Skip to main content
Search
Search
    Quick Search anywhere
    Quick search in Citations
Advanced Search
Skip main navigation
Previous article
Next article
Originalarbeit

Was passiert nach dem letzten Klick?

Entwicklung der Veränderungsmotivation und Symptomatik nach Abschluss eines internetgestützten Motivationsprogramms bei Essstörungen. Eine Follow-up-Studie

Published Online:April 22, 2016https://doi.org/10.1026/1616-3443/a000349

Abstract

Zusammenfassung.Theoretischer Hintergrund: Bisherige Studien zeigen, dass internetbasierte Interventionen kurzfristig die Veränderungsmotivation bei Essstörungen verbessern können. Zur Stabilität dieser Effekte ist jedoch wenig bekannt. Fragestellung: Wie entwickeln sich die Veränderungsmotivation, die Essstörungspsychopathologie und das Selbstwertgefühl 8 Wochen nach Abschluss eines internetbasierten Motivationsprogramms? Methode: Neunzig Frauen bearbeiteten den Stages of Change Questionnaire for Eating Disorders, den Eating Disorder Examination-Questionnaire und die Rosenberg Self-Esteem-Scale unmittelbar (Post) sowie 8 Wochen nach Abschluss der Intervention (Katamnese). Ergebnisse: Es zeigten sich stabile Effekte in der Veränderungsmotivation sowie im Selbstwertgefühl. Zusätzlich zeigten sich in der Essstörungspsychopathologie signifikante Verbesserungen. Schlussfolgerungen: Die Studie belegt die längerfristige Wirksamkeit eines internetbasierten Motivationsprogramms für Frauen mit Essstörungen.


What Happens After the Last Click? Changes in Symptoms and Motivation to Change After Completing an Internet-Delivered Intervention to Enhance Motivation to Change in Patients With Eating Disorders

Abstract.Background: Previous studies show that web-based interventions are able to enhance motivation to change in women with eating disorders in the short term; however, little is known about the stability of these effects. Objective: To investigate motivation to change, eating disorder psychopathology, and self-esteem in subjects 8 weeks after finishing a web-based motivational enhancement program. Method: In all, 90 women completed the Stages of Change Questionnaire for Eating Disorders, the Eating Disorder Examination Questionnaire, and the Rosenberg Self-Esteem Scale after the intervention (post) and at 8 weeks’ follow-up. Results: Stable effects were found for motivation to change and self-esteem. Additionally, participants showed significant improvement concerning their eating disorder psychopathology. Conclusion: This study shows the long-term effectiveness of a web-based intervention to enhance motivation in women with eating disorders.

Literatur

  • Allen, K. L., Fursland, A., Raykos, B., Steele, A., Watson, H. & Byrne, S. M. (2012). Motivation-focused treatment for eating disorders: A sequential trial of enhanced cognitive behaviour therapy with and without preceding motivation-focused therapy. European Eating Disorders Review, 20, 232 – 239. First citation in articleCrossref, Google Scholar

  • American Psychiatric Association (APA). (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-V). 5th edition. Washington: APA. First citation in articleCrossref, Google Scholar

  • Bandini, S., Antonelli, G., Moretti, P., Pampanelli, S., Quartesan, R. & Perriello, G. (2006). Factors affecting dropout in outpatient eating disorders treatment. Eating and Weight Disorders, 11, 179 – 184. First citation in articleCrossref, Google Scholar

  • Barak, A., Hen, L., Boniel-Nissim, M. & Shapira, N. (2008). A comprehensive review and a meta-analysis of the effectiveness of internet-based psychotherapeutic interventions. Journal of Technology in Human Services, 26, 109 – 160. First citation in articleCrossref, Google Scholar

  • Bardone-Cone, A. M. (2012). Examining the match between assessed eating disorders recovery and subjective sense of recovery: preliminary findings. European Eating Disorders Review, 20, 246 – 249. First citation in articleCrossref, Google Scholar

  • Bell, L. (2001). What predicts failure to engage in or drop out from treatment for bulimia nervosa and what implications does this have for treatment? Clinical Psychological and Psychotherapy, 8, 424 – 435. First citation in articleCrossref, Google Scholar

  • Beintner, I. & Jacobi, C. (2011). Internetgestütze Nachsorge bei Bulimia nervosa: Behandlungsmanual und Studiendesgin. Psychotherapeut, 56, 516 – 521. First citation in articleCrossref, Google Scholar

  • Blake, W., Turnbull, S. & Treasure, J. (1997). Stages and processes of change in eating disorders: implications for therapy. Clinical Psychology and Psychotherapy, 4, 186 – 191. First citation in articleCrossref, Google Scholar

  • Brachel, R. von, Hötzel, K., Hirschfeld, G., Rieger, E., Schmidt, U. & Kosfelder, J., et al. (2014). Eating disorder pathology and depressive mood predict dropout from an internet-based motivation program for women with eating disorders. Journal of Medical Internet Research, 16, e92. First citation in articleCrossref, Google Scholar

