Acceptance-Based Separated Family Treatment for Adolescent Anorexia Nervosa

基于接受的分离家庭治疗青少年神经性厌食症

• 批准号: 7826738
• 负责人: C. Alix Timko
• 金额: $ 18.88万
• 依托单位: TOWSON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-05-05 至 2012-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7826738
• 关键词: 19 year old; 7 year old; Acute; Adaptive Behaviors; Address; Adolescence; Adolescent; Affect; Aftercare; Age; Age of Onset; Anorexia Nervosa; Arts; Awareness; Behavior; Behavior Therapy; Behavioral; Behavioral inhibition; Binge eating disorder; Brain; Bulimia; Cardiovascular system; Caregiver Burden; Caregivers; Case Study; Cessation of life; Characteristics; Child; Cognition; Cognitive; Cognitive Therapy; Combined Modality Therapy; Communication; Comorbidity; Data; Deltastab; Development; Diagnosis; Disease; Distal; Distress; Eating Disorders; Educational Curriculum; Effectiveness; Elements; Emotional; Emotions; Evaluation; Event; Expectancy; Expressed Emotion; Family; Family member; Family psychotherapy; Feedback; Feeling; Frequencies; Funding; Goals; Growth; Health Care Costs; Hospitals; Individual; Intervention; Knowledge; Length; Life; London; Manuals; Medical; Menarche; Mental disorders; Modality; Modeling; Muscle Rigidity; Obesity; Onset of illness; Organ failure; Osteoporosis; Outcome; Parents; Participant; Phase; Population; Prevention; Psychopathology; Randomized Clinical Trials; Randomized Controlled Clinical Trials; Randomized Controlled Trials; Recovery; Relapse; Reporting; Research; Research Project Grants; Risk; Schizophrenia; Severities; Siblings; Site; Staging; Suicide; Symptoms; Techniques; Testing; Thinking; Time; Treatment Effectiveness; Treatment Efficacy; Weight; base; bodily sensation; brain volume; cognitive rigidity; coping; critical period; design; eating pathology; empowered; experience; falls; flexibility; improved; innovation; mortality; new technology; prevent; prognostic; psychologic; public health relevance; reproductive; severe mental illness; skills; stressor; symptom management; therapy development; trait; treatment adherence; treatment effect; treatment program; willingness

DESCRIPTION (provided by applicant): Anorexia Nervosa (AN) is a debilitating psychiatric illness with physical and psychological sequelae. AN, which is characterized by significant malnourishment, often emerges in adolescence, a period of rapid brain development and maturation. Effectively intervening at this pivotal period may circumvent potentially irreversible damage and restore adolescents to a more normal developmental trajectory. Recent progress in treating adolescents with AN supports the importance of family involvement. However, the most optimal manner to incorporate the family requires further study, particularly given the significant caregiver burden and frequent psychopathology reported among AN family members. Preliminary evidence indicates that separated family treatment (SFT), in which a family intervention is delivered to adolescent and caregiver separately, may be more appropriate than conjoint interventions for families with difficulties such as high expressed emotion. Family-based treatments that target trait features associated with AN, such as behavioral and cognitive rigidity, high harm avoidance, and poor interoceptive awareness may prevent symptom relapse as these young people encounter new life stressors. The purpose of the proposed research is to develop a treatment for adolescent AN that includes the family in a way that has broad appeal and applicability (even with more distressed families) and incorporates newer technologies from behavior therapy which may be well-suited to address trait features of AN. These newer technologies are acceptance-based and specifically designed to target behavioral rigidity in the presence of difficult thoughts, feelings, and bodily sensations. The specific aims of this treatment development project are as follows: 1) develop and refine a 20 session, 24 week acceptance-based separated family treatment for adolescents with anorexia nervosa (ASFT) that combines an existing state-of-the- art parent therapy component (Zucker, 2008) with an innovative individual adolescent component, 2) evaluate the acceptability and feasibility of the treatment program, and 3) provide preliminary data regarding the efficacy of the treatment approach. Treatment development will be iterative, and will occur over three phases. Each phase will implement an increasingly refined version of the treatment, evaluate credibility and expectancy of treatment, adherence, and obtain qualitative and quantitative feedback from participants. Multimodal assessment will be employed; and participants will be assessed at baseline, 10 weeks, post-treatment, and three months post-treatment. It is anticipated that the resultant data and treatment manual will set the stage for a large scale RCT comparing ASFT to more traditional family treatments. PUBLIC HEALTH RELEVANCE: Anorexia nervosa (AN) is a debilitating mental illness with the potential to permanently dislodge adolescents from healthy developmental trajectories. Involvement of the family is essential for effective management, however, the degree of caregiver burden is extreme. Interventions that involve the family and yet target acute symptom management, ease caregiver burden, and address trait features associated with illness relapse are essential for sustained recovery from these threatening disorders.

