Better Safe Than Sorry. A Scoping Review of Monitoring for Negative Effects in Preregistrations of Psychological Interventions.

Although negative effects of psychological interventions are suspected to be common, they are rarely investigated. Experts and international guidelines agree that monitoring for negative effects in clinical studies is needed to make psychological interventions safer and to empower patients before they give their consent to participate. Therefore, monitoring should already be considered during planning and preregistration of a study. The aim of this scoping review was to find out how frequently studies on psychological interventions monitor their negative effects according to preregistrations and to investigate reasons why monitoring is not carried out. Preregistrations of psychological interventions on ClinicalTrials.gov were scrutinized for information on monitoring of negative effects and other study characteristics. In a survey, researchers of studies where no monitoring was reported were asked for reasons for not doing so. Overall, 2231 preregistrations of psychological interventions were found; of these, only 3.4% included explicit information on monitoring for negative effects. In the survey, more researchers reported having conducted monitoring, although the type of monitoring was often inadequate. The type of monitoring varied widely, and specific monitoring measurements were rarely used repeatedly. Monitoring for negative effects was more prevalent in studies investigating treatments versus low-threshold interventions, in studies conducted in Europe versus other continents and in more recent studies. Researchers reported lack of knowledge as the most frequent reason for not monitoring negative effects. Our results imply a lack of monitoring and inconsistent information on negative effects in preregistrations, with inconsistent use of the term monitoring and measurements, and a lack of knowledge among researchers. Improved knowledge and a standardized approach, starting with an adequate preregistration, would be helpful to routinely examine negative effects in psychological interventions to make them safer and better.

[Structures, aims and needs of early career scientists at the German Center for Mental Health]. / Strukturen, Ziele und Bedürfnisse der Early Career Scientists am Deutschen Zentrum für Psychische Gesundheit.

BACKGROUND: Early career scientists (ECS) are agents of change and driving forces in the promotion of mental health. The German Center for Mental Health (DZPG) is a powerful initiative to guide and support careers in the field of mental health. OBJECTIVE: The DZPG aims to make investments to educate, engage, excite, and empower ECS in an interdisciplinary and interinstitutional scientific community. STRUCTURES, TOPICS AND INITIATIVES: To achieve this, the ECS Board at the DZPG plays a central role and consists of 18 elected ECS representatives. The ECS culture gives members the right of voice and embraces bottom-to-top ideas and acknowledges autonomy and co-determination. The DZPG academy was developed to facilitate communication and networking and encourage collaboration among ECS members. The DZPG also navigates several key issues, such as equality, diversity, inclusion, family friendliness and work-life balance, which are essential for a functioning research landscape. The DZPG also extends opportunities to ECS to develop skills and competencies that are essential for contemporary ECS. It complements nationwide support for ECS with funding opportunities, mental health support at work, careers advice and guidance activities. Importantly, the ECS Board is committed to patient and public involvement and engagement, scientific communication and knowledge transfer to multiple settings. CONCLUSION: The DZPG will contribute to fostering ECS training programs for student and academic exchanges, collaborative research, and pooling of resources to acquire grants and scholarships. It will also support the establishment of hubs for ECS networks and promote the expansion of international competence of ECS in Germany.

A dual-factor model perspective on depressed inpatients: examining the dynamics of mental health and therapy outcomes.

Background: The dual-factor model of mental health posits that mental health and mental illness constitute two distinct axes; accordingly the model identifies four mental health groups: (1) complete mental health, (2) troubled, (3) vulnerable, (4) symptomatic but content. Yet, only a few studies investigated effectiveness of therapy on both dimensions of mental health simultaneously. Against this background, the present study aimed to determine proportions and changes of group assignments in depressed inpatients undergoing therapy. Method: N = 1,044 depressed inpatients (age in years: M = 53.36, SD = 9.81, range: 17-83) completed a pre- and a post-treatment survey including questionnaires on depression, anxiety, and positive mental health. A total of n = 328 persons completed the survey also at 6-month and 12-month follow-up assessments. Results: In the classification that included depression symptoms and positive mental health, 49% of the participants were classified as troubled and 13.2% were classified as completely mentally healthy at the pre-treatment assessment. At the post-treatment, 9.5% were classified as troubled and 55.7% were classified as completely mentally healthy. In the classification that included anxiety symptoms and positive mental health, 21.9% of the participants were classified as troubled and 14.2% were classified as completely mentally healthy at the pre-treatment assessment. At the post-treatment, 3.7% were classified as troubled and 56.1% were classified as completely mentally healthy. About 10 to 20% of patients showed an improvement in depression/anxiety and positive mental health, whereas another 10 to 20% showed a reduction in depression/anxiety, but only a minor increase in positive mental health between pre- and post-treatment. Conclusion: Findings are in line with past research inspired by the dual-factor model in showing that enhancing positive mental health and alleviating psychopathology do not always co-occur in treatment. It is therefore important to implement measures of both psychopathology and positive mental health in therapy outcome studies, and to promote interventions targeting both psychopathology and positive mental health.

