Pre-treatment patient characteristics as predictors of drop-out and treatment outcome in individual and family therapy for adolescents and adults with anorexia nervosa: A systematic review and meta-analysis

Gregertsen, Eva C.; Mandy, William; Kanakam, Natalie; Armstrong, Stephanie; Serpell, Lucy

doi:10.1016/j.psychres.2018.11.068

Cited by 39 publications

(45 citation statements)

References 67 publications

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“…Results hold in the trimmed and full samples. Second, our combined probability analysis showed that the association between pretreatment motivation and EOT anxiety/depression symptoms was not Indicates the 28 studies that have not been included in the previous meta-analyses by Wade (2015, 2016) or by Gregertsen et al (2019).…”

Section: Combined-probability Analysesmentioning

confidence: 76%

Pretreatment motivation and therapy outcomes in eating disorders: A systematic review and meta‐analysis

Sansfaçon

Booij

Gauvin

et al. 2020

Intl J Eating Disorders

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Objective: Identifying modifiable predictors of outcomes following treatment for eating disorders may help to tailor interventions to patients' individual needs, improve treatment efficacy, and develop new interventions. The goal of this meta-analysis was to quantify the association between pretreatment motivation and posttreatment changes in eating disorder symptomology. Method: We reviewed 196 longitudinal studies reporting on change on indices of overall eating-disorder symptomatology, weight gain, binge-eating, vomiting, anxiety/depression, and treatment adherence. Meta-analyses were performed using two complementary approaches: (a) combined probability analysis using the added Z's method; (b) effect size analyses. Using random-effect models, effect sizes were pooled when there were at least three studies with the same type of statistical design and reporting statistics on the same outcome. Heterogeneity in study outcome was evaluated using Q and I 2 statistics. Studies were reviewed qualitatively when the number of studies or reported data were insufficient to perform a meta-analysis. Results: Forty-two articles were included. Although samples and treatments differed substantially across studies, results across studies were remarkably consistent. Both combined-probability and effect-size analyses indicated positive effects of pretreatment motivation on improvement in general eating-disorder symptoms (Cohen's r = .17), and an absence of effects on anxiety/depression symptoms. Remaining outcome indices were subject to selective reporting and/or small sample size bias. Discussion: Our findings underscore the importance of incorporating treatment engagement approaches in the treatment of eating disorders. Optimal reporting of study findings and improving study quality would improve future efforts to obtain an in-depth understanding of the relationship between motivation and eating disorder symptoms.

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Section: Combined-probability Analysesmentioning

confidence: 76%

Pretreatment motivation and therapy outcomes in eating disorders: A systematic review and meta‐analysis

Sansfaçon

Booij

Gauvin

et al. 2020

Intl J Eating Disorders

View full text Add to dashboard Cite

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“…The aim of the current study was to provide a systematic review and meta‐analysis of the association between duration and treatment outcome for eating disorders. The meta‐analysis includes substantially more studies than previous meta‐analyses (Gregertsen et al, 2019; Vall & Wade, 2015), allowing us to perform sub‐group analyses with respect to diagnosis, nature (binary or continuous) and type of the outcome variable used (recovery, eating disorder psychopathology, weight gain), as well as two stand‐alone meta‐analyses. Across all the meta‐analyses conducted, there was no association between duration and treatment outcome.…”

Section: Discussionmentioning

confidence: 99%

“…The first authors searched four data bases: PsychInfo, Medline, ProQuest Dissertations & Theses Global, and PubMed using the following terms in the title or abstract: (anorexia OR Eating Disorder* OR disordered eat* OR binge eat OR bulimia) and (treatment OR therapy OR psychotherapy) and (response OR outcome) and (predictor OR predict). We searched from 2015 onwards in order to add studies already identified in the Vall and Wade (2015) meta‐analysis, using search terms based on that of Linardon et al (2017) and Gregertsen et al (2019). The secondary search strategy involved hand searching of all relevant articles identified in the primary electronic search.…”

Section: Methodsmentioning

confidence: 99%

“…This systematic review and meta‐analysis explore whether there is a direct contribution of duration to treatment outcome for both anorexia nervosa and bulimia nervosa, regardless of SEED status. We contribute new information to the field, building on recent meta‐analyses or reviews of predictors of treatment outcome (Gregertsen, Mandy, Kanakam, Armstrong, & Serpell, 2019; Linardon, de la Piedad Garcia, & Brennan, 2017; Vall & Wade, 2015). The first of these (Vall & Wade, 2015) reviewed publications related to both anorexia nervosa and bulimia nervosa and included seven studies relating to either duration or age of onset, thus confounding these two variables.…”

