Predictors of relapse following successful dialectical behavior therapy for binge eating disorder.

Objective: To identify predictors of relapse at 6-month follow-up for women with binge eating disorder (BED).

Method: Participants were 32 women with BED who had initially achieved abstinence from binge eating after 20 weeks of dialectical behavior therapy (DBT) adapted for patients with BED. Posttreatment predictor variables included the subscales Restraint, Weight Concerns, and Shape Concerns from the Eating Disorders Examination (EDE), the Emotional Eating Scale score, the Rosenberg Self-Esteem Scale, body mass index, and early versus late age of binge eating onset.

Dialectical behavior therapy for binge eating disorder.

This study evaluated the use of dialectical behavior therapy (DBT) adapted for binge eating disorder (BED). Women with BED (N = 44) were randomly assigned to group DBT or to a wait-list control condition and were administered the Eating Disorder Examination in addition to measures of weight, mood, and affect regulation at baseline and posttreatment. Treated women evidenced significant improvement on measures of binge eating and eating pathology compared with controls, and 89% of the women receiving DBT had stopped binge eating by the end of treatment.

Dialectical behavior therapy adapted for bulimia: a case report.

Objective: This case report describes the application of dialectical behavior therapy (DBT) to the treatment of bulimia nervosa in a 20-session manualized therapy.

Method: The treatment, based on an affect regulation model of eating disorders, was developed to teach emotion regulation skills to replace eating-disordered behaviors. The patient, a 36-year-old woman, had a long history of binge eating and purging that had not responded to 2 years of counseling.

Subtyping binge eating-disordered women along dieting and negative affect dimensions.

Objective: Because etiologic and maintenance models of binge eating center around dieting and affect regulation, this study tested whether binge eating-disordered (BED) individuals could be subtyped along dieting and negative affect dimensions and whether subtypes differed in eating pathology, social functioning, psychiatric comorbidity, and response to treatment.

Method: Three independent samples of interviewer-diagnosed BED women (N = 218) were subtyped along dieting and negative affect dimensions using cluster analysis and compared on the outcomes of interest.

Results: Cluster analyses replicated across the three independent samples and revealed a dietary subtype (63%) and a dietary-depressive subtype (37%).

Perfectionism in women with binge eating disorder.

Objective: This study examined self-oriented (SOP), socially prescribed (SPP), and other-oriented (OOP) perfectionism in 127 obese women with binge eating disorder (BED).

Method: Relationships between eating disorder and general psychopathology variables and SOP, SPP, and OOP were assessed. Levels of SOP, SPP, and OOP in the BED sample were compared with those of 32 normal weight women with bulimia nervosa (BN) and 60 obese non-eating-disordered individuals (NED).

Dialectical behavior therapy for bulimia nervosa.

Objective: The effects of dialectical behavior therapy adapted for the treatment of binge/purge behaviors were examined.

Method: Thirty-one women (averaging at least one binge/purge episode per week) were randomly assigned to 20 weeks of dialectical behavior therapy or 20 weeks of a waiting-list comparison condition. The manual-based dialectical behavior therapy focused on training in emotion regulation skills.

Development and validation of the Eating Disorder Diagnostic Scale: a brief self-report measure of anorexia, bulimia, and binge-eating disorder.

This article describes the development and validation of a brief self-report scale for diagnosing anorexia nervosa, bulimia nervosa, and binge-eating disorder. Study 1 used a panel of eating-disorder experts and provided evidence for the content validity of this scale. Study 2 used data from female participants with and without eating disorders (N = 367) and suggested that the diagnoses from this scale possessed temporal reliability (mean kappa = .

Dialectical behavior therapy for Binge-Eating Disorder.

Binge-eating episodes have alternately been described as stemming from strict dieting behaviors driven by overvalued ideas of weight and shape, or as arising from problematic interpersonal experiences. A third way of conceptualizing an eating binge is as a maladaptive emotion-regulation strategy, suggesting that facilitating more adaptive and effective affect regulation capacities may be a useful treatment. Dialectical Behavior Therapy (DBT), a treatment aimed at increasing emotion regulation skill, is currently being adapted for use with a binge-eating disorder population.

