Baucom Donald H, Kirby Jennifer S, Fischer Melanie S, Baucom Brian R, Hamer Robert, Bulik Cynthia M
Department of Psychology, University of North Carolina at Chapel Hill.
Department of Psychiatry, University of North Carolina at Chapel Hill.
J Fam Psychol. 2017 Aug;31(5):584-591. doi: 10.1037/fam0000273. Epub 2017 Mar 20.
Adult anorexia nervosa (AN) often is persistent, significantly erodes quality of life for both the patient and loved ones, and carries high medical and psychiatric comorbidity. Whereas individual psychotherapy for adult AN leads to improvement in some patients, recent findings indicate that the magnitude of improvement is limited: Only a small percentage of individuals fully recover and dropout rates are high. Thus, it is important to build upon current interventions to improve treatment response. We present results from an open trial of a couple-based intervention for adult anorexia nervosa as an adjunct treatment to standard multidisciplinary care. Twenty couples received treatment over approximately 26 weeks, including a couple-based intervention, individual CBT sessions, psychiatry visits for medication management, and nutritional counseling sessions. The results indicate that patients improved at posttest and 3-month follow-up on a variety of AN-related measures, anxiety and depression, and relationship adjustment. Partners also improved on anxiety, depression, and relationship adjustment. In an exploratory analysis, the multicomponent couple treatment intervention was benchmarked to well-conducted randomized controlled trials of individual therapy for AN; the couple intervention seems to compare favorably on AN-related measures and was associated with a lower dropout rate. In spite of methodological limitations, the findings suggest that including partners in the treatment of adult AN holds potential for bolstering treatment outcomes. (PsycINFO Database Record
成人神经性厌食症(AN)通常具有持续性,会严重损害患者及其亲人的生活质量,并伴有较高的医学和精神共病率。虽然针对成人AN的个体心理治疗能使部分患者病情有所改善,但最近的研究结果表明,改善程度有限:只有一小部分人能完全康复,且脱落率很高。因此,在现有干预措施的基础上提高治疗反应很重要。我们展示了一项针对成人神经性厌食症的夫妻干预开放试验的结果,该干预作为标准多学科护理的辅助治疗。二十对夫妻接受了约26周的治疗,包括夫妻干预、个体认知行为疗法(CBT)疗程、精神科药物管理问诊以及营养咨询疗程。结果表明,患者在治疗后及3个月随访时,在各种与AN相关的指标、焦虑和抑郁以及关系调适方面均有改善。伴侣在焦虑、抑郁和关系调适方面也有改善。在一项探索性分析中,将多成分夫妻治疗干预与精心开展的AN个体治疗随机对照试验进行了对比;夫妻干预在与AN相关的指标上似乎表现更佳,且脱落率较低。尽管存在方法学上的局限性,但研究结果表明,让伴侣参与成人AN的治疗可能有助于提高治疗效果。(《心理学文摘数据库记录》