CHILD & ADOLESCENT
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Eating Disorder Research: Klarman Eating Disorder Center
Ambivalence About Recovery Among Patients in Residential Treatment for Eating Disorders
Sherrie S. Delinsky, Ph.D., Sarah St. Germain, B.S., William H. Fagley, M.Ed., Anne E. Becker, M.D., PhD., Sc.M., and Philip Levendusky, Ph.D.
Ambivalence and resistance to change are key challenges in the treatment of patients with eating disorders. The Decisional Balance Scale (DBS) is a relatively new measure to assess ambivalence that consists of three subscales: negative effects of illness (Burdens), positive effects of illness (Benefits), and ways the illness allows avoidance of emotions, responsibilities, and challenges of adult life (Functional Avoidance). The objectives of the study are: (1) to describe ambivalence among residential patients; (2) to examine the relation of ambivalence to treatment outcome and other patient factors; and (3) to describe change in ambivalence that occurs over the course of treatment. To date, 30 residential patients with AN (Binge Purge subtype and Restricting subtype), BN, and EDNOS were assessed at intake using the DBS, SCID, EDE-Q, BDI, and other measures, and re-assessed at 2 weeks, 4 weeks, and discharge. Patients’ mean age was 18.67 (SD = 1.86), mean % expected body weight was 91.04 (SD = 3.23), and mean age of onset was 14.90 (SD = 2.48). Residential patients displayed high levels of ambivalence, comparable to those reported in other clinical samples. There was a significant difference among diagnostic subtypes on DBS-Burdens (F (21) = 4.35, p = .018), with AN-BP reporting greater burden than AN-R. DBS subscales were not significantly correlated with current age, age of onset, or number of previous hospitalizations; however, DBS-Benefits was significantly correlated with BDI score (r = .64, p = .002). Additionally, DBS-Benefits (r = .47, p = .022) and DB-Functional Avoidance (r = .44, p = .033) were both significantly correlated with the EDE-Q Weight Concern subscale. Ambivalence about change appears to differ across diagnostic subtype and is related to depression and weight concern. Change in ambivalence and its relation to treatment outcome will be reported, as data collection with the final sample is underway.
McLean Hospital Research
| 02/01/2007 | First National Survey on Eating Disorders Finds Binge Eating More Common Than Other Eating Disorders |
| 03/06/2006 | Binge Eating Disorder May Have Genetic Ties, McLean Study Finds |