Anna Oldershaw1,2, Tony Lavender1, Ulrike Schmidt2,3. 1. Salomons Centre for Applied Psychology, Canterbury Christ Church University, Tunbridge Wells, UK. 2. Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. 3. Eating Disorders Unit, South London and Maudsley NHS Foundation Trust, London, UK.
Abstract
BACKGROUND:Emotional, social, and neurocognitive factors are theorised to maintain anorexia nervosa (AN). Yet whether they predict outcomes or relate to clinical change remains unclear. METHODS:Seventy-one consecutive adult outpatient eating disorder service referrals presenting with AN, who participated in a randomised controlled trial comparing 2 psychotherapies, were assessed for emotional processing, social cognition, and neurocognition pretherapy and posttherapy. Intention-to-treat analysis employed maximum-likelihood methods to model missing data. Baseline self-reported emotional processing, social cognitive, or neurocognitive task performance was entered into forward stepwise regression models with posttreatment clinical outcomes (weight, eating disorder psychopathology, psychosocial functioning) as dependent variables. Correlation analyses examined relationships between clinical and self-report/task score change. RESULTS:Self-reported emotional avoidance (behavioural/cognitive avoidance, low acceptance) and submissive behaviour predicted clinical outcomes. Social cognitive (emotion recognition, emotional theory of mind) and neurocognitive performance (set-shifting, detail focus) had limited predictive ability. CONCLUSIONS: Emotional avoidance and submissiveness may represent maintenance factors for AN.
RCT Entities:
BACKGROUND: Emotional, social, and neurocognitive factors are theorised to maintain anorexia nervosa (AN). Yet whether they predict outcomes or relate to clinical change remains unclear. METHODS: Seventy-one consecutive adult outpatienteating disorder service referrals presenting with AN, who participated in a randomised controlled trial comparing 2 psychotherapies, were assessed for emotional processing, social cognition, and neurocognition pretherapy and posttherapy. Intention-to-treat analysis employed maximum-likelihood methods to model missing data. Baseline self-reported emotional processing, social cognitive, or neurocognitive task performance was entered into forward stepwise regression models with posttreatment clinical outcomes (weight, eating disorder psychopathology, psychosocial functioning) as dependent variables. Correlation analyses examined relationships between clinical and self-report/task score change. RESULTS: Self-reported emotional avoidance (behavioural/cognitive avoidance, low acceptance) and submissive behaviour predicted clinical outcomes. Social cognitive (emotion recognition, emotional theory of mind) and neurocognitive performance (set-shifting, detail focus) had limited predictive ability. CONCLUSIONS: Emotional avoidance and submissiveness may represent maintenance factors for AN.
Authors: Danielle Drinkwater; Sue Holttum; Tony Lavender; Helen Startup; Anna Oldershaw Journal: Front Psychiatry Date: 2022-06-24 Impact factor: 5.435
Authors: Nuria Mallorquí-Bagué; María Lozano-Madrid; Giulia Testa; Cristina Vintró-Alcaraz; Isabel Sánchez; Nadine Riesco; José César Perales; Juan Francisco Navas; Ignacio Martínez-Zalacaín; Alberto Megías; Roser Granero; Misericordia Veciana De Las Heras; Rayane Chami; Susana Jiménez-Murcia; José Antonio Fernández-Formoso; Janet Treasure; Fernando Fernández-Aranda Journal: J Clin Med Date: 2020-03-31 Impact factor: 4.241