Motivation to Change and Reduction of Symptoms Peer Reviewed Journal

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Motivation to Change and Reduction of Symptoms in Adolescents Suffering from Bulimia Nervosa

In research published by Castro-Fornieles (et al., 2011) the relationship between recovery from bulimia nervosa and motivation to change in adolescence sufferers is examined. The authors of the research had not found any similar research which had looked at this specific area of study. However, the research is based on previous research where strong links between behavioral changes in adults suffering from eating disorders and level of motivational for change. The importance of motivation has been generally accepted as an important influence and predictor of successful change in a range of health issues, such as smoking, which rely on patients implementing and maintaining behavioral changes. When looking specifically as bulimia nervosa, further research has found that relapses are more likely where adults suffering from the condition. In adolescents there has also been research examining motivation and the relationship between recovery from anorexia nervosa which has established a positive correlation between motivation levels and better treatment responses. While there appear to be some commonalities there are also differences; the adults level of motivations appears to be positive correlated to age, in the adolescents with anorexia nervosa age does not appear to be a significant influence. The aim of the research presented in this paper was to analyze the relationship between the level of motivation present during the first assessment and the subsequent decreased level of symptoms in adolescent bulimic patients. It was hypothesized that there would be a direct connection between the motivation to change and response to treatment, with motivational level being a predictor of the patients' behavioral response to their treatment.

Research was undertaken with a sample of patients diagnosed with bulimia nervosa according to DSM-IV. In all cases the diagnosis was undertaken by the same psychologist and staff group. The initial sample size was 40, which was heavily skewed towards female patients, who made up 39 of the sample.

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The patient ages ranged between 14 and 18 years old, with a mean age of 6.2 years, and a standard deviation of 1.1 years. All of the patients were of the Hospital Clinic Universitari in Barcelona attending the Eating Disorders Unit of the Child and Adolescent Psychiatry and Psychology Department.

The patients were assessed at two stages, on the first assessment in the hospital department, and subsequently at between the six-month an eight-month mark. The patients were evaluated using a number of generally accepted tools which were applied at both of these assessments. The tools utilized where the Bulimia Nervosa Stages of Change Questionnaire

(BNSOCQ), the Eating Disorders Inventory-2 (EDI-2) and the Beck Depression Inventory (BDI). All patients that participated did so voluntarily, with assurances that any their responses would remain confidential. Only 31 patients were subject to the second evaluation, the remaining nine patients had withdrawn from the treatment program. These nine patients were similar to those who remained in the study, so the departure does not appear to have biased the research.

In all cases the subject underwent the same basic treatment approach, which consisted of a multidisciplinary approach designed to help improve the eating patterns of the patients and reduce compensatory behaviors with the majority of the bulimic adolescents being seen as outpatients. 31 of the patients (77.5%) were treated as outpatients. Treatments varied slightly, and could include cognitive treatment on either a group or an individual basis, and parent counseling. In moderate and severe cases some patients may have received pharmacological treatment; this amounted to 29 (72.5%) of the cases in this study.

Once the results were gathered from the 31 subjects completed both sets of evaluations, the results were analyzed statistically using the computer program SPSS (version 16), comparing the two sets of questionnaires in order to identify differences. MANOVA was used to compare the psychopathological scales used to compare the.....

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