In-Session-Reflective-Functioning in Anorexia Nervosa: An Analysis of Psychotherapeutic Sessions of the ANTOP Study
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In-Session-Reflective-Functioning in Anorexia Nervosa: An Analysis of Psychotherapeutic Sessions of the ANTOP Study. / Zeeck, Almut; Taubner, Svenja; Gablonski, Thorsten C; Lau, Inga; Zipfel, Stephan; Herzog, Wolfgang; Wild, Beate; Friederich, Hans-Christoph; Resmark, Gaby; Giel, Katrin; Teufel, Martin; Burgmer, Markus; Dinkel, Andreas; Herpertz, Stephan; Löwe, Bernd; Tagay, Sefik; von Wietersheim, Jörn; De Zwaan, Martina; Zettl, Max; Meier, Alexander F; Hartmann, Armin.
In: FRONT PSYCHIATRY, Vol. 13, 814441, 2022.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - In-Session-Reflective-Functioning in Anorexia Nervosa: An Analysis of Psychotherapeutic Sessions of the ANTOP Study
AU - Zeeck, Almut
AU - Taubner, Svenja
AU - Gablonski, Thorsten C
AU - Lau, Inga
AU - Zipfel, Stephan
AU - Herzog, Wolfgang
AU - Wild, Beate
AU - Friederich, Hans-Christoph
AU - Resmark, Gaby
AU - Giel, Katrin
AU - Teufel, Martin
AU - Burgmer, Markus
AU - Dinkel, Andreas
AU - Herpertz, Stephan
AU - Löwe, Bernd
AU - Tagay, Sefik
AU - von Wietersheim, Jörn
AU - De Zwaan, Martina
AU - Zettl, Max
AU - Meier, Alexander F
AU - Hartmann, Armin
N1 - Copyright © 2022 Zeeck, Taubner, Gablonski, Lau, Zipfel, Herzog, Wild, Friederich, Resmark, Giel, Teufel, Burgmer, Dinkel, Herpertz, Löwe, Tagay, von Wietersheim, De Zwaan, Zettl, Meier and Hartmann.
PY - 2022
Y1 - 2022
N2 - Objective: Previous research suggests that patients with anorexia nervosa (AN) show an impaired capacity to mentalize (reflective functioning, RF). RF is discussed as a possible predictor of outcome in psychotherapeutic processes. The study aimed to explore RF in sessions of patients with AN and its association with outcome and type of treatment.Methods: A post-hoc data analysis of selected cases from a randomized trial on outpatient psychotherapy for AN was conducted. Transcripts from 84 sessions of 28 patients (early phase, middle phase, and end of treatment) were assessed using the In-Session-Reflective-Functioning-Scale [14 cognitive-behavior therapy, enhanced (CBT-E); 14 focal psychodynamic therapy (FPT); 16 with good, 12 with poor outcome after 1 year]. Relations between the level of RF, type of treatment, and outcome were investigated using mixed linear models. Additionally, associations with depressive symptoms, weight gain, and therapeutic alliance were explored.Results: Mean in-session RF was low. It was higher in FPT when compared to CBT-E treatments. The findings point to an association between RF increase and a positive outcome. An increase in BMI in the first half of treatment was associated with higher subsequent in-session RF. There was no association between RF and depressive symptoms or the therapeutic alliance.Discussion: Patients with AN show a low capacity to mentalize in sessions, which seems to be at least partly dependent on the degree of starvation. The results suggest a possible relationship between an increase in in-session RF and outcome, which has to be replicated by further studies.
AB - Objective: Previous research suggests that patients with anorexia nervosa (AN) show an impaired capacity to mentalize (reflective functioning, RF). RF is discussed as a possible predictor of outcome in psychotherapeutic processes. The study aimed to explore RF in sessions of patients with AN and its association with outcome and type of treatment.Methods: A post-hoc data analysis of selected cases from a randomized trial on outpatient psychotherapy for AN was conducted. Transcripts from 84 sessions of 28 patients (early phase, middle phase, and end of treatment) were assessed using the In-Session-Reflective-Functioning-Scale [14 cognitive-behavior therapy, enhanced (CBT-E); 14 focal psychodynamic therapy (FPT); 16 with good, 12 with poor outcome after 1 year]. Relations between the level of RF, type of treatment, and outcome were investigated using mixed linear models. Additionally, associations with depressive symptoms, weight gain, and therapeutic alliance were explored.Results: Mean in-session RF was low. It was higher in FPT when compared to CBT-E treatments. The findings point to an association between RF increase and a positive outcome. An increase in BMI in the first half of treatment was associated with higher subsequent in-session RF. There was no association between RF and depressive symptoms or the therapeutic alliance.Discussion: Patients with AN show a low capacity to mentalize in sessions, which seems to be at least partly dependent on the degree of starvation. The results suggest a possible relationship between an increase in in-session RF and outcome, which has to be replicated by further studies.
U2 - 10.3389/fpsyt.2022.814441
DO - 10.3389/fpsyt.2022.814441
M3 - SCORING: Journal article
C2 - 35677868
VL - 13
JO - FRONT PSYCHIATRY
JF - FRONT PSYCHIATRY
SN - 1664-0640
M1 - 814441
ER -