Waller G
Department of Psychology, University of Southampton, Highfield, UK.
Int J Eat Disord. 1997 Jul;22(1):35-41. doi: 10.1002/(sici)1098-108x(199707)22:1<35::aid-eat4>3.0.co;2-3.
It was the aim of this study to explore the characteristics of bulimics who fail to complete therapy. Noncompleters were divided into those who failed to engage and those who dropped out, so that these groups could be directly compared.
Participants were 50 women (bulimia nervosa or anorexia nervosa of the bulimic subtype) recruited from a case series of referrals to an eating disorders clinic, who were offered individual cognitive-behavior therapy. The women (28 completers; 7 failure to engage; 15 drop-outs) were compared on standardized measures of eating, psychological, and family characteristics.
The noncompleting groups both had high levels of borderline psychopathology and more severe perceived bulimic characteristics than the completers. However, the "drop-out" and "failures to engage" had very different patterns of perceived family emotional involvement, with the failures to engage reporting relatively healthy functioning.
Our understanding of the eating disorders (and of the effectiveness of treatment) is skewed by the nature of the samples involved. The characteristics of noncompleters could be used at initial assessment to target clinical work towards lowering rates of drop-out and failure to engage.
本研究旨在探索未能完成治疗的贪食症患者的特征。未完成治疗者被分为未参与治疗者和中途退出者，以便对这两组进行直接比较。
研究对象为50名女性（神经性贪食症或贪食型神经性厌食症患者），她们来自一家饮食失调诊所的一系列转诊病例，均接受了个体认知行为疗法。对这些女性（28名完成治疗者；7名未参与治疗者；15名中途退出者）在饮食、心理和家庭特征的标准化测量方面进行了比较。
与完成治疗者相比，未完成治疗的两组患者边缘性精神病理学水平较高，且暴食特征更为严重。然而，“中途退出者”和“未参与治疗者”在感知到的家庭情感卷入模式上有很大差异，未参与治疗者报告家庭功能相对健康。
我们对饮食失调（以及治疗效果）的理解因所涉及样本的性质而存在偏差。未完成治疗者的特征可在初始评估时用于指导临床工作，以降低中途退出率和未参与治疗率。
