{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T20:49:36Z","timestamp":1781988576790,"version":"3.54.5"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,10,27]],"date-time":"2022-10-27T00:00:00Z","timestamp":1666828800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Eating Disorders"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Evaluating treatment efficacy solely on whether sample\u2010level change is statistically significant does not indicate whether clinically significant change (CSC) has occurred at the individual\u2010level. We assessed whether change in measures of eating disorder psychopathology was statistically significant at the sample\u2010level and <jats:italic>clinically significant at the individual\u2010level<\/jats:italic> for inpatients treated in a hospital\u2010based eating disorder program.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Participants (<jats:italic>N<\/jats:italic>\u00a0=\u00a0143) were consecutive underweight distinct admissions diagnosed with anorexia nervosa or other specified feeding and eating disorder. The Eating Disorder Examination Questionnaire (EDEQ) and Eating Disorder Recovery Self\u2010efficacy Questionnaire (EDRSQ) were assessed at admission and program discharge. CSC was defined as individual score change that was both statistically reliable <jats:italic>and<\/jats:italic> shifted from dysfunctional to normative.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Mean EDRSQ and EDEQ scores significantly improved with treatment across the sample; effect sizes were moderate to large. Individual\u2010level analyses demonstrated that 85%, 50%, and 20\u201335% of participants had CSC <jats:italic>or<\/jats:italic> statistically reliable change in BMI, eating symptomatology, and body image respectively. One\u2010third of participants showed CSC on BMI <jats:italic>and<\/jats:italic> on at least one self\u2010report measure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Individual\u2010level analyses offer more nuanced outcome data that could identify patients at higher risk of relapse who may benefit from adjunctive interventions during or immediately post\u2010discharge.<\/jats:p><\/jats:sec><jats:sec><jats:title>Public Significance Statement<\/jats:title><jats:p>This study examined change in eating pathology for inpatients with eating disorders using sample\u2010 and individual\u2010level analyses, including whether change was statistically reliable and clinically significant (scores statistically improved and moved into the healthy range). Only half of patients responded robustly to treatment, which may be related to high relapse rates following discharge. Individual\u2010level analyses provided a detailed view of treatment response and may identify patients at higher relapse risk.<\/jats:p><\/jats:sec>","DOI":"10.1002\/eat.23842","type":"journal-article","created":{"date-parts":[[2022,10,27]],"date-time":"2022-10-27T10:14:00Z","timestamp":1666865640000},"page":"452-457","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Evaluating individual\u2010 and <scp>sample\u2010level<\/scp> response to treatment for inpatients with eating disorders: Is change clinically significant?"],"prefix":"10.1002","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6739-5997","authenticated-orcid":false,"given":"Colleen C.","family":"Schreyer","sequence":"first","affiliation":[{"name":"Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allisyn","family":"Pletch","sequence":"additional","affiliation":[{"name":"Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irina A.","family":"Vanzhula","sequence":"additional","affiliation":[{"name":"Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1355-729X","authenticated-orcid":false,"given":"Angela S.","family":"Guarda","sequence":"additional","affiliation":[{"name":"Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,10,27]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.22665"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1037\/\/0033-295x.84.2.191"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/YCO.0000000000000453"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.20931"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2021.06.009"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/erv.2589"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/10503307.2012.717308"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2020.07.043"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.23272"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eatbeh.2021.101518"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/erv.996"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40337-020-00349-6"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.20956"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/1098-108X(199412)16:4<363::AID-EAT2260160405>3.0.CO;2-#"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40337-020-00348-7"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.23386"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.22899"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2008.08060957"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.22981"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1037\/\/0022-006x.59.1.12"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2020.599945"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.20256"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eatbeh.2007.07.001"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.22390"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2021.01.070"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-014-0258-z"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000200041"},{"key":"e_1_2_9_29_1","volume-title":"Structured clinical interview for DSM\u20105 disorders: Clinician version","author":"Spitzer R. 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