Changes in meal-related anxiety predict treatment outcomes in an intensive family-based treatment program for adolescents with anorexia nervosa

Smith, Kellsey; Huysse, Jessica L. Van; Rienecke, Renee D.

doi:10.1080/10640266.2019.1688008

Cited by 13 publications

(23 citation statements)

References 21 publications

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“…As in phase 1 of FBT, the focus of the PHP is on parental management of food and other ED behaviors to facilitate weight restoration. Further details about this program are described elsewhere (e.g., Hoste, ; Smith, Van Huysse, & Rienecke, ).…”

Section: Methodsmentioning

confidence: 99%

Early weight gain predicts treatment response in adolescents with anorexia nervosa enrolled in a family‐based partial hospitalization program

Huysse

Smith

Mammel

et al. 2020

Intl J Eating Disorders

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Objective: Improved treatment outcome in family-based treatment (FBT) for anorexia nervosa (AN) is predicted by weight gain occurring early in the course of treatment (i.e., about 4 lbs by week 4). Although prior work suggests that early weight gain in higher levels of care (e.g., partial hospitalization programs [PHP]) predicts weight restoration at discharge, no study has examined the specific rate of gain within FBT-informed PHP programs that best predicts treatment response. Method: This study examined rate of weight gain in pounds and percent expected body weight (EBW) that predicts positive outcome in 70 patients (M age = 15.49 years, SD = 2.56) with AN who were enrolled in a family-based PHP. Results: Receiver operator characteristic analyses demonstrated that changes in % EBW during weeks 2-5 were more useful than changes in weight in predicting positive outcome. Gaining at least 8.9 pounds or over 8% of EBW in the first 4 weeks of treatment significantly predicted positive outcome. Discussion: Findings suggest that positive outcome in an FBT-informed PHP is predicted by rapid weight gain in the initial weeks of treatment. Research is needed to identify specific family and patient characteristics that facilitate weight gain and to develop corresponding interventions to improve outcome. K E Y W O R D S adolescent, anorexia nervosa, body weight, treatment outcome, weight gain

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Section: Methodsmentioning

confidence: 99%

Early weight gain predicts treatment response in adolescents with anorexia nervosa enrolled in a family‐based partial hospitalization program

Huysse

Smith

Mammel

et al. 2020

Intl J Eating Disorders

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“…The results of this study also stresses the relevance of measuring meal related anxiety. Previous studies have found meal related anxiety to be related to outcome, both in underweight patients with AN [14] and in weight restored AN [13], and at least one study found that therapeutic interventions in relation to meal intake may influence meal-related anxiety [26]. The results of this study add to the number of studies including meal related anxiety as an outcome for intervention trials.…”

Section: Discussionmentioning

confidence: 54%

“…The anxiety may additionally remain even after weight restoration, as shown in a study where pre-meal anxiety in weight-restored patients with AN was significantly higher compared to healthy controls independent of meal type digested [13]. Furthermore, meal related anxiety has been found to be directly correlated to outcome [13,14], and even proposed as a specific target for treatment to improve outcome [13]. Thus, efforts to reduce meal related anxiety in a ward setting, remains a critical prerequisite for being able to achieve better treatment results with fewer relapses.…”

Section: Introductionmentioning

confidence: 95%

“…As the evidence for an effect of weight increase on anxiety is still sparce, and mealrelated anxiety is an important prognostic factor [13,14], and since increasing meal-related anxiety may directly counteract treatment efforts, and the influence of several factors such as medication and comorbid depression has not been studied, we aimed to examine levels of post-meal anxiety in patients with AN undergoing weight restoration as inpatients. Based upon clinical observations of inpatients with AN, we expected that anxiety would remain stable or even increase as the patients gained weight, hypothetically because weight gain would trigger the psychopathology of fear of weight gain.…”

Section: Introductionmentioning

confidence: 99%

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Inpatient Weight Restoration Treatment Is Associated with Decrease in Post-Meal Anxiety

