title: Mediation of symptom changes during inpatient treatment for eating disorders: the role of obsessive-compulsive features.
abstract: The present study examined the relative contributions of changes in obsessive-compulsive symptoms among eating-disorder patients with (n = 254) and without (n = 254) obsessive-compulsive disorder (OCD) to eating-disorder symptom improvement observed with inpatient treatment. Consistent with hypothesis, multilevel mediation analyses revealed that improvements in OCD symptoms over time accounted for significant variance in the improvements in eating-disorder symptoms over time, with stronger mediation evident among eating-disorder patients with comorbid OCD (percent mediated; P(M) = 22.5%) compared to those without OCD (P(M) = 12.2%). However, decreases in eating-disorder symptoms over time fully mediated improvements in OCD symptoms over time, and this mediated pathway did not vary substantially as a function of comorbid OCD status. The theoretical and treatment implications of these findings for conceptualizing the relationship between eating disorders and OCD are discussed.
authors.affiliation: Department of Psychology, Vanderbilt University, 301 Wilson Hall, 111 21st Avenue South, Nashville, TN 37203, USA. olubunmi.o.olatunji@vanderbilt.edu
authors.forename: Bunmi O
authors.initials: BO
authors.lastname: Olatunji
authors.forename: Candyce D
authors.initials: CD
authors.lastname: Tart
authors.forename: Shona
authors.initials: S
authors.lastname: Shewmaker
authors.forename: David
authors.initials: D
authors.lastname: Wall
authors.forename: Jasper A J
authors.initials: JA
authors.lastname: Smits
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D001828:Body Image; D052018:Bulimia Nervosa / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D016022:Case-Control Studies; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D015897:Comorbidity; D005196:Family Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D007297:Inpatients / Q000523:psychology; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D011582:Psychological Theory; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult