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      Transdiagnostic cognitive behaviour therapy for adolescents with an eating disorder who are not underweight

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          Abstract

          Little is known about the treatment of adolescents with an eating disorder who are not underweight. Enhanced cognitive behaviour therapy (CBT-E) is a potential option as it is a treatment for adult patients with eating disorders of this type and it has been shown to be effective with adolescent patients who are underweight. The aim of the present cohort study was to evaluate the effects of CBT-E on non-underweight adolescents with an eating disorder. Sixty-eight adolescent patients with an eating disorder and a body mass index (BMI) centile corresponding to an adult BMI ≥18.5 were recruited from consecutive referrals to a community-based eating disorder clinic. Each was offered 20 sessions of CBT-E over 20 weeks. Three-quarters completed the full 20 sessions. There was a marked treatment response with two-thirds (67.6%, intent-to-treat) having minimal residual eating disorder psychopathology by the end of treatment. CBT-E therefore appears to be a promising treatment for those adolescents with an eating disorder who are not underweight.

          Highlights

          • •

            A cohort of non-underweight adolescents with an eating disorder was treated with enhanced CBT (CBT-E).

          • •

            Three-quarters completed the full 20 sessions.

          • •

            Two-thirds had minimal eating disorder psychopathology by the end (intent-to-treat).

          • •

            CBT-E appears to be a promising treatment for this patient group.

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          Eating Disorder Examination Questionnaire (EDE-Q): norms for young adult women.

          J. Mond, P. Hay, B. Rodgers … (2006)
          In order to establish norms for the Eating Disorder Examination Questionnaire (EDE-Q) among young adult women, the questionnaire was administered to a large general population sample of women aged 18-42 yr in the Australian Capital Territory (ACT) region of Australia. Normative data were derived for EDE-Q subscales and for the occurrence of specific eating disorder behaviours, for each of five age bands (18-22, 23-27, 28-32, 33-37, 38-42 yr). Mean scores (SDs) for the Restraint, Eating Concern, Weight Concern and Shape Concern subscales for the total sample (n = 5,255) were, respectively, 1.30 (1.40), 0.76 (1.06), 1.79 (1.51) and 2.23 (1.65). The mean global score was 1.52 (1.25). The regular occurrence of objective and subjective overeating episodes was reported by 10.6% and 12.7% of participants, respectively. The regular use of self-induced vomiting, laxative misuse, and use of diuretics, was reported by 1.4%, 1.0%, and 0.3%, of participants, respectively, while 2.2% of participants reported regularly using diet pills. "Extreme dietary restraint" and "excessive exercise" were reported by 3.4% and 4.9% of participants, respectively. Both attitudinal and behavioural features of eating disorder psychopathology tended to decrease with increasing age. These data will inform researchers intending to use the EDE-Q in epidemiological studies.
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            Therapist competence, therapy quality, and therapist training

            Christopher Fairburn, Zafra Cooper (2011)
            Large numbers of therapists worldwide wish to receive training in how to deliver psychological treatments. Current methods of training are poorly suited to this task as they are costly and require scarce expertise. New forms of training therefore need to be developed that are more cost-effective and scalable. Internet-based methods might fulfil these requirements whilst having the added advantage of being able to provide trainees with extensive exposure to the treatment as practised. New strategies and procedures for evaluating training outcome are also required. These need to be capable of assessing the therapist’s knowledge of the treatment and its use, as well as the therapist’s ability to apply this knowledge in clinical practice. Standardised role play-based techniques might be of value in this regard.
            Article 0 comments Cited 97 times – based on 0 reviews     Review now
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              A transdiagnostic comparison of enhanced cognitive behaviour therapy (CBT-E) and interpersonal psychotherapy in the treatment of eating disorders

              Christopher Fairburn, Suzanne Bailey-Straebler, Shawnee Basden … (2015)
              Eating disorders may be viewed from a transdiagnostic perspective and there is evidence supporting a transdiagnostic form of cognitive behaviour therapy (CBT-E). The aim of the present study was to compare CBT-E with interpersonal psychotherapy (IPT), a leading alternative treatment for adults with an eating disorder. One hundred and thirty patients with any form of eating disorder (body mass index >17.5 to <40.0) were randomized to either CBT-E or IPT. Both treatments involved 20 sessions over 20 weeks followed by a 60-week closed follow-up period. Outcome was measured by independent blinded assessors. Twenty-nine participants (22.3%) did not complete treatment or were withdrawn. At post-treatment 65.5% of the CBT-E participants met criteria for remission compared with 33.3% of the IPT participants (p < 0.001). Over follow-up the proportion of participants meeting criteria for remission increased, particularly in the IPT condition, but the CBT-E remission rate remained higher (CBT-E 69.4%, IPT 49.0%; p = 0.028). The response to CBT-E was very similar to that observed in an earlier study. The findings indicate that CBT-E is potent treatment for the majority of outpatients with an eating disorder. IPT remains an alternative to CBT-E, but the response is less pronounced and slower to be expressed. Current controlled trials ISRCTN 15562271.
              Article 0 comments Cited 82 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Riccardo Dalle Grave
                Simona Calugi
                Massimiliano Sartirana
                Christopher G. Fairburn
                Journal
                Journal ID (nlm-ta): Behav Res Ther
                Journal ID (iso-abbrev): Behav Res Ther
                Title: Behaviour Research and Therapy
                Publisher: Elsevier Science
                ISSN (Print): 0005-7967
                ISSN (Electronic): 1873-622X
                Publication date PMC-release: 1 October 2015
                Publication date (Print): October 2015
                Volume: 73
                Pages: 79-82
                Affiliations
                [a ]Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo, 89, I-37016 Garda, VR, Italy
                [b ]Oxford University, Department of Psychiatry, Warneford Hospital, Oxford OX3 7JX, UK
                Author notes
                [∗ ]Corresponding author. rdalleg@ 123456tin.it
                Article
                Publisher ID: S0005-7967(15)30021-8
                DOI: 10.1016/j.brat.2015.07.014
                PMC ID: 4582043
                PubMed ID: 26275760
                SO-VID: 09158419-2e3e-4608-bd10-de73d0b58942
                Copyright © © 2015 The Authors
                License:

                This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

                History
                Date received : 13 July 2015
                Date revision received : 29 July 2015
                Date accepted : 30 July 2015
                Categories
                Subject: Shorter Communication

                ScienceOpen disciplines: Clinical Psychology & Psychiatry
                Keywords: eating disorders,treatment,cognitive behaviour therapy,bulimia nervosa,binge eating disorders,adolescents
                Data availability:
                ScienceOpen disciplines: Clinical Psychology & Psychiatry
                Keywords: eating disorders, treatment, cognitive behaviour therapy, bulimia nervosa, binge eating disorders, adolescents

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