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促进健康饮食(PAS)的结果:让拉丁裔家庭参与饮食失调治疗。

Promoviendo una Alimentación Saludable (PAS) results: Engaging Latino families in eating disorder treatment.

机构信息

Department of Psychiatry, University of North Carolina, Chapel Hill, NC, United States of America.

Department of Psychiatry, University of North Carolina, Chapel Hill, NC, United States of America; Division of Paediatrics, The University of Western Australia, Perth, Australia; School of Psychology, Curtin University, Perth, Australia.

出版信息

Eat Behav. 2021 Aug;42:101534. doi: 10.1016/j.eatbeh.2021.101534. Epub 2021 Jun 25.

Abstract

Latinos/as are underrepresented in eating disorders clinical trials. This study compared results of a culturally adapted individual cognitive-behavioral treatment (CBT) for binge-spectrum eating disorders that included or excluded a family enhanced module (CBT + FE), in a proof-of-principle pilot study with a sample of Latina adults and one family member per patient. Twenty-five patients (M = 37 yrs) and 25 family members (M = 40 yrs) were randomized to CBT (n = 13) or CBT+ FE (n = 12). DSM-IV eating disorder diagnoses were: 48% (n = 12) bulimia nervosa, 28% (n = 7) binge-eating disorder, and 24% (n = 6) eating disorder not otherwise specified. Effect sizes favored CBT + FE on adherence and retention, and scores on treatment satisfaction and therapeutic alliance were high, indicating treatment acceptability. In spite of the hypothesis that family outcomes such as support, familism, cohesion, pride, family cultural conflict, burden, and marital satisfaction (in couples) would be superior in CBT + FE, the preliminary data were inconclusive and results were mixed. The hypothesis that eating disorder outcomes including global eating psychopathology, binge eating, and purging would improve in CBT + FE was not supported. There was some evidence that patients in CBT improved more particularly on binge eating, otherwise the groups had no differences. In conclusion, the results suggest that CBT + FE could enhance treatment adherence and retention, although this did not automatically translate to better family and symptom outcomes.

摘要

拉丁裔人群在饮食失调临床试验中代表性不足。本研究在一项概念验证性试点研究中,比较了包含或不包含家庭增强模块的文化适应性个体认知行为治疗(CBT)对暴食症谱系饮食失调的治疗效果,该研究纳入了一组拉丁裔成年患者及其每位患者的一名家庭成员。25 名患者(M=37 岁)和 25 名家庭成员(M=40 岁)被随机分为 CBT 组(n=13)或 CBT+FE 组(n=12)。DSM-IV 饮食障碍诊断为:48%(n=12)神经性贪食症,28%(n=7)暴食症,24%(n=6)未特定饮食障碍。治疗依从性和保留率方面,CBT+FE 的效果较好,治疗满意度和治疗联盟评分较高,表明治疗可接受性。尽管假设 CBT+FE 组在家庭方面的结果(如支持、家庭主义、凝聚力、自豪感、家庭文化冲突、负担和婚姻满意度(在夫妻中)会更好,但初步数据尚无定论,结果喜忧参半。CBT+FE 组在包括整体饮食病理学、暴食和催吐在内的饮食失调结果会改善的假设并未得到支持。有一些证据表明,CBT 组的患者在暴食方面的改善更为明显,否则两组没有差异。总之,结果表明,CBT+FE 可以增强治疗的依从性和保留率,尽管这并不一定自动转化为更好的家庭和症状结果。

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