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Dufour R, Novack K, Picard L, Chadi N, Booij L. The use of technology in the treatment of youth with eating disorders: A scoping review. J Eat Disord 2022; 10:182. [PMID: 36434657 PMCID: PMC9700893 DOI: 10.1186/s40337-022-00697-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 11/08/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Adolescence and young adulthood is a high-risk period for the development of eating disorders. In recent years, there has been an increase in use of technology-based interventions (TBIs) for the treatment of eating disorders. The objective of this study was to determine the types of technology used for eating disorder treatment in youth and their effectiveness. METHODS A scoping review was conducted according to PRISMA-ScR guidelines. Four databases were searched. Eligible articles included: (1) a TBI (2) participants with a mean age between 10- and 25-years and meeting DSM-IV or DSM-5 criteria for any eating disorder and (3) qualitative or quantitative designs. Quantitative and qualitative studies were assessed for quality. RESULTS The search identified 1621 articles. After screening of titles and abstracts, 130 articles were read in full and assessed for eligibility by two raters. Forty-nine (29 quantitative and 20 qualitative, observational, or mixed methods studies) met inclusion criteria. Quality ratings indicated that 78% of quantitative studies had a low risk of bias and 22% had a moderate risk. Technologies reviewed in our study included videoconference therapy, mobile applications, and online self-help. We considered interventions used both within sessions with clinicians as well as those used in between sessions by patients alone. Fifteen of 18 (83%) quantitative studies found that TBIs reduce eating disorder symptomatology, with nine of those reporting medium-to-large effect sizes. Qualitative data was of high quality and suggested that virtual interventions are acceptable in this population. CONCLUSIONS Although identified studies are of high quality, they are limited in number. More research is needed, particularly regarding videoconferencing and mobile applications. Nonetheless, TBIs show promise for the treatment of eating disorders in youth. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Rachel Dufour
- Sainte-Justine Hospital Research Centre, Montreal, Canada.,Department of Psychology, Concordia University, Montreal, Canada
| | - Kaylee Novack
- Sainte-Justine Hospital Research Centre, Montreal, Canada.,Department of Psychiatry and Addictology, Université de Montréal, Montreal, Canada.,Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Louis Picard
- Division of Adolescent Medicine, Department of Pediatrics, Sainte-Justine University Hospital Centre, 3175 Chemin de La Côte-Ste-Catherine, Montreal, QC, H3T 1C5, Canada
| | - Nicholas Chadi
- Sainte-Justine Hospital Research Centre, Montreal, Canada. .,Division of Adolescent Medicine, Department of Pediatrics, Université de Montréal, Montreal, Canada. .,Division of Adolescent Medicine, Department of Pediatrics, Sainte-Justine University Hospital Centre, 3175 Chemin de La Côte-Ste-Catherine, Montreal, QC, H3T 1C5, Canada.
| | - Linda Booij
- Sainte-Justine Hospital Research Centre, Montreal, Canada.,Department of Psychology, Concordia University, Montreal, Canada.,Department of Psychiatry and Addictology, Université de Montréal, Montreal, Canada.,Department of Psychiatry, McGill University, Montreal, Canada
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2
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Margherita G, Muzii B, Caffieri A, Di Francia A, Somma B. 'Isolated together': online group treatments during the COVID-19 pandemic. A systematic review. RESEARCH IN PSYCHOTHERAPY (MILANO) 2022; 25:639. [PMID: 36373389 PMCID: PMC9893046 DOI: 10.4081/ripppo.2022.639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 10/03/2022] [Indexed: 11/09/2022]
Abstract
Considering the emerging need to face the negative impact of the pandemic on mental health, social support, and access to health services, it became a critical issue to adapt to online group settings and create new group interventions to face the developing distress during this time. The aim of the current study is to investigate the main findings on OPGI conducted during the COVID-19 pandemic from March 2020 until March 2022, with a particular focus on: i) the therapeutic group factors; ii) what kind of OPGI works and for whom; iii) settings and emerging dimensions. In accordance with PRISMA guidelines, we performed a systematic review on scientific databases (PsychINFO, PubMed, Web of Science and EBSCO) searching for studies published between March 2020 and March 2022. 'Group intervention' or 'group therapy' or 'group treatment' crossed with 'COVID-19' and synonymous, were used as keywords. Internet based intervention was used as an eligibility criteria during the full-text screening. A total of 1326 articles were identified, of which 24 met the inclusion criteria. Among all studies, with different participants and different orientations, data extracted supported psychological online group interventions as an effective approach to reducing psychological distress and increasing psychological resources in the interpersonal field. Our findings also showed that COVID-19 has led to new needs and issues, that require the investigation of new dimensions for online psychological interventions. Methodological and clinical implications will be discussed through a descriptive table related to setting characteristics. Recommendations are made for future research.
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Affiliation(s)
- Giorgia Margherita
- Department of Humanistic Studies, University of Naples Federico II, Naples, Italy,I.I.P.G., Italian Institute of Group Psychoanalysis and European Federation for Psychoanalytic Psychotherapy in the Public Sector, Rome, Italy,Department of Humanistic Studies, University of Naples Federico II, Naples, Italy.
