Internet-Based Motivation Program for Women With Eating Disorders: Eating Disorder Pathology and Depressive Mood Predict Dropout
Internet-Based Motivation Program for Women With Eating Disorders: Eating Disorder Pathology and Depressive Mood Predict Dropout
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DOI：
10.2196/jmir.3104
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发表时间：
2014-03-01
影响因子：
7.4
通讯作者：
Vocks, Silja
中科院分区：
文献类型：
--
作者：
von Brachel, Ruth;Hoetzel, Katrin;Vocks, Silja
背景：互联网提供的一系列疾病干预措施的主要问题之一是高辍学率，但对与此相关的因素知之甚少。我们最近开发并测试了一个基于网络的6期计划，以增强患有神经性厌食症、神经性贪食症或相关阈下进食病理的女性改变的动机。目的：本研究的目的是确定从该网络计划退学的预测因素。方法：共有179名女性参与了这项研究。我们使用生存分析（Cox回归）来研究饮食失调病理（通过饮食失调检查问卷；eed - q评估）、抑郁情绪（霍普金斯症状检查表）、改变动机（罗德岛大学改变评估量表；URICA）和参与者的辍学年龄的预测作用。为了确定预测因子，我们使用了最小绝对收缩和选择算子（LASSO）方法。结果：辍学率为50.8%(91/179)，在6个疗程中平均分布。LASSO分析显示，在ed - q的形状关注子量表上得分越高，暴食和呕吐的频率越高，以及抑郁得分越高，退学的可能性就会显著增加。然而，我们没有发现任何影响的uica或年龄对辍学。结论：患有更严重的饮食失调病理和抑郁情绪的女性退出基于网络的动机增强计划的可能性更高。像我们这样的干预措施需要解决患有更严重的饮食失调病理和抑郁情绪的妇女的具体需求，并为她们提供额外的支持，以防止她们过早停止治疗。
Background: One of the main problems of Internet-delivered interventions for a range of disorders is the high dropout rate, yet little is known about the factors associated with this. We recently developed and tested a Web-based 6-session program to enhance motivation to change for women with anorexia nervosa, bulimia nervosa, or related subthreshold eating pathology.Objective: The aim of the present study was to identify predictors of dropout from this Web program.Methods: A total of 179 women took part in the study. We used survival analyses (Cox regression) to investigate the predictive effect of eating disorder pathology (assessed by the Eating Disorders Examination-Questionnaire; EDE-Q), depressive mood (Hopkins Symptom Checklist), motivation to change (University of Rhode Island Change Assessment Scale; URICA), and participants' age at dropout. To identify predictors, we used the least absolute shrinkage and selection operator (LASSO) method.Results: The dropout rate was 50.8% (91/179) and was equally distributed across the 6 treatment sessions. The LASSO analysis revealed that higher scores on the Shape Concerns subscale of the EDE-Q, a higher frequency of binge eating episodes and vomiting, as well as higher depression scores significantly increased the probability of dropout. However, we did not find any effect of the URICA or age on dropout.Conclusions: Women with more severe eating disorder pathology and depressive mood had a higher likelihood of dropping out from a Web-based motivational enhancement program. Interventions such as ours need to address the specific needs of women with more severe eating disorder pathology and depressive mood and offer them additional support to prevent them from prematurely discontinuing treatment.