Prediction of Outcomes of an Eating Disorders Treatment Program PDF Download

Author: Dawn O. Witherspoon
Publisher:
ISBN:
Category : Eating disorders
Languages : en
Pages : 150

View

Book Description
Eating disorders are common psychiatric disorders, especially in adolescent and adult females. Given the significant impairment these disorders cause, patients often require intensive inpatient treatment; however the majority of outcome studies are related to outpatient treatment. The purpose of this study was to create and test a theoretical model that predict inpatient treatment outcomes for patients with eating disorders using structural equation modeling. The goal of the current study was to examine predictors of treatment outcomes in an inpatient and partial hospitalization eating disorder program. The sample consisted of a total of 140 subjects with bulimia nervosa, anorexia nervosa and eating disorders NOS. Empirically supported risk factors for the development and maintenance of eating disorders, including demographic factors, biological factors and psychological factors were included in the model. Structural equation modeling was used because it allows for the production and testing of theoretical models that can then be used in predicting and studying treatment outcomes in this population. To refine the proposed model separate linear regression analyses were conducted on both the psychological and eating disorder severity risk factors and the treatment outcome variable. Overall, psychological severity risk factors model was statistically significant. The results from this multivariate regression using eating disorder severity factors were statistically significant as well. The revised model was tested by an EFA including the variables in the model. The items converged into two factors; however they did not align according to the predicted model of Psychological Severity and Eating Disorder Severity Factors. Instead they formed the first factor termed: Mental Health Factors in ED and the second factor called Self Destructive/Impulsive Behavior. The final model showed a superior fit to the data. One important clinical implication is the effect of financial restraints and health care insurance systems on clinical treatments, as evident by the relatively large number of patients who had to leave treatment early due to financial restraints. Other findings support the need for early treatment intervention to reduce morbidity and mortality.

Author: James Lock
Publisher: Guilford Publications
ISBN: 1462542840
Category : Medical
Languages : en
Pages : 242

View

Book Description
From pioneering family-based treatment developer James Lock, this is the first comprehensive guide to adolescent-focused therapy (AFT) for anorexia nervosa (AN), an evidence-based individual approach. AFT is an effective alternative to family-based treatment that may be a better fit for some patients. Lock explains how AN serves as a maladaptive response to developmental challenges of adolescence. He presents a manualized framework for helping adolescents find more adaptive coping strategies, manage difficult emotions, and develop greater autonomy and a stronger sense of self, while reducing risky behaviors and restoring weight. AFT emphasizes the therapist–patient alliance and involves parents in a supportive role. Rich case material and sample dialogues illustrate how to implement each phase of the approach. AFT is recognized as a best practice for the treatment of anorexia nervosa in adolescents by the U.K. National Institute for Health and Care Excellence (NICE).

Author:
Publisher:
ISBN:
Category :
Languages : en
Pages : 107

View

Book Description
Prior research has examined the eating disorders in terms of etiology, predictive factors, treatment modalities, clinical course, and outcome with variable results and minimal consensus. No research was found linking collected assessment data to discharge needs, nor was research addressing the impact of discharge planning on successful treatment outcome identified. The purpose of this study was to determine if data collected for individuals during the initial assessment phase of an eating disorders program could predict the nature of discharge needs at the time of treatment completion. Using a data collection tool developed by the researcher, a one time retrospective chart review of 29 female subjects treated in an outpatient eating disorders program between 1994 and 1996 was accomplished. Using the Statistical Package for the Social Sciences, descriptive statistics were used to assess the characteristics of the sample population, analysis of variance was employed to examine differences between diagnostic groups for particular variables and a Chi-square test was applied to test for associations. Probability levels were set at .05 for statistical significance and .10 to indicate a trend. Although limited by available data, several significant findings were noted. Women diagnosed with Bulimia Nervosa (BN) had significantly higher admission Global Assessment of Functioning versus women with Anorexia Nervosa (AN); those with AN were positively linked to a family history of mood disorders; a significant relationship existed between BN and a family history of eating disorders and to brothers having a psychiatric history; a link between treatment involvement and a) discharge type and b) clinical outcome; and a positive relationship between those with AN and the lack of follow through with discharge plans.

