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使用个性化模型对饮食失调进行个性化治疗:一项开放性系列试验。

Personalizing eating disorder treatment using idiographic models: An open series trial.

作者信息

Levinson Cheri A, Williams Brenna M, Christian Caroline, Hunt Rowan A, Keshishian Ani C, Brosof Leigh C, Vanzhula Irina A, Davis Gabrielle G, Brown Mackenzie L, Bridges-Curry Zoe, Sandoval-Araujo Luis E, Ralph-Nearman Christina

机构信息

University of Louisville, Department of Psychological and Brain Sciences.

出版信息

J Consult Clin Psychol. 2023 Jan;91(1):14-28. doi: 10.1037/ccp0000785.

Abstract

OBJECTIVE

Treatments for adults with eating disorders (EDs) only work in about 50% of individuals, and for some diagnoses (e.g., anorexia nervosa; atypical anorexia nervosa), there are no existing evidence-based treatments. Part of the reason that treatments may only work in a subset of individuals is because of the high heterogeneity present in the EDs, even within diagnoses. Manualized treatments delivered in a standard format may not always address the most relevant symptoms for a specific individual.

METHOD

The current open series trial recruited participants with transdiagnostic ED diagnoses (N = 79) to investigate the feasibility, acceptability, and initial clinical efficacy of a 10-session network-informed personalized treatment for eating disorders. This treatment uses idiographic (i.e., one-person) network models of ecological momentary assessment symptom data to match participants to evidence-based modules of treatment.

RESULTS

We found that network-informed personalized treatment was highly feasible with low dropout rates, was rated as highly acceptable, and had strong initial clinical efficacy. ED severity decreased from pre- to posttreatment and at 1-year follow-up with a large effect size. ED cognitions, behaviors, clinical impairment, worry, and depression also decreased from pre- to posttreatment.

CONCLUSIONS

These data suggest that network-informed personalized treatment has high acceptability and feasibility and can decrease ED and related pathology, possibly serving as a feasible alternative to existing treatments. Future randomized controlled trials comparing network-informed personalized treatment for ED to existing gold standard treatments are needed. Additionally, more research is needed on this type of personalized treatment both in the EDs, as well as in additional forms of psychopathology, such as depression. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

摘要

目的

针对患有饮食失调症(EDs)的成年人的治疗方法仅对约50%的个体有效,并且对于某些诊断(例如神经性厌食症;非典型神经性厌食症),目前尚无基于证据的治疗方法。治疗可能仅对一部分个体有效的部分原因是饮食失调症存在高度异质性,即使在同一诊断内也是如此。以标准形式提供的手册化治疗可能并不总是能解决特定个体最相关的症状。

方法

当前的开放系列试验招募了患有跨诊断饮食失调症的参与者(N = 79),以研究一种为期10节的基于网络信息的饮食失调个性化治疗的可行性、可接受性和初步临床疗效。这种治疗使用生态瞬时评估症状数据的个性化(即针对个体)网络模型,将参与者与基于证据的治疗模块相匹配。

结果

我们发现基于网络信息的个性化治疗具有很高的可行性,脱落率低,被评为高度可接受,并且具有很强的初步临床疗效。饮食失调严重程度从治疗前到治疗后以及在1年随访时均有所下降,效应量较大。饮食失调认知、行为、临床损害、担忧和抑郁从治疗前到治疗后也有所下降。

结论

这些数据表明,基于网络信息的个性化治疗具有很高的可接受性和可行性,并且可以减轻饮食失调及相关病理状况,可能成为现有治疗方法的可行替代方案。未来需要进行随机对照试验,将基于网络信息的饮食失调个性化治疗与现有的金标准治疗方法进行比较。此外,对于这种类型的个性化治疗,在饮食失调症以及其他形式的精神病理学(如抑郁症)方面都需要进行更多研究。(PsycInfo数据库记录(c)2023美国心理学会,保留所有权利)

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