Tracking Readiness and Motivation for Change in Individuals with Eating Disorders Over the Course of Treatment

Abstract

Ambivalence about recovery is a key aspect of the symptom presentation of individuals with eating disorders and increased attention has focused on understanding readiness for change in this group. This research examined shifts in global and symptom-specific readiness and motivation for change during residential eating disorders treatment. Forty-two participants completed the Readiness and MotivationInterview (RMI) prior to treatment, at week 7, and following the 12-15 week program. Demographic and symptom severity measures were completed at pre and at post. Overall, increases in readiness to change behavioral symptoms occurred prior to increases in readiness to change cognitive symptoms. Shifts in locus of control for change were less pronounced during treatment, and occurred only for the cognitive symptom domain. Subgroup analyses revealed that relative to the other eating disorder diagnostic groups (bulimia nervosa and eating disorder not otherwise specified), readiness for change in individuals with anorexia nervosa shifted less over the course of treatment.

The Concept of Body Image Disturbance in Anorexia Nervosa: An Empirical Inquiry Utilizing Patients' Subjective Experiences

“…The patients' contribution to weak therapeutic alliances is often described in terms of phenomena like "denial of illness" (Vandereycken, 2006a;Vandereycken, 2006b;Vandereycken & Van Humbeeck, 2008) "lack of motivation" (Geller, 2002;Geller, Zaitsoff, & Srikameswaran, 2005;Nordbø et al, 2011;Vitousek et al, 1998) and "difficulties in expressing emotions" (Taylor et al, 1996). As shown in our results, anorectic behaviour is highly complex in the way the patients "translate" their emotions into body dissatisfaction or eating disorder behaviour.…”

Factors associated with improvements in readiness for change: Low vs. normal BMI eating disorders

“…6 Together, these findings suggest that for normal weight individuals, improvements in readiness are associated with decreased eating disorder symptomatology, whether or not they are participating in treatment that requires adherence to behavioral contingencies, and independent of baseline readiness status. In contrast, for low BMI individuals, improvements in readiness were not associated with reductions in eating disorder symptoms.…”

“…6 Interestingly, although readiness for change generally increased over time in these individuals as their eating disorder and psychiatric symptoms improved, differences between normal weight and low weight participants were also noted. For instance, normal weight individuals showed more rapid improvements in readiness at the beginning of treatment, and low weight individuals showed fewer overall improvements in readiness over time.…”

“…For instance, normal weight individuals showed more rapid improvements in readiness at the beginning of treatment, and low weight individuals showed fewer overall improvements in readiness over time. 6 These findings suggest that in determining factors that are associated with improvements in readiness, weight status may be an important variable to consider.…”

Addressing the EDNOS issue and improving upon the utility of DSM‐IV: Classifying eating disorders using symptom profiles

“…Geller, Brown, Zaitsoff, Goodrich, & Hastings, 2003;Geller et al, 2004;Geller, Zaitsoff, & Srikameswaran, 2005). Thus, in the current study all subscale scores are continuous and range from 0 to 100%.…”