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
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.
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Funding
This study was funded by a “Swiss Anorexia Nervosa Foundation” grant awarded to Professor B. Löwe and Dr. B. Meyer.
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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.
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Informed consent was obtained from all participants included in the study.
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A. Gumz and D. Kästner contributed equally to this work (shared first authorship).
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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