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暴食障碍的心理治疗。

Psychological treatments for binge eating disorder.

机构信息

Department of Psychology, Washington University in St. Louis, Campus Box 1125, One Brookings Drive, St. Louis, MO 63130, USA.

出版信息

Curr Psychiatry Rep. 2012 Aug;14(4):432-46. doi: 10.1007/s11920-012-0277-8.

Abstract

Binge eating disorder (BED) is the most prevalent eating disorder in adults, and individuals with BED report greater general and specific psychopathology than non-eating disordered individuals. The current paper reviews research on psychological treatments for BED, including the rationale and empirical support for cognitive behavioral therapy (CBT), interpersonal psychotherapy (IPT), dialectical behavior therapy (DBT), behavioral weight loss (BWL), and other treatments warranting further study. Research supports the effectiveness of CBT and IPT for the treatment of BED, particularly for those with higher eating disorder and general psychopathology. Guided self-help CBT has shown efficacy for BED without additional pathology. DBT has shown some promise as a treatment for BED, but requires further study to determine its long-term efficacy. Predictors and moderators of treatment response, such as weight and shape concerns, are highlighted and a stepped-care model proposed. Future directions include expanding the adoption of efficacious treatments in clinical practice, testing adapted treatments in diverse samples (e.g., minorities and youth), improving treatment outcomes for nonresponders, and developing efficient and cost-effective stepped-care models.

摘要

暴食障碍(BED)是成年人中最常见的饮食障碍,与非饮食障碍个体相比,BED 个体报告有更多的一般和特定精神病理学问题。本文综述了暴食障碍的心理治疗研究,包括认知行为疗法(CBT)、人际心理治疗(IPT)、辩证行为疗法(DBT)、行为体重管理(BWL)和其他值得进一步研究的治疗方法的基本原理和实证支持。研究支持 CBT 和 IPT 对 BED 的有效性,特别是对那些有更高饮食障碍和一般精神病理学的患者。指导自助 CBT 对没有额外病理的 BED 显示出疗效。DBT 作为 BED 的一种治疗方法显示出一定的前景,但需要进一步的研究来确定其长期疗效。强调了治疗反应的预测因素和调节因素,如体重和体型的关注,并提出了一种阶梯式治疗模式。未来的方向包括在临床实践中扩大采用有效的治疗方法,在不同的样本中测试适应性治疗(例如少数民族和青少年),改善无反应者的治疗效果,并开发高效和具有成本效益的阶梯式治疗模式。

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