Dropout from Brief Psychotherapy in Anorexia nervosa

Abstract

Background: Dropout from psychotherapy is an important issue that has received little systematic attention. This study investigated the phenomenon of dropout from brief psychotherapy for anorexia nervosa (AN). Methods: 99 outpatients suffering from AN of the restrictor type (n = 53) or binge/purging type (n = 46) were evaluated. Their clinical and personal characteristics were recorded, and body mass index was calculated for participants. They were administered the Eating Disorder Inventory-II (EDI-II), the State-Trait Anger Expression Inventory (STAXI) and the Temperament and Character Inventory (TCI). Results: Significant differences in some baseline psychopathologic (EDI-II, STAXI) and personality (TCI) variables emerged from the comparison between dropouts and completers. Patients who dropped out of the treatment showed higher levels of anger temperament, anger expression-in and expression-out and lower scores for the dimensions of character (low self-directedness and low cooperativeness). No differences were found between the two groups regarding sociodemographic and clinical variables. Conclusions: Dropout from brief psychotherapy seems to be related to either psychopathologic or personality aspects, such as the tendency to repress anger, which is encountered also in psychosomatic disorders, and the presence of more compromised dimensions of character, typical of subjects with personality disorders. This study of dropout from brief psychotherapy in AN provided interesting results that will need further confirmation. Possible implications for treatment are addressed.

Anger and Perceived Parenting: A Study of a Japanese Population

“…Behaviour and the human mind, however, cannot be adequately understood without an appreciation of the pivotal role played by anger. Studies have examined the relation of anger with hypertension and cardiac diseases [1][2][3][4][5][6][7][8][9][10][11][12][13][14], eating disorders [15][16][17][18][19][20][21][22][23][24][25], and personality disorders [26, pp 20-21; 27, pp 267-268], as well as many other psychiatric disorders.…”

Effect of Aggression Regulation on Eating Disorder Pathology: RCT of a Brief Body and Movement Oriented Intervention

“…It is suggested that treatment of non-suicidal self-injury in ED should focus on stabilizing affective states rather than on reducing affects like anger (Vansteelandt et al, 2013). Despite such findings, there is a lack of research on how to approach anger and aggression in the treatment of ED (Fassino, Daga, Piero, & Rovera, 2002;Krug et al, 2008;Miotto et al, 2003;Truglia et al, 2006).A specific evidence-based intervention protocol targeted at aggression is missing. In this respect, psychomotor therapy (PMT) -a body and movement oriented therapy frequently used in mental health care in the Netherlands and Belgium (Probst, Knapen, Poot, & Vancampfort, 2010) -may prove useful.…”

“…It is suggested that treatment of non-suicidal self-injury in ED should focus on stabilizing affective states rather than on reducing affects like anger (Vansteelandt et al, 2013). Despite such findings, there is a lack of research on how to approach anger and aggression in the treatment of ED (Fassino, Daga, Piero, & Rovera, 2002;Krug et al, 2008;Miotto et al, 2003;Truglia et al, 2006).…”

Fatores de risco para o abandono do tratamento hospitalar para transtorno alimentares

“…Na investigação do impacto de comorbidades psiquiátricas na decisão de continuar um tratamento para transtornos alimentares, são utilizados tanto diagnósticos estabelecidos quanto a presença de sintomas psiquiátricos. O diagnóstico do transtorno de personalidade borderline ou a presença de sintomas borderline foi relacionada ao abandono do tratamento para transtornos alimentares em diversos estudos (Coker, et al, 1993;Waller, 1997;Fassino et al, 2002;Fassino et al, 2003;Surgenor et al, 2004;Woodside et al, 2004;Zeeck et al, 2005). Maiores níveis de sintomas depressivos foram encontrados como fator de risco para o abandono do tratamento tanto para a anorexia como para a bulimia nervosa (Coker et al, 1993;Steel et al, 2000;Woodside et al, 2004 ) ou fator protetor a conclusão do tratamento (Zeeck et al, 2005 …”

“…Grande parte das pesquisas que investigou esta relação, não encontrou diferenças significativas entre as médias de idade entre quem completou o tratamento ou decidiu interrompê-lo sem a concordância médica seja esse tratamento oferecido na modalidade ambulatorial (Waller, 1997;Steel et al, 2000;Fassino et al, 2002;Fassino et al, 2003;Grave; 2008) hospitalar (Zeeck et al, 2005;Surgenor et al, 2004;Masson et al, 2007), em hospital -dia (Franzen et al, 2004), ou para adolescentes (Lock et al, 2006;Hoste et al, 2007).…”