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EDRS 2012
46
and seven (30,4%) at long-term reported loss of control over
eating. Point prevalence of grazing behavior was significant-
ly different (Chi²=11,395, p<0,05), with 34,5% (59), 11,6%
(5) and 47,8% (11) of patients reporting grazing at pre,
short-term and long-term after surgery respectively. Loss of
control related with poorer outcomes, particularly at long-time
follow-up, with highest BMI, least weight loss, most weight
regain, and highest eating disorders symptoms, particularly
when associated with grazing behavior. A final regression
model including eating related features, explained 68,5% of
the variance in weight regain (p <0 ,001) and 31,5% of the
variance of %weight loss (p <0 ,001).Despite the improve-
ment in eating behavior and related symptomatology with
bariatric surgery, the presence binge eating, grazing behavior
and eating related psychological features were related to
weight regain and poorest outcomes.
F14
ATTENTIONAL PROCESSING TO INFANT CUES IN AN-
OREXIA NERVOSA
Freya Corfield
1
, Valentina Cardi
1
, Rebecca Hibbs
1
, Jenni Lep-
panen
1
, Charlotte Rhind
1
, Stephanie Deriziotis
1
, Nadia Micali
2
,
Janet Treasure
1
1
Institute of Psychiatry, King’s College London, London, Unit-
ed Kingdom,
2
Behavioural and Brain Sciences Unit, Universi-
ty College London, London, United Kingdom
Introduction
People with Anorexia Nervosa (AN) have
abnormal cognitive processing of social cues. Previous work
found attentional avoidance of positive social information
(e.g. kind faces). The aim of this study is to replicate these
findings using pictures of infants.
Method
The dot-probe par-
adigm was used to measure immediate (500ms) and delayed
(1250ms) attentional processes in response to infant cues
(happy or sad faces) in patients with AN (N=32) and healthy
controls (HCs) (N=55).
Results
Initially AN patients showed
attentional avoidance of happy infants (mean attentional bias
(AB)=-14.22,SD=70.08), which contrasted with the vigilance
of HCs (mean AB=1.99ms,SD=.67.98) (
d
=0.23). With longer
presentation, AN paid more attention to happy infants (mean
AB=3.29ms,SD= 65.63), yet less attention than that observed
in HCs (mean AB=12.72ms,SD=62.73) (
d
=0.15). Initially AN
were more vigilant to sad infants (mean AB=1.27ms,SD=
59.87) than HCs (mean AB= 0.98,SD=63.59) (
d
=0.00). With
longer presentation they showed avoidance (mean AB=-
3.04ms,SD=56.10), whereas HCs increased their attention
(mean AB=3.88ms, SD= 49.42) (
d
=0.13).
Conclusion
Patients with AN show attentional disengagement of positive
cues, at 500ms they showed vigilance to sad babies, as well
as HCs. Diminished processing to infant cues may have
implications for parenting and reward sensitivity.
F15
IMMEDIATE AND LONGER-TERM EFFECTS OF INPA-
TIENT COGNITIVE BEHAVIOR THERAPY FOR ANOREXIA
NERVOSA
Riccardo Dalle Grave
1
, Simona Calugi
1
, Maddalena Conti
1
,
Helen Doll
2
, Christopher G Fairburn
2
1
Villa Garda Hospital, Department of Eating and Weight Dis-
order, Garda (VR), Italy,
2
2Oxford University Department of
Psychiatry, Warneford Hospital, Oxford, United Kingdom
Introduction: Inpatient treatment for anorexia nervosa is often
successful in restoring body weight, but a high percentage
of patients relapse following discharge. The aim of this study
was to establish the immediate and longer-term effects of a
novel inpatient program for severe anorexia nervosa de-
signed to produce enduring change. Methods: 80 consecu-
tive patients with severe anorexia nervosa were admitted to
20-week inpatient treatment based upon enhanced cognitive
behavioral therapy (CBT-E). Patients were assessed be-
fore and after hospitalization and six and 12 months later.
The outcome measures were body mass index and Eating
Disorder Examination scores. Results: 90% of patients com-
pleted the program. These patients achieved a substantial
improvement in weight, eating disorder features and general
psychopathology. Deterioration after discharge did occur but
it was not marked and it was restricted to the first six months.
