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虚拟交付的针对回避性限制性食物摄入障碍的认知行为疗法(CBT-AR):一名具有高自闭症特征成年人的案例研究

Virtually delivered cognitive behavioural therapy for avoidant restrictive food intake disorder (CBT-AR): a case study in an adult with elevated autistic traits.

作者信息

Price Tom, Apostolopoulou Theoni, Jones Kezia

机构信息

HelloSelf, Cheapside, London, UK.

Eating Disorders Outpatient Service, South London and Maudsley NHS Foundation Trust, London, UK.

出版信息

Eat Disord. 2025 Mar-Apr;33(2):177-197. doi: 10.1080/10640266.2024.2346372. Epub 2024 May 2.

Abstract

Cognitive Behavioural Therapy for Avoidant and Restrictive Food Intake Disorder (CBT-AR; ARIFD) is a psychological treatment that targets many of the core symptoms of ARFID. Although a growing literature supports the efficacy of behavioural interventions for paediatric feeding and eating disorders, including ARFID, the applicability of these methods to adults remains undetermined. Telehealth delivery of CBT-AR in adults with autism has yet to be tested. With this study, we conduct a preliminary evaluation of CBT-AR delivered virtually to a 26-year-old white British female, with mixed ARFID and elevated autistic traits. She attended 23 remote CBT-AR sessions facilitated through a dedicated telehealth platform. Adjustments were made to accommodate her lived experience of neurodiversity. Using a pre-post treatment design, changes on measures of subjective goal attainment, eating-related and general psychosocial impairment, general anxiety, and depression were evaluated. Following treatment, the participant had made significant progress towards personally meaningful goals, with improvements observed in nutritional intake, general well-being, and reductions in eating-related psychosocial impairment and general anxiety. The results offer preliminary insights into acceptability and efficacy of virtual CBT-AR for neurodiverse individuals.

摘要

针对回避性和限制性食物摄入障碍的认知行为疗法(CBT-AR;ARIFD)是一种针对ARFID许多核心症状的心理治疗方法。尽管越来越多的文献支持行为干预对包括ARFID在内的儿童喂养和进食障碍的疗效,但这些方法对成年人的适用性仍未确定。针对患有自闭症的成年人进行远程医疗形式的CBT-AR治疗尚未经过测试。在这项研究中,我们对以虚拟方式为一名26岁的英国白人女性提供的CBT-AR进行了初步评估,该女性同时患有混合性ARFID且具有较高的自闭症特征。她参加了通过一个专门的远程医疗平台进行的23次远程CBT-AR治疗课程。我们进行了调整以适应她的神经多样性生活体验。采用治疗前后设计,评估了主观目标达成、饮食相关和一般心理社会损害、一般焦虑和抑郁等指标的变化。治疗后,参与者在个人有意义的目标方面取得了显著进展,在营养摄入、总体幸福感方面有所改善,与饮食相关的心理社会损害和一般焦虑有所减轻。研究结果为虚拟CBT-AR对神经多样性个体的可接受性和疗效提供了初步见解。

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