| | - Benedetta Muzii
- Department of Humanistic Studies, University of Naples Federico II, Naples, Italy
| | - Alessia Caffieri
- Department of Humanistic Studies, University of Naples Federico II, Naples, Italy
| | - Adriana Di Francia
- Department of Humanistic Studies, University of Naples Federico II, Naples, Italy
| | - Brenda Somma
- Department of Humanistic Studies, University of Naples Federico II, Naples, Italy
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3
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Matherne CE, Watson H, Fassnacht DB, Ali K, Zerwas S, Peat C, Runfola C, Levine MD, Marcus MD, Zimmer B, Moessner M, Crosby R, Bulik CM. An exploratory investigation of predictors of outcome in face-to-face and online cognitive-behavioural therapy for bulimia nervosa. EUROPEAN EATING DISORDERS REVIEW 2022; 30:373-387. [PMID: 35474624 DOI: 10.1002/erv.2898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 03/08/2022] [Accepted: 03/17/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Cognitive-behavioural therapy (CBT) delivered face-to-face and via the internet reduces bulimia nervosa (BN) symptoms. However, our empirical understanding of factors affecting patient outcomes is limited. METHOD Using data from a randomised, controlled trial comparing internet-based (CBT4BN, n = 78) with face-to-face (CBTF2F, n = 71) group CBT (97% female, M = 28 years), we examined general treatment (across conditions) and modality-specific predictors of end-treatment and 1-year outcomes (abstinence, binge-eating frequency, purging frequency). RESULTS Improved eating disorder-related quality of life (EDQOL) during treatment and follow-up predicted abstinence at end-treatment and 1-year assessments. Improved EDQOL, disordered eating cognitions, and anxiety symptoms predicted less frequent binge eating and purging. Previous CBT and being employed predicted more frequent binge eating and purging at both assessments. Higher self-transcendence and self-directedness predicted less frequent binge eating. More severe binge eating and purging at baseline and end-treatment predicted more frequent binge eating and purging at subsequent assessments. Improved EDQOL was more strongly associated with positive outcome in CBT4BN; improved depressive symptoms and health-related QOL predicted positive outcome in CBT4BN but not CBTF2F. DISCUSSION Symptom improvement and certain character traits predicted positive outcome, whereas more severe presentation and prior CBT experience predicted poorer outcome. Consideration of intreatment symptom improvement may facilitate care recommendations, particularly for internet-based modalities.
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Affiliation(s)
- Camden E Matherne
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Hunna Watson
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,School of Psychology, Curtin University, Bentley, Western Australia, Australia.,Division of Paediatrics, The University of Western Australia, Crawley, Western Australia, Australia
| | - Daniel B Fassnacht
- College of Education, Psychology and Social Work, Flinders University, Adelaide, South Australia, Australia.,Research School of Psychology, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Kathina Ali
- College of Education, Psychology and Social Work, Flinders University, Adelaide, South Australia, Australia.,Research School of Psychology, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Stephanie Zerwas
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Christine Peat
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Cristin Runfola
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA
| | - Michele D Levine
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Marsha D Marcus
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Benjamin Zimmer
- Center for Psychotherapy Research, University Hospital, Heidelberg, Germany
| | - Markus Moessner
- Center for Psychotherapy Research, University Hospital, Heidelberg, Germany
| | - Ross Crosby
- Sanford Center for Biobehavioral Research, Fargo, North Dakota, USA.,Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA
| | - Cynthia M Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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4
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Watson HJ, McLagan N, Zerwas SC, Crosby RD, Levine MD, Runfola CD, Peat CM, Moessner M, Zimmer B, Hofmeier SM, Hamer RM, Marcus MD, Bulik CM, Crow SJ. Cost-Effectiveness of Internet-Based Cognitive-Behavioral Treatment for Bulimia Nervosa: Results of a Randomized Controlled Trial. J Clin Psychiatry 2019; 79:16m11314. [PMID: 29228517 PMCID: PMC5837958 DOI: 10.4088/jcp.16m11314] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 05/22/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To evaluate the cost-effectiveness of Internet-based cognitive-behavioral therapy for bulimia nervosa (CBT-BN) compared to face-to-face delivery of CBT-BN. METHODS This study is a planned secondary analysis of data from a randomized clinical trial. Participants were 179 adults (98% female, mean age = 28 years) meeting DSM-IV criteria for bulimia nervosa who were randomized to group face-to-face or group Internet-based CBT-BN for 16 sessions during 20 weeks. The cost-effectiveness analysis was conducted from a third-party payor perspective, and a partial societal perspective analysis was conducted to investigate cost-utility (ie, cost per gain in quality-adjusted life-years) and patient out-of-pocket travel-related costs. Net health care costs were calculated from protocol and nonprotocol health care services using third-party payor cost estimates. The primary outcome measure in the clinical trial was abstinence from binge eating and purging, and the trial start and end dates were 2008 and 2016. RESULTS The mean cost per abstinent patient at posttreatment was $7,757 (95% confidence limit [CL], $4,515, $13,361) for face-to-face and $11,870 (95% CL, $6,486, $22,188) for Internet-based CBT-BN, and at 1-year follow-up was $16,777 (95% CL, $10,298, $27,042) for face-to-face and $14,561 (95% CL, $10,165, $21,028) for Internet-based CBT-BN. There were no statistically significant differences between treatment arms in cost-effectiveness or cost-utility at posttreatment or 1-year follow-up. Out-of-pocket patient costs were significantly higher for face-to-face (mean [95% CL] = $178 [$127, $140]) than Internet-based ($50 [$50, $50]) therapy. CONCLUSIONS Third-party payor cost-effectiveness of Internet-based CBT-BN is comparable with that of an accepted standard. Internet-based dissemination of CBT-BN may be a viable alternative for patients geographically distant from specialist eating disorder services who have an unmet need for treatment. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT00877786.
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Affiliation(s)
- Hunna J Watson
- Department of Psychiatry, The University of North Carolina at Chapel Hill, CB #7160, 101 Manning Dr, Chapel Hill, NC 27599.
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- School of Paediatrics and Child Health, The University of Western Australia, Perth, Western Australia, Australia
- School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia, Australia
| | - Nicole McLagan
- Eating Disorders Program, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
| | - Stephanie C Zerwas
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Ross D Crosby
- Neuropsychiatric Research Institute, Fargo, North Dakota, USA
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA
| | - Michele D Levine
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Cristin D Runfola
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, California, USA
| | - Christine M Peat
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Neurosurgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Markus Moessner
- Center for Psychotherapy Research, University Hospital Heidelberg, Heidelberg, Baden-Württemberg, Germany
| | - Benjamin Zimmer
- Center for Psychotherapy Research, University Hospital Heidelberg, Heidelberg, Baden-Württemberg, Germany
| | - Sara M Hofmeier
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Robert M Hamer
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Marsha D Marcus
- Eating Disorders Program, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
| | - Cynthia M Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Scott J Crow
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, Minnesota, USA
- The Emily Program, St Paul, Minnesota, USA
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5
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MacNeil BA, Hudson CC, Leung P. It's raining men: descriptive results for engaging men with eating disorders in a specialized male assessment and treatment track (MATT). Eat Weight Disord 2018; 23:817-824. [PMID: 30306497 DOI: 10.1007/s40519-018-0586-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 09/25/2018] [Indexed: 01/07/2023] Open
Abstract
PURPOSE Men with eating disorders are not well understood and there is a need for innovative methods for engaging men in specialized outpatient assessment and treatment. We examined data collected over a 4-year period to explore whether the addition of a designated track for men at a hospital-based adult eating disorders program influenced the number of referrals or treatment engagement. METHODS During assessment and treatment as usual (ATAU; September 2013-August 2015), 283 referrals were received (275 women, 8 men), with 3 men engaging in assessment and treatment (Mage = 36 years, SD = 14.18). After instatement of a male assessment and treatment track (MATT; September 2015-August 2017), 320 referrals were received (300 women, 20 men), with 14 men engaging in the specialized assessment and treatment (Mage = 28.21 years, SD = 8.04). Both groups of men completed measures of demographic characteristics, life satisfaction, depressive and anxiety symptoms, and eating disorder symptoms. RESULTS Significantly more referrals for men, but not women, were received after the instatement of the MATT (i.e., a 250% increase). More men also engaged in specialized assessment and treatment after the instatement of the MATT (i.e., a 467% increase in engagement). CONCLUSIONS The current study describes the number of referrals and the number of men who engaged in treatment before and after the instatement of a specialized treatment track for men. The results suggest that the addition of the MATT helped to increase the number of men referred and promoted their engagement in recommended care. LEVEL OF EVIDENCE V retrospective descriptive study.
