Keel Pamela K, Haedt Alissa
Department of Psychology, University of Iowa, Iowa, City, IA 52242, USA.
J Clin Child Adolesc Psychol. 2008 Jan;37(1):39-61. doi: 10.1080/15374410701817832.
Eating disorders represent a significant source of psychological impairment among adolescents. However, most controlled treatment studies have focused on adult populations. This review provides a synthesis of existing data concerning the efficacy of various psychosocial interventions for eating disorders in adolescent samples. Modes of therapy examined in adolescent samples include family therapy, cognitive therapy, behavioral therapy, and cognitive behavioral therapy mostly in patients with anorexia nervosa. At this time, the evidence base is strongest for the Maudsley model of family therapy for anorexia nervosa. Evidence of efficacy for other treatments and other conditions is limited by several methodological factors including the small number of studies, failure to use appropriate control conditions or randomization procedures, and small sample sizes (i.e., fewer than 10 participants per treatment arm). Potential moderators and mediators of treatment effect are reviewed. Finally, results from adolescent studies are contrasted with those from adult studies of eating disorders treatment. Many studies of adult populations comprise late adolescent/young adult participants, suggesting that findings regarding the efficacy of cognitive behavioral therapy for bulimia nervosa in adults likely extend to older adolescent populations.
饮食失调是青少年心理障碍的一个重要来源。然而，大多数对照治疗研究都集中在成年人群体上。本综述综合了有关各种心理社会干预措施对青少年样本饮食失调疗效的现有数据。在青少年样本中研究的治疗模式包括家庭治疗、认知治疗、行为治疗以及主要针对神经性厌食症患者的认知行为治疗。目前，关于莫兹利家庭治疗模式对神经性厌食症疗效的证据最为充分。其他治疗方法和其他病症疗效的证据受到几个方法学因素的限制，包括研究数量少、未使用适当的对照条件或随机程序以及样本量小（即每个治疗组参与者少于10人）。文中还综述了治疗效果的潜在调节因素和中介因素。最后，将青少年研究的结果与饮食失调治疗的成人研究结果进行了对比。许多针对成年人群体的研究纳入了青少年晚期/青年成人参与者，这表明认知行为疗法对成人神经性贪食症疗效的研究结果可能也适用于年龄较大的青少年群体。
