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Avoidant Restrictive Food Intake Disorder (ARFID)—Looking beyond the eating disorder lens? 回避型限制性食物摄入障碍(ARFID)--超越饮食失调的视角?
IF 5.3 2区 心理学 Q1 PSYCHIATRY Pub Date : 2024-04-02 DOI: 10.1002/erv.3093
Fiona Duffy, Emma Willmott, Emy Nimbley, Andrew Lawton, Helen Sharpe, Kyle Buchan, Karri Gillespie-Smith

Avoidant Restrictive Food Intake Disorder (ARFID) was first included as a diagnostic category in 2013, and over the past 10 years has been adopted by the international eating disorder community. While greater awareness of these difficulties has increased identification, demand and enabled advocacy for clinical services, the heterogeneous nature of ARFID poses unique challenges for eating disorder clinicians and researchers. This commentary aims to reflect on some of these challenges, focussing specifically on the risk of viewing ARFID through an eating disorder lens. This includes potential biases in the literature as most recent research has been conducted in specialist child and adolescent eating disorder clinic settings, bringing in to question the generalisability of findings to the broad spectrum of individuals affected by ARFID. We also consider whether viewing ARFID predominantly through an eating disorder lens risks us as a field being blinkered to the range of effective skills our multi-disciplinary feeding colleagues may bring. There are opportunities that may come with the eating disorder field navigating treatment pathways for ARFID, including more joined up working with multi-disciplinary colleagues, the ability to transfer skills used in ARFID treatment to individuals with eating disorder presentations, and most notably an opportunity to provide more effective treatment and service pathways for individuals with ARFID and their families. However, these opportunities will only be realised if eating disorder clinicians and researchers step out of their current silos.

回避型限制性食物摄入障碍(ARFID)于 2013 年首次被列为诊断类别,在过去 10 年中已被国际进食障碍界所采用。虽然对这些困难的进一步认识增加了对临床服务的识别、需求和宣传,但 ARFID 的异质性为进食障碍临床医生和研究人员带来了独特的挑战。本评论旨在反思其中的一些挑战,特别关注从饮食失调的角度看待 ARFID 的风险。这包括文献中可能存在的偏见,因为最近的大多数研究都是在儿童和青少年饮食失调症专科门诊环境中进行的,这就使研究结果是否能普遍适用于受 ARFID 影响的广泛人群成为疑问。我们还考虑到,如果主要从饮食失调的角度来看待 ARFID,那么作为一个领域,我们是否有可能对我们的多学科喂养同事可能带来的一系列有效技能视而不见。饮食失调领域在探索ARFID的治疗途径时可能会遇到一些机遇,包括与多学科同事进行更多的联合工作,能够将ARFID治疗中使用的技能传授给有饮食失调表现的个体,最值得注意的是,有机会为ARFID患者及其家庭提供更有效的治疗和服务途径。然而,只有当饮食失调症临床医生和研究人员走出目前的孤岛,这些机会才能实现。
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引用次数: 0
Autobiographical memory following weight gain in adult patients with Anorexia Nervosa: A longitudinal study 成年厌食症患者体重增加后的自传体记忆:纵向研究
IF 5.3 2区 心理学 Q1 PSYCHIATRY Pub Date : 2024-04-01 DOI: 10.1002/erv.3091
Valentin Terhoeven, Sandra Faschingbauer, Julia Huber, Joe J. Simon, Wolfgang Herzog, Hans-Christoph Friederich, Christoph Nikendei

Background

Patients with anorexia nervosa (AN) show overgeneralization of memory (OGM) when generating autobiographical episodes related to food and body shape. These memories are central for the construction of a coherent self-concept, interpersonal relationships, and problem-solving abilities. The current study aims to investigate changes in autobiographical memory following weight gain.

