Stages of change, treatment outcome and therapeutic alliance in adult inpatients with chronic anorexia nervosa

BMC Psychiatry

Katrin Elisabeth Giel¹  Stephan Zipfel¹  Katharina Keifenheim¹  Martin Teufel¹  Johannes Mander¹ 

[1] Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Osianderstr. 5, 72076 Tübingen, Germany

关键词: Transtheoretical model;    Stages of change;    Therapy;    Motivation;    Inpatient;    Eating disorder;    Chronic;    Anorexia nervosa;    Alliance;   

Others  :  1124083
DOI  :  10.1186/1471-244X-13-111

 received in 2012-12-12, accepted in 2013-03-27,  发布年份 2013

【 摘 要 】

Background

Anorexia nervosa (AN) is associated with high rates of chronicity and relapse risk is a considerable therapeutic challenge in the disorder. The aim of the present study was to investigate the association of stages of change and outcome with a focus on the relapse struggle in the maintenance stage in patients with predominantly chronic AN. Further, therapeutic alliance and stages of change associations were explored.

Methods

As an instrument measuring relapse struggle in the maintenance stage, we applied the short form of the University of Rhode Island Change Assessment-Short (URICA-S). We assessed stages of change in 39 patients with a predominantly chronic course of AN in early, middle, and late stages of inpatient psychotherapy. General symptom severity as assessed by the SCL-90-R and weight change were investigated as outcome measures.

Results

In-line with earlier evidence, contemplation significantly predicted therapeutic alliance. Further, we demonstrated that relapse risk as operationalized by URICA-S maintenance is an important predictor of general psychopathology. BMI change was not predicted by stages of change.

Conclusions

The URICA-S maintenance scale might be applied to help identify patients at relapse risk. High URICA-S maintenance scores could be considered as one critical aspect of AN patients who might especially benefit from relapse-preventing aftercare programs.

【 授权许可】

   
2013 Mander et al.; licensee BioMed Central Ltd.

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