Psychoeducation in Affect Regulation for Patients with Eating Disorders: A Randomized Controlled Feasibility Study

Abstract

This study examined the effects of a psychoeducational training program in affect regulation for patients with eating disorders. Nineteen female patients completed measures of affect regulation (ACS-90), alexithymia (TAS-26), and eating behavior (EDE-Q). Data were assessed at baseline and at 3 and 12 months posttreatment. Dependent on date of entering hospital, the patients were allocated consecutively to the control group (n =11), which received inpatient treatment as usual, or to the treatment group (n = 8), which received training in addition to usual inpatient treatment. At follow-up, the training was associated with statistically significant improvement in the skill of down-regulating negative affect and with a tendency towards less dietary restraint. Regarding alexithymia no clear results were found. Despite the small sample size, results showed that in addition to the general improvement due to the treatment usually provided in the clinical setting, the training program resulted in specific benefits for the patients with regard to their affect regulation skills.

Alexithymia and eating disorders: a critical review of the literature

“…When the TAS-20 subscales were examined, across diagnostic groups, only the difficulties identifying feelings factor showed a statistically significant reduction from pre- to post-treatment. Similarly, Storch and colleagues [75] found that following inpatient treatment for eating disorders (i.e., AN-R, AN-B/N, and BN) patients evidenced a significant increase in their ability to identify emotions.…”

“…These studies have shown that alexithymia scores decrease significantly post-treatment in patients with AN, BN, and BED [27,71-75]. For instance, Becker-Stoll and Gerlinghoff [71] examined the effects of a 4-month day hospital treatment on alexithymia levels in a sample of 47 patients (AN = 18, BN = 25, and EDNOS = 4).…”

“…With respect to treatment, alexithymia levels decrease significantly in response to psychological treatments that place an emphasis on identifying and describing emotions in addition to symptom reduction [27,71-75]. However, despite these significant decreases in alexithymia scores from pre- to post-treatment, alexithymia scores still remain elevated compared to control scores at post-treatment, suggesting that more intensive treatment focused on emotion regulation may be needed.…”

Alexithymia as a prognostic risk factor for health problems: a brief review of epidemiological studies

“…In total, 38 articles were identified that reported the clinical impacts of alexithymia on prognosis [24-61]. Major types of participants were patients with psychiatric or psychosomatic illness recruited consecutively and the main outcome was the treatment response.…”

Thinking about internal states, a qualitative investigation into metacognitions in women with eating disorders

“…A common theme was that emotions were confusing with the implication that the participants therefore needed to use an unhelpful coping strategy to manage these confusing emotions. The addition of psychoeducation in affect regulation to treatment as usual (CBT) has been shown to improve the skill of down-regulating negative affect in patients with AN and BN, and to also reduce dietary restraint [30]. This suggests that educating individuals with EDs about emotions can improve their ability to handle emotions and impact their ED symptomatology.…”