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1.
Eva?M.?EpsteinEmail author Denise?M.?Sloan 《Journal of Contemporary Psychotherapy》2005,35(4):317-330
There is a wealth of data indicating the effectiveness of cognitive behavioral therapy in the treatment of bulimia nervosa.
However, the best evidence indicates a treatment success rate of 50%. The purpose of this paper is to briefly describe cognitive
behavioral treatment of bulimia nervosa and to offer suggestions on how this therapy approach may be tailored to best serve
the needs of individual clients. Such tailoring should ultimately lead to even greater treatment success. 相似文献
2.
Clausen L 《Scandinavian journal of psychology》2004,45(3):247-252
The purpose of the study was to test if design and research methods of studies predict outcome results of bulimia nervosa. Fifty-seven articles on outcome of bulimia nervosa were found through MEDLINE and PSYCHINFO databases and 25 were included in the statistical analysis. Percentages of patients with a good outcome ranged from 24% to 74% with a mean of 51.1%. The variables best predicting outcome were time to follow-up and number of symptoms evaluated in definition of good outcome whereas dropout, design of studies, treatments, and sample characteristics did not predict significantly. The implications of these findings are discussed. 相似文献
3.
Cognitive behaviour therapy for eating disorders: a "transdiagnostic" theory and treatment 总被引:4,自引:0,他引:4
This paper is concerned with the psychopathological processes that account for the persistence of severe eating disorders. Two separate but interrelated lines of argument are developed. One is that the leading evidence-based theory of the maintenance of eating disorders, the cognitive behavioural theory of bulimia nervosa, should be extended in its focus to embrace four additional maintaining mechanisms. Specifically, we propose that in certain patients one or more of four additional maintaining processes interact with the core eating disorder maintaining mechanisms and that when this occurs it is an obstacle to change. The additional maintaining processes concern the influence of clinical perfectionism, core low self-esteem, mood intolerance and interpersonal difficulties. The second line of argument is that in the case of eating disorders shared, but distinctive, clinical features tend to be maintained by similar psychopathological processes. Accordingly, we suggest that common mechanisms are involved in the persistence of bulimia nervosa, anorexia nervosa and the atypical eating disorders. Together, these two lines of argument lead us to propose a new transdiagnostic theory of the maintenance of the full range of eating disorders, a theory which embraces a broader range of maintaining mechanisms than the current theory concerning bulimia nervosa. In the final sections of the paper we describe a transdiagnostic treatment derived from the new theory, and we consider in principle the broader relevance of transdiagnostic theories of maintenance. 相似文献
4.
One of the unresolved issues regarding research on bulimia nervosa concerns the question as to how patients diagnosed with bulimia nervosa respond to body image exposure. In addition, it remains unclear whether there are differential responses associated with different exposure techniques (e.g. in vivo exposure vs. exposure by visualization). The aim of the present study was to investigate psychological responses to body image exposure. Twenty participants diagnosed with bulimia nervosa (DSM IV) and twenty non-eating disordered individuals were exposed to their body image using a video recording (video confrontation). In addition, they were asked to imagine and describe the appearance of their body (imagery task). Results indicate that self-reported negative emotions increased in response to both, video confrontation and imagery task, in the clinical as well as in the control group. Furthermore, video confrontation led to more pronounced group differences than exposure by visualization (imagery task). Participants diagnosed with bulimia nervosa took less time to describe their waist, hips and bottom compared to non-eating disturbed controls. This last result could be interpreted in terms of avoidance behavior and other mechanisms during body image exposure. 相似文献
5.
《Revista latinoamericana de psicología》2014,46(3):189-197
Recent studies agree in that patients with Eating Disorders (ED) suffer from inefficiencies in Executive Functions as a consequence of the disease. In order to determine whether or not such inefficiencies make part of the endophenotype of ED—not that they result as a mere consequence of ED—69 women were evaluated: 23 diagnosed with ED, 23 with symptoms associated to ED and 23 women without any ED or risks for developing them. All participants were administered the Eating Attitude Test (EAT -40), the Interview for Diagnosis of Eating Disorders-IV (IDED -IV), the Tower of London Test and the Wisconsin Card Sorting Test. The results showed inefficiencies in executive functions—specifically in planning and cognitive flexibility for both the analogous symptoms group and the diagnosed ED group. The findings suggest that these alterations could be present prior to the establishment of the ED, and that they can actually constitute a risk factor 相似文献
6.
