KariAnne Vrabel

• Holbæk, Ingunn; Vrabel, KariAnne & Halvorsen, Margrethe S. (2024). “Now there are fewer of me". A qualitative study of the impact of psychoeducative groups for complex dissociative disorder. Revue Européenne du Trauma et de la Dissociation. ISSN 2468-7499. 8(2). doi: 10.1016/j.ejtd.2024.100390.
• Vrabel, KariAnne; Waller, Glenn; Goss, Ken; Wampold, Bruce E.; Kopland, Maren Gunnulfsen & Hoffart, Asle (2024). Cognitive behavioral therapy versus compassion focused therapy for adult patients with eating disorders with and without childhood trauma: A randomized controlled trial in an intensive treatment setting. Behaviour Research and Therapy. ISSN 0005-7967. 174. doi: 10.1016/j.brat.2024.104480.
• Yang, Lisbeth Xin-Yi; Vrabel, KariAnne; Rø, Øyvind & Johnson, Sverre Urnes (2023). Kognitiv atferdsterapi for spiseforstyrrelser (CBT-E) – en poliklinisk behandlingsstudie. Tidsskrift for Norsk Psykologforening. ISSN 0332-6470. 60(11), s. 696–696. doi: 10.52734/TDCK5656. Fulltekst i vitenarkiv
• Vrabel, KariAnne & Bratland-Sanda, Solfrid (2023). Effects of inpatient treatment on compulsive exercise in adults with longstanding eating disorders: Secondary analysis from a randomized controlled trial with 12-month follow-up. International Journal of Eating Disorders. ISSN 0276-3478. doi: 10.1002/eat.24108. Fulltekst i vitenarkiv
• Finsrud, Ingvild; Nissen-Lie, Helene, Amundsen ; Ulvenes, Pål Gunnar; Vrabel, KariAnne; Melsom, Linne & Wampold, Bruce E. (2023). Emotional and Cognitive Processes in Psychotherapy Are Associated With Different Aspects of the Therapeutic Relationship. Journal of Consulting and Clinical Psychology. ISSN 0022-006X. doi: 10.1037/ccp0000853. Vis sammendrag

  Objective: In this naturalistic study we aimed to investigate the relationships between two central change processes (affective and cognitive) and two common relationship factors (“Confidence in the therapist” and “Confidence in the treatment”), which have been shown to impact outcomes in a clinical context. We also investigated whether these interrelationships varied across treatment orientations (i.e., cognitive or psychodynamic focused). Method: The sample consisted of 631 patients with a primary anxiety or depressive disorder who were admitted to an inpatient program and treated with psychotherapy. The data consisted of weekly measures of cognitive (i.e., “rumination”) and affective (i.e., “problems with emotional clarity”) change processes as well as scores on Confidence in the therapist and Confidence in the treatment and symptom distress. A multivariate version of the latent curve model with structured residuals was used to investigate the within-patient effects of week-to-week changes in all variables. Results: Initial analyses established that both problems with emotional clarity and rumination predicted symptom distress. Further, we found that higher Confidence in the therapist predicted higher emotional clarity (but not lower rumination) whereas higher Confidence in the treatment predicted lower rumination (but did not affect emotional clarity). Post hoc analyses found that these interrelationships varied across treatment orientation (i.e., cognitive vs. psychodynamic). Discussion: The results indicate that patients’ experience of the therapist is associated with emotional change processes, and that patients’ experience of the coherence and meaningfulness of treatment, on the other hand, is associated with cognitive change processes. Implications for clinical practice are discussed.

• Kopland, Maren Cecilie Gunnulfsen; Vrabel, KariAnne; Slof-Op ‘t Landt, Margarita; Hoffart, Asle; Johnson, Sverre Urnes & Giltay, Erik J. (2023). Breaking the cycle: Identifying key symptom pathways of eating disorders and the influence of childhood maltreatment. International Journal of Eating Disorders. ISSN 0276-3478. s. 1–11. doi: 10.1002/eat.24097. Fulltekst i vitenarkiv
• Salvesen, Katinka Thorne; Stige, Signe Hjelen; Wästlund, Malin & Vrabel, KariAnne (2023). Change despite obstacles: A mixed-methods pilot study of a trauma-sensitive mindfulness and compassion intervention. Revue Européenne du Trauma et de la Dissociation. ISSN 2468-7499. 7(4). doi: 10.1016/j.ejtd.2023.100361. Vis sammendrag

  This mixed-methods pilot study aimed to assess the symptomatic changes of post-traumatic stress disorder, complex post-traumatic stress disorder, dissociative symptoms, self-critique, and self-compassion following participation in a 16-week trauma-sensitive mindfulness and compassion intervention. The adverse experiences of participation were also explored explicitly. Seventeen predominantly female clients with severe post-traumatic stress disorder symptomatology participated in the trauma-sensitive mindfulness and compassion intervention. All clients completed questionnaires before (pre) and after (post) the intervention to gain information on symptom change, self-critique, and self-compassion. Second, a qualitative interview addressing clients’ experiences of participation, including an explicit focus on adverse experiences, was conducted. There was a significant decrease in PTSD, CPTSD, dissociative symptoms, self-hatred, and inadequate self before and after the intervention. All the clients reported having adverse experiences during participation but no lasting negative effects. The results point to the potential of the TMC intervention in helping reduce trauma symptoms and self-critique while also elucidating the tremendous stress that clients with trauma experience undergoing trauma treatment. However, no injurious adverse effects were reported. These preliminary results warrant further investigation via a randomized control trial to examine the efficacy of TMC. The study is registered in ClinicalTrials.gov ID: NCT05993468.

