Targeting the experience of the anorexic voice in psychological therapy with people with a diagnosis of anorexia nervosa

Aims
To synthesise, beyond weight restoration, what constitutes an outcome within studies assessing the impact of psychological interventions for adults diagnosed with anorexia nervosa, how these outcomes are assessed and whether outcome domains are evolving in line with new research.

Method
A systematic literature search and narrative synthesis was conducted using the databases:PubMed, Psycinfo, Medline, and CINAHL. The Mixed Methods Appraisal Tool was used to assess bias and quality of identified articles.

Results
Out of 4599 identified articles, 229 were reviewed and 24 were included in the review. Five overarching outcome domains were found: eating attitudes and behaviours, co-occurring mental health difficulties and psychological distress, quality of life, motivation to change, and satisfaction with therapy. Heterogeneity in the selection of outcome measure instruments varied between domains. Increasingly, multiple outcome domains are being assessed in anorexia nervosa psychotherapy research. However, there is still scope to align the selection of outcomes with the evolving evidence base, particularly in incorporating constructs that reflect lived experience models of recovery.

Conclusion
Consistency and consensus regarding the selection of outcomes, along with the need for extended follow-up are essential for future evaluation of the effectiveness of psychological interventions for individuals diagnosed with anorexia nervosa.