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neuropsychiatrie
Erschienen in: neuropsychiatrie 4/2021

30.11.2020 | original article

Individual and group format adjunct therapy on social emotional skills for adolescent inpatients with severe and complex eating disorders (CREST-A)

verfasst von: Dr. Amy Harrison, Pamela Stavri, Prof. Kate Tchanturia

Erschienen in: neuropsychiatrie | Ausgabe 4/2021

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Summary

Background

Relatively little is known about which psychological treatment adjuncts might be helpful for supporting people with the most severe and complex forms of anorexia nervosa (AN) with very low weight and malnutrition requiring inpatient admissions, but targeting key perpetuating factors such as social emotional difficulties may be one way to advance knowledge. This pilot feasibility project reports on the development of an adolescent adaptation of Cognitive Remediation and Emotion Skills Training (CREST-A) and explores its acceptability, feasibility and possible benefits.

Methods

An uncontrolled, repeated measures design was employed with data collected at the start and end of treatment. CREST‑A was investigated in two formats: a 10-session individual format delivered to a case series of 12 patients and a 5-session group format delivered to 3 groups of 9 patients.

Results

Acceptability, measured using a Patient Satisfaction Scale was 7/10 for the individual and 6/10 for the group format. Individual take-up was 100% and group take-up was 34.62%. Drop-out was 8.33% and 29.63% in the individual and group formats respectively. Homework was completed 66.67% and 75% of the time in the individual and group formats respectively. Patients reported medium-sized improvements in components of social emotional functioning measured using the Work and Social Adjustment Scale, the Toronto Alexithymia Scale and the Revised Social Anhedonia Scale in the individual and group formats.

