Anorexia nervosa - The journey towards recovery : A randomized controlled treatment trial: assessment, prediction, treatment outcome and clinical change

Sammanfattning: The overall aim of this thesis was to study young adult women with anorexia nervosa (AN) participating in an randomized controlled trial in relation to assessment, treatment outcome, prediction, and clinical change. The results confirm the Eating Disorder Inventory-3 as a valid instrument for measuring eating disorder symptoms and general psychopathology. AN patients, however, rate themselves significantly lower than patients with other eating disorder diagnoses, and interoceptive deficits are the best predictive subscale for AN diagnosis. Patients significantly improved in terms of weight and eating disorder psychopathology, with no differences between individual CBT and family therapy (FT). Most patients did not fulfill the diagnostic criteria at post-assessment, at 76% and 86% at followup. Patients in FT were considered completers to a higher extent than patients receiving CBT, and 8% were prematurely discharged, in comparison to 30% for CBT. Bulimic symptoms and emotional dysregulation at baseline had a negative effect on diagnostic symptoms, and lower levels of interoceptive deficits predicted weight increase in the FT group. Lower levels of emotional dysregulation and higher levels of interoceptive deficits explained 37% of the variance in BMI changes in the CBT group. The classifications of CS/RCI were shown to be valid when compared to normal controls. Patients classified as clinically significantly improved constituted 35-47% of all patients, and only three patients fulfilled the proposed definition of recovery. The agreement of the diagnostic criteria was fair.The results suggest that individual CBT and FT are effective treatments for young adults. The ability to acknowledge, interpret, and handle emotions is an important aspect of treatment. Self-report measurements are useful for evaluating individual changes; however, diagnostic criteria do not accord with self-reported symptom changes and physical, behavioral, and psychological measurements are important for a complete estimation of recovery.