Specificity of psychological treatments for bulimia nervosa and binge eating disorder? A meta-analysis of direct comparisons

Spielmans, Glen I.; Benish, Steven G.; Marin, Catherine; Bowman, Wesley M.; Menster, Maria; Wheeler, Anthony J.

doi:10.1016/j.cpr.2013.01.008

Cited by 52 publications

(36 citation statements)

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“…Rates and type of ancillary treatment over follow-up were similar across conditions, suggesting that differential care should not have biased estimates of intervention effects. The eating disorder symptom reduction effect ( d = .95), which was large in magnitude, was similar to effects produced by the individual treatments of choice for various eating disorders relative to usual care controls ( M d = .79; Dare et al, 2001; Grilo et al, 2005; Kirkley et al, 1985; Peterson et al, 2009; Spielmans et al, 2013) and for enhanced CBT for women with binge spectrum EDs ( d = .98; Fairburn et al 2009, though threshold/subthreshold anorexia nervosa cases were excluded from the latter trial). The similarity in effects is noteworthy because Body Acceptance Therapy is more cost-effective than the typical 20-session individual treatment; one clinician can treat 8 individuals in 8 hours of group therapy, versus 160 hours required for individual therapy with 8 patients (8 patients x 20 hours).…”

Section: Discussionmentioning

confidence: 66%

“…Cognitive-behavioral therapy (CBT) is effective for bulimia nervosa, producing larger pre-post reductions in symptoms ( M d = .94) and remission rates than control conditions (29-52% vs. 6-24%) (e.g., Kirkley, Schneider, Agras, & Bachman, 1985; Spielmans et al, 2013). CBT is also effective for binge eating disorder, producing larger pre-post symptom reductions ( M d = 1.07) and remission rates than control conditions (39-73% vs. 0-30%) (e.g., Grilo, Masheb, & Wilson, 2005; Peterson et al, 2009).…”

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confidence: 99%

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Randomized Controlled Pilot Trial of a Novel Dissonance-Based Group Treatment for Eating Disorders

Stice

Rohde

Butryn

et al. 2015

Behaviour Research and Therapy

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Objective Conduct a pilot trial of a new dissonance-based group eating disorder treatment designed to be a cost-effective front-line transdiagnostic treatment that could be more widely disseminated than extant individual or family treatments that are more expensive and difficult to deliver. Method Young women with a DSM-5 eating disorder (N = 72) were randomized to an 8-week dissonance-based Body Acceptance Therapy group treatment or a usual care control condition, completing diagnostic interviews and questionnaires at pre, post, and 2-month follow-up. Results Intent-to-treat analyses revealed that intervention participants showed greater reductions in outcomes than usual care controls in a multivariate multilevel model (χ2[6] = 34.1, p < .001), producing large effects for thin-ideal internalization (d = 0.79), body dissatisfaction (d = 1.14), and blinded interview-assessed eating disorder symptoms (d = .95), and medium effects for dissonance regarding perpetuating the thin ideal (d = .65) and negative affect (d = .55). Midway through this pilot we refined engagement procedures, which was associated with increased effect sizes (e.g., the d for eating disorder symptoms increased from .51 to 2.30). Conclusions This new group treatment produced large reductions in eating disorder symptoms, which is encouraging because it requires about 1/20th the therapist time necessary for extant individual and family treatments, and has the potential to provide a cost-effective and efficacious approach to reaching the majority of individuals with eating disorders who do not presently received treatment.

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Section: Discussionmentioning

confidence: 66%

mentioning

confidence: 99%

Randomized Controlled Pilot Trial of a Novel Dissonance-Based Group Treatment for Eating Disorders

Stice

Rohde

Butryn

et al. 2015

Behaviour Research and Therapy

View full text Add to dashboard Cite

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“…Cognitive Behavioral Therapy (CBT) for BN and BED, including an enhanced, transdiagnostic version, Cognitive Behavioral Therapy-Enhanced (CBT-E), demonstrates the best outcomes to date for these disorders (Byrne et al, 2011; Excellence, N.I.f.C., 2011; Fairburn et al, 2009; Hay et al, 2009; Shapiro et al, 2007; Wonderlich et al, 2013). Interpersonal Psychotherapy (IPT) for BN also has strong empirical support, but has consistently yielded outcomes that are comparable or slightly worse than those of CBT-E (Spielmans et al, 2013). However, one of the most comprehensive and recent studies of CBT-E found that by the end of treatment, only 38.6% of patients with BN met remission criteria and by 60-weeks follow-up, 45.6% met remission criteria (Byrne et al, 2011).…”

