Assessing the effectiveness and feasibility of the Experienced Carers Helping Others program in relatives of adolescents with eating disorders using an online application format with individual sessions.

Eating disorders (ED) usually involve hospital admission and a high relapse rate, with the return home being a critical moment for patients and their families. After their return home, they often have trouble incorporating the guidelines they have learned into their daily context. ECHOMANTRA intervention program aims to facilitate this transition by offering psychological strategies that involve both patients and their families and carers. Specifically, the ECHO program is aimed at the relatives of these patients. The present study aimed to analyze the efficacy of adding the ECHO program to the usual treatment (TAU) of relatives through a novel format based on individual intervention and with an online format and to examine the acceptability and feasibility of this new format. The study design was multi-center, randomized, controlled, with a longitudinal design and comparing two parallel groups. A total of 108 family members participated. Results indicated that relatives from both groups, TAU and ECHO + TAU, showed improvements in expressed emotion, accommodation, impact of the ED, emotional well-being, and caregiver skills. However, effect sizes in the ECHO + TAU group were slightly larger than the TAU group. In addition, the changes were greater in depression and caregiver skills when the ECHO component was added. Most caregivers (81.48%) completed the ECHO and indicated a high level of satisfaction with the program. These results suggest the efficacy and the feasibility of adding the ECHO intervention program to the usual treatment in an individual online format.

Anger as comorbid factor for interpersonal problems and emotional dysregulation in patients with eating disorders.

UNLABELLED: This work was undertaken to analyze general levels of anger in patients with eating disorders (ED) compared to a normative group, diagnosis-dependent differences in expressing anger, and the relation between anger dimensions and specific items of the Eating Disorder Inventory, third revision (EDI-3) (emotional dysregulation, interpersonal deficit, low self-esteem, and asceticism) and body mass index (BMI). METHODS: The study participants were 58 women with a diagnosis of ED hospitalized at the Reina Sofia General University Hospital in Murcia. The women had a mean age of 25.68 (SD=7.00) years. The distribution of ED diagnoses was 27.58% anorexia nervosa with food restriction (AN-R), 15.51% anorexia nervosa with purging (AN-P), 41.37% bulimia nervosa (BN), and 15.51% eating disorder not otherwise specified (EDNOS). ED was evaluated using the EDI-3 and anger was assessed with the State-Trait Anxiety Inventory-2 (STAXI-2). RESULTS: The general anger levels of the patients with ED were higher than those of the normative group compared. Patients diagnosed of AN-R had significantly higher scores than patients diagnosed of BN on the internal control of anger scale. The emotional dysregulation, interpersonal deficit, low self-esteem, and asceticism scales correlated significantly with different anger dimensions. No significant relation was found between body mass index (BMI) and anger. CONCLUSIONS: These results show the importance of including anger management in any therapeutic approach to EDs.

Quality of Life and Clinical Impairment in Spanish Adolescent Anorexia Nervosa Patients.

Eating disorders have serious physical, mental and social consequences that can affect the quality of life of the sufferer. This study aimed to evaluate the relationship between the severity of ED-related psychopathology and clinical impairment in adolescents with anorexia nervosa (AN) as well as their perception of health-related quality of life. Eighty-six Spanish young women with AN completed a set of questionnaires assessing eating disorder pathology, clinical impairment, and quality of life. The set included the following instruments: the Eating Disorder Examination Questionnaire, Clinical Impairment Assessment, Short Form-12 Item Health Survey, and the Eating Disorder-Specific Heath-Related Quality of Life instrument. Descriptive and regression analyses were applied to identify associations between variables. Higher scores on clinical impairment domains were associated with greater impairment of mental and physical health. Moreover, clinical impairment domains and concerns due to ED were related to a lower quality of life. In conclusion, adolescents with AN have a poor quality of life. Moreover, the findings suggest that the clinical features of impairment may serve as severity indicators of quality of life.

Positive and Negative Emotional Eating Are Not the Same-The Spanish Version of the Positive-Negative Emotional Eating Scale (PNEES).

The literature points to the importance of distinguishing between positive and negative emotional eating in relation to overeating and binge eating. The aim of this study was to evaluate the Spanish version of the Positive-Negative Emotional Eating Scale (PNEES) in a Spanish community sample. The sample consisted of 628 participants. The mean age was 27.5 (SD = 12.7) and 70.1% of them were women. The participants completed the PNEES, and measures of anxiety and depression (HADS), and eating disorder-related scales (TFEQ-R18, BULIT-R, and EAT-26) that were selected to examine convergent validity. A confirmatory factor analysis was conducted, replicating the original two-factor solution, consisting of Negative Emotional Eating (PNEES-N) and Positive Emotional Eating (PNEES-P). The results showed an acceptable fit of the model (CFI = 0.986; TLI = 0.984, RMSEA = 0.055). Internal consistency ranged from ω = 0.92 to ω = 0.96 for both subscales and the total score. PNEES-P correlations with other variables were lower with respect to the PNEES-N, showing that they are different constructs. A mediation analysis was conducted, in which PNEES-P significantly predicted binge eating and PNEES-N was a partially mediator variable. The results showed that the adaptation process was successful.