• Bang, Lasse; Nordmo, Morten; Nordmo, Magnus; Vrabel, KariAnne; Danielsen, Marit & Rø, Øyvind (2023). Comparison between the brief seven-item and full eating disorder examination-questionnaire (EDE-Q) in clinical and non-clinical female Norwegian samples. Journal of Eating Disorders. ISSN 2050-2974. 11. doi: 10.1186/s40337-023-00920-x. Fulltekst i vitenarkiv Vis sammendrag

  The Eating Disorder Examination-Questionnaire (EDE-Q) is a widely used self-report measure to assess eating disorder symptoms in clinical and research settings. One limitation of the EDE-Q is its length (28 questions), which can preclude its use in research studies where assessments need to be short. A brief seven-question version has been proposed (referred to as the EDE-Q7), but few studies have evaluated its usefulness in comparison to the full EDE-Q. In our study we aimed to provide a comparison between the brief EDE-Q7 and the full EDE-Q among female Norwegian patients and non-patients. The brief EDE-Q7 produced similar responses compared to the full EDE-Q and performed well in tests of its integrity as a measure. Our findings suggest that the EDE-Q7 may serve as a viable alternative to the full EDE-Q for brief assessment and screening purposes.

• Eielsen, Hanna Kristine Punsvik; Ulvenes, Pål Gunnar; Hoffart, Asle; Rø, Øyvind; Rosenvinge, Jan Harald & Vrabel, KariAnne (2023). Childhood trauma and outcome trajectories in patients with longstanding eating disorders across 17 years. International Journal of Eating Disorders. ISSN 0276-3478. doi: 10.1002/eat.24067. Fulltekst i vitenarkiv
• Vrabel, KariAnne; Johnson, Sverre Urnes; Ebrahimi, Omid Vakili & Hoffart, Asle (2023). Anxiety and depressive symptoms among migrants during the COVID-19 pandemic in Norway: A two-wave longitudinal study. Psychiatry Research Communications. ISSN 2772-5987. 3(2), s. 1–9. doi: 10.1016/j.psycom.2023.100115. Fulltekst i vitenarkiv
• Christoffersen, Hedvig; Skårderud, Hanna Røed; Vrabel, KariAnne & Weider, Siri (2023). Self-compassion as a mechanism of change in patients with eating disorders and childhood trauma receiving CFT-E; a study of within-person processes. Nordic Psychology. ISSN 1901-2276. doi: 10.1080/19012276.2023.2192396.
• Mathisen, Therese Fostervold; Sundgot-Borgen, Jorunn; Rosenvinge, Jan H; Bratland-Sanda, Solfrid; Svendsen, Mette & Pettersen, Gunn [Vis alle 8 forfattere av denne artikkelen] (2023). Metabolic profile in women with bulimia nervosa or binge-eating disorder before and after treatment: secondary analysis from the randomized PED-t trial. Eating and Weight Disorders. ISSN 1124-4909. 28. doi: 10.1007/s40519-023-01567-y. Fulltekst i vitenarkiv Vis sammendrag

  Purpose: Chaotic eating and purging behavior pose a risk to the metabolic health of women with bulimia nervosa (BN) and binge-eating disorder (BED). This study reports on one-year changes in blood markers of metabolic health and thyroid hormones in women with BN or BED attending two different treatments. Methods: These are secondary analyses from a randomized controlled trial of 16-week group treatment of either physical exercise and dietary therapy (PED-t) or cognitive behavior therapy (CBT). Blood samples collected at pre-treatment, week eight, post-treatment, and at 6- and 12-month follow-ups were analyzed for glucose, lipids (triglycerides (TG), total cholesterol (TC), LDL cholesterol (LDL-c), HDL cholesterol (HDL-c), apolipoprotein A (ApoA) and apolipoprotein B (ApoB) lipoproteins), and thyroid hormones (thyroxine (T4), thyroid stimulating hormone (TSH), and thyroperoxidase antibodies). Result: The average levels of blood glucose, lipids and thyroid hormones were within the recommended range, but clinical levels of TC and LDL-c were detected in 32.5% and 39.1%, respectively. More women with BED compared with BN had low HDL-c, and a larger increase over time in TC and TSH. No significant differences occurred between PED-t and CBT at any measurement. Exploratory moderator analyses indicated a more unfavorable metabolic response at follow-up among treatment non-responders. Conclusion: The proportion of women with impaired lipid profiles and unfavorable lipid changes, suggests active monitoring with necessary management of the metabolic health of women with BN or BED, as recommended by metabolic health guidelines.

