Cognitive Remediation and Emotion Skills Training (CREST) for anorexia nervosa in individual format: Self-reported outcomes

Abstract

Background: To evaluate self-reported outcomes after a brief course of skills-based individual therapy for inpatients with anorexia nervosa (AN). Methods: In this case series study 37 adults with AN participated in cognitive remediation and emotion skills training (CREST) sessions, and completed social anhedonia, alexithymia and motivational measures before and after the intervention. Results: The CREST primary outcome measures were total scores on the Revised Social Anhedonia Scale (RSAS), which decreased significantly (p=0.03) with an effect size of 0.31, and the Toronto Alexithymia Scale (TAS), which also decreased significantly (p=0.05) with an effect size of 0.35. The secondary outcome measures focused on motivation: perceived 'importance to change' and 'ability to change'; the second of which increased significantly (p<0.001) with a medium effect size (d=0.71). Conclusions: The individual format of CREST led to a decrease in patients' self-reported social anhedonia, an improvement in the ability to label their emotions, and increased confidence in their ability to change. Considering the limited number of individual sessions, this is a promising preliminary finding which warrants further research.