Not sad enough for a depression trial? A systematic review of depression measures and cut points in clinical trial registrations.

INTRODUCTION: Patient reported outcomes are central to the evaluation of behavioral, drug, or somatic interventions focusing depression. Continuous measures are mostly interpreted with cut points that serve as inclusion criteria and define remission. The present review provides an overview of measures (BDI; BDI-II; CESD; HADS; HAMD-17; MADRS; PHQ-9; QIDS) and cut points in clinical trials on depression and tests for systematic differences concerning varying types of interventions. METHODS: We analyzed 2632 trials registered via clinicaltrials.gov registered between 2000/01/01 - 2019/12/31 that used one or more pre-specified measures of depression of which 1600 reported cut points for either inclusion of participants or the definition of clinical remission. RESULTS: The included studies more often used clinician-administered scales than self-report questionnaires as criterion for the inclusion of study participants and for the definition of clinical remission. Clinician administered scales are dominating in drug trials, while self-report questionnaires are primarily used in behavioral trials. This trend accelerated during the last 20 years. Compared to studies on behavioral therapies, studies with drug or other interventions used higher cut points to include patients. Comparisons between the interventions revealed highly significant differences in the used cut points of MADRS, HAMD-17 and PHQ-9. CONCLUSIONS: Choice of measure and cut points is an important aspect of trial design and should be homogenized in order to make trials of different types of interventions more readily comparable. Similarly, systematic differences between treatment types in how patients are included and how remission is defined also hamper the comparisons between different treatment modalities.

Affective Styles in Panic Disorder and Specific Phobia: Changes Through Cognitive Behavior Therapy and Prediction of Remission.

Affective styles appear to be relevant to the development of psychopathology, especially anxiety disorders. The aim of the current study was to investigate changes in affective styles in patients with panic disorder and specific phobia, as a result of undergoing cognitive-behavioral therapy, and to identify a possible link between certain affective styles and remission. The sample consisted of outpatients (N = 101) suffering from panic disorder, specific phobia, or agoraphobia who completed the Affective Style Questionnaire (ASQ) before and after therapy, as well as at a 6-month follow-up assessment. Multivariate analyses of variance were conducted to test for changes due to therapy. Logistic regression analyses were calculated to test for the impact of affective styles on remission from anxiety disorders, and hierarchical regression analyses were calculated to examine the association between changes in affective styles and symptom reduction. Results indicated significant increases on the ASQ subscales adjusting and tolerating after therapy. Concealing did not decrease significantly after therapy. In addition, higher scores on adjusting significantly predicted remission from anxiety disorders. Finally, we found a significant association between increases on the adjusting scale and the reduction of anxiety symptoms.

Screening for health-related quality of life in children and adolescents: Optimal cut points for the KIDSCREEN-10 for epidemiological studies.

INTRODUCTION: Generic measures of health-related quality of life are important in pediatrics. Here, we try to establish optimal cut points for the self-report and parental-report versions of the KIDSCREEN-10. METHOD: We re-analyzed data from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) study. In total, data from 2566 children, 2136 younger adolescents, and 2740 older adolescents were used. The KIDSCREEN-10 was contrasted to three different anchors: the strength and difficulties questionnaire, self-rated general health, and chronic diseases. A kernel-based method and bootstrapping were used to determine the optimal cut points and their variability. RESULTS: We found large differences in HRQoL between children with vs. without mental health problems but there is only medium-to-small differences in HRQoL between children with vs. without chronic diseases and children with self-rated good vs. poor physical health. Acceptable levels of classification accuracy were found in relation to mental health problems for all versions (AUCs between 0.77 and 0.79), but only for the parental-report version in relation to general health and for no version in relation to chronic diseases. Cut points identified as optimal differed systematically between parental-report versions (cut point = 41.13) and self-report for younger (cut point = 42.52) and older adolescents (cut point = 40.29). CONCLUSION: The results aid the interpretation of KIDSCREEN-10 in epidemiological studies. Specifically, we suggest a cut point of 41 should be used to interpret the parental-report version of the KIDSCREEN and 40 and 42, respectively, for young and older adolescents.