• Kopland, Maren C. G.; Vrabel, KariAnne; Melsom, Linne; Hoffart, Asle & Johnson, Sverre Urnes (2023). Self-compassion in eating disorders and childhood trauma: A study of within-person effects in a randomized controlled trial. Psychotherapy Research. ISSN 1050-3307. doi: 10.1080/10503307.2022.2149363. Fulltekst i vitenarkiv
• Bratland-Sanda, Solfrid; Schmidt, Sabrina Krogh; Reinboth, Michael Sæther & Vrabel, KariAnne (2022). Under pressure to exercise: a cross-sectional study of characteristics and predictors of compulsive exercise in early adolescents. Journal of Eating Disorders. ISSN 2050-2974. 10(1). doi: 10.1186/s40337-022-00686-8. Vis sammendrag

  Although there is a huge concern about adolescents being insufficiently physically active, there are also adolescents who struggle with issues of compulsive exercise. The issues of compulsive exercise have rarely studied in adolescents. We therefore aimed to describe compulsive exercise and factors that were associated with and could explain presence of compulsive exercise. A total of 572 8th graders (age 13.9 ± 0.3 yrs) responded to the study. We found that the score on compulsive exercise was higher in boys than in girls, and that adolescents with high score on compulsive exercise had higher body mass index, more weight loss attempts, and lower physical fitness compared to adolescents with low score on compulsive exercise. Also, we found that exercise obsessions, i.e., thinking of exercise without actually exercising, was present in four percent of the respondents. Being a boy, attempting weight loss, exercising to avoid shame/guilt, and exercising for the perceived value of exercise predicted compulsive exercise. Awareness of the compulsive exercise and exercise obsessions is important in public health initiatives that aim to increase adolescents' physical activity level.

• Eielsen, Hanna Kristine Punsvik; Vrabel, KariAnne; Hoffart, Asle; Rø, Øyvind & Rosenvinge, Jan H (2022). Reciprocal relationships between personality disorders and eating disorders in a prospective 17-year follow-up study. International Journal of Eating Disorders. ISSN 0276-3478. doi: 10.1002/eat.23823. Fulltekst i vitenarkiv
• Finsrud, Ingvild; Nissen-Lie, Helene Amundsen; Ulvenes, Pål Gunnar; Melsom, Linne; Vrabel, KariAnne & Wampold, Bruce E. (2022). Confidence in the therapist and confidence in the treatment predict symptomatic improvement week by week in therapy: A latent curve modeling approach. Journal of Counseling Psychology. ISSN 0022-0167. doi: 10.1037/cou0000640. Vis sammendrag

  Previous research suggests that common relationship factors are composed of two overarching factors, “Confidence in the therapist” and “Confidence in the treatment.” The aim of this naturalistic process–outcome study was to investigate the reciprocal relationships between these two constructs and patients’ symptom level across treatment. The sample consisted of 587 patients who were admitted to an inpatient program and treated with psychotherapy for a range of mental health disorders, such as chronic depression, anxiety disorders, and eating disorders. Our data consisted of weekly measures of symptomatic distress (Patient Health Questionnaire) and the common relationship factors were measured weekly using a newly developed scale. Latent curve modeling with structured residuals was used to investigate the between- and within effects of week-to-week changes in the two components as predictors of subsequent symptom level. An increase in both relationship factors predicted a decrease in subsequent levels of symptoms at the within-patient level, and the other way around, but the two relationship factors did not systematically relate to one another at the within-patient level over the course of treatment. Our findings indicate that patients’ perceptions of the therapist as a person and their appraisal of the treatment, are important, different predictors of therapeutic change. Furthermore, they support prior research demonstrating a reciprocal relationship between common relationship factors and symptomatic distress and add to existing common factor theory by exploring the role of two central relationship dimensions and using a method which examines reciprocal relationships and within-patient effects simultaneously

• Olofsson, Malin Elisabeth; Vrabel, KariAnne; Hoffart, Asle & Oddli, Hanne Berit Weie (2022). Covert therapeutic micro-processes in non-recovered eating disorders with childhood trauma: an interpersonal process recall study. Journal of Eating Disorders. ISSN 2050-2974. 10. doi: 10.1186/s40337-022-00566-1. Vis sammendrag

  A patient perspective on individual ED treatment processes is scarce for difficult-to-treat eating disorders (EDs) with childhood trauma (CT). We therefore interviewed six poor long-term outcome inpatients through video-assisted recall about a self-selected therapy session. Patients' covert in-session strategies included self-effacing behaviours in relation to their therapists, their respective preferences for closeness or distance to their therapist to be able to open up in a session, and being more prone to engage in therapists' reflective interventions rather than experiential. In sum, patients were preoccupied with calibrating the emotional-relational landscape between patient and therapist in session, which were strategies that went undetected. We hypothesized that a lack of psychological security and affective tolerance limit patients freedom to explore own experiences from the perspective of traumatice attachment and self-differentiation theory.

• Nitter, Cathrine Bergh; Vrabel, KariAnne; Binder, Per Einar & Kingswick, Irene (2022). Bli venn med maten: evaluering av et lavterskel kurstilbud for personer med overspisingsproblematikk. Tidsskrift for Norsk Psykologforening. ISSN 0332-6470. 59(1), s. 18–25. doi: 10.52734/53T9gEC2.
• Eik-Nes, Trine T.; Vrabel, KariAnne; Raman, Jayanthi; Clark, Melinda Rose & Berg, Kjersti Hognes (2021). A Group Intervention for Individuals With Obesity and Comorbid Binge Eating Disorder: Results From a Feasibility Study. Frontiers in Endocrinology. ISSN 1664-2392. 12, s. 1–16. doi: 10.3389/fendo.2021.738856. Fulltekst i vitenarkiv Vis sammendrag

