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为适应团体环境而调整的饮食失调强化认知行为疗法。

Enhanced cognitive behavioral therapy for eating disorders adapted for a group setting.

作者信息

Wade Stephanie, Byrne Sue, Allen Karina

机构信息

School of Psychology, University of Western Australia, Perth, Australia.

Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, United Kingdom.

出版信息

Int J Eat Disord. 2017 Aug;50(8):863-872. doi: 10.1002/eat.22723. Epub 2017 May 10.

Abstract

OBJECTIVE

This randomized control trial is an evaluation of the effectiveness of enhanced cognitive behavioral treatment (CBT-E) for eating disorders adapted for a group setting. The study aimed to examine the effects of group CBT-E on eating disorder psychopathology and additional maintaining pathology.

METHOD

A transdiagnostic sample of individuals with eating disorders with a BMI ≥ 18 kg/m (N = 40) were randomized to an immediate-start or delayed-start condition so as to compare therapeutic effects of group CBT-E with a waitlist control. Global Eating Disorder Examination Questionnaire (EDE-Q) scores, BMI, and measures of Clinical Perfectionism, Self-Esteem, Interpersonal Difficulties, and Mood Intolerance were measured across the 8-week control period, throughout the group treatment and at 3-months post-treatment.

RESULTS

Over 70% of those who entered the trial completed treatment. The first eight weeks of group CBT-E were more effective at reducing Global EDE-Q scores than no treatment (waitlist control). By post-treatment, good outcome (a Global EDE-Q within 1 SD of Australian community norms plus BMI ≥ 18.5) was achieved by 67.9% of treatment completers and 66.7% of the total sample. Symptom abstinence within the previous month was reported by 14.3% of treatment completers and 10.3% of the total sample. Significant reductions in Clinical Perfectionism, Self-Esteem, Interpersonal Difficulties, and Mood Intolerance were also observed.

DISCUSSION

This study demonstrated that a group version of CBT-E can be effective at reducing eating disorder psychopathology in a transdiagnostic sample of individuals with eating disorders. Group CBT-E could provide a means of increasing availability of evidence-based treatment for eating disorders.

摘要

目的

本随机对照试验旨在评估适用于团体环境的强化认知行为疗法(CBT-E)对饮食失调的疗效。该研究旨在检验团体CBT-E对饮食失调精神病理学及其他维持性病理学的影响。

方法

将体重指数(BMI)≥18 kg/m²的饮食失调个体的跨诊断样本(N = 40)随机分为立即开始治疗组或延迟开始治疗组,以比较团体CBT-E与等待名单对照组的治疗效果。在为期8周的对照期、整个团体治疗期间以及治疗后3个月,测量全球饮食失调检查问卷(EDE-Q)得分、BMI以及临床完美主义、自尊、人际困难和情绪不耐受的测量指标。

结果

超过70%进入试验的人完成了治疗。团体CBT-E的前八周在降低全球EDE-Q得分方面比不治疗(等待名单对照组)更有效。到治疗后,67.9%的治疗完成者和66.7%的总样本实现了良好结局(全球EDE-Q在澳大利亚社区规范的1个标准差范围内且BMI≥18.5)。14.3%的治疗完成者和10.3%的总样本报告在前一个月症状戒断。临床完美主义、自尊、人际困难和情绪不耐受也有显著降低。

讨论

本研究表明,团体版CBT-E在饮食失调个体的跨诊断样本中可有效减少饮食失调精神病理学。团体CBT-E可为增加饮食失调循证治疗的可及性提供一种方法。

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