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Affiliation(s)
- Brad A MacNeil
- Adult Eating Disorders Program, Kingston Health Sciences Centre (KHSC), Hotel Dieu Hospital Site, 166 Brock Street, Kingston, ON, K7L5G2, Canada. .,Department of Psychiatry, Queen's University, 752 King Street West, Postal Bag 603, Kingston, ON, K7L7X3, Canada. .,Counseling and Psychological Services, George Mason University, Student Union Building 1, Suite 3129, 4400 University Drive, MS 2A2, Fairfax, VA, 22030, USA.
| | - Chloe C Hudson
- Adult Eating Disorders Program, Kingston Health Sciences Centre (KHSC), Hotel Dieu Hospital Site, 166 Brock Street, Kingston, ON, K7L5G2, Canada.,Department of Psychology, Queen's University, 62 Arch Street Humphrey Hall, Room 232, Kingston, ON, K7L3N6, Canada
| | - Pauline Leung
- Adult Eating Disorders Program, Kingston Health Sciences Centre (KHSC), Hotel Dieu Hospital Site, 166 Brock Street, Kingston, ON, K7L5G2, Canada.,Department of Psychology, Queen's University, 62 Arch Street Humphrey Hall, Room 232, Kingston, ON, K7L3N6, Canada
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6
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Exposure with response prevention (ERP) for body dissatisfaction in a group therapy format: an exploratory study. Eat Weight Disord 2018; 23:225-232. [PMID: 27830582 DOI: 10.1007/s40519-016-0340-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 10/24/2016] [Indexed: 10/20/2022] Open
Abstract
PURPOSE The aim of this exploratory study was to examine patient satisfaction and outcomes from exposure with response prevention (ERP) delivered in a group therapy format. The group was aimed at addressing eating disorder symptoms associated with body dissatisfaction in the later stages of outpatient treatment. METHODS 33 adults with a DSM-5 diagnosis of an eating disorder participated in the ERP group. Participants completed pre- and post-ERP group measures of depression, anxiety, self-evaluation based on body image, restraint, eating concern, weight concern, shape concern, upward and downward appearance comparisons, and patient satisfaction. RESULTS Involvement in the ERP group was associated with significant decreases in self-evaluation based on body image, restraint, eating concern, weight concern, shape concern, and upward physical appearance comparisons post-group treatment. This adjunct treatment group was well received and viewed as being helpful by participants. CONCLUSIONS ERP in a group therapy format for addressing body dissatisfaction may represent a complimentary approach to current evidence-based treatments for an eating disorder, and warrant further investigation.
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7
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Agras WS, Fitzsimmons-Craft EE, Wilfley DE. Evolution of cognitive-behavioral therapy for eating disorders. Behav Res Ther 2017; 88:26-36. [PMID: 28110674 DOI: 10.1016/j.brat.2016.09.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 09/02/2016] [Accepted: 09/06/2016] [Indexed: 01/20/2023]
Abstract
The evolution of cognitive-behavioral therapy (CBT) for the treatment of bulimic disorders is described in this review. The impacts of successive attempts to enhance CBT such as the addition of exposure and response prevention; the development of enhanced CBT; and broadening the treatment from bulimia nervosa to binge eating disorder are considered. In addition to developing advanced forms of CBT, shortening treatment to guided self-help was the first step in broadening access to treatment. The use of technology such as computer-based therapy and more recently the Internet, promises further broadening of access to self-help and to therapist guided treatment. Controlled studies in this area are reviewed, and the balance of risks and benefits that accompany the use of technology and lessened therapist input are considered. Looking into the future, more sophisticated forms of treatment delivered as mobile applications ("apps") may lead to more personalized and efficacious treatments for bulimic disorders, thus enhancing the delivery of treatments for eating disorders.
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Affiliation(s)
- W Stewart Agras
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Rd., Stanford, CA 94305, USA.
| | - Ellen E Fitzsimmons-Craft
- Department of Psychiatry, Washington University School of Medicine, Campus Box 8134, 660 S. Euclid Ave., St. Louis, MO 63110, USA.
| | - Denise E Wilfley
- Department of Psychiatry, Washington University School of Medicine, Campus Box 8134, 660 S. Euclid Ave., St. Louis, MO 63110, USA.
