Developing Identity: An Eating Disorders Nursing Therapy

发展身份：饮食失调护理疗法

• 批准号: 6408382
• 负责人: Karen F. Stein
• 金额: $ 28.98万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-08-01 至 2006-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6408382
• 关键词: adolescence (12-20); anorexia nervosa; attitude; body weight; bulimia nervosa; clinical trials; cognitive behavior therapy; counseling; eating; female; human subject; human therapy evaluation; identity; nursing intervention; nursing models; patient oriented research; psychiatric nursing; self concept; women's health; young adult human (21-34)

The eating disorders of anorexia nervosa (AN) and bulimia nervosa(BN) are life-threatening health problems that affect as many as 5 million American females each year. Although a number of psychotherapeutic approaches to treatment have been developed, their effectiveness in producing recovery is low. One limitation of existing treatment approaches is that they tend to focus on altering symptoms of the eating disorders but do not systematically address underlying cause. The intervention program tested in this study is founded on the cognitive approach to the study of the self-concept and an empirically-supported model that suggests that the eating disorders of AN and BN stem from deficits in overall identity development. More specifically, the model suggests that the availability in memory of few positive and many negative self-cognitions and high interrelatedness among the self-cognitions contributes to the disordered attitudes and behaviors associated with AN and BN. A randomized clinical trial will test the effectiveness of a cognitive-behavioral social identity intervention program in fostering development of new and separate positive self- cognitions and promoting recovery from AN and BN. It will further examine the effects of these self-cognition changes on nutritional, psychological and functional health. An experimental pretest-posttest design will be used with supportive psychotherapy as the control intervention. Based on American Psychiatric Association Guidelines, nutritional counseling and medical care components of treatment will be held constant across both experimental and control intervention conditions. The effects of the intervention on self-cognitions, eating disordered attitudes and behaviors, nutritional, psychological and functional health will be monitored pre and post-intervention (immediate, 6 and 12 months post-intervention) in 150 women with threshold and subthreshold levels of AN and BN. The Structured Clinical Interview will be used to establish the eating disorder diagnosis and Ecological Momentary Assessment methodology will be used to prospectively measure eating disorder behaviors. This project extends an established program of research on the role of self-cognitions in emotional and behavioral self-regulation and holds the potential for contributing to the development of an evidence-based psychiatric nursing treatment to promote the recovery of health in women with an eating disorder.

神经性厌食症（AN）和神经性贪食症（BN）的饮食失调是威胁生命的健康问题，每年影响多达500万美国女性。 尽管已经开发了许多心理治疗方法，但它们在产生恢复方面的有效性很低。 现有治疗方法的一种局限性是，它们倾向于专注于改变饮食失调的症状，但没有系统地解决根本原因。 在这项研究中测试的干预计划是基于对自我概念研究的认知方法的建立，并且是经验支持的模型，这表明A和BN的饮食失调源于整体身份发展中的缺陷。 更具体地说，该模型表明，自我认知之间很少有积极和许多负面的自我认知和高度相互关联的可用性有助于与AN和BN相关的无序态度和行为。 一项随机临床试验将测试认知行为社会认同干预计划在促进新的和独立的积极自我认知发展并促进从AN和BN中恢复的有效性。 它将进一步研究这些自我认知变化对营养，心理和功能健康的影响。实验性预测试设计将以支持性心理治疗作为控制干预措施。 根据美国精神病学协会的指南，在实验和控制干预条件下，营养咨询和治疗的医疗服务将保持不变。 干预对自我认知，饮食失调的态度和行为，营养，心理和功能健康的影响将在150名An和bn的阈值和亚基水平的妇女中进行干预前和后干预后（立即进行干预后的6个月和12个月）。 结构化的临床访谈将用于建立饮食失调诊断，生态瞬时评估方法将用于前瞻性衡量饮食失调行为。 该项目扩展了一项关于自我认知在情绪和行为自我调节中作用的研究计划，并具有有助于发展基于证据的精神病护理治疗以促进饮食失调女性健康的康复的潜力。