Methods

OGM was assessed with an adapted version of the Autobiographical Memory Test including food-, body-, depression-related, and neutral cues. N = 41 female patients with AN (28 restricting-, 13 binge-eating/purging-subtype; mean disease duration: 4.5 years; mean BMI: 14.5 kg/m2) and N = 27 healthy controls (HC) were included at baseline. After inpatient treatment (mean duration: 11 weeks), 24 patients with AN and 24 age-matched HC were reassessed. Group differences were assessed using independent samples t-tests for cross-sectional comparisons and repeated measures ANOVAs for longitudinal data.

Results

At baseline, patients with AN generated significantly fewer specific memories than HC, independent of word category (F(1.66) = 27.167, p < 0.001). During inpatient stay, the average weight gain of patients with AN was 3.1 body mass index points. At follow-up, patients with AN showed a significant improvement in the number of specific memories for both depression-related and neutral cues, but not for food- and body-related cues.

Conclusions

Generalised OGM (i.e., independent of word category) in patients with AN before weight restoration may be a general incapacity to recall autobiographical memory. After weight gain, the previously well-studied pattern of eating disorder-related OGM emerges. The clinical relevance of the continuing disorder-related OGM in patients with AN after weight gain is discussed.

背景:神经性厌食症(AN)患者在产生与食物和体型有关的自传情节时,会表现出记忆过度泛化(OGM)。这些记忆对于构建连贯的自我概念、人际关系和解决问题的能力至关重要。本研究旨在调查体重增加后自传体记忆的变化:方法:采用改编版自传体记忆测试评估自传体记忆,包括食物、身体、抑郁相关和中性线索。N = 41 名女性 AN 患者(28 名限制型,13 名暴食/暴饮暴食亚型;平均病程 4.5 年;平均体重指数(BMI)1.5):基线包括 41 名女性 AN 患者(28 名限制型,13 名暴食/节食亚型;平均病程:4.5 年;平均体重指数:14.5 kg/m2)和 N = 27 名健康对照组(HC)。住院治疗(平均持续时间:11 周)后,24 名 AN 患者和 24 名年龄匹配的 HC 患者接受了重新评估。横向比较采用独立样本t检验,纵向数据采用重复测量方差分析:结果:在基线时,自闭症患者产生的特定记忆明显少于正常人,这与词的类别无关(F(1.66)= 27.167,p 结论:自闭症患者产生的特定记忆明显少于正常人,这与词的类别无关(F(1.66)= 27.167,p 结论):在体重恢复前,自闭症患者的普遍OGM(即与词的类别无关)可能是回忆自传体记忆的一种普遍能力。体重增加后,出现了之前已被充分研究过的与进食障碍相关的 OGM 模式。本文讨论了体重增加后 AN 患者持续出现与饮食失调相关的 OGM 的临床意义。
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引用次数: 0
Withdrawal: Anu Raevuori, Temperament, character and eating disorders, European Eating Disorders Review, 28 February 2002, Vol:10, Issue: 2 戒断:Anu Raevuori,《气质、性格与饮食失调》,《欧洲饮食失调评论》,2002 年 2 月 28 日,第 10 卷第 2 期。
IF 5.3 2区 心理学 Q1 PSYCHIATRY Pub Date : 2024-03-26 DOI: 10.1002/erv.3057

Withdrawal: The above article, published online on 28 February 2002 on Wiley Online Library (https://onlinelibrary.wiley.com/doi/10.1002/erv.461) has been withdrawn by agreement between the author Anu Raevuori, the Editor-in-Chief, Beate Herpertz-Dahlmann, the Eating Disorders Association, and John Wiley & Sons Ltd. The withdrawal has been agreed due to concerns over violation of the privacy of a research subject.

