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Is motivation enough? Confidence as a predictor of outcome in inpatient treatment for eating disorders Iyar, Megumi M.


While motivation has been shown to be a robust predictor of eating disorder treatment outcome, little attention has been paid to the role of confidence. This study sought to better understand the role of confidence and the possible interaction it may have with motivation in promoting eating disorder symptom change. Participants were adult women (N = 159) in inpatient treatment for eating disorders. They completed measures of readiness and motivation for change, which assessed precontemplation, action, confidence and internality (changing for oneself vs. for others) and eating disorder symptom severity at pre- and post-treatment. Medical variables (e.g. height and weight) were also recorded. Precontemplation and confidence had significant effects on pre-and post-treatment symptom severity, while action only had a significant effect on pre-treatment symptoms. Confidence was also shown to moderate relations between both measures of readiness (i.e., precontemplation and action) and change in symptoms. Follow up analyses indicated that high precontemplation (low readiness) was associated with poor outcome, irrespective of confidence, however, low precontemplation (high readiness) was associated with better outcome at high levels of confidence. The interaction between confidence and action was significant only at very high levels of confidence. Among individuals who had high action at baseline, those with lower confidence had significantly poorer outcomes relative to those with high levels of confidence. Findings indicate that readiness and confidence are important prognostic factors and suggest that early behaviour change in the absence of confidence does not guarantee best outcomes in inpatient eating disorder treatment.

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