Emotions in play: young people\u2019s and clinicians\u2019 experience of \u2018Thinking about Emotions\u2019 group

Sophie Nesbitt,Kate Tchanturia,Jenni Leppanen,Lucia Giombini,Hannah Cox,Anna Foxall,Abigail Easter

doi:10.1007/s40519-019-00646-3

Abstract

PurposeEmotional difficulties in young people (YP) with anorexia nervosa (AN) are well recognised. Improved strategies are needed to support inpatients to tolerate group therapy and to help them to better identify and manage their emotions. Cognitive Remediation and Emotion Skills Training (CREST) for AN adults, aimed at improving emotional processing skills, has been found beneficial in adult AN groups. A case series of CREST was conducted in an inpatient ward for YP (CREST-YP) to evaluate its suitability for a younger population.MethodsA mixed-methods assessment was used. Thirty-two YP and 3 facilitators took part in qualitative interviews. YP (n = 32) also completed pre- and post-self-report questionnaires assessing emotional functioning.ResultsPreliminary qualitative results showed that YP found it helpful to learn about emotion processes. More support is needed to clarify the link between emotions and AN. Quantitative results showed no significant changes in YP’s self-perceived emotional functioning. Although no statistically significant changes were observed, a small increase in YP’s use of both reappraisal (standardised mean changes scores, SMCC 0.22) and suppression (SMCC − 0.22) as a means to regulate their emotions was found.ConclusionsPilot findings suggest that CREST-YP is a suitable intervention for YP with AN. Age-appropriate adaptations are needed to improve YP’s engagement in group CREST.Level of evidenceLevel IV: Evidence obtained from multiple time series.

Highlights

Emotional regulation is significantly impaired among individuals with anorexia nervosa (AN), and has been shown to be a key contributing factor to the maintenance of the illness
The present study aims to assess the suitability of Cognitive Remediation and Emotion Skills Training (CREST)-YP (CREST for young people) in a group format in a child and adolescent eating disorder (ED) inpatient unit, by conducting a mixed-method assessment
The weight for height (WfH) percentage was measured at the beginning of CREST-YP

Summary

Introduction

Emotional regulation is significantly impaired among individuals with anorexia nervosa (AN), and has been shown to be a key contributing factor to the maintenance of the illness. Patients with AN have difficulties with intimacy, attachment, self-referential processing and body perception [1]. They experience emotions and social interactions as highly problematic, showing high rates of alexithymia [2, 3] and emotional avoidance, and poor facial expressivity, which can perpetuate AN symptomatology [4, 5]. As well as cognitive inflexibility, may be an obstacle to recovery in AN [6, 7]. Identifying effective interventions that target emotional processing is vital to improving long-term outcomes in this group. Interventions targeting emotional processing have been explored in AN populations, mainly in adults and adolescents.

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Results

Conclusion