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Radically open-dialectical behavior therapy for adult anorexia nervosa: feasibility and outcomes from an inpatient program

Radically open-dialectical behavior therapy for adult anorexia nervosa: feasibility and outcomes from an inpatient program
Radically open-dialectical behavior therapy for adult anorexia nervosa: feasibility and outcomes from an inpatient program
Background
Anorexia Nervosa (AN) is a highly life-threatening disorder that is extremely difficult to treat. There is evidence that family-based therapies are effective for adolescent AN, but no treatment has been proven to be clearly effective for adult AN. The methodological challenges associated with studying the disorder have resulted in recommendations that new treatments undergo preliminary testing prior to being evaluated in a randomized clinical trial. The aim of this study was to provide preliminary evidence on the effectiveness of a treatment program based on a novel adaptation of Dialectical Behavior Therapy (DBT) for adult Anorexia Nervosa (Radically Open-DBT; RO-DBT) that conceptualizes AN as a disorder of overcontrol.

Methods
Forty-seven individuals diagnosed with Anorexia Nervosa-restrictive type (AN-R; mean admission body mass index = 14.43) received the adapted DBT inpatient program (mean length of treatment = 21.7 weeks).

Results
Seventy-two percent completed the treatment program demonstrating substantial increases in body mass index (BMI; mean change in BMI = 3.57) corresponding to a large effect size (d = 1.91). Thirty-five percent of treatment completers were in full remission, and an additional 55% were in partial remission resulting in an overall response rate of 90%. These same individuals demonstrated significant and large improvements in eating-disorder related psychopathology symptoms (d = 1.17), eating disorder-related quality of life (d = 1.03), and reductions in psychological distress (d = 1.34).

Conclusions
RO-DBT was associated with significant improvements in weight gain, reductions in eating disorder symptoms, decreases in eating-disorder related psychopathology and increases in eating disorder-related quality of life in a severely underweight sample. These findings provide preliminary support for RO-DBT in treating AN-R suggesting the importance of further evaluation examining long-term outcomes using randomized controlled trial methodology.
1471-244X
293
Lynch, Thomas R.
29e90123-0aef-46c8-b320-1617fb48bb20
Gray, Katie L.H.
b86092bd-a484-4e3f-a367-4c709e90ed77
Hempel, Roelie J.
2dfa9856-74dd-49b5-86e6-f78eace6727f
Titley, Marian
6d7c7091-7335-4cc7-802b-77fbedc30840
Chen, Eunice Y.
edeeb058-ef54-4624-ad05-2c93550fd204
O'Mahen, Heather A.
1738063f-7935-48a0-ad8e-0d8955b53b48
Lynch, Thomas R.
29e90123-0aef-46c8-b320-1617fb48bb20
Gray, Katie L.H.
b86092bd-a484-4e3f-a367-4c709e90ed77
Hempel, Roelie J.
2dfa9856-74dd-49b5-86e6-f78eace6727f
Titley, Marian
6d7c7091-7335-4cc7-802b-77fbedc30840
Chen, Eunice Y.
edeeb058-ef54-4624-ad05-2c93550fd204
O'Mahen, Heather A.
1738063f-7935-48a0-ad8e-0d8955b53b48

Lynch, Thomas R., Gray, Katie L.H., Hempel, Roelie J., Titley, Marian, Chen, Eunice Y. and O'Mahen, Heather A. (2013) Radically open-dialectical behavior therapy for adult anorexia nervosa: feasibility and outcomes from an inpatient program. BMC Psychiatry, 13, 293. (doi:10.1186/1471-244X-13-293).

Record type: Article

Abstract

Background
Anorexia Nervosa (AN) is a highly life-threatening disorder that is extremely difficult to treat. There is evidence that family-based therapies are effective for adolescent AN, but no treatment has been proven to be clearly effective for adult AN. The methodological challenges associated with studying the disorder have resulted in recommendations that new treatments undergo preliminary testing prior to being evaluated in a randomized clinical trial. The aim of this study was to provide preliminary evidence on the effectiveness of a treatment program based on a novel adaptation of Dialectical Behavior Therapy (DBT) for adult Anorexia Nervosa (Radically Open-DBT; RO-DBT) that conceptualizes AN as a disorder of overcontrol.

Methods
Forty-seven individuals diagnosed with Anorexia Nervosa-restrictive type (AN-R; mean admission body mass index = 14.43) received the adapted DBT inpatient program (mean length of treatment = 21.7 weeks).

Results
Seventy-two percent completed the treatment program demonstrating substantial increases in body mass index (BMI; mean change in BMI = 3.57) corresponding to a large effect size (d = 1.91). Thirty-five percent of treatment completers were in full remission, and an additional 55% were in partial remission resulting in an overall response rate of 90%. These same individuals demonstrated significant and large improvements in eating-disorder related psychopathology symptoms (d = 1.17), eating disorder-related quality of life (d = 1.03), and reductions in psychological distress (d = 1.34).

Conclusions
RO-DBT was associated with significant improvements in weight gain, reductions in eating disorder symptoms, decreases in eating-disorder related psychopathology and increases in eating disorder-related quality of life in a severely underweight sample. These findings provide preliminary support for RO-DBT in treating AN-R suggesting the importance of further evaluation examining long-term outcomes using randomized controlled trial methodology.

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Lynch et al RO-DBT for Anorexia 2013 BMC Psy.pdf - Other
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Published date: 7 November 2013
Organisations: Psychology

Identifiers

Local EPrints ID: 360382
URI: http://eprints.soton.ac.uk/id/eprint/360382
ISSN: 1471-244X
PURE UUID: 6366f140-eeae-4b6e-8c85-6b375966d7dc
ORCID for Thomas R. Lynch: ORCID iD orcid.org/0000-0003-1270-6097

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Date deposited: 05 Dec 2013 17:48
Last modified: 15 Mar 2024 03:32

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Contributors

Author: Thomas R. Lynch ORCID iD
Author: Katie L.H. Gray
Author: Roelie J. Hempel
Author: Marian Titley
Author: Eunice Y. Chen
Author: Heather A. O'Mahen

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