撤稿:经作者 Anu Raevuori、主编 Beate Herpertz-Dahlmann、进食障碍协会和 John Wiley & Sons Ltd.协商,2002 年 2 月 28 日在线发表在 Wiley Online Library (https://onlinelibrary.wiley.com/doi/10.1002/erv.461) 上的上述文章已被撤回。同意撤稿的原因是担心侵犯研究对象的隐私。
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引用次数: 0
Eating disorder symptom non-endorsers in hospitalised patients with anorexia nervosa: Who are they? 住院的神经性厌食症患者中不赞同饮食失调症状者:他们是谁?
IF 5.3 2区 心理学 Q1 PSYCHIATRY Pub Date : 2024-03-25 DOI: 10.1002/erv.3087
Irina Vanzhula, Kelsey Hagan, Sarah Ann Duck, Isabella Pan, Erin Y. Wang, Joanna Steinglass, Evelyn Attia, Jennifer E. Wildes, Angela S. Guarda, Colleen Schreyer

Objective

Impaired insight and illness denial are common in anorexia nervosa (AN). Missing an AN diagnosis may delay treatment and negatively impact outcomes.

Method

The current retrospective study examined the prevalence and characteristics of AN symptom non-endorsement (i.e., scoring within the normal range on the Eating Disorder Examination Questionnaire [EDE-Q] or the Eating Disorder Examination [EDE] interview) in three independent samples of hospitalised patients with AN (N1 = 154; N2 = 300; N3 = 194). A qualitative chart review of a subsample of non-endorsers (N4 = 32) extracted reports of disordered eating behaviours observed by the treatment team.

Results

The prevalence of non-endorsement ranged from 11% to 34% across sites. Non-endorsers were more likely to be diagnosed with AN restricting type (AN-R) and reported fewer symptoms of co-occurring psychopathology than endorsers. Groups benefitted equally from treatment. The qualitative chart review indicated that objective symptoms of AN were recorded by staff in over 90% of non-endorsers.

Conclusions

Eating disorder symptom assessments using the EDE-Q or EDE may miss symptomatology in up to a third of individuals hospitalised with AN. This study highlights the potential utility of multi-modal assessment including patient interviews, collateral informants, and behavioural observation to circumvent non-endorsement.

目的:神经性厌食症(AN)患者普遍存在洞察力受损和否认疾病的情况。错过神经性厌食症的诊断可能会延误治疗并对治疗效果产生负面影响:本回顾性研究对三个独立样本(N1 = 154;N2 = 300;N3 = 194)的住院厌食症患者的厌食症症状不认可(即在饮食紊乱检查问卷[EDE-Q]或饮食紊乱检查[EDE]访谈中得分在正常范围内)的发生率和特征进行了研究。对未认可者的子样本(N4 = 32)进行了定性病历审查,提取了治疗小组观察到的饮食紊乱行为报告:结果:在不同地点,不认可者的比例从 11% 到 34% 不等。与认可者相比,不认可者更有可能被诊断为限制型进食障碍(AN-R),并且报告的并发精神病理学症状更少。两组患者从治疗中获益相同。定性病历审查表明,90%以上的非认可者都被工作人员记录了进食障碍的客观症状:结论:使用EDE-Q或EDE进行进食障碍症状评估可能会漏掉多达三分之一的住院AN患者的症状。这项研究强调了多模式评估的潜在作用,包括患者访谈、旁证和行为观察,以规避不认可的情况。
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引用次数: 0
Stomach size in anorexia nervosa: A new challenge? 厌食症患者的胃部大小:新的挑战?
IF 5.3 2区 心理学 Q1 PSYCHIATRY Pub Date : 2024-03-23 DOI: 10.1002/erv.3089
Marie-Alix Joyeux, Antoine Pierre, Marion Barrois, Christine Hoeffel, Antoine Devie, Mathias Brugel, Eric Bertin

Background & Aims

Changes in stomach size may impact eating behaviour. A recent study showed gastric dilatation in restrictive eating disorders using computed tomography scans. This study aimed to describe stomach size in the standing position in women with anorexia nervosa (AN).