Section: Current Treatments For Eating Disordersmentioning

confidence: 99%

Could training executive function improve treatment outcomes for eating disorders?

et al. 2015

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Current gold standard treatments for eating disorders (EDs) lack satisfactory efficacy, and traditional psychological treatments do not directly address executive functioning deficits underpinning ED pathology. The goal of this paper is to explore the potential for enhancing ED treatment outcomes by improving executive functioning deficits that have been demonstrated to underlie eating pathology. To achieve our objective, we (1) review existing evidence for executive functioning deficits that underpin EDs and consider the extent to which these deficits could be targeted in neurocognitive training programs, (2) present the evidence for the one ED neurocognitive training program well-studied to date (Cognitive Remediation Therapy), (3) discuss the utility of neurocognitive training programs that have been developed for other psychiatric disorders with similar deficits, and (4) provide suggestions for the future development and research of neurocognitive training programs for EDs. Despite the fact that the body of empirical work on neurocognitive training programs for eating disorders is very small, we conclude that their potential is high given the combined evidence for the role of deficits in executive functioning in EDs, the initial promise of Cognitive Remediation Training, and the success in treating related conditions with neurocognitive training. Based on the evidence to date, it appears that the development and empirical evaluation of neurocognitive training programs for EDs is warranted.

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“…For adults with BED, cognitive-behavioral therapy (CBT) is the most well-established psychological treatment, as reflected in systematic reviews [37-39], meta-analysis [40], and clinical guidelines [41], although superiority to other bona fide treatments has not been demonstrated clearly [42]. Efficacy studies of CBT documented substantial reductions in binge eating and associated symptomatology that can be maintained over the long-term [43].…”

Section: Introductionmentioning

confidence: 99%

Cognitive-behavioral therapy for binge eating disorder in adolescents: study protocol for a randomized controlled trial

Hilbert

2013

Trials

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BackgroundBinge eating disorder is a prevalent adolescent disorder, associated with increased eating disorder and general psychopathology as well as an increased risk for overweight and obesity. As opposed to binge eating disorder in adults, there is a lack of validated psychological treatments for this condition in adolescents. The goal of this research project is therefore to determine the efficacy of age-adapted cognitive-behavioral therapy in adolescents with binge eating disorder – the gold standard treatment for adults with binge eating disorder.Methods/designIn a single-center efficacy trial, 60 12- to 20-year-old adolescents meeting diagnostic criteria of binge eating disorder (full-syndrome or subthreshold) according to the Diagnostic and Statistical Manual of Mental Disorders 4th or 5th Edition, will be centrally randomized to 4 months of cognitive-behavioral therapy (n = 30) or a waiting-list control condition (n = 30). Using an observer-blind design, patients are assessed at baseline, mid-treatment, post-treatment, and at 6- and 12-month follow-ups after the end of treatment. In 20 individual outpatient sessions, cognitive-behavioral therapy for adolescents focuses on eating behavior, body image, and stress; parents receive psychoeducation on these topics. Primary endpoint is the number of episodes with binge eating over the previous 28 days at post-treatment using a state-of-the art clinical interview. Secondary outcome measures address the specific eating disorder psychopathology, general psychopathology, mental comorbidity, self-esteem, quality of life, and body weight.DiscussionThis trial will allow us to determine the short- and long-term efficacy of cognitive-behavioral therapy in adolescent binge eating disorder, to determine cost-effectiveness, and to identify predictors of treatment outcome. Evidence will be gathered regarding whether this treatment will help to prevent excessive weight gain. If efficacy can be demonstrated, the results from this trial will enhance availability of evidence-based treatment of adolescent binge eating disorder.Trial registrationGerman Clinical Trials Register: DRKS00000542

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Specificity of psychological treatments for bulimia nervosa and binge eating disorder? A meta-analysis of direct comparisons

Cited by 52 publications

References 100 publications

Randomized Controlled Pilot Trial of a Novel Dissonance-Based Group Treatment for Eating Disorders

Randomized Controlled Pilot Trial of a Novel Dissonance-Based Group Treatment for Eating Disorders

Could training executive function improve treatment outcomes for eating disorders?

Cognitive-behavioral therapy for binge eating disorder in adolescents: study protocol for a randomized controlled trial

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