Stanford University, Dept. of Psychiatry and Behavioral Sciences, 401 Quarry Rd., MC 5722, Stanford, CA 94305, USA. dlsafer@stanford
Behav Ther. 2010 Mar;41(1):106-20. doi: 10.1016/j.beth.2009.01.006. Epub 2010 Jan 25.
Dialectical Behavior Therapy for Binge Eating Disorder (DBT-BED) aims to reduce binge eating by improving adaptive emotion-regulation skills. Preliminary findings have been promising but have only compared DBT-BED to a wait-list. To control for the hypothesized specific effects of DBT-BED, the present study compared DBT-BED to an active comparison group therapy (ACGT). Men and women (n=101) meeting DSM-IV BED research criteria were randomly assigned to 20 group sessions of DBT-BED (n=50) or ACGT (n=51). DBT-BED had a significantly lower dropout rate (4%) than ACGT (33.3%). Linear Mixed Models revealed that posttreatment binge abstinence and reductions in binge frequency were achieved more quickly for DBT-BED than for ACGT (posttreatment abstinence rate=64% for DBT-BED vs. 36% for ACGT) though differences did not persist over the 3-, 6-, and 12-month follow-up assessments (e.g., 12-month follow-up abstinence rate=64% for DBT-BED vs. 56% for ACGT). Secondary outcome measures revealed no sustained impact on emotion regulation. Although both DBT-BED and ACGT reduced binge eating, DBT-BED showed significantly fewer dropouts and greater initial efficacy (e.g., at posttreatment) than ACGT. The lack of differential findings over follow-up suggests that the hypothesized specific effects of DBT-BED do not show long-term impact beyond those attributable to nonspecific common therapeutic factors.
辩证行为治疗暴食障碍(DBT-BED)旨在通过提高适应性情绪调节技能来减少暴食行为。初步研究结果很有希望,但仅将 DBT-BED 与等待名单进行了比较。为了控制 DBT-BED 的假设特定效果,本研究将 DBT-BED 与积极比较组治疗(ACGT)进行了比较。符合 DSM-IV BED 研究标准的男性和女性(n=101)被随机分配到 20 次 DBT-BED 团体治疗(n=50)或 ACGT(n=51)。DBT-BED 的辍学率(4%)明显低于 ACGT(33.3%)。线性混合模型显示,DBT-BED 比 ACGT 更快地实现了治疗后戒断和减少暴食频率(DBT-BED 的治疗后戒断率为 64%,而 ACGT 的治疗后戒断率为 36%),尽管这些差异在 3、6 和 12 个月的随访评估中并未持续存在(例如,12 个月随访时的戒断率为 64%的 DBT-BED 与 56%的 ACGT)。次要结果表明,情绪调节没有持续的影响。尽管 DBT-BED 和 ACGT 都减少了暴食行为,但 DBT-BED 的辍学率明显较低,初始疗效更高(例如,在治疗后)。在随访中没有发现差异的结果表明,DBT-BED 的假设特定效果在长期内并没有超出非特异性共同治疗因素的影响。