Psychiatric comorbidity in women with binge eating disorder: prevalence rates from a non-treatment-seeking sample.

This study provides estimates of comorbid psychiatric disorders in women with binge eating disorder (BED). Sixty-one BED and 60 control participants, who were recruited from the community, completed the Structured Clinical Interview for DSM-III-R Axis I and Axis II disorders and self-report measures of eating and general psychiatric symptomatology. Regarding psychiatric diagnoses, women with BED had higher lifetime prevalence rates for major depression, any Axis I disorder, and any Axis II disorder relative to controls.

Obese women with binge eating disorder define the term binge.

Objective: The purpose of this study was to provide information regarding the criteria used by women with binge eating disorder (BED) to classify an eating episode a binge.

Method: Sixty women who met DSM-IV research criteria for BED were interviewed and asked to define binge eating in their own words. Two independent raters classified subjects' responses according to a structured classification scheme.

Eating attitudes and behaviors in 1,435 South African Caucasian and non-Caucasian college students.

Objective: The purpose of this study was to examine the presence and severity of eating disorder pathology in students representing South Africa's ethnically and culturally diverse population.

Method: A questionnaire survey, which involved the Eating Attitude Test and the Bulimic Investigatory Test, was administered to 1,435 South African college students (739 Caucasian and 696 non-Caucasian) from six universities in two urban centers.

Results: Black students scored significantly higher than the other ethnic groups on these measures.

Skills training treatment for adaptive affect regulation in a woman with binge-eating disorder.

This case study describes a skills training treatment for binge eating which focused on teaching adaptive affect regulation. A 36-year-old obese woman with a long history of severe binge eating received individual treatment specifically aimed at enhancing her emotion regulation abilities. By treatment end she no longer met criteria for binge eating disorder.

The effects of extending cognitive-behavioral therapy for binge eating disorder among initial treatment nonresponders.

Objective: The study was designed with the aim of determining whether extending group cognitive-behavioral therapy (CBT) would enhance outcome among individuals with binge eating disorder (BED) who failed to stop binge eating after an initial 12-week CBT intervention.

Method: Forty-six participants who met diagnostic criteria for BED were randomly allocated to either a 12-week group CBT intervention or a waiting list control condition. At the end of 12 weeks, treated participants who met clinical criteria for improvement subsequently received 12 sessions of behavioral weight loss.

Eating and general psychopathology in a sample of Caucasian and ethnic minority subjects.

Objective: Most research on eating disorders (ED) has been conducted on Caucasian women. Considerable uncertainty remains as to the presentation of ED in ethnic minorities. The primary aim of this study was to investigate whether or not Caucasian and minority eating disorder subjects differ on key ED symptomatology and general psychopathology.

One-year follow-up of cognitive-behavioral therapy for obese individuals with binge eating disorder.

The results of a 1-year posttreatment follow-up of 93 obese women diagnosed as having binge eating disorder (BED) and treated with group cognitive-behavioral therapy (CBT) followed by weight loss treatment are described. The group as a whole maintained both reductions in binge eating and abstinence rates fairly well. However, they regained the weight lost during treatment.

Do emotional states influence binge eating in the obese?

Objective: The purpose of this experimental investigation was to test the hypothesis that negative affective states trigger disinhibited eating in the form of binge eating in subjects with binge eating disorder (BED).

Method: BED subjects and weight-matched non-eating disordered subjects (NED) attended a laboratory experiment during which they were randomly assigned to a negative or neutral mood induction procedure prior to being served a multi-item buffet. The dependent variable of interest was postmood induction caloric intake.

The effects of short-term food deprivation on caloric intake in eating-disordered subjects.

The primary aim of this experimental investigation was to examine the effects of short-term dietary restriction on caloric consumption in eating disordered subjects. Subjects with bulimia nervosa, binge eating disorder, and overweight non-eating disordered subjects, attended a laboratory experiment during which they were randomly assigned to either a 1 h or a 6 h food deprivation condition prior to being served a multi-item buffet. The primary measure of interest was calories consumed during the laboratory experiment.

Maintenance following a very-low-calorie diet.

