Validity of a measure of readiness to recover in Spanish adolescent patients with anorexia nervosa (original) (raw)
Related papers
Readiness to recover in adolescent anorexia nervosa: prediction of hospital admission
Journal of Child Psychology and Psychiatry, 2005
Objectives: To determine if motivation to change in anorexia nervosa during treatment is a predictor of hospitalisation in adolescent patients.Method: The Anorexia Nervosa Stages of Change Questionnaire (ANSOCQ), the Eating Disorders Inventory-2 (EDI-2) and the Beck Depression Inventory (BDI) were administered to a group of 70 anorexia nervosa patients (mean age 15.6 years). They were all receiving treatment at a specialised Eating Disorder Unit and were at different points in the treatment programme. Admission during 6–9 month follow-up was recorded in 63 of these patients who had been admitted to the Unit. The other 7 patients were contacted by phone to determine if they had been hospitalised in another unit during the follow-up period.Results: Patients who needed hospital admission during follow-up had higher mean scores at first evaluation on some of the EDI-2 scales and on the BDI, lower ANSOCQ scores and were more likely to have been outpatients at first evaluation. In the logistic regression analysis a low ANSOCQ score and being an outpatient at first evaluation were shown to be independent predictors of hospitalisation during follow-up.Conclusions: Low motivation to change, depressive symptomatology and some EDI-2 scales are related to the necessity of hospital admission in adolescent patients with anorexia nervosa.
Anorexia nervosa in a Spanish adolescent sample: an 8‐year longitudinal study
Acta Psychiatrica Scandinavica, 1999
ObjectiveThe aim of this study was to determine the intermediate‐term outcome of a sample of Spanish children and adolescents with anorexia nervosa (AN).MethodA total of 48 female patients were evaluated at a mean follow‐up time of 8 years by means of the Psychiatric Status Rating Scale, the Morgan and Russell Outcome Scale, a structured DSM‐III interview and several self‐report questionnaires. Their scores were compared with a sex‐ and age‐matched control group.ResultsThree patients (6%) still had AN, two (4%) had partial syndromes of anorexia, 11 patients (23%)) had recovered but still showed concern about foodlbody weight and 32 patients (67%) had recovered completely. The crude mortality rate was 2%).ConclusionThe majority of this sample of children and adolescents with anorexia nervosa sample recovered. Perfectionism and interpersonal distrust were significantly more common in the anorexic patients than in the controls. Depression and phobias, including social phobia, were the ...
A clinical and phenomenological study of 185 Spanish adolescents with anorexia nervosa
European Child & Adolescent Psychiatry, 1995
The objectives of the present study were the following: to determine the socio-familial, academic and interpersonal characteristics specific to anorexia nervosa (AN); to study comorbidity in patients with anorexia and morbidity in their parents; and to ascertain whether patients with anorexia nervosa in Spain are similar to those in other countries. The research team revised the clinical records of 185 Spanish adolescents with AN (aged 11-18 years). The results were compared with those obtained from a group of 185 psychiatric patients without AN matched by sex, age, time of consultation and centre. No significant differences were found with regard to broken home, birth order or parent-patient conflict. The parents of patients with anorexia have a higher standard of education and develop more affective disorders. When compared with other patients, the individuals with anorexia nervosa perform much better academically but are more socially withdrawn. Males with anorexia nervosa perform worse academically than females and have more anxiety diagnoses. Patients with anorexia have a high comorbidity for affective and obsessivecompulsive disorders. Sufferers from anorexia nervosa in Spain are clinically analogous to patients with anorexia in other countries. The two characteristics specific to these patients are a hig h standard of academic performance and an intense degree of social withdrawal, although there are certain factors common to other pathologies relating to adolescence.
Readiness to recover in anorexia nervosa: what does it depend on in female inpatients?
European Eating Disorders Review, 2006
Anorexia nervosa (AN) is difficult to treat, especially when the patient's condition is sufficiently severe to require an inpatient admission. An impediment to treatment is the disinclination of the patient to recover, who often prefers the distress of AN over weight gain. An inpatient-rated visual analogue scale depicting readiness to recover (RR) was studied to determine (a) its concurrent prediction by AN diagnostic criteria and risk-related factors and (b) its relationships to an adapted stages of change questionnaire (a-SCQ) and comparison of their predictions of drive for thinness (EDI-DT) at discharge. For (a), fear of gaining weight, state anger and ineffectiveness undermined RR, while higher BMI and the capacity to see low weight as a health risk supported it. For (b), RR was related to a-SCQ, but only RR predicted discharge EDI-DT. The findings reinforce the conceptual complexity of readiness to recover and indicate practical interventions in preparing sufferers of AN for recovery in an inpatient setting.
