Morando, Sara;
(2024)
Mentalizing in Eating Disorders.
Doctoral thesis (Ph.D), UCL (University College London).
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Mentalizing in Eating Disorders- PhD Thesis - UCL.pdf - Other Access restricted to UCL open access staff until 1 June 2025. Download (12MB) |
Abstract
Mentalizing denotes the capacity to perceive self and others through the lens of intentional mental states such as feelings, thoughts, and beliefs. This research seeks to elucidate the implications of mentalizing deficits in eating disorders (EDs), to enhance treatment efficacy, especially for complex cases. In the present Thesis, a meta-analysis revealed pronounced mentalizing deficits in individuals with anorexia nervosa (AN) and bulimia nervosa (BN) compared to healthy controls. Notably, these deficits were absent in eating disorder not otherwise specified (EDNOS), binge eating disorder (BED), or recovered AN individuals. A lower Body Mass Index (BMI) correlated with amplified mentalizing deficits, hinting at the influence of starvation. Exploring the potential of interpersonal therapies targeting mentalizing enhancement for multifaceted EDs, I collaborated on a Multi-Centre Randomised Controlled Trial (RCT). This revealed that Mentalization-Based Therapy for EDs (MBT-ED) surpassed Specialist Supportive Clinical Management for EDs (SSCM-ED) in alleviating weight and shape anxieties in ED patients with impulsivity and self-harm tendencies. However, high dropout rates during follow-ups tempered the study's validity. To delve deeper into the mentalizing deficit's role in EDs, I undertook an observational study involving 521 ED outpatients, contrasting the outcomes and outcome predictors between Cognitive Analytic Therapy (CAT) and Cognitive Behavioural Therapy (CBT). Both therapies demonstrated comparable efficacy. Nevertheless, CAT might be preferable for AN clients with prevalent self-induced vomiting, while CBT might better address binge/purging symptoms in BN and BED patients. Further observational studies and RCTs are imperative to discern whether effective treatments rectify mentalizing deficits and to verify the potential of MBT-ED as a viable ED treatment.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | Ph.D |
| Title: | Mentalizing in Eating Disorders |
| Language: | English |
| Additional information: | Copyright © The Author 2024. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10191717 |
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