Long-Term Effectiveness of Cognitive Behavioral Therapy in Routine Outpatient Care: A 5- to 20-Year Follow-Up Study.

OBJECTIVE: Long-term follow-ups several years after receiving cognitive behavioral therapy (CBT) are scarce and most of the existing literature describes follow-up data of randomized-controlled trials. Thus, very little is known about the long-term effects of CBT in routine care. METHODS: We investigated psychological functioning in a sample of 263 former outpatients who had received CBT for a variety of mental disorders such as depression, anxiety-, eating- or somatoform disorders 8.06 (SD 5.08) years after treatment termination. All participants completed a diagnostic interview as well as the Brief-Symptom Inventory (BSI) and the Beck Depression Inventory (BDI). Effect sizes and response rates according to Jacobson and Truax [J Consult Clin Psychol 1991;59:12-9] were calculated from pre- to posttreatment and from pretreatment to follow-up assessment. RESULTS: Pre- to posttreatment effect sizes ranged between 0.75 (BDI) and 0.63 (BSI) and pretreatment to follow-up effect sizes were 0.92 (BDI) and 0.75 (BSI). Of all patients, 29% (BDI) and 17% (BSI) experienced clinically significant change at posttreatment and 42% (BDI) and 24% (BSI) at follow-up. CONCLUSION: The results point to the long-term effectiveness of CBT under routine conditions for a wide array of problems, especially when compared to the long-term effects of medical treatment. It is noteworthy that the results at follow-up were even better than at posttreatment, indicating further improvement. However, about a quarter of the patients did not respond sufficiently to therapy, neither concerning short-term nor long-term effects.

Suicide ideation as a predictor of treatment outcomes in cognitive-behavioral therapy for unipolar mood disorders.

Background/Objective: Suicide ideation is common in depressed patients. However, no studies to date have examined whether pretreatment suicide ideation is associated with poorer outcomes after cognitive-behavioral therapy for adult depression. Method: 475 depressed outpatients (age: M = 39.9 years, SD = 11.71; 60.2% female) took part in a pre-treatment and a post-treatment assessment. Pre-treatment suicide ideation measured with the BDI suicide item was considered as a predictor of treatment outcomes - controlling for age, gender, number of attended therapy sessions, as well as pre-treatment depression severity. Results: Hierarchical regression revealed that age, gender, number of completed therapy sessions and depression severity at baseline could explain 25% of the variance in post-treatment BDI-scores. Adding suicide ideation significantly improved the amount of variance explained to 27%. Treatment outcomes were worse for patients with more severe depression, suicidal patients, patients receiving more therapy-sessions and older patients. Conclusions: Suicide ideation added only little incremental variance to the prospective prediction of post-treatment depression severity. Depressed patients with suicide ideation can attain almost as good treatment outcomes as patients without suicide ideation, which is a clinically encouraging result.

Antecedentes/Objetivo: La ideación suicida es común en pacientes deprimidos. No obstante, hasta la fecha no hay estudios que hayan examinado si la ideación suicida previa al tratamiento está asociada con resultados más pobres de la terapia cognitivo-conductual para la depresión en adultos. Método: 475 pacientes ambulatorios deprimidos (edad: M = 39,9 años; DT = 11,71; 60,2% mujeres) participaron en una evaluación previa al tratamiento y posterior al tratamiento. La ideación suicida previa al tratamiento medida con el ítem "suicidio" del BDI se consideró como predictor de los resultados del tratamiento ­ controlando la edad, el género, el número de sesiones de terapia recibidas así como la gravedad de la depresión previa al tratamiento. Resultados: la regresión jerárquica reveló que la edad, el género, el número de sesiones de terapia recibidas y la gravedad de la depresión al inicio del estudio pudieron explicar el 25% de la varianza de las puntuaciones del BDI después del tratamiento. Añadir la ideación suicida elevó significativamente el procentaje de varianza explicada al 27%. Los resultados del tratamiento fueron peores para los pacientes con depresión más grave, pacientes con tendencias suicidas, pacientes que recibieron más sesiones de terapia y pacientes mayores. Conclusiones: la ideación suicida agregó solo una pequeña variación incremental a la predicción prospectiva de la gravedad de la depresión posterior al tratamiento. Los pacientes deprimidos con ideación suicida obtienen casi el mismo beneficio de la terapia cognitivo-conductual que los pacientes deprimidos sin ideación suicida, siendo este un resultado alentador desde un punto de vista clínico.

