To ensure that this area continues to develop with robust and clinically relevant findings, future studies should adopt a consistent definition of outcome and continue to examine complex multivariate predictor models. Growth in this area will allow for stronger conclusions to be drawn about the prediction of outcome for specific diagnoses and treatment types.

No abstract

Set-shifting inefficiencies have been consistently identified in adults with anorexia nervosa (AN). It is less clear to what degree similar inefficiencies are present in those with bulimia nervosa (BN). It is also unknown whether perfectionism is related to set-shifting performance. We employed a commonly used set-shifting measure, the Trail Making Test (TMT), to compare the performance of inpatients with AN and BN with a healthy control sample. We also investigated whether perfectionism predicted TMT scores. Only the BN sample showed significantly suboptimal performance, while the AN sample was indistinguishable from controls on all measures. There were no differences between the AN subtypes (restrictive or binge/purge), but group sizes were small. Higher personal standards perfectionism was associated with better TMT scores across groups. Higher concern over mistakes perfectionism predicted better accuracy in the BN sample. Further research into the set-shifting profile of individuals with BN or binge/purge behaviours is needed.

Objective: This pilot study investigated predictors, moderators, and mediators of outcome and readmission in adolescents receiving specialist inpatient treatment for anorexia nervosa.Method: Adolescents (n = 40) aged between 14 and 17 years (mean = 15.42) were assessed at admission and discharge from a specialist inpatient programme and again at three-month follow-up on the following outcome variables: eating disorder pathology, quality of life (QOL), and body mass index (BMI) centile. Readmissions to hospital were recorded over the three months post-discharge period. Potential predictors were drawn from theoretical models.Results: Readmission during the three-month follow-up period was less likely for first presentations. Higher baseline purging, concern over mistakes, perfectionism, ineffectiveness, and mood intolerance were associated with higher levels of eating disorder pathology and poorer QOL over all points of follow-up. Driven exercise moderated weight outcomes such that higher levels of baseline exercise resulted in a lower BMI centile at follow-up. Greater weight gain during treatment predicted higher BMI centile at followup, and increased perfectionism during treatment predicted a greater likelihood of being readmitted within three months of discharge. Conclusions:Weight gain during inpatient treatment should be encouraged to improve later weight outcomes. Focusing on the prevention of growth in perfectionism may be useful in improving psychological outcomes as will prioritising the elimination of purging and improved emotional regulation and self-efficacy. Efforts should be made to reduce driven exercise to promote better weight-related outcomes.

Service development informed by research evidence, clinical expertise, and consideration of patients' characteristics, values, and circumstances, allows for a flexible but accountable development strategy.