Binge Eating Disorder
Conditions
Keywords
eating disorder, binge eating
Brief summary
The proposed study will employ a randomized design to evaluate the efficacy of two group-based guided self-help treatments: Integrative Response Therapy (IRT) and Cognitive Behavior Therapy Guided Self-Help, a treatment of known efficacy, in group-format (CBT-GSHg) in the treatment of Binge Eating Disorder (BED), and explore (1) moderators and mediators of treatment, (2) the relative cost-effectiveness of the two treatments, and (3) between group differences on secondary measures (e.g., eating disorder and general psychopathology).
Detailed description
The focus of this proposal is on BED among an adult population. Guided self-help treatments (GSH) for BED appear promising and may be more readily disseminated than efficacious specialty treatments such as Cognitive Behavioral Therapy (CBT) and Interpersonal Psychotherapy (IPT) given the latter's administration costs and time requirements. The proposed study uses a new group-based, guided self-help BED treatment called Integrative Response Therapy (IRT). IRT is primarily based upon the affect regulation theory of binge eating (e.g., binge eating is an attempt to alter distressing emotional states), while adding cognitive restructuring techniques. IRT teaches effective ways to cope with aversive emotions and reframe faulty cognitions while reducing vulnerabilities that are likely to lead to problematic emotional responding & cognitions such as physical needs (e.g., hunger, sleep deprivation), interpersonal conflict, and, when possible, unpleasant external events. IRT's primary goal is to significantly decrease episodes of binge eating and associated eating disorder pathology. CBT-GSH is a frequently used manual-based form of GSH that has demonstrated efficacy. CBT, based on the restraint model, intervenes via behavioral techniques to replace restrained eating with more regular eating patterns and cognitive techniques to restructure an individual's problematic thoughts that over-evaluate shape and weight. Research literature indicates that CBT-GSH is a viable self-help BED treatment that appears to be superior to wait-list control conditions, equivalent to IPT, a specialty treatment, and superior to Behavioral Weight Loss treatment at 2-year follow-up. There are then, a number of reasons for further research on GSH in general and CBT-gsh specifically. The proposed study will lay the groundwork for identifying which GSH treatment should be investigated in a subsequent, larger trial that would evaluate a clinically relevant algorithm for the treatment of BED.
Interventions
BEHAVIORALIntegrative Response Therapy
A 10 session manualized version of IRT is employed . Each of the 10 group therapy sessions will be 60 minutes in length. Non-specialty trained Masters-level therapists will lead IRT after undergoing IRT training with the PI.
BEHAVIORALCognitive Behavioral Therapy
A 10 session manualized version of CBT-GSH is employed . Each of the 10 group therapy sessions will be 60 minutes in length. Non-specialty trained Masters-level therapists will lead CBT-GSH after undergoing CBT-GSH training with the PI.
Sponsors
Stanford University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* Meet DSM-IV research criteria for Binge Eating Disorder (although frequency criteria will be lessened to that proposed in DSM-V;1 time per week for 3 months). * Be male or female between 18 and 75 years. * Be available and committed to attend full treatment and follow-up * Adequate transportation to the clinic. * Be literate in English (this is required for inclusion because sessions will be conducted in English and written and visual materials are in English). * Have a Primary Health Care Provider.
Exclusion criteria
* Current psychosis or severe depression with suicidal risk; a severity that would likely require additional psychotherapeutic or psychopharmacologic treatment or interfere with participation in this group therapy or with day to day functioning. Depressive disorders not meeting the intensity factor of the
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| number of binge days over the previous 28 days | 16 weeks post-treatment | Assessed via the Eating Disorder Examination |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| adaptation time intervals and response accuracy for emotion related stimuli | 16 weeks post-treatment | Assessed via the Emotion Conflict Adaptation Task |
| depression | 16 weeks post-treatment, 6 and 12 month follow-up | Assessed via the Beck Depression Inventory |
| emotion driven urges to eat | 16 weeks post-treatment, 6 and 12 month follow-up | Assessed via the Emotional Eating Scale |
| quality of life | post-treatment, 6 and 12 month follow-up | Assessed via the Quality of Well-Being Scale |
| use of health services | at (approximately) 1 month intervals throughout 16 week intervention (4 times total) | Assessed via the Health Care Diary |
| self-esteem | 16 weeks post-treatment, 6 and 12 month follow-up | Assessed via the Rosenberg Self-Esteem Scale |
Countries
United States
Outcome results
None listed