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回避/限制性食物摄入障碍认知行为疗法的疗效预测因素

Predictors of Outcome in Cognitive-Behavioral Therapy for Avoidant/Restrictive Food Intake Disorder.

作者信息

Palmer Lilian P, Kambanis P Evelyna, Stern Casey M, Rossman Setareh M, Mancuso Christopher J, Andrea Alexandrea M, Burton-Murray Helen, Becker Kendra R, Breithaupt Lauren, Freid Cathryn, Asanza Elisa, Lawson Elizabeth A, Eddy Kamryn T, Thomas Jennifer J

机构信息

Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts, USA.

Mass General Brigham Eating Disorders Research Collaborative, Boston, Massachusetts, USA.

出版信息

Int J Eat Disord. 2025 Mar;58(3):647-653. doi: 10.1002/eat.24345. Epub 2024 Dec 16.

Abstract

OBJECTIVE

Cognitive-behavioral therapy for avoidant/restrictive food intake disorder (ARFID; CBT-AR) shows promise in improving clinical outcomes in children/adolescents and adults. We aimed to identify predictors of outcomes in CBT-AR. We hypothesized that younger age, non-underweight status, and presence of the fear of aversive consequences profile of ARFID would predict greater likelihood of remission post-treatment, and that presence of the lack of interest in eating/food and sensory sensitivity profiles would predict greater likelihood of persistence post-treatment. We included sex as an exploratory predictor.

METHOD

Individuals (N = 94, ages 10-55 years) were offered 20-30 outpatient sessions of CBT-AR. We collected clinical and demographic data at pre-treatment, and remission status at post-treatment.

RESULTS

Consistent with our hypothesis, presence (versus absence) of the fear profile predicted an almost three-fold increased likelihood of remission. Presence of the sensory profile, lack of interest profile, age, weight status, and sex were not predictors of ARFID outcome.

DISCUSSION

The fear of aversive consequences profile of ARFID may be more amenable to treatment with CBT-AR. This is the first study to identify predictors of treatment outcome following CBT-AR. Randomized controlled trials are needed to confirm these findings and examine moderators.

摘要

目的

针对回避型/限制性食物摄入障碍(ARFID;认知行为疗法-ARFID)的认知行为疗法在改善儿童/青少年及成人的临床结局方面显示出前景。我们旨在确定认知行为疗法-ARFID治疗结局的预测因素。我们假设年龄较小、非体重过轻状态以及存在ARFID的厌恶后果恐惧特征将预测治疗后缓解的可能性更大,并且存在对进食/食物缺乏兴趣和感官敏感特征将预测治疗后持续存在的可能性更大。我们将性别作为一个探索性预测因素纳入。

方法

为个体(N = 94,年龄10 - 55岁)提供20 - 30次认知行为疗法-ARFID门诊治疗。我们在治疗前收集临床和人口统计学数据,在治疗后收集缓解状态数据。

结果

与我们的假设一致,恐惧特征的存在(与不存在相比)预测缓解的可能性增加近三倍。感官特征、缺乏兴趣特征、年龄、体重状态和性别不是ARFID治疗结局的预测因素。

讨论

ARFID的厌恶后果恐惧特征可能更适合采用认知行为疗法-ARFID进行治疗。这是第一项确定认知行为疗法-ARFID治疗结局预测因素的研究。需要进行随机对照试验来证实这些发现并检验调节因素

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