  • Brachel, R. von, Hötzel, K., Schloßmacher, L., Hechler, T., Kosfelder, J. & Rieger, E., et al. (2012). Entwicklung und Validierung einer deutschsprachigen Skala zur Erfassung der Veränderungsmotivation bei Essstörungen – The Stages of Change Questionnaire for Eating Disorders (SOCQ-ED). Psychotherapie Psychosomatik Medizinische Psychologie, 62, 1 – 12. First citation in articleGoogle Scholar

  • Casasnovas, C., Fernández-Aranda, F., Granero, R., Krug, I., Jiménez-Murcia, S. & Bulik, C. M., et al. (2007). Motivation to change in eating disorders: Clinical and therapeutic implications. European Eating Disorders Review, 15, 449 – 456. First citation in articleCrossref, Google Scholar

  • Cassin, S. E., Ranson, K. M. von, Heng, K., Brar, J. & Wojtowicz, A. E. (2008). Adapted motivational interviewing for women with binge eating disorder: A randomized randomized controlled trial. Psychology of Addictive Behaviours, 22, 417 – 425. First citation in articleCrossref, Google Scholar

  • Castro-Fornieles, J., Bigorra, A., Martinez-Mallen, E., Gonzalez, L., Moreno, E. & Font, E., et al. (2011). Motivation to change in adolescents with bulimia nervosa mediates clinical change after treatment. European Eating Disorders Review, 19, 46 – 54. First citation in articleCrossref, Google Scholar

  • Dean, H. Y., Touyz, S. W., Rieger, E. & Thornton, C. E. (2008). Group motivational enhancement therapy as an adjunct to inpatient treatment for eating disorders: A preliminary study. European Eating Disorders Review, 16, 256 – 267. First citation in articleCrossref, Google Scholar

  • Dejong, H., Broadbent, H. & Schmidt, U. (2012). A systematic review of dropout from treatment in outpatients with anorexia nervosa. International Journal of Eating Disorders, 45, 635 – 647. First citation in articleCrossref, Google Scholar

  • Dilling, H., Mombour, W. & Schmidt, M. H. (Hrsg.) (2013). Internationale Klassifikation psychischer Störungen: ICD-10 Kapitel V (F) Klinisch-diagnostische Leitlinien. Bern: Huber. First citation in articleGoogle Scholar

  • Dray, S. & Wade, T. D. (2012). Is the transtheoretical model and motivational interviewing approach applicable to the treatment of eating disorders? A review. Clinical Psychology Review, 32, 558 – 565. First citation in articleCrossref, Google Scholar

  • Dunn, E. C., Neighbors, C. & Larimer, M. E. (2006). Motivational enhancement therapy and self-help treatment for binge-eaters. Psychology of Addictive Behaviors, 20, 44 – 52. First citation in articleCrossref, Google Scholar

  • Fairburn, C. G. & Beglin, S. J. (1994). Assessment of eating disorders: Interview or self-report questionnaire? International Journal of Eating Disorders, 16, 363 – 370. First citation in articleCrossref, Google Scholar

  • Feld, R., Woodside, D. B., Kaplan, A. S., Olmsted, M. P. & Carter, J. C. (2001). Pretreatment motivational enhancement therapy for eating disorders: A pilot study. International Journal of Eating Disorders, 29, 393 – 400. First citation in articleCrossref, Google Scholar

  • Ferring, D. & Filipp, S. H. (1996). Messung des Selbstwertgefühls: Befunde zu Realibilität, Validität und Stabilität der Rosenberg-Skala. Diagnostica, 42, 284 – 292. First citation in articleGoogle Scholar

  • Geller, J., Cockell, S. J. & Drab, D. L. (2001). Assessing readiness for change in the eating disorders: The psychometric properties of the Readiness and Motivation Interview. Psychological Assessment, 13, 189 – 198. First citation in articleCrossref, Google Scholar

  • Geller, J., Drab-Hudson, D. L., Whisenhunt, B. L. & Srikameswaran, S. (2004). Readiness to change dietary restriction predicts outcomes in the eating disorders. Eating Disorders, 12, 209 – 224. First citation in articleCrossref, Google Scholar

  • Geller, J. & Dunn, E. C. (2011). Integrating Motivational Interviewing and Cognitive Behavioral Therapy in the Treatment of Eating Disorders: Tailoring Interventions to Patient Readiness for Change. Cognitive and Behavioral Practice, 18, 5 – 15. First citation in articleCrossref, Google Scholar

  • Gowers, S. G. & Smyth, B. (2004). The impact of a motivational assessment interview on initial response to treatment in adolescent anorexia nervosa. European Eating Disorders Review, 12, 87 – 93. First citation in articleCrossref, Google Scholar

  • Hilbert, A. & Tuschen-Caffier, B. (2006). Eating Disorder Examination-Questionnaire: Deutschsprachige Übersetzung. Münster: Verlag für Psychotherapie. First citation in articleGoogle Scholar

  • Hoek, H. W. & Hoeken, D. van (2003). Review of the prevalence and incidence of eating disorders. International Journal of Eating Disorders, 34, 383 – 396. First citation in articleCrossref, Google Scholar

