Modified metacognitive therapy for anorexia nervosa: An open trial in an outpatient setting.

OBJECTIVE: Current evidence indicates treatment for adults with anorexia nervosa (AN) requires improvement given recovery rates are low to moderate, and relapse rates are high. Metacognitive therapy (MCT) is an effective treatment for anxiety and depressive disorders. This study evaluates if MCT can be successfully modified to treat AN in a naturalistic clinical setting. METHOD: Twenty-four patients with AN participated in an open trial of modified metacognitive therapy (MCT-AN). Twelve of the 24 patients (50%) completed treatment. MCT was modified to include components specific to eating disorders. The MCT-AN was delivered by clinical psychologists who had undertaken training in MCT in a specialist outpatient service. Group and single participant data analyses were undertaken on those who completed treatment. RESULTS: As well as statistically significant differences from pre- to posttreatment in the group data there were also clinically significant improvements at the individual patient level for eating disorder and depressive symptoms, as well as weight. The mean number of therapy sessions was 18. DISCUSSION: These findings indicate that MCT-AN may be a promising intervention in the treatment of AN, warranting further investigation. PUBLIC SIGNIFICANCE: Treatment for anorexia nervosa in adults requires improvement. Research indicates that Metacognitive therapy (MCT) is an effective treatment for anxiety and depression and may be applicable to the eating disorders. This small open trial suggests that MCT can be modified successfully to treat patients with anorexia nervosa (AN). The results are preliminary and require further research to provide more evidence on the effectiveness of this treatment for AN.

Lifespan differences in emotional contagion while watching emotion-eliciting videos.

Previous research has examined empathic concern by presenting toddlers with a sad stimulus and examining their emotional response, with the conclusion that toddlers display empathy. Yet, such research has failed to include basic control conditions involving some other aversive stimulus such as white noise. Nor has it compared toddlers to adults to examine potential development in empathy. In the present study, we showed toddlers and adults four video types: infant crying, infant laughing, infant babbling, and a neutral infant accompanied by white noise. We then coded happiness and sadness while viewing the videos, and created a difference score (happiness minus sadness), testing 52 toddlers and 61 adults. Whereas adults showed more sadness towards infant crying than any other stimulus, toddlers' response to crying and white noise was similar. Thus, the toddler response to crying was comparable to previous studies (slight sadness), but was no different to white noise and was significantly reduced relative to adults. As such, toddlers' response seemed to be better characterized as a reaction to an aversive stimulus rather than empathy.