Methods

Women treated for AN at our institution were retrospectively included if they had undergone upper gastrointestinal radiography (UGR) after the diagnosis of AN. Two control groups (CG1 and CG2) were included, both comprising female patients: CG1 patients were not obese and underwent UGR for digestive symptoms of other aetiologies, and CG2 comprised obese individuals who had UGR before bariatric surgery. A UGR-based Stomach Size Index (SSI), calculated as the ratio of the length of the stomach to the distance between the upper end of the stomach and the top of the iliac crests, was measured in all three groups. Gastromegaly was defined as SSI >1.00.

Results

45 patients suffering from AN (28 with restrictive and 17 with binge/purge subtype), 10 CG1 and 20 CG2 subjects were included in this study. Stomach Size Index was significantly higher in AN (1.27 ± 0.24) than in CG1 (0.80 ± 0.11) and CG2 (0.68 ± 0.09); p < 0.001, but was not significantly different between patients with the restrictive and binge/purge subtypes. Gastromegaly was present in 82.2% of patients with AN and not present in the control groups. In patients with AN, gastromegaly was present in 12/15 patients without digestive symptoms (80.0%) and in 25/30 patients with digestive complaints (83.3%) at time of UGR (p = 0.99). In the AN group, no significant relationship was found between SSI and body mass index.

Conclusion

Gastromegaly is frequent in AN and could influence AN recovery. This anatomical modification could partially explain the alterations of gastric motility previously reported in AN.

背景和目的:胃的大小变化可能会影响进食行为。最近的一项研究表明,通过计算机断层扫描,限制性饮食症患者的胃会扩张。本研究旨在描述神经性厌食症(AN)女性患者站立时的胃部大小:方法:对在我院接受厌食症治疗的女性患者进行回顾性研究,如果她们在确诊厌食症后接受了上消化道放射摄影术(UGR)。两组对照组(CG1 和 CG2)均由女性患者组成:CG1 组患者并不肥胖,因其他病因引起的消化道症状而接受了 UGR 检查;CG2 组由肥胖者组成,他们在减肥手术前接受了 UGR 检查。所有三组患者都测量了基于 UGR 的胃大小指数(SSI),该指数按胃长度与胃上端到髂嵴顶部之间距离的比值计算。SSI大于1.00即为胃扩张:本研究共纳入 45 名 AN 患者(28 名限制型和 17 名暴饮暴食亚型)、10 名 CG1 和 20 名 CG2 受试者。AN患者的胃大小指数(1.27 ± 0.24)明显高于CG1(0.80 ± 0.11)和CG2(0.68 ± 0.09);P 结论:AN患者的胃大小指数(1.27 ± 0.24)明显高于CG1(0.80 ± 0.11)和CG2(0.68 ± 0.09):胃下垂在AN中很常见,可能会影响AN的恢复。这种解剖学上的改变可以部分解释之前报道的AN中胃运动的改变。
{"title":"Stomach size in anorexia nervosa: A new challenge?","authors":"Marie-Alix Joyeux,&nbsp;Antoine Pierre,&nbsp;Marion Barrois,&nbsp;Christine Hoeffel,&nbsp;Antoine Devie,&nbsp;Mathias Brugel,&nbsp;Eric Bertin","doi":"10.1002/erv.3089","DOIUrl":"10.1002/erv.3089","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background &amp; Aims</h3>\u0000 \u0000 <p>Changes in stomach size may impact eating behaviour. A recent study showed gastric dilatation in restrictive eating disorders using computed tomography scans. This study aimed to describe stomach size in the standing position in women with anorexia nervosa (AN).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Women treated for AN at our institution were retrospectively included if they had undergone upper gastrointestinal radiography (UGR) after the diagnosis of AN. Two control groups (CG1 and CG2) were included, both comprising female patients: CG1 patients were not obese and underwent UGR for digestive symptoms of other aetiologies, and CG2 comprised obese individuals who had UGR before bariatric surgery. A UGR-based Stomach Size Index (SSI), calculated as the ratio of the length of the stomach to the distance between the upper end of the stomach and the top of the iliac crests, was measured in all three groups. Gastromegaly was defined as SSI &gt;1.00.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>45 patients suffering from AN (28 with restrictive and 17 with binge/purge subtype), 10 CG1 and 20 CG2 subjects were included in this study. Stomach Size Index was significantly higher in AN (1.27 ± 0.24) than in CG1 (0.80 ± 0.11) and CG2 (0.68 ± 0.09); <i>p</i> &lt; 0.001, but was not significantly different between patients with the restrictive and binge/purge subtypes. Gastromegaly was present in 82.2% of patients with AN and not present in the control groups. In patients with AN, gastromegaly was present in 12/15 patients without digestive symptoms (80.0%) and in 25/30 patients with digestive complaints (83.3%) at time of UGR (<i>p</i> = 0.99). In the AN group, no significant relationship was found between SSI and body mass index.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Gastromegaly is frequent in AN and could influence AN recovery. This anatomical modification could partially explain the alterations of gastric motility previously reported in AN.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48117,"journal":{"name":"European Eating Disorders Review","volume":"32 4","pages":"784-794"},"PeriodicalIF":5.3,"publicationDate":"2024-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/erv.3089","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140194840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Development of a visual-perceptual method to assess body image: A cross-cultural validation in Canadian and Spanish women 开发评估身体形象的视觉感知方法:在加拿大和西班牙女性中进行跨文化验证。
IF 5.3 2区 心理学 Q1 PSYCHIATRY Pub Date : 2024-03-21 DOI: 10.1002/erv.3086
Giulia Corno, Amélia Paquette, Diana Burychka, Marta Miragall, Marie-Christine Rivard, Rosa M. Baños, Stéphane Bouchard