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8
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Reducing the burden of suffering from eating disorders: Unmet treatment needs, cost of illness, and the quest for cost-effectiveness. Behav Res Ther 2017; 88:49-64. [PMID: 28110676 DOI: 10.1016/j.brat.2016.09.006] [Citation(s) in RCA: 97] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2016] [Revised: 09/13/2016] [Accepted: 09/15/2016] [Indexed: 01/27/2023]
Abstract
Eating disorders are serious mental disorders as reflected in significant impairments in health and psychosocial functioning and excess mortality. Despite the clear evidence of clinical significance and despite availability of evidence-based, effective treatments, research has shown a paradox of elevated health services use and, yet, infrequent treatment specifically targeting the eating disorder (i.e., high unmet treatment need). This review paper summarizes key studies conducted in collaboration with G. Terence Wilson and offers an update of the research literature published since 2011 in three research areas that undergirded our collaborative research project: unmet treatment needs, cost of illness, and cost-effectiveness of treatments. In regards to unmet treatment needs, epidemiological studies find that the number of individuals with an eating disorder who do not receive disorder-specific treatment continues to remain high. Cost-of-illness show that eating disorders are associated with substantial financial burdens for individuals, their family, and society, yet comprehensive examination of costs across public sectors is lacking. Cost measures vary widely, making it difficult to draw firm conclusions. Hospitalization is a major driver of medical costs incurred by individuals with an eating disorder. Only a handful of cost-effectiveness studies have been conducted, leaving policy makers with little information on which to base decisions about allocation of resources to help reduce the burden of suffering attributable to eating disorders.
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9
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Watson HJ, Levine MD, Zerwas SC, Hamer RM, Crosby RD, Sprecher CS, O'Brien A, Zimmer B, Hofmeier SM, Kordy H, Moessner M, Peat CM, Runfola CD, Marcus MD, Bulik CM. Predictors of dropout in face-to-face and internet-based cognitive-behavioral therapy for bulimia nervosa in a randomized controlled trial. Int J Eat Disord 2017; 50:569-577. [PMID: 27862108 PMCID: PMC5429209 DOI: 10.1002/eat.22644] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 10/11/2016] [Accepted: 10/11/2016] [Indexed: 11/08/2022]
Abstract
OBJECTIVE We sought to identify predictors and moderators of failure to engage (i.e., pretreatment attrition) and dropout in both Internet-based and traditional face-to-face cognitive-behavioral therapy (CBT) for bulimia nervosa. We also sought to determine if Internet-based treatment reduced failure to engage and dropout. METHOD Participants (N = 191, 98% female) were randomized to Internet-based CBT (CBT4BN) or traditional face-to-face group CBT (CBTF2F). Sociodemographics, clinical history, eating disorder severity, comorbid psychopathology, health status and quality of life, personality and temperament, and treatment-related factors were investigated as predictors. RESULTS Failure to engage was associated with lower perceived treatment credibility and expectancy (odds ratio [OR] = 0.91, 95% CI: 0.82, 0.97) and body mass index (BMI) (OR = 1.10; 95% CI: 1.03, 1.18). Dropout was predicted by not having a college degree (hazard ratio [HR] = 0.55; 95% CI: 0.37, 0.81), novelty seeking (HR = 1.02; 95% CI: 1.01, 1.03), previous CBT experience (HR = 1.77; 95% CI: 1.16, 2.71), and randomization to the individual's nonpreferred treatment format (HR = 1.95, 95% CI: 1.28, 2.96). DISCUSSION Those most at risk of failure to engage had a higher BMI and perceived treatment as less credible and less likely to succeed. Dropout was associated with less education, higher novelty seeking, previous CBT experience, and a mismatch between preferred and assigned treatment. Contrary to expectations, Internet-based CBT did not reduce failure to engage or dropout. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2017; 50:569-577).
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Affiliation(s)
- Hunna J. Watson
- Department of Psychiatry, University of North Carolina at Chapel Hill, United States
- Eating Disorders Program, Child and Adolescent Health Service, Department of Health in Western Australia, Australia
- School of Paediatrics and Child Health, The University of Western Australia, Australia
- School of Psychology and Speech Pathology, Curtin University, Australia
| | - Michele D. Levine
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, United States
| | - Stephanie C. Zerwas
- Department of Psychiatry, University of North Carolina at Chapel Hill, United States
| | - Robert M. Hamer
- Department of Psychiatry, University of North Carolina at Chapel Hill, United States
- Department of Biostatistics, University of North Carolina at Chapel Hill, United States
| | - Ross D. Crosby
- Neuropsychiatric Research Institute, United States
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, United States
| | - Caroline S. Sprecher
- Department of Psychiatry, University of North Carolina at Chapel Hill, United States
| | - Amy O'Brien
- Eating Disorders Program, Child and Adolescent Health Service, Department of Health in Western Australia, Australia
| | - Benjamin Zimmer
- Center for Psychotherapy Research, University Hospital Heidelberg, Germany
| | - Sara M. Hofmeier
- Department of Psychiatry, University of North Carolina at Chapel Hill, United States
| | - Hans Kordy
- Center for Psychotherapy Research, University Hospital Heidelberg, Germany
| | - Markus Moessner
- Center for Psychotherapy Research, University Hospital Heidelberg, Germany
| | - Christine M. Peat
- Department of Psychiatry, University of North Carolina at Chapel Hill, United States
| | - Cristin D. Runfola
- Department of Psychiatry, University of North Carolina at Chapel Hill, United States
| | - Marsha D. Marcus
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, United States
| | - Cynthia M. Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, United States
- Department of Nutrition, University of North Carolina at Chapel Hill, United States
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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10
