between groups in partner relationships may explain differences in service utilisation. The study confirms SSCM as a useful treatment for out-patients with anorexia nervosa but suggests that MANTRA may need adaptations to fully exploit its potential.
Social emotional functioning and cognitive styles in eating disorders
- Authors:
- HARRISON Amy, et al
- Journal article citation:
- British Journal of Clinical Psychology, 51(3), September 2012, pp.261-279.
- Publisher:
- Wiley
Models of eating disorders (EDs) argue that both cognitive style and social emotional difficulties are involved in the maintenance of EDs. This study investigated the factor structure of cognitive and social emotional functioning and investigated whether a particular cognitive or social emotional profile was associated with a more severe and chronic form of illness. Two hundred twenty-five participants were assessed using a battery of set shifting, coherence, and social emotional measures. Findings indicated that there were no significant correlations between the cognitive or social emotional variables. Analysis identified three components: a fragmented perseverative cognitive style (worry and rumination), for which the ED group scored highly; a global flexible cognitive style, for which HCs scored highly; and a social emotional difficulties profile, for which those with EDs scored highly. Individuals in recovery from an ED did not differ from the acute group, suggesting this cognitive and social emotional profile may be a trait associated with EDs. The authors concluded that the findings provided empirical support for Schmidt and Treasure's (2006) maintenance model of EDs. Implications for practice are discussed.
Deficits in emotion regulation mediate the relationship between childhood abuse and later eating disorder symptoms
- Authors:
- BURNS Erin E., et al
- Journal article citation:
- Child Abuse and Neglect, 36(1), 2012, pp.32-39.
- Publisher:
- Elsevier
This study investigated the relationship between child abuse and emotion dysregulation and subsequent eating disorders. It examined the impact of childhood emotional abuse (CEA) on emotion dysregulation and eating disorder (ED) symptoms while controlling for the effects of sexual and physical abuse. Structural equation modelling was used to examine the effects of all three abuse types on multiple variables as well as whether deficits in emotion regulation mediated the relationship between abuse and eating disorders. Participants included 1,254 female college students from the United States. Findings revealed significant paths from abuse subtypes to specific eating disorder symptoms, with CEA evidencing the strongest association with ED symptoms. Emotion dysregulation was positively associated with ED symptoms, and mediated the effects of emotional abuse on symptoms. The authors concluded that the findings highlight the importance of the assessment of CEA in the treatment of ED symptoms later in life.
Childhood eating disorders: British national surveillance study
- Authors:
- NICHOLLS Dasha E., LYNN Richard, VINER Russell M.
- Journal article citation:
- British Journal of Psychiatry, 198(4), April 2011, pp.295-301.
- Publisher:
- Cambridge University Press
The incidence of eating disorders has been fairly static over the last few decades, however individuals with anorexia nervosa seem to be presenting at an earlier age. Current knowledge about early onset (before 13 years of age) has mostly been derived from specialised clinical settings. The broader epidemiological data needed to plan appropriate services are limited. New cases of early-onset eating disorders presenting to secondary care in the UK over a 14 month surveillance period were identified. Overall incidence was 3.01/100 000 (208 individuals, 82% female, 86% white British). There was a clear link between incidence and increasing age; no cases were identified under the age of five years. In total, 37% met criteria for anorexia nervosa; 1.4% for bulimia nervosa; and 43% for eating disorder not otherwise specified. Nineteen per cent showed determined food avoidance and underweight without weight/shape concerns. Rates of comorbidity (depression, anxiety and OCD) were 41%; family history of psychiatric disorder 44%; and early feeding difficulties 21%. Time to presentation was more than 8 months. A total of 50% were admitted to hospital, usually soon after diagnosis. Outcome data were available for 76% of individuals; at 1 year, 73% were reported improved, 6% worse and 10% unchanged (11% unknown). Most were still in treatment, and seven were hospital in-patients for most of the year.
