Pilot data from the Self-Blame and Perspective-Taking Intervention for eating disorders

Hunt, Bethany J.; Hagan, Whitney Smith; Pelfrey, Sarah; Mericle, Susan; Harper, Jack; Palka, Jayme M.; McAdams, Carrie J.

doi:10.1016/j.jbct.2020.11.002

Cited by 9 publications

(6 citation statements)

References 39 publications

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“…Fewer differences in self-concept metrics were observed in the weight-recovered adult cohort with a history of AN. Changes in negative self-attributions have been associated with improved clinical outcomes in AN (Harper et al, 2017) and a brief psychoeducation intervention targeting negative self-attribution biases improved selfesteem in a transdiagnostic cohort of eating disorder patients (Hunt et al, 2021). Many qualitative studies have also reported changes in self-concept to be integral in recovery from AN (Stockford et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

Neural processes related to negative self‐concept in adult and adolescent anorexia nervosa

Mendoza

Palka

Pelfrey

et al. 2021

Euro Eating Disorders Rev

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Objective: Negative self-concept is characteristic of anorexia nervosa (AN), but the neural processes mediating this component of AN is unknown. These studies investigated how valence and social perspectives impact neural processing in both adults and adolescents with AN. Method:In an fMRI task, participants evaluated positive and negative adjectives from three social perspectives. Two studies were completed, one in 59 women (healthy, with AN, recovered from AN) and one in 42 adolescents (healthy, with AN). Neural regions of interest (ROIs) related to valence were identified and activations compared across groups and social perspectives.Results: Behaviourally, both adult and adolescent cohorts with AN were less positive during self-evaluations. In the adult study, neural differences related to clinical group and condition were observed in ROIs more responsive to positive social stimuli (medial prefrontal cortex, precuneus, left temporoparietal junction) but not in ROIs more responsive to negative social stimuli. No neural differences in relation to clinical group were observed in the adolescents. Conclusions: Behavioural differences related to negative self-concept are present in both adolescents and adults with AN, and neural differences, selective for positive social stimuli, were also observed in adults. AN may interfere with neurodevelopmental processes involved in positive self-concept.

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Section: Discussionmentioning

confidence: 99%

Neural processes related to negative self‐concept in adult and adolescent anorexia nervosa

Mendoza

Palka

Pelfrey

et al. 2021

Euro Eating Disorders Rev

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“…Participants were screened with the Mini-International Neuropsychiatric Interview (MINI) and the Eating Disorder Assessment-5 (EDA-5) to confirm an eating disorder diagnosis [ 33 , 34 ], intelligence was assessed with the Wechsler Abbreviated Scale of Intelligence [ 35 ], and demographic information collected. Pre and post-intervention assessments included both clinician-rated and self-report measures that addressed depression, anxiety, eating, self-esteem, and interpersonal attributions (see [ 36 ]). Qualitative questionnaires about the participants’ experiences with the SBPI were completed at the end of the last session and at the first follow-up post assessment.…”

Section: Methodsmentioning

confidence: 99%

“…Each of the art tasks required the group to cooperate and communicate clearly; the focus of the art tasks coordinated with psychoeducation about social function in EDs, with the specific topics selected being self-blame, positive and negative biases, and perspective-taking (upper panel, Fig. 1 , additional details [ 32 ]). Four SBPI groups were offered between January 2018 and March 2019, with five to eight individuals enrolled per group.…”

Section: Methodsmentioning

confidence: 99%

“…Recently, we reported on the psychological and clinical results of this intervention, finding improvements in both assessments of self-concept as well as clinical symptoms of anxiety, depression, and eating disorders [ 32 ]. Specifically, participants reported a more positive self-attribution bias, as well as increased trait and state self-esteem at the first post-intervention follow-up.…”

