Animal-assisted therapy in eating disorder treatment: A systematic review.

INTRODUCTION: Eating disorders (EDs) are deadly illnesses with high relapse rates, highlighting need for better interventions. Animal-assisted therapy (AAT) has been implemented supplementally for EDs, with horses utilized at many residential facilities. AAT shows promise with meta-analyses of randomized control trials (RCTs) showing significant decreases in depression, anxiety, and negative affect; however, no review to date has evaluated efficacy for EDs. Therefore, this study conducted a systematic review of primary literature to investigate the efficacy of AAT for EDs. METHOD: A systematic review was conducted via PubMed, PsycInfo, and Google Scholar, up to and including September 2021, yielding 10 studies. Therapy animals included horses (n = 8), dogs (n = 1), and dolphins (n = 1). Populations included AAT ED therapists and patients (ages 11 to adult). The PRISMA methodology was used (registration PROSPERO CRD42021256239). Risk of bias assessment used Cochrane method for quantitative studies, Critical Appraisal Skills Programme checklist for qualitative studies, and JBI Critical Appraisal Checklist for Case Reports. Given study type heterogeneity, neither synthesis nor certainty assessments were conducted. RESULTS: Case and qualitative studies reported improvement in cognitive flexibility, ability to relinquish control, and confidence. Quantitative studies demonstrated an inverse relationship between AAT utilization and ED symptoms post-treatment. Effect sizes, when reported, were mostly moderate. All but one study had low, or unclear, risk of bias. Limited randomization and a lack of RCTs measuring ED symptomology directly makes drawing conclusions difficult. CONCLUSION: While preliminary research indicates possible benefits of AAT as a complement to traditional ED treatment, more research is needed to establish efficacy. Future studies should employ randomized control trials and examine key mechanisms of change.

The empirical status of the third-wave behaviour therapies for the treatment of eating disorders: A systematic review.

Although third-wave behaviour therapies are being increasingly used for the treatment of eating disorders, their efficacy is largely unknown. This systematic review and meta-analysis aimed to examine the empirical status of these therapies. Twenty-seven studies met full inclusion criteria. Only 13 randomized controlled trials (RCT) were identified, most on binge eating disorder (BED). Pooled within- (pre-post change) and between-groups effect sizes were calculated for the meta-analysis. Large pre-post symptom improvements were observed for all third-wave treatments, including dialectical behaviour therapy (DBT), schema therapy (ST), acceptance and commitment therapy (ACT), mindfulness-based interventions (MBI), and compassion-focused therapy (CFT). Third-wave therapies were not superior to active comparisons generally, or to cognitive-behaviour therapy (CBT) in RCTs. Based on our qualitative synthesis, none of the third-wave therapies meet established criteria for an empirically supported treatment for particular eating disorder subgroups. Until further RCTs demonstrate the efficacy of third-wave therapies for particular eating disorder subgroups, the available data suggest that CBT should retain its status as the recommended treatment approach for bulimia nervosa (BN) and BED, and the front running treatment for anorexia nervosa (AN) in adults, with interpersonal psychotherapy (IPT) considered a strong empirically-supported alternative.

An exploration of salivation patterns in normal weight and obese children.

We examined whether children's changes in salivary habituation to food vary based on weight status and/or allocating attention to a task. Children (31 non-overweight and 26 obese, ages 9-12 year) were presented with nine trials of a food stimulus and either listened to an audiobook (attention-demanding) or white noise (no-attention control). The salivary pattern differed significantly by weight status but not by condition or a condition by weight status interaction. This is the first study of salivary habituation in obese children; findings dovetail with an emerging set of evidence that obese individuals display distinctive biological responses to food.

Spirituality among young women at risk for eating disorders.

OBJECTIVE: This study examined the spiritual and religious (S/R) beliefs and practices of college-age women at high-risk for eating disorders, and the relationship between body image distress, coping, and S/R. METHOD: Two hundred fifty-five college-age women with elevated weight and shape concerns, assessed using the Weight/Shape Concerns Scale and the Eating Disorder Examination (EDE), completed surveys about their S/R beliefs and practices. RESULTS: Women with strong S/R beliefs and practices cope with body dissatisfaction differently than women without strong S/R beliefs. Participants with strong S/R were significantly more likely to pray, meditate, or read religious/spiritual texts to cope with body image distress. Participants without strong beliefs and practices were more likely to cope utilizing distraction. Women with strong beliefs who prayed found it effective. DISCUSSION: Study participants were heterogenenous in their S/R beliefs and practices. These beliefs and practices may be underutilized resources for coping with body image concerns.