Thought-shape fusion in residential eating disorder treatment: Cognitive defusion as a mediator between thought-action fusion and treatment outcome

IF 2.4 3区医学 Q2 PSYCHIATRY

Eating behaviors Pub Date : 2024-08-01 DOI:10.1016/j.eatbeh.2024.101909

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引用次数: 0

Abstract

An understudied cognitive bias within eating disorder (ED) psychopathology is Thought-Shape Fusion (TSF), which involves irrational beliefs about the likelihood and moral implications of feared outcomes related to shape, weight, and food. This phenomenon has received less attention within the context of ED treatment, with little known about potential processes of change to address TSF and ultimately promote ED recovery. We propose cognitive defusion as a process of change, a metacognitive process that emphasizes observing thoughts objectively rather than appraising thoughts as absolute truth. We explored whether cognitive defusion, that is, reductions in body image-related cognitive fusion, mediated the relationship between trait-level TSF and treatment outcomes in a transdiagnostic ED sample of adult and adolescent females (N = 130) presenting to residential care. We found that reductions in body image-related cognitive fusion mediates the association between trait-level TSF at baseline and ED severity at discharge. However, when the sample was separated into adolescent and adult subgroups, these results only remained significant for adolescents. These findings underscore the relevance of targeting cognitive defusion as a potential mechanism to address the impact of trait levels of TSF cognitions on ED psychopathology.

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饮食失调住院治疗中的思维-行为融合：认知化解是思维-行动融合与治疗效果之间的中介因素

饮食失调症（ED）心理病理学中一种未被充分研究的认知偏差是 "思维-形状融合"（TSF），它涉及对与形状、体重和食物有关的令人担忧的结果的可能性和道德影响的非理性信念。这种现象在情绪障碍治疗中受到的关注较少，人们对解决 TSF 并最终促进情绪障碍康复的潜在变化过程知之甚少。我们提出将认知消解作为一种改变过程，这种元认知过程强调客观地观察想法，而不是将想法评价为绝对真理。我们探讨了认知消解，即与身体形象相关的认知融合的减少，是否在跨诊断的成人和青少年女性 ED 样本（N = 130）中介导了特质水平的 TSF 与治疗结果之间的关系。我们发现，与身体形象相关的认知融合的减少会调节基线特质水平 TSF 与出院时 ED 严重程度之间的关系。然而，当把样本分成青少年和成人两个亚组时，这些结果只对青少年有显著影响。这些发现强调了将认知融合作为一种潜在机制来解决TSF认知特质水平对ED精神病理学影响的相关性。

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来源期刊

Eating behaviors Multiple-

CiteScore

4.20

自引率

3.60%

发文量

审稿时长

60 days

期刊介绍： Eating Behaviors is an international peer-reviewed scientific journal publishing human research on the etiology, prevention, and treatment of obesity, binge eating, and eating disorders in adults and children. Studies related to the promotion of healthy eating patterns to treat or prevent medical conditions (e.g., hypertension, diabetes mellitus, cancer) are also acceptable. Two types of manuscripts are encouraged: (1) Descriptive studies establishing functional relationships between eating behaviors and social, cognitive, environmental, attitudinal, emotional or biochemical factors; (2) Clinical outcome research evaluating the efficacy of prevention or treatment protocols.