A Randomized Controlled Study of Cognitive Behavior Therapy and Behavioral Family Therapy for Anorexia Nervosa Patients

Abstract

Very few studies have examined the role of cognitive behavior therapy (CBT) in the outpatient treatment of anorexia nervosa. This study used a randomized, controlled design to evaluate a 12-month, manual based program of CBT, with behavioral family therapy as the comparison group. Twenty-five adolescents and young adults with anorexia nervosa, currently living with their families, were recruited into the study with both treatment groups receiving 21-25 sessions of therapy. Outcome measures included nutritional status, eating behaviors, mood, self-esteem, and family communication. Sixty percent of the total sample and 72% of treatment completers had "good" outcome (defined as maintaining weight within 10% of average body weight and regular menstrual cycles) at post-treatment and at six months follow-up. No significant differences between treatment groups were found and the majority of patients did not reach symptomatic recovery. While limited by the small sample size, the findings compliment and extend previous research.

Are obsessive‐compulsive personality traits associated with a poor outcome in anorexia nervosa? A systematic review of randomized controlled trials and naturalistic outcome studies

“…6,22,23,26,28 However, the effect sizes between the instruments used to measure the traits differed. The effect size in two studies reporting pre and post scores using the YBC-ED were 0.89 (ritual and preoccupation scale) 22 and 0.75 for long, versus 0.48 for short, family therapy.…”

“…6 In the remaining studies, either predictors of outcome were not assessed, assessed but not reported, 22,30,32 or no or other more significant predictors of outcome were found. 23,26,27,29,31 In two of these studies 23,31 it was unclear whether personality variables were included in outcome analyses.…”

Evidence-based psychotherapy for treatment of anorexia nervosa in children and adolescents: systematic review

“…In all studies, the criterion for the diagnosis of AN was DSM-III, IV or V, depending on the time of the study. The age group selected in the studies ranged from 11 to 20 years, with mean age ranging from 13.9 years (SD = 2.1) 29 to 18.45 (SD = 2.57) 25 . Female adolescents represented the majority in all studies.…”

Anorexia nervosa: diagnosis, risk factors and evidence‐based treatments

“…60 So far studies have provided little support for specialised psychotherapies or pharmacotherapies, conducted with both underweight and weight-restored individuals. [61][62][63][64][65][66][67][68][69] However, the Maudsley family-based therapy approach is one of the few empirical, evidencebased studies showing effectiveness in young people with AN under the age of 18 years. 70,71 Cognitive behavioural therapy (CBT) Due to some diagnostic uncertainties, an enhanced, 'trans diagnostic' approach to CBT has been established (CBT-E).…”