Conclusions: Inpatient CBT-E attenuates the weight loss that
typically follows hospitalization for anorexia nervosa.
F16
THE INFLUENCE OF NEGATIVE EMOTIONS ON DECI-
SION MAKING IN WOMEN WITH ANOREXIA NERVOSA
Unna N. Danner
1,2
, Lot Sternheim
1,2,3
, Tiny A.M. Geerets
4
,
Alexandra Dingemans
5
, Annemarie A. van Elburg
1,2,6
1
Altrecht Eating Disorders Rintveld, Zeist, Netherlands,
2
Utrecht Research Group Eating disorders, Utrecht, Nether-
lands,
3
Faculty of Social Sciences, Utrecht University, Neth-
erlands,
4
5Geerets & Kuypers, Utrecht, Netherlands,
5
Centre
for Eating Disorders Ursula, Leidschendam, Netherlands,
6
Department of Child & Adolescent Psychiatry, University
Medical Center Utrecht, Netherlands
Rationale and aim:
There is growing evidence that pa-
tients with anorexia nervosa (AN) have impaired decision
making (DM) ability. Affective processes are essential for
adequate DM and a possible factor underlying impaired DM
in AN might be the affective disturbances seen in many AN
patients. However, not all studies show consistent findings.
Most studies do not differentiate between AN subtypes, while
there are important personality differences between type of
patients that may account for variation in DM ability such as
emotion-driven impulsivity in patients with AN binge-purging
(ANBP) subtype. Moreover, Cavedini et al (2004) showed
that the two AN subtypes displayed different patterns of DM
impairment. The current study aims to examine the influ-
ence of negative emotions on DM ability in women with AN
restrictive (ANR) vs. ANBP subtype in comparison to healthy
women.
Method:
Participants are 60 women with ANR or
ANBP (no history of eating disorders diagnostic crossover)
and 30 control women without current or lifetime eating dis-
orders. Negative emotions were manipulated by asking half
of the participants to watch a sad movie and the other half
to watch a neutral movie. DM was assessed using the Iowa
Gambling Task (IGT) and the Game of Dice Task (GDT) and
participants were asked to fill in several questionnaires (e.g.
emotion regulation, depression, eating pathology).
Results:
Data collection is currently ongoing and first results will be
presented at the conference.
F17
MULTI-CENTER RCT ON THE COST-EFFECTIVENESS OF
CBT-E
Martie de Jong
1
, Kees Korrelboom
2
, Philip Spinhoven
3
, Hans
W Hoek
1,4,5
1
PsyQ Haaglanden, Eating Disorders & Obesity, The Hague,
Netherlands,
2
PsyQ Haaglanden, Research & Innovation,
The Hague, Netherlands,
3
Leiden University, Faculty of Social
and Behavioural Sciences, Leiden, Netherlands,
4
Columbia
University Mailman School of Public Health, Dept. of Epidemi-
ology, New York, NY, USA,
5
University of Groningen, Dept. of
Psychiatry, Groningen, Netherlands
Introduction:
Cognitive behavior therapy (CBT) is treatment
of first choice for eating disorders. Effectiveness studies of
CBT are scarce, especially in the Netherlands. This study
assesses the (cost-)effectiveness of Enhanced Cognitive
Behavioral Therapy (CBT-E) compared to Treatment as Usual
(TAU) for patients with an Eating Disorder (ED). The total
treatment costs per patient per year are estimated at 3540
Euro for CBT-E (20*177) and 9027 (51*177) for TAU.
Methods:
240 outpatients with a DSM-IV eating disorder
(BMI >17.5 and <40) will be enrolled in a multi-center (study
with 4 sites) randomized controlled trial, involving 20 weeks
of CBT-E treatment and a 60-week period of follow-up
compared with TAU (treatment as usual). Primary outcome
measure is recovery from ED (EDE). Secondary outcome
measures include general psychopathology (SCL-90, BDI2),
self-esteem (RSE, IAT), perfectionism (F-MPS), health
related quality of life (EQ-5D and SF-36), service receipt and
productivity loss (TiC-P) and caregiver burden (CarerQoL).
Results:
The pilot-study is implemented and first data will be
presented.
Discussion:
Our expectation that CBT-E is more
cost-effective than TAU, the design of the study and the pilot
data will be discussed.
POSTER SESSION 2 ABSTRACTS