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Levinson CA, Zerwas S, Calebs B, Forbush K, Kordy H, Watson H, Hofmeier S, Levine M, Crosby RD, Peat C, Runfola CD, Zimmer B, Moesner M, Marcus MD, Bulik CM. The core symptoms of bulimia nervosa, anxiety, and depression: A network analysis. JOURNAL OF ABNORMAL PSYCHOLOGY 2017; 126:340-354. [PMID: 28277735 DOI: 10.1037/abn0000254] [Citation(s) in RCA: 142] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Bulimia nervosa (BN) is characterized by symptoms of binge eating and compensatory behavior, and overevaluation of weight and shape, which often co-occur with symptoms of anxiety and depression. However, there is little research identifying which specific BN symptoms maintain BN psychopathology and how they are associated with symptoms of depression and anxiety. Network analyses represent an emerging method in psychopathology research to examine how symptoms interact and may become self-reinforcing. In the current study of adults with a Diagnostic and Statistical Manual for Mental Disorders-Fourth Edition (DSM-IV) diagnosis of BN (N = 196), we used network analysis to identify the central symptoms of BN, as well as symptoms that may bridge the association between BN symptoms and anxiety and depression symptoms. Results showed that fear of weight gain was central to BN psychopathology, whereas binge eating, purging, and restriction were less central in the symptom network. Symptoms related to sensitivity to physical sensations (e.g., changes in appetite, feeling dizzy, and wobbly) were identified as bridge symptoms between BN, and anxiety and depressive symptoms. We discuss our findings with respect to cognitive-behavioral treatment approaches for BN. These findings suggest that treatments for BN should focus on fear of weight gain, perhaps through exposure therapies. Further, interventions focusing on exposure to physical sensations may also address BN psychopathology, as well as co-occurring anxiety and depressive symptoms. (PsycINFO Database Record
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Affiliation(s)
| | - Stephanie Zerwas
- Department of Psychiatry, University of North Carolina at Chapel Hill
| | | | | | - Hans Kordy
- Center for Psychotherapy Research, University of Heidelberg
| | - Hunna Watson
- Department of Psychiatry, University of North Carolina at Chapel Hill
| | | | - Michele Levine
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center
| | | | - Christine Peat
- Department of Psychiatry and Neurosurgery, University of North Carolina at Chapel Hill
| | - Cristin D Runfola
- Department of Psychiatry, University of North Carolina at Chapel Hill
| | | | - Markus Moesner
- Center for Psychotherapy Research, University of Heidelberg
| | - Marsha D Marcus
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center
| | - Cynthia M Bulik
- Department of Psychiatry and Nutrition, University of North Carolina at Chapel Hill
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11
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Kazdin AE, Fitzsimmons-Craft EE, Wilfley DE. Addressing critical gaps in the treatment of eating disorders. Int J Eat Disord 2017; 50:170-189. [PMID: 28102908 PMCID: PMC6169314 DOI: 10.1002/eat.22670] [Citation(s) in RCA: 178] [Impact Index Per Article: 25.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 12/21/2016] [Accepted: 12/22/2016] [Indexed: 12/11/2022]
Abstract
Remarkable progress has been made in developing psychosocial interventions for eating disorders and other mental disorders. Two priorities in providing treatment consist of addressing the research-practice gap and the treatment gap. The research-practice gap pertains to the dissemination of evidence-based treatments from controlled settings to routine clinical care. Closing the gap between what is known about effective treatment and what is actually provided to patients who receive care is crucial in improving mental health care, particularly for conditions such as eating disorders. The treatment gap pertains to extending treatments in ways that will reach the large number of people in need of clinical care who currently receive nothing. Currently, in the United States (and worldwide), the vast majority of individuals in need of mental health services for eating disorders and other mental health problems do not receive treatment. This article discusses the approaches required to better ensure: (1) that more people who are receiving treatment obtain high-quality, evidence-based care, using such strategies as train-the-trainer, web-centered training, best-buy interventions, electronic support tools, higher-level support and policy; and (2) that a higher proportion of those who are currently underserved receive treatment, using such strategies as task shifting and disruptive innovations, including treatment delivery via telemedicine, the Internet, and mobile apps.
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Affiliation(s)
- Alan E. Kazdin
- Department of Psychology, Yale University, New Haven, CT, USA
| | | | - Denise E. Wilfley
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
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12
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Zerwas SC, Watson HJ, Hofmeier SM, Levine MD, Hamer RM, Crosby RD, Runfola CD, Peat CM, Shapiro JR, Zimmer B, Moessner M, Kordy H, Marcus MD, Bulik CM. CBT4BN: A Randomized Controlled Trial of Online Chat and Face-to-Face Group Therapy for Bulimia Nervosa. PSYCHOTHERAPY AND PSYCHOSOMATICS 2017; 86:47-53. [PMID: 27883997 PMCID: PMC5143175 DOI: 10.1159/000449025] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 08/02/2016] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Although cognitive-behavioral therapy (CBT) represents the first-line evidence-based psychotherapy for bulimia nervosa (BN), most individuals seeking treatment do not have access to this specialized intervention. We compared an Internet-based manualized version of CBT group therapy for BN conducted via a therapeutic chat group (CBT4BN) to the same treatment conducted via a traditional face-to-face group therapy (CBTF2F). METHOD In a two-site, randomized, controlled noninferiority trial, we tested the hypothesis that CBT4BN would not be inferior to CBTF2F. A total of 179 adult patients with BN (2.6% males) received up to 16 sessions of group CBT over 20 weeks in either CBT4BN or CBTF2F, and outcomes were compared at the end of treatment and at the 12-month follow-up. RESULTS At the end of treatment, CBT4BN was inferior to CBTF2F in producing abstinence from binge eating and purging. However, by the 12-month follow-up, CBT4BN was mostly not inferior to CBTF2F. Participants in the CBT4BN condition, but not CBTF2F, continued to reduce their binge-eating and purging frequency from the end of treatment to the 12-month follow-up. CONCLUSIONS CBT delivered online in a group chat format appears to be an efficacious treatment for BN, although the trajectory of recovery may be slower than face-to-face group therapy. Online chat groups may increase accessibility of treatment and represent a cost-effective approach to service delivery. However, barriers in service delivery such as state-specific license and ethical guidelines for online therapists need to be addressed.