Suicide ideation as a predictor of treatment outcomes in cognitive-behavioral therapy for unipolar mood disorders / La ideación suicida como predictor de los resultados del tratamiento en terapia cognitivo-conductual para los trastornos del estado de ánimo unipolares

Background/Objective: Suicide ideation is common in depressed patients. However, no studies to date have examined whether pretreatment suicide ideation is associated with poorer outcomes after cognitive-behavioral therapy for adult depression. Method: 475 depressed outpatients (age: M = 39.9 years, SD = 11.71; 60.2% female) took part in a pre-treatment and a post-treatment assessment. Pre-treatment suicide ideation measured with the BDI suicide item was considered as a predictor of treatment outcomes - controlling for age, gender, number of attended therapy sessions, as well as pre-treatment depression severity. Results: Hierarchical regression revealed that age, gender, number of completed therapy sessions and depression severity at baseline could explain 25% of the variance in post-treatment BDI-scores. Adding suicide ideation significantly improved the amount of variance explained to 27%. Treatment outcomes were worse for patients with more severe depression, suicidal patients, patients receiving more therapy-sessions and older patients. Conclusions: Suicide ideation added only little incremental variance to the prospective prediction of post-treatment depression severity. Depressed patients with suicide ideation can attain almost as good treatment outcomes as patients without suicide ideation, which is a clinically encouraging result

Antecedentes/Objetivo: La ideación suicida es común en pacientes deprimidos. No obstante, hasta la fecha no hay estudios que hayan examinado si la ideación suicida previa al tratamiento está asociada con resultados más pobres de la terapia cognitivo-conductual para la depresión en adultos. Método: 475 pacientes ambulatorios deprimidos (edad: M = 39,9 años; DT=11,71; 60,2% mujeres) participaron en una evaluación previa al tratamiento y posterior al tratamiento. La ideación suicida previa al tratamiento medida con el ítem "suicidio" del BDI se consideró como predictor de los resultados del tratamiento - controlando la edad, el género, el número de sesiones de terapia recibidas así como la gravedad de la depresión previa al tratamiento. Resultados: la regresión jerárquica reveló que la edad, el género, el número de sesiones de terapia recibidas y la gravedad de la depresión al inicio del estudio pudieron explicar el 25% de la varianza de las puntuaciones del BDI después del tratamiento. Añadir la ideación suicida elevó significativamente el procentaje de varianza explicada al 27%. Los resultados del tratamiento fueron peores para los pacientes con depresión más grave, pacientes con tendencias suicidas, pacientes que recibieron más sesiones de terapia y pacientes mayores. Conclusiones: la ideación suicida agregó solo una pequeña variación incremental a la predicción prospectiva de la gravedad de la depresión posterior al tratamiento. Los pacientes deprimidos con ideación suicida obtienen casi el mismo beneficio de la terapia cognitivo-conductual que los pacientes deprimidos sin ideación suicida, siendo este un resultado alentador desde un punto de vista clínico

How depressed is "depressed"? A systematic review and diagnostic meta-analysis of optimal cut points for the Beck Depression Inventory revised (BDI-II).

INTRODUCTION: The Beck Depression Inventory revised (BDI-II) is widely used tool to screen for depression. The aim of the present study was to systematically review and synthesize studies that determined optimal cut points for the BDI-II. METHOD: We identified 27 studies that tried to identify optimal cut points for the BDI-II. Study quality was assessed using QUADAS criteria. Cut points and their variability were analyzed descriptively, via simulation and synthesized with a diagnostic meta-analysis. Analysis was performed on all studies and subgroups based on the setting (psychiatric, somatic, healthy). RESULTS: Cut points identified as optimal ranged from 10 to 25 across all studies. Simulation-based estimations of the variability inherent in studies show that much of the between-study differences may be attributed to random fluctuations. Diagnostic meta-analysis across all studies revealed that a cut point of 14.5 (95% CI 12.75-16.44) is optimal, yielding a sensitivity of 0.86 and a specificity of 0.78. Analyses within the different settings suggest using sample-specific cut points, specifically 18.18 in psychiatric settings, and 12.9 in primary care settings and healthy populations. CONCLUSION: Most studies aimed at determining optimal cut points fail to acknowledge that reported results are only estimates and subject to random fluctuations resulting in conflicting recommendations for practitioners. Taking into account these fluctuations, we find that practitioners should use different cut points to screen for depression in primary care and healthy populations (a score of 13 and higher indicates depression) and psychiatric settings (a score of 19 and higher indicates depression). Methods to describe this variability and meta-analysis to synthesize findings across studies should be used more widely.

