Body image concern and treatment outcomes in adolescents with anorexia nervosa
Body image concern and treatment outcomes in adolescents with anorexia nervosa
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DOI：
10.1002/eat.23031
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发表时间：
2019-05-01
影响因子：
5.5
通讯作者：
Dalle Grave, Riccardo
中科院分区：
文献类型：
--
作者：
Calugi, Simona;Dalle Grave, Riccardo
目的探讨体像基线测量(BIC)对神经性厌食症(AN)青少年强化认知行为治疗(CBT-E)后体重指数(BMI)、百分位数和精神病理结果的影响。方法记录62例青少年AN患者12个月内4个时间点的BMI百分位数，并于入院和出院时记录进食障碍检查表(EDE)和简明症状自评量表(BSI)评分。在入院和出院时评估三个BIC成分的变化，即“对形状/体重的关注”、“对体重增加的恐惧”和“感觉肥胖”。结果CBT-E与结果变量和BIC成分的显著改善相关。在完成治疗的患者中，96.4%的患者在18年时达到了与BMI>；=18.5相对应的治疗结束BMI百分位数，在6个月和12个月的随访中，这一比例分别略有下降至78.7%和80.4%。基线“对身材/体重的关注”和“感觉肥胖”预测了随着时间的推移BMI百分位数的改善，所有这三个基线BIC成分都独立地预测了治疗结束时EDE饮食问题分量表的得分。基线“感觉肥胖”也预测了治疗结束时的EDE饮食限制子量表和BSI评分。讨论这些发现强调了在处理青少年AN患者时评估和处理身体形象的重要性。
Objective To ascertain the role of baseline measures of body-image concern (BIC) in changes in body mass index (BMI) centile and psychopathological outcomes associated with intensive enhanced cognitive behavioral therapy (CBT-E) in adolescents with anorexia nervosa (AN). Method The BMI centile of 62 adolescent patients with AN was recorded at four time-points over 12 months, and Eating Disorder Examination interview (EDE) and Brief Symptom Inventory (BSI) scores, were recorded at admission and discharge from CBT-E. Changes in three BIC components, namely "Preoccupation with shape/weight", "Fear of weight gain" and "Feeling fat", were assessed at admission and discharge. Results CBT-E was associated with a significant improvement in outcome variables and BIC components. Among completers, 96.4% reached an end-of treatment BMI centile corresponding to a BMI >= 18.5 at 18 years, which fell slightly to 78.7% and 80.4% at 6- and 12-month follow-ups, respectively. Baseline "Preoccupation with shape/weight" and "Feeling fat" predicted improvement in BMI centile over time, and all three baseline BIC components independently predicted end-of-treatment EDE Eating Concern subscale score. Baseline "Feeling fat" also predicted end-of-treatment EDE Dietary Restraint subscale and BSI scores. Discussion These findings highlight the importance of assessing and addressing body image when managing adolescent patients with AN.