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Affiliation(s)
- Stephanie C. Zerwas
- Department of Psychiatry, University of North Carolina at Chapel Hill, CB 7160, Chapel Hill, NC 27599
| | - Hunna J. Watson
- Department of Psychiatry, University of North Carolina at Chapel Hill, CB 7160, Chapel Hill, NC 27599,School of Paediatrics and Child Health, Faculty of Medicine, Dentistry, and Health Sciences, The University of Western Australia, Stirling Highway, Crawley, Western Australia, Australia 6009,School of Psychology and Speech Pathology, Faculty of Health Sciences, Curtin University, Kent Street, Bentley, Western Australia, Australia 6102
| | - Sara M. Hofmeier
- Department of Psychiatry, University of North Carolina at Chapel Hill, CB 7160, Chapel Hill, NC 27599
| | - Michele D. Levine
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, 3811 O’Hara Street, Pittsburgh, PA 15213
| | - Robert M. Hamer
- Department of Psychiatry, University of North Carolina at Chapel Hill, CB 7160, Chapel Hill, NC 27599,Department of Biostatistics, University of North Carolina at Chapel Hill, CB 7160, Chapel Hill, NC 27599
| | - Ross D. Crosby
- Neuropsychiatric Research Institute, 120 Eighth Street South Fargo, ND 58107,Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, ND 58102
| | | | - Christine M. Peat
- Department of Psychiatry, University of North Carolina at Chapel Hill, CB 7160, Chapel Hill, NC 27599,Department of Neurosurgery, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599
| | - Jennifer R. Shapiro
- Department of Psychiatry, University of North Carolina at Chapel Hill, CB 7160, Chapel Hill, NC 27599
| | - Benjamin Zimmer
- Center for Psychotherapy Research, University of Heidelberg, Bergheimer Str. 54, 69115 Heidelberg, Germany
| | - Markus Moessner
- Center for Psychotherapy Research, University of Heidelberg, Bergheimer Str. 54, 69115 Heidelberg, Germany
| | - Hans Kordy
- Center for Psychotherapy Research, University of Heidelberg, Bergheimer Str. 54, 69115 Heidelberg, Germany
| | - Marsha D. Marcus
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, 3811 O’Hara Street, Pittsburgh, PA 15213
| | - Cynthia M. Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, CB 7160, Chapel Hill, NC 27599,Department of Nutrition, University of North Carolina at Chapel Hill, CB 7160, Chapel Hill, NC 27599,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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13
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Aardoom JJ, Dingemans AE, Van Furth EF. E-Health Interventions for Eating Disorders: Emerging Findings, Issues, and Opportunities. Curr Psychiatry Rep 2016; 18:42. [PMID: 26946513 DOI: 10.1007/s11920-016-0673-6] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
This study aimed to review the emerging findings regarding E-health interventions for eating disorders and to critically discuss emerging issues as well as challenges for future research. Internet-based cognitive behavioral therapy and guided self-help have demonstrated promising results in terms of reducing eating disorder psychopathology. Emerging findings also suggest that E-health interventions reach an underserved population and improve access to care. The use of smartphone applications is becoming increasingly popular and has much potential although their clinical utility and effectiveness is presently unknown and requires investigation. Important challenges include the diagnostic process in E-health interventions, the optimization of E-health within existing health care models, and the investigation and implementation of blended care. More high-quality research is needed to bring the field forward and to determine the place for E-health in our health care service delivery systems.
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Affiliation(s)
- Jiska J Aardoom
- Rivierduinen Eating Disorders Ursula, P.O. Box 549, 2300 AM, Leiden, The Netherlands.
| | - Alexandra E Dingemans
- Rivierduinen Eating Disorders Ursula, P.O. Box 549, 2300 AM, Leiden, The Netherlands.
| | - Eric F Van Furth
- Rivierduinen Eating Disorders Ursula, P.O. Box 549, 2300 AM, Leiden, The Netherlands. .,Department of Psychiatry, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.
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14
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Kolar C, von Treuer K. Alcohol Misuse Interventions in the Workplace: A Systematic Review of Workplace and Sports Management Alcohol Interventions. Int J Ment Health Addict 2015. [DOI: 10.1007/s11469-015-9558-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
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15
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Silva TABD, Vasconcelos FMDND, Ximenes RCC, Sampaio TPDA, Sougey EB. As terapias cognitivo-comportamentais no tratamento da bulimia nervosa: uma revisão. JORNAL BRASILEIRO DE PSIQUIATRIA 2015. [DOI: 10.1590/0047-2085000000072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objetivo Realizar uma revisão na literatura sobre a utilização da terapia cognitivo-comportamental (TCC) no tratamento da bulimia nervosa entre 2009 e 2013. Métodos Três bases de dados eletrônicas foram pesquisadas, considerando artigos em língua inglesa, espanhola e portuguesa. Resultados Após as análises e exclusão dos artigos, seguindo o método PRISMA, foram selecionados 20 artigos. Os artigos selecionados foram produzidos ou na Europa ou nos Estados Unidos, em língua inglesa. Os diagnósticos da amostra variaram de exclusivamente bulimia nervosa (60%) aos que incluíram pessoas com transtorno de compulsão alimentar (35%), além de diagnósticos mistos (5%). Os estudos foram, em sua maioria, realizados em mulheres adultas. A TCC, em sua abordagem clássica no consultório, foi utilizada em todos os artigos, ora utilizada individualmente, ora comparada com outras intervenções (internet, CD-ROM e autoajuda). Encontrou-se como resultado que a TCC diminui os sintomas de compulsão alimentar e de purgação, além de oferecer ganhos secundários aos participantes, como melhora de sintomas depressivos, de ansiedade e até mudanças na personalidade. As outras intervenções pesquisadas obtiveram bons resultados na modificação dos sintomas, demonstrando que há um novo caminho a ser galgado com essas novas formas de tratamento. Conclusão O tratamento da bulimia nervosa possui evidências suficientes para que seja realizado com a terapia cognitivo-comportamental. Além dela, intervenções psicoterápicas inovadoras baseadas na TCC clássica apresentam bons indicativos de eficácia. Futuras pesquisas sobre essas diferentes intervenções são necessárias.
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Abstract
The research-practice gap is of concern in the treatment of eating disorders. Despite the existence of empirically supported treatments, few receive them. The barriers to wider dissemination and implementation of evidence-based treatment include clinician attitudes towards such treatments and the lack of sufficient numbers of suitably trained therapists to provide treatment. In this review we discuss these barriers in the context of the wider issue of the dissemination and implementation of psychological treatments and review the research with regard to the treatment of eating disorders. Particular emphasis is placed on examining recent efforts to expand the availability and reach of treatments by making treatment delivery and training more scalable. We highlight promising developments and areas where further research is needed.
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Affiliation(s)
- Zafra Cooper
- Department of Psychiatry, Warneford Hospital, Oxford University, Oxford, OX3 7JX UK
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17
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Gulec H, Moessner M, Túry F, Fiedler P, Mezei A, Bauer S. A randomized controlled trial of an internet-based posttreatment care for patients with eating disorders. Telemed J E Health 2014; 20:916-22. [PMID: 25188398 DOI: 10.1089/tmj.2013.0353] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Despite effective treatment approaches, relapses are frequent in eating disorders. Posttreatment care is essential to enhance continuous recovery and prevent deterioration. This study evaluated the effects of an Internet-based intervention following routine care. MATERIALS AND METHODS One hundred five women who received treatment for bulimia nervosa and related eating disorders not otherwise specified were randomly assigned either to an immediate Internet-based support program (EDINA) over 4 months or to a 4-month waiting-list treatment as usual (TAU) control condition. The primary outcome was eating disorder-related attitudes at baseline and after 4 months assessed by the Eating Disorder Examination Questionnaire (EDE-Q). RESULTS The program proved feasible and was well accepted. A significant reduction in eating disorder-related attitudes could be shown for both groups at the end of the 4 months. There was a tendency for participants of the aftercare intervention to show better results on all outcome measures. In total, 40.6% (13/32) of the EDINA participants and 24.4% (10/41) of the TAU participants showed statistically reliable improvement on the EDE-Q total score by the end of the intervention period [χ(2)(1)=2.195, p=0.138]. CONCLUSIONS The Internet-based support program was feasible and well accepted but did not prove efficacious in a heterogeneous sample of patients following routine care.
