Readiness to change mediates the impact of eating disorder symptomatology on treatment outcome in anorexia nervosa

Bewell, Carmen; Carter, Jacqueline C.

doi:10.1002/eat.20513

Cited by 74 publications

(68 citation statements)

References 13 publications

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“…These concepts have been applied to different behaviours and disorders such as physical activity (Berry, Naylor, & Wharf-Higgins, 2004), smoking (DiClemente, Prochaska, Fairhurst, Velicer, Velasquez, & Rossi, 1991), alcohol abuse (Rollnick, Heather, Gold & Hall, 1992) or obesity (Prochaska, Norcross, Fowler, Follick, & Abrams, 1992). Several studies have stressed the importance of motivation to change in adults with eating disorders with regard to ensuring clinical improvement and maintenance (Bewell & Carter, 2008;Geller, Cockell & Drab, 2001;Hasler, Delsignore, Milos, Buddeberg, & Schneyeder, 2004;RodriguezCano & Beato-Fernández, 2005;Vitousek, Watson, & Wilson, 1998;Wolk & Devlin, 2001). In adolescents with anorexia nervosa, motivation to change has also been related to better treatment response (Ametller, Castro, Serrano, Martínez, & Toro, 2005;CastroFornieles et al, 2007).…”

Section: Introductionmentioning

confidence: 96%

Motivation to change in adolescents with bulimia nervosa mediates clinical change after treatment

Castro‐Fornieles

Bigorra

Martinez-Mallen

et al. 2010

Euro Eating Disorders Rev

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Several studies have related motivation to change and treatment response in adult patients with bulimia nervosa but there are no longitudinal studies analysing this relationship in adolescents. The objective was to determine whether motivation to change is related to clinical improvement after treatment in adolescent patients with bulimia nervosa. The Bulimia Nervosa Stages of Change Questionnaire, the Eating Disorders Inventory (EDI-2) and the Beck Depression Inventory (BDI) were administered at the beginning of treatment to 40 adolescent patients with bulimia nervosa (DSM-IV) (mean age = 16.2 years). Thirty-one patients were re-assessed after 6 months of treatment. The majority of clinical and psychological variables improved significantly at the second evaluation. There were significant correlations between initial motivation to change and improvement in number of binges and the EDI-2 scales of Bulimia and Interoceptive Awareness. In the stepwise multiple linear regression analysis, which included initial motivation to change and other potential confounding variables such as age, BDI, duration of disorder and body mass index, only motivation to change was selected as a predictor of improvement in number of binges (standardized β coefficient = 0.45; p = 0.012) and of decrease on the Bulimia scale (standardized β coefficient = 0.43; p = 0.029). Regarding improvement in Interoceptive Awareness, only the BDI score was selected as an independent predictor (β coefficient = 0.58; p = 0.002). In conclusion, in adolescent patients receiving treatment for bulimia nervosa, improvement in bulimic symptomatology seems to be especially related to initial motivation to change.

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Section: Introductionmentioning

confidence: 96%

Motivation to change in adolescents with bulimia nervosa mediates clinical change after treatment

Castro‐Fornieles

Bigorra

Martinez-Mallen

et al. 2010

Euro Eating Disorders Rev

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“…7,10 It has been also argued that readiness for change is a significant predictor of treatment outcome in AN 11 .…”

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confidence: 99%

Becoming ‘whole’ again: A qualitative study of women's views of recovering from anorexia nervosa

Jenkins

Ogden

2011

Euro Eating Disorders Rev

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Objectives: The study explored women's perceptions of their recovery process and what recovery means to them in order to gain a better understanding of the predictors of recovery from anorexia nervosa (AN).Method: The data were analysed usingInterpretative Phenomenological Analysis (IPA). Semi-structured telephone interviews were carried out with fifteen women who received a diagnosis of AN and defined themselves as recovered/in recovery. The women were recruited from beat. Results:The women described their experiences in terms of four broad areas; being anorexic; dissatisfaction with treatment; process of change; and being recovered. Whilst anorexic, women experienced a series of dichotomies. In particular, they described splits between mind and body, AN behaviour and cognitions and rational and irrational side. Recovery occurred when the above dichotomies became resolved. Conclusion:Recovery occurs only when an individual becomes "whole" again, which is a lengthy psychological process. Therefore, it is also essential that therapy is not discontinued after patients reach their target weight.

