Penn State College of Medicine, Department of Pediatrics, Hershey, Pennsylvania, USA.
Penn State College of Medicine, Department of Psychiatry and Behavioral Health, Hershey, Pennsylvania, USA.
Int J Eat Disord. 2021 Apr;54(4):606-614. doi: 10.1002/eat.23468. Epub 2021 Feb 1.
Exposure therapy appears underutilized in the treatment of eating disorders (EDs), perhaps due to clinicians' concerns that patients will dislike exposure therapy. The present study aims to investigate the attitudes of child patients, adult patients, and parents of child patients with EDs toward exposure therapy relative to four other treatments for EDs.
A questionnaire was administered to patients and parents (N = 126) upon admission to a partial hospitalization program for EDs. Participants read vignettes describing five different treatments for EDs, and answered questions assessing attitudes about each treatment.
At admission, participants reported the most favorable attitudes toward cognitive therapy, and the least favorable attitudes toward psychiatric medication. Exposure therapy generally received similar scores as interpersonal and expressive art therapy, and was perceived as significantly more preferable and effective in the long-term than psychiatric medication. Relative to child and adult patients, parents reported greater preferences for all treatments except medication, and perceived all treatments as more credible except medication and art therapy. Preliminary findings from a subset of participants who also completed the questionnaire at discharge indicated that positive attitudes toward exposure therapy increased over the course of treatment.
Individuals with EDs and their parents may enter treatment with particularly favorable views toward cognitive therapy, and do not appear to have strong attitudes toward exposure therapy one way or the other. Clinicians' concerns that patients with EDs will dislike exposure therapy may be largely unfounded.
暴露疗法在治疗饮食失调症(ED)中的应用似乎不足,这可能是由于临床医生担心患者会不喜欢暴露疗法。本研究旨在调查 ED 患儿患者、成年患者及其父母对暴露疗法的态度,将其与 ED 的其他四种治疗方法进行相对比较。
在 ED 的部分住院治疗计划入院时,向患者和家长(N=126)发放了一份问卷。参与者阅读了描述 ED 五种不同治疗方法的小插图,并回答了有关每种治疗方法的态度问题。
入院时,参与者报告对认知疗法的态度最积极,对精神药物的态度最消极。暴露疗法通常与人际和表达性艺术疗法的评分相似,并且被认为在长期内比精神药物更可取和有效。与儿童和成年患者相比,父母对除药物治疗以外的所有治疗方法都有更高的偏好,并且认为除药物和艺术治疗以外的所有治疗方法都更可信。对在出院时也完成问卷的一部分参与者的初步研究结果表明,对暴露疗法的积极态度在治疗过程中有所增加。
ED 患者及其父母在进入治疗时可能对认知疗法有特别积极的看法,并且对暴露疗法的态度似乎没有明显的倾向。临床医生担心 ED 患者会不喜欢暴露疗法,这种担忧可能在很大程度上是没有根据的。