Abstract
Context
Eating disorders (ED) are very difficult conditions to treat. Therefore, interventions in this field are shifting their main target towards the disorder’s impact in quality of life, rather than ED symptomatology in itself. In this sense, a focus in the promotion of positive emotions and well-being is emerging to ameliorate the harmful effects caused by ED. However, evidence of the potential benefits of this type of interventions is still scarce.
Purpose
This study introduces a 4-week positive psychology group program specifically designed for ED patients’ needs and to present data about feasibility and acceptability.
Method
Seven female inpatients of an eating disorder service aged from 13 to 38 years old attended the group. Measures of affect and optimistic thinking were taken before the program and after each session.
Results
The program was very well rated by participants, and there was no attrition. Furthermore, possible benefits were found in terms of optimistic thinking at the end of the group program, and these benefits were noticeable, but non-significant, in the case of affect.
Conclusions
This study opens the door to conduct larger and controlled studies for testing interventions aimed at promoting positive emotions and well-being in ED populations. Thus, these interventions could support the efficacy of current treatments in order to improve patients’ quality of life.
Level of evidence
Level IV, multiple time series analysis, with the intervention.
Similar content being viewed by others
References
Arcelus J, Mitchell AJ, Wales J, Nielsen S (2011) Mortality rates in patients with anorexia nervosa and other eating disorders. Arch Gen Psychiatry 68:724–731. https://doi.org/10.1001/archgenpsychiatry.2011.74
Watson HJ, Bulik CM (2013) Update on the treatment of anorexia nervosa: review of clinical trials, practice guidelines and emerging interventions. Psychol Med 43:2477–2500. https://doi.org/10.1017/S0033291712002620
Fairburn CG (2005) Evidence-based treatment of anorexia nervosa. Int J Eat Disord 37:S26–S30. https://doi.org/10.1002/eat.20112
Wonderlich S, Mitchell JE, Crosby RD et al (2012) Minimizing and treating chronicity in the eating disorders: a clinical overview. Int J Eat Disord 45:467–475. https://doi.org/10.1002/eat.20978
Jenkins PE, Hoste RR, Meyer C, Blissett JM (2011) Eating disorders and quality of life: a review of the literature. Clin Psychol Rev 31:113–121. https://doi.org/10.1016/j.cpr.2010.08.003
Brannan ME, Petrie TA (2011) Psychological well-being and the body dissatisfaction-bulimic symptomatology relationship: an examination of moderators. Eat Behav 12:233–241. https://doi.org/10.1016/j.eatbeh.2011.06.002
Kitsantas A, Gilligan TD, Kamata A (2003) College women with eating disorders: self-regulation, life satisfaction, and positive/negative affect. J Psychol 137:381–395. https://doi.org/10.1080/00223980309600622
Tozzi F, Sullivan PF, Fear JL et al (2003) Causes and recovery in anorexia nervosa: the patient’s perspective. Int J Eat Disord 33:143–154. https://doi.org/10.1002/eat.10120
Tchanturia K, Dapelo MAM, Harrison A, Hambrook D (2015) Why study positive emotions in the context of eating disorders? Curr Psychiatry Rep. https://doi.org/10.1007/s11920-014-0537-x
Harrison A, Al-Khairulla H, Kikoler M (2015) The feasibility, acceptability and possible benefit of a positive psychology intervention group in an adolescent inpatient eating disorder service. J Posit Psychol. https://doi.org/10.1080/17439760.2015.1117125
Lyubomirsky S, Layous K (2013) How do simple positive activities increase well-being? Curr Dir Psychol Sci 22:57–62. https://doi.org/10.1177/0963721412469809
Malson H, Lin B, Clarke S et al (2011) Un/imaginable future selves: a discourse analysis of in-patients’ talk about recovery from an “eating disorder”. Eur Eat Disord Rev 19:25–36. https://doi.org/10.1002/erv.1011
Turton P, Demetriou A, Boland W et al (2011) One size fits all: or horses for courses? Recovery-based care in specialist mental health services. Soc Psychiatry Psychiatr Epidemiol 46:127–136. https://doi.org/10.1007/s00127-009-0174-6
Malouff JM, Schutte NS (2016) Can psychological interventions increase optimism?. J Posit Psychol, A meta-analysis. https://doi.org/10.1080/17439760.2016.1221122
King L (2001) The health benefits of writing about life goals. Pers Soc Psychol Bull 27:798–807. https://doi.org/10.1177/0146167201277003
Leon AC, Davis LL, Kraemer HC (2012) Role and interpretation of pilot studies in clinical research. J Psychiatr Res 45:626–629. https://doi.org/10.1016/j.jpsychires.2010.10.008.The
APA (2000) DSM-IV-TR: Diagnostic and statistical manual of mental disorders, text revision. American Psychiatric Association, Washington
Baños RM, Etchemendy E, Farfallini L et al (2014) EARTH of Well-Being System: a pilot study of an information and communication technology-based positive psychology intervention. J Posit Psychol 9:482–488. https://doi.org/10.1080/17439760.2014.927906
Botella C, Baños RM, Etchemendy E et al (2016) Psychological countermeasures in manned space missions:“EARTH” system for the Mars-500 project. Comput Human Behav 55:898–908. https://doi.org/10.1016/j.chb.2015.10.010