Adaptation and Implementation of an Intervention Programme on Spanish Carers and Adolescent Patients With an Eating Disorder: Study Protocol of a Randomized Controlled Trial.

Introduction: One of the major problems with inpatient treatment of adolescent girls with an eating disorder (ED) is that the strategies learned during their hospital stay are not easily applied or maintained in their daily lives, and this has been related to high rates of relapse and readmission. The ECHOMANTRA programme was developed to optimize outcomes during and following inpatient or day-patient treatment. ECHOMANTRA is based on interventions for carers (Experienced Carers Helping Others, ECHO) and patients (Maudsley Model of Anorexia Nervosa Treatment for Adults, MANTRA) and is developed from the cognitive interpersonal model of anorexia (Schmidt and Treasure, 2006; Treasure and Schmidt, 2013). This study aims to describe the study protocol of a randomized controlled trial (RCT) for evaluating the efficacy of an adaptation of a novel intervention for patients and carers (ECHOMANTRA) to be implemented as an add-on to treatment-as-usual (TAU). Method: In a multi-center pilot RCT, 80 female adolescent patients with a DSM-5 diagnosis of an ED and their carers will be invited to participate in the study. They will then be randomized to receive either the ECHOMANTRA intervention as an add-on to TAU or TAU alone. A repeated measures design will be conducted across four time points. Primary outcomes will be patient psychological well-being and eating disorder symptoms, and secondary outcomes will include body mass index, obsessive-compulsive symptoms, perfectionism, motivation to change and psychosocial adjustment. For carers, outcome variables will include psychological well-being, expressed emotion, accommodation and enabling behaviors, burden, and care skills. Discussion: The results from this trial will establish the effectiveness of ECHOMANTRA and may reveal whether and to what extent this novel intervention can optimize outcomes during and following inpatient treatment. This study will also provide the adaptation of the ECHOMANTRA in the Spanish context for inpatient/day-care treatment.

Illness Perception in Adolescent Patients With Anorexia: Does It Play a Role in socio-Emotional and Academic Adjustment?

People's beliefs about their illness have been shown to affect their adjustment. The aim of this study was to describe illness perception in adolescent patients with anorexia nervosa (AN) and assess its relationship with socio-emotional and academic adjustment following Leventhal's Self-Regulation Model. Thirty-four female AN patients, with a mean age of 15.76 (SD = 2.00), completed the Revised Illness Perception Questionnaire (IPQ-R), the Psychosocial Adjustment to Illness Scale (PAIS) and the Hospital Anxiety and Depression Scale (HAD). Adolescent anorexia patients perceived that they had control over their illness and treatment would improve their condition. However, they also believed that it was highly distressing, going to last a long time and would have serious consequences. As for the causes of the disorder, they were attributed primarily to a specific eating disorder and psychological factors. The results showed that anorexia patients' illness perceptions were related to socio-emotional and academic adjustment. In this sense, identity with the illness was associated with a worse academic adjustment, while emotional representation was associated with a worse emotional and social adjustment. These findings highlight how important it is for patients' beliefs about their disease to be considered in the treatment of anorexia. In this respect, clinicians treating these patients should consider how certain beliefs affect their academic and socio-emotional adjustment. It would be interesting for patients to become aware of how these beliefs influence the strategies they use to cope with their disease as well as their adjustment to it.

Adaptation and validation of the Spanish version of the Social Comparison Scale in chronic illness patients.

This study examined the Social Comparison Scale in Spanish chronic illness context and analyzed its psychometric properties. The article presented the results of two studies. The first explored the test's dimensional structure in a sample of 202 patients in a range of several chronic illnesses. The second study examined the instrument's structure in a sample of 186 patients with specific chronic illness. The results replicated the original structure of the scale and proved to be valid for use with optimum reliability.

Using common sense model in eating disorders.

UNLABELLED: The aim of this study was to explore the relationships proposed in the Common Sense Model (CSM) in eating disorder (ED) patients. METHOD: 98 female (ED) patients completed measures of illness representation and psychosocial adjustment. RESULTS: The confirmatory structural equation analysis revealed that illness representation dimensions were predictors of psychosocial adjustment. The hypothesis that coping mediates the relationship between illness representation and adjustment could not be confirmed. CONCLUSIONS: It may be helpful to consider the relationships between illness representation and adjustment when carrying out therapeutic work with these patients.