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“…Bei Bulimia nervosa besteht zwar meist ein vordergründig höherer Leidensdruck aufgrund der Essattacken, dennoch zeigt sich häufig eine mangelnde Einsicht in Bezug auf das Aufgeben des Schlankheitswunsches sowie der kompensatorischen Mechanismen wie Diäten, Erbrechen und exzessivem Sport. Eine höhere Behandlungsmotivation ist verbunden mit e iner besseren Prognose [92,93]. Die Motivationsförderung ist daher ein äusserst wichtiges Ziel jeder Essstörungs-behandlung.…”

Section: Einzelpsychotherapieunclassified

Anorexia nervosa, Bulimia nervosa und andere Essstörungen bei Kindern und Jugendlichen

2013

Swiss Arch Neurol Psychiatr

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Summary Anorexia nervosa, bulimia nervosa and other eating disorders in childhood and a dolescence. Review and recommendations on diagnosis and treatment.The diagnosis and treatment of eating disorders in childhood and adolescence demands specific knowledge of the particular features of symptomatology and approaches in this age group. The diagnostic criteria in the handbooks are only conditionally valid in young patients and their application must be adapted to the patient's age. Clinically relevant atypical eating disorders have a prevalence similar to the classic forms of anorexia nervosa or bulimia n ervosa. High rates of comorbidity exist, in particular with anxiety states and also depression. Monitoring of concomitant somatic symptoms is indispensable. Early detection and treatment improve prognosis. Treatment is multidisciplinary and multimodal. Transdiagnostic approaches take into account the high migration rate of eating disorder diagnoses. There is evidence for the efficacy of family-based therapy in adolescents with anorexia nervosa. In i ndividual psychotherapy motivational treatment, and in bulimia nervosa cognitive behavioural therapy, are in the forefront. Fluoxetine has proved e ffective in the treatment of binge eating in bulimia nervosa.Key words: eating disorders in children and adolescents; eating disoder; child; a dolescent; treatment; review; anorexia nervosa; bulimia nervosa Einleitung Trotz Fortschritten in der Behandlung ist die Anorexia n ervosa als bekannteste und am meisten gefürchtete Essstörung immer noch eine der Erkrankungen des Kindesund Jugendalters mit der höchsten Todesrate [1,2]. Die E rkenntnisse zur Wirksamkeit der Behandlungsmethoden bei Essstörungen wachsen, sind aber immer noch unzureichend. Die Anorexia nervosa nimmt häufig in der frühen oder mittleren Pubertät ihren Anfang, die Bulimia nervosa eher in der späteren Adoleszenz oder im jungen Erwachsenenalter. Behandelnde Fachärzte dieser Altersgruppe sollten daher über Früherkennung und Behandlung von Essstörun-gen bei jungen Menschen gut informiert sein.

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Readiness to change mediates the impact of eating disorder symptomatology on treatment outcome in anorexia nervosa

Abstract: These findings suggest not only that readiness to make changes is an important indicator of future inpatient treatment outcome, but that it is the mechanism by which eating disorder symptomatology predicts success in a treatment program.

Cited by 74 publications

References 13 publications

Motivation to change in adolescents with bulimia nervosa mediates clinical change after treatment

Motivation to change in adolescents with bulimia nervosa mediates clinical change after treatment

Becoming ‘whole’ again: A qualitative study of women's views of recovering from anorexia nervosa

Anorexia nervosa, Bulimia nervosa und andere Essstörungen bei Kindern und Jugendlichen

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