Juarascio Adrienne S, Manasse Stephanie M, Espel Hallie M, Schumacher Leah M, Kerrigan Stephanie, Forman Evan M
Drexel University, Department of Psychology, Philadelphia PA.
J Contextual Behav Sci. 2017 Jan;6(1):1-7. doi: 10.1016/j.jcbs.2016.12.003. Epub 2017 Jan 18.
While existing treatments produce remission in a relatively large percentage of individuals with binge eating disorder (BED), room for improvement remains. Interventions designed to increase emotion regulation skills and clarify one's chosen values may be well-suited to address factors known to maintain BED. The current study examined the preliminary efficacy of a group-based treatment, Acceptance-based Behavioral Therapy (ABBT), in a small open trial (=19), as well as the relationship between changes in hypothesized mechanisms of action and outcomes. ABBT includes the behavioral components of cognitive behavioral treatment for BED and emotion-focused strategies from acceptance and commitment therapy and dialectical behavioral therapy. Results from generalized linear multilevel modeling revealed significant fixed linear effects of time on depression, quality of life, global eating pathology, and binge frequency (all s < .05). Global eating disorder symptoms appeared to improve rapidly from pre- to mid-treatment, and continued to improve toward post-treatment and follow-up, but at a slower rate. Binge frequency decreased rapidly from pre- to mid-treatment, followed by a slight increase at post-treatment and a reduction again by follow-up. Improvements in experiential acceptance were strongly and consistently related to decreases in overall eating pathology across several measures (s = .35-.54). Additionally, greater access to emotion regulation strategies was strongly related to decreases in overall eating pathology (= .67). Preliminary results support the efficacy of this novel treatment approach and indicate that additional research on ABBT for BED is warranted.
虽然现有治疗方法能使相当大比例的暴饮暴食症(BED)患者病情缓解,但仍有改进空间。旨在提高情绪调节技能和明确个人所选择价值观的干预措施可能非常适合解决已知维持BED的因素。本研究在一项小型开放性试验(n = 19)中检验了基于团体的治疗方法——基于接纳的行为疗法(ABBT)的初步疗效,以及假设的作用机制变化与结果之间的关系。ABBT包括针对BED的认知行为治疗的行为成分以及来自接纳与承诺疗法和辩证行为疗法的以情绪为中心的策略。广义线性多级模型的结果显示,时间对抑郁、生活质量、总体饮食病理学和暴饮暴食频率有显著的固定线性效应(所有p值 < .05)。总体饮食失调症状在治疗前到治疗中期似乎迅速改善,并在治疗后和随访期间持续改善,但速度较慢。暴饮暴食频率在治疗前到治疗中期迅速下降,然后在治疗后略有增加,在随访时再次下降。在多项测量中,体验接纳的改善与总体饮食病理学的降低密切且持续相关(p值 = .35 - .54)。此外,更多地使用情绪调节策略与总体饮食病理学的降低密切相关(p值 = .67)。初步结果支持这种新型治疗方法的疗效,并表明有必要对用于治疗BED的ABBT进行更多研究。