Early Intervention in Eating Disorders
Start date: February 2019
Award:
This studentship is funded by the Health Foundation for 3 years for UK and EU candidates. It includes a tax-free stipend up to £ 16,777 per annum (MRC rate), full fees and an allowance for research consumables and conference travel.
Application deadline: 15th October 2018
Project:
Eating Disorders (EDs) are severe mental disorders with a peak onset in adolescence / early adulthood, at a developmentally sensitive time when the brain is still developing. Thus, they have the potential for seriously impacting on cognitive, socio-emotional and educational trajectories. EDs are associated with high levels of disability and mortality and pose a major burden for individuals and families. Importantly, starvation, extreme weight loss practices and raised stress hormones (cortisol) have neurotoxic effects, leading to lasting brain changes which negatively affect chances of recovery. Thus, early effective intervention within about 3 years of onset is essential to prevent the disorder becoming chronic and treatment-refractory.
A key barrier to early effective treatment is poor access to services. Research studies have shown that ED patients who have to wait for treatment tend to drop out more and deteriorate or stay symptomatic whilst waiting. Younger patients seem to be particularly at risk of deterioration whilst waiting. Importantly, once patients who waited do start treatment they have worse outcomes than those treated immediately. In summary, available evidence provides a compelling case for reducing the duration of untreated ED or DUED (and wait-time as an important component of DUED) in young people with ED.
This mixed-methods project will evaluate implementation of FREED (first episode rapid early intervention for EDs), an evidence-based service model for adolescents and emerging adults (Schmidt et al., 2016), across a network of ten specialist ED services in England (FREED-4-All). We have previously shown that introduction of FREED into a specialist ED service shortens DUED and improves outcomes in anorexia nervosa patients with recent onset eating disorders, compared to similar patients being seen with a standard outpatient model where lengthy waits for assessment and treatment are common place (Brown et al., 2018; McClelland et al., 2018).
To provide context, the PhD project will start with a systematic review of novel and established service models for EDs and the evidence supporting them. The candidate will then carry out studies focusing on the implementation of FREED in the network. This will include a qualitative interview study of different health professionals (psychologists, nurses, doctors) working in participating services to establish their attitudes, expectations and views on early intervention in general and the FREED model in particular and perceived facilitators and barriers to implementation. In addition, the candidate will collect data on the duration of untreated illness in participating services and how this is impacted by the implementation of FREED. Further, they will assess the fidelity of implementation through comparing clinician-self-rated with objective implementation fidelity via audio recordings from assessment and early treatment sessions. They will also assess impact of implementation of FREED on routine clinical outcomes (body mass index, eating disorder symptoms, quality of life) in participating ED services. Finally they will conduct a Delphi study with young people in the community to obtain their views on clinical prioritisation in EDs services.
The successful candidate for this project will be registered in, and be part of the vibrant postgraduate research community in the King’s College London Eating Disorders Research Group in the Department of Psychological Medicine in the Institute of Psychiatry, Psychology and Neuroscience.
References:
Brown A, McClelland J, Boysen E, Mountford V, Glennon D, Schmidt U. The FREED Project (first episode and rapid early intervention in eating disorders): service model, feasibility and acceptability. Early Interv Psychiatry. 2018 Apr;12(2):250-257.
McClelland J, Hodsoll J, Brown A, Lang K, Boysen E, Flynn M, Mountford VA, Glennon D, Schmidt U. A pilot evaluation of a novel First Episode and Rapid Early Intervention service for Eating Disorders (FREED). Eur Eat Disord Rev. 2018 Mar;26(2):129-140.
Schmidt U, Brown A, McClelland J, Glennon D, Mountford VA. Will a comprehensive, person-centered, team-based early intervention approach to first episode illness improve outcomes in eating disorders? Int J Eat Disord. 2016 Apr;49(4):374-7.
Supervisors: Professor Ulrike Schmidt, ulrike.schmidt@kcl.ac.uk; Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King’s College London.
Dr. Karina Allen, karina.allen@slam.nhs.uk, South London and Maudsley NHS Foundation Trust.
Candidate profile: Applications are invited from candidates with an interest in multi-disciplinary research and who have a 1st class or upper second degree in psychology or any other relevant health related discipline. A master’s degree in a relevant area will be an advantage, as will be experience of working with people with eating disorders or other mental health conditions.
This studentship covers full Home/EU tuition fees and includes a tax-free stipend up to £ 16,777 per annum (MRC rate), and an allowance for research consumables and conference travel.
International students are welcome to apply but need to know that this studentship does not cover full international fees. Thus interested international applicants would need to find funds to pick up the difference between home and international fees elsewhere.
How to apply:
Applicants must complete and submit an online admissions application via the admissions portal by midnight (23:59 GMT) on 15th October 2018. On the choosing a programme page please select ‘Research degrees’ and enter the keyword Psychological Medicine Research MPhil/PhD (Full-time).
In your application you will be asked to include:
- Academic Transcripts – where applicable, academic transcripts must be submitted with the online admissions application
- Details of your qualifications (you will need to attach copies)
- Details of previous employment
- A personal statement describing your interests and why you wish to apply for this project. Please include this as an attachment rather than using the text box.
- Academic References – all admissions applications require two supporting references. If the applicant is relying on his/her referees to submit references directly to the College after he/she has submitted his/her admissions application, then the applicant must ensure that their chosen referees are made aware of the funding deadline.
In the funding section, please tick box 5 and include the following reference: US-EDPHD-2018
Please note there is no need to complete the Research Proposal section in your application as the project has already been set.
You are welcome to email Prof. Ulrike Schmidt (supervisor) for more information regarding the project and studentship. If you have any queries regarding the application process, please contact Lauren Soules, the Postgraduate Research Administrative Assistant.
References must be received by the deadline for the applicant to be eligible.
Only shortlisted applicants will be contacted.
Interviews will be notified by email.
Futher information:
About the IoPPN ( http://www.kcl.ac.uk/ioppn/about/index.aspx)
Studying at the IoPPN ( http://www.kcl.ac.uk/ioppn/study/index.aspx)
Research degrees at the IoPPN (http://www.kcl.ac.uk/ioppn/study/prospective-students/programmes-of-study/pgr/welcome.aspx)
KCL Researcher Development Programme http://www.kcl.ac.uk/study/pg/school/RDP/training-and-development/Researcher-Development-Programme-2014-15.pdf)