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The change process in adult anorexia nervosa inpatient treatment: a path model

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Abstract

Purpose

Knowledge on the change process in the treatment of anorexia nervosa (AN) is an important starting point for the improvement of treatment, yet very little evidence exists. In an exploratory analysis, we aimed to investigate the interdependencies between higher-rank change process factors, BMI and AN-specific cognitions and behaviours over the course of inpatient treatment.

Methods

We included 176 female adult AN inpatients from three specialized centres. The temporal interdependencies between the change factors and the outcome variables over the course of treatment (t0: beginning, t1: mid-treatment, t2: end) were investigated using a path model.

Results

The sample had a mean age of 27.1 years (SD = 8.9 years) and a mean BMI at admission of 15.0 kg/m2 (SD = 1.6 kg/m2). A greater basic need satisfaction and a greater emotional involvement and commitment to treatment at t0 positively influenced the BMI at t1. Furthermore, greater basic need satisfaction at t0 led to less AN-specific cognitions and behaviours at t2.

Conclusions

The results are discussed with respect to the self-determination theory and the consistency theory. Further research on the change process in AN treatment is recommended.

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Notes

  1. Odd numbered treatment durations were rounded down. If this measurement point was missing, we rounded up and used the data from the following measurement point.

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Acknowledgements

We would like to thank Prof. M. Rose and Dr. B. Meyer for their valuable contributions to the study design and Alexandra Murray for her constructive and important comments on the manuscript. We gratefully acknowledge the support of all physicians and psychotherapists in the three study centres and all patients who participated in our study.

Author information

Author notes

    Authors and Affiliations

    1. Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf and Schön Clinic Hamburg Eilbek, Hamburg, Germany

      Antje Gumz, Denise Kästner, Angelika Weigel & Bernd Löwe

    2. Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

      Anne Daubmann

    3. Schön Clinic Bad Bramstedt, Bad Bramstedt, Germany

      Bernhard Osen & Eileen Wollburg

    4. Schön Clinic Roseneck Prien, Prien am Chiemsee, Germany

      Matislava Karacic & Ulrich Voderholzer

    5. Department of Psychiatry and Psychotherapy, University Hospital Freiburg, Freiburg im Breisgau, Germany

      Ulrich Voderholzer

    Authors
    1. Antje Gumz
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    2. Denise Kästner
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    4. Anne Daubmann
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    7. Eileen Wollburg
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    8. Ulrich Voderholzer
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    Corresponding author

    Correspondence to Denise Kästner.

    Ethics declarations

    Funding

    This study was funded by a “Swiss Anorexia Nervosa Foundation” grant awarded to Professor B. Löwe and Dr. B. Meyer.

    Conflict of interest

    The authors declare that they have no conflict of interest.

    Ethical standards

    The study was approved by all local research ethic committees (Medical Chamber Hamburg MC-419/10, Medical Association Schleswig-Holstein: AZ 030/10; University Medical Center Munich: 246-10). All procedures performed were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

    Informed consent

    Informed consent was obtained from all participants included in the study.

    Additional information

    A. Gumz and D. Kästner contributed equally to this work (shared first authorship).

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    Supplementary material 1 (DOCX 22 kb)

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    Gumz, A., Kästner, D., Weigel, A. et al. The change process in adult anorexia nervosa inpatient treatment: a path model. Eat Weight Disord 23, 313–320 (2018). https://doi.org/10.1007/s40519-016-0341-1

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    • DOI: https://doi.org/10.1007/s40519-016-0341-1

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