Integrative Response Therapy for Binge Eating Disorder

Abstract

Binge Eating Disorder (BED), a chronic condition characterized by eating disorder psychopathology and physical and social disability, represents a significant public health problem. Guided Self Help (GSH) treatments for BED appear promising and may be more readily disseminable to mental health care providers, accessible to patients, and cost-effective than existing, efficacious BED specialty treatments which are limited in public health utility and impact given their time and expense demands. No existing BED GSH treatment has incorporated affect regulation models of binge eating, which appears warranted given research linking negative affect and binge eating. Integrative Response Therapy (IRT), a new group-based guided self-help treatment, based on the affect regulation model of binge eating, that has shown initial promise in a pilot sample of adults meeting DSM IV criteria for BED, is described. Fifty-four% and 67% of participants were abstinent at post-treatment and three month follow-up respectively. There was a significant reduction in the number of binge days over the previous 28 days from baseline to post-treatment [14.44 (±7.16) to 3.15 (±5.70); t=7.71, p<.001; d=2.2] and from baseline to follow-up [14.44 (±7.16) to 1.50 (±2.88); t=5.64, p<.001; d=1.7]. All subscales from both the Eating Disorder Examination – Questionnaire and Emotional Eating Scale were significantly lower at post-treatment compared to baseline. 100% of IRT participants would recommend the program to a friend or family member in need. IRT’s longer-term efficacy and acceptability are presently being tested in a National Institute of Mental Health funded randomized controlled trial.

Eating pathology, emotion regulation, and emotional overeating in obese adults with binge eating disorder

“…A substantial body of literature suggests that individuals with BED report overeating in response to emotions (Eldredge & Agras, 1996; Masheb & Grilo, 2006; Stein, Kenardy, Wiseman, Zoler Dounchis, Arnow, & Wilfley, 2007). There have been a number of trials examining the efficacy of treatments for BED which focus on developing adaptive emotion regulation skills, with the intent of reducing emotional overeating (Robinson, 2012; Telch, Agras, & Linehan, 2001). It is important to better characterize the relationship between emotion regulation difficulties and disordered eating behaviors within a sample of adults with BED, as this may provide us with valuable information regarding appropriate points of intervention for these individuals.…”

Does implicit emotion regulation in binge eating disorder matter?

“…BL and PT data for BED participants (n=43) were collected as part of a larger randomized clinical trial of a treatment outcome study comparing two manualized BED treatments: Cognitive Behavioral Therapy (CBT; n=19; 44%; based largely on the restraint model of binge eating) and Integrative Response Therapy (IRT; n=24; 56%; based on affect regulation models of binge eating (32)). The current study's sample was selected from the larger BED trial's sample of n=86 participants because they were not taking psychotropic medications nor had used a benzodiazepine within 48 hours of completing the task, and thus were eligible.…”

“…The ECT has been validated for use in healthy control and psychiatric populations (13-14, 28) and is the only emotion regulation task now supported by lesion evidence (31). The ECT is a variant of the classic Stroop paradigm (16) in which words are presented in colors either congruent with the word itself (red in red ink) or incongruent with the word (red in blue ink) to provide a measure of cognitive, rather than emotional, conflict (32). In the ECT, emotional conflict arises from incompatibility between the task-relevant and task-irrelevant emotional dimensions of a stimulus, hence representing an emotional analog to the color-word Stroop task (33).…”

Tratamientos actuales del trastorno por atracón

“…Existen otras técnicas, como la terapia de respuesta integrativa (Robinson, 2013), las cuales se han empleado menos y no poseen aún suficiente aval empírico, por lo que no se recogen en esta revisión.…”