Agras W S, Schneider J A, Arnow B, Raeburn S D, Telch C F
J Consult Clin Psychol. 1989 Apr;57(2):215-21. doi: 10.1037//0022-006x.57.2.215.
This study was designed to assess the additive effects of major components of cognitive-behavioral treatment for bulimia nervosa. Seventy-seven female patients with bulimia nervosa were allocated at random to one of four conditions: wait-list control, self-monitoring of caloric intake and purging behaviors, cognitive-behavioral treatment, and cognitive-behavioral treatment combined with response prevention of vomiting. In the treatment conditions, participants were seen individually for fourteen 1-hr sessions over a 4-month period. All the treatment groups showed significant improvement, whereas the wait-list control group did not. Cognitive-behavioral treatment was, however, the most successful in reducing purging and in promoting positive psychological changes. Fifty-six percent of participants in this condition ceased binge eating and purging by the end of treatment, and the frequency of purging declined by 77.2% during the same period. Of the three treatment conditions, only cognitive-behavioral treatment was superior to the wait-list control. At the 6-month follow-up, 59% of the cognitive-behavioral group were abstinent, and purging had declined by 80%. Cognitive-behavioral treatment was significantly superior to the other treatment groups at this time. Thus, the addition of response prevention of vomiting did not enhance the efficacy of cognitive-behavioral treatment, and the evidence suggests that it may have had a deleterious effect.
本研究旨在评估神经性贪食症认知行为治疗主要组成部分的附加效果。77名神经性贪食症女性患者被随机分配到以下四种情况之一：等待名单对照组、热量摄入和清除行为自我监测组、认知行为治疗组以及认知行为治疗联合呕吐反应预防组。在治疗阶段，参与者在4个月内接受了14次每次1小时的个体治疗。所有治疗组均有显著改善，而等待名单对照组则没有。然而，认知行为治疗在减少清除行为和促进积极心理变化方面最为成功。该组56%的参与者在治疗结束时停止了暴饮暴食和清除行为，同期清除行为的频率下降了77.2%。在三种治疗情况中，只有认知行为治疗组优于等待名单对照组。在6个月的随访中，认知行为治疗组59%的患者停止了相关行为，清除行为减少了80%。此时，认知行为治疗组明显优于其他治疗组。因此，增加呕吐反应预防并未提高认知行为治疗的疗效，且有证据表明这可能产生了有害影响。
