Cognitive-behavioral therapy for bulimia nervosa: Time course and mechanisms of change.

Abstract

Cognitive-behavioral therapy (CBT) is an effective treatment of bulimia nervosa, but its mechanisms of action have not been established. In this study the authors analyzed the results of a randomized control trial comparing CBT with Interpersonal Psychotherapy (IPT) to identify possible mediators of change of CBT for BN and its time course of action. Reduction in dietary restraint as early as Week 4 mediated posttreatment improvement in both binge eating and vomiting. Measures of self-efficacy concerning eating behavior, negative affect, and body shape and weight at midtreatment were also significantly associated with posttreatment outcome at 20 weeks. No evidence was found that the therapeutic alliance mediated treatment outcome. CBT had a significantly more rapid treatment effect than IPT, with 62% of posttreatment improvement evident by Week 6.

Cites (4)

1. Inventory of interpersonal problems: Psychometric properties and clinical applications.
   Horowitz, Leonard M., Rosenberg, Saul E., Baer, Barbara A., Ureño, Gilbert, Villaseñor, Valerie S. · 1988 · Journal of Consulting and Clinical Psychology
2. Assessment of social adjustment by patient self report.
   Weissman, Myrna M. · 1976 · Archives of General Psychiatry
3. Toward the delineation of therapeutic change principles.
   Goldfried, Marvin R. · 1980 · American Psychologist
4. Toward a stepped care approach to treating problem drinkers: the predictive utility of within‐treatment variables and therapist prognostic ratings
   BRESLIN, F. CURTIS, SOBELL, MARK B., SOBELL, LINDA C., BUCHAN, GIAO, CUNNINGHAM, JOHN A. · 1997 · Addiction

Show all 4 references

Cited by (37)

1. Cognitive behaviour therapy for eating disorders: a “transdiagnostic” theory and treatment
   Fairburn, Christopher G, Cooper, Zafra, Shafran, Roz · 2003 · Behaviour Research and Therapy
2. The growing field of digital psychiatry: current evidence and the future of apps, social media, chatbots, and virtual reality
   Torous, John, Bucci, Sandra, Bell, Imogen H., Kessing, Lars V., Faurholt‐Jepsen, Maria, Whelan, Pauline, Carvalho, Andre F., Keshavan, Matcheri, Linardon, Jake, Firth, Joseph · 2021 · World Psychiatry
3. Advances in cognitive theory and therapy: The generic cognitive model
   Beck, Aaron T., Haigh, Emily A.P. · 2014 · Annual Review of Clinical Psychology
4. Acceptance and mindfulness-based therapy: New wave or old hat?
   Hofmann, Stefan G., Asmundson, Gordon J.G. · 2008 · Clinical Psychology Review
5. Recovery from anorexia nervosa and bulimia nervosa at 22-year follow-up
   Eddy, Kamryn T., Tabri, Nassim, Thomas, Jennifer J., Murray, Helen B., Keshaviah, Aparna, Hastings, Elizabeth, Edkins, Katherine, Krishna, Meera, Herzog, David B., Keel, Pamela K. et al. · 2017 · The Journal of Clinical Psychiatry

See all 318