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Latent trajectories of eating disorder treatment response among female patients in residential care
Author(s) -
EspelHuynh Hallie M.,
Zhang Fengqing,
Boswell James F.,
Thomas John Graham,
ThompsonBrenner Heather,
Juarascio Adrienne S.,
Lowe Michael R.
Publication year - 2020
Publication title -
international journal of eating disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.785
H-Index - 138
eISSN - 1098-108X
pISSN - 0276-3478
DOI - 10.1002/eat.23369
Subject(s) - bulimia nervosa , anorexia nervosa , psychopathology , binge eating disorder , eating disorders , psychology , body mass index , psychiatry , differential treatment , binge eating , clinical psychology , medicine , international trade , business
Objective Eating disorder (ED) treatment outcomes are highly variable from beginning to end of treatment; however, little is known about differential trajectories during the course of treatment. This study sought to characterize heterogeneous patterns of ED treatment response during residential care. Method Participants were adolescent girls and adult women ( N = 360) receiving residential ED treatment for anorexia nervosa, bulimia nervosa, binge‐eating disorder, other specified feeding or eating disorder, unspecified feeding or eating disorder, or avoidant/restrictive food intake disorder. Self‐report symptom assessments were completed at admission, discharge, and approximately weekly throughout the residential stay to assess curvilinear patterns of change. Latent growth mixture modeling was applied to identify subgroups of patients with similar treatment response trajectories. Results Three latent groups emerged, including gradual response (58.3%; steady improvements from admission to discharge), rapid response (23.9%; steep early improvements that were maintained through discharge), and low‐symptom static response (17.8%; nearly nonclinical self‐reported symptoms at admission that remained static through discharge). Groups differed on important clinical characteristics, such as body mass index, endorsement of compensatory behaviors, severity of global ED psychopathology at admission, and degree of symptom improvement by end of treatment. Discussion Patients follow heterogeneous response patterns in residential ED treatment, and these patterns are associated with differential treatment outcome. Future work should explore whether these trajectories are associated with differential outcomes at follow‐up and whether tailoring clinical intervention to a patient's trajectory type can improve treatment response.