Outpatient treatment for adults with complex eating disorders and co-morbid conditions: a decision making model and case example

Marino, Joanna M.; Hardin, Rebecca; Gasbarro, Alexandra; Dansereau, Victoria A; Fischer, Sarah

doi:10.1080/10640266.2020.1723372

Cited by 7 publications

(2 citation statements)

References 23 publications

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“…However, many clients with OCD and co-occurring conditions may not initially present to an OCD specialty treatment center. In a community private practice setting, which sees a wide range of clients, the overwhelming majority of clients have multiple diagnoses (e.g., depression, suicidality, EDs, substance use, attention deficit hyperactivity disorder, and other anxiety-related disorders) and unsuccessful previous treatment attempts (e.g., Marino et al, 2020). These significant comorbidities need to be considered when planning ERP for OCD due to their complexities and the impact that they may have on the client’s ability to engage in effective treatment for their OCD.…”

Section: Settingmentioning

confidence: 99%

Assessing exposure and response prevention readiness for clients with obsessive compulsive disorder and co-occurring conditions: A decision-making model and case example.

Gordon,

Gasbarro,

Wendell

et al. 2023

Professional Psychology: Research and Practice

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Individuals with obsessive compulsive disorder (OCD) may have psychological comorbidity and behaviors that interfere with effective treatment. Exposure and response prevention (ERP) is the most efficacious treatment for OCD to date. Several studies exist examining the impact of comorbid major depressive disorder (MDD), generalized anxiety disorder, and other anxiety disorders on response to ERP, whereas almost none examine the impact of eating disorders or nonsuicidal self-injury on the effectiveness of ERP. This makes it difficult to determine readiness, specifically in regard to ERP treatment, when clients present with OCD and comorbid conditions other than MDD and anxiety-related conditions. This article describes a decisionmaking model for clinicians regarding whether or not to begin ERP when a client has comorbid symptoms that are potentially life threatening and impact their functioning more severely than the OCD diagnosis. The decision-making model was developed based on previous models of readiness for ERP (VanDyke & Pollard, 2005) and incorporates research literature and the treatment team's clinical experience with other severe psychopathology. The model is described and two case examples are presented: one who was ready for ERP treatment and the other who was not and was therefore referred for another evidence-based intervention. Public Significance StatementExposure and response prevention is an effective treatment for obsessive compulsive disorder (OCD). Many individuals with OCD have co-occurring conditions such as eating disorders, suicidality, and major depressive disorder. This study described a model to assist clinicians in making decisions about how to sequence treatment for OCD when an individual has other co-occurring conditions that also severely impact quality of life.

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Section: Settingmentioning

confidence: 99%

Assessing exposure and response prevention readiness for clients with obsessive compulsive disorder and co-occurring conditions: A decision-making model and case example.

Gordon,

Gasbarro,

Wendell

et al. 2023

Professional Psychology: Research and Practice

Self Cite

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“…Given the high comorbidity and observation that eating disorder patients who do—compared with those who do not—engage in NSSI present with a different, yet more complex, clinical profile that may affect the treatment response [ 14 , 52 •], it is problematic that RCTs typically do not include data on NSSI and suicidality. In the absence of clear guidelines, Marino and colleagues recently developed a decision-making model to aid clinicians in deciding which treatment (i.e., CBT-E or DBT) should be prioritized for adult clients with a complex eating disorder and comorbid conditions [ 107 ••]. The model directly refers to DBT when a client is diagnosed with BPD, functional assessment indicates that NSSI (or other harmful behaviors including ED behaviors) are engaged in for emotion regulation purposes, or when previous treatment attempts failed due to interfering behaviors.…”

Section: Evidence-based Treatment Of Nssi and Ed Disordersmentioning

confidence: 99%

Non-Suicidal Self-Injury and Eating Disordered Behaviors: An Update on What We Do and Do Not Know

Kiekens

Claes

2020

Curr Psychiatry Rep

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Purpose of Review The current report aims to summarize recent advances about the relationship between non-suicidal self-injury (NSSI) and eating disordered (ED) behaviors and highlights meaningful directions for future research. Recent Findings While there is solid evidence indicating a robust cross-sectional association between NSSI and ED behaviors, emerging evidence suggests that the temporal relationship between these behaviors may be bidirectional. Shared functions and risk factors may explain why these behaviors often co-develop. At the same time, little is still known about the psychosocial consequences of comorbid NSSI and ED engagement, and there is a lack of intervention studies that target these behaviors simultaneously. Summary It is well-established that NSSI and ED behaviors frequently co-occur. The field should now turn to longitudinal designs to advance our understanding of the longer-term developmental and the shorter-term momentary relationship of these behaviors in daily life. Providing insight into these areas will help guide the deployment of evidence-based interventions that match the needs of clients who report comorbid NSSI and ED behaviors.

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Nicht-suizidales Selbstverletzendes Verhalten und Essstörungen

Plener

2022

Handbuch Essstörungen Und Adipositas

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Outpatient treatment for adults with complex eating disorders and co-morbid conditions: a decision making model and case example

Cited by 7 publications

References 23 publications

Assessing exposure and response prevention readiness for clients with obsessive compulsive disorder and co-occurring conditions: A decision-making model and case example.

Assessing exposure and response prevention readiness for clients with obsessive compulsive disorder and co-occurring conditions: A decision-making model and case example.

Non-Suicidal Self-Injury and Eating Disordered Behaviors: An Update on What We Do and Do Not Know

Nicht-suizidales Selbstverletzendes Verhalten und Essstörungen

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