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Affiliation(s)
- Hayriye Gulec
- 1 Institute of Behavioural Sciences, Semmelweis University , Budapest, Hungary
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18
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Brauhardt A, de Zwaan M, Hilbert A. The therapeutic process in psychological treatments for eating disorders: a systematic review. Int J Eat Disord 2014; 47:565-84. [PMID: 24796817 DOI: 10.1002/eat.22287] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Revised: 03/29/2014] [Accepted: 04/01/2014] [Indexed: 11/12/2022]
Abstract
OBJECTIVE For eating disorders, a vast number of investigations have demonstrated the efficacy of psychological treatments. However, evidence supporting the impact of therapeutic process aspects on outcome (i.e., process-outcome research) has not been disentangled. METHOD Using the Generic Model of Psychotherapy (GMP) to organize various process aspects, a systematic literature search was conducted on psychological treatment studies for anorexia nervosa, bulimia nervosa, binge-eating disorder, and eating disorders not otherwise specified. RESULTS Improved outcomes resulted for family-based treatment compared to individual treatment, for individual compared to group treatment, booster sessions, and positive patient expectations (GMP contract aspect); for nutritional counseling and exercising but not exposure with response prevention as adjunct interventions (therapeutic operations); for highly motivated patients and, to a lesser extent, for therapeutic alliance (therapeutic bond); as well as for rapid response and longer overall treatment duration (temporal patterns). Regarding other GMP aspects, studies on self-relatedness were completely lacking and in-session impacts were rarely investigated. DISCUSSION As most studies assessed only a limited number of process aspects, the ability to draw conclusions about their overall impact regarding outcome is rather limited. Therefore, future process-outcome research is needed beyond investigations of treatment efficacy for eating disorders.
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Affiliation(s)
- Anne Brauhardt
- Leipzig University Medical Center, Medical Psychology and Medical Sociology, Integrated Research and Treatment Center AdiposityDiseases, Philipp-Rosenthal-Strasse 27, 04103, Leipzig, Germany
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Amon KL, Campbell AJ, Hawke C, Steinbeck K. Facebook as a recruitment tool for adolescent health research: a systematic review. Acad Pediatr 2014; 14:439-447.e4. [PMID: 25169155 DOI: 10.1016/j.acap.2014.05.049] [Citation(s) in RCA: 87] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 05/21/2014] [Accepted: 05/31/2014] [Indexed: 11/18/2022]
Abstract
BACKGROUND Researchers are increasingly using social media to recruit participants to surveys and clinical studies. However, the evidence of the efficacy and validity of adolescent recruitment through Facebook is yet to be established. OBJECTIVE To conduct a systematic review of the literature on the use of Facebook to recruit adolescents for health research. DATA SOURCES Nine electronic databases and reference lists were searched for articles published between 2004 and 2013. STUDY ELIGIBILITY CRITERIA Studies were included in the review if: 1) participants were aged ≥ 10 to ≤ 18 years, 2) studies addressed a physical or mental health issue, 3) Facebook was identified as a recruitment tool, 4) recruitment details using Facebook were outlined in the methods section and considered in the discussion, or information was obtained by contacting the authors, 5) results revealed how many participants were recruited using Facebook, and 6) studies addressed how adolescent consent and/or parental consent was obtained. STUDY APPRAISALS AND SYNTHESIS METHODS Titles, abstracts, and keywords were scanned and duplicates removed by 2 reviewers. Full text was evaluated for inclusion criteria, and 2 reviewers independently extracted data. RESULTS The search resulted in 587 publications, of which 25 full-text papers were analyzed. Six studies met all the criteria for inclusion in the review. Three recruitment methods using Facebook was identified: 1) paid Facebook advertising, 2) use of the Facebook search tool, and 3) creation and use of a Facebook Page. CONCLUSIONS Eligible studies described the use of paid Facebook advertising and Facebook as a search tool as methods to successfully recruit adolescent participants. Online and verbal consent was obtained from participants recruited from Facebook.
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Affiliation(s)
- Krestina L Amon
- Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia.
| | - Andrew J Campbell
- Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Catherine Hawke
- School of Rural Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Katharine Steinbeck
- Academic Department of Adolescent Medicine, Sydney Medical School, The University of Sydney and the Sydney Children's Hospital, Westmead, New South Wales, Australia
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20
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Abstract
Illness-associated costs are a major concern in eating disorders (ED). Economic aspects of (ED) have been an area receiving research attention. In the last three years a number of studies have been completed, including studies examining national costs of ED; third party payer costs for ED treatment; societal costs of ED; and cost effectiveness analysis of specific treatments. Additionally, some work has been done to model costs associated with ED prevention efforts. A number of further cost effectiveness analyses are planned. This area will be a fertile one for continued study.
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Affiliation(s)
- Scott Crow
- University of Minnesota Medical School, F282/2A West, 2450 Riverside Avenue, Minneapolis, MN, 55454, USA,
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Jenkins PE, Luck A, Burrows A, Boughton N. Comparison of face-to-face versus email guided self-help for binge eating: study protocol for a randomised controlled trial. Trials 2014; 15:181. [PMID: 24886555 PMCID: PMC4035724 DOI: 10.1186/1745-6215-15-181] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Accepted: 05/08/2014] [Indexed: 01/18/2023] Open
Abstract
Background Guided self-help is a recommended first-step treatment for bulimia nervosa, binge eating disorder and atypical variants of these disorders. Further research is needed to compare guided self-help that is delivered face-to-face versus via email. Methods/Design This clinical trial uses a randomised, controlled design to investigate the effectiveness of providing guided self-help either face-to-face or via e-mail, also using a delayed treatment control condition. At least 17 individuals are required per group, giving a minimum N of 51. Discussion Symptom outcomes will be assessed and estimates of cost-effectiveness made. Results are proposed to be disseminated locally and internationally (through submission to conferences and peer-reviewed journals), and will hopefully inform local service provision. The trial has been approved by an ethics review board and was registered with ClinicalTrials.gov NCT01832792 on 9 April 2013.
