The acceptability, feasibility and possible benefits of a group-based intervention targeting intolerance of uncertainty in adolescent inpatients with anorexia nervosa

Abstract

Despite the effectiveness of family-based interventions for adolescents with anorexia nervosa (AN), up to 30% of patients may not fully benefit. Comorbidity such as depression and anxiety, of which Intolerance of Uncertainty (IU) is established as a key predictor, may account for this reduced treatment response. This pilot study evaluates the acceptability, feasibility and possible benefits of a group-based intervention targeting IU in adolescent inpatients with AN. Ten female patients received a 12-session open-group intervention adapted from a previously developed intervention for adults which took a cognitive behavioural stance and included sessions on psychoeducation and raising awareness around IU, problem-solving in the context of uncertainty, beliefs about worry, behavioural experiments and relapse prevention. Fifty-five staff hours were required to run the group and resources were suitably adapted from adult materials. Patients rated the intervention as acceptable and there were no dropouts. Qualitative outcomes highlighted patients benefited from the group and there was a trend towards IU reducing after the intervention and at 3-month follow-up, although the improvements fell short of a meaningful change in therapy cut-off. Results suggest the group was feasible to run and acceptable to patients and warrants further investigation to optimise possible clinical benefits.

Keywords

• intolerance of uncertainty
• adolescents
• inpatient treatment
• anorexia nervosa
• eating disorders