Feasibility, Acceptability, and Preliminary Target Engagement of a Healthy Physical Activity Promotion Intervention for Bulimia Nervosa: Development and Evaluation via Case Series Design.
Feasibility, Acceptability, and Preliminary Target Engagement of a Healthy Physical Activity Promotion Intervention for Bulimia Nervosa: Development and Evaluation via Case Series Design.
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DOI：
10.1016/j.cbpra.2021.05.006
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发表时间：
2022-08
影响因子：
2.9
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神经性贪食症（BN）的特征是暴饮暴食和代偿行为，以及在自我评价中过度强调体重和形状。虽然认知行为疗法（CBT）是有效的，但最近的综述表明，只有30%的患者在治疗后达到禁欲。这些不良结果的一个潜在原因是CBT未能充分降低升高的负面影响（NA）以及形状和体重问题，这些问题已被证明与BN的不良治疗结果相关。因此，需要新的治疗成分，重点是改善NA和形状和重量的关注，以提高结果。促进身体活动（PA）是一种有希望的途径，通过该途径可以减少NA并改善健康个体、其他临床人群（例如，患有抑郁症或焦虑症的个体）和患有饮食失调症的个体。虽然为BN患者开具PA处方一直存在争议（由于担心运动可能被用于补偿狂欢发作或成为驱动或强迫性），但这种方法可能有许多好处，包括促进健康的终身运动习惯，通过改善情绪调节技能和体重调节来降低复发的可能性。鉴于PA的承诺，针对BN的关键维护因素，我们开发了一个12个会议的健康PA促进BN的干预和测试的初步可行性，可接受性，初步目标参与的迭代病例系列设计（n = 3）。该治疗提供了认知行为技能，旨在识别，实践和实现行为目标，同时要求患者每周进行长达150分钟的中度到剧烈的PA，这是在与客户的治疗师的每次会议期间预先计划的。结果表明，健康PA促进干预是可行的和可接受的交付。此外，干预导致每个参与者的BN症状频率在临床上显著降低。此外，参与者在NA和形状和体重方面表现出临床显著的下降。目前的研究表明，健康的PA干预措施可以对BN症状，NA以及形状和体重问题产生有益的影响。然而，由于样本量小，必须谨慎对待结论。未来的研究应该调查促进健康PA的其他方法，并包括更大的样本，以进一步测试这种治疗方法的初步疗效。
Bulimia nervosa (BN) is characterized by a pattern of binge eating and compensatory behaviors as well as an overemphasis on body weight and shape in self-evaluation. Although cognitive behavioral therapy (CBT) is efficacious, recent reviews suggest that only 30% of patients reach abstinence at posttreatment. One potential reason for these poor outcomes is that CBT fails to adequately reduce elevated negative affect (NA) and shape and weight concern, which have been shown to be correlated with poorer treatment outcomes in BN. Therefore, novel treatment components that focus on improving NA and shape and weight concern are needed in order to enhance outcomes. Promoting physical activity (PA) is a promising avenue through which to reduce NA and improve body image in healthy individuals, other clinical populations (e.g., individuals with depression or anxiety), and individuals with eating disorders. While prescribing PA for individuals with BN has been controversial (due to concerns that exercise maybe be used to compensate for binge episodes or become driven or compulsive), this approach may have many benefits, including promoting healthy lifetime exercise habits that reduce likelihood of relapse through the improvement of emotion regulation skills and weight regulation. Given the promise of PA for targeting key maintenance factors of BN, we developed a 12-session healthy PA promotion intervention for BN and tested initial feasibility, acceptability, and preliminary target engagement in an iterative case series design (n = 3). The treatment provided cognitive-behavioral skills designed to identify, practice, and achieve behavioral goals while asking patients to engage in up to 150 minutes of moderate-to-vigorous PA per week, which was preplanned during each session with the client’s therapist. Results suggested that the healthy PA promotion intervention was both feasible and acceptable to deliver. In addition, the intervention resulted in a clinically significant decrease in BN symptom frequency in each participant. Further, participants showed clinically significant decreases in NA and shape and weight concern. The current study demonstrates that healthy PA interventions can have beneficial effects on BN symptoms, NA, and shape and weight concern. However, due to the small sample size, conclusions must be treated with caution. Future research should investigate additional approaches for promoting healthy PA and include a larger sample in order to further test initial efficacy of this treatment approach.