Shea Munyi, Cachelin Fary M, Gutierrez Guadalupe, Wang Sherry, Phimphasone Phoutdavone
Department of Psychology, California State University.
Department of Psychology, University of North Carolina.
Psychol Serv. 2016 Feb;13(1):31-41. doi: 10.1037/ser0000055. Epub 2015 Oct 12.
The prevalence of bulimia nervosa (BN) and binge eating disorder (BED) among Latinas is comparable to those of the general population; however, few interventions and treatment trial research have focused on this group. Cognitive-behavioral therapy (CBT) is the treatment of choice for binge eating related disorders. CBT-based guided self-help (CBTgsh)-a low-cost minimal intervention-has also been shown effective in improving binge eating related symptom, but the effectiveness of the CBTgsh among ethnic minority women is not well understood. Cultural adaptation of evidence-based treatments can be an important step for promoting treatment accessibility and engagement among underserved groups. This qualitative study was part of a larger investigation that examined the feasibility and efficacy of a culturally adapted CBTgsh program among Mexican American women with binge eating disorders. Posttreatment focus groups were conducted with 12 Mexican American women with BN or BED who participated in the intervention. Data were analyzed with the grounded theory methodology (Corbin & Strauss, 2008). Three themes emerged from the data: (a) eating behavior and body ideals are socially and culturally constructed, (b) multifaceted support system is crucial to Mexican American women's treatment engagement and success, and (c) the culturally adapted CBTgsh program is feasible and relevant to Mexican American women's experience, but it can be strengthened with increased family and peer involvement. The findings provide suggestions for further adaptation and refinement of the CBTgsh, and implications for future research as well as early intervention for disordered eating in organized care settings.
神经性贪食症(BN)和暴饮暴食症(BED)在拉丁裔女性中的患病率与普通人群相当;然而,很少有干预措施和治疗试验研究关注这一群体。认知行为疗法(CBT)是治疗暴饮暴食相关疾病的首选方法。基于认知行为疗法的自助指导(CBTgsh)——一种低成本的最小干预措施——也已被证明能有效改善与暴饮暴食相关的症状,但CBTgsh在少数族裔女性中的有效性尚不清楚。对循证治疗进行文化调适可能是促进弱势群体获得治疗并提高其参与度的重要一步。这项定性研究是一项更大规模调查的一部分,该调查考察了一种经过文化调适的CBTgsh项目在患有暴饮暴食症的墨西哥裔美国女性中的可行性和疗效。对12名参与干预的患有神经性贪食症或暴饮暴食症的墨西哥裔美国女性进行了治疗后焦点小组访谈。采用扎根理论方法(Corbin & Strauss,2008)对数据进行了分析。数据中出现了三个主题:(a)饮食行为和身体理想是社会和文化建构的;(b)多方面的支持系统对墨西哥裔美国女性的治疗参与度和治疗成功至关重要;(c)经过文化调适的CBTgsh项目是可行的,并且与墨西哥裔美国女性的经历相关,但可以通过增加家庭和同伴的参与来加强。这些研究结果为进一步调适和完善CBTgsh提供了建议,并对未来研究以及在有组织的护理环境中对饮食失调进行早期干预具有启示意义。