Group cognitive remediation therapy for younger adolescents with anorexia nervosa: a feasibility study in a Japanese sample

Rie Kuge; Katie Lang; Ayano Yokota; Shoko Kodama; Yuriko Morino; Michiko Nakazato; Eiji Shimizu

doi:10.1186/s13104-017-2642-5

Group cognitive remediation therapy for younger adolescents with anorexia nervosa: a feasibility study in a Japanese sample

BMC Res Notes. 2017 Jul 25;10(1):317. doi: 10.1186/s13104-017-2642-5.

Authors

Rie Kuge^{1

2}, Katie Lang³, Ayano Yokota⁴, Shoko Kodama⁵, Yuriko Morino⁵, Michiko Nakazato⁶, Eiji Shimizu⁷

Affiliations

¹ Support Center for Children and Family, Department of Psychology and Welfare, Tokyo Metropolitan Children's Medical Center, 2-8-29 Musashidai, Fuchu-shi, Tokyo, 183-8561, Japan. rie_kuge@tmhp.jp.
² Department of Cognitive Behavioral Physiology, Graduate School of Medicine Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8670, Japan. rie_kuge@tmhp.jp.
³ Psychological Medicine, Section Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, Kings' College London, Basement, Ground and 1st Floor 103, Denmark Hill, London, SE5 8AZ, UK.
⁴ Department of Clinical Psychology, Tokyo Metropolitan Matsuzawa Hospital, 2-1-1, Kamikitazawa, Setagaya-ku, Tokyo, 156-0057, Japan.
⁵ Department of Child and Adolescent Psychiatry, Tokyo Metropolitan Children's Medical Center, 2-8-29 Musashidai, Fuchu-shi, Tokyo, 183-8561, Japan.
⁶ Department of Psychiatry, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8670, Japan.
⁷ Department of Cognitive Behavioral Physiology, Graduate School of Medicine Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8670, Japan.

Abstract

Objective: Cognitive remediation therapy (CRT) aims to increase patients' cognitive flexibility by practicing new ways of thinking as well as facilitating bigger picture thinking, supporting patients with relevant tasks and encouraging an awareness of their own thinking styles. CRT has been applied in the treatment of adult anorexia nervosa (AN), and has been shown to be effective and acceptable. In adolescents, CRT has been piloted on both individual and group format. However, no studies are published in CRT for adolescents with AN in a Japanese sample. The objectives of this study were to assess the feasibility, to estimate effect sizes for the purpose of designing a larger study, and to assess the acceptability of a CRT group for younger adolescents with AN in a Japanese sample.

Methods: Group CRT interventions were carried out with a total of seven adolescents with AN. Neuropsychological and psychological assessments (motivation, self-efficacy and depression) were administered before and after the group intervention. The participants completed worksheets (documents of participants' thinking about their thinking style and the relation of the skills that they learnt through each session to real-life) and questionnaires after the group.

Results: There were small effect sizes differences between the part of the pre and post neuropsychological tests and the pre and post ability to change (motivation). There were medium effect sizes differences between the pre and post depressive symptoms and importance to change (motivation). There was a large effect size shown between the pre and post weights. All participants were able to reflect on their own thinking styles, such as having difficulty with changing feelings and the tendency to focus on details in real-life. Adolescents' feedback was positive, and the rate of dropout was low.

Conclusion: CRT groups could be feasible and acceptable for younger adolescents with AN in a Japanese sample. Trial registration UMIN No. 000020623. Registered 18 January 2016.

Keywords: Adolescents; Anorexia nervosa; Cognitive remediation therapy; Group therapy; Neuropsychological assessments.

MeSH terms

Adolescent
Anorexia Nervosa / psychology*
Cognitive Remediation*
Demography
Feasibility Studies
Female
Humans
Neuropsychological Tests
Psychotherapy, Group*