  Purpose: A common challenge among a subgroup of individuals with obesity is binge eating, that exists on a continuum from mild binge eating episodes to severe binge eating disorder (BED). BED is common among bariatric patients and the prevalence of disordered eating and ED in bariatric surgery populations is well known. Conventional treatments and assessment of obesity seldom address the underlying psychological mechanisms of binge eating and subsequent obesity. This study, titled PnP (People need People) is a psychoeducational group pilot intervention for individuals with BED and obesity including patients with previous bariatric surgery. Design, feasibility, and a broad description of the study population is reported. Material and Methods: A total of 42 patients were from an obesity clinic referred to assessment and treatment with PnP in a psychoeducational group setting (3-hour weekly meetings for 10 weeks). Of these, 6 (14.3%) patients had a previous history of bariatric surgery. Feasibility was assessed by tracking attendance, potentially adverse effects and outcome measures including body mass index (BMI), eating disorder pathology, overvaluation of shape and weight, impairment, self-reported childhood difficulties, alexithymia, internalized shame as well as health related quality of life (HRQoL). Results: All 42 patients completed the intervention, with no adverse effects and a high attendance rate with a median attendance of 10 sessions, 95% CI (8.9,9.6) and 0% attrition. Extent of psychosocial impairment due to eating disorder pathology, body dissatisfaction and severity of ED symptoms were high among the patients at baseline. Additionally, self-reported childhood difficulties, alexithymia, and internalized shame were high among the patients and indicate a need to address underlying psychological mechanisms in individuals with BED and comorbid obesity. Improvement of HRQoL and reduction of binge eating between baseline and the end of the intervention was observed with a medium effect Conclusion: This feasibility study supports PnP as a potential group psychoeducational intervention for patients living with BED and comorbid obesity. Assessments of BED and delivery of this intervention may optimize selection of candidates and bariatric outcomes. These preliminary results warrant further investigation via a randomized control trial (RCT) to examine the efficacy and effectiveness of PnP.

• Finsrud, Ingvild; Nissen-Lie, Helene, Amundsen ; Vrabel, KariAnne; Høstmælingen, Andreas; Wampold, Bruce E. & Ulvenes, Pål Gunnar (2021). It's the therapist and the treatment: The structure of common therapeutic relationship factors. Psychotherapy Research. ISSN 1050-3307. 32, s. 139–150. doi: 10.1080/10503307.2021.1916640.
• Eielsen, Hanna Kristine Punsvik; Vrabel, KariAnne; Hoffart, Asle; Rø, Øyvind & Rosenvinge, Jan H (2021). The 17-year outcome of 62 adult patients with longstanding eating disorders—A prospective study. International Journal of Eating Disorders. ISSN 0276-3478. 54(5), s. 841–850. doi: 10.1002/eat.23495.
• Dahlgren, Anna Maria Camilla Lindvall; Walsh, B. Timothy; Vrabel, Karianne; Siegwarth, Cecilie & Rø, Øyvind (2020). Eating disorder diagnostics in the digital era: Validation of the Norwegian version of the Eating Disorder Assessment for DSM-5 (EDA-5). Journal of Eating Disorders. ISSN 2050-2974. 8(1), s. 1–7. doi: 10.1186/s40337-020-00310-7. Fulltekst i vitenarkiv
• Olofsson, Malin Elisabeth; Oddli, Hanne; Vrabel, KariAnne & Hoffart, Asle (2020). «In solitude is safeness»: a patient perspective on eating disorders in the context of multiple childhood trauma. Nordic Psychology. ISSN 1901-2276. doi: 10.1080/19012276.2020.1762714. Fulltekst i vitenarkiv
• Mathisen, Therese Fostervold; Rosenvinge, Jan H; Friborg, Oddgeir; Vrabel, KariAnne; Bratland-Sanda, Solfrid & Pettersen, Gunn [Vis alle 7 forfattere av denne artikkelen] (2020). Is physical exercise and dietary therapy a feasible alternative to cognitive behavior therapy in treatment of eating disorders? A randomized controlled trial of two group therapies. International Journal of Eating Disorders. ISSN 0276-3478. 53(4), s. 574–585. doi: 10.1002/eat.23228. Fulltekst i vitenarkiv Vis sammendrag

  Objective: To compare effects of physical exercise and dietary therapy (PED‐t) to cognitive behavioral therapy (CBT) in treatment of bulimia nervosa (BN) and binge‐eating disorder (BED). Method: The active sample (18–40 years of age) consisted of 76 women in the PED‐t condition and 73 in the CBT condition. Participants who chose not to initiate treatment immediately (n = 23) were put on a waiting list. Outcome measures were the eating disorder examination questionnaire (EDE‐Q), Clinical Impairment Assessment (CIA), Satisfaction with Life Scale (SWLS), Beck Depression Inventory (BDI), and numbers in remission at posttreatment, and at 6‐, 12‐, and 24‐months follow‐up. Results: Both treatment conditions produced medium to strong significant improvements on all outcomes with long‐term effect. The PED‐t produced a faster improvement in EDE‐Q and CIA, but these differences vanished at follow‐ups. Only PED‐t provided improvements in BDI, still with no between‐group difference. Totally, 30–50% of participants responded favorable to treatments, with no statistical between‐group difference. Discussion: Both treatments shared a focus on normalizing eating patterns, correcting basic self‐regulatory processes and reducing idealized aesthetic evaluations of self‐worth. The results point to the PED‐t as an alternative to CBT for BN and BED, although results are limited due to compliance and dropout rates. Replications are needed by independent research groups as well as in more clinical settings.

