Motivation to change among residential treatment patients with an eating disorder: Assessment of the multidimensionality of motivation and its relation to treatment outcome
ABSTRACT To examine the multidimensional nature of motivation to change in an adolescent sample in residential eating disorder (ED) treatment and relate it to outcome.
To determine whether different dimensions of motivation (benefits, burdens, and functional avoidance) are differentially associated with symptom severity and outcome, we assessed eating pathology and motivation to change in consecutively admitted female patients (n = 67) with AN, BN, and EDNOS in a residential ED program with the Eating Disorder Examination Questionnaire (EDE-Q) and the Decisional Balance Scale (DB).
Pretreatment DB benefits and functional avoidance subscales were correlated with ED and comorbid psychopathology. Admission to discharge change in DB benefits-but not other measured dimensions of motivation was significantly associated with post-treatment EDE-Q global scores.
Our findings support that motivation to change is a multidimensional construct among ED patients. A reduction in perceived benefits of illness is associated with less severe post-treatment eating pathology.
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- "These findings are in contrast to past research asking sufferers’ to evaluate the impact (positive and negative) of their eating disorder on their lives. Where such beliefs are concerned, it is the strength of positive rather than negative ED cognitions that predict resistance to treatment [8,26] and lesser motivation to change . At an experiential level, however, it is the strength of predominantly negative self-talk that predicts ED severity. "
ABSTRACT: Background While self-talk has been argued to play a crucial role in the development and maintenance of eating disorders (EDs), it has received limited research attention. This study aimed to explore the relationship of ED self-talk with ED severity and symptomatology. Methods Analysis of the existing literature, supplemented with a small-scale pilot study, identified 24 distinct categories of ED self-talk. The main study involved the completion of on-line questionnaires by 172 women aged 18–49, recruited through clinical services, ED websites, and the general population. Participants were assigned to clinical (n = 83) and non-clinical (n = 89) samples, using the Eating Disorder Examination Questionnaire to screen for ED psychopathology. Results Substantial differences in the levels of ED self-talk were found between the clinical and non-clinical populations. Principal components analysis, conducted within the clinical sample, revealed ED self-talk to have a two-component structure. Self-talk reflecting an ‘abusive relationship’ between the sufferer and the ED strongly predicted overall severity and several aspects of symptomatology. ‘Ascetic attitudes’ towards thinness were linked with compulsive exercising and lower BMIs but not with overall severity. Conclusions Close examination of the ‘abusive relationship’ component suggests a need to loosen the connection between negative appraisals of the abused self and the abusive voice of the ED so that the former can fulfil their potential as a force for change. Further, in seeking to counter the impact of the ED voice, it is suggested that the seducer and abuser roles require primary clinical focus.International Journal of Eating Disorders 05/2014; 2:14. DOI:10.1186/2050-2974-2-14 · 3.13 Impact Factor
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ABSTRACT: The aim of this multi-method qualitative study was to explore the eating behaviors and food choices of nine purposively sampled low-income women aged 29 to 40 years who were engaged in a residential substance use disorders recovery program. Findings were limited to photo-elicitation interviews with the women that focused on nutritional choices and issues outside their family context. Consensual data analysis revealed a recovery process that began with cognitive reawakening and an increased focus on and desire for healthier nutrition-related decisions and lifestyle, particularly in the area of weight gain that many of the women experienced. Keywords: Substance use disorder, women, residential recovery program, photo-elicitation, qualitative, nutritionJournal of Human Behavior in the Social Environment 10/2014; 24(8):951-965. DOI:10.1080/10911359.2014.923359
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ABSTRACT: Aims: This study compared the effects of residential treatment on improving health-related quality of life (HRQOL) between males and females diagnosed with eating disorders (EDs) from admission to discharge and at follow-up. This study also analyzed the association between changes in HRQOL and changes in the severity of ED pathology, depression, and trait anxiety. Methods: 145 consecutive patients (34 males and 111 females) admitted to a residential ED unit completed a panel of surveys at admission and discharge. The survey panel included the Eating Disorders Quality of Life Survey (EDQLS), the Eating Disorder Examination Questionnaire, the Quick Inventory of Depressive Symptomatology and the State-Trait Anxiety Inventory. An online follow-up survey was also conducted for the EDQLS. Mixed-factorial ANOVA was used to examine sex differences and changes in HRQOL between admission, discharge and post-treatment follow-up. Multiple regression analysis was used to investigate the relationship between sex, change in HRQOL, and changes in all other variables studied. Results: By the end of residential treatment, both males and females had made similar statistically significant improvements in HRQOL from admission to discharge, which persisted after treatment. Greater decreases in ED pathology and trait anxiety significantly predicted greater increases in HRQOL during residential treatment while sex and changes in depression did not. Conclusion: The data show that residential treatment is an effective approach to improving HRQOL in both males and females with EDs. Greater improvements in trait anxiety and ED pathology contributed to greater improvement in HRQOL in these patients.Eating and weight disorders: EWD 11/2014; 20(3). DOI:10.1007/s40519-014-0162-z · 0.79 Impact Factor