Feasibility and Preliminary Outcomes of Group–Based Cognitive Remediation and Emotion Skills Training (CREST) for Adult Women With Anorexia Nervosa and Bulimia Nervosa: A Pilot Pre–Post Study

Abstract

Introduction: Cognitive and emotional deficits are common in eating disorders (EDs), especially anorexia nervosa (AN) and bulimia nervosa (BN), and can hinder engagement and recovery. This pilot single–group pre–post study examined the feasibility and preliminary outcomes of group–based Cognitive Remediation and Emotion Skills Training (CREST) for adult women with AN/BN in a day care programme setting. Methods: Fifty seven women enroled; 32 completed the 5-week, 10–session programme. Completers and non–completers were compared to identify predictors of adherence. Emotional functioning was assessed using symptom and trait self–report measures, including the TAS–20, Zung Self–Rating Anxiety Scale, BDI–II, EDE–Q, TEQ, and the Self–Compassion Scale. Feasibility was evaluated based on enrolment, completion rates, and treatment adherence. Results: Preliminary analyses indicated decreases in anxiety (SAS, p < 0.001) and depression (BDI–II, p < 0.001), alongside higher self–compassion (SCS, p < 0.001). Results should be interpreted cautiously given the absence of a control group and notable attrition; improvements may reflect combined effects of CREST and standard multidisciplinary care. Higher BMI and shorter illness duration were associated with completion; in regression, only more previous hospitalisations remained significant. Conclusions: Pilot findings suggest that group–based CREST may represent a feasible adjunctive intervention for patients with AN and BN. Further controlled studies are required to disentangle its specific effects from standard care to confirm its effectiveness.