进食障碍随机临床试验和脱落率：脱落者的特征和决定因素。
An eating disorder randomized clinical trial and attrition: profiles and determinants of dropout.
机构信息
School of Nursing and Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA.
出版信息
Int J Eat Disord. 2011 May;44(4):356-68. doi: 10.1002/eat.20800.
Abstract
OBJECTIVE
This study sought to determine whether differential treatment effects in the targeted mechanisms of change and eating disorder (ED) symptoms are associated with patterns of attrition from a RCT.
METHOD
The main study was a RCT of a psychotherapy designed to alter the non-weight related self-cognitions as the means to promote recovery and health in a sample of 69 women with AN or BN. Four groups based on point of dropout were compared on demographic, self-cognitions and ED symptoms using logit and piecewise mixed effects modeling.
RESULTS
Attrition was highest during treatment phase but no significant predictors were found. During the measurement phase, the direction and amount of change in self-cognition interrelatedness and body dissatisfaction differed according to point of dropout and treatment group.
DISCUSSION
Attention to changes both in symptoms and mediating factors that occur during treatment and follow-up may help to identify those who are at risk for dropout and to develop strategies to promote RCT participant retention.
摘要
目的
本研究旨在确定针对目标机制改变和饮食失调（ED）症状的差异治疗效果是否与 RCT 中退出的模式相关。
方法
主要研究是一项针对心理治疗的 RCT，旨在改变非体重相关的自我认知，作为促进 AN 或 BN 女性样本康复和健康的手段。根据退出点，使用对数和分段混合效应模型，将四个基于组别的点比较人口统计学、自我认知和 ED 症状。
结果
在治疗阶段，退出率最高，但未发现显著预测因素。在测量阶段，自我认知相关性和身体不满的变化方向和数量根据退出点和治疗组而有所不同。
讨论
关注治疗和随访期间症状和中介因素的变化，可能有助于识别那些有退出风险的人，并制定策略来促进 RCT 参与者的保留。
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本文引用的文献
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2
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Am J Psychiatry. 2009 Mar;166(3):311-9. doi: 10.1176/appi.ajp.2008.08040608. Epub 2008 Dec 15.
3
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The identity impairment model: a longitudinal study of self-schemas as predictors of disordered eating behaviors.身份认同损害模型：一项关于自我图式作为饮食失调行为预测指标的纵向研究。
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