Author: Hallie Marie Espel-Huynh
Publisher:
ISBN:
Category : Clinical psychology
Languages : en
Pages : 135

View

Book Description
Eating disorders (EDs) are severe psychiatric illnesses which can lead to substantial psychological impairment and significant medical comorbidity. Relative to those with other psychiatric illnesses, individuals with EDs are particularly prone to treatment nonresponse (e.g., reliable deterioration or inadequate improvement during treatment). Further, very little is known about treatment response patterns in intensive treatment settings such as residential care. Evidence from general outpatient psychotherapy research suggests that risk for treatment nonresponse can be significantly reduced with use of Progress Monitoring and clinician Feedback (PM-FB) systems. PM-FB systems use empirically-derived benchmarking and prediction algorithms to determine a patient's expected course of treatment. When integrated into clinical practice, PM-FB systems significantly improve treatment outcomes and reduce risk of treatment nonresponse; effects are particularly pronounced for patients at risk for deterioration. Given the high rates of treatment nonresponse among patients with EDs, PM-FB may be a particularly effective tool for improving ED treatment outcomes. To date, PM-FB systems have been developed and tested primarily for use in general outpatient therapy settings. Their utility in ED treatment settings is largely unknown, particularly in intensive residential treatment. Development of an ED- and treatment-specific PM-FB system could facilitate increased treatment effectiveness. The present study sought to: (1) develop and validate an ED-specific PM measure for residential treatment (the Progress Monitoring tool for EDs, PMED); (2) identify an expected treatment response curve characterizing typical patterns of weekly symptom change; and (3) develop an algorithm to predict patient treatment outcome using only early treatment data. Thirty-seven PMED items were generated by a team of content experts, clinicians, and administrative staff from the target treatment setting. Items were administered to 531 residential patients with EDs as part of routine intake assessments and subsequently submitted to factor analysis. Results yielded a 5-factor, 26-item structure with adequate psychometric properties. To generate expected treatment response curves, the refined PMED was then administered to 371 patients at admission, discharge, and weekly throughout treatment. Latent growth mixture modeling was applied to characterize the number and nature of possible response patterns in residential care. A three-class trajectory model was the best fit for the data. Patients were classified into one of the three groups based on posterior predicted probabilities associated with their individual treatment response trajectories from admission to discharge. Using only data from the first two assessments, support vector machine learning was applied to predict patients' ultimate response class from early treatment data. Analyses yielded 84% overall prediction accuracy, which was significantly better than chance prediction. Findings suggest that residential ED treatment response is best characterized by three distinct patterns of symptom change. Treatment response patterns in residential ED treatment are heterogeneous in nature and are best represented by three distinct patterns of response. Results from machine learning analyses support the feasibility and accuracy of machine learning methods in predicting ED these response patterns early on in treatment. In the future, data from a patient's active treatment could be entered into this algorithm; information on the likely response pattern would inform therapeutic treatment planning and alert providers of risk for nonresponse.

Author: David B. Allison
Publisher: Springer Science & Business Media
ISBN: 1461519012
Category : Science
Languages : en
Pages : 275

View

Book Description
Treatment outcome has certainly improved since Stunkard and McLaren-Hume (1959) reviewed the literature and found that less than 25% of obese patients lost 20 pounds or more and less than 5% lost 40 pounds or more. However, one of the few points on which almost all obesity researchers agree is that to date, our results are quite modest and we are generally unsuccessful in promoting effective weight maintenance among obese persons. As the title of a more recent article, "Improving long-term weight loss: Pushing the limits of treatment," (Brownell & Jeffrey, 1987, [emphasis added]) suggests, many believe that we have pushed our current treatment paradigms to the limit. It was with this background in mind that we organized the meeting from which these proceedings issue. The purpose of the three day international meeting was to evaluate the current knowledge base and conceptual paradigms of obesity treatment and to suggest directions for future research and clinical practice. Rather than simply for research reporting, the meeting was primarily for research generation. All speakers were established scientists in the field who were asked to summarize our state of knowledge in a given area rather than present the results of their latest research. Great efforts were taken to ensure that panel discussions occupied a central portion of the conference, and that the questions "What else do we need to know?" and "How do we find it out?" were consistently addressed.

Author: Anna Mae Jorgensen
Publisher:
ISBN:
Category : Electronic dissertations
Languages : en
Pages : 74

View

Book Description
The present investigation examined characteristic, symptomatic, and familial predictors of long-term symptom severity of eating disorders. The purpose of the study was to determine if, after accounting for a number of known predictors of outcome, familial variables explained a significant amount of additional variance in disordered eating and general well-being scores measured at post-treatment follow-up. The sample included 398 women, ages 13 to 56, who had completed eating disorder treatment at an inpatient facility. Hierarchal multiple regression analysis demonstrated that familial predictors at admission to treatment did significantly predict long-term outcomes, while changes from admission to treatment in symptoms and perceptions of parents did not predict recovery. Patients' relationships with their fathers significantly contributed to the regression model. Recommendations for future investigations are discussed.

