{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T11:13:02Z","timestamp":1788347582434,"version":"build-2803163510"},"reference-count":30,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:00:00Z","timestamp":1778457600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:00:00Z","timestamp":1778457600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Eating Disorders"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Eating\u2010disorder\u2013specific functional impairment may represent a boundary condition for treatment response, yet this possibility has rarely been examined. We investigated whether baseline functional impairment constrains short\u2010term eating\u2010disorder symptom improvement, indexed by change in EDE\u2010Q Global scores during inpatient treatment using a necessity\u2010based framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>We retrospectively analyzed 462 inpatients who completed the Eating Disorder Examination Questionnaire (EDE\u2010Q 6.0) at admission and discharge. Functional impairment (Clinical Impairment Assessment, CIA), general psychopathology (SCL\u201090\u2010R GSI), and body uneasiness (BUT\u2010GSI) were assessed at baseline. Short\u2010term eating\u2010disorder symptom improvement was defined as clinically meaningful improvement based on the Reliable Change Index and as continuous change in EDE\u2010Q Global scores. Necessary condition analysis with permutation testing and bottleneck analysis was applied, with subgroup analyses for anorexia nervosa versus non\u2010anorexia nervosa.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      ED\u2010specific functional impairment emerged as a statistically significant necessary condition for clinically meaningful improvement (NCA\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u20090.167,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.011) and symptom change (\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u20090.159,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002). Neither general psychopathology nor body uneasiness met criteria for necessity. Bottleneck analysis showed that larger symptom reductions occurred only above increasing CIA thresholds. Necessity effects were robust in AN but absent in non\u2010 diagnoses.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Functional impairment appears to constrain short\u2010term inpatient EDE\u2010Q improvement in anorexia nervosa, whereas no necessity effect was observed in non\u2010anorexia nervosa diagnoses. These findings suggest that ED\u2010specific functional impairment may function as a boundary condition for short\u2010term EDE\u2010Q improvement in anorexia nervosa within the present sample, whereas no corresponding necessity effect was observed for general psychopathology, body uneasiness, or non\u2010anorexia nervosa diagnoses.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/eat.70131","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T12:23:31Z","timestamp":1778502211000},"page":"2084-2090","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["When Is Improvement Possible? A Necessity\u2010Based Analysis of Short\u2010Term Eating Disorder Symptom Improvement During Inpatient Treatment"],"prefix":"10.1002","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3323-6071","authenticated-orcid":false,"given":"Paolo","family":"Meneguzzo","sequence":"first","affiliation":[{"name":"Department of Neuroscience University of Padova  Padova Italy"},{"name":"Padova Neuroscience Center University of Padova  Padova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2212-9855","authenticated-orcid":false,"given":"Patrizia","family":"Todisco","sequence":"additional","affiliation":[{"name":"Eating Disorder Unit, Casa di Cura \u201cVilla Margherita\u201d \u2013 KOS Group  Arcugnano Italy"},{"name":"Psyco\u2010Nutritional Center  Verona, Vicenza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,11]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2025.0132"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40337-022-00717-4"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2008.06.012"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2021.102032"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF03327738"},{"key":"e_1_2_13_7_1","unstructured":"Derogatis L. 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