38
EDRS 2013
T70
Empirically-Derived Subtypes of Anorexia Nervosa: Evidence for
Short-Term Stability
Jennifer E. Wildes
1,2
,
Kelsie T. Forbush
3
1
Department of Psychiatry, University of Pittsburgh School of Medicine,
Pittsburgh, PA, USA,
2
Western Psychiatric Institute and Clinic, University
of Pittsburgh Medical Center, Pittsburgh, PA, USA,
3
Department of
Psychological Sciences, Purdue University, West Lafayette, IN, USA
Introduction:
Within-group heterogeneity in anorexia nervosa (AN) poses
problems for research on etiology and treatment. Thus, we aimed to
identify homogeneous AN subtypes, and examine their short-term stability
using empirical methods.
Methods:
194
AN patients aged > 16 years were assessed at baseline
and 6- and 12-month follow-ups. Latent class analysis was used to identify
AN subtypes on the basis of eating disorder symptoms, i.e., objective
binge episodes, subjective binge episodes, purging, overvaluation of
shape or weight, and fear of fatness, and latent transition analysis (LTA)
was used to examine class stability.
Results:
We identified 3 subtypes: 1)
Fat-Phobic Restricting AN (AN-R-FP); 2) Fat-Phobic Binge-Eating/Purging
AN (AN-BP-FP); and 3) Non-Fat-Phobic Restricting AN (AN-R-NFP).
Subtype membership was highly stable, with probabilities of remaining
in the same class of 0.68-0.88 from baseline to 6 months, and 0.87-1.00
from 6 to 12 months. The most common transition pattern was between
AN-R-FP and AN-R-NFP (56.8% of transitions); the majority of these
patients (20/21) transitioned from AN-R-FP to AN-R-NFP. Disinhibition (vs.
constraint), lifetime obesity, and illness duration were negative predictors
of latent transition.
Conclusions:
This study supports the presence of 3 AN subtypes that
generally are stable over short-term follow-up. Transitions between AN-R-
FP and AN-R-NFP are intriguing and suggest that fat phobia may be less
stable than other AN symptoms.
T71
Everyday Practice in Treating Bulimia Nervosa (BN) in Germany: A
Survey.
Almut Zeeck
1
,
Burkard Jäger
2
,
Armin Hartmann
1
1
Department of Psychosomatic Medicine and Psychotherapy, University
Clinic, Freiburg, Germany,
2
Department for Psychosomatic Medicine and
Psychotherapy, University Clinic, Hannover, Germany
Introduction
In Germany, there is insufficient knowledge on everyday
practice in the treatment of BN. Our research questions were: What
are the characteristics of expert therapists treating BN? What types of
interventions are used? What should be done to improve outcome?
Methods
A questionnaire was developed comprising questions on
therapist`s background (oriented on the DPCCQ; Orlinsky & Ronnestad
2005),
ratings on interventions used (treatment phases, subgroups;
oriented on the CPPS, Hilsenroth et al. 2005) and other bulimia related
items. It was send to all members of the German eating-disorder-guideline
group, members of the German Eating Disorder Research Society and
distributed to expert practitioners in the eating disorder field.
Results
Of N=56 therapists 39% were trained in CBT, 27% in psychodynamic/
psychoanalytic psychotherapy and 25% in both orientations (other: 9%).
Therapists use symptom-oriented as well as relationship and insight-
oriented interventions, their application depending on treatment phase
and co-morbid conditions. Therapists rated the ambivalence of patients
and insufficient training as most important reasons for low remission rates.
Conclusions
BN treatment seems to be more integrative than expected
(
limitation: self-assessment, representativeness unclear): a high number
of therapists is trained in or influenced by more than one theoretical
orientation. Overall, a more specific training is desirable.
POSTER SESSION 1 ABSTRACTS
