The Effectiveness of Cognitive Behavioral Therapy Interventions on Depression and Anxiety in the Adult East Asian and Related Diaspora Populations: a Meta-analysis

Karat, Bradley; Narikuzhy, Sandhya; Bonato, Sarah; Sanches, Marcos; Ahmed, Sarah; Liang, Liangbing; Husain, Muhammad Ishrat; Husain, Muhammad; Farooq, Saeed; Ayub, Muhammad; Kidd, Sean A.; McKenzie, Kwame; Ali, Farnoosh; Naeem, Farooq

doi:10.1007/s41811-022-00153-x

Cited by 1 publication

(3 citation statements)

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“…For studies that included adolescents, discussions are lacking around cultural‐specific factors related to adolescent development, such as how independence and individuality are gained within a collectivist culture that promotes interdependence and extended family ties, and how they may contribute to or buffer against the development of ED. However, we might caution that some CAs might occur naturally due to the therapists sharing similar cultural backgrounds to the patients (Karat et al, 2022), which can be different from adapting an intervention for “diaspora” ethnic minorities where the majority culture was different (Acle et al, 2021). When compared with previous literature, surprisingly, “non‐fat phobia” (Lee, 1991) was not mentioned as an adaptation.…”

Section: Discussionmentioning

confidence: 99%

“…Cultural adaptations might be needed due to these unique cultural factors. This may also mean that therapists are seen as an authority, with implications for the usually collaborative therapist stance in interventions such as CBT (Karat et al, 2022). However, findings regarding whether the effectiveness of culturally adapted and non-adapted interventions differs, are mixed.…”

Section: Introductionmentioning

confidence: 99%

“…However, findings regarding whether the effectiveness of culturally adapted and non-adapted interventions differs, are mixed. A recent meta-analysis on the effectiveness of cognitive-behavioral interventions in mood and anxiety disorders in East Asian and related Diaspora populations found a nonsignificant effect regarding effectiveness between culturally adapted and non-adapted interventions in the moderator analysis, although they cautioned that therapists and patients shared the same culture, which adaptations might have informally/indirectly taken place (Karat et al, 2022). In the area of ED, a review synthesized 11 core recommendations for addressing culture in ED treatment effectively, including, but not limited to, using culturally sensitive interventions and culturally flexible diagnostic models and exploring ethnic identity (Acle et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

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The effectiveness and cultural adaptations of psychological interventions for eating disorders in East Asia: A systematic scoping review

Yim,

Schmidt

2023

Intl J Eating Disorders

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ObjectiveThere has been no review on eating disorder‐focused psychological interventions in East Asia. The aims of this systematic scoping review were to summarize existing and forthcoming studies and to synthesize the cultural adaptations and effectiveness of the interventions identified.MethodFive databases (PubMed, Embase, Global Health, Medline, PsychInfo) and seven trial registries were searched. Studies examining eating disorder (ED)‐focused psychological interventions in East Asia were included. Narrative synthesis was used for the analysis.ResultsEighteen published studies and 14 ongoing/completed but unpublished studies were included. Most published studies were uncontrolled and five were feasibility studies. Among the ongoing studies, 71% are randomized controlled trials. Cognitive therapies were the main approach used, including individual cognitive behavioral therapy (CBT), internet CBT, group CBT, guided self‐help, and cognitive remediation therapy. Cultural adaptations were mostly related to language, communication style and tailoring the dietary requirements to local diets. Interventions were shortened to increase acceptability and reduce financial and time burden to patients. Overall, studies showed good acceptability, completion rates and positive effects on ED symptoms (indicated by moderate to large effect sizes or statistical significance).DiscussionStudies were underpowered and uncontrolled, thus precluding meaningful interpretations of effectiveness to be made. However, the psychological interventions were acceptable and showed promise in delivery. Digital and group interventions seemed to be the most feasible given barriers in the local health systems. More controlled studies, as well as studies on children and adolescents, are needed in future.Public significanceThis is the first systematic scoping review examining psychological interventions for eating disorders in East Asia. Research in eating disorders has largely focused on White people and in Western countries. This review will be helpful for clinicians and researchers to understand the current state of the field through a non‐Eurocentric lens, to identify gaps and plan future research.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%