Sjögren

Kizilkaya

Støving

2021

JPM

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Objective: Anorexia nervosa (AN) is characterized by weight loss, distorted body image with fear of becoming fat and associated with anxiety, especially in relation to food intake. Anxiety in relation to meals and weight restoration remains a major challenge in the treatment of AN. We examined the effects of inpatient weight restoration treatment on levels of post-meal anxiety using visual analogue scale (VAS) ratings in patients with AN. Materials: Thirty-two patients with AN, all part of the PROspective Longitudinal all-comer inclusion study on Eating Disorders (PROLED) were followed over eight weeks with baseline psychometric measures and weekly VAS anxiety self-scoring. Methods: Apart from the weekly body mass index (BMI) and VAS, patients were characterized at baseline using the Eating Disorder Examination Questionnaire (EDE-Q), Eating Disorder Inventory (EDI), Symptom Check List 92 (SCL-92), Major Depression Inventory (MDI), and Autism Quotient (AQ). Results: The results showed a significant time effect, Wilks Lambda = 0.523, F = 3.12, p < 0.05 (power of 0.862), indicating a reduction in VAS scores of anxiety from baseline to week 8. There was no effect of baseline medication or scores of MDI on the results. BMI increased from a mean of 15.16 (week 1) to 17.35 (week 8). In comparison, patients dropping out after only three weeks (n = 31) also had a trend toward a reduction in VAS anxiety (ns). Conclusions: Inpatient weight restoration treatment is associated with a decrease in post-meal anxiety in AN, an effect that occurs early and becomes clinically significant in patients who stay in treatment.

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“…In a recent study, Smith et al [ 12 ] examined changes occurring in meal-related anxiety as a potential predictor of outcomes within the context of a family-based partial hospitalisation programme and suggested that reductions in meal-related anxiety may be an important predictor of outcomes within the sphere of family-based interventions. Various researchers have underlined that future investigations are required to examine whether the direct targeting of meal anxiety may enhance the outcome of therapy.…”

Section: Introductionmentioning

confidence: 99%

Effects of Music Therapy in the Reduction of Pre-Meal Anxiety in Patients Suffering from Anorexia Nervosa

Ceccato

Roveran

2022

Brain Sciences

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Literature reviews appear to indicate that Music Therapy (MT) may instil a sense of empowerment and generate feelings of renewed self-confidence, distracting subjects who follow this type of intervention from negative thoughts and, generally, helping patients suffering from Anorexia Nervosa (AN) to redevelop or rediscover their identity. The purpose of the study reported in this paper is to investigate whether MT proposed before an evening meal is capable of decreasing pre-meal anxiety in adolescents suffering from AN who follow the Day-hospital Treatment Programme at the San Bortolo Hospital of Vicenza (Italy). A total of 24 patients participated voluntarily in once-weekly sessions of group-based MT conducted by a qualified music therapist over a period of six months. Before evening meals on Monday, Tuesday and Wednesday, pre-meal anxiety was measured using a self-report scale, and the MT group session occurred every Wednesday before the evening meal was consumed. MT activities were both active and receptive. It has been found that with respect to Mondays and Tuesdays, pre-meal anxiety was significantly lower on Wednesdays following participation in the MT group. MT is evidently capable of reducing pre-meal anxiety and may be adopted as a supportive element in treatment plans relating to patients with AN in a day-hospital treatment programme.

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Changes in meal-related anxiety predict treatment outcomes in an intensive family-based treatment program for adolescents with anorexia nervosa

Cited by 13 publications

References 21 publications

Early weight gain predicts treatment response in adolescents with anorexia nervosa enrolled in a family‐based partial hospitalization program

Early weight gain predicts treatment response in adolescents with anorexia nervosa enrolled in a family‐based partial hospitalization program

Inpatient Weight Restoration Treatment Is Associated with Decrease in Post-Meal Anxiety

Effects of Music Therapy in the Reduction of Pre-Meal Anxiety in Patients Suffering from Anorexia Nervosa

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