Initial self-blame predicts eating disorder remission after 9 years

Journal of Eating Disorders

Lars Brudin¹  Andreas Birgegård²  Elin Monell²  Emma Forsén Mantilla³  David Clinton⁴  Caroline Björck⁵  Suzanne Petersson⁶ 

[1] Department of Clinical Physiology, Region Kalmar County, Kalmar, Sweden;Department of Medical and Health Sciences, Linköping University, Linköping, Sweden;Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden;Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden;Centre for Psychiatry Research, Stockholm Health Care Services, Karolinska Institutet, Stockholm, Sweden;Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden;Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden;Institute for Eating Disorders, Villa Sult, Oslo, Norway;Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden;Department of Rehabilitation, Kalmar Regional Council, Hus 13, plan 7, 391 85, Länssjukhuset, Kalmar, Sweden;Department for Medicine and Optometry, Linnaeus University, Kalmar, Sweden;

关键词: Eating disorders;    Outcome;    Prediction;    Self-image;   

DOI  :  10.1186/s40337-021-00435-3

来源: Springer

【 摘 要 】

BackgroundResearch into predictors of outcome in eating disorders (ED) has shown conflicting results, with few studies of long-term predictors and the possible importance of psychological variables that may act as risk- and maintenance factors.AimTo identify baseline predictors of ED remission nine years after initial clinical assessment using self-report measures of ED psychopathology, psychiatric symptoms, and self-image in a sample of adult ED patients (N = 104) treated at specialist units in Stockholm, Sweden. Sixty patients participated in the follow-up, of whom 41 patients (68%) had achieved remission.ResultsResults suggested that the only significant predictor of diagnostic remission after nine years was initial levels of self-blame.ConclusionIn order to ensure long-term recovery in ED it may be important for clinicians to widen their therapeutic repertoire and utilise techniques that reduce self-blame and increase self-compassion.Plain English summaryIt is difficult to predict how an eating disorder will develop, and research has found varying factors that affect the outcome of the condition. Recovery rates vary from nearly nil to over 90%. This variation could be explained by different research factors, but are more likely due to varying definitions of ‘recovery’, with less stringent definitions yielding high recovery rates and more stringent definitions yielding lower rates. The present study investigated whether the severity of eating disorder symptoms and other psychiatric symptoms could predict recovery nine years from first admission to specialised eating disorder care. Sixty patients at three eating disorder treatment units participated, and their scores on self-report measures of symptoms were used as predictor variables. Forty-one participants had no eating disorder diagnosis at nine-year follow-up. Most participants with binge-eating disorder had recovered, while the poorest outcome was found for anorexia nervosa with slightly over half of patients recovered after nine years. The only predictor for the nine-year outcome was a higher initial rating of self-blame, measured with the Structural Analysis of the Social Behavior. It was concluded that it may be important for clinicians to detect and address self-blame early in the treatment of eating disorders in order to enhance the possibility of recovery. Treatment should focus on reducing self-blame and increasing self-acceptance.

【 授权许可】

CC BY