An intensive DBT program for patients with multidiagnostic eating disorder presentations: A case series analysis

Abstract

Objective: This study presents case-series data on a novel outpatient program that blends dialectical behavior therapy (DBT) with standard eating disorder (ED) interventions (i.e., food exposure, weight monitoring, cognitive modification, ED psychoeducation) for patients with complex and multidiagnostic ED presentations.Method: Quantitative and qualitative data was collected on a sample of seven consecutively admitted women who presented with a severe ED, a history of several failed treatment attempts, pervasive emotion dysregulation, and significant Axis I or II psychiatric comorbidity (e.g., PTSD, borderline personality disorder).Results: Treatment was associated with reductions in ED symptoms, suicidal and self-injurious behaviors, treatment interfering behaviors, psychiatric and medical hospitalizations, and clinican burnout.Discussion: Overall, the results suggest that this blended DBT/cognitive behavior therapy for ED treatment model is a promising intervention for this complex and ''hard to treat'' population. V V C 2013 by Wiley Periodicals, Inc.

Adapting dialectical behavior therapy for outpatient adult anorexia nervosa—A pilot study

“…Given the extreme fearful avoidance of food commonly observed with AN and the difficulties clients experience accepting weight recovery, DBT was also thought to be effective in teaching skillful emotional responding for the former and uniquely balancing these change‐based strategies with acceptance‐based strategies for the latter. There is also an evidence base for both standard DBT for borderline personality disorder and eating disorders and inpatient eating disorders …”

Obsessive–compulsive symptomatology in female adolescent inpatients with restrictive compared with binge–purge eating disorders

“…The finding of the multivariate linear regression analyses, that is, that the ED diagnosis, along with baseline state anxiety, predicts the Y‐BOCS score on admission and is the only predictor of the change of the Y‐BOCS scores from the acute stage of the illness to ED‐related stabilization, supports studies showing that obsessionality may be considered particularly important in both the predisposition to and maintenance of EDs (Anderluh, Tchanturia, Rabe‐Hesketh, & Treasure, ). The potential co‐occurrence of elevated obsessionality and impulsivity in patients with AN‐B/P may require the use of combined cognitive and dialectical behaviour therapies in these patients to address both symptom types (Federici & Wisniewski, ). Further longitudinal prospective research in a large sample of ambulatory patients with different types of EDs from the early stages of the illness to recovery is needed to better clarify the impact of general non‐ED obsessionality on the course and outcome of EDs.…”

Aversive tension of adolescents with anorexia nervosa in daily course: a case-controlled and smartphone-based ambulatory monitoring trial

“…So far, there has been only one controlled trial conducted comparing DBT with treatment as usual in adolescent patients with AN 21. Few pilot studies on adapted DBT programmes for patients with AN and a comorbid BPD exist,22 23 but all of these findings are promising regarding the effectiveness of DBT in the therapy of AN. As previously mentioned, DBT focuses on emotion regulation.…”