A challenge in the treatment of eating disorders (EDs) is the low response rates even when patients receive the most evidence-based treatment (Eielsen et al., 2021; Solmi et al., 2024; Wilson et al., 2007). Survivors of CM are overrepresented in this group (Vrabel et al., 2010), even at 17-year follow-up (Eielsen et al., 2024). Psychotherapy research focusing solely on change from pre- to post-treatment fails to answer important questions regarding which mechanisms or active treatment ingredients cause changes that can lead to recovery. This dissertation focuses on mechanisms of change in patients with and without a history of childhood maltreatment in the context of a randomized controlled trial.
- A change in the overvaluation of shape predicted a change in other ED symptoms in a transdiagnostic sample.
- Different ED symptoms seem to drive change according to trauma background. The findings suggest that self-compassion and hopelessness about the future are key predictors of change for patients with childhood maltreatment. Anxiety symptoms like nervousness, worry, and restlessness, are predictive of change for patients without childhood maltreatment.
- The different processes pave the way for more research on transdiagnostic ED treatment and how childhood maltreatment might influence both therapy processes in ED behavior and clinical implications.
- Overall, the dissertation contributes to the understanding of change processes in ED treatment, particularly for patients with a history of childhood maltreatment, indicating the importance of personalized, evidence-based care.