A Multidimensional Meta-Analysis of Psychotherapy for Bulimia Nervosa.

Abstract

We report a multidimensional meta‐analysis of psychotherapy trials for bulimia nervosa published between 1980 and 2000, including multiple variables in addition to effect size such as inclusion and exclusion, recovery, and sustained recovery rates. The data point to four conclusions. First, psychotherapy leads to large improvements from baseline. Approximately 40% of patients who complete treatment recover completely, although 60% maintain clinically significant posttreatment symptoms. Second, individual therapy shows substantially better effects than group therapy for the therapies tested. Third, additional approaches or treatment parameters (e.g., number of sessions) need to be tested for the substantial number of patients who enter treatment and do not recover. Finally, the utility of meta‐analyses can be augmented by including a wider range of outcome metrics, such as recovery rates and posttreatment symptom levels.

Who is Providing what Type of Psychotherapy to Eating Disorder Clients? A Survey

“…Reliance on clinical judgment is at odds with a body of research on clinical versus actuarial prediction indicating that, on the whole, actuarial methods are superior, in part, because clinicians tend to identify too many exceptions to effective rules (Dawes, Faust, & Meehl, 1989). Controlled research has demonstrated that CBT and, secondarily, IPT, have the greatest efficacy for BN (National Institute for Clinical Excellence, 2004;Thompson'-Brenner et al, 2003), so these are the treatment decisions with the greatest likelihood for success. However, community clinicians are not basing treatment decisions on this evidence.…”

“…Two psychological interventions have demonstrated efficacy in improving eating disorder symptoms. Cognitivebehavior therapy (CBT) is generally considered to be the first-line treatment of choice for bulimia nervosa (BN; Thompson-Brenner, Glass, & Westen, 2003), and has also been applied to anorexia nervosa (AN; Vitousek, 2002) and binge eating disorder (BED; Wilfley et al, 2002). Interpersonal psychotherapy (IPT) has similar efficacy for BN as CBT, although its effects appear more slowly (Wilson & Pike, 2001).…”

Effectiveness of routine psychotherapy: Method matters

“…We consulted with experts in their respective fields to ensure that the meta-analyses found were representative. In some cases, when a single meta-analysis was not Thompson-Brenner, Glass, & Westen, 2003;Vocks, 2010). No relevant meta-analyses could be identified for Academic Distress, as this is not a typical focus of psychotherapy.…”

Motivation to change among residential treatment patients with an eating disorder: Assessment of the multidimensionality of motivation and its relation to treatment outcome

“…[33][34][35] The potentially limited generalizability of findings from psychotherapy trials for BN due to high rates of exclusion based on study eligibility criteria has also been described. 36 Because eligibility criteria for this study did not specify exclusion criteria (e.g., comorbid Axis I and II psychopathology, previous hospitalizations) that are typical of controlled psychotherapy research, a strength may be its comparable representativeness with regard to patients admitted to residential treatment settings for eating disorders. Moreover, the attrition observed in this study, although suboptimal for its potential to introduce bias, is consistent with the high rates of study and treatment attrition reported across the eating disorder treatment literature.…”