Hunt Bethany J, Smith Hagan Whitney, Pelfrey Sarah, Mericle Susan, Harper Jessica A, Palka Jayme M, McAdams Carrie
Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, USA 75390-9070.
J Behav Cogn Ther. 2021 Mar;31(1):57-66. doi: 10.1016/j.jbct.2020.11.002. Epub 2021 Mar 3.
Eating disorders (EDs) are characterized by altered eating behaviors and valuation of self-image, as well as difficulty establishing supportive social relationships. This pilot study evaluated feasibility, acceptability, and clinical responses to a novel and brief group-therapy intervention for EDs, the Self-Blame and Perspective-Taking Intervention (SBPI). The SBPI consisted of four sessions of experiential art therapy activities in conjunction with psychoeducation targeting interpersonal attributions and mentalization. Twenty-four outpatient, treatment-seeking women with EDs participated in the SBPI, with 87.5% completing the intervention and 94% rating their participation positively. ED symptoms, depression, anxiety, self-attribution bias, and self-esteem were assessed before (T1) and after participation (N = 20 at T2; N = 18 at T3). Separate repeated measures MANOVAs were performed to assess these clinical and self-concept variables. Relative to baseline, participants demonstrated significant improvements in two all self-concept measures: self-attribution bias, trait self-esteem and state self-esteem at T2. ED, depression, and anxiety symptoms were significantly decreased at both T2 (1-4 weeks post) and T3 (3-5 months post). The SBPI altered self-concept targets acutely and led to sustained clinical improvements. Future work is needed to evaluate how self-concept and social constructs are related to clinical symptom expression in EDs.
饮食失调(EDs)的特征是饮食行为和自我形象评估发生改变,以及难以建立支持性的社会关系。这项初步研究评估了一种针对饮食失调的新颖且简短的团体治疗干预措施——自责与换位思考干预(SBPI)的可行性、可接受性和临床反应。SBPI包括四节体验式艺术治疗活动,并结合针对人际归因和心理化的心理教育。24名寻求治疗的门诊饮食失调女性参与了SBPI,其中87.5%完成了干预,94%对她们的参与给予了积极评价。在参与前(T1)和参与后(T2时N = 20;T3时N = 18)评估了饮食失调症状、抑郁、焦虑、自我归因偏差和自尊。进行了单独的重复测量多变量方差分析以评估这些临床和自我概念变量。相对于基线,参与者在两项自我概念测量中均有显著改善:T2时的自我归因偏差、特质自尊和状态自尊。在T2(干预后1 - 4周)和T3(干预后3 - 5个月)时,饮食失调、抑郁和焦虑症状均显著减轻。SBPI能迅速改变自我概念目标并带来持续的临床改善。未来需要开展工作来评估自我概念和社会结构如何与饮食失调中的临床症状表现相关。