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Affiliation(s)
- Paul E Jenkins
- Cotswold House Eating Disorders Service, Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK.
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22
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Baños RM, Cebolla A, Moragrega I, Van Strien T, Fernández-Aranda F, Agüera Z, de la Torre R, Casanueva FF, Fernández-Real JM, Fernández-García JC, Frühbeck G, Gómez-Ambrosi J, Jiménez-Murcia S, Rodríguez R, Tinahones FJ, Botella C. Relationship between eating styles and temperament in an Anorexia Nervosa, Healthy Control, and Morbid Obesity female sample. Appetite 2014; 76:76-83. [DOI: 10.1016/j.appet.2014.01.012] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Revised: 01/07/2014] [Accepted: 01/16/2014] [Indexed: 12/15/2022]
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24
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Aardoom JJ, Dingemans AE, Spinhoven P, Van Furth EF. Treating eating disorders over the internet: a systematic review and future research directions. Int J Eat Disord 2013; 46:539-52. [PMID: 23674367 DOI: 10.1002/eat.22135] [Citation(s) in RCA: 98] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/24/2013] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To review the literature regarding internet-based treatment of eating disorders (ED). METHOD Relevant studies were identified by searching electronic databases (including Medline, Embase, PsycInfo, and Web of Science). Eligible studies evaluated an internet-based treatment for ED, or an ED treatment that included at least one internet-based component. RESULTS Twenty-one studies were included. Methodological quality varied. Internet-based treatments were superior to waiting lists in reducing ED psychopathology, frequency of binge eating and purging, and in improving (ED-related) quality of life. Internet-based treatment was more effective for individuals with less comorbid psychopathology, binge eating as opposed to restrictive problems, and individuals with binge eating disorder as opposed to bulimia nervosa. Higher levels of compliance were related to more improvements in ED symptoms. Study dropout ranged from 5.3 to 76.8%. Inclusion of face-to-face assessments and therapist support seemed to enhance study compliance. Overall, the internet can be considered an acceptable vehicle for delivering ED treatment. DISCUSSION Future research should determine the utility of internet-based treatment by comparing them to face-to-face treatment. Research should furthermore focus on unraveling predictors and mediators of treatment outcome, compliance, and dropout, respectively. Studies with good methodological quality are needed with reports according to CONSORT guidelines.
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Affiliation(s)
- Jiska J Aardoom
- Center for Eating Disorders 'Ursula', Leidschendam, The Netherlands
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25
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Bauer S, Moessner M. Harnessing the power of technology for the treatment and prevention of eating disorders. Int J Eat Disord 2013; 46:508-15. [PMID: 23658102 DOI: 10.1002/eat.22109] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/03/2012] [Indexed: 11/11/2022]
Abstract
OBJECTIVE The objective of this article is to review the available literature regarding the development and evaluation of technology-enhanced interventions for eating disorders. METHOD Literature was reviewed pertaining to interventions that use technology (e.g., Internet, mobile phones) for prevention, guided self-help, treatment, relapse prevention, and carer support. RESULTS A number of technology-enhanced approaches have been developed for each facet of the care spectrum, and experiences that are reported with their implementation are overall promising. However, only few of them have been evaluated in adequately designed and powered trials. DISCUSSION This review suggests that technology-enhanced interventions offer multiple opportunities to improve care for eating disorders. More research is needed on the efficacy, effectiveness, cost-effectiveness, and reach of these approaches to ultimately estimate their public health impact. It is discussed to what extent innovative models of care integrating technology-enhanced interventions and face-to-face interventions may improve service delivery for eating disorders.
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Affiliation(s)
- Stephanie Bauer
- Center for Psychotherapy Research, University Hospital Heidelberg, Heidelberg, Germany.
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26
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Fichter MM, Quadflieg N, Lindner S. Internet-based relapse prevention for anorexia nervosa: nine- month follow-up. J Eat Disord 2013; 1:23. [PMID: 24999404 PMCID: PMC4081799 DOI: 10.1186/2050-2974-1-23] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Accepted: 05/31/2013] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND To study the longer term effects of an internet-based CBT intervention for relapse prevention (RP) in anorexia nervosa. METHODS 210 women randomized to the RP intervention group (full and partial completers) or the control group were assessed for eating and general psychopathology. Multiple regression analysis identified predictors of favorable course concerning Body Mass Index (BMI). Logistic regression analysis identified predictors of adherence to the RP program. RESULTS Most variables assessed showed more improvement for the RP than for the control group. However, only some scales reached statistical significance (bulimic behavior and menstrual function, assessed by expert interviewers blind to treatment condition). Very good results (BMI) were seen for the subgroup of "full completers" who participated in all nine monthly RP internet-based intervention sessions. "Partial completers" and controls (the latter non-significantly) underwent more weeks of inpatient treatment during the study period than "full completers", indicating better health and less need for additional treatment among the "full completers". Main long-term predictors for favorable course were adherence to RP, more spontaneity, and more ineffectiveness. Main predictors of good adherence to RP were remission from lifetime mood and lifetime anxiety disorder, a shorter duration of eating disorder, and additional inpatient treatment during RP. CONCLUSIONS Considering the high chronicity of AN, internet-based relapse prevention following intensive treatment appears to be promising.
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Affiliation(s)
- Manfred Maximilian Fichter
- Department of Psychiatry and Psychotherapy, University of Munich (LMU), Nussbaumstraße 7, 80336 München, Germany ; Schön Klinik Roseneck affiliated with the Medical Faculty of the University of Munich (LMU), 83209 Prien, Germany
| | - Norbert Quadflieg
- Department of Psychiatry and Psychotherapy, University of Munich (LMU), Nussbaumstraße 7, 80336 München, Germany
| | - Susanne Lindner
- Department of Psychiatry and Psychotherapy, University of Munich (LMU), Nussbaumstraße 7, 80336 München, Germany
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