As psychology has moved toward emphasizing evidence-based practice, use of treatment manuals has extended from research trials into clinical practice. Minimal research has directly evaluated use of manuals in clinical practice. This survey of international eating disorder professionals examined use of manuals with 259 clinicians’ most recent client with bulimia nervosa. Although evidence-based manuals for bulimia nervosa exist, only 35.9% of clinicians reported using a manual. Clinicians were more likely to use a manual if they were younger; were treating an adult client; were clinical psychologists; were involved in research related to eating disorders; and endorsed a cognitive-behavioral orientation. Clinicians were less likely to use a manual if they provided eclectic psychotherapy that incorporated multiple psychotherapeutic approaches. We conclude that psychotherapy provided in clinical practice often does not align with the specific form validated in research trials, and “eclecticism” is at odds with efforts to disseminate manuals into clinical practice. 相似文献
7.
Aim
The purpose of the present study was to evaluate reducing perfectionism as a potential treatment target for individuals with Bulimia Nervosa (BN).Method
Forty-eight individuals meeting DSM-IV criteria for BN or eating disorder - not otherwise specified with binge eating [objective or subjective] or purging at least once per week were recruited. Participants were randomly assigned to receive 8 sessions of manual-based guided self-help (GSH) over a 6-week period that was focused on either cognitive behaviour therapy (CBT) for perfectionism, CBT for BN, or a placebo. Individuals were assessed at baseline, pre-treatment, post-treatment and at six-month follow-up on 12 outcome variables, including diagnostic criteria and psychological variables.Results
There was no significant change in any of the outcome variables over a 6-week no-treatment period but at post-treatment and 6-month follow-up there were significant main effects of time for 10 and 8 outcome variables respectively, suggesting that all groups reported significant reductions in bulimic symptomatology and related psychopathology at post-treatment and follow-up.Conclusions
These findings show potential for the use of novel interventions in GSH for BN. 相似文献8.
Prospective studies suggest dieting increases bulimic symptoms, but experiments suggest that dieting decreases bulimic symptoms. One possible explanation for the conflicting findings is that real world dieting involves less healthy dieting techniques, such as meal skipping, than prescribed diets. We tested whether the manipulation of eating episode frequency during dieting impacted bulimic symptoms. We expected that people on a diet involving fewer eating episodes would exhibit greater increases in bulimic symptoms than people on a diet involving more frequent eating episodes or waitlist controls. Participants on both 6-week diets lost more weight than controls, confirming dieting was manipulated, and showed greater reductions in bulimic symptoms than controls; however, the dieting conditions did not differ on either outcome. Results provide further experimental evidence that dieting does not increase bulimic symptoms, but suggests that eating episode frequency has little impact on this outcome. 相似文献
9.
Subtyping adolescents with bulimia nervosa 总被引:1,自引:0,他引:1
Cluster analyses of eating disorder patients have yielded a "dietary-depressive" subtype, typified by greater negative affect, and a "dietary" subtype, typified by dietary restraint. This study aimed to replicate these findings in an adolescent sample with bulimia nervosa (BN) from a randomized controlled trial and to examine the validity and reliability of this methodology. In the sample of BN adolescents (N=80), cluster analysis revealed a "dietary-depressive" subtype (37.5%) and a "dietary" subtype (62.5%) using the Beck Depression Inventory, Rosenberg Self-Esteem Scale and Eating Disorder Examination Restraint subscale. The "dietary-depressive" subtype compared to the "dietary" subtype was significantly more likely to: (1) report co-occurring disorders, (2) greater eating and weight concerns, and (3) less vomiting abstinence at post-treatment (all p's<.05). The cluster analysis based on "dietary" and "dietary-depressive" subtypes appeared to have concurrent validity, yielding more distinct groups than subtyping by vomiting frequency. In order to assess the reliability of the subtyping scheme, a larger sample of adolescents with mixed eating and weight disorders in an outpatient eating disorder clinic (N=149) was subtyped, yielding similar subtypes. These results support the validity and reliability of the subtyping strategy in two adolescent samples. 相似文献
10.