• Vrabel, Kari-Anne & Bratland-Sanda, Solfrid (2019). Exercise obsession and compulsion in adults with longstanding eating disorders: Validation of the Norwegian version of the compulsive exercise test. Frontiers in Psychology. ISSN 1664-1078. 10(2370). doi: 10.3389/fpsyg.2019.02370. Fulltekst i vitenarkiv Vis sammendrag

  Objectives: The objectives of this study were to (1) validate the Norwegian version of the Compulsive Exercise Test (CET) in adults with longstanding eating disorders, and (2) explore predictors of high CET-score. Methods: Adult inpatients (n = 166) with longstanding DSM-IV Anorexia Nervosa, Bulimia Nervosa (BN) or Eating Disorder not Otherwise Specified (EDNOS) completed the CET instrument, Eating Disorder examination questionnaire (EDE-Q), Beck Depression Inventory-II (BDI-II) and Symptom checklist-90 (SCL-90). A total CET score of 15 or above was defined as high CET-score. ANOVA, Confirmatory factor analysis, Pearson’s correlation, and logistic regression were used to analyze the data. Results: Cronbach’s alpha varied from 0.68 to 0.96 for the CET and its subscales. The confirmatory factor analysis showed adequate fit. Convergent validity of the CET demonstrated correlation between EDE-Q global and subscale scores and CET total score. The same pattern was found for correlation between CET subscales and EDE-Q subscales. EDE-Q global score and frequency of exercise episodes predicted high CET-score, yet 21% of the patients with high CET score had less than one episode of exercise per week. Conclusion: The Norwegian version of CET is valid and useful for assessing compulsive exercise in a sample with longstanding ED. The understanding of compulsive exercise must to a greater extent differ between obsessions and compulsions, as a significant number of patients with high CET score showed no or little exercise behavior.

• Olofsson, Malin Elisabeth; Oddli, Hanne; Hoffart, Asle; Eielsen, Hanna Kristine Punsvik & Vrabel, Kari-Anne (2019). Change Processes Related to Long-Term Outcomes in Eating Disorders With Childhood Trauma: An Explorative Qualitative Study. Journal of Counseling Psychology. ISSN 0022-0167. doi: 10.1037/cou0000375.
• Vrabel, Kari-Anne; Wampold, Bruce E.; Quintana, Daniel; Goss, Ken; Waller, Glenn & Hoffart, Asle (2019). The modum-ED trial protocol: Comparing compassion-focused therapy and cognitive-behavioral therapy in treatment of eating disorders with and without childhood trauma: Protocol of a randomized trial. Frontiers in Psychology. ISSN 1664-1078. 10:1638(JULY), s. 1–10. doi: 10.3389/fpsyg.2019.01638. Fulltekst i vitenarkiv
• Karlsen, Kari Ebbesen; Vrabel, Kari-Anne; Bratland-Sanda, Solfrid; Ulleberg, Pål & Benum, Kirsten (2018). Effect of yoga in the treatment of eating disorders: A single-blinded randomized controlled trial with 6-months follow-up. International Journal of Yoga. ISSN 0973-6131. 11(2), s. 166–169. doi: 10.4103/ijoy.IJOY_3_17. Fulltekst i vitenarkiv
• Mathisen, Therese Fostervold; Bratland-Sanda, Solfrid; Rosenvinge, Jan H; Friborg, Oddgeir; Pettersen, Gunn & Vrabel, Kari-Anne [Vis alle 7 forfattere av denne artikkelen] (2018). Treatment effects on compulsive exercise and physical activity in eating disorders. Journal of Eating Disorders. ISSN 2050-2974. 6, s. 1–9. doi: 10.1186/s40337-018-0215-1. Fulltekst i vitenarkiv Vis sammendrag

  Background: Dysfunctional thoughts- and use of physical activity (PA) are core symptoms of the eating disorders (ED) bulimia nervosa (BN) and binge eating disorder (BED). The compulsive desire for PA complicates a favourable treatment outcome; hence, regular, adapted PA led by personnel with competence in exercise science is rarely part of treatment of BN and BED. The present study compared cognitive behaviour therapy (CBT) with a new treatment combining physical exercise and dietary therapy (PED-t) with respect to the short- and long-term changes in the level of compulsive exercise and actual level of PA in women with BN or BED. Methods: We enrolled 187 women with BN or BED, aged 18–40 years, with BMI 17.5–35, in an outpatient randomised controlled therapy trial. Participants were randomised to PED-t or CBT, while waitlist participants served as a control group during the treatment period. The treatment covered 16 weeks, with 6- and 12 months follow-up, and outcomes included self-reported compulsive exercise (CE) and objectively measured PA, analysed by linear mixed regression models. Results: Both CBT and PED-t reduced CE from baseline (P < 0.01, Hedges g ~ 0.4), but with no difference to control group. Compared to baseline, only PED-t significantly reduced the number of patients who scored above cut-off rating for CE, but with no between-group differences. The proportion of participants complying with the official recommendation for PA neither changed following treatment, nor emerged different between the treatment arms. Conclusion: Both therapies resulted in significant improvements in compulsive exercise, a change not found in the control group, however there were no between-group differences. The findings are tempered by the low statistical power due to a small control group size. The number of participants complying with the recommendation for PA were stable throughout the study, and no change in total PA was found. Presence and intensity of CE decline with treatment, but a need to increase PA towards healthy levels remains unsolved.

