Enhancing emotional abilities in anorexia nervosa treatment: A rolling-group cognitive remediation and emotional skills training protocol

Eur Eat Disord Rev. 2024 Sep;32(5):1026-1037. doi: 10.1002/erv.3113. Epub 2024 Jun 4.

Abstract

Introduction: Anorexia nervosa (AN) is characterised by limited remission rates and emotional dimensions are often neglected. Cognitive remediation and emotional skills training (CREST) protocol aims to address cognitive and emotional factors. This study evaluates the feasibility and effectiveness of a modified rolling-group CREST protocol in an inpatient setting.

Methods: Quasi-experimental design evaluated CREST protocol in a rehabilitation programme. A total of 116 females diagnosed with AN were included, of whom 63 were included in the CREST protocol and 53 in the standard rehabilitation treatment. Various standardized measures were employed to assess psychopathology. Data collection occurred longitudinally, before and after CREST implementation.

Results: No significant differences emerged between groups regarding changes in specific eating psychopathology. CREST group exhibited significant improvements in emotion regulation (p = 0.002) and social skills (p = 0.014), besides a reduction in alexithymia (p < 0.001) and cognitive rigidity (p = 0.013). Empathic features remained stable. Participants reported positive perceptions of the CREST intervention.

Discussion: The study highlights the potential benefits of integrating emotional training within multidisciplinary intensive treatment for AN. Results emphasise the importance of treatment protocol with more affective and hot-cognition-related interventions, beyond weight-related psychopathology. Implementing a rolling-group CREST protocol in an inpatient setting showed promise in enhancing the emotional abilities of AN patients.

Keywords: alexithymia; anorexia nervosa; emotion skills; emotional remediation; flexibility; rehabilitation; social cognition; social interaction.

MeSH terms

  • Adolescent
  • Adult
  • Anorexia Nervosa* / psychology
  • Anorexia Nervosa* / therapy
  • Cognitive Remediation* / methods
  • Emotional Regulation
  • Emotions
  • Female
  • Humans
  • Psychotherapy, Group / methods
  • Social Skills
  • Treatment Outcome
  • Young Adult