In-session-reflective-functioning in anorexia nervosa: an analysis of psychotherapeutic sessions of the ANTOP study

Abstract: Objective: Previous research suggests that patients with anorexia nervosa (AN) show an impaired capacity to mentalize (reflective functioning, RF). RF is discussed as a possible predictor of outcome in psychotherapeutic processes. The study aimed to explore RF in sessions of patients with AN and its association with outcome and type of treatment.

Methods: A post-hoc data analysis of selected cases from a randomized trial on outpatient psychotherapy for AN was conducted. Transcripts from 84 sessions of 28 patients (early phase, middle phase, and end of treatment) were assessed using the In-Session-Reflective-Functioning-Scale [14 cognitive-behavior therapy, enhanced (CBT-E); 14 focal psychodynamic therapy (FPT); 16 with good, 12 with poor outcome after 1 year]. Relations between the level of RF, type of treatment, and outcome were investigated using mixed linear models. Additionally, associations with depressive symptoms, weight gain, and therapeutic alliance were explored.

Results: Mean in-session RF was low. It was higher in FPT when compared to CBT-E treatments. The findings point to an association between RF increase and a positive outcome. An increase in BMI in the first half of treatment was associated with higher subsequent in-session RF. There was no association between RF and depressive symptoms or the therapeutic alliance.

Discussion: Patients with AN show a low capacity to mentalize in sessions, which seems to be at least partly dependent on the degree of starvation. The results suggest a possible relationship between an increase in in-session RF and outcome, which has to be replicated by further studies

Object Details

• Location: Deutsche Nationalbibliothek Frankfurt am Main
• Extent: Online-Ressource
• Language: Englisch
• Notes: Frontiers in psychiatry. - 13 (2022) , 814441, ISSN: 1664-0640

Contributors, Places and Time

• Event: Veröffentlichung
• (where): Freiburg
• (who): Universität
• (when): 2022
• Creator: Zeeck, Almut ; Taubner, Svenja ; Gablonski, Thorsten-Christian ; Lau, Inga ; Zipfel, Stephan ; Herzog, Wolfgang ; Wild, Beate ; Friederich, Hans-Christoph ; Resmark, Gaby ; Giel, Katrin ; Teufel, Martin ; Burgmer, Markus ; Dinkel, Andreas ; Herpertz, Stephan ; Löwe, Bernd ; Tagay, Sefik ; Wietersheim, Jörn von ; Zwaan, Martina de ; Zettl, Max ; Meier, Alexander Ferdinand ; Hartmann, Armin

Further information

• DOI: 10.3389/fpsyt.2022.814441
• URN: urn:nbn:de:bsz:25-freidok-2278582
• Rights: Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
• Last update: 25.03.2025, 1:55 PM CET