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When family therapy isn't enough: New treatment directions for highly anxious and dysregulated adolescents with anorexia nervosa.

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  • Author(s): Simic, Mima. National and Specialist CAMHS DBT Service, Maudsley Hospital, London, United Kingdom; Anderson, Leslie Karwoski. UC San Diego Eating Disorders Center for Treatment and Research, San Diego, CA, US; Berner, Laura A.. UC San Diego Eating Disorders Center for Treatment and Research, San Diego, CA, US; Peck, Stephanie Knatz. Intensive Family Treatment (IFT) Programs, UCSD Eating Disorders Treatment and Research Center, San Diego, CA, US; Hunt, Katrina. National and Specialist Child and Adolescent Eating Disorder Service, Maudsley Hospital, London, United Kingdom; Kaye, Walter H.. Eating Disorder Research and Treatment Program, UC San Diego School of Medicine, San Diego, CA, US; Eisler, Ivan. King's College London, London, United Kingdom
  • Source:
    Innovations in family therapy for eating disorders: Novel treatment developments, patient insights, and the role of carers. Murray, Stuart B., (Ed); Anderson, Leslie Karwoski, (Ed); Cohn, Leigh, (Ed); pp. 113-131; New York, NY, US: Routledge/Taylor & Francis Group; 2017. xxvi, 308 pp.
  • Language:
    English
  • Document Type:
    Chapter
  • Publication Type:
    Book; Edited Book
  • Additional Information
    • Physical Description:
      19
    • ISBN:
      978-1-138-64899-9 (Paperback)
      978-1-138-64898-2 (Hardcover)
      978-1-315-62608-6 (Digital (undefined format))
    • Keywords:
      family therapy, treatment directions, anorexia nervosa, eating disorders, treatment nonresponse, comorbidity, treatment modification
    • Abstract:
      Eating disorders-focused family therapy (FT-AN) has been shown through about a dozen randomized controlled trial (RCTs) to be the first-line treatment for adolescents with anorexia nervosa (AN). Studies show that FT-AN leads to full remission by the end of treatment in between 35 and 50 percent of patients, while between 10 and 40 percent have a poor outcome. Thus, there is a need to modify the standard family treatment or add additional elements to address the needs of adolescents who do not respond to existing family therapy treatment approaches. A few studies have attempted to delineate the factors that moderate response to treatment for adolescents with AN. Two sets of factors have been Iinked to poorer outcomes in the literature: (1) overall severity of coexisting psychopathology, such as obsessionality, anxiety, or depression; and (2) family functioning impairment and emotional dysregulation. It is not exactly clear why adolescents with higher levels of anxiety and obsessionality, or those with pronounced emotional and behavioral dysregulation tend to be more treatment refractory. Examining the literature on neurobiology of AN and its comorbid disorders as well as the literature on attachment relationships in families with AN offers some possible directions for treatment modification, development, and augmentation. To explore the issue of non-response in family therapy for eating disorder, we will review factors that have been shown to moderate treatment response in FT-AN, how the biological bases of some of these factors may not be addressed by current family therapy for eating disorders, and modifications to treatment that have been trialed with the aim of improving response in these groups. We will then propose a framework for enhanced treatment modifications and explore directions for the future. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
    • Subject Terms:
    • PsycINFO Classification:
      Health & Mental Health Treatment & Prevention (3300)
    • Population:
      Human
    • Age Group:
      Adolescence (13-17 yrs)
    • Intended Audience:
      Psychology: Professional & Research (PS)
    • Physical Description:
      Print
    • Publication Date:
      20171109
    • Publication Date:
      20190211
    • Accession Number:
      2017-14618-010
  • Citations
    • ABNT:
      SIMIC, M. et al. When family therapy isn’t enough: New treatment directions for highly anxious and dysregulated adolescents with anorexia nervosa. In: MURRAY, S. B.; ANDERSON, L. K.; COHN, L. (Eds.). Innovations in family therapy for eating disorders: Novel treatment developments, patient insights, and the role of carers. New York, NY: Routledge/Taylor & Francis Group, 2017. p. 113–131. ISBN 978-1-138-64899-9. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=psyh&AN=2017-14618-010. Acesso em: 9 abr. 2020.
