Follow‐up Assessment of Cognitive Remediation Therapy in Adolescent Anorexia Nervosa: A Pilot Study

Herbrich, Laura; Noort, Betteke van; Pfeiffer, E. F.; Lehmkuhl, Ulrike; Winter, Sibylle; Kappel, Viola

doi:10.1002/erv.2501

Cited by 18 publications

(35 citation statements)

References 79 publications

(151 reference statements)

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“…An inpatient case series (n = 20) found significant improvements in a number of neuropsychological functions, including visuospatial (Lindvall Dahlgren, Lask, Landrø, & Rø, 2013). A subsequent follow-up trial using this same sample, with some additional participants (n = 33), compared individuals with AN who received CRT to those who received no additional treatment (Herbrich et al, 2017). Compellingly, this study found improvements in cognitive flexibility following the intervention (using different neuropsychological tests), whereas the healthy controls showed no improvement over the same time period.…”

Section: Study Characteristicsmentioning

confidence: 76%

“…However, this analysis may have been compromised because of two studies from the same research group using overlapping samples (Herbrich et al, 2017;van Noort et al, 2016). However, the meta-analysis of common outcome measures indicated small effect size improvements in central coherence following CRT for individuals, suggesting that YP exhibited a gestalt information processing style following CRT.…”

Section: Discussionmentioning

confidence: 99%

“…Overall executive functioning, as measured by BRIEF, showed significant improvements after CRT. However, this analysis may have been compromised because of two studies from the same research group using overlapping samples (Herbrich et al, 2017;van Noort et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

“…Compellingly, this study found improvements in cognitive flexibility following the intervention (using different neuropsychological tests), whereas the healthy controls showed no improvement over the same time period. A subsequent follow-up trial using this same sample, with some additional participants (n = 33), compared individuals with AN who received CRT to those who received no additional treatment (Herbrich et al, 2017). Data were collected at the start of treatment, at the end of treatment and at 6 months following the end of treatment.…”

Section: Study Characteristicsmentioning

confidence: 99%

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Evidence for Cognitive Remediation Therapy in Young People with Anorexia Nervosa: Systematic Review and Meta‐analysis of the Literature

Tchanturia

Giombini

Leppänen

et al. 2017

Euro Eating Disorders Rev

101

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Cognitive remediation therapy (CRT) for eating disorders has demonstrated promising findings in adult age groups, with randomised treatment trials and systematic reviews demonstrating medium to large effect sizes in improved cognitive performance. In recent years, several case series have been conducted for young people with anorexia nervosa, but these findings have not been synthesised in the form of a systematic review. This systematic review aimed to evaluate the evidence for the efficacy of CRT in child and adolescent age groups. Nine studies were identified, with a subsequent meta-analysis suggesting improvements in cognitive performance with small effect sizes. Patient feedback was positive, with low dropout rates. These findings suggest that CRT has potential as a supplementary treatment for young people with anorexia nervosa, warranting further investigation using randomised treatment trials. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

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Section: Study Characteristicsmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

See 2 more Smart Citations

Evidence for Cognitive Remediation Therapy in Young People with Anorexia Nervosa: Systematic Review and Meta‐analysis of the Literature

Tchanturia

Giombini

Leppänen

et al. 2017

Euro Eating Disorders Rev

101

View full text Add to dashboard Cite

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“…Despite this, fewer studies have addressed the application of CRT for young patients with AN and findings have been mixed (for review, see Tchanturia, Giombini, Leppanen, & Kinnaird, 2017). Some recent evidence suggests improved set-shifting abilities for adolescents with AN following CRT (Harrison et al, 2018), which supports further investigation using randomized controlled trials (Herbrich et al, 2017;Lock, Fitzpatrick, Agras, Weinbach, & Jo, 2018;Timko, Goulazian, Fitzpatrick, & Rodriguez, 2018).…”

Section: Introductionmentioning

confidence: 99%

A randomized controlled trial of group cognitive remediation therapy for anorexia nervosa: Effects on set‐shifting tasks for inpatient adults and adolescents

