Eleonora Rossi1, Giovanni Castellini2, Emanuele Cassioli1, Carolina Sensi1, Milena Mancini3, Giovanni Stanghellini3, Valdo Ricca1. 1. Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy. 2. Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy. giovanni.castellini@unifi.it. 3. Department of Psychological, Health and Territorial Sciences, G. D'Annunzio University, Chieti, Italy.
Abstract
PURPOSE: Recent studies demonstrated that the embodiment disorder represents a core feature of eating disorders (EDs). The aim of this study was to evaluate the role of its variation as a possible mediator of the efficacy of enhanced cognitive behavioural therapy (CBT-E) on classic ED symptomatology, including body uneasiness. METHODS: 73 patients with anorexia nervosa and 68 with bulimia nervosa were treated with a multidisciplinary approach including CBT-E. Psychometric questionnaires were administered at baseline (T0) and after one (T1) and 2 years (T2) to evaluate general and ED-specific psychopathology, body uneasiness and the embodiment disorder. Data regarding diagnostic crossover and remission were also collected. RESULTS: Longitudinal analysis showed an improvement of all psychopathological dimensions at T1, which remained stable at T2 (p < 0.05). Remission rate at T2 was 44.7%, and diagnostic crossover occurred in 17.0% of patients. Higher levels of embodiment disorder predicted increased diagnostic instability (OR: 1.80 [1.01-3.20], p = 0.045). The amelioration of the embodiment disorder mediated the decrease in both ED-specific psychopathology (indirect effect: 0.67 [0.46-0.92]) and body uneasiness (indirect effect: 0.43 [0.28-0.59]). CONCLUSION: For the first time, these findings highlighted the role of the embodiment disorder as a maintaining factor of ED symptomatology, supporting the importance of integrating CBT-E with a phenomenological model of EDs. LEVEL OF EVIDENCE: Level IV, longitudinal observational study (case series).
PURPOSE: Recent studies demonstrated that the embodiment disorder represents a core feature of eating disorders (EDs). The aim of this study was to evaluate the role of its variation as a possible mediator of the efficacy of enhanced cognitive behavioural therapy (CBT-E) on classic ED symptomatology, including body uneasiness. METHODS: 73 patients with anorexia nervosa and 68 with bulimia nervosa were treated with a multidisciplinary approach including CBT-E. Psychometric questionnaires were administered at baseline (T0) and after one (T1) and 2 years (T2) to evaluate general and ED-specific psychopathology, body uneasiness and the embodiment disorder. Data regarding diagnostic crossover and remission were also collected. RESULTS: Longitudinal analysis showed an improvement of all psychopathological dimensions at T1, which remained stable at T2 (p < 0.05). Remission rate at T2 was 44.7%, and diagnostic crossover occurred in 17.0% of patients. Higher levels of embodiment disorder predicted increased diagnostic instability (OR: 1.80 [1.01-3.20], p = 0.045). The amelioration of the embodiment disorder mediated the decrease in both ED-specific psychopathology (indirect effect: 0.67 [0.46-0.92]) and body uneasiness (indirect effect: 0.43 [0.28-0.59]). CONCLUSION: For the first time, these findings highlighted the role of the embodiment disorder as a maintaining factor of ED symptomatology, supporting the importance of integrating CBT-E with a phenomenological model of EDs. LEVEL OF EVIDENCE: Level IV, longitudinal observational study (case series).
Authors: Valdo Ricca; Giovanni Castellini; Carolina Lo Sauro; Edoardo Mannucci; Claudia Ravaldi; Francesco Rotella; Carlo Faravelli Journal: Psychother Psychosom Date: 2010-05-25 Impact factor: 17.659
Authors: Giovanni Stanghellini; Francesca Trisolini; Giovanni Castellini; Alessandra Ambrosini; Carlo Faravelli; Valdo Ricca Journal: Psychopathology Date: 2014-10-22 Impact factor: 1.944
Authors: Giovanni Stanghellini; Giovanni Castellini; Patrizia Brogna; Carlo Faravelli; Valdo Ricca Journal: Psychopathology Date: 2012-03-02 Impact factor: 1.944
Authors: Heather Thompson-Brenner; Rebecca M Shingleton; Douglas R Thompson; Dana A Satir; Lauren K Richards; Elizabeth M Pratt; David H Barlow Journal: Int J Eat Disord Date: 2015-12-09 Impact factor: 4.861
Authors: Florian Junne; Beate Wild; Gaby Resmark; Katrin E Giel; Martin Teufel; Peter Martus; Katrin Ziser; Hans-Christoph Friederich; Martina de Zwaan; Bernd Löwe; Andreas Dinkel; Stephan Herpertz; Markus Burgmer; Sefik Tagay; Eva Rothermund; Almut Zeeck; Wolfgang Herzog; Stephan Zipfel Journal: Eur Eat Disord Rev Date: 2018-07-16