Zompa Luca, Cassioli Emanuele, Rossi Eleonora, Cordasco Valentina Zofia, Caiati Leda, Lucarelli Stefano, Giunti Ilenia, Lazzeretti Lisa, D'Anna Giulio, Dei Simona, Cardamone Giuseppe, Ricca Valdo, Rotella Francesco, Castellini Giovanni
Psychiatry Unit, Department of Health Science, University of Florence, 50100 Florence, Italy.
Eating Disorders Unit, Central Tuscany Local Health Authority, 50142 Florence, Italy.
Nutrients. 2025 Jun 14;17(12):2003. doi: 10.3390/nu17122003.
Dialectical Behaviour Therapy (DBT) has emerged as a promising intervention for Eating Disorders (Eds), especially Binge Eating Disorder (BED), which is often characterized by severe emotion dysregulation. The aims of this study were to evaluate the longitudinal course of BED symptomatology following a group-based DBT intervention focused on two specific modules, Emotion Regulation and Distress Tolerance, and to examine the mediating role of emotion dysregulation and alexithymia in symptom improvement. This non-randomized longitudinal clinical study involved 170 patients with BED who received a 16-week DBT group treatment including modules targeting emotion regulation and distress tolerance. Self-report questionnaires were administered at baseline (T0) and at the end of treatment (T1). Linear mixed models were used to analyze the longitudinal trend, and a mediation analysis was conducted to examine whether changes in emotion dysregulation and alexithymia mediated symptom improvement. Longitudinal analyses showed a significant reduction in BED symptoms at the end of treatment as well as in the levels of emotion dysregulation and alexithymia. Mediation analyses revealed that both emotion dysregulation (indirect effect: -0.68 [-1.20; -0.31]) and alexithymia (indirect effect: -0.59 [-1.33; -0.20]) significantly mediated the improvement in BED symptoms over time. These findings support the application of focused DBT group interventions targeting emotion regulation and distress tolerance in reducing BED symptomatology. Emotion dysregulation and alexithymia were identified as mediators of longitudinal clinical improvement, highlighting the importance of modular and precision-based approaches in the treatment of BED.
辩证行为疗法（DBT）已成为一种有前景的饮食失调（Eds）干预方法，尤其是针对暴饮暴食症（BED），该病症通常以严重的情绪失调为特征。本研究的目的是评估基于团体的DBT干预（聚焦于情绪调节和痛苦耐受这两个特定模块）后BED症状的纵向变化过程，并检验情绪失调和述情障碍在症状改善中的中介作用。这项非随机纵向临床研究纳入了170名BED患者，他们接受了为期16周的DBT团体治疗，其中包括针对情绪调节和痛苦耐受的模块。在基线期（T0）和治疗结束时（T1）进行了自我报告问卷调查。使用线性混合模型分析纵向趋势，并进行中介分析以检验情绪失调和述情障碍的变化是否介导了症状改善。纵向分析显示，治疗结束时BED症状以及情绪失调和述情障碍水平均显著降低。中介分析表明，情绪失调（间接效应：-0.68 [-1.20；-0.31]）和述情障碍（间接效应：-0.59 [-1.33；-0.20]）均显著介导了随时间推移BED症状的改善。这些发现支持了聚焦于情绪调节和痛苦耐受的DBT团体干预在减轻BED症状方面的应用。情绪失调和述情障碍被确定为纵向临床改善的中介因素，突出了模块化和精准化方法在BED治疗中的重要性。