Affective styles in mood and anxiety disorders - Clinical validation of the "Affective Style Questionnaire" (ASQ).

BACKGROUND: Emotion regulation plays a critical role in the development and maintenance of psychological disorders. Less is known about the association of affective styles and psychopathology. The 20-item "Affective Style Questionnaire" (ASQ) has been validated in nonclinical samples. The American and German validation studies resulted in a three-factor structure (concealing, adjusting, and tolerating). The present study aimed to investigate three aspects: (1) the validation of the ASQ within a clinical sample, (2) the examination of possible differences in affective styles between patients suffering from affective versus anxiety disorders, and (3) the association of affective styles and anxiety, depression, and stress symptoms. METHODS: Overall 917 patients receiving cognitive-behavioral therapy at an outpatient clinic participated in this study, 550 participants were female. All data were collected before the beginning of treatment. RESULTS: Confirmatory factor analyses revealed the same three-factor structure found in the previous Western samples (CFI = 0.90, RMSEA = 0.06): Concealing (α = 0.81), adjusting (α = 0.71), and tolerating (α = 0.70). Significantly lower scores in the ASQ subscale adjusting were found in patients suffering from affective disorders than patients suffering from anxiety disorders. The results of the regression analyses showed that the ASQ adjusting and concealing behavior seem to play a more important role than the ERQ reappraisal and suppression for depression, anxiety, and stress among clinical populations. LIMITATIONS: A number of limitations must be taken into consideration while evaluating the present study. First and foremost, the clinical data were based on primary diagnoses. We did not ascertain comorbid diagnoses. This distinction may be important, since affective and anxiety disorders are often linked to each other. In addition, we only used data collected before the beginning of psychotherapeutic treatment and were therefore not able to analyze changes in affective styles during and after intervention. Furthermore, all data were based on self-reported information of patients. We did not implement either a therapeutic rating of affective styles or physiological measures, for instance arousal, which could have shown whether the used strategies successfully reduce negative emotions. Future research should address this question. Another limitation is the fact that we concentrated on the main categories of mental disorders and, therefore, did not subdivide patients with affective and anxiety disorders in terms of their concrete diagnoses. This is of special importance, because there might also be differences in affective styles within the main categories.

A Prospective Examination of Perceived Burdensomeness and Thwarted Belongingness As Risk Factors for Suicide Ideation In Adult Outpatients Receiving Cognitive-Behavioral Therapy.

OBJECTIVE: The interpersonal-psychological theory of suicidal behavior posits that 2 proximal, causal, and interactive risk factors must be present for someone to desire suicide: perceived burdensomeness and thwarted belongingness. The purpose of the present study was to evaluate the predictive power of these 2 risk factors in a prospective study. METHOD: A total of 231 adult outpatients (age: mean = 38.1, standard deviation = 12.3) undergoing cognitive-behavioral therapy took part in a pretreatment and a midtreatment assessment after the 10th therapy session. RESULTS: Perceived burdensomeness, thwarted belongingness, and the interaction between these 2 risk factors did not add incremental variance to the prediction of midtreatment suicide ideation after controlling for age, gender, depression, hopelessness, impulsivity, lifetime suicide attempts, and pretreatment suicide ideation. The best predictor of midtreatment suicide ideation was pretreatment suicide ideation. CONCLUSION: Results offer only limited support to the assumptions of the interpersonal theory of suicide.

Internet-based motivation program for women with eating disorders: eating disorder pathology and depressive mood predict dropout.