The authors posed 2 questions in this randomized study of maintenance procedures in which participants were followed for 15 months after completion of a very-low-calorie diet: Would stimulus narrowing during the reintroduction of solid food, achieved by the use of prepackaged foods, improve weight losses and the maintenance of those losses as compared with the use of regular food? Would reintroduction of foods dependent on progress in losing or maintaining weight be superior to reintroduction on a time-dependent basis? Neither the stimulus narrowing condition nor the reintroduction procedure enhanced either maximum weight loss or maintenance of those losses. The stimulus narrowing condition appeared to be poorly tolerated; compliance and attendance were poorer in this condition than in the regular food condition.

Comparing the cost effectiveness of psychiatric treatments: bulimia nervosa.

We conducted an exploratory post hoc study that compared the cost effectiveness of five treatments for bulimia nervosa: 15 weeks of cognitive behavioral therapy (CB) followed by three monthly sessions, 16 weeks (Med16) and 24 weeks (Med24) of desipramine (< or = 300 mg/day), and CB combined with desipramine for those durations (Combo16 and Combo24). We illustrate how a treatment's cost effectiveness varies according to when evaluation is done and how effectiveness and cost are defined. At 32 weeks, Med16 appears the most cost-effective treatment, and Combo16 appears the least.

Does interpersonal therapy help patients with binge eating disorder who fail to respond to cognitive-behavioral therapy?

The aim of this quasi-experimental study was to examine the effectiveness of group interpersonal therapy (IPT) in treating overweight patients with binge eating disorder who did not stop binge eating after 12 weeks of group cognitive-behavioral therapy (CBT). Participants in this study were randomly allocated to either group CBT or to an assessment-only control group. After 12 weeks of treatment with CBT, 55% of participants met criteria for improvement and began 12 weeks of weight loss therapy, whereas the nonresponders began 12 weeks of group IPT.

One-year follow-up of psychosocial and pharmacologic treatments for bulimia nervosa.

Background: This study examined the outcome 1-year posttreatment of the use of desipramine, cognitive-behavioral therapy (CBT), and their combination in the treatment of bulimia nervosa.

Method: Sixty-one patients meeting DSM-III-R criteria for bulimia nervosa were randomly assigned to one of five groups--desipramine (withdrawn at 16 or 24 weeks), CBT (18 sessions), or the combined treatment (18 sessions of CBT plus desipramine withdrawn at 16 or 24 weeks)--and were followed to 1-year posttreatment.

Results: At 1-year follow-up, both the combined 24-week treatment and CBT alone were significantly superior in reducing binge eating to desipramine given for 16 weeks.

Obesity, binge eating and psychopathology: are they related?

Obese female subjects with binge eating disorder BED; (N = 107) completed the Beck Depression Inventory, Symptom Checklist-90, Inventory of Interpersonal Problems, and Rosenberg Self-Esteem Scale. Subjects were divided into moderate or severe binger on the basis of scores on the Binge Eating Scale, and grouped into moderately or severely obese by performing a median split on their weights. Spearman correlational analyses were performed to determine the relationship between psychopathology and obesity and psychopathology and binge eating.

Cluster B personality disorder characteristics predict outcome in the treatment of bulimia nervosa.

The Personality Disorders Examination (PDE) was administered to 71 bulimia nervosa patients at baseline assessment in a study comparing the effectiveness of cognitive-behavioral treatment with desipramine or the combination of both treatments. Personality disorder subscales were combined into single DSM-III-R cluster scores. A high cluster B score (consisting of antisocial, borderline, histrionic, and narcissistic features) significantly predicted poor outcome at 16 weeks and was a better predictor of outcome than borderline personality characteristics alone or any other DSM-III-R cluster score or combination of cluster scores.

Group cognitive-behavioral therapy and group interpersonal psychotherapy for the nonpurging bulimic individual: a controlled comparison.

This study evaluated the effectiveness of group cognitive-behavioral treatment (CBT) and group interpersonal psychotherapy (IPT) for binge eating. Fifty-six women with nonpurging bulimia were randomly assigned to 1 of 3 groups: CBT, IPT, or a wait-list control (WL). Treatment was administered in small groups that met for 16 weekly sessions.