An open trial of app-assisted acceptance and commitment therapy (iACT) for eating disorders in type 1 diabetes.
An open trial of app-assisted acceptance and commitment therapy (iACT) for eating disorders in type 1 diabetes.
复制标题
DOI：
10.1186/s40337-020-00357-6
复制
发表时间：
2021-01-06
影响因子：
4.1
通讯作者：
Sangvai D
中科院分区：
文献类型：
--
作者：
Merwin RM;Moskovich AA;Babyak M;Feinglos M;Honeycutt LK;Mooney J;Freeman SP;Batchelder H;Sangvai D
1型糖尿病（T1D）患者的饮食失调（EDs）增加了早期和严重糖尿病相关并发症和过早死亡的风险。传统的饮食失调（ED）治疗在很大程度上对T1D患者无效，这表明需要针对这类患者群体和ED症状出现的独特条件（在一种需要持续控制血糖、饮食和运动的慢性疾病的背景下）量身定制治疗。目前的研究是iACT的一项试点开放试验，iACT是一种基于接受和承诺治疗（ACT）的新型干预措施。iACT的前提是，当个体试图应对T1D和相关的情绪困扰时，ED症状就会出现。iACT教授接受和正念作为对不适应的回避和控制的替代，并利用个人价值观来增加参与T1D管理的意愿，即使在令人沮丧的时候（例如，在暴饮暴食之后）。在会议间隙使用了定制的移动应用程序（“应用程序”），以便在个人做出糖尿病管理决策时促进ACT技能的应用。符合ED标准的成年T1D患者完成了12次iACT治疗（其中有3次可选的逐渐减少治疗）。除了检查治疗是否可接受和可行（研究的主要目的）外，该研究还检查了iACT是否与增加的心理灵活性（即，在追求个人有意义的价值观的同时对糖尿病有痛苦的想法/感觉的能力）以及ED症状、糖尿病管理和糖尿病痛苦的改善有关。T1D合并ed患者治疗可接受，实施可行。参与者报告说，与糖尿病相关的想法/感受的心理灵活性增加了，在追求个人价值方面的障碍减少了，进步也更大了。从基线到治疗结束，ED症状、糖尿病自我管理和糖尿病痛苦的改变都有很大的影响（Cohen’s d = 0.90 - 1.79）。血红蛋白A1c也有改善，但p值无统计学意义，p = .08。研究结果为iACT改善T1D ed患者的预后提供了初步证据，并支持在对照试验中进一步评估该方法。NCT02980627。2016年7月8日注册。
Eating disorders (EDs) among individuals with type 1 diabetes (T1D) increase the risk of early and severe diabetes-related medical complications and premature death. Conventional eating disorder (ED) treatments have been largely ineffective for T1D patients, indicating the need to tailor treatments to this patient population and the unique conditions under which ED symptoms emerge (in the context of a chronic illness with unrelenting demands to control blood glucose, diet and exercise). The current study was a pilot open trial of iACT, a novel intervention for EDs in T1D grounded in Acceptance and Commitment Therapy (ACT). iACT was based on the premise that ED symptoms emerge as individuals attempt to cope with T1D and related emotional distress. iACT taught acceptance and mindfulness as an alternative to maladaptive avoidance and control, and leveraged personal values to increase willingness to engage in T1D management, even when it was upsetting (e.g., after overeating). A tailored mobile application (“app”) was used in between sessions to facilitate the application of ACT skills in the moment that individuals are making decisions about their diabetes management. Adults with T1D who met criteria for an ED completed 12 sessions of iACT (with three optional tapering sessions). In addition to examining whether treatment was acceptable and feasible (the primary aim of the study), the study also examined whether iACT was associated with increased psychological flexibility (i.e., the ability to have distressing thoughts/feelings about diabetes while pursuing personally meaningful values), and improvements in ED symptoms, diabetes management and diabetes distress. Treatment was acceptable to T1D patients with EDs and feasible to implement. Participants reported increased psychological flexibility with diabetes-related thoughts/feelings, and less obstruction and greater progress in pursuing personal values. There were large effects for change in ED symptoms, diabetes self-management and diabetes distress from baseline to end-of-treatment (Cohen’s d = .90–1.79). Hemoglobin A1c also improved, but the p-value did not reach statistical significance, p = .08. Findings provide preliminary evidence for iACT to improve outcomes for T1D patients with EDs and support further evaluation of this approach in a controlled trial. NCT02980627. Registered 8 July 2016.
登录
查看更多内容
影响因子：
5.5
作者：
Araia, Emanuala;Hendrieckx, Christel;King, Ross M.
通讯作者：
King, Ross M.
影响因子：
3.6
作者：
Berg, Kelly C.;Peterson, Carol B.;Crow, Scott J.
通讯作者：
Crow, Scott J.
影响因子：
16.2
作者：
Colton, Patricia A.;Olmsted, Marion P.;Rodin, Gary M.
通讯作者：
Rodin, Gary M.
影响因子：
4.1
作者：
Fairburn, Christopher G.;Bailey-Straebler, Suzanne;Basden, Shawnee;Doll, Helen A.;Jones, Rebecca;Murphy, Rebecca;O'Connor, Marianne E.;Cooper, Zafra
通讯作者：
Cooper, Zafra
影响因子：
5.9
作者：
Gregg, Jennifer A.;Callaghan, Glenn A.;Glenn-Lawson, June L.
通讯作者：
Glenn-Lawson, June L.