Thompson-Brenner Heather, Singh Simar, Gardner Taylor, Brooks Gayle E, Smith Melanie T, Lowe Michael R, Boswell James F
The Renfrew Center, Coconut Creek, FL, United States.
Department of Psychology, Drexel University, Philadelphia, PA, United States.
Front Psychiatry. 2021 Mar 5;12:641601. doi: 10.3389/fpsyt.2021.641601. eCollection 2021.
The Renfrew Unified Treatment for Eating Disorders and Comorbidity (UT) is a transdiagnostic, emotion-focused treatment adapted for use in residential group treatment. This study examined the effect of UT implementation across five years of treatment delivery. Data were collected by questionnaire at admission, discharge (DC), and 6-month follow-up (6MFU). Patient outcomes were measured by the Eating Disorder Examination-Questionnaire, Center for Epidemiologic Studies-Depression Scale, Brief Experiential Avoidance Questionnaire (BEAQ), Anxiety Sensitivity Index, and Southampton Mindfulness Scale. Data were analyzed for = 345 patients treated with treatment-as-usual (TAU), and = 2,763 treated with the UT in subsequent years. Results from multilevel models demonstrated a significant interaction between implementation status (TAU vs. UT) and time, both linear and quadratic, for the depression, experiential avoidance, anxiety sensitivity, and mindfulness variables. Patients treated with the UT showed more improvement in these variables on average, as well as more rebound between DC and 6MFU. Results from multilevel models examining eating disorder outcome showed no significant difference between the TAU and UT for the full sample, but a significant three-way interaction indicated that the UT produced more improvement in the EDE-Q relative to the TAU particularly for patients who entered treatment with high levels of experiential avoidance (BEAQ score). This long-term study of a transdiagnostic, evidence-based treatment in residential care for eating disorders and comorbidity suggests implementation was associated with beneficial effects on depression and emotion function outcomes, as well as eating disorder severity for patients with high levels of baseline emotion regulation problems. These effects did not appear to diminish in the 5 years following initial implementation.
伦弗鲁饮食失调与共病综合治疗方案（UT）是一种经调整后适用于住院团体治疗的跨诊断、以情绪为中心的治疗方法。本研究考察了在五年治疗期间实施UT的效果。在入院、出院（DC）和6个月随访（6MFU）时通过问卷调查收集数据。患者的治疗效果通过饮食失调检查问卷、流行病学研究中心抑郁量表、简易经验性回避问卷（BEAQ）、焦虑敏感性指数和南安普敦正念量表进行测量。对345例接受常规治疗（TAU）的患者以及随后几年接受UT治疗的2763例患者的数据进行了分析。多层次模型的结果表明，在抑郁、经验性回避、焦虑敏感性和正念变量方面，实施状态（TAU与UT）与时间之间存在显著的线性和二次交互作用。接受UT治疗的患者在这些变量上平均改善更大，并且在DC和6MFU之间的反弹也更大。检查饮食失调结果的多层次模型结果显示，整个样本中TAU和UT之间没有显著差异，但显著的三向交互作用表明，相对于TAU，UT在EDE-Q方面产生了更大的改善，特别是对于那些以高水平经验性回避（BEAQ评分）进入治疗的患者。这项针对饮食失调与共病住院护理中跨诊断、循证治疗的长期研究表明，实施该治疗与对抑郁和情绪功能结果以及对基线情绪调节问题水平较高的患者的饮食失调严重程度产生有益影响相关。这些效果在最初实施后的5年中似乎并未减弱。
