Control and perceived criticism in eating disorders

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Control and perceived criticism in eating disorders: their psychopathological role and significance for treatment Sandra ...

Clinical background <ul><li>Our research on control in ED began with the observation of anorexic clients who clearly becam...

Clinical underground <ul><li>This attitude was fundamental in resisting to change proposed by the psychotherapist </li></u...

Control in eating disorders <ul><li>In our opinion, the clinical concept of anxious perception of lack of control is appli...

Control in eating disorders <ul><li>Subjects with ED often look for control (Bruch, 1973; Button, 1985). </li></ul><ul><l...

Control in eating disorders <ul><li>Hence, ED could be described as disorders of the sense of self-esteem combined with a ...

Control in eating disorders <ul><li>However, this popular theory did not generate empirical research on the role of the ne...

Criticism in eating disorders <ul><li>The second variable which attracted our clinical attention was perceived criticism ...

Criticism in eating disorders <ul><li>In fact, maladaptive perfectionism includes an intense self-critical attitude ( Fr...

Criticism in eating disorders <ul><li>The association between perceived criticism and maladaptive perfectionism in individ...

Control and criticism <ul><li>During past years, we developed empirical research aimed at testing the roles of control an...

Our studies: interaction between control, criticism and perfectionism <ul><li>We tested how control and perceived criticis...

More frequently used instruments in our studies <ul><li>Drive for thinness , bulimia , and body dissatisfaction subscal...

Results <ul><li>Perfectionism mediates between criticism and ED, while control moderate the influence of perfectionism...

Visual summary of results of our correlational studies (Sassaroli et al., 2003, 2005, 2008; Ruggiero 2005)

Control: discussion <ul><li>Our results suggest that ED psychopathology reflects not only cognitive constructs of perfect...

Treating control <ul><li>Concerning the treatment of issues of control, the therapist should develop a strategy that chall...

Treating control <ul><li>The final aim of a treatment focused on control is to encourage the patient: </li></ul><ul><li>To...

Criticism: discussion <ul><li>In addition, results suggest that restrictive dieting would be related to a process in whic...

Treating criticism <ul><li>Concerning criticism, the intervention should be aimed at assessing suffering related to the co...

Sandra Sassaroli, M.D. 1 , Roberta Fiscaletti, Psy.D. 1 , Francesca Fiore, Ph.D. 1 , Sara Bertelli, M.D. 3 , Silvio Scaron...

Introduction <ul><li>The Control Focused Treatment of Eating Disorders (CFT-ED) applies our research results to clinical p...

CFT-ED <ul><li>CFT-ED adds interest about the cognitive belief of control to Fairburn ’ s clinical protocol and comprise...

Method: Instruments <ul><li>30 patients who receive treatment in Ospedale San Paolo di Milano, Cà Granda, with Bulimia N...

Method: Participants <ul><li>30 Subjects divided in two groups: </li></ul><ul><ul><li>CFT-ED group (CFT, Sassaroli & Rugg...

Method: Therapy and therapists <ul><li>12 sessions of Fairburn ’s CBT-ED and 12 sessions of CFT-ED were delivered to pati...

Baseline <ul><li>The data were analyzed by a series of multivariate analysis; </li></ul><ul><li>Comparison between the two...

Results: CFT-ED group from T0 (beginning) to T1 (12 sessions) Clinical variables improved: bulimia, body dissatisfaction, ...

Results: Fairburn’s CBT-ED group from T0 (beginning) to T1 (12 sessions) Clinical variables improved: bulimia

Comparison between CFT-ED and Fairburn’ s CBT-ED at T1 (12 sessions) Concern over mistakes lower (= better) in Fairburn CB...

Comparison between CFT-ED and Fairburn ’s E-CBT-ED at T2 (6 months follow-up) No difference regarding Concern over mistak...

Summing up <ul><li>At the 12th session : </li></ul><ul><ul><li>Fairburn ’s CBT-ED group clinically improved </li></ul></u...

Discussion <ul><li>From a clinical viewpoint: both Fairburn’ s CBT-ED and CFT-ED interventions show a significant improv...

Discussion <ul><li>From a cognitive viewpoint, results confirm cognitive targets: Fairburn ’s E-CBT-ED influences mainly...

Clinical implications <ul><li>In conclusion, a treatment more focused on control could add a degree of psychological well-...

Limitations <ul><li>Increasing the number of patients per group </li></ul><ul><li>Exploring the mediators/moderators of ch...

<ul><li>Thank you very much! </li></ul><ul><li>Email: [email_address] [email_address] </li></ul>

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