What works for adolescents with AN? A systematic review of psychosocial interventions

  • S. Tierney
  • K. Wyatt
Review Article


Objective: To determine the effectiveness of psychosocial interventions for adolescents with AN. Methods: An extensive and systematic literature search was conducted for randomised controlled trials (RCTs) addressing the effectiveness of psychosocial interventions for teenagers (11–18 years) with AN. Results: Eight RCTs were located meeting the review’s inclusion criteria, the majority of which focused on some form of family-related intervention. Discussion: Unfortunately, a lack of robust primary research on which to base the review meant that clear recommendations could not be made. More good quality research, examining a range of interventions, and involving larger samples, is required before a similar systematic review is executed.

Key words

Systematic review adolescents AN psychosocial interventions 


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  1. 1.
    Bryant-Waugh R., Lask B.: Eating disorders: An overview. J. Fam. Ther., 17, 13–30, 1995.CrossRefGoogle Scholar
  2. 2.
    Chisholm K.: Hungry Hell: What it’s really like to be anorexic: A personal story. London, Short Books, 2002, pp.17.Google Scholar
  3. 3.
    Steinhausen H.C.: Psychosocial aspects of chronic disease in children and adolescents. Horm. Res., 41, 36–41, 1994.PubMedCrossRefGoogle Scholar
  4. 4.
    Mizes J.S.: Neglected topics in eating disorders: Guidelines for clinicians. Clin. Psychol. Rev., 18, 387–390, 1998.PubMedCrossRefGoogle Scholar
  5. 5.
    Russell G.F.M., Szmukler G.I., Dare C., Eisler I.: An evaluation of family therapy in anorexia nervosa and bulimia nervosa. Arch. Gen. Psychiatry, 44, 1047–1056, 1987.PubMedCrossRefGoogle Scholar
  6. 6.
    Shugar G., Kruger S.: Aggressive family communication, weight gain, and improved eating attitudes during systematic family therapy for anorexia nervosa. Int. J. Eat. Disord., 17, 23–31, 1995.PubMedCrossRefGoogle Scholar
  7. 7.
    Steinhausen H.C., Seidel R.: Short term and intermediate term of outcome in adolescent eating disorders. Acta Psychiatr. Scand., 88, 169–173, 1993.PubMedCrossRefGoogle Scholar
  8. 8.
    Baguley I. Baguley C.: Psychosocial interventions in the treatment of psychosis. Mental Health Care, 21, 314–317, 1999.Google Scholar
  9. 9.
    Greenhalgh T.: How to read a paper: The basics of evidence based medicine, 2nd Ed. London, BMJ Publishing, 2001.Google Scholar
  10. 10.
    Eisler I., Dare C., Hodes M., Russell G., Dodge E., Le Grange D.: Family therapy for adolescent anorexia nervosa: The results of a controlled comparison of two family interventions. J. Child Psychol. Psychiatry, 41, 727–736, 2000.PubMedCrossRefGoogle Scholar
  11. 11.
    Dare C., Chania E., Eisler I., Hodes M., Dodge E.: The eating disorders inventory as an instrument to explore change in adolescents in family therapy for anorexia nervosa. Eur. Eat. Disord. Rev., 8, 369–383, 2000.CrossRefGoogle Scholar
  12. 12.
    Geist R., Heinmaa M., Stephens D., Davis R., Katzman D.K.: Comparison of family therapy and family group psychoeducation in adolescents with anorexia nervosa. Can. J. Psychiatry, 45, 173–178, 2000.PubMedGoogle Scholar
  13. 13.
    Goldfarb L.A., Fuhr R., Tsujimoto R.N., Fischman S.E.: Systematic desensitisation and relaxation as adjuncts in the treatment of anorexia nervosa: A preliminary study. Psychol. Reports, 60, 511–518, 1987.CrossRefGoogle Scholar
  14. 14.
    Paul G.L.: Insight versus desensitization in psychotherapy: An experiment in anxiety reduction. Stanford, Stanford University Press, 1966.Google Scholar
  15. 15.
    Le Grange D., Eisler I., Dare C., Russell G.F.M.: Evaluation of family treatments in adolescent anorexia nervosa: A pilot study. Int. J. Eat. Disord., 12, 347–357, 1992.CrossRefGoogle Scholar
  16. 16.
    Robin A.L., Siegel P.T., Moye A.W., Gilroy M., Baker Dennis A., Sikard A.: A controlled comparison of family versus individual therapy for adolescents with anorexia nervosa. J. Am. Acad. Child Adolesc. Psychiatry, 38, 1482–1489, 1999.PubMedCrossRefGoogle Scholar
  17. 17.
    Eisler I., Dare C., Russell G.F.M., Szmukler G., Le Grange D., Dodge E.: Family and individual therapy in anorexia nervosa: A five-year follow-up. Arch. Gen. Psychiatry, 54, 1025–1030, 1997.PubMedCrossRefGoogle Scholar
  18. 18.
    Touyz S.W., Williams H., Marden K., Kopec-Schrader E., Beumont P.J.V.: Videotape feedback of eating behaviour in patients with anorexia nervosa: Does it normalise eating behaviour? Austr. J. Nutr. Dietetics, 51, 79–82, 1994.Google Scholar
  19. 19.
    Touyz S.W., Beumont B.J.V., Glaun D., Phillips T., Cavie I.: A comparison of lenient and strict operant conditioning programmes in refeeding patients with anorexia nervosa. Br. J. Psychiatry, 144, 517–520, 1984.PubMedCrossRefGoogle Scholar
