Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA.
Eat Disord. 2020 Jan-Feb;28(1):67-79. doi: 10.1080/10640266.2019.1568101. Epub 2019 Jan 23.
Dialectical behavior therapy (DBT) is commonly used in the treatment of eating disorders (ED), yet few studies have examined the utility of DBT skills groups as an adjunct to evidence-based therapy for ED. Thus, we sought to examine the preliminary efficacy of a DBT skills group as an adjunct to Family-Based Treatment (FBT) for adolescent restrictive ED. Our preliminary pilot study included 18 adolescent girls ages 13-18 (= 15.3, = 1.64) with restrictive ED, including Anorexia Nervosa (AN; N = 10), Atypical Anorexia Nervosa (AAN, N = 5), and Other Specific Feeding or Eating Disorder (OSFED; N = 3). All participants were enrolled in a 6-month, weekly DBT skills group and were concurrently receiving family-based treatment (FBT). Participants who completed the intervention experienced large effect sizes for increases in adaptive skills (Cohen's = .71) and decreases in general dysfunctional coping strategies (Cohen's = .85); and small to medium effect sizes for decreases in binge eating (Cohen's = .40) and increases in percent expected body weight (% EBW; Cohen's = .32). Finally, small effect sizes were evidenced in decreases in Global EDE-Q scores (Cohen's = .26), EDE-Q restraint (Cohen's = .29) and CDI scores (Cohen's = .28). Our study presents promising preliminary data suggesting that adolescents with restrictive EDs receiving FBT could benefit from an adjunctive DBT skills group. Feasibility of and considerations for tailoring a DBT skills group to an outpatient ED treatment program are discussed.
辩证行为疗法(DBT)常用于治疗饮食失调症(ED),但很少有研究检查 DBT 技能组作为 ED 循证治疗的辅助手段的效用。因此,我们试图研究 DBT 技能组作为辅助家庭为基础的治疗(FBT)对青少年限制型 ED 的初步疗效。我们的初步试点研究包括 18 名 13-18 岁(= 15.3,= 1.64)的患有限制型 ED 的青少年女孩,包括神经性厌食症(AN;N = 10)、非典型神经性厌食症(AAN,N = 5)和其他特定的喂养或进食障碍(OSFED;N = 3)。所有参与者都参加了为期 6 个月的每周 DBT 技能组,并同时接受家庭为基础的治疗(FBT)。完成干预的参与者在适应性技能方面的增加有较大的效果量(Cohen's = 0.71),在一般功能失调的应对策略方面的减少有较大的效果量(Cohen's = 0.85);在暴食方面的减少和预计体重百分比(%EBW)的增加有较小到中等的效果量(Cohen's = 0.40)。最后,在全球饮食失调问卷(EDE-Q)评分(Cohen's = 0.26)、EDE-Q 约束(Cohen's = 0.29)和 CDI 评分(Cohen's = 0.28)方面也有较小的效果量。我们的研究提供了有希望的初步数据,表明接受 FBT 的限制型 ED 青少年可能受益于辅助的 DBT 技能组。讨论了将 DBT 技能组纳入门诊 ED 治疗计划的可行性和调整考虑因素。