Timko C Alix, Zucker Nancy L, Herbert James D, Rodriguez Daniel, Merwin Rhonda M
Department of Behavioral and Social Sciences, University of the Sciences, 600 S. 43rd St, Philadelphia, PA 19063, USA; Department of Psychology, Towson University, 8000 York Rd., Towson, MD 21252, USA.
Department of Psychology and Neuroscience, Duke University, Durham, NC 27710, USA; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.
Behav Res Ther. 2015 Jun;69:63-74. doi: 10.1016/j.brat.2015.03.011. Epub 2015 Mar 28.
Family based-treatments have the most empirical support in the treatment of adolescent anorexia nervosa; yet, a significant percentage of adolescents and their families do not respond to manualized family based treatment (FBT). The aim of this open trial was to conduct a preliminary evaluation of an innovative family-based approach to the treatment of anorexia: Acceptance-based Separated Family Treatment (ASFT). Treatment was grounded in Acceptance and Commitment Therapy (ACT), delivered in a separated format, and included an ACT-informed skills program. Adolescents (ages 12-18) with anorexia or sub-threshold anorexia and their families received 20 treatment sessions over 24 weeks. Outcome indices included eating disorder symptomatology reported by the parent and adolescent, percentage of expected body weight achieved, and changes in psychological acceptance/avoidance. Half of the adolescents (48.0%) met criteria for full remission at the end of treatment, 29.8% met criteria for partial remission, and 21.3% did not improve. Overall, adolescents had a significant reduction in eating disorder symptoms and reached expected body weight. Treatment resulted in changes in psychological acceptance in the expected direction for both parents and adolescents. This open trial provides preliminary evidence for the feasibility, acceptability, and efficacy of ASFT for adolescents with anorexia. Directions for future research are discussed.
基于家庭的治疗方法在青少年神经性厌食症的治疗中得到了最多的实证支持；然而，相当一部分青少年及其家庭对手册化的基于家庭的治疗（FBT）没有反应。这项开放性试验的目的是对一种创新的基于家庭的厌食症治疗方法：基于接纳的分离式家庭治疗（ASFT）进行初步评估。治疗以接纳与承诺疗法（ACT）为基础，以分离的形式进行，并包括一个基于ACT的技能项目。患有厌食症或亚阈值厌食症的青少年（12 - 18岁）及其家庭在24周内接受了20次治疗。结果指标包括家长和青少年报告的饮食失调症状、达到预期体重的百分比以及心理接纳/回避的变化。一半的青少年（48.0%）在治疗结束时达到完全缓解标准，29.8%达到部分缓解标准，21.3%没有改善。总体而言，青少年的饮食失调症状显著减轻，并达到了预期体重。治疗使家长和青少年的心理接纳朝着预期方向发生了变化。这项开放性试验为ASFT治疗青少年厌食症的可行性、可接受性和有效性提供了初步证据。讨论了未来研究的方向。
