A treatment programme, based on the use of behavioural principles, is described. Important components of the programme include the active participation of the patient in all phases of treatment planning, the use of contingent reinforcement for weight gain rather than eating behaviour, the provision of frequent feedback regarding progress and the lowering of the ‘response cost’ for eating. In addition contracting, and the use of random scheduling of follow-up contacts, along with family therapy, are employed to maintain weight gain following discharge. The results achieved with an initial group of 5 female patients are briefly discussed.
References
1.
AgrasW. S.BarlowD. H.ChapinH. N.AbelG. G.LeitenbergH. (1974). Behaviour modification of anorexia nervosa. Archives of General Psychiatry30: 279.
2.
AllyonT.AzrinN. H. (1968). The Token Economy: A Motivational System for Therapy and RehabilitationAppleton-Century Crofts, New York.
3.
BachrachA. J.ErwinW. J.MohrJ. P. (1965). The control of eating behaviour in an anorexic by operant conditioning techniques, in Case Studies in Behaviour Modification (eds. UllmanL. P.KrasnerL) Holt, Rinehart and Winston, New York.
4.
BhanjiS.ThompsonJ. (1974). Operant conditioning in the treatment of anorexia nervosa: a review and retrospective study of eleven cases. British Journal of Psychiatry124: 166.
5.
BlinderB. J.FreemanD. M.StunkardA. J. (1970). Behaviour therapy of anorexia nervosa: effectiveness of activity as a reinforcer of weight gain. American Journal of Psychiatry126: 1093.
6.
BlissE. L.BranchC. H. H. (1960). Anorexia Nervosa: Its History, Psychology and BiologyHoeber, New York.
7.
BruchH. (1974). Perils of behaviour modification in treatment of anorexia nervosa. Journal of the American Medical Association230: 1419.
8.
DallyP. (1969). Anorexia Nervosa. William Heinemann Medical Books, London.
9.
DallyP. J.SargantW. (1960). A new treatment of anorexia nervosa. British Medical Journal1: 1770.
10.
GarfinkelP. E.KlineS. A.StancerH. C. (1973). Treatment of anorexia nervosa using operant conditioning techniques. Journal of Nervous and Mental Diseases157: 428.
11.
GoldiamondI. (1962). Perception, in Experimental Foundations of Clinical Psychology (ed. BachrachA. J.), Basic Books, New York.
12.
GullW. W. (1874). Anorexia Nervosa. Transactions of the Clinical Society (London), 7: 22.
13.
HalmiK. A.PowersP.CunninghamS. (1975). Treatment of anorexia nervosa with behaviour modification: effectiveness of formula feeding and isolation. Archives of General Psychiatry32, 93.
14.
HurstA. (1939). Discussion on anorexia nervosa. Proceedings of the Royal Society of Medicine32: 744.
15.
KisselS.ArkinsV. (1973). Anorexia nervosa re-examined. Child Psychiatry and Human Development3: 255.
16.
LaboncariéJ.BarrèsP. (1954). Les aspects cliniques, pathogéniques et thérapeutique de l'Anorexia Mentale (d'après 50 observations)L'Evolution Psychiatrique.1: 119.
17.
LeitenbergH.AgrasW. S.ThompsonL. E. (1968). A sequential analysis of the effects of selective positive reinforcement in modifying anorexia nervosa. Behaviour Research and Therapy6: 211.
18.
NemiahJ. C. (1958). Anorexia nervosa, fact and theory. American Journal of Digestive Diseases3: 249.
19.
NeumanM.GaoniB. (1975). Preferred food as the reinforcing agent in a case of anorexia nervosa. Journal of Behaviour Therapy and Experimental Psychiatry6: 331.
20.
RussellG. F. M. (1970). Anorexia nervosa: its identity as an illness and its treatment, in Modern Trends in Psychological Illness (ed. PriceJ. H.), Butterworth, London.
21.
RyleJ. A. (1936). Anorexia nervosa. Lancet2: 893.
22.
SargantW. (1951). Leucotomy in psychosomatic disorders. Lancet2: 877.
23.
SchmidtM. P. W.DuncanB. A. B. (1974). Modifying eating behaviour in anorexia nervosa. American Journal of Nursing74: 1646.
24.
SchnurerA. T.RubinR. R.RoyA. (1973). Systematic desensitization of anorexia nervosa seen as a weight phobia. Journal of Behaviour Therapy and Experimental Psychiatry4: 149.
25.
ThomaH. (1967). Anorexia Nervosa (translated by BrydoneG.). International Universities Press, New York.
