Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA.
Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, Pennsylvania, USA.
Int J Eat Disord. 2021 Mar;54(3):451-458. doi: 10.1002/eat.23426. Epub 2020 Dec 7.
Outcomes from cognitive behavioral therapy for binge-eating spectrum disorders are suboptimal, possibly due in part to deficits in self-regulation (i.e., the ability to control behavior in pursuit of long-term goals despite internal challenges). Mindfulness and acceptance-based treatments (MABTs) integrate behavioral treatment with psychological strategies designed to enhance self-regulation, yet little is known about how and for whom they are effective. The present study will utilize the multiphase optimization strategy to identify which of four MABT components (mindful awareness, distress tolerance, emotion modulation, values-based decision making) to include in a fully powered clinical trial. Participants (n = 256) will be randomized to 16 sessions in one of 16 conditions, each a different combination of MABT components being included or excluded from a base behavioral treatment. Our primary aim is to evaluate each component's independent efficacy on disordered eating symptoms. Our secondary aims are to confirm each component's target engagement (i.e., whether each component improves the targeted variable and outcomes), and test that each component's efficacy is moderated by baseline weaknesses in the same component (e.g., that participants with poor distress tolerance at baseline benefit most from the distress tolerance component). Our exploratory aim is to quantify the component interaction effects.
针对暴食症谱系障碍的认知行为疗法的效果并不理想，部分原因可能是自我调节能力不足（即，尽管存在内部挑战，但仍有能力控制行为以追求长期目标）。基于正念和接纳的治疗方法（MABT）将行为治疗与旨在增强自我调节能力的心理策略相结合，但对于它们的有效性及其适用人群知之甚少。本研究将利用多阶段优化策略来确定四种 MABT 成分（正念意识、痛苦耐受力、情绪调节、基于价值观的决策制定）中的哪一种应包含在全面的临床试验中。参与者（n=256）将被随机分配到 16 种条件中的一种，每种条件都是从基础行为治疗中包含或排除不同的 MABT 成分组合。我们的主要目的是评估每个成分对饮食失调症状的独立疗效。我们的次要目的是确认每个成分的目标参与度（即，每个成分是否改善了目标变量和结果），并测试每个成分的疗效是否受到相同成分基线弱点的调节（例如，基线痛苦耐受力差的参与者从痛苦耐受力成分中获益最多）。我们的探索性目的是量化成分的交互作用效应。
