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Motivation to change among residential treatment patients with an eating disorder: Assessment of the multidimensionality of motivation and its relation to treatment outcome

Authors

  • Sherrie S. Delinsky PhD,

    Corresponding author
    1. Klarman Eating Disorders Center, McLean Hospital, Belmont, Massachusetts
    2. Eating Disorders Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
    3. Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
    • Klarman Eating Disorders Center, McLean Hospital, Belmont, Massachusetts
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  • Jennifer J. Thomas PhD,

    1. Klarman Eating Disorders Center, McLean Hospital, Belmont, Massachusetts
    2. Eating Disorders Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
    3. Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
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  • Sarah A. St. Germain MA,

    1. Klarman Eating Disorders Center, McLean Hospital, Belmont, Massachusetts
    2. Department of Psychology, Harvard University, Cambridge, Massachusetts
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  • Katherine Ellison Craigen BA,

    1. Klarman Eating Disorders Center, McLean Hospital, Belmont, Massachusetts
    2. Department of Psychology, Fairleigh Dickinson University, Teaneck, New Jersey
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  • Thomas J. Weigel MD,

    1. Klarman Eating Disorders Center, McLean Hospital, Belmont, Massachusetts
    2. Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
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  • Philip G. Levendusky PhD,

    1. Klarman Eating Disorders Center, McLean Hospital, Belmont, Massachusetts
    2. Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
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  • Anne E. Becker MD, PhD, ScM

    1. Eating Disorders Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
    2. Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
    3. Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts
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  • A portion of this manuscript was presented at the 2007 International Conference on Eating Disorders, Baltimore, MD.

Abstract

Objective:

To examine the multidimensional nature of motivation to change in an adolescent sample in residential eating disorder (ED) treatment and relate it to outcome.

Method:

To determine whether different dimensions of motivation (benefits, burdens, and functional avoidance) are differentially associated with symptom severity and outcome, we assessed eating pathology and motivation to change in consecutively admitted female patients (n = 67) with AN, BN, and EDNOS in a residential ED program with the Eating Disorder Examination Questionnaire (EDE-Q) and the Decisional Balance Scale (DB).

Results:

Pretreatment DB benefits and functional avoidance subscales were correlated with ED and comorbid psychopathology. Admission to discharge change in DB benefits—but not other measured dimensions of motivation was significantly associated with post-treatment EDE-Q global scores.

Discussion:

Our findings support that motivation to change is a multidimensional construct among ED patients. A reduction in perceived benefits of illness is associated with less severe post-treatment eating pathology. © 2010 by Wiley Periodicals, Inc. (Int J Eat Disord 2011; 44:340–348)

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