Stages of change, treatment outcome and therapeutic alliance in adult inpatients with chronic anorexia nervosa

Abstract

BackgroundAnorexia nervosa (AN) is associated with high rates of chronicity and relapse risk is a considerable therapeutic challenge in the disorder. The aim of the present study was to investigate the association of stages of change and outcome with a focus on the relapse struggle in the maintenance stage in patients with predominantly chronic AN. Further, therapeutic alliance and stages of change associations were explored.MethodsAs an instrument measuring relapse struggle in the maintenance stage, we applied the short form of the University of Rhode Island Change Assessment-Short (URICA-S). We assessed stages of change in 39 patients with a predominantly chronic course of AN in early, middle, and late stages of inpatient psychotherapy. General symptom severity as assessed by the SCL-90-R and weight change were investigated as outcome measures.ResultsIn-line with earlier evidence, contemplation significantly predicted therapeutic alliance. Further, we demonstrated that relapse risk as operationalized by URICA-S maintenance is an important predictor of general psychopathology. BMI change was not predicted by stages of change.ConclusionsThe URICA-S maintenance scale might be applied to help identify patients at relapse risk. High URICA-S maintenance scores could be considered as one critical aspect of AN patients who might especially benefit from relapse-preventing aftercare programs.

Validation of the clinical perfectionism questionnaire in an eating disorder sample: A bifactor approach

“…Another area for future research, given the link between clinical perfectionism and difficulties with motivation to change due to ambivalence (Egan, Piek, Dyck, Rees, & Hagger, 2013), would be to investigate the relationship between the CPQ and measures of stages of change, given their association with eating disorders (Mander et al, 2013). Participants may have under reported their eating disorder symptoms or perfectionistic tendencies.…”

Eating disorders in older women

“…The most common are: depression, obsessive-compulsive disorder, agoraphobia, social phobia and panic disorders [ 29 ]. The percentage of adult patients with a diagnosis of a major depression as comorbidity can be as high as 56.4% [31].…”

Gibt es spezifische Wirkfaktoren in der Psychotherapie der Anorexia nervosa?

“…Die Arbeit an der (Veränderungs-) Motivation durchzieht daher in der Essstörungsbehandlung den kompletten Therapieprozess [14] und kann nicht immer als Grundlage der Behandlung vorausgesetzt werden. Verschiedene Autoren [29,30] betonen, dass die Ausprägung der Therapiemotivation bei Patienten mit Essstörungen entscheidend für den Therapieerfolg ist und zeigen Wege auf (z. B.…”