Hilbert Anja, Saelens Brian E, Stein Richard I, Mockus Danyte S, Welch R Robinson, Matt Georg E, Wilfley Denise E
Department of Psychology, Philipps University of Marburg, Marburg, Germany.
J Consult Clin Psychol. 2007 Aug;75(4):645-51. doi: 10.1037/0022-006X.75.4.645.
The present study examined pretreatment and process predictors of individual nonresponse to psychological group treatment of binge eating disorder (BED). In a randomized trial, 162 overweight patients with BED were treated with either group cognitive-behavioral therapy or group interpersonal psychotherapy. Treatment nonresponse, which was defined as nonabstinence from binge eating, was assessed at posttreatment and at 1 year following treatment completion. Using 4 signal detection analyses, greater extent of interpersonal problems prior to treatment or at midtreatment were identified as predictors of nonresponse, both at posttreatment and at 1-year follow-up. Greater pretreatment and midtreatment concerns about shape and weight, among those patients with low interpersonal problems, were predictive of posttreatment nonresponse. Lower group cohesion during the early treatment phase predicted nonresponse at 1-year follow-up. Attention to specific pre- or intreatment predictors could allow for targeted selection into differential or augmented care and could thus improve response to group psychotherapy for BED.
本研究考察了暴食症(BED)个体对心理团体治疗无反应的预处理和过程预测因素。在一项随机试验中,162名超重的BED患者接受了团体认知行为疗法或团体人际心理治疗。治疗无反应被定义为未能戒除暴饮暴食,在治疗后及治疗结束后1年进行评估。通过4种信号检测分析,治疗前或治疗中期人际问题程度较高被确定为治疗后及1年随访时无反应的预测因素。在人际问题较少的患者中,治疗前和治疗中期对体型和体重的关注度较高可预测治疗后无反应。治疗早期阶段较低的团体凝聚力可预测1年随访时的无反应。关注特定的治疗前或治疗中预测因素可有助于有针对性地选择差异化或强化治疗,从而改善对BED团体心理治疗的反应。