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This article explores the family consultations during the inpatient treatment of children and adolescents with anorexia nervosa. There were three study goals: to explore the therapeutic team's interventions, to study the team's perception of parental reactions toward the interventions, and to compare two groups of parents. Medical records of 32 were analyzed using Consensual Qualitative Research. There were eight categories of interventions discussed. Parents with better cooperation were more concentrated on their personal experiences (p = 0.005), whereas parents with poorer cooperation had more work on marital conflict (p = 0.004). Bereavement also appeared to be a particularly important theme. [ABSTRACT FROM AUTHOR]

Objective: Motivation to change is an important predictor for treatment outcomes in individuals with anorexia nervosa (AN), however, the existence and clinical relevance of distinct motivational dimensions are understudied. This study aimed to structurally validate the AN Stage of Change Questionnaire (ANSOCQ) in the Italian adult AN population to identify separate motivational dimensions and their association with clinical variables and outcomes. Method: Inpatients and outpatients with AN (N = 300) completed the ANSOCQ and measures assessing eating and depressive psychopathology. Unique Variable Analysis and Exploratory Graph Analysis were employed to identify dimensions in the network structure of ANSOCQ. Cross‐sectional associations with clinical variables were assessed in the whole sample. Predictive value on weight and psychopathology was assessed in inpatients. Results: Two dimensions were identified, one comprising items relative to weight gain, and the second items regarding attitudes towards eating, body, and emotional problems. Feelings associated with eating resulted as most central in the network. Higher scores in the first dimension and ANSOCQ total predicted weight gain during hospitalisation. No significant predictors emerged for changes in eating psychopathology. Discussion: These findings confirm the robust psychometric properties of ANSOCQ and provide support for the use of its subdimensions in clinical practice. Highlights: Motivation to change is an important predictor of clinical improvement in individuals with anorexia nervosa (AN). The AN Stages of Change is a reliable tool for assessing motivation, and valuable clinical information can be obtained from its structure.In this study, we utilise an innovative method based on network analysis to assess motivational dimensions and their associations with weight gain and psychopathology in the Italian population.Two main dimensions emerged, one pertaining to weight gain and significantly associated to inpatient weight increase, and the second regarding attitudes towards eating, body, and emotional problems. The application of network analysis to motivation to change introduces a novel and potentially valuable model for future investigations. [ABSTRACT FROM AUTHOR]

Objective: An increasing demand for inpatient treatment for adolescents with anorexia nervosa (AN) during and after the Covid‐19 pandemic contrasts with limited capacity and long waiting times. The current pilot study evaluated an outpatient group therapy (GT) as early intervention for adolescents with AN prior to inpatient treatment. Methods: Seventeen female adolescents who participated at the GT (intervention group, INT) were compared to 16 adolescents without GT (treatment‐as‐usual, TAU). BMI, eating disorder psychopathology and motivation of change (MoC) were assessed at three timepoints. Results: Comparing pre‐ versus post‐ group participation, we identified a significant increase of MoC and a trend towards a decreased AN‐specific psychopathology. Comparing INT with TAU adolescents, we found a significant lower AN psychopathology at inpatient admission for the INT group and a trend for different BMI courses: While the BMI of the TAU group decreased during waiting time, the INT group did not show a decrease during GT resulting in a higher BMI at admission. Conclusions: Results of the current pilot study suggest positive effects of an early outpatient intervention in a group setting for adolescents with AN prior to inpatient treatment. Further research with larger sample sizes is necessary to validate the current pilot results. Highlights: Outpatient group therapy (GT) for adolescents with anorexia nervosa (AN) prior to inpatient treatment represents an early intervention and may improve the starting conditions of inpatient treatment.Motivation to change improves while participating in an outpatient GT prior to inpatient treatment for adolescents with AN.Adolescents with AN participating in GT show less weight loss from first outpatient contact to inpatient admission compared to TAU adolescents. [ABSTRACT FROM AUTHOR]

Objective: We aimed to evaluate longitudinal changes in set‐shifting and central coherence in a predominantly adolescent cohort with anorexia nervosa (AN) and to explore whether these factors predict long‐term eating disorder outcomes. Method: Ninety‐two female patients with AN (mean age: 16.2, range: 13–21 years) completed neurocognitive tests (Rey Complex Figure Test, Adapted Version of the Wisconsin Card Sorting Test) before and after 12 months of psychotherapeutic treatment (n = 45 Maudsley AN Treatment, MANTRa; n = 47 standard psychotherapy; groups not randomised). Eating disorder severity was assessed at baseline, after 6, 12 and 18 months. Results: Central coherence (indicated by an increase in the Rey Figure Style Index) and set‐shifting (indicated by a reduction in the percentage of perseverative errors) significantly improved over the course of treatment, with similar outcomes across groups. Lower central coherence was associated with higher eating disorder severity. Individuals with lower baseline set‐shifting ability tended to have worse eating disorder outcomes in the long‐term. However, this trend did not reach statistical significance in a multilevel linear mixed model. Conclusions: Neurocognitive difficulties in adolescents and young adults with AN can improve after treatment. Interventions specifically addressing flexibility in thinking and behaviour may contribute to treatment success. Highlights: Central coherence and set‐shifting significantly improved over the course of treatment, with similar outcomes across groups (MANTRa treatment vs. standard psychotherapy).Lower central coherence was associated with higher eating disorder severity.There was a trend towards lower set‐shifting being associated with worse eating disorder outcomes in the long‐term, indicating that interventions addressing cognitive flexibility may contribute to treatment success. [ABSTRACT FROM AUTHOR]

Purpose: The transition period from eating disorder inpatient (IP) care to outpatient care can be difficult for patients and is often characterised by high relapse rates. This study aims to co-develop a novel treatment pathway to support patients during this critical period. Design/methodology/approach: This was a mixed-methods case study using co-production methodology and a nested qualitative component. The authors co-developed an initial proposed pathway structure with clinicians and people with lived experience of an eating disorder, based on a review of the literature. They then conducted interviews with clinicians and patients (n = 8) to refine the pathway; these were analysed using framework analysis. Findings: A four-component pathway structure was developed. Six main themes emerged from this qualitative analysis: autonomy, the need for holistic patient care, difficult experiences, service provision, relationships and feedback on the discharge pathway. Practical implications: This study highlighted the importance of centring patient autonomy during treatment, as well as ensuring treatments are holistic in nature. This may reduce the high levels of relapse associated with discharge from IP treatment and improve the quality and effectiveness of eating disorder treatment delivered. Originality/value: Co-production approaches were used to develop the IP discharge pathway with members of a Lived Experience Advisory Panel alongside clinicians. To the best of the authors' knowledge, this study was also the first intervention development study aimed at providing targeted support for patients dealing with the adverse effects of hospitalisation and difficulties transitioning to outpatient care. [ABSTRACT FROM AUTHOR]