• Bratland-Sanda, Solfrid & Vrabel, Kari-Anne (2018). An investigation of the process of change in psychopathology and exercise during inpatient treatment for adults with longstanding eating disorders. Journal of Eating Disorders. ISSN 2050-2974. 6(1). doi: 10.1186/s40337-018-0201-7. Fulltekst i vitenarkiv Vis sammendrag

  Background: Excessive exercise is recognized as a predictor of poor outcome in eating disorders. However, little is known about how excessive exercise might affect the treatment process. The aim of this study was to describe process of weekly changes in eating disorder psychopathology, general psychopathology and exercise, and the possible interactive effects of excessive exercise on these changes during inpatient treatment of longstanding eating disorders. Methods: Eighty-four patients meeting the DSM-IV criteria for Anorexia Nervosa, Bulimia Nervosa, or Eating Disorders Not Otherwise Specified received inpatient cognitive-behavioural therapy including, physical activity and nutritional counselling treatment over 12 weeks. Excessive exercise was defined as having ≥6 episodes of driven exercise during week 1 of treatment. Excessive exercisers received one additional session of individual counseling with the clinical exercise physiologist. The study used repeated measurements during treatment and collected measures of eating disorders: psychopathology (EDE-Q), general psychopathology (SCL-5), and frequencies of exercise and body mass index (BMI). Statistical analysis was performed using repeated measures ANOVA. Results: Both eating disorders and general psychopathology were reduced from admission to discharge in excessive exercisers and non-exercisers. There was an overall interaction effect between time (week) and excessive exercise for the process of exercise and eating disorders psychopathology reduction. This interaction effect was also found in week 10 vs 11 regarding general psychopathology. The excessive exercisers showed steep reduction at first, followed by a smaller increase towards the end of treatment in both eating disorder and general psychopathology; this pattern was not found among the non-exercisers. Conclusion: The process of change in exercise and psychopathology during inpatient treatment of longstanding eating disorders differs across excessive and non-excessive exercisers. Although excessive exercisers were given special attention for their exercise cognition and behavior during treatment, it is apparent that this part of treatment must be further developed.

• Mathisen, Therese Fostervold; Rosenvinge, Jan H; Friborg, Oddgeir; Pettersen, Gunn; Stensrud, Trine & Hansen, Bjørge Hermann [Vis alle 12 forfattere av denne artikkelen] (2018). Body composition and physical fitness in women with bulimia nervosa or binge-eating disorder. International Journal of Eating Disorders. ISSN 0276-3478. 51(4), s. 331–342. doi: 10.1002/eat.22841. Fulltekst i vitenarkiv Vis sammendrag

  Objective:Knowledge about physical fitness in women with bulimia nervosa (BN) or binge-eatingdisorder (BED) is sparse. Previous studies have measured physical activity largely through self-report, and physical fitness variables are mainly restricted to body mass index (BMI) and bone min-eral density. We expanded the current knowledge in these groups by including a wider range ofphysical fitness indicators and objective measures of physical activity, assessed the influence of ahistory of anorexia nervosa (AN), and evaluated predictive variables for physical fitness.Method:Physical activity, blood pressure, cardiorespiratory fitness (CRF), muscle strength, bodycomposition, and bone mineral density were measured in 156 women with BN or BED, with mean(SD) age 28.4 years (5.7) and BMI 25.3 (4.8) kg m22.Results:Level of physical activity was higher than normative levels, still<50% met the officialphysical activity recommendation. Fitness in women with BN were on an average comparable withrecommendations or normative levels, while women with BED had lower CRF and higher BMI,VAT, and body fat percentage. We found 10–12% with masked obesity. A history of AN did notpredict current physical fitness, still values for current body composition were lower when compar-ing those with history of AN to those with no such history.Discussion:Overall, participants with BN or BED displayed adequate physical fitness; however, ahigh number had unfavorable CRF and body composition. This finding calls for inclusion of physicalfitness in routine clinical examinations and guided physical activity and dietary recommendationsin the treatment of BN and BED.

