Mobile Self-Help Interventions as Augmentation Therapy for Patients with Anorexia Nervosa

Kim, Youl‐Ri; Cardi, Valentina; Lee, Gi Young; An, Sohyun; Kim, Jione; Kwon, Gemma; Kim, Jong Won; Eom, Jin Sup; Treasure, Janet

doi:10.1089/tmj.2018.0180

Cited by 11 publications

(15 citation statements)

References 23 publications

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“…These findings stand in contrast to studies in Israeli adults of different age groups with other medical disorders, showing that over 60% used telemedicine health services [ 75 , 76 ]. The current results are also different from the positive attitudes expressed by adult patients with AN toward long-distance treatments provided during regular non-pandemic times [ 77 ]. Perhaps this relates to the fact that during routine times, telemedicine may be chosen as one of multiple possible treatment options, whereas during the COVID-19 pandemic it was more a necessity than a choice.…”

Section: Discussioncontrasting

confidence: 94%

The emotional-behavioral state of Israeli adolescent and young adult females with anorexia nervosa during the COVID19 pandemic

et al. 2022

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Background During the COVID-19 pandemic in Israel, the number of patients with eating disorders (EDs) seeking treatment increased significantly. The present study sought to evaluate whether, during the pandemic (2020–21), patients with anorexia nervosa (AN) would show more ED-related, comorbid, and COVID-19-related symptoms in comparison to a naturalistic control group, and whether differences would be found between adult and adolescent patients with AN. We also examined attitudes to telemedicine use during the pandemic in patients receiving long-distance interventions. Methods Using online self-report questionnaires, we assessed general and COVID-19-specific symptoms with a secure digital platform (REDCap®) in 36 female adolescents with AN, 35 female adults with AN, and 25 female controls. Results Compared with controls, patients with AN showed more symptoms of EDs, anxiety, depression, and post-traumatic stress disorder (PTSD), elevated suicidal ideation, more COVID-related emotional-behavioral disturbances, and lower resilience. Adult patients with AN fared worse than adolescent patients on most of these measures. Adult patients using telemedicine during the COVID-19 pandemic showed fewer positive attitudes toward this treatment than adolescents (telemedicine was offered to all, but used by 18/35 adolescents and 21/36 adults with AN). Last, elevated COVID-19-related symptomatology was correlated with more symptoms of ED, anxiety, depression and PTSD, and with lower resilience. Conclusions Our findings suggest that the emotional-behavioral state of Israeli females with AN, particularly adults, was worse during the COVID-19 pandemic in comparison to controls. Many patients did not use telemedicine for their treatment. Adult patients using telemedicine were less satisfied with it than adolescent patients.

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Section: Discussioncontrasting

confidence: 94%

The emotional-behavioral state of Israeli adolescent and young adult females with anorexia nervosa during the COVID19 pandemic

et al. 2022

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“…The researchers found that participants who received Media Smart-Targeted were 75% less likely than those who received tips for body image to meet diagnostic criteria for an ED 12 months after the intervention [ 71 ]. In a non-randomized study in participants with AN, the authors [ 30 ] examined the effectiveness of treatment as usual when supplemented by videos on ED recovery (i.e., self-help component), daily text messages, and one weekly in-person meeting (n = 22, mean age = 25 years). Results showed significant reductions in participants’ global (∆η2 = 0.59, corresponding to a large effect size) and subscale (∆η2 range = 0.41–0.60, corresponding to large effect sizes) scores on the EDE-Q [ 30 ].…”

Section: Resultsmentioning

confidence: 99%

“…Evidence for the use of self-help for patients with AN is also limited, based on our study though there may be some benefits in terms of weight gain [ 27 , 28 , 31 ]. As for restrictive ED symptoms, findings were mixed, ranging from a decrease to no change or even an increase in restrictive symptoms from baseline to end of treatment [ 22 , 28 , 30 , 71 ]. It is noteworthy to mention the studies in which symptoms decreased were either uncontrolled or used a passive placebo group.…”

Section: Discussionmentioning

confidence: 99%

“…With regards to internet self-help of all types, design may be an important feature and interventions incorporating multimedia elements, that is, a combination of audio, text, video, etc., are associated with the greatest ED symptom reduction in treatment groups [ 85 ]. Though technology design was not a key element of our research, interventions explicitly described as interactive and/or multimedia in manuscripts were effective [ 22 , 30 , 71 ]. Even so, results should be interpreted cautiously as the improvements seen in the study by Kim [ 30 ] cannot be attributed to the multimedia intervention alone, as patients continued to receive TAU and weekly in-person guidance for technology usage.…”

