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Dialectical Behavior Therapy for Bulimia Nervosa
Abstract
OBJECTIVE: The effects of dialectical behavior therapy adapted for the treatment of binge/purge behaviors were examined. METHOD: Thirty-one women (averaging at least one binge/purge episode per week) were randomly assigned to 20 weeks of dialectical behavior therapy or 20 weeks of a waiting-list comparison condition. The manual-based dialectical behavior therapy focused on training in emotion regulation skills. RESULTS: An intent-to-treat analysis showed highly significant decreases in binge/purge behavior with dialectical behavior therapy compared to the waiting-list condition. No significant group differences were found on any of the secondary measures. CONCLUSIONS: The use of dialectical behavior therapy adapted for treatment of bulimia nervosa was associated with a promising decrease in binge/purge behaviors.
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In the citing paper
“bulimia (Safer, Telch, & Agras, 2001)”
From Effects of mindfulness on psychological health: A review of empirical studies (2011) · cites this paper as Safer, Telch, & Agras, 2001
In the citing paper
“Dialectical behavior therapy (DBT) has been proved effective to treat ED in disorders other than autism spectrum disorder.”
From Feasibility, Acceptability and Preliminary Efficacy of Dialectical Behavior Therapy for Autistic Adults without Intellectual Disability: A Mixed Methods Study (2022) · cites this paper as Safer et al., 2001
In the citing paper
“In addition to BPD, DBT has been found to be effective in several psychiatric disorders characterized by ED, e.g., complex post-traumatic stress disorder (c-PTSD), depression, anxiety and eating disorders (Safer et al., 2001; Lynch et al., 2003; Chen et al., 2008; Harley et al., 2008; Bohus et al., 2013; Neacsiu et al., 2014).”
From Feasibility, Acceptability and Preliminary Efficacy of Dialectical Behavior Therapy for Autistic Adults without Intellectual Disability: A Mixed Methods Study (2022) · cites this paper as Safer et al., 2001
In the citing paper
“Independent of a BPD diagnosis, empirical literature supports the use of DBT for individuals with treatment-resistant depression (Harley, Sprich, Safren, Jacobo, & Fava, 2008), eating disorders (Safer, Telch, & Agras, 2001;Telch, Agras, & Linehan, 2001), and depression in older adults with mixed personality features (Lynch et al., 2007).”
From Transdiagnostic applications of DBT for adolescents and adults (2015) · cites this paper as Safer, Telch, & Agras, 2001
In the citing paper
“Considerable empirical evidence now supports the use of DBT adapted for eating disorders, substance use disorders, and posttraumatic stress disorder.”
From Transdiagnostic applications of DBT for adolescents and adults (2015) · cites this paper as Safer, Telch, & Agras, 2001
In the citing paper
“There is growing empirical support that DBT is effective for clients with EDs, particularly in the areas of BN and BED (Safer, Telch, & Agras, 2001;Telch, Agras, & Linehan 2001).”
From Transdiagnostic applications of DBT for adolescents and adults (2015) · cites this paper as Safer, Telch, & Agras, 2001
In the citing paper
“In addition, DBT has been adapted and successfully tested for BPD with several comorbidities and other psychiatric conditions in which problems in emotion regulation lead to psychopathology such as substance misuse (Linehan et al., 1999, 2002; Dimeff and Linehan, 2008), eating disorder (Safer et al., 2001; Telch et al., 2001; Kröger et al., 2010), post-traumatic stress disorder (Steil et al., 2011”
From Emotion regulation in schema therapy and dialectical behavior therapy. (2016) · cites this paper as Safer et al., 2001
In the citing paper
“DBT has also shown effect in treating BPD with several comorbidities and other psychiatric conditions such as substance misuse (Linehan et al., 1999, 2002; Dimeff and Linehan, 2008), eating disorder (Safer et al., 2001; Telch et al., 2001; Kröger et al., 2010), post-traumatic stress disorder (Steil et al., 2011; Harned et al., 2012, 2014; Bohus et al., 2013), or depression (Lynch et al., 2007).”
