Aggregating factors of the change process in the treatment of anorexia nervosa

Antje Gumz; Denise Kästner; Karolina A Raczka; Angelika Weigel; Bernhard Osen; Matthias Rose; Björn Meyer; Eileen Wollburg; Ulrich Voderholzer; Matislava Karacic; Eik Vettorazzi; Bernd Löwe

doi:10.1016/j.eatbeh.2015.06.002

Aggregating factors of the change process in the treatment of anorexia nervosa

Eat Behav. 2015 Dec:19:81-5. doi: 10.1016/j.eatbeh.2015.06.002. Epub 2015 Jun 21.

Authors

Affiliations

¹ Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, and Schön Clinic Hamburg Eilbek, Hamburg, Germany. Electronic address: a.gumz@uke.de.
² Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, and Schön Clinic Hamburg Eilbek, Hamburg, Germany.
³ Schön Clinic Bad Bramstedt, Germany.
⁴ Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, and Schön Clinic Hamburg Eilbek, Hamburg, Germany; Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Charité, Berlin, Germany.
⁵ Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, and Schön Clinic Hamburg Eilbek, Hamburg, Germany; Department of Psychology, City University, London, UK.
⁶ Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, and Schön Clinic Hamburg Eilbek, Hamburg, Germany; The Pennsylvania State University, Altoona, USA.
⁷ Schön Clinic Roseneck Prien, Germany; Department of Psychiatry and Psychotherapy, University Hospital Freiburg, Germany.
⁸ Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Germany.

PMID: 26202211
DOI: 10.1016/j.eatbeh.2015.06.002

Abstract

Purpose: We aimed to reduce the large body of factors which may be associated with the change process in treatments for Anorexia Nervosa (AN) into a clinically and scientifically useful number of higher-rank dimensions. In addition, we examined the associations between the identified factors and eating disorder psychopathology and body mass index (BMI) in exploratory analyses.

Methods: Within a naturalistic multicenter study we administered the Change Process Questionnaire (CPQ-AN) to inpatients with AN upon admission. The factorial structure of the CPQ-AN was explored via factor analysis. Multiple regression analyses were performed to examine the associations with BMI and eating disorder symptomatology (EDI-2).

Results: In total 233 female inpatients with AN (mean BMI=14.9 kg/m(2), SD=1.7) participated. The factor analysis yielded four latent factors: basic need satisfaction, AN-specific cognitions and behavior, emotional involvement and commitment to treatment, and alliance and treatment confidence. Furthermore, greater basic need satisfaction and less AN-specific cognitions and behavior predicted lower EDI-2 scores. Higher alliance and treatment confidence were associated with higher BMI as well as a lower EDI-2 score.

Conclusion: The associations between the newly derived dimensions and BMI and AN-psychopathology provide evidence to support the clinical relevance of the identified change process dimensions. Future investigations could provide further insights to deepen our understanding of the change process in AN.

Keywords: Anorexia nervosa; Change mechanisms; Change process; Common factors.

Publication types

Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Anorexia Nervosa / psychology*
Anorexia Nervosa / therapy*
Attitude to Health
Body Mass Index
Cognition
Emotions
Factor Analysis, Statistical
Female
Hospitalization
Humans
Inpatients / psychology*
Inpatients / statistics & numerical data
Patient Compliance / psychology
Personal Satisfaction
Psychopathology
Surveys and Questionnaires
Young Adult