Ferrer-García Marta, Gutiérrez-Maldonado José, Pla-Sanjuanelo Joana, Vilalta-Abella Ferran, Riva Giuseppe, Clerici Massimo, Ribas-Sabaté Joan, Andreu-Gracia Alexis, Fernandez-Aranda Fernando, Forcano Laura, Riesco Nadine, Sánchez Isabel, Escandón-Nagel Neli, Gomez-Tricio Osane, Tena Virginia, Dakanalis Antonios
Department of Clinical Psychology and Psychobiology, University of Barcelona, Spain.
Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Italy.
Eur Eat Disord Rev. 2017 Nov;25(6):479-490. doi: 10.1002/erv.2538. Epub 2017 Aug 14.
A question that arises from the literature on therapy is whether second-level treatment is effective for patients with recurrent binge eating who fail first-level treatment. It has been shown that subjects who do not stop binge eating after an initial structured cognitive-behavioural treatment (CBT) programme benefit from additional CBT (A-CBT) sessions; however, it has been suggested that these resistant patients would benefit even more from cue exposure therapy (CET) targeting features associated with poor response (e.g. urge to binge in response to a cue and anxiety experienced in the presence of binge-related cues). We assessed the effectiveness of virtual reality-CET as a second-level treatment strategy for 64 patients with bulimia nervosa and binge eating disorder who had been treated with limited results after using a structured CBT programme, in comparison with A-CBT. The significant differences observed between the two groups at post-treatment in dimensional (behavioural and attitudinal features, anxiety, food craving) and categorical (abstinence rates) outcomes highlighted the superiority of virtual reality-CET over A-CBT. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
治疗文献中出现的一个问题是，二级治疗对一级治疗失败的复发性暴饮暴食患者是否有效。研究表明，在初始结构化认知行为疗法（CBT）项目后仍未停止暴饮暴食的受试者会从额外的CBT（A-CBT）疗程中获益；然而，有人提出，这些抵抗性患者会从针对与不良反应相关特征（如因提示而产生的暴饮暴食冲动以及在出现与暴饮暴食相关提示时所体验到的焦虑）的线索暴露疗法（CET）中获益更多。我们评估了虚拟现实-CET作为二级治疗策略对64名神经性贪食症和暴饮暴食症患者的有效性，这些患者在使用结构化CBT项目后治疗效果有限，将其与A-CBT进行比较。两组在治疗后维度（行为和态度特征、焦虑、食物渴望）和分类（节制率）结果上观察到的显著差异突出了虚拟现实-CET相对于A-CBT的优越性。版权所有© 2017约翰·威利父子有限公司和饮食失调协会。