BACKGROUND: One of the main problems of Internet-delivered interventions for a range of disorders is the high dropout rate, yet little is known about the factors associated with this. We recently developed and tested a Web-based 6-session program to enhance motivation to change for women with anorexia nervosa, bulimia nervosa, or related subthreshold eating pathology. OBJECTIVE: The aim of the present study was to identify predictors of dropout from this Web program. METHODS: A total of 179 women took part in the study. We used survival analyses (Cox regression) to investigate the predictive effect of eating disorder pathology (assessed by the Eating Disorders Examination-Questionnaire; EDE-Q), depressive mood (Hopkins Symptom Checklist), motivation to change (University of Rhode Island Change Assessment Scale; URICA), and participants' age at dropout. To identify predictors, we used the least absolute shrinkage and selection operator (LASSO) method. RESULTS: The dropout rate was 50.8% (91/179) and was equally distributed across the 6 treatment sessions. The LASSO analysis revealed that higher scores on the Shape Concerns subscale of the EDE-Q, a higher frequency of binge eating episodes and vomiting, as well as higher depression scores significantly increased the probability of dropout. However, we did not find any effect of the URICA or age on dropout. CONCLUSIONS: Women with more severe eating disorder pathology and depressive mood had a higher likelihood of dropping out from a Web-based motivational enhancement program. Interventions such as ours need to address the specific needs of women with more severe eating disorder pathology and depressive mood and offer them additional support to prevent them from prematurely discontinuing treatment.

A randomized controlled trial on the effectiveness of a rumination-focused group treatment for residual depression.

The maintenance of residual symptoms following acute treatment is common and is associated with poor long-term prognosis. This study investigates whether a cognitive-behavioral group treatment is effective in reducing residual depression by targeting depressive rumination. Participants (N=60) were randomly assigned to either the group treatment or a wait-list control condition. Treatment significantly improved depressed mood, rumination, perceived control over rumination and dysfunctional metacognitive beliefs compared with the wait condition. Treatment gains were maintained over the follow-up period of 1 year. Attrition was low and treatment satisfaction was high. Eight individuals suffered from a depressive relapse/recurrence in the year following treatment. The results indicate that cognitive-behavioral group therapy for depressive rumination is effective and well accepted by patients suffering from residual depression.

Assessing motivation to change in eating disorders: a systematic review.

BACKGROUND: Patients with anorexia and bulimia nervosa are often ambivalent about their eating disorder symptoms. Therefore, a lack of motivation to change is a frequent problem in the treatment of eating disorders. This is of high relevance, as a low motivation to change is a predictor of an unfavourable treatment outcome and high treatment dropout rates. In order to quantify the degree of motivation to change, valid and reliable instruments are required in research and practice. The transtheoretical model of behaviour change (TTM) offers a framework for these measurements. OBJECTIVE: This paper reviews existing instruments assessing motivation to change in eating disorders. METHOD: We screened N = 119 studies from the databases Medline and Psycinfo found by combinations of the search keywords 'eating disorder', 'anorexia nervosa', 'bulimia nervosa', 'motivation', 'readiness to change', 'assessment', 'measurement', and 'questionnaire'. RESULTS: Ultimately, n = 15 studies investigating psychometric properties of different assessment tools of motivation to change in eating disorders were identified. Reviewed instruments can be divided into those assessing the stages of change according to the TTM (6 instruments) and those capturing decisional balance (3 instruments). Overall, the psychometric properties of these instruments are satisfactory to good. DISCUSSION: Advantages, disadvantages, and limitations of the reviewed assessment tools are discussed. So far, the TTM provides the only framework to assess motivation to change in eating disorders.

[Development and validation of a German questionnaire assessing motivation to change in eating disorders - the Stages of Change Questionnaire for Eating Disorders (SOCQ-ED)]. / Entwicklung und Validierung einer deutschsprachigen Skala zur Erfassung der Veränderungsmotivation bei Essstörungen - The Stages of Change Questionnaire for Eating Disorders (SOCQ-ED).

The present study describes the development and validation of a German questionnaire assessing motivation to change in individuals with eating disorders (Stages of Change Questionnaire-Eating Disorders, SOCQ-ED). The SOCQ-ED measures stages of change separately for each eating disorder symptom domain. Psychometric properties were assessed in a sample of N=63 women with Anorexia Nervosa or Bulimia Nervosa. Test-retest reliability ranged from rtt=0.42 to 0.78 (Mdn=0.56), correlations with the University of Rhode Island Change Assessment were between r=0.21 and 0.32 and correlations with measurements of eating pathology ranged from r=0.19 to 0.46. The results provide initial support for the reliability and validity of the SOCQ-ED.