From Emotion regulation in schema therapy and dialectical behavior therapy. (2016) · cites this paper as Safer et al., 2001
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Chapter 5. Manifestations, Assessment, Diagnosis, and Differential Diagnosis
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Chapter 4. The Alternative DSM-5 Model for Personality Disorders
Skodol, A. E., Bender, D. S., & Oldham, J. M. (2021) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615379699.lg04
Chapter 22. Antisocial Personality Disorder and Other Antisocial Behavior
Black, D. W., & Blum, N. S. (2021) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615379699.lg22
Chapter 12. Psychodynamic Psychotherapies
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Gutheil, T. G. (2021) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615379699.lg19
Chapter 14. Treatment of Binge Eating, Including Bulimia Nervosa and Binge-Eating Disorder
Gianini, L. M., Broft, A. I., & Devlin, M. J. (2015) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615378609.lg14
Chapter 20. Assessing and Managing Suicide Risk
Links, P. S., Boursiquot, P., & Links, M. (2021) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615379699.lg20
Choi-Kain, L. W., & Hersh, R. (2021) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615379699.lg15
Chapter 14. Cognitive-Behavioral Therapy
Fowler, J. C., Orme, W. H., & Hart, J. M. (2021) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615379699.lg14
Chapter 2. Theories of Personality and Personality Disorders
Westen, D., & Heim, A. K. (2021) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615379699.lg02
Chapter 11. Therapeutic Alliance
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Chapter 8. Genetics and Neurobiology
Fred-Torres, S., Pérez-Rodríguez, M. M., New, A. S., Rosell, D. R., & Koenigsberg, H. W. (2021) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615379699.lg08
Robinson, A. H., & Kirz, N. (2018) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615379095.lg03
Chapter 23. Personality Disorders in the Medical Setting
Nash, S. S., Sotsky, J., Hicks, C., & Muskin, P. R. (2021) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615379699.lg23
Chapter 17. Pharmacological Management
Nelson, K. J., & Tsheringla, S. (2021) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615379699.lg17
Chapter 1. Personality Disorders: Recent History and New Directions
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Chapter 16. Group, Family, and Couples Therapies
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Chapter 18. Collaborative Treatment
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Chapter 25. Translational Research in Borderline Personality Disorder
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Chapter 21. Co-occurring Substance Use Disorders
Gorfinkel, L., Prins, S. J., Elliott, J. C., Meyers, J. L., & Hasin, D. S. (2021) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615379699.lg21
Chapter 9. Longitudinal Course and Outcomes
Grilo, C. M., & Skodol, A. E. (2021) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615379699.lg09
Chapter 1. Eating Disorders: The Basics
Lock, J., & Osipov, L. (2018) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615379095.lg01
Chapter 7. Eating Disorders in the Context of Obesity
Bohon, C., & Welch, H. A. (2018) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615379095.lg07
Chapter 11. Cognitive-Behavioral Therapies: Dialectical Behavior Therapy and Cognitive Therapies
(2008) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615377954.lg11
Metadata
- Authors
- Safer, D. L., Telch, C. F., & Agras, W. S.
- Affiliations
- Stanford Medicine (US)
- Venue
- American Journal of Psychiatry
- Published
- 2001-04-01
- Volume
- 158
- Issue
- 4
- Pages
- 632-634
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- OpenAlex
- W2132031412
- Cited by
- 526
- References
- 20
- Citations by year
- 2026: 7 · 2025: 17 · 2024: 16 · 2023: 9 · 2022: 17 · 2021: 49 · 2020: 14 · 2019: 23 · 2018: 19 · 2017: 22 · 2016: 21 · 2015: 21 · 2014: 30 · 2013: 26 · 2012: 34
- FWCI
- 11.96
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Public Health Service (5-T32 NG-19938)
- National Institute of Mental Health (MH-19938, MH50371, T32MH019938)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- dialectical behavior therapy, bulimia nervosa, binge-purge behavior, emotion regulation skills, women, psychotherapy treatment
- MeSH terms
- Adolescent, Adult, Behavior Therapy, Bulimia, Emotions, Female, Humans, Middle Aged, Personality Inventory, Research Design, Treatment Outcome
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