Individual cognitive remediation therapy benefits for patients with anorexia nervosa and high autistic features

Dandil, Yasemin; Smith, Katherine A.; Adamson, James; Tchanturia, Kate

doi:10.1002/erv.2707

Cited by 22 publications

(40 citation statements)

References 17 publications

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“…35 (b) Individual interventions rather than group work. 18,19,36 (c) Allowing for longer treatment durations. 37 (d) Training and supervision in working with people with autism for eating disorder clinicians, for example in adapting communicative styles (Kinnaird et al, 21,22 current study).…”

Section: Discussionmentioning

confidence: 99%

Carers’ views on autism and eating disorders comorbidity: qualitative study

et al. 2020

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Background Patients with co-occurring anorexia nervosa and autism respond differently to eating disorder treatments. Previous interviews with patients with both conditions and clinicians working in eating disorder services has highlighted service and treatment adaptations might be beneficial and could improve outcomes for these individuals. Aims The aim of this study was to explore carers’ experiences of current treatment approaches for people with autism who have anorexia nervosa, and their views on how these can be improved. Method Ten carers of a loved one diagnosed with autism and anorexia nervosa were interviewed using a semi-structured interview schedule and the transcripts were analysed with thematic analysis. Results Four key themes emerged from the interviews: the role of autism in anorexia nervosa, carers’ problems with clinical services, the impact on carers and suggestions for future improvements. Conclusions Carers agreed that autism played a significant role in the development and maintenance of their daughters’ anorexia nervosa. However, this comorbidity does not appear to be appropriately addressed in current treatment provisions. They described several difficulties, including problems getting an autism diagnosis and the perception that eating disorder services did not accept or adapt around the condition. This resulted in feelings of frustration and isolation for families, a scenario exacerbated by a perceived lack of support or specific resources for carers of individuals on the autism spectrum. Clinical recommendations on the basis of the current and previous studies are outlined.

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Section: Discussionmentioning

confidence: 99%

Carers’ views on autism and eating disorders comorbidity: qualitative study

et al. 2020

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“…This paper restricts itself to summarizing the findings narratively. CR interventions and ASC was examined in 13 studies; four RCTs (10,(18)(19)(20); two non-randomized control trials (27,28); four case series (30)(31)(32)34); two feasibility studies (29,33) and one case study (35). Table 1 includes a summary of limitations associated with each study that may impact interpretation.…”

Section: Discussionmentioning

confidence: 99%

“…More recently CRT has been adapted for use in people with AN, a manualized approach focusing on cognitive flexibility and additions were made to address central coherence-meaning that the adapted manual for eating disorders added cognitive exercises supporting participants in "bigger picture" thinking (11). This intervention was used in four studies (31,(33)(34)(35). Two studies investigated Cognitive Enhancement Therapy (19,29).…”

Section: Crosssectionalmentioning

confidence: 99%

“…Furthermore, a preliminary study aimed to examine the difference in the effects of individual CRT treatment for adult female's diagnosed with anorexia nervosa with either high or low ASC characteristics (34). In total 99 inpatients on an eating disorder unit were initially included in the intervention.…”

Section: Case Series and Case Studymentioning

confidence: 99%

“…Studies identified were predominantly case series and have supported the feasibility and acceptability of individual CR interventions with positive feedback from participants (29,30,(32)(33)(34). However, the case series identified had small sample sizes which resulted in a lack of power to detect statistical differences and limits the generalizability of the findings.…”

Section: Summary Of Main Findingsmentioning

confidence: 99%

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Cognitive Remediation Interventions in Autism Spectrum Condition: A Systematic Review

et al. 2020

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Background: Autism spectrum condition (ASC) is a lifelong neurodevelopmental condition characterized by difficulties in social cognition and heterogeneity of executive function which are suggested to be underpinned by neurobiological, prenatal and genetic factors. Cognitive remediation (CR) interventions are frequently used to address cognitive characteristics and improve cognitive and general functioning. However, the evidence is limited for ASC. This systematic review is the first to provide a narrative synthesis of all studies of CR interventions and ASC. The review aimed to delineate the development of research in this area in both adolescents and adults, with implications for clinical practice and future research. Method: The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement. The literature was reviewed using the PubMed, PsycINFO, Web of Science, Scopus and Embase from inception to 1st April 2020. Out of 1,503 publications, a total of 13 papers were identified as being relevant for the review. Results: The 13 studies meeting the inclusion criteria were: four randomized control trials (RCTs); two non-randomized control trials, four case series, two feasibility studies and one case study. A narrative synthesis of the data suggested that CR interventions are potentially effective in improving social cognition and cognitive functioning in ASC. RCTs supported the efficacy of CR interventions in improving social cognition and executive functioning. Non-randomized control trials provided evidence for the effectiveness of social cognition remediation interventions in ASC. Case series and a case study have also supported the feasibility of CR interventions, including reflections on their adaptation for ASC populations and the positive feedback from participants. Conclusions: CR interventions are potentially effective in improving social cognition and cognitive functioning in ASC. However, the generalizability of the included empirical studies was hampered by several methodological limitations. To further strengthen understandings of the effectiveness of CR interventions for ASC, future RCTs are needed with larger sample sizes in exploring the long-term effectiveness of CR

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A Mixed Method Systematic Review Into the Impact of ED Treatment in Autistic People and Those With High Autistic Traits

Nimbley,

Sharpe,

Maloney

et al. 2024

Intl J Eating Disorders

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ObjectiveOur understanding of the impact of eating disorders (ED) treatment in Autistic people remains elusive. Research has begun to explore ED treatment outcomes and experiences in this population, however current understandings are poorly integrated. The current review therefore sought to explore the impact of ED treatment on Autistic people and those with higher Autistic traits.MethodA convergent, segregated approach was used, independently evaluating quantitative then qualitative studies before integrating findings into a coherent narrative synthesis.ResultsAutistic people and people with higher Autistic traits report poorer experiences of treatment and may be at increased risk of inpatient admission and prolonged inpatient treatment, possibly explained by difficulties with treatment timeframes and a lack of autism‐informed support. Both groups reported similar improvements in ED symptoms and BMI. Higher rates of psychosocial difficulties pre‐and post‐treatment were reported in those with higher Autistic traits, and emotion‐focused interventions were felt to be particularly relevant to Autistic presentations of EDs. Concerns were reported as to how well aligned group‐based programs and cognitive‐based interventions are for Autistic individuals and those reporting higher Autistic traits.DiscussionFuture research in diagnosed autism samples is urgently needed to develop a more robust understanding of Autistic outcomes and experiences. Review findings demonstrate the need for increased understanding of ED presentations and the possible need for treatment adaptations, for Autistic people or those with higher Autistic traits.

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Individual cognitive remediation therapy benefits for patients with anorexia nervosa and high autistic features

Cited by 22 publications

References 17 publications

Carers’ views on autism and eating disorders comorbidity: qualitative study

Carers’ views on autism and eating disorders comorbidity: qualitative study

Cognitive Remediation Interventions in Autism Spectrum Condition: A Systematic Review

A Mixed Method Systematic Review Into the Impact of ED Treatment in Autistic People and Those With High Autistic Traits

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