Conclusion

Future studies employing randomized controlled designs may now be warranted to advance this evidence base of this low intensity treatment adjunct.
Nächster Artikel Students’ perceptions of an online mental health intervention: a qualitative interview study
Literatur
1.
Arkell J, Robinson P. A pilot case series using qualitative and quantitative methods: biological, psychological and social outcome in severe and enduring eating disorder (anorexia nervosa). Int J Eat Disord. 2008;41(7):650–6.PubMed
2.
Jenkins PE, Hoste RR, Doyle AC, Eddy K, Crosby RD, Hill L, et al. Health-related quality of life among adolescents with eating disorders. J Psychosom Res. 2014;76(1):1–5.PubMed
3.
Arcelus J, Mitchell AJ, Wales J, Nielsen S. Mortality rates in patients with anorexia nervosa and other eating disorders: a meta-analysis of 36 studies. Arch Gen Psychiatry. 2011;68(7):724–31.PubMed
4.
Eisler I, Simic M, Russell GF, Dare C. A randomised controlled treatment trial of two forms of family therapy in adolescent anorexia nervosa: a five-year follow-up. J Child Psychol Psychiatry. 2007;48(6):552–60.PubMed
5.
Andersen AE, Bowers W, Evans K. Inpatient treatment of anorexia nervosa. Handb Treat Eat Disord. 1997;2:327–53.
6.
Gowers S, Clark A, Roberts C, Byford S, Barrett B, Griffiths A, et al. A randomised controlled multicentre trial of treatments for adolescent anorexia nervosa including assessment of cost-effectiveness and patient acceptability—the TOuCAN trial. Health Technol Assess. 2010;14(15):1–98.PubMed
7.
National Collaborating Centre for Mental Health (UK). Eating disorders: core interventions in the treatment and management of anorexia nervosa, bulimia nervosa and related eating disorders. 2004; Leicestee, UK: British Psychological Society.
8.
Jewell T, Blessitt E, Stewart C, Simic M, Eisler I. Family therapy for child and adolescent eating disorders: a critical review. Fam Process. 2016;55(3):577–94.PubMed
9.
Treasure J, Schmidt U. The cognitive-interpersonal maintenance model of anorexia nervosa revisited: a summary of the evidence for cognitive, socio-emotional and interpersonal predisposing and perpetuating factors. J Eat Disord. 2013;1(1):13.PubMedPubMedCentral
10.
Hay PJ, Touyz S, Sud R. Treatment for severe and enduring anorexia nervosa: a review. Aust N Z J Psychiatry. 2012;46(12):1136–44.PubMed
11.
Tchanturia K, Giombini L, Leppanen J, Kinnaird E. Evidence for cognitive remediation therapy in young people with anorexia nervosa: systematic review and meta-analysis of the literature. Eur Eat Disord Rev. 2017;25(4):227–36.PubMed
12.
Tchanturia K, Doris E, Fleming C. Effectiveness of cognitive remediation and emotion skills training (CREST) for anorexia nervosa in group format: a naturalistic pilot study. Eur Eat Disord Rev. 2014;22(3):200–5.PubMed
13.
Tchanturia K, Lloyd S, Lang K. Cognitive remediation therapy for anorexia nervosa: current evidence and future research directions. Int J Eat Disord. 2013;46(5):492–5.PubMed
14.
Money C, Genders R, Treasure J, Schmidt U, Tchanturia K. A brief emotion focused intervention for inpatients with anorexia nervosa: a qualitative study. J Health Psychol. 2011;16(6):947–58.PubMed
15.
Money C, Davies H, Tchanturia K. A case study introducing cognitive remediation and emotion skills training for anorexia nervosa inpatient care. Clin Case Stud. 2011;10(2):110–21.
16.
Tchanturia K, Doris E, Mountford V, Fleming C. Cognitive Remediation and emotion skills training (CREST) for anorexia nervosa in individual format: self-reported outcomes. BMC Psychiat. 2015;15(1):53.
17.
Kyriacou O, Easter A, Tchanturia K. Comparing views of patients, parents, and clinicians on emotions in anorexia: a qualitative study. J Health Psychol. 2009;14(7):843–54.PubMed
18.
Lang K, Lopez C, Stahl D, Tchanturia K, Treasure J. Central coherence in eating disorders: an updated systematic review and meta-analysis. World J Bio Psychiat. 2014;15(8):586–98.
19.
Lang K, Stahl D, Espie J, Treasure J, Tchanturia K. Set shifting in children and adolescents with anorexia nervosa: An exploratory systematic review and meta-analysis. Int J Eat Disord. 2014;47(4):394–9.PubMed
20.
Westwood H, Stahl D, Mandy W, Tchanturia K. The set-shifting profiles of anorexia nervosa and autism spectrum disorder using the Wisconsin Card Sorting Test: a systematic review and meta-analysis. Psychol Med. 2016;46(9):1809–27.PubMed
21.
Oldershaw A, Hambrook D, Stahl D, Tchanturia K, Treasure J, Schmidt U. The socio-emotional processing stream in anorexia nervosa. Neurosci Biobehav Rev. 2011;35(3):970–88.PubMed
22.
Courty A, Godart N, Lalanne C, Berthoz S. Alexithymia, a compounding factor for eating and social avoidance symptoms in anorexia nervosa. Compr Psychiatry. 2015;56:217–28.PubMed
23.
Dapelo MM, Surguladze S, Morris R, Tchanturia K. Emotion recognition in blended facial expressions in women with anorexia nervosa. Eur Eat Disord Rev. 2016;24(1):34–42.PubMed
24.
Brockmeyer T, Bents H, Holtforth MG, Pfeiffer N, Herzog W, Friederich H‑C. Specific emotion regulation impairments in major depression and anorexia nervosa. Psychiatry Res. 2012;200(2–3):550–3.PubMed
25.