  • Hötzel, K., Brachel, R. von, Schlossmacher, L. & Vocks, S. (2013). Assessing motivation to change in eating disorders: A systematic review. Journal of Eating Disorders, 1, 38. First citation in articleCrossref, Google Scholar

  • Hötzel, K., Brachel, R. von, Schmidt, U., Rieger, E., Kosfelder, J. & Hechler, T., et al. (2014). An internet-based program to enhance motivation to change in females with symptoms of an eating disorder: A randomized-controlled trial. Psychological Medicine, 44, 1947 – 1963. First citation in articleCrossref, Google Scholar

  • Kaltiala-Heino, R., Rissanen, A., Rimpelä, M. & Rantanen, P. (1999). Bulimia and bulimia behavior in middle adolescence: more common than thought? Acta Psychiatrica Scandinavica, 100, 33 – 39. First citation in articleCrossref, Google Scholar

  • Katzman, M. A., Bara-Carril, N., Rabe-Hesketh, S., Schmidt, U., Troop, N. & Treasure, J. (2010). A randomized controlled two-stage trial in the treatment of bulimia nervosa, comparing CBT versus motivational enhancement in Phase 1 followed by group versus individual CBT in Phase 2. Psychosomatic Medicine, 72, 656 – 663. First citation in articleCrossref, Google Scholar

  • Leung, S. F., Ma, J. & Russell, J. (2013). Enhancing motivation to change in eating disorders with an online self-help program. International Journal of Mental Health Nursing, 22, 329 – 339. First citation in articleCrossref, Google Scholar

  • Macdonald, P., Hibbs, R., Corfield, F. & Treasure, J. (2012). The use of motivational interviewing in eating disorders: a systematic review. Psychiatry Research, 200, 1 – 11. First citation in articleCrossref, Google Scholar

  • Mansour, S., Bruce, K. R., Steiger, H., Zuroff, D. C., Horowitz, S. & Anestin, A. S., et al. (2012). Autonomous motivation: a predictor of treatment outcome in bulimia-spectrum eating disorders. European Eating Disorders Review, 20, 116 – 122. First citation in articleCrossref, Google Scholar

  • Martínez, E., Castro, J., Bigorra, A., Morer, A., Calvo, R. & Vila, M., et al. (2007). Assessing motivation to change in bulimia nervosa: The Bulimia Nervosa Stages of Change Questionnaire. European Eating Disorders Review, 15, 13 – 23. First citation in articleCrossref, Google Scholar

  • Masson, P. C., Perlman, C. M., Ross, S. A. & Gates, A. L. (2007). Premature termination of treatment in an inpatient eating disorder programme. European Eating Disorders Review, 15, 275 – 282. First citation in articleCrossref, Google Scholar

  • Miller, W. R. & Rollnick, S. (2002). Motivational interviewing: Preparing people for change (2nd ed.). New York: Guilford Press. First citation in articleGoogle Scholar

  • Neumark-Sztainer, D. & Hannan, P. J. (2000). Weight related behaviors among adolescent girls and boys: results from a national survey. Archives of Pediatrics & Adolescent Medicine, 154, 569 – 577. First citation in articleCrossref, Google Scholar

  • Prochaska, J. O. & DiClemente, C. C. (1983). Stages and process of self-change of smoking: toward an integrative model of change. Journal of Consulting and Clinical Psychology, 51, 390 – 395. First citation in articleCrossref, Google Scholar

  • Richard, M., Bauer, S., Kordy, H. & COST Action B6 (2005). Relapse in anorexia and bulimia nervosa – A 2.5-year follow-up study. European Eating Disorders Review, 13, 180 – 190. First citation in articleCrossref, Google Scholar

  • Rieger, E., Touyz, S., Schotte, D., Beaumont, P., Russel, J. & Clarke, S., et al. (2000). Development of an instrument to assess readiness to recover in anorexia nervosa. International Journal for Eating Disorders, 28, 387 – 396. First citation in articleCrossref, Google Scholar

  • Schmidt, U. & Treasure, J. (2006). Anorexia nervosa: Valued and visible. A cognitive-interpersonal maintenance model and its implication for research and practice. British Journal of Clinical Psychology, 45, 343 – 366. First citation in articleCrossref, Google Scholar

  • Treasure, J. & Schmidt, U. (2001). Ready, willing and able to change: motivational aspects of the assessment and treatment of eating disorders. European Eating Disorders Review, 9, 4 – 18. First citation in articleCrossref, Google Scholar

  • Vansteenkiste, M., Soenens, B. & Vandereycken, W. (2005). Motivation to change in eating disorder patients: A conceptual clarification on the basis of self-determination theory. International Journal of Eating Disorders, 37, 207 – 219. First citation in articleCrossref, Google Scholar

  • Vitousek, K., Watson, S. & Wilson, G. T. (1998). Enhancing motivation for change in treatment-resistant eating disorders. Clinical Psychology Review, 18, 391 – 420. First citation in articleCrossref, Google Scholar

  • Wagner, B. & Lange, A. (2008). Internetbasierte Psychotherapie „Interapy“. In Bauer, S.Kordy, H.Hrsg., E-Mental-Health (S. 105 – 120). Heidelberg: Springer. First citation in articleGoogle Scholar