Section: Discussionmentioning

confidence: 99%

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The use of technology in the treatment of youth with eating disorders: A scoping review

et al. 2022

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Background Adolescence and young adulthood is a high-risk period for the development of eating disorders. In recent years, there has been an increase in use of technology-based interventions (TBIs) for the treatment of eating disorders. The objective of this study was to determine the types of technology used for eating disorder treatment in youth and their effectiveness. Methods A scoping review was conducted according to PRISMA-ScR guidelines. Four databases were searched. Eligible articles included: (1) a TBI (2) participants with a mean age between 10- and 25-years and meeting DSM-IV or DSM-5 criteria for any eating disorder and (3) qualitative or quantitative designs. Quantitative and qualitative studies were assessed for quality. Results The search identified 1621 articles. After screening of titles and abstracts, 130 articles were read in full and assessed for eligibility by two raters. Forty-nine (29 quantitative and 20 qualitative, observational, or mixed methods studies) met inclusion criteria. Quality ratings indicated that 78% of quantitative studies had a low risk of bias and 22% had a moderate risk. Technologies reviewed in our study included videoconference therapy, mobile applications, and online self-help. We considered interventions used both within sessions with clinicians as well as those used in between sessions by patients alone. Fifteen of 18 (83%) quantitative studies found that TBIs reduce eating disorder symptomatology, with nine of those reporting medium-to-large effect sizes. Qualitative data was of high quality and suggested that virtual interventions are acceptable in this population. Conclusions Although identified studies are of high quality, they are limited in number. More research is needed, particularly regarding videoconferencing and mobile applications. Nonetheless, TBIs show promise for the treatment of eating disorders in youth. Trial registration: Not applicable.

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“…The integration of mobile technology into eating disorder (ED) treatment appears to be challenging because of the low rates of adherence and the high resistance to change (Linardon et al, 2020). A guided self‐help (GSH) intervention incorporating a mobile component with short video clips (vodcasts) on EDs has been developed (Treasure et al, 2010) and the Recovery vodcasts enhancing motivation to change and skill‐sharing were proved to be effective in the treatment of EDs (Treasure et al, 2010), which were also acceptable to Korean patients with EDs (Kim et al, 2019). Other vodcasts developed to induce a positive mood had an inhibitory effect on binge eating (Cardi et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Feasibility and acceptability of a digital tele‐guided intervention targeting components of the addictive appetite model for bulimia nervosa and binge‐eating disorder in Korea

Kwag

Kim

Lee

et al. 2022

Intl J Eating Disorders

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Objective: We aimed to evaluate the feasibility, acceptability, and potential impact of a tele-guided digital-based intervention based on the addictive appetite model of recurrent binge eating.Method: Female college students with bulimia nervosa (BN) or binge-eating disorder (BED) (n = 22) received a 6-week guided intervention targeting addictive processes and emotion regulation. The feasibility of the intervention was evaluated, and the outcomes were assessed at baseline, the end of the intervention, and 1-month follow-up.Results: Of the participants, 86.4% (n = 19) completed the intervention. The self-help materials were viewed 6.03 ± 3.06 times per week, and the duration of using the self-help materials was 113.16 ± 160.19 min/week. The intervention group experienced a significant reduction with a moderate effect on binge eating at the end of the intervention (Hedges' g = 0.58), and the effects lasted through follow-up (Hedges' g = 0.82).Discussion: The results suggest that the digital intervention targeting a maintenance mechanism of recurrent binge eating was feasible and acceptable for patients with BN and BED, proving the potential for symptom improvement.

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Mobile Self-Help Interventions as Augmentation Therapy for Patients with Anorexia Nervosa

Cited by 11 publications

References 23 publications

The emotional-behavioral state of Israeli adolescent and young adult females with anorexia nervosa during the COVID19 pandemic

The emotional-behavioral state of Israeli adolescent and young adult females with anorexia nervosa during the COVID19 pandemic

The use of technology in the treatment of youth with eating disorders: A scoping review

Feasibility and acceptability of a digital tele‐guided intervention targeting components of the addictive appetite model for bulimia nervosa and binge‐eating disorder in Korea

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