Anorexia nervosa: One non-biological treatment

Question 1

What did Fairburn do and why is CBT enhanced?

2

Answer 1

• Created CBT-E as individual therapy for all eating disorders
• Recent strats used in cog theory to change behaviour

Question 2

What does the broad type of CBT treat?

3

Answer 2

• Central pathology of AN (evaluate body shape/weight)
• Additional symptoms external to core pathology (perfectionism)
• Challenge disassociation

Question 3

What does the focused type of CBT not do and what is it?

2

Answer 3

• Doesn’t tackle external symptoms, focus only on central pathology (disassociation)
• Default treatment

Question 4

What is 1 intensity of CBT-E (BMI<17.5) and what are these clients assumed to be like?
2

Answer 4

• V underweight clients = 40 sessions over 40weeks

- Lack motivation to ^their weight

Question 5

What is 1 intensity of CBT-E (BMI>17.5)?

1

Answer 5

• 20 sessions over 20 weeks, standard protocol

Question 6

What does stage 1 of CBT-E involve (Murphy et al.)?

1

Answer 6

• Start well, client/therapist identifies key AN related cognitions + behaviours (irrational thoughts)

Question 7

What are the crucial elements introduced in stage 1 and the benefit of such elements (Murphy et al.)?
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Answer 7

• Weekly weighing = weight recorded on graph, can’t weigh at any other time (home)
• Regular eating = They devise eating plan, gives structure to eating habits + daily routine
• No eating outside plan

Question 8

What does stage 2 of CBT-E involve (Murphy et al.)?

3

Answer 8

• Review of progress (over 2 sessions)
• Identify barriers to change, plan stage 3
• May decide to switch to broad CBT-E if ext symptoms

Question 9

What does stage 3 of CBT-E involve (Murphy et al.)?

3

Answer 9

• Identify ways clients self-eval dependent on body weight/shape
• Dietary rules identified (avoid types of foods), therapist help client break them via behavioural exprmt
• Show breaking self imposed rules = no negative cons that they’re afraid of (weight gain)

Question 10

What does stage 4 of CBT-E involve (Murphy et al.)?

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Answer 10

• End well, prevent relapse
• Weekly weighing continues at home
• Client continues w strats (rule breaking/avoid body checks), encouraged to view relapse as inevitable but something they can overcome

Question 11

Evaluate CBT as treatment for AN

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Answer 11

Fairburn et al. allocated eating disorders ppt to CBT-E or interpersonal psychotherapy. 20 weeks later, 65.5% of CBT-E and 33.3% (IPT ppt) judged to be in remission. 60 week follow up = 69.4% (CBT) 49% (IPT)

Sodersten et al. compared CBT and normalisation of eating procedure (provided client w feedback at meal times to ^normal eating - eliminate bingeing). Remission % = 75%, relapse = 10% (5yrs), CBT remission = 45%, relapse = 30%. Cog element not necessary

CBT for AN = demanding therapy. Requires commitment, client attends sessions, complete regular HW. Also make difficult changes to behaviour/thought processes. Carter et al. found 45% dropout rate (CBT-E)