Carter Frances A, Bulik Cynthia M, McIntosh Virginia V, Joyce Peter R
University Department of Psychological Medicine, Christchurch School of Medicine, Otago University, New Zealand.
Int J Eat Disord. 2002 Apr;31(3):240-50. doi: 10.1002/eat.10041.
The present study sought to evaluate specific hypotheses concerning the relation between cue reactivity and outcome among women with bulimia nervosa. Participants were 135 women aged between 17 and 45 years with a current, primary diagnosis of bulimia nervosa who participated in a randomized clinical trial evaluating the additive efficacy of exposure and nonexposure-based behavior therapy, to a core of cognitive behavior therapy (CBT). Physiological, self-report, and behavioral measures of cue reactivity to individualized high-risk binge foods were obtained at pretreatment and posttreatment. Primary, secondary, and tertiary outcome measures are reported for posttreatment and six-month follow-up. Self-report measures of cue reactivity at posttreatment were significantly positively associated with symptomatology at posttreatment. Cue reactivity at posttreatment was significantly positively associated with symptomatology at 6-month follow-up. However, cue reactivity at posttreatment did not contribute to the prediction of outcome at follow-up over and above posttreatment outcome. The notion that pretreatment cue reactivity may predict which treatment modality will be most beneficial (exposure or nonexposure-based treatment), as measured by reductions in symptomatology at posttreatment could not be supported. Implications for future research are discussed.
本研究旨在评估有关神经性贪食症女性提示反应性与治疗结果之间关系的特定假设。研究参与者为135名年龄在17至45岁之间、目前初步诊断为神经性贪食症的女性，她们参与了一项随机临床试验，该试验评估了基于暴露和非暴露的行为疗法与核心认知行为疗法（CBT）相结合的疗效。在治疗前和治疗后获取了对个体化高风险暴食食物的提示反应性的生理、自我报告和行为测量数据。报告了治疗后及六个月随访的主要、次要和三级治疗结果指标。治疗后提示反应性的自我报告测量与治疗后症状显著正相关。治疗后提示反应性与六个月随访时的症状显著正相关。然而，治疗后提示反应性在随访时对结果的预测作用并不超过治疗后的结果。无法支持以下观点：治疗前提示反应性可预测哪种治疗方式（暴露或非暴露治疗）最有益，这是通过治疗后症状减轻来衡量的。文中讨论了对未来研究的启示。