The objectives of this study were (a) to explore the preliminary cross-cultural validity of a visual-perceptual method to assess body image; (b) to examine potential differences and similarities in body image phenomena between women from two Western countries (i.e., Canada and Spain). 201 self-identified women participated in this cross-sectional study. Ideal, normal, and self-perceived body sizes were assessed using a visual-perceptual method, whereas body dissatisfaction was measured using both a visual-perceptual method and a questionnaire. Visual-perceptual body dissatisfaction was significantly correlated with questionnaire body dissatisfaction, suggesting a preliminary convergent validity between the two assessment methods. Women in both countries were dissatisfied with their bodies. Compared to their self-perceived body, all women chose a significantly thinner visual representation of their “normal” and ideal body. These results may suggest a shift towards the “thin” body as not only ideal, but also normative. This study provides the first evidence for the cross-cultural validity of a visual-perceptual body image assessment tool. The results of the current study confirm the presence of “normative discontent”, and suggest more cross-country similarities than differences among women from these two Western societies.

本研究的目的是:(a) 探索一种评估身体形象的视觉感知方法的初步跨文化有效性;(b) 研究来自两个西方国家(即加拿大和西班牙)的女性在身体形象现象方面的潜在差异和相似性。201 名自我认同的女性参与了这项横断面研究。研究采用视觉感知法对理想体型、正常体型和自我感觉体型进行了评估,同时采用视觉感知法和问卷调查法对身体不满意度进行了测量。视觉感知的身体不满意度与问卷调查的身体不满意度有明显的相关性,表明这两种评估方法有初步的趋同性。两个国家的妇女都对自己的身体不满意。与自我感觉的身材相比,所有女性选择的 "正常 "和理想身材的视觉代表都明显较瘦。这些结果可能表明,"瘦 "身材不仅是理想的,也是规范的。这项研究首次证明了视觉感知身体形象评估工具的跨文化有效性。本次研究的结果证实了 "规范性不满 "的存在,并表明这两个西方社会的女性之间的跨国相似性多于差异性。
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引用次数: 0
Correction to “Comparing randomized controlled trials of outpatient family-based or inpatient multimodal treatment followed by outpatient care in youth with anorexia nervosa: Differences in populations, metrics, and outcomes” 对 "比较以家庭为基础的门诊治疗或以门诊治疗为后继的住院多模式治疗对神经性厌食症青少年的随机对照试验:人群、指标和结果的差异"。
IF 5.3 2区 心理学 Q1 PSYCHIATRY Pub Date : 2024-03-21 DOI: 10.1002/erv.3085

