title: Aggregating factors of the change process in the treatment of anorexia nervosa.
abstract: OBJECTIVE
  We aimed to reduce the large body of factors which may be associated with the change process in treatments for Anorexia Nervosa (AN) into a clinically and scientifically useful number of higher-rank dimensions. In addition, we examined the associations between the identified factors and eating disorder psychopathology and body mass index (BMI) in exploratory analyses.
  
  
  METHODS
  Within a naturalistic multicenter study we administered the Change Process Questionnaire (CPQ-AN) to inpatients with AN upon admission. The factorial structure of the CPQ-AN was explored via factor analysis. Multiple regression analyses were performed to examine the associations with BMI and eating disorder symptomatology (EDI-2).
  
  
  RESULTS
  In total 233 female inpatients with AN (mean BMI=14.9 kg/m(2), SD=1.7) participated. The factor analysis yielded four latent factors: basic need satisfaction, AN-specific cognitions and behavior, emotional involvement and commitment to treatment, and alliance and treatment confidence. Furthermore, greater basic need satisfaction and less AN-specific cognitions and behavior predicted lower EDI-2 scores. Higher alliance and treatment confidence were associated with higher BMI as well as a lower EDI-2 score.
  
  
  CONCLUSIONS
  The associations between the newly derived dimensions and BMI and AN-psychopathology provide evidence to support the clinical relevance of the identified change process dimensions. Future investigations could provide further insights to deepen our understanding of the change process in AN.
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, and Schön Clinic Hamburg Eilbek, Hamburg, Germany. Electronic address: a.gumz@uke.de.
authors.forename: Antje
authors.initials: A
authors.lastname: Gumz
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, and Schön Clinic Hamburg Eilbek, Hamburg, Germany.
authors.forename: Denise
authors.initials: D
authors.lastname: Kästner
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, and Schön Clinic Hamburg Eilbek, Hamburg, Germany.
authors.forename: Karolina A
authors.initials: KA
authors.lastname: Raczka
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, and Schön Clinic Hamburg Eilbek, Hamburg, Germany.
authors.forename: Angelika
authors.initials: A
authors.lastname: Weigel
authors.affiliation: Schön Clinic Bad Bramstedt, Germany.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Osen
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, and Schön Clinic Hamburg Eilbek, Hamburg, Germany; Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Charité, Berlin, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Rose
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, and Schön Clinic Hamburg Eilbek, Hamburg, Germany; Department of Psychology, City University, London, UK.
authors.forename: Björn
authors.initials: B
authors.lastname: Meyer
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, and Schön Clinic Hamburg Eilbek, Hamburg, Germany; The Pennsylvania State University, Altoona, USA.
authors.forename: Eileen
authors.initials: E
authors.lastname: Wollburg
authors.affiliation: Schön Clinic Roseneck Prien, Germany; Department of Psychiatry and Psychotherapy, University Hospital Freiburg, Germany.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Voderholzer
authors.affiliation: Schön Clinic Roseneck Prien, Germany; Department of Psychiatry and Psychotherapy, University Hospital Freiburg, Germany.
authors.forename: Matislava
authors.initials: M
authors.lastname: Karacic
authors.affiliation: Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Germany.
authors.forename: Eik
authors.initials: E
authors.lastname: Vettorazzi
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, and Schön Clinic Hamburg Eilbek, Hamburg, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Löwe
mesh_terms: D000328:Adult; D000856:Anorexia Nervosa / Q000523:psychology* / Q000628:therapy*; D001294:Attitude to Health; D015992:Body Mass Index; D003071:Cognition; D004644:Emotions; D005163:Factor Analysis, Statistical; D005260:Female; D006760:Hospitalization; D006801:Humans; D007297:Inpatients / Q000523:psychology* / Q000706:statistics & numerical data; D010349:Patient Compliance / Q000523:psychology; D010549:Personal Satisfaction; D011599:Psychopathology; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Anorexia nervosa; Change mechanisms; Change process; Common factors