Sproch

Anderson

Sherman

et al. 2019

Intl J Eating Disorders

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Objective The aim of this randomized controlled trial with a parallel design was to evaluate the effect of brief, cognitive remediation therapy (CRT) for anorexia nervosa (AN) on set‐shifting. Method Two hundred seventy‐five inpatient adults and adolescents with AN (mean age = 23.1; SD = 12.7) were randomly assigned (using simple randomization procedures) to either a CRT or control condition. All participants received treatment as usual; however, the CRT condition completed five CRT group sessions in lieu of other group therapies provided on the unit. Set‐shifting abilities were evaluated by: (a) neuropsychological measures and (b) experimental cognitive behavior therapy thought records. Blinding of group assignment occurred during baseline assessment and ended following group commencement. Results Data from 135 CRT and 140 control condition participants were analyzed. On all neuropsychological measures, results revealed no between group condition effects, but did show statistically significant time effects, with medium to large effect sizes. Thought record analysis revealed a significant condition by age interaction effect where adults in the CRT condition generated significantly more alternative thoughts and had stronger believability of alternative thoughts than children, a trend that was not found in the control condition. This yielded moderate to large effect sizes of.0.56 and 0.72, respectively. Discussion Based on traditional neuropsychological measures, these findings do not suggest a differential effect of CRT for AN in the format applied. However, results suggest that CRT may have some increased beneficial cognitive effect for adults, as compared to children, based on thought record analysis.

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The importance of improving cognitive flexibility in adolescents with anorexia nervosa: The case for cognitive remediation therapy

Timko,

Schnabel,

Orloff

2024

Intl J Eating Disorders

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ObjectiveInefficiencies in executive functioning (EF), more specifically cognitive flexibility and an overly detailed processing style, are frequently observed in individuals with Anorexia Nervosa (AN) and have been identified as potential targets in treatment. Cognitive Remediation Therapy (CRT) is an adjunctive treatment approach specifically designed to have a positive impact on EF. Mainly evaluated in adults, CRT has been criticized for its perceived ineffectiveness in promoting weight restoration or directly reducing eating disorder symptoms.MethodWe argue that we need to refocus our conceptual framework for using CRT as an adjunctive treatment and specifically explore its potential benefit in adolescents.ResultsAdolescence is a critical window for EF development during which CRT has the potential to have the most impact. While it may not specifically ameliorate eating disorder symptoms and directly improve weight gain, CRT may mitigate the impact of malnutrition on adolescent brain development, reduce attrition rates in treatment, and improve cognitive flexibility and (indirectly) other maintaining factors, thereby improving global functioning.DiscussionMore research needs to be done to understand the development of EF in adolescents with AN and how best to employ CRT as an adjunctive treatment to support development and target maintaining factors. The current article broadly reviews findings on executive functioning inefficiencies in adolescents with AN and discusses the purpose and role of CRT in treating AN. Finally, we highlight key critiques of using CRT and pose questions for future research.Public SignificanceTreatments targeting executive functioning in adolescents with AN are limited. We need to better understand how CRT can benefit adolescents in treatment. Increasing treatment options, including adjunctive treatments, is necessary to reduce the long‐term impact of AN.

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Follow‐up Assessment of Cognitive Remediation Therapy in Adolescent Anorexia Nervosa: A Pilot Study

Abstract: Results provide a first insight into follow-up-assessments of CRT in adolescent AN. More randomized controlled studies are needed to clarify the long-term effects of CRT. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

Cited by 18 publications

References 79 publications

Evidence for Cognitive Remediation Therapy in Young People with Anorexia Nervosa: Systematic Review and Meta‐analysis of the Literature

Evidence for Cognitive Remediation Therapy in Young People with Anorexia Nervosa: Systematic Review and Meta‐analysis of the Literature

A randomized controlled trial of group cognitive remediation therapy for anorexia nervosa: Effects on set‐shifting tasks for inpatient adults and adolescents

The importance of improving cognitive flexibility in adolescents with anorexia nervosa: The case for cognitive remediation therapy

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