At-risk offspring continue to develop new disorders as they progress through adolescence. These results support the need to screen and monitor the offspring of adults presenting for treatment of panic disorder or major depressive disorder.
Over the course of the COVID-19 pandemic, rates of eating disorders have increased, further straining systems of care that were already overburdened. The current paper describes novel interventions, largely informed by Family-Based Treatment (FBT), that were implemented by a tertiary specialist adolescent eating disorders service. In response to the pandemic, programming was designed to bridge access to care while waiting for availability of evidence-based therapy. The Brief Psychology Consultation Clinic provides several sessions to patients and families, focused on psychoeducation and problem-solving informed by FBT and other evidence-based therapies. Two groups, the FBT Caregiver Workshop Series and FBT Caregiver Support Group, provide psychoeducation and support for caregivers of youth with eating disorders. Perceived strengths and benefits of these services, as well as barriers to implementation and future research directions are discussed.
Objective
This study tested clinical utility of the DSM‐5 severity specifier for bulimia nervosa (BN) in predicting treatment response among adolescents (N = 110) within a randomized clinical trial of two psychosocial treatments.
Method
Analyses grouped individuals meeting criteria for BN diagnosis by baseline severity, per DSM‐5. Associations among baseline severity classification and BN behavior (i.e., binge eating and compensatory behavior) and eating disorder examination (EDE) Global scores at end‐of‐treatment (EOT), 6‐ and 12‐month follow‐up were examined.
Results
Associations between severity categories with BN symptoms were not significant at EOT, or follow‐up. Test for linear trend in BN behavior was significant at EOT, F = 5.23, p = 0.02, without demonstrating a linear pattern. Relation between severity categories with EDE Global scores was significant at 6‐month follow‐up, F = 3.76, p = 0.01. Tests for linear trend in EDE Global scores were significant at EOT, F = 5.40, p = 0.02, and at 6 months, F = 10.73, p = 0.002, with the expected linear pattern.
Discussion
Findings suggest the DSM‐5 BN severity specifier holds questionable utility in anticipating outpatient treatment response in adolescents with BN. The specifier may have improved ability to predict attitudinal rather than behavioral treatment outcomes.
This study evaluated the effects of two treatments for adolescent bulimia nervosa (BN), family‐based treatment (FBT‐BN), and cognitive behavioral therapy (CBT‐A), on both attitudinal and behavioural outcomes at end‐of‐treatment. These associations were examined specifically relative to motivation for change in obsessive–compulsive (OC) features of eating disorder (ED) symptoms. Adolescents (N = 110) were randomly assigned to FBT‐BN or CBT‐A and completed assessments of eating pathology and OC‐ED behaviour. Across both treatments, greater motivation for change in OC‐ED behaviour was associated with improved attitudinal features of ED at end‐of‐treatment. Motivation for change did not demonstrate a direct or interaction effect on BN behavioural outcomes. Results suggest that adolescents with BN who are more motivated to change OC‐ED behaviours at the start of treatment, FBT‐BN or CBT‐A, are more likely to demonstrate improvements in cognitions, but not behaviours associated with EDs, at treatment conclusion.
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