Section: Introductionmentioning

confidence: 99%

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Qualitative patient experiences from the Self-Blame and Perspective-Taking Intervention for eating disorders

et al. 2021

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Background Problems in social cognition and social support contribute to eating disorders (ED). Group therapy provides an ideal format to create an experiential learning environment focused on understanding social interactions. This pilot study examined the qualitative content of the participants’ experiences in the Self-Blame and Perspective-Taking Intervention (SBPI) for ED. Methods The SBPI was a 4-week group therapy intervention involving art therapy and psychoeducation that focused on social behaviors in ED patients. Participants received surveys immediately after the intervention and at 1 to 4 weeks after the post-intervention. Thematic analyses of qualitative feedback were performed using Braun and Clarke’s thematic analysis framework. Results Inductive analyses revealed three main themes: (1) Developing self-acceptance through emotional reflection, (2) Changing expectations with neurosocial knowledge, and (3) Bonding and vulnerability in social interactions; all concepts intentionally targeted by the SBPI. Participants varied in their support of a guideline to exclude personal discussion of ED-related cognitions and behaviors in the group. Conclusions As a whole, patients valued the combination of psychosocial education with group experientials focused on social behavior. Positive feedback from the SBPI suggests that adjunctive treatments that target mental-wellness constructs indirectly related to ED pathology may be helpful by allowing patients to see themselves as separable from the illness. Trial registration ClinicalTrials.gov, NCT0487758. Registered 7 May 2021—Retrospectively registered. https://clinicaltrials.gov/ct2/show/NCT04877158.

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“…Cognitive remediation and emotional skill training (CREST) augments treatment of severe AN, addressing social anhedonia, alexithymia, and quality of life [53,54]. Improvements in eating disorder symptoms, anxiety, and depression were observed with a brief group therapy intervention targeting self-attributions and perspective-taking for outpatients with eating disorders [55]. Since these social cognitive processes (PPO and NPO) differ both in relation to illness (both pwAN and wrAN differ from HC), and the degree of difference is impacted by illness state (pwAN is worse than wrAN), these data support a hypothesis that social cognition is altered during the course of recovering from AN.…”

Section: Discussionmentioning

confidence: 99%

Structural brain differences in recovering and weight-recovered adult outpatient women with anorexia nervosa

et al. 2021

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Background Anorexia nervosa is a complex psychiatric illness that includes severe low body weight with cognitive distortions and altered eating behaviors. Brain structures, including cortical thicknesses in many regions, are reduced in underweight patients who are acutely ill with anorexia nervosa. However, few studies have examined adult outpatients in the process of recovering from anorexia nervosa. Evaluating neurobiological problems at different physiological stages of anorexia nervosa may facilitate our understanding of the recovery process. Methods Magnetic resonance imaging (MRI) images from 37 partially weight-restored women with anorexia nervosa (pwAN), 32 women with a history of anorexia nervosa maintaining weight restoration (wrAN), and 41 healthy control women were analyzed using FreeSurfer. Group differences in brain structure, including cortical thickness, areas, and volumes, were compared using a series of factorial f-tests, including age as a covariate, and correcting for multiple comparisons with the False Discovery Rate method. Results The pwAN and wrAN cohorts differed from each other in body mass index, eating disorder symptoms, and social problem solving orientations, but not depression or self-esteem. Relative to the HC cohort, eight cortical thicknesses were thinner for the pwAN cohort; these regions were predominately right-sided and in the cingulate and frontal lobe. One of these regions, the right pars orbitalis, was also thinner for the wrAN cohort. One region, the right parahippocampal gyrus, was thicker in the pwAN cohort. One volume, the right cerebellar white matter, was reduced in the pwAN cohort. There were no differences in global white matter, gray matter, or subcortical volumes across the cohorts. Conclusions Many regional structural differences were observed in the pwAN cohort with minimal differences in the wrAN cohort. These data support a treatment focus on achieving and sustaining full weight restoration to mitigate possible neurobiological sequela of AN. In addition, the regions showing cortical thinning are similar to structural changes reported elsewhere for suicide attempts, anxiety disorders, and autistic spectrum disorder. Understanding how brain structure and function are related to clinical symptoms expressed during the course of recovering from AN is needed.

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Pilot data from the Self-Blame and Perspective-Taking Intervention for eating disorders

Cited by 9 publications

References 39 publications

Neural processes related to negative self‐concept in adult and adolescent anorexia nervosa

Neural processes related to negative self‐concept in adult and adolescent anorexia nervosa

Qualitative patient experiences from the Self-Blame and Perspective-Taking Intervention for eating disorders

Structural brain differences in recovering and weight-recovered adult outpatient women with anorexia nervosa

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