Haas, V., Nadler, J., Crosby, R. D., Madden, S., Kohn, M., L Grange, D., Gonçalves, A. S. O., Hebebrand, J., & Correll, C. U. (2022). Comparing randomized controlled trials of outpatient family-based or inpatient multimodal treatment followed by outpatient care in youth with anorexia nervosa: Differences in populations, metrics, and outcomes. European Eating Disorders Review, 30(6), 693–705. https://doi.org/10.1002/erv.2907

Funding details in the Acknowledgements section was incomplete. It should have been:

Haas, V., Nadler, J., Crosby, R. D., Madden, S., Kohn, M., L Grange, D., Gonçalves, A. S. O., Hebebrand, J., & Correll, C. U. (2022)。比较对神经性厌食症青少年进行的基于家庭的门诊或住院多模式治疗后的门诊护理随机对照试验:人群、指标和结果的差异。欧洲进食障碍评论》,30(6),693-705。https://doi.org/10.1002/erv.2907Funding,致谢部分的细节不完整。应该是
{"title":"Correction to “Comparing randomized controlled trials of outpatient family-based or inpatient multimodal treatment followed by outpatient care in youth with anorexia nervosa: Differences in populations, metrics, and outcomes”","authors":"","doi":"10.1002/erv.3085","DOIUrl":"10.1002/erv.3085","url":null,"abstract":"<p>Haas, V., Nadler, J., Crosby, R. D., Madden, S., Kohn, M., L Grange, D., Gonçalves, A. S. O., Hebebrand, J., &amp; Correll, C. U. (2022). Comparing randomized controlled trials of outpatient family-based or inpatient multimodal treatment followed by outpatient care in youth with anorexia nervosa: Differences in populations, metrics, and outcomes. European Eating Disorders Review, 30(6), 693–705. https://doi.org/10.1002/erv.2907</p><p>Funding details in the Acknowledgements section was incomplete. It should have been:</p>","PeriodicalId":48117,"journal":{"name":"European Eating Disorders Review","volume":"32 3","pages":"612"},"PeriodicalIF":5.3,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/erv.3085","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140177193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Parental perceptions of participation in young adult-focused eating disorder treatment. 父母对参与以青少年为重点的饮食失调治疗的看法。
IF 5.3 2区 心理学 Q1 PSYCHIATRY Pub Date : 2024-03-21 DOI: 10.1002/erv.3084
Stephanie Knatz Peck, Terra Towne, Christina Wierenga, Taylor Perry, McKenzie Miller, Jessie Kim, Walter Kaye

Background: Eating disorders (ED) are serious mental illnesses affecting young adults (YA). Parent-supported treatment for this age cohort is an important consideration given the unique developmental needs and norms of familial social support, but more research is needed to understand parental perceptions of treatment involvement.

Methods: 33 parent-supports of YA with ED completed self-report assessments at admission and discharge of participation in brief, intensive, young-adult focused eating disorder treatment. Assessments measured programme satisfaction, parental self-efficacy, and parent and YA report of eating disorder-related psychopathology. Repeated measures ANOVAs were used to examine pre-post outcome differences and between group differences among parent-supports and their YA (i.e., the patients) on eating disorder psychopathology, clinical impairment, and family functioning using the EDEQ/P-EDEQ Global, P-CIA/CIA, and Family Assessment Device Family Functioning scales. Group differences across time points were examined with paired sample t-tests adjusted for multiple comparisons. Changes in parental self-efficacy were examined separately using two-tailed paired sample t-tests.