• Johnson, Sverre Urnes; Hoffart, Asle; Nordahl, Hans Morten; Ulvenes, Pål; Vrabel, Kari-Anne & Wampold, Bruce E. (2017). Metacognition and cognition in inpatient mct and cbt for comorbid anxiety disorders: A study of within-person effects. Journal of Counseling Psychology. ISSN 0022-0167. 65(1), s. 86–97. doi: 10.1037/cou0000226.
• Langkaas, Tomas Formo; Johnson, Sverre Urnes; Stenshorne, Kjersti; Collin-Tiller, Cecilie & Vrabel, Kari-Anne (2017). Klinisk signifikans i praksis. Tidsskrift for Norsk Psykologforening. ISSN 0332-6470. 54(12), s. 1160–1167.
• Mathisen, Therese Fostervold; Rosenvinge, Jan H; Pettersen, Gunn; Friborg, Oddgeir; Vrabel, Kari-Anne & Bratland-Sanda, Solfrid [Vis alle 11 forfattere av denne artikkelen] (2017). The PED-t trial protocol: The effect of physical exercise –and dietary therapy compared with cognitive behavior therapy in treatment of bulimia nervosa and binge eating disorder. Study protocol of a randomized controlled trial. BMC Psychiatry. ISSN 1471-244X. 17:180, s. 1–11. doi: 10.1186/s12888-017-1312-4. Fulltekst i vitenarkiv
• Vrabel, Kari-Anne; Ulvenes, Pål & Wampold, Bruce E. (2015). Alliance and symptom improvement in inpatient treatment for eating disorder patients: A study of within-patient processes. International Journal of Eating Disorders. ISSN 0276-3478. 48(8), s. 1113–1121. doi: 10.1002/eat.22434.
• Vrabel, Kari-Anne Rasmussen; Hoffart, Asle; Rø, Øyvind; Martinsen, Egil Wilhelm & Rosenvinge, Jan H (2010). Co-Occurrence of Avoidant Personality Disorder and Child Sexual Abuse Predicts Poor Outcome in Long-Standing Eating Disorder. Journal of Abnormal Psychology. ISSN 0021-843X. 119(3), s. 623–629. doi: 10.1037/a0019857.
• Vrabel, Kari-Anne Rasmussen; Rø, Øyvind; Martinsen, EW; Hoffart, Asle & Rosenvinge, Jan H (2010). Five-Year Prospective Study of Personality Disorders in Adults with Longstanding Eating Disorders. International Journal of Eating Disorders. ISSN 0276-3478. 43(1), s. 22–28. doi: 10.1002/eat.20662.
• Bratland-Sanda, S; Bratland Sanda, Solfrid; Rosenvinge, Jan H; Vrabel, Kari-Anne Rasmussen; Norring, Claes & Sundgot-Borgen, J [Vis alle 9 forfattere av denne artikkelen] (2009). Physical activity in treatment units for eating disorders: Clinical practice and attitudes. Eating and Weight Disorders. ISSN 1124-4909. 14(2-3), s. E106–E112.
• Vrabel, Kari Anne R; Rø, Øyvind; Martinsen, Egil Wilhelm; Hoffart, Asle & Rosenvinge, Jan H. (2009). Five-year prospective study of personality disorders in adults with longstanding eating disorders. International Journal of Eating Disorders. ISSN 0276-3478. 43(1), s. 22–28.
• Vrabel, Kari-Anne; Rosenvinge, Jan H; Hoffart, Asle; Martinsen, Egil Wilhelm & Rø, Øyvind (2008). The course of illness following inpatient treatment of adults with longstanding eating disorders: A 5-year follow-up. International Journal of Eating Disorders. ISSN 0276-3478. 43, s. 22–28.
• Rosenvinge, Jan H; Rø, Øyvind; Hoffart, Asle; Martinsen, Egil & Vrabel, Kari-Anne Rasmussen (2005). Two-year prospective study of personality disorders in patients with long standing eating disorders. International Journal of Eating Disorders. ISSN 0276-3478. 37, s. 112–118.