Author: Michael Barkham
Publisher: John Wiley & Sons
ISBN: 1119536588
Category : Psychology
Languages : en
Pages : 852

View

Book Description
Celebrating the 50th anniversary of a best-selling and renowned reference in psychotherapy research and practice. Now celebrating its 50th anniversary and in its seventh edition, Bergin and Garfield's Handbook of Psychotherapy and Behavior Change, maintains its position as the essential reference volume for psychotherapy research. This bestselling reference remains the most important overview of research findings in psychotherapy. It is a rigorous and evidence-based text for academics, researchers, practitioners, and students. In recognition of the 50th anniversary, this edition contains a Foreword by Allen Bergin while the Handbook covers the following main themes: historical and methodological issues, measuring and evidencing change in efficacy and practice-based research, therapeutic ingredients, therapeutic approaches and formats, increasing precision and scale of delivery, and future directions in the field of psychotherapy research. Chapters have either been completely rewritten and updated or comprise new topics by contributors including: Characteristics of effective therapists Mindfulness and acceptance-based therapies Personalized treatment approaches The internet as a medium for treatment delivery Models of therapy and how to scale up treatment delivery to address unmet needs The newest edition of this renowned Handbook offers state-of-the-art updates to the key areas in psychotherapy research and practice today. Over 60 authors, experts in their fields, from over 10 countries have contributed to this anniversary edition, providing in-depth, measured and insightful summaries of the current field.

Author: American Psychiatric Association
Publisher: American Psychiatric Publishing
ISBN:
Category : Medical
Languages : en
Pages : 92

View

Book Description
The care of patients with eating disorders involves a comprehensive array of approaches. These guidelines contain the clinical factors that need to be considered when treating a patient with anorexia nervosa or bulimia nervosa.

Author:
Publisher:
ISBN:
Category : Eating disorders
Languages : en
Pages : 108

View

Book Description
This study explores the possibility of temperament and character predicting dropout from partial hospitalization program (PHP) eating disorder treatment at Eating Recovery Center of Washington (ERCWA) in Bellevue, Washington. The hypotheses for this research were (a) significant differences in temperament and character scores on harm avoidance (HA), persistence (P), novelty seeking (NS), and reward dependence (RD) would predict dropout in all eating disorder diagnosis (b) significant differences in persistence and harm avoidance would predict dropout in anorexia nervosa (AN) (c) significant differences in persistence and novelty seeking would predict dropout in bulimia nervosa (BN). Archival data of 15 male and 153 female participants aged 18-65 years diagnosed with an eating disorder receiving treatment at ERCWA adult PHP during 2014 and 2015 were used in this study. Dropout was defined as participants who dropped out of treatment utilizing the 72-hour notice Commitment to Recovery (Appendix D) or who left treatment against medical advice (AMA) or against clinical advice (ACA). A Multiple Logistic Regression Analysis was conducted to determine the probability of predicting treatment dropout considering the Temperament and Character Inventory (TCI-3 v1) dimensions. Results indicated increased cooperativeness is associated with increased likelihood of treatment dropout and increased reward dependence is associated with increased treatment completion. Assessing temperament and character traits may be a useful tool in predicting and reducing treatment dropout.

Author: Mary Tantillo
Publisher: Routledge
ISBN: 0429863497
Category : Psychology
Languages : en
Pages : 298

View

Book Description
Multifamily Therapy Group for Young Adults with Anorexia Nervosa describes a new and innovative family-centered outpatient Multifamily Therapy Group (MFTG) approach called Reconnecting for Recovery (R4R) for young adults with anorexia nervosa that is based on a relational reframing of eating disorders. Developed in concert with young adults and their families and informed by clinical observations, theory, and research, R4R is designed to help young adults and family members learn the emotional and relational skills required to avoid or repair relationship ruptures for continued collaboration in recovery. The book begins with an overview of anorexia nervosa, MFTG treatment approaches, and the development of R4R and moves into a session by session review of R4R including session goals, exercises and handouts. Protocols, case vignettes, and other materials help translate the theory and research underlying this multifamily therapy group model into practice. This treatment manual provides readers with explicit guidance in how to develop and conduct an outpatient R4R MFTG and a deeper understanding of the nature, purposes, and processes that characterize one.