Results: Parents reported high acceptability and learning, improvements in self-efficacy, and significant reductions of YA psychopathology at post-treatment. Parents reported comparable reductions in ED psychopathology post-treatment, but significantly greater reductions in clinical impairment compared to YA. Measures of family functioning did not improve for either parent or YA at post-treatment.

Conclusion: Results from this study suggest that parental involvement in a YA programme is feasible and acceptable from a parental perspective and improves parental self-efficacy.

背景:进食障碍(ED)是影响青少年(YA)的严重精神疾病。鉴于其独特的发展需求和家庭社会支持规范,针对这一年龄组的家长支持治疗是一个重要的考虑因素,但还需要更多的研究来了解家长对参与治疗的看法。方法:33 名患有进食障碍的青少年的家长支持者在入院和出院时完成了自我报告评估,并参加了以青少年为重点的简短、强化进食障碍治疗。评估内容包括项目满意度、家长自我效能感以及家长和青少年对饮食失调相关心理病理学的报告。使用 EDEQ/P-EDEQ Global、P-CIA/CIA 和 Family Assessment Device Family Functioning 等量表,采用重复测量方差分析来检验父母支持者及其青少年(即患者)在饮食失调精神病理学、临床损害和家庭功能方面的前后结果差异和组间差异。采用经多重比较调整的配对样本 t 检验法来检验各时间点的组间差异。使用双尾配对样本 t 检验分别考察了家长自我效能感的变化:结果:治疗后,家长对治疗的接受度和学习能力较高,自我效能感有所提高,YA 心理病理学显著降低。家长们表示,治疗后教育心理病理的减少程度相当,但临床损害的减少程度明显高于 YA。治疗后,父母或青少年的家庭功能均未得到改善:这项研究的结果表明,从家长的角度来看,让家长参与到青少年教育计划中是可行的,也是可以接受的,而且还能提高家长的自我效能感。
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引用次数: 0
Trajectories and predictive factors of weight recovery in patients with anorexia nervosa completing treatment. A latent class mixed model approach 完成治疗的神经性厌食症患者体重恢复的轨迹和预测因素。潜类混合模型法
IF 5.3 2区 心理学 Q1 PSYCHIATRY Pub Date : 2024-03-19 DOI: 10.1002/erv.3088
Laura Di Lodovico, Amir Al Tabchi, Julia Clarke, Rossella Letizia Mancusi, Dylan Messeca, Philibert Duriez, Mouna Hanachi, Philip Gorwood

Background

Treatment of anorexia nervosa (AN) sometimes requires hospitalisation, which is often lengthy, with little ability to predict individual trajectory. Depicting specific profiles of treatment response and their clinical predictors could be beneficial to tailor inpatient management. The aim of this research was to identify clusters of weight recovery during inpatient treatment, and their clinical predictors.

Methods

A sample of 181 inpatients who completed a treatment programme for AN was included in a retrospective study. A latent class mixed model approach was used to identify distinct weight-gain trajectories. Clinical variables were introduced in a multinomial logistic regression model as predictors of the different classes.

Results

A four-class quadratic model was retained, able to correctly classify 63.7% of the cohort. It encompassed a late-rising, flattening, moderate trajectory of body mass index (BMI) increase (class 1), a late-rising, steady, high trajectory (class 2), an early-rising, flattening, high trajectory (class 3) and an early-rising, steady, high trajectory (class 4). Significant predictors of belonging to a class were baseline BMI (all classes), illness duration (class 2), and benzodiazepine prescription (class 3).

Conclusion

Predicting different kinetics of weight recovery based on routinely collected clinical indicators could improve clinician awareness and patient engagement by enabling shared expectations of treatment response.