  20. 20.
    Wallin U., Kronovall P., Majewski M. L.: Body awareness therapy in teenage anorexia nervosa: Outcome after 2 years. Eur. Eat. Disord. Rev., 8, 19–30, 2000.CrossRefGoogle Scholar
  21. 21.
    Morgan H.G., Russell GFM.: Value of family background and clinical features as predictors of long-term outcome in anorexia nervosa: Four-year follow-up study of 41 patients. Psychol. Med., 5, 355–371, 1975.PubMedCrossRefGoogle Scholar
  22. 22.
    Garner D.M., Olmstead M.P., Polivy J.: Development and validation of a multidimensional eating disorder inventory for anorexia nervosa and bulimia. Int. J. Eat. Disord., 2, 15–34, 1983.CrossRefGoogle Scholar
  23. 23.
    Angold A., Costello E.J., Messer S.C., Pickles A.: Development of a short questionnaire for use in epidemiological studies of depression in children and adolescents. Int. J Meth. Psychiatr. Res., 5, 237–249, 1995.Google Scholar
  24. 24.
    Rosenberg M.: Society and the adolescent self-image. Princeton, Princeton University Press, 1965.Google Scholar
  25. 25.
    Goldfarb L.A., Dykens E.M., Gerrard M.: The Goldfarb Fear of Fat Scale. J. Person. Assess., 49, 329–332, 1985.CrossRefGoogle Scholar
  26. 26.
    Garner D.M., Garfinkel P.E.: The eating attitudes test: An index of symptoms of anorexia nervosa. Psychol. Med., 10, 647–656, 1979.CrossRefGoogle Scholar
  27. 27.
    Beck A.T.: Cognitive therapy and emotional disturbances. New York, International Universities Press, 1976.Google Scholar
  28. 28.
    Wilson A.S., Touyz S.W., Dunn S.M., Beumont P.J.V.: The eating behaviour rating scale (EBRS): A measure of eating pathology in anorexia nervosa. Int. J. Eat. Disord., 8, 583–592, 1989.CrossRefGoogle Scholar
  29. 29.
    Garfinkel P., Moldofsky H., Garner D.: The outcome of anorexia nervosa: Significance of clinical features, body image, and behavior modification. In: Vigersky R.A. (ed.) anorexia nervosa. New York, Raven Press, 1977.Google Scholar
  30. 30.
    Olson D.H., Sprenkle D.H., Russell C.S.: Circumplex model of marital and family system: I. Cohesion and adaptability dimensions, family types, and clinical applications. Family Process, 18, 3–28, 1979.PubMedCrossRefGoogle Scholar
  31. 31.
    Kovacs M.: The children’s depression inventory. Toronto, Multi-Health Systems, 1992.Google Scholar
  32. 32.
    Derogatis L.R.: The brief symptom inventory (BSI): Administration, scoring and procedures. Manual II. Baltimore, Clin. Psychosom. Res., 1992.Google Scholar
  33. 33.
    Skinner H.A., Steinhausen P.D., Santa-Barbara J.: The family assessment measure. Toronto, Multi-Health Systems, 1991.Google Scholar
  34. 34.
    Schulz K.F., Chalmers I., Hayes R.J., Altman D.G.: Empirical evidence of bias: Dimensions of methodological quality associated with estimates of treatment effects in controlled trials. J. Am. Med. Assoc., 273, 408–412, 1995.CrossRefGoogle Scholar
  35. 35.
    Hsu L.K.G.: Outcome of anorexia nervosa: A review of the literature (1954–1978). Arch. Gen. Psychiatry, 37, 1041–1046, 1980.PubMedCrossRefGoogle Scholar
  36. 36.
    Hsu L.K.G.: Outcome and treatment effects. In: Beumont P.J.V., Burrows G.D., Casper R.C. (eds.) Handbook of eating disorders (Part 1): Anorexia and bulimia nervosa. Amsterdam, New York, Oxford, Elsevier, 1987.Google Scholar
  37. 37.
    NICE: Eating disorders: Core interventions in the treatment and management of anorexia nervosa, bulimia nervosa and related eating disorders: A national clinical practice guideline. London, National Institute for Excellence, 2004.Google Scholar
  38. 38.
    Wilson G.T., Fairburn C.G.: Treatments for eating disorders. In: Nathan P.E., Gorman J.M. (Eds.), A guide to treatments that work. New York, Oxford, Oxford University Press, 1998.Google Scholar
  39. 39.
    Sheldon B.: Cognitive-behavioural therapy: Research, practice and philosophy. London, New York, Routledge, 1995.CrossRefGoogle Scholar
  40. 40.
    Silber T.: anorexia nervosa: Morbidity and mortality. Pediatr. Ann., 13, 851–859, 1984.PubMedGoogle Scholar
  41. 41.
    Channon S., de Silva P., Hemsley D., Perkins R.: A controlled trial of cognitive behavioral and behavioral treatment of anorexia nervosa. Behav. Res. Ther., 27, 529–535, 1989.PubMedCrossRefGoogle Scholar
  42. 42.
    Cooper Z., Fairburn C.G.: Eating Disorder Examination, 2nd ed. Oxford, Warneford Hospital, 1987.Google Scholar
  43. 43.
    Pike K.M., Walsh B.T., Vitousek K., Wilson G.T., Bauer J.: Cognitive behavior therapy in the posthospitalization treatment of anorexia nervosa. Am. J. Psychiatry, 160, 2046–2049, 2003.PubMedCrossRefGoogle Scholar

Copyright information

© Editrice Kurtis 2005

Authors and Affiliations

  1. 1.The Institute for Access studiesStaffordshire UniversityStoke-on-TrentU.K.
  2. 2.Exeter & North Devon Research & Development Support UnitU.K.

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