Translating laboratory research into practice: foundations, functions and future of cognitive remediation therapy for anorexia nervosa

Baldock, Emma; Tchanturia, Kate

doi:10.2217/14750708.4.3.285

Cited by 30 publications

(25 citation statements)

References 34 publications

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“…Patients with a low BMI do not seem to profit more from CRT than patients with a higher BMI [10,25,45]. The case studies in which the effectiveness of CRT has been investigated focused on patients with AN [9,19,20] because AN is often associated with a rigid, inflexible and perfectionistic thinking style [46,47]. However, the results of this study might suggest that CRT could also be beneficial for patients with bulimic behaviors (purging and binging) because poor set-shifting abilities could be a transdiagnostic feature in women with eating disorders [25].…”

Section: Discussionmentioning

confidence: 99%

The Effectiveness of Cognitive Remediation Therapy in Patients with a Severe or Enduring Eating Disorder: A Randomized Controlled Trial

Dingemans¹,

Danner

Donker³

et al. 2013

Psychother Psychosom

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Background: Individuals with eating disorders show deficits in neuropsychological functioning which might preexist and underlie the etiology of the eating disorders and influence relapse. Deficits in cognitive flexibility, i.e. set-shifting and central coherence, might perpetuate the symptoms. Cognitive remediation therapy (CRT) was developed to improve cognitive flexibility, thereby increasing the likelihood of improved outcome. The focus of CRT is on how patients think, rather than on what patients think. The present study investigated the effectiveness of CRT for patients with a severe or enduring eating disorder by means of a randomized controlled trial comparing intensive treatment as usual (TAU) to CRT plus TAU. Methods: Eighty-two patients were randomly assigned to CRT plus TAU (n = 41) or TAU alone (n = 41). Outcome measures were set-shifting, central coherence, eating disorder and general psychopathology, motivation, quality of life and self-esteem. Assessments were performed at baseline (n = 82) and after 6 weeks (T1; n = 75) and 6 months (T2; n = 67). Data were analyzed by means of linear mixed model analyses. Results: Patients who received CRT in addition to TAU improved significantly more with regard to eating disorder-related quality of life at the end of treatment (T1) and eating disorder psychopathology at follow-up (T2), compared to those who received TAU only. Moreover, moderator analyses revealed that patients with poor baseline set-shifting abilities benefited more from CRT than patients with no deficits in set-shifting abilities at baseline; the quality of life of the former group was higher than that of the latter at follow-up. Conclusions: CRT seems to be promising in enhancing the effectiveness of concurrent treatment.

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Section: Discussionmentioning

confidence: 99%

The Effectiveness of Cognitive Remediation Therapy in Patients with a Severe or Enduring Eating Disorder: A Randomized Controlled Trial

Dingemans¹,

Danner

Donker³

et al. 2013

Psychother Psychosom

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“…Three studies evaluating the combination of cognitive remediation therapy and emotional skills training (CREST) [49][50][51] were excluded from the review as the design of these studies did not allow for assessment of CRT specific contributions. Finally, three theoretical CRT papers lacking clinical data were omitted [28][29][30]. The search strategy used to identify and screen studies for review is presented in the PRISMA flow diagram (Figure 1).…”

Section: Excluded Studiesmentioning

confidence: 99%

“…Three papers have sought to describe the current evidence of CRT for AN, and its future directions [28][29][30]. The first of these was published seven years ago [28] (merely two years after the first CRT for AN paper) and lacks a current update of the field.…”

Section: Introductionmentioning

confidence: 99%

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A systematic review of cognitive remediation therapy for anorexia nervosa ¿ development, current state and implications for future research and clinical practice

Dahlgren

Rø

2014

J Eat Disord

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Objective: To systematically review studies of cognitive remediation therapy (CRT) for anorexia nervosa (AN), and to discuss findings with references to clinical practice and future research. Method:The literature was reviewed using the PubMed, Web of Science and PsycINFO search terms "cognitive remediation therapy" AND "anorexia nervosa". Papers published online between 2005 and 2013 were selected on the basis of three inclusion criteria: 1) studies of any design focusing on CRT for AN, 2) papers that were written in English or had an available published English translation, and 3) papers published in peer reviewed journals.Results: A total of 45 papers were identified of which 21 were recognized as being relevant for the review. Relevant papers were divided into three different categories 1) single case reports, 2) case series and 3) randomised controlled trials (RCTs). Single case studies and case series yielded strong evidence of feasibility and acceptability of CRT for AN despite great variety in sample compositions. Four RCTs demonstrate that CRT has the potential of enhancing the effectiveness of current treatments, reduce attrition, increase cognitive set-shifting abilities and quality of life, as well as reduce eating disorder psychopathology. Discussion: The number of CRT studies published is growing rapidly, in particular RCTs. Further research is needed to define the primary aim of delivering CRT to patients with eating disorders, and to establish how to best measure the effect of the intervention. Moreover, researchers and clinicians should focus on identifying and assessing specific versus non-specific CRT contributions, and explore long-term effects of the intervention. It is imperative that adolescent RCTs are conducted to evaluate how CRT may be effective as a treatment for this young patient group.

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“…Two case reports of patients who have received the intervention and one theoretical paper 17 have been recently published. 18,19 Following the intervention, both patients demonstrated some changes within their neuropsychological profile and both expressed a positive experience of participating in the intervention.…”

Section: Introductionmentioning

confidence: 99%

Service users' feedback on cognitive training in the treatment of anorexia nervosa: A qualitative study

Whitney

Easter

Tchanturia

2008

Intl J Eating Disorders

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Translating laboratory research into practice: foundations, functions and future of cognitive remediation therapy for anorexia nervosa

Cited by 30 publications

References 34 publications

The Effectiveness of Cognitive Remediation Therapy in Patients with a Severe or Enduring Eating Disorder: A Randomized Controlled Trial

The Effectiveness of Cognitive Remediation Therapy in Patients with a Severe or Enduring Eating Disorder: A Randomized Controlled Trial

A systematic review of cognitive remediation therapy for anorexia nervosa ¿ development, current state and implications for future research and clinical practice

Service users' feedback on cognitive training in the treatment of anorexia nervosa: A qualitative study

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