The short term effectiveness of day treatment for eating disorders in reducing psychosocial impairment: utilizing the clinical impairment assessment in routine practice
- Authors:
- HEPBURN Zoe, et al
- Journal article citation:
- Mental Health Review Journal, 21(1), 2016, pp.11-22.
- Publisher:
- Emerald
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. (Publisher abstract)
Effectiveness of adult day treatment for eating disorders
- Authors:
- HEPBURN Zoe, WILSON Kim
- Journal article citation:
- Mental Health Review Journal, 19(2), 2014, pp.131-144.
- Publisher:
- Emerald
Purpose: This paper assesses 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. (Edited publisher abstract)
Effectiveness of parent counselling in eating disorders
- Authors:
- ABBATE-DAGA Giovanni, et al
- Journal article citation:
- British Journal of Guidance and Counselling, 41(4), 2013, pp.375-394.
- Publisher:
- Taylor and Francis
Eating Disorders (ED) are often severe illnesses entailing a heavy burden for families. Family therapy is recommended for young patients, but only a few studies have investigated therapeutic interventions with families tailored also to adult and longstanding patients. The authors recruited 87 families with daughters affected by an ED, aiming to assess the effectiveness of eight sessions of parent counselling. The primary outcome was the improvement of parents' coping abilities to achieve more effective support skills. Before treatment, 54% of parents showed poor coping resources whereas 43.7% of the sample improved after parent counselling. Parents with good coping resources responded significantly better to this treatment. Although future research is warranted, these preliminary findings support the effectiveness of parent counselling in ED.
Multiple family therapy for adolescents with anorexia nervosa: a pilot study of eating disorder symptoms and interpersonal functioning
- Authors:
- HOLLESEN Anette, CLAUSEN Loa, ROKKEDAL Kristian
- Journal article citation:
- Journal of Family Therapy, 35(S1), 2013, pp.53-67.
- Publisher:
- Wiley
The study examined the effect of multiple family therapy on eating disorder symptoms and interpersonal functioning in adolescents with anorexia nervosa (AN). Pre-treatment and post-treatment, twenty patients with AN (n = 8) or atypical AN (EDNOS-AN) (n = 12) attending an Eating Disorder Centre in Denmark were assessed using the eating disorder examination and the eating disorder inventory, inventory of interpersonal problems and structural analysis of social behaviour-Intrex questionnaires. A group was made up of six to seven patients and their families and treatment consisted of 12 days spread over approximately 1 year. The expected reduction in eating disorder symptomatology was observed, with significant improvement in the patients' body mass index, and a reduction in their restriction, eating concern, weight concern, amount of exercise and drive for thinness. Significant improvements were also found in their interoceptive awareness, self-affirmation and a reduction in their self-blame. The expected reduction in interpersonal problems was not found. However, tendencies for the patients to feel less dominating and vindictive in general, as well as tendencies towards more control/emancipation in relation to the parents were found and are discussed. (Edited publisher abstract)
Assessing the impact on patient health of attending a day treatment programme for eating disorders
- Authors:
- WOLFE Emma, OGDEN Jane, CLARE Leigh
- Journal article citation:
- Mental Health Review Journal, 14(1), March 2009, pp.12-19.
- Publisher:
- Emerald
A repeated measures cohort study was conducted to investigate the impact of attending a day treatment programme on physical and psychological state, and to assess which baseline factors predicted level of recovery. Physical and psychological outcomes of treatment were analysed for 116 patients admitted to the treatment programme at the Landsdown Unit, Farnham Hospital and Centre for Health in Surrey, between 1996 and 2006 and were found to be in line with previous day care evaluations, with the majority of patients showing improvements on all measures. A multiple regression analysis revealed several factors to be predictive of treatment outcomes including patient demographics, comorbidities and traumatic life events. In particular, those patients who benefited most from the treatment had a lower body mass index at admission, stayed longer at the unit, were older, less likely to have other physical and psychiatric comorbidities, particularly obsessive compulsive disorder or a history of sexual abuse, and whose most predominant eating disorder problem was characterised by low weight.