International Journal of Eating Disorders, 2011
Treatment guidelines recommend evidence-based guided self-help (GSH) as the first stage of treatment for bulimia nervosa and binge eating disorder. The current randomised control trial evaluated a cognitive behavioural therapy-based GSH pack, 'Working to Overcome Eating Difficulties,' delivered by trained mental health professionals in 6 sessions over 3 months. It was congruent with the transdiagnostic approach and so was intended as suitable for all disordered eating, except severe anorexia nervosa. Eighty one clients were randomly allocated to either a GSH or waiting list condition. Eating disorder psychopathology (EDE-Q), key behavioural features and global distress (CORE) were measured at preand post-intervention, and 3-and 6-month follow-up. Results showed significant improvements in eating disorder psychopathology, laxative abuse, exercise behaviours, and global distress, with the GSH condition being superior to the waiting list on all outcomes. Treatment gains were maintained at 3 and 6 months. This study adds to the evidence supporting GSH for disordered eating, including EDNOS. However, further work is needed to establish the factors that contribute to observed therapeutic improvements and determine for whom GSH is most suitable.
Journal of Child Psychology and Psychiatry, 2001
The aim of the present study was to follow up the long-term course of adolescent-onset anorexia nervosa by repeated assessment, to analyze the association between the course of the eating disorder and psychiatric comorbidity, and to evaluate psychosocial outcome. The sample consisted of 39 inpatients who were reinvestigated 3, 7, and 10 years after discharge. The patients and 39 controls matched for age, gender, and occupational status were assessed with structured interviews on DSM-III-R eating disorders, additional axis I and axis II psychiatric disorders, and psychosocial functioning. Results showed that 69 % of the original subjects met the criteria for full recovery at the 10-year follow-up. One patient (3 %) still exhibited the full syndrome of restrictive anorexia nervosa, two patients (5 %) the full syndrome of bulimia nervosa. None of the patients had died. Of the subjects, 51 % currently had an axis I psychiatric disorder and 23 % met the full criteria for a personality disorder. Apart from the eating disorder, anxiety disorders and avoidant-dependent and obsessivecompulsive personality disorders were the most common psychiatric diagnoses. There was a significant association between psychiatric comorbidity and the outcome of the eating disorder and between outcome and psychosocial adaptation. With regard to psychiatric morbidity and psychosocial functioning, long-term recovered patients did not differ significantly from normal controls. It is concluded that in most patients adolescent anorexia nervosa takes a prolonged course, although it seems to be more favorable than in adult-onset forms. Those who achieve complete recovery from the eating disorder have a good chance of overcoming other psychiatric disorders and to adapt to social requirements.
Journal of Eating Disorders
Background: Understanding motivation to change is a key issue in both the assessment and the treatment of eating disorders. Therefore, sound instruments assessing this construct are of great help to clinicians. Accordingly, the present study analysed the psychometric properties of the Anorexia Nervosa Stages of Change Questionnaire (ANSOCQ), including its relation to coping style and self-esteem. Methods: N = 92 adolescents referred to an eating disorders outpatient clinic meeting criteria for anorexia nervosa gave written informed consent to participate in this study and completed the ANSOCQ, the Eating Disorder Inventory, the Eating Attitudes Test, the Body Image Questionnaire, two questionnaires measuring Self-Related Cognitions and the Coping Across Situations Questionnaire. After a treatment period of nine months, clinical anorexia nervosa diagnosis and the body mass index were reassessed. In addition to exploratory factor analysis, correlational analysis was used to test for the convergent validity of the ANSOCQ and logistic regression analysis was used to test its predictive validity. Results: The ANSOCQ had good psychometric properties. Factor analysis yielded two meaningful factors labelled as 'weight gain and control' and 'attitudes and feelings'. Internal consistencies of the two factors amounted to Cronbach's alpha = .87 and .76, respectively. Significant correlations with other scales measuring eating disorder psychopathology were indicative of meaningful construct validity. Higher motivation to change was related to higher self-esteem and a more active coping style. Higher (positive) ANSOCQ total scores predicted remission of anorexia nervosa after nine months of treatment. A higher score on 'attitudes and feelings' was a protective factor against drop-out from intervention. Conclusions: The ANSOCQ is a clinically useful instrument for measuring motivation to change in adolescents with AN. Two factorial dimensions explain most of the variation. Self-esteem and coping style are relevant additional constructs for the understanding of the motivation to change in anorexia nervosa.
Short-term outcome of anorexia nervosa in adolescents after inpatient treatment: a prospective study
European Child & Adolescent Psychiatry, 2009
The current study describes the short-term outcome of adolescent inpatient population suffering from anorexia nervosa (AN) and analyzes the clinical predictors of poor outcome in these patients. Fifty-seven female AN patients (mean = 15.8, SD = 1.3) admitted for inpatient treatment to a specialized eating disorder unit at a university medical center were reassessed 1 year after being discharged. Assessments were made at the beginning and at the end of the inpatient treatment as well as at the 1-year followup. Self-rating data and expert-rating interview data were obtained. Adequate data for 55 (96.5%) cases allowed for the assignment of an outcome category. A total of 28.1% of the patients' cases showed a good outcome, meaning the patients fully recovered, and 8.8% had an intermediate outcome, and 59.6% of the patients' cases had a poor outcome. Significant predictors of poor outcome included the patient's BMI at the beginning of the treatment as well as psychiatric comorbidity, and purging behavior. Adolescent AN is a severe disorder with a poor outcome in a substantial amount of adolescents.