    • AMA:
      Simic M, Anderson LK, Berner LA, et al. When family therapy isn’t enough: New treatment directions for highly anxious and dysregulated adolescents with anorexia nervosa. In: Murray SB, Anderson LK, Cohn L, eds. Innovations in Family Therapy for Eating Disorders: Novel Treatment Developments, Patient Insights, and the Role of Carers. New York, NY: Routledge/Taylor & Francis Group; 2017:113-131. http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=psyh&AN=2017-14618-010. Accessed April 9, 2020.
    • APA:
      Simic, M., Anderson, L. K., Berner, L. A., Peck, S. K., Hunt, K., Kaye, W. H., & Eisler, I. (2017). When family therapy isn’t enough: New treatment directions for highly anxious and dysregulated adolescents with anorexia nervosa. In S. B. Murray, L. K. Anderson, & L. Cohn (Eds.), Innovations in family therapy for eating disorders: Novel treatment developments, patient insights, and the role of carers. (pp. 113–131). Routledge/Taylor & Francis Group.
    • Chicago/Turabian: Author-Date:
      Simic, Mima, Leslie Karwoski Anderson, Laura A. Berner, Stephanie Knatz Peck, Katrina Hunt, Walter H. Kaye, and Ivan Eisler. 2017. “When Family Therapy Isn’t Enough: New Treatment Directions for Highly Anxious and Dysregulated Adolescents with Anorexia Nervosa.” In Innovations in Family Therapy for Eating Disorders: Novel Treatment Developments, Patient Insights, and the Role of Carers., edited by Stuart B. Murray, Leslie Karwoski Anderson, and Leigh Cohn, 113–31. New York, NY: Routledge/Taylor & Francis Group. http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=psyh&AN=2017-14618-010.
    • Harvard:
      Simic, M. et al. (2017) ‘When family therapy isn’t enough: New treatment directions for highly anxious and dysregulated adolescents with anorexia nervosa’, in Murray, S. B., Anderson, L. K., and Cohn, L. (eds) Innovations in family therapy for eating disorders: Novel treatment developments, patient insights, and the role of carers. New York, NY: Routledge/Taylor & Francis Group, pp. 113–131. Available at: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=psyh&AN=2017-14618-010 (Accessed: 9 April 2020).
    • Harvard: Australian:
      Simic, M, Anderson, LK, Berner, LA, Peck, SK, Hunt, K, Kaye, WH & Eisler, I 2017, ‘When family therapy isn’t enough: New treatment directions for highly anxious and dysregulated adolescents with anorexia nervosa’, in SB Murray, LK Anderson & L Cohn (eds), Innovations in family therapy for eating disorders: Novel treatment developments, patient insights, and the role of carers., Routledge/Taylor & Francis Group, New York, NY, pp. 113–131, viewed 9 April 2020, .
    • MLA:
      Simic, Mima, et al. “When Family Therapy Isn’t Enough: New Treatment Directions for Highly Anxious and Dysregulated Adolescents with Anorexia Nervosa.” Innovations in Family Therapy for Eating Disorders: Novel Treatment Developments, Patient Insights, and the Role of Carers., edited by Stuart B. Murray et al., Routledge/Taylor & Francis Group, 2017, pp. 113–131. EBSCOhost, search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=psyh&AN=2017-14618-010.
    • Chicago/Turabian: Humanities:
      Simic, Mima, Leslie Karwoski Anderson, Laura A. Berner, Stephanie Knatz Peck, Katrina Hunt, Walter H. Kaye, and Ivan Eisler. “When Family Therapy Isn’t Enough: New Treatment Directions for Highly Anxious and Dysregulated Adolescents with Anorexia Nervosa.” In Innovations in Family Therapy for Eating Disorders: Novel Treatment Developments, Patient Insights, and the Role of Carers., edited by Stuart B. Murray, Leslie Karwoski Anderson, and Leigh Cohn, 113–31. New York, NY: Routledge/Taylor & Francis Group, 2017. http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=psyh&AN=2017-14618-010.
    • Vancouver/ICMJE:
      Simic M, Anderson LK, Berner LA, Peck SK, Hunt K, Kaye WH, et al. When family therapy isn’t enough: New treatment directions for highly anxious and dysregulated adolescents with anorexia nervosa. In: Murray SB, Anderson LK, Cohn L, editors. Innovations in family therapy for eating disorders: Novel treatment developments, patient insights, and the role of carers [Internet]. New York, NY: Routledge/Taylor & Francis Group; 2017 [cited 2020 Apr 9]. p. 113–31. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=psyh&AN=2017-14618-010