描述（由申请人提供）：神经性厌食症（AN）是一种使人衰弱的精神疾病，伴有身体和心理后遗症。AN的特征是严重营养不良，通常出现在青春期，这是大脑快速发育和成熟的时期。在这一关键时期进行有效干预，可以避免潜在的不可逆转的损害，使青少年恢复到更正常的发展轨道。最近在治疗青少年AN支持家庭参与的重要性。然而，最佳的方式，将家庭需要进一步的研究，特别是考虑到显着的照顾者的负担和频繁的精神病理学AN家庭成员之间的报告。初步证据表明，分离的家庭治疗（SFT），其中的家庭干预是提供给青少年和照顾者分开，可能比联合干预的困难，如高表达的情绪的家庭更合适。以家庭为基础的治疗，针对与AN相关的特质特征，如行为和认知僵化，高伤害回避，以及不良的内感受意识，可以防止这些年轻人遇到新的生活压力时症状复发。拟议研究的目的是开发一种治疗青少年AN的方法，包括以具有广泛吸引力和适用性的方式（即使是更痛苦的家庭）的家庭，并结合行为治疗的新技术，这些技术可能非常适合解决AN的特质特征。这些较新的技术是基于接受的，专门针对存在困难思想，感觉和身体感觉的行为僵化。这一治疗发展项目的具体目标如下：1）开发和完善一个20个疗程，24周的基于接受的分离家庭治疗青少年神经性厌食症（ASFT），结合现有的最先进的父母治疗组成部分（Zucker，2008年）与一个创新的个人青少年组成部分，2）评估治疗方案的可接受性和可行性，以及3）提供关于治疗方法的功效的初步数据。治疗开发将是迭代的，将分三个阶段进行。每个阶段都将实施一个日益完善的治疗版本，评估治疗的可信度和预期，依从性，并从参与者那里获得定性和定量的反馈。将采用多模式评估;参与者将在基线、10周、治疗后和治疗后3个月进行评估。预计由此产生的数据和治疗手册将为大规模RCT奠定基础，将ASFT与更传统的家庭治疗进行比较。 公共卫生关系：神经性厌食症（AN）是一种使人衰弱的精神疾病，有可能永久性地使青少年脱离健康的发展轨道。家庭的参与是有效管理的必要条件，然而，照顾者的负担是极端的。涉及家庭的干预措施，但针对急性症状管理，减轻照顾者的负担，并解决与疾病复发相关的特质特征是从这些威胁性疾病中持续恢复的关键。

项目成果

A Pilot Study of an Acceptance-Based Separated Family Treatment for Adolescent Anorexia Nervosa.

基于接受的分离家庭治疗青少年神经性厌食症的初步研究。

• DOI: 10.1016/j.cbpra.2012.11.001
• 发表时间: 2013
• 期刊: Cognitive and behavioral practice
• 影响因子: 2.9
• 作者: Merwin,RhondaM;Zucker,NancyL;Timko,CAlix
• 通讯作者: Timko,CAlix

An open trial of Acceptance-based Separated Family Treatment (ASFT) for adolescents with anorexia nervosa.

针对神经性厌食症青少年的基于接受的分离家庭治疗 (ASFT) 的公开试验。

• DOI: 10.1016/j.brat.2015.03.011
• 发表时间: 2015
• 期刊: Behaviour research and therapy
• 影响因子: 4.1
• 作者: Timko,CAlix;Zucker,NancyL;Herbert,JamesD;Rodriguez,Daniel;Merwin,RhondaM
• 通讯作者: Merwin,RhondaM