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.