Dapelo MM, Bodas S, Morris R, Tchanturia K. Deliberately generated and imitated facial expressions of emotions in people with eating disorders. J Affect Disord. 2016;191:1–7.PubMed
26.
Harrison A, Genders R, Davies H, Treasure J, Tchanturia K. Experimental measurement of the regulation of anger and aggression in women with anorexia nervosa. Clin Psychol Psychother. 2011;18(6):445–52.PubMed
27.
Doris E, Westwood H, Mandy W, Tchanturia K. A qualitative study of friendship in patients with anorexia nervosa and possible autism spectrum disorder. Psychology. 2014;5(11):1338.
28.
Harrison A, Mountford VA, Tchanturia K. Social anhedonia and work and social functioning in the acute and recovered phases of eating disorders. Psychiatry Res. 2014;218(1–2):187–94.PubMed
29.
Harrison A, Tchanturia K, Naumann U, Treasure J. Social emotional functioning and cognitive styles in eating disorders. Br J Clin Psychol. 2012;51(3):261–79.PubMed
30.
31.
Hildebrandt T, Grotzinger A, Schulz K. Anorexia nervosa, emotional go/no-go, and the distinct effect of testosterone. Int J Eat Disord. 2016;49(1):69–76.PubMed
32.
Zonnevylle-Bender MJ, Van Goozen SH, Cohen-Kettenis PT, van Elburg TA, Van Engeland H. Emotional functioning in adolescent anorexia nervosa patients. Eur Child Adolesc Psychiatry. 2004;13(1):28–34.PubMed
33.
Laghi F, Pompili S, Zanna V, Castiglioni MC, Criscuolo M, Chianello I, et al. Are adolescents with anorexia nervosa better at reading minds? Cog Neuropsychiat. 2015;20(6):489–501.
34.
35.
Fairburn CG, Beglin SJ. Assessment of eating disorders: Interview or self-report questionnaire? Int J Eat Disord. 1994;16(4):363–70.PubMed
36.
Peterson CB, Crosby RD, Wonderlich SA, Joiner T, Crow SJ, Mitchell JE, et al. Psychometric properties of the eating disorder examination-questionnaire: Factor structure and internal consistency. Int J Eat Disord. 2007;40(4):386–9.PubMed
37.
Eckblad M, Chapman L, Chapman J, Mishlove M. The revised social anhedonia scale. Unpublished test. 1982.
38.
Healey KL, Morgan J, Musselman SC, Olino TM, Forbes EE. Social anhedonia and medial prefrontal response to mutual liking in late adolescents. Brain Cogn. 2014;89:39–50.PubMedPubMedCentral
39.
Pelizza L, Ferrari A. Anhedonia in schizophrenia and major depression: state or trait? Ann Gen Psychiatry. 2009;8(1):22.PubMedPubMedCentral
40.
Fonseca-Pedrero E, Paino M, Lemos-Giráldez S, García-Cueto E, Villazón-García Ú, Bobes J, et al. Psychometric properties of the revised physical and social anhedonia scales in non-clinical young adults. Span J Psychol. 2009;12(2):815–22.PubMed
41.
Bagby RM, Parker JD, Taylor GJ. The twenty-item Toronto Alexithymia Scale—I. Item selection and cross-validation of the factor structure. J Psychosom Res. 1994;38(1):23–32.PubMed
42.
Bomba M, Marfone M, Brivio E, Oggiano S, Broggi F, Neri F, et al. Autobiographical memory in adolescent girls with anorexia nervosa. Eur Eat Disord Rev. 2014;22(6):479–86.PubMed
43.
Parker JD, Taylor GJ, Bagby RM. The 20-Item Toronto Alexithymia Scale: III. Reliability and factorial validity in a community population. J Psychosom Res. 2003;55(3):269–75.PubMed
44.
Mundt JC, Marks IM, Shear MK, Greist JM. The work and social adjustment scale: a simple measure of impairment in functioning. Br J Psychiat. 2002;180(5):461–4.
45.
Royal College of Psychiatrists. MARSIPAN junior: management of really sick patients under 18 with anorexia nervosa. Royal college of psychiatrists. 2012.
46.
47.
Jacobson NS, Truax P. Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. J Consult Clin Psychol. 1992;59(1):12–9.
48.
Amianto F, Bertorello A, Migliore F, Abbate-Daga G, Fassino S. Alexithymia in anorexia and bulimia: ubiquitous and primary trait? Cogent Psychol. 2016;3(1):1185994.
49.
50.
Little RJ, Rubin DB. Statistical analysis with missing data. Hoboken: John Wiley & Sons; 2019.
51.
Zeeck A, Hartmann A, Buchholz C, Herzog T. Drop outs from in-patient treatment of anorexia nervosa. Acta Psychiatr Scand. 2005;111(1):29–37.PubMed
52.
Linville D, Brown T, Sturm K, McDougal T. Eating disorders and social support: perspectives of recovered individuals. Eat Disord. 2012;20(3):216–31.PubMed
53.
Davies H, Fox J, Naumann U, Treasure J, Schmidt U, Tchanturia K. Cognitive remediation and emotion skills training for anorexia nervosa: an observational study using neuropsychological outcomes. Eur Eat Disord Rev. 2012;20(3):211–7.PubMed
54.
Giombini L, Nesbitt S, Leppanen J, Cox H, Foxall A, Easter A, et al. Emotions in play: young people’s and clinicians’ experience of ‘Thinking about Emotions’ group. Eat Weight Disord. 2019;24(4):605–14.PubMedPubMedCentral
55.
Giombini L, Nesbitt S, Kusosa R, Fabian C, Easter A, Tchanturia K. Adapted emotion skills training group for young people with anorexia nervosa. Neuropsychiatrie. 2020;29:1–8.
Metadaten
Titel
Individual and group format adjunct therapy on social emotional skills for adolescent inpatients with severe and complex eating disorders (CREST-A)
verfasst von
Dr. Amy Harrison
Pamela Stavri
Prof. Kate Tchanturia
Publikationsdatum
30.11.2020
Verlag
Springer Vienna
Erschienen in
neuropsychiatrie / Ausgabe 4/2021
Print ISSN: 0948-6259
Elektronische ISSN: 2194-1327
DOI
https://doi.org/10.1007/s40211-020-00375-5

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