Hofstra University.
Eating Disorders Center for Treatment and Research, University of California, San Diego.
Behav Ther. 2021 May;52(3):698-708. doi: 10.1016/j.beth.2020.09.002. Epub 2020 Sep 14.
There is a critical need to identify processes that may influence outcome in existing treatments for eating disorders (EDs). Intolerance of uncertainty (IU), which refers to excessive distress regarding uncertain situations, is a well-established feature of anxiety disorders. Emerging work suggests that IU decreases over the course of cognitive-behavioral treatments and may relate to better treatment outcomes. As some literature has suggested IU may functionally maintain ED symptoms, testing whether changes in IU over treatment relate to outcome may result in the identification of novel treatment targets. This study aimed to build upon past work documenting links between IU and ED symptoms by exploring changes in IU over treatment and links between early change in IU (1-month) and discharge symptoms. Participants (N = 274) receiving partial hospitalization treatment completed the Eating Pathology Symptoms Inventory and Intolerance of Uncertainty Scale at admission, 1-month post-admission, and discharge. Results suggested that IU significantly reduced from admission to discharge and that reductions in IU scores from admission to 1-month related to cognitive restraint, dietary restriction, and body image at discharge. However, this pattern did not hold for exercise, binge eating, or purging. Altogether, these results replicate past work supporting IU as a common feature across ED diagnoses and provide initial data suggesting that targeting IU early in treatment may enhance treatment outcomes.
目前迫切需要确定可能影响现有进食障碍(ED)治疗效果的因素。无法容忍不确定性(IU)是焦虑障碍的一个既定特征,它是指对不确定情况的过度痛苦。新的研究表明,IU 在认知行为治疗过程中会逐渐降低,并且可能与更好的治疗效果相关。鉴于一些文献表明 IU 可能会对 ED 症状起到维持作用,因此,检测 IU 在治疗过程中的变化是否与治疗结果相关,可能会发现新的治疗靶点。本研究旨在在前人研究的基础上进一步探索 IU 与 ED 症状之间的关系,通过研究 IU 在治疗过程中的变化,以及 IU 在治疗早期(1 个月)的变化与出院症状之间的关系,来检验 IU 变化与治疗结果的相关性。共有 274 名接受部分住院治疗的患者在入院时、入院后 1 个月和出院时完成了进食障碍症状清单和无法容忍不确定性量表的评估。结果表明,IU 从入院到出院显著降低,IU 评分从入院到 1 个月的降低与出院时的认知约束、饮食限制和身体意象有关。然而,这种模式并不适用于运动、暴食或催吐。总的来说,这些结果复制了之前的研究结果,支持 IU 是 ED 各种诊断共有的特征,并提供了初步数据,表明在治疗早期针对 IU 进行治疗可能会增强治疗效果。