Section: Introductionmentioning

confidence: 99%

“…The second (Linardon et al, 2017) provided a systematic review but no meta‐analytic data related to bulimia nervosa. The third (Gregertsen et al, 2019) only reported two studies examining duration as a predictor of outcome in anorexia nervosa, showing a negligible effect, r = 0.15, 95% CI: −0.03, 0.26. We provide a narrative summary of those studies from which it was not possible to extract an effect size for a meta‐analysis ( n = 7), as well as a meta‐analysis of obtained effect sizes between duration and treatment outcome across 36 outcomes from 24 different studies.…”

Section: Introductionmentioning

confidence: 99%

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Relationship between eating disorder duration and treatment outcome: Systematic review and meta‐analysis

Radunz

Keegan

Osenk

et al. 2020

Intl J Eating Disorders

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Objective: This systematic review and meta-analysis examine the contribution of duration to treatment outcome for eating disorders. Method: Studies (n = 31) were identified that examined associations (r) between duration and 45 different outcomes. We were unable to extract r for seven studies (9 outcomes) and extracted r for 36 outcomes across 24 studies (2,349 participants). Indicators of treatment outcome were heterogeneous and thus a series of different meta-analyses, aimed at increasing homogeneity, were conducted. Results: First, we examined the average effect size for one primary eating disorder related outcome from each of the 24 studies. There was no association between duration and treatment outcome (r = .05, 95% CI: −.03:.13), with high heterogeneity. Second, we conducted three subgroup analyses to explore possible sources of heterogeneity (diagnosis: anorexia nervosa versus bulimia nervosa; nature of the outcome: binary versus continuous; or type of outcome: binary indicator of recovery, eating disorder psychopathology, weight gain). There was no significant moderation or associations between duration and outcome (ranging from .02-.08), with low to medium heterogeneity. Third, two stand-alone analyses examined outcomes related to weight gain (n = 8) and eating disorder psychopathology (n = 5), with nonsignificant rs of .23/−.06, respectively. High levels of heterogeneity were present. Discussion: Duration did not influence treatment outcome across any of our metaanalyses. Increasing homogeneity and power will allow more stable estimates of the impact of duration on outcome to be calculated; to this end, future treatment studies should include outcome related to weight gain (anorexia nervosa) and improvements in eating disorder psychopathology. Resumen Antecedentes: Esta revisión sistemática y metaanálisis examinan la contribución de la duración al resultado del tratamiento para los trastornos de la conducta alimentaria. Métodos: Se identificaron estudios (n = 31) que examinaron las asociaciones (r) entre la duración y 45 diferentes resultados. No fue posible extraer r para siete estudios (nueve resultados) y se extrajo r para 36 resultados en 24 estudios (2349 participantes). Los indicadores del resultado del tratamiento fueron heterogéneos y, por lo

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Is personality the key in cognitive‐behavioural therapy for eating disorders? A review

Fumagalli

Margola

2021

Clin Psychology and Psychoth

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The efficacy of individual cognitive-behavioural therapy (CBT) for eating disorders can be assessed by investigating the potential predictors, mediators and moderators of treatment. The present review focused on personality since its crucial role has been emphasized both by research and practice. Sixteen studies were collected, and data were extracted through a highly operationalized coding system. Overall, personality disorders were the most investigated construct; however, their influence was somewhat contradictory. A more cogent result occurred for borderline personality disorder (BPD) when considered as a moderator (not a predictor nor a mediator).Patients with a more disturbed borderline personality benefited to a greater extent from treatments including booster modules on affects, interpersonal relationships and mood intolerance, rather than symptoms exclusively. Nine additional personality dimensions, beyond BPD, were investigated sparsely, and results regarding them were barely indicative in this review. However, some of these dimensions (e.g., affective lability and stimulus-seeking behaviours) could be traced back to BPD, thereby strengthening evidence of the role of borderline disorder as a moderator.Although research on the relationship between personality and eating disorders needs to be increased and methodologically improved, personality, taken as a whole, emerged as a promising variable for enhancing the efficacy of CBT.

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Pre-treatment patient characteristics as predictors of drop-out and treatment outcome in individual and family therapy for adolescents and adults with anorexia nervosa: A systematic review and meta-analysis

Cited by 39 publications

References 67 publications

Pretreatment motivation and therapy outcomes in eating disorders: A systematic review and meta‐analysis

Pretreatment motivation and therapy outcomes in eating disorders: A systematic review and meta‐analysis

Relationship between eating disorder duration and treatment outcome: Systematic review and meta‐analysis

Is personality the key in cognitive‐behavioural therapy for eating disorders? A review

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