Centre for Mental Health, University Health Network.
Department of Psychology, Ryerson University.
J Consult Clin Psychol. 2017 Sep;85(9):896-908. doi: 10.1037/ccp0000221. Epub 2017 Jun 1.
Rapid response to cognitive behavior therapy (CBT) for eating disorders (i.e., rapid and substantial change to key eating disorder behaviors in the initial weeks of treatment) robustly predicts good outcome at end-of-treatment and in follow up. The objective of this study was to determine whether rapid response to day hospital (DH) eating disorder treatment could be facilitated using a brief adjunctive CBT intervention focused on early change.
44 women (average age 27.3 [8.4]; 75% White, 6.3% Black, 6.9% Asian) were randomly assigned to 1 of 2 4-session adjunctive interventions: CBT focused on early change, or motivational interviewing (MI). DH was administered as usual. Outcomes included binge/purge frequency, Eating Disorder Examination-Questionnaire and Difficulties in Emotion Regulation Scale. Intent-to-treat analyses were used.
The CBT group had a higher rate of rapid response (95.7%) compared to MI (71.4%; p = .04, V = .33). Those who received CBT also had fewer binge/purge episodes (p = .02) in the first 4 weeks of DH. By end-of-DH, CBT participants made greater improvements on overvaluation of weight and shape (p = .008), and emotion regulation (ps < .008). Across conditions, there were no significant baseline differences between rapid and nonrapid responders (ps > .05).
The results of this study demonstrate that rapid response can be clinically facilitated using a CBT intervention that explicitly encourages early change. This provides the foundation for future research investigating whether enhancing rates of rapid response using such an intervention results in improved longer term outcomes. (PsycINFO Database Record
快速响应认知行为疗法（CBT）治疗进食障碍（即在治疗的最初几周内，关键进食障碍行为迅速而显著地改变）可有力预测治疗结束时和随访时的良好结局。本研究旨在确定是否可以使用简短的辅助 CBT 干预措施来促进对日间医院（DH）进食障碍治疗的快速反应，该干预措施侧重于早期变化。
44 名女性（平均年龄 27.3 [8.4]；75%为白人，6.3%为黑人，6.9%为亚洲人）被随机分配到 2 种 4 节辅助干预措施中的 1 种：侧重于早期变化的 CBT 或动机性访谈（MI）。DH 按常规进行。结果包括暴食/催吐频率、饮食障碍检查问卷和情绪调节困难量表。采用意向治疗分析。
CBT 组快速反应率（95.7%）高于 MI 组（71.4%；p =.04，V =.33）。接受 CBT 的患者在 DH 的前 4 周内暴食/催吐次数也更少（p =.02）。在 DH 结束时，CBT 组在体重和体型的过度重视（p =.008）和情绪调节（p <.008）方面的改善更大。在所有条件下，快速反应者和非快速反应者之间在基线时没有显著差异（p >.05）。
本研究结果表明，可以使用明确鼓励早期变化的 CBT 干预措施来临床促进快速反应。这为未来研究提供了基础，研究是否使用这种干预措施提高快速反应率会导致改善长期结果。
