Blackbird Initiative, Órama Research Institute, Flinders University, Adelaide, South Australia, Australia.
Int J Eat Disord. 2021 Oct;54(10):1887-1895. doi: 10.1002/eat.23594. Epub 2021 Aug 18.
Socio-economic-status (SES) has rarely been reported or investigated in eating disorders (EDs) research. This Research Forum considers, from various perspectives, how SES may impact on evaluating evidence-based treatments for EDs.
We first reviewed previous literature that informs how SES impacts prevalence of EDs, help-seeking, and treatment outcome. We then present findings from a case series effectiveness study of an early intervention program in low SES areas for EDs and discuss implications about the impact of SES on the effectiveness of evidence-based interventions. Finally, we examine barriers to conducting rigorous evaluations in this population and discuss directions for future treatment outcome research.
Evidence suggests a higher level of disordered eating but less help seeking in lower SES groups. In our case series, 96 participants started treatment and completed a mean of 13.85 sessions, 84 (87.5%) completed a mean of 6.40 sessional measures on ED cognitions and behaviors, but only 31% completed more extensive pre-treatment and post-treatment measures. The completer effect size decrease for the global Eating Disorder Examination-Questionnaire score was 2.05 (95% CI: 1.43, 2.68) commensurate with other effectiveness studies in mixed SES groups. The high rates of missing data related to more extensive assessment present a barrier to evaluating evidence-based treatments in this population.
Evidence from the present study revealed individuals from low SES can achieve similar treatment outcomes to other populations when receiving evidence-based ED treatment. Future studies should investigate a range of approaches to maximizing data collection, including use of shorter sessional measures.
社会经济地位（SES）在饮食失调（ED）研究中很少被报道或研究。本研究论坛从多个角度探讨了 SES 如何影响 ED 基于证据的治疗方法的评估。
我们首先回顾了先前的文献，这些文献说明了 SES 如何影响 ED 的患病率、寻求帮助和治疗结果。然后，我们展示了一项针对 ED 低 SES 地区早期干预计划的病例系列有效性研究的结果，并讨论了 SES 对基于证据的干预措施有效性的影响。最后，我们检查了在该人群中进行严格评估的障碍，并讨论了未来治疗结果研究的方向。
有证据表明，SES 较低的人群中存在更高水平的饮食紊乱，但寻求帮助的意愿较低。在我们的病例系列中，96 名参与者开始接受治疗并完成了平均 13.85 次治疗，84 名（87.5%）完成了平均 6.40 次关于 ED 认知和行为的治疗过程测量，但只有 31%完成了更广泛的治疗前和治疗后测量。全球饮食失调检查问卷评分的完成者效应大小减小了 2.05（95%置信区间：1.43，2.68），与混合 SES 组的其他有效性研究相当。与更广泛评估相关的大量缺失数据是评估该人群中基于证据的治疗方法的障碍。
本研究的证据表明，接受基于证据的 ED 治疗的 SES 较低的个体可以获得与其他人群相似的治疗结果。未来的研究应研究各种方法来最大程度地收集数据，包括使用更短的治疗过程测量。