MacLeod AK (1996) Affect, emotional disorder, and future-directed thinking. Cogn Emot 10:69–86. https://doi.org/10.1080/026999396380394
Meevissen YMC, Peters ML, Alberts HJEM (2011) Become more optimistic by imagining a best possible self: effects of a two week intervention. J Behav Ther Exp Psychiatry 42:371–378. https://doi.org/10.1016/j.jbtep.2011.02.012
Enrique A, Bretón-López J, Molinari G et al (2018) Implementation of a positive technology application in patients with eating disorders: a pilot randomized control trial. Front Psychol 9:1–13. https://doi.org/10.3389/fpsyg.2018.00934
Watson D, Clark LA, Tellegen A (1988) Development and validation of brief measures of positive and negative affect: the PANAS scales. J Pers Soc Psychol 54:1063
Sandín B, Chorot P, Lostao L et al (1999) Escalas PANAS de afecto positivo y negativo: validación factorial y convergencia transcultural. Psicothema 11:37–51
Borkovec TD, Nau SD (1972) Credibility of analogue therapy rationales. J Behav Ther Exp Psychiatry 3:257–260. https://doi.org/10.1016/0005-7916(72)90045-6
Garner DM, Olmsted MP, Bohr Y, Garfinkel PE (1982) The eating attitudes test: psychometric features and clinical correlates. Psychol Med 12:871–878. https://doi.org/10.1017/S0033291700049163
Toro J, Castro J, Garcia M et al (1989) Eating attitudes, sociodemographic factors and body shape evaluation in adolescence. Br J Med Psychol 62:61–70. https://doi.org/10.1111/j.2044-8341.1989.tb02811.x
Rivas T, Bersabé R, Jiménez M, Berrocal C (2010) The Eating Attitudes Test (EAT-26): reliability and validity in Spanish female samples. Span J Psychol 13:1044–1056. https://doi.org/10.1017/S1138741600002687
Solano N, Cano A (2010) IMAGEN Evaluación de la Insatisfacción de la Imagen Corporal. TEA Ediciones, Madrid
Snyder CR (2000) Handbook of hope : theory, measures & applications. Academic Press, Kansas
Jacobson NS, Truax P (1991) Clinical Significance: a Statistical approach to defining meaningful change in psychotherapy research. J Consult Clin Psychol 59:12–19. https://doi.org/10.1037/0022-006X.59.1.12
Dragomir-Davis A (2014) Future-directed thinking in general and clinical samples: validation of the Spanish version of the subjective probability task. Dissertation, Universitat Jaume I
DeJong H, Oldershaw A, Sternheim L et al (2013) Quality of life in anorexia nervosa, bulimia nervosa and eating disorder not-otherwise-specified. J Eat Disord 1:1–8. https://doi.org/10.1186/2050-2974-1-43
de Graaf LE, Huibers MJH, Riper H et al (2009) Use and acceptability of unsupported online computerized cognitive behavioral therapy for depression and associations with clinical outcome. J Affect Disord 116:227–231. https://doi.org/10.1016/j.jad.2008.12.009
Park J, Chen RK (2007) Positive psychology and hope as means to recovery from mental illness. J Appl Rehabil Couns 47:34–43. https://doi.org/10.1891/0047-2220.47.2.34
Hayes SC, Hayes SC, Luoma JB et al (2006) Acceptance and commitment therapy: model, processes and outcomes. Behav Res Ther 44:1–25. https://doi.org/10.1016/j.brat.2005.06.006
King LA, Raspin C (2004) Lost and found possible selves, subjective well-being, and ego development in divorced women. J Pers 72:603–632. https://doi.org/10.1111/j.0022-3506.2004.00274.x
Botella C, Riva G, Gaggioli A et al (2012) The present and future of positive technologies. Cyberpsychol Behav Soc Netw 15:78–84. https://doi.org/10.1089/cyber.2011.0140
Tomba E, Tecuta L, Schumann R, Ballardini D (2017) Does psychological well-being change following treatment? An exploratory study on outpatients with eating disorders. Compr Psychiatry 74:61–69. https://doi.org/10.1016/j.comppsych.2017.01.001
Bos EH, Snippe E, de Jonge P, Jeronimus BF (2016) Preserving subjective wellbeing in the face of psychopathology: buffering effects of personal strengths and resources. PLoS ONE 11:e0150867. https://doi.org/10.1371/journal.pone.0150867
Funding
Funding for the study was provided by grants: Red de Excelencia (PSI2014-56303-REDT) PROMOSAM: Research in processes, mechanisms and psychological treatments for mental health promotion from the Ministerio de Economía y Competitividad (2014); a PhD grant from Jaume I University (PREDOC/2012/51), and CIBER: CIBER Fisiopatología de la Obesidad y Nutrición is an initiative of ISCIII.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interests
The authors declare that they have no conflict of interest.
Ethical approval
We confirm that any aspect of the work covered in this manuscript that has involved human patients has been conducted with the ethical approval of all relevant bodies and that such approvals are acknowledged within the manuscript. The study was approved by the Research Ethics Committee of the Provincial Hospital of Castellón (Spain; October 31st, 2014).
Informed consent
All the patients signed an informed consent form, and in the case of under-age patients, this consent form was signed by their parents.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Enrique, A., Bretón-López, J., Molinari, G. et al. Implementation of a positive psychology group program in an inpatient eating disorders service: a pilot study. Eat Weight Disord 26, 679–688 (2021). https://doi.org/10.1007/s40519-020-00908-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s40519-020-00908-5