背景:神经性厌食症(AN)的治疗有时需要住院,住院时间往往很长,而且几乎无法预测个体的治疗轨迹。描绘治疗反应的具体轮廓及其临床预测因素可能有利于调整住院管理。本研究旨在确定住院治疗期间体重恢复的群组及其临床预测因素:这项回顾性研究的样本包括181名完成自闭症治疗计划的住院患者。研究采用潜类混合模型法来识别不同的体重增加轨迹。临床变量被引入多项式逻辑回归模型,作为不同等级的预测因子:结果:保留了一个四级四元模型,能正确划分出 63.7% 的人群。该模型包括体重指数(BMI)增长轨迹晚期上升、平缓、中等(1级),增长轨迹晚期上升、稳定、高(2级),增长轨迹早期上升、平缓、高(3级)和增长轨迹早期上升、稳定、高(4级)。基线体重指数(所有级别)、病程(第 2 级)和苯二氮卓处方(第 3 级)是预测属于某一级别的重要因素:结论:根据常规收集的临床指标预测体重恢复的不同动力,可以提高临床医生对治疗反应的共同预期,从而提高临床医生的认识和患者的参与度。
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引用次数: 0
Rates and correlates of study enrolment and use of a chatbot aimed to promote mental health services use for eating disorders following online screening 在线筛查后,旨在促进饮食失调心理健康服务使用的聊天机器人的研究注册和使用率及相关因素
IF 5.3 2区 心理学 Q1 PSYCHIATRY Pub Date : 2024-03-19 DOI: 10.1002/erv.3082
Laura D’Adamo, Anne Claire Grammer, Gavin N. Rackoff, Jillian Shah, Marie-Laure Firebaugh, C. Barr Taylor, Denise E. Wilfley, Ellen E. Fitzsimmons-Craft

Objective

We developed a chatbot aimed to facilitate mental health services use for eating disorders (EDs) and offered the opportunity to enrol in a research study and use the chatbot to all adult respondents to a publicly available online ED screen who screened positive for clinical/subclinical EDs and reported not currently being in treatment. We examined the rates and correlates of enrolment in the study and uptake of the chatbot.

Method

Following screening, eligible respondents (≥18 years, screened positive for a clinical/subclinical ED, not in treatment for an ED) were shown the study opportunity. Chi-square tests and logistic regressions explored differences in demographics, ED symptoms, suicidality, weight, and probable ED diagnoses between those who enroled and engaged with the chatbot versus those who did not.

Results

6747 respondents were shown the opportunity (80.0% of all adult screens). 3.0% enroled, of whom 90.2% subsequently used the chatbot. Enrolment and chatbot uptake were more common among respondents aged ≥25 years old versus those aged 18–24 and less common among respondents who reported engaging in regular dietary restriction.

Conclusions

Overall enrolment was low, yet uptake was high among those that enroled and did not differ across most demographics and symptom presentations. Future directions include evaluating respondents' attitudes towards treatment-promoting tools and removing barriers to uptake.

目的我们开发了一款聊天机器人,旨在促进进食障碍(ED)患者使用心理健康服务,并向所有接受过公开在线 ED 筛查、临床/亚临床 ED 筛查呈阳性且报告目前未接受治疗的成年受访者提供了参加研究和使用聊天机器人的机会。我们研究了研究注册率和相关性以及聊天机器人的使用情况。方法筛查后,向符合条件的受访者(≥18 岁,临床/亚临床 ED 筛查呈阳性,未接受 ED 治疗)展示研究机会。卡方检验和逻辑回归探讨了注册并使用聊天机器人的受访者与未注册并使用聊天机器人的受访者在人口统计学、ED 症状、自杀倾向、体重和可能的 ED 诊断方面的差异。3.0%的人注册,其中 90.2%的人随后使用了聊天机器人。在年龄≥25 岁的受访者中,注册和使用聊天机器人的比例高于 18-24 岁的受访者,而在报告经常限制饮食的受访者中,注册和使用聊天机器人的比例较低。结论总体注册率较低,但在注册的受访者中使用率较高,并且在大多数人口统计学和症状表现方面没有差异。未来的研究方向包括评估受访者对治疗促进工具的态度以及消除使用障碍。
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European Eating Disorders Review
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