Sasha Gorrell1, Catherine E Byrne2, Paige J Trojanowski2, Sarah Fischer2, Daniel Le Grange3,4. 1. Department of Psychiatry and Behavioral Sciences, University of California, 401 Parnassus Avenue, San Francisco, CA, 94143, USA. sasha.gorrell@ucsf.edu. 2. Department of Psychology, George Mason University, Fairfax, VA, USA. 3. Department of Psychiatry and Behavioral Sciences, University of California, 401 Parnassus Avenue, San Francisco, CA, 94143, USA. 4. Department of Psychiatry and Behavioral Neurosciences, The University of Chicago, Chicago, IL, USA.
Abstract
PURPOSE: This scoping review presents an up-to-date synthesis of the current evidence base for non-specific predictors, moderators, and mediators of family-based treatment (FBT) for adolescent anorexia and bulimia nervosa. METHODS: We identify ways in which end-of-treatment outcomes have been shown to differ based upon baseline clinical features and person-specific factors and explore psychological mechanisms that may explain differences in treatment response. We draw from this evidence base to outline recommendations for clinical practice, as well as directions for future clinical eating disorder research. RESULTS: Noted findings from review include that early response in weight gain and parental criticism may be particularly influential in treatment for anorexia nervosa. Further, for adolescents with either anorexia or bulimia nervosa, eating-related obsessionality may be a key intervention target to improve outcomes. CONCLUSION: In addition to highlighting a need for attention to specific patient- and caregiver-level factors that impact treatment response, recommendations for research and clinical practice include testing whether certain targeted treatments (e.g., exposure-based approaches) may be suitable within the context of FBT for eating disorders. LEVEL OF EVIDENCE: Level I: Evidence obtained from: at least one properly designed randomized controlled trials; experimental studies.
PURPOSE: This scoping review presents an up-to-date synthesis of the current evidence base for non-specific predictors, moderators, and mediators of family-based treatment (FBT) for adolescent anorexia and bulimia nervosa. METHODS: We identify ways in which end-of-treatment outcomes have been shown to differ based upon baseline clinical features and person-specific factors and explore psychological mechanisms that may explain differences in treatment response. We draw from this evidence base to outline recommendations for clinical practice, as well as directions for future clinical eating disorder research. RESULTS: Noted findings from review include that early response in weight gain and parental criticism may be particularly influential in treatment for anorexia nervosa. Further, for adolescents with either anorexia or bulimia nervosa, eating-related obsessionality may be a key intervention target to improve outcomes. CONCLUSION: In addition to highlighting a need for attention to specific patient- and caregiver-level factors that impact treatment response, recommendations for research and clinical practice include testing whether certain targeted treatments (e.g., exposure-based approaches) may be suitable within the context of FBT for eating disorders. LEVEL OF EVIDENCE: Level I: Evidence obtained from: at least one properly designed randomized controlled trials; experimental studies.
Authors: K Bühren; R Schwarte; F Fluck; N Timmesfeld; M Krei; K Egberts; E Pfeiffer; C Fleischhaker; C Wewetzer; B Herpertz-Dahlmann Journal: Eur Eat Disord Rev Date: 2013-09-12
Authors: Leslie K Anderson; Erin E Reilly; Laura Berner; Christina E Wierenga; Michelle D Jones; Tiffany A Brown; Walter H Kaye; Anne Cusack Journal: Curr Psychiatry Rep Date: 2017-08 Impact factor: 5.285
Authors: Stuart B Murray; Daniel S Quintana; Katharine L Loeb; Scott Griffiths; Daniel Le Grange Journal: Psychol Med Date: 2018-08-13 Impact factor: 7.723