Department of Psychology, University of Kansas, Lawrence, KS, USA.
Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, IL, USA.
Psychol Med. 2024 Jul;54(9):2181-2188. doi: 10.1017/S003329172400028X. Epub 2024 Feb 28.
Loss of control eating is more likely to occur in the evening and is uniquely associated with distress. No studies have examined the effect of treatment on within-day timing of loss of control eating severity. We examined whether time of day differentially predicted loss of control eating severity at baseline (i.e. pretreatment), end-of-treatment, and 6-month follow-up for individuals with binge-eating disorder (BED), hypothesizing that loss of control eating severity would increase throughout the day pretreatment and that this pattern would be less pronounced following treatment. We explored differential treatment effects of cognitive-behavioral guided self-help (CBTgsh) and Integrative Cognitive-Affective Therapy (ICAT).
Individuals with BED ( = 112) were randomized to receive CBTgsh or ICAT and completed a 1-week ecological momentary assessment protocol at baseline, end-of-treatment, and 6-month follow-up to assess loss of control eating severity. We used multilevel models to assess within-day slope trajectories of loss of control eating severity across assessment periods and treatment type.
Within-day increases in loss of control eating severity were reduced at end-of-treatment and 6-month follow-up relative to baseline. Evening acceleration of loss of control eating severity was greater at 6-month follow-up relative to end-of-treatment. Within-day increases in loss of control severity did not differ between treatments at end-of-treatment; however, evening loss of control severity intensified for individuals who received CBTgsh relative to those who received ICAT at 6-month follow-up.
Findings suggest that treatment reduces evening-shifted loss of control eating severity, and that this effect may be more durable following ICAT relative to CBTgsh.
失控性进食更有可能发生在晚上，且与痛苦情绪独特相关。目前尚无研究探讨治疗对进食障碍患者日内失控性进食严重程度时间变化的影响。我们旨在检验日间时间是否会在基线（即治疗前）、治疗结束时和 6 个月随访时，对暴食障碍患者的失控性进食严重程度产生不同的预测作用，假设治疗前，失控性进食严重程度会在一天中逐渐增加，而治疗后，这种模式的影响将不那么明显。我们还探讨了认知行为引导自助疗法（CBTgsh）和整合认知情感疗法（ICAT）的不同治疗效果。
将 112 名暴食障碍患者随机分为 CBTgsh 组和 ICAT 组，在基线、治疗结束时和 6 个月随访时完成为期 1 周的生态瞬时评估方案，以评估失控性进食严重程度。我们使用多层模型评估治疗前、治疗结束时和 6 个月随访期间，评估期间和治疗类型的失控性进食严重程度的日内斜率轨迹。
与基线相比，治疗结束时和 6 个月随访时，失控性进食严重程度的日内增加幅度降低。与治疗结束时相比，6 个月随访时，失控性进食严重程度在晚上的加速程度更大。治疗结束时，两种治疗方法之间的日内失控性进食严重程度增加没有差异；然而，与接受 ICAT 的患者相比，接受 CBTgsh 的患者在 6 个月随访时，晚上的失控性进食严重程度加剧。
研究结果表明，治疗可以减少晚上出现的失控性进食严重程度，且与 CBTgsh 相比，ICAT 可能会产生更持久的效果。
