Wade Stephanie, Byrne Sue, Allen Karina
School of Psychology, University of Western Australia, Perth, Australia.
Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, United Kingdom.
Int J Eat Disord. 2017 Aug;50(8):863-872. doi: 10.1002/eat.22723. Epub 2017 May 10.
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.
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.
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.
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.
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。
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。
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。
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。