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• Havdahl, Alexandra; Lønning, Kari-Jussie; Rootwelt, Terje; Vrabel, KariAnne & Høstmælingen, Andreas (2023). Presisjonsbehandling i psykisk helsevern: Hvor står vi? [Internett]. Arendalsuka.
• Ohnstad, Anders; Vrabel, KariAnne; Danielsen, Yngvild Sørebø; Binder, Per-Einar; Korsnes, Kristina & Hærem, Selma Edvarda [Vis alle 7 forfattere av denne artikkelen] (2023). Self-compassion and difficulties with eating in a help seeking community sample.
• Bratland-Sanda, Solfrid & Vrabel, KariAnne (2022). Changes in Eating Disorder Psychopathology Among Compulsive and Non-Compulsive Exercisers During Inpatient Treatment of Longstanding Eating Disorders: A Single-Blinded RCT With 12-months Follow-Up. .
• Dahlgren, Anna Maria Camilla Lindvall; Walsh, Timothy; Vrabel, KariAnne; Siegwarth, Cecilie & Rø, Øyvind (2020). Validation of the Norwegian version of the Eating Disorder Assessment for DSM-5 (EDA-5): Final results.
• Vrabel, KariAnne (2019). Om compassionfokusert terapi.
• Vrabel, KariAnne (2019). Comparing Compassion Focused Therapy and Cognitive Behavioural Therapy in Treatment of Eating Disorders with and without Childhood Trauma: A randomized controlled trial.
• Vrabel, KariAnne (2019). Hva er egentlig «selvmedfølelse» og hvordan kan vi bruke det i forebygging og behandling? .
• Vrabel, KariAnne (2019). Om overspisingslidelser.
• Vrabel, KariAnne (2019). Traumer og spiseforstyrrelse .
• Vrabel, KariAnne (2019). Comparing Compassion Focused Therapy and Cognitive Behavioural Therapy in Treatment of Eating Disorders with and without Childhood Trauma: A randomized controlled trial .
• Vrabel, KariAnne (2019). Kvinner på randen: om stress, press og tidsklemma .
• Mathisen, Therese Fostervold; Rosenvinge, Jan H; Friborg, Oddgeir; Pettersen, Gunn; Vrabel, Kari-Anne & Bratland-Sanda, Solfrid [Vis alle 7 forfattere av denne artikkelen] (2019). How do physical exercise and dietary therapy compare to cognitive behavior therapy in outpatient treatment of women with BN or BED?
• Eielsen, Hanna Kristine Punsvik; Vrabel, Kari-Anne; Hoffart, Asle; Rø, Øyvind & Rosenvinge, Jan H (2019). Seventeen-year coure and outcome of eating disorders in an adult population.
• Olofsson, Malin Elisabeth; Oddli, Hanne; Vrabel, Kari-Anne & Hoffart, Asle (2018). "In solitude is safenss": a patient perspective on eating disorders in the context of childhood trauma".
• Eik-Nes, Trine Tetlie; Vrabel, Kari-Anne; Weider, Siri; Stedal, Kristin; Dahlgren, Anna Maria Camilla Lindvall & Berg, Kjersti Hognes [Vis alle 7 forfattere av denne artikkelen] (2018). Mental Health and Obesity (the MHOBY study) A transdisciplinary approach to obesity treatment .
• Eielsen, Hanna Kristine Punsvik; Vrabel, Kari-Anne; Rø, Øyvind; Rosenvinge, Jan H & Hoffart, Asle (2018). Longstanding, severe eating disorders - 17-year prospective follow-up study.
• Vrabel, Kari-Anne (2017). Huspsykolog. [Internett]. Pia og Psyken.
• Vrabel, Kari-Anne (2017). Spiseforstyrrelser. [Radio]. Ekko.
• Vrabel, Kari-Anne (2017). Uttalelse i forbindelse med sak om anorexia og genforskning. [Avis]. Dagbladet.
• Vrabel, Kari-Anne (2017). Overspisingslidelser. [TV]. God morgen Norge, TV2.
• Vrabel, Kari-Anne (2017). Podcast Pia og Psyken. [Internett]. Podcast.
• Vrabel, Kari-Anne (2017). "Perfeksjonisme". [Radio]. Buskerudsendingen.
• Olofsson, Malin Elisabeth & Vrabel, Kari-Anne (2017). Medfølelse for spiseforstyrrelser. Tidsskrift for Norsk Psykologforening. ISSN 0332-6470. s. 1184–1187.
• Vrabel, Kari-Anne (2016). Spennende forskning under "kløveren". [Tidsskrift]. Fredrikke - Norske Kvinners Sanitetsforening Nr. 2 Mai 2016.
• Vrabel, Kari-Anne & Reistad, Hilde Mollestad Tveit (2013). Ortoreksi. Norsk tidsskrift for ernæring (NTFE). ISSN 1503-5034. 1(13), s. 24–28.
• Vrabel, Kari-Anne (2012). Hellstrøm rydder opp. [TV]. TV3.
• Vrabel, Kari-Anne (2011). Behandling av spiseforstyrrelser og PTSD.
• Vrabel, Kari-Anne (2011). A five-year prospective follow-up study of longstanding eating disorders and child sexual abuse.
• Vrabel, Kari-Anne (2011). Når pasienten ikke vil - om motivasjonsarbeid i behandling av spiseforstyrrelser.
• Vrabel, Kari-Anne (2011). Behandling av spiseforstyrrelser og PTSD.
• Vrabel, Kari-Anne (2011). Årets doktorgrad til Øvre Eiker-kvinne. [Avis]. Drammens Tidende.
• Vrabel, Kari-Anne (2011). Har påvist en sammenheng mellom spiseforstyrrelser og seksuelt misbruk som barn. Psykolog og forsker ved Modum Bad, KariAnne Vrabel, ble i dag tildelt prisen "Årets doktorgrad 2010". [Internett]. www.modum-bad.no.
• Vrabel, Kari-Anne (2011). Intervjuet i Norgesglasset i P1 i forbindelse med utdeling av Årets doktorgrad.
• Vrabel, Kari-Anne (2011). Spiseforstyrrelser kan kureres. [Avis]. Dagen.
• Vrabel, Kari-Anne (2011). Behandling gir håp for personer med spiseforstyrrelser. [Avis]. Haugesund Avis.
• Vrabel, Kari-Anne (2011). Årets doktorgrad 2010 til Øvre Eiker kvinne. [Avis]. DrammensTidende.
• Vrabel, Kari-Anne (2011). Intervjuet i God Morgen Norge i forbindelse med blogging og spiseforstyrrelser. [TV]. TV2, God Morgen Norge.
• Vrabel, Kari-Anne (2010). Improving emotional processing in the treatment of posttraumatic stress disorder (PTSD).
• Vrabel, Kari-Anne (2010). Når følelser blir farlig - behandling av PTSD og spiseforstyrrelser.
• Vrabel, Kari-Anne (2010). Om spiseforstyrrelser - hvor er vi i dag?
• Vrabel, Kari-Anne (2010). Behandling av spiseforstyrrelser i Norge: Hvilke tilbud finnes?
• Vrabel, Kari-Anne (2010). Historier om spiseforstyrrelser - behandlerens perspektiv.
• Vrabel, Kari-Anne (2010). Om spiseforstyrrelser og selvskade - forståelse og behandling.
• Vrabel, Kari-Anne (2010). A five-year prospective follow-up study of longstanding eating disorders - influence from personality disorders and child sexual abuse.
• Vrabel, Kari-Anne (2010). A five-year prospective follow-up study of longstanding eating disorders. Influence from personality disorders and child sexual abuse.
• Vrabel, Kari-Anne (2010). Om forståelse av spiseforstyrrelsene.
• Vrabel, Kari-Anne (2010). Levende eller utopiske kropper?
• Vrabel, Kari-Anne (2010). Optimisme med bismak. [Internett]. www.forskning.no.
• Vrabel, Kari-Anne (2009). Forskningsfunn bidrar til at enda flere kan bli friske. [Avis]. Kvinnekraft.
• Isaksson Rø, Karin Elisabet & Vrabel, Kari-Anne (2008). "Fikk en million av sanitetskvinnene". [Avis]. Bygdeposten.
• Vrabel, Kari-Anne Rasmussen; Rosenvinge, Jan H; Martinsen, Egil; Hoffart, Asle & Rø, Øyvind (2008). Personality disorders and diagnostic crossovers in a longitydinal prospective follow up study of longstanding eating disorders.
• Vrabel, Kari-Anne (2009). A five-year prospective follow-up study of longstanding eating disorders. Influence from personality disorders and child sexual abuse. UiT Norges arktiske universitet. ISSN 978-82-7589-261-2.

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