Comparing integrative cognitive-affective therapy and guided self-help cognitive-behavioral therapy to treat binge-eating disorder using standard and naturalistic momentary outcome measures: A randomized controlled trial.
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2020-09
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Abstract
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Innovative treatments and outcome measures are needed for binge-eating disorder (BED). This randomized controlled trial compared Integrative Cognitive-Affective Therapy (ICAT-BED), an individual psychotherapy targeting momentary behavioral and emotional precipitants of binge eating, with an established cognitive-behavioral guided self-help (CBTgsh) treatment using standard and ecological momentary assessment (EMA) outcome measures.Method
A total of 112 participants were randomized to 17 weeks of treatment (21 sessions for ICAT-BED and 10 sessions for CBTgsh). Binge-eating frequency was assessed with the Eating Disorder Examination (EDE) as well as EMA using cell phone-based real-time, naturalistic assessment at end of treatment (EOT) and 6-month follow-up. Hypothesized maintenance mechanisms were assessed using self-report questionnaires.Results
Binge-eating frequency as measured by the EDE and real-time assessment showed significant reductions at EOT and follow-up, with no significant differences between treatments. Hypothesized maintenance mechanisms, including emotion regulation, cognitive self-discrepancy, self-directed style, as well as measures of associated eating disorder psychopathology, depression, anxiety, impulsivity, and negative affect, showed similar improvement at EOT and follow-up with no differences between treatments. Abstinence rates at EOT (ICAT-BED: 57.1%; CBTgsh: 42.9%) and 6-month follow-up (ICAT-BED: 46.4%; CBTgsh: 42.9%) were not significantly different. Treatment retention was significantly higher for ICAT-BED (87.5%) than CBTgsh (71.4%).Discussion
These findings suggest that ICAT-BED and CBTgsh were associated with similar improvements in binge eating, psychopathology, and putative maintenance mechanisms as measured by traditional self-report and momentary, naturalistic assessments and that these changes were generally sustained at 6-month follow-up.Type
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Peterson, Carol B, Scott G Engel, Ross D Crosby, Timothy Strauman, Tracey L Smith, Marjorie Klein, Scott J Crow, James E Mitchell, et al. (2020). Comparing integrative cognitive-affective therapy and guided self-help cognitive-behavioral therapy to treat binge-eating disorder using standard and naturalistic momentary outcome measures: A randomized controlled trial. The International journal of eating disorders, 53(9). pp. 1418–1427. 10.1002/eat.23324 Retrieved from https://hdl.handle.net/10161/31187.
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Timothy J. Strauman
Professor Strauman’s work is grounded in the premise that mental health and well-being are fundamentally shaped by self-regulation—how individuals pursue goals, respond to challenges, and adapt over time. His research integrates clinical psychology, affective neuroscience, and behavioral science to characterize the psychological and neurobiological systems that support self-regulation, and to understand how disruptions in these systems contribute to vulnerability to depression and related conditions.
Across a program of experimental, clinical, and neuroimaging research, his work has examined self-regulation as a multi-level system, including its cognitive and motivational mechanisms, its development through socialization, and its links to affective and immunological processes. This work has also informed the development and evaluation of novel interventions targeting self-regulatory dysfunction.
More recently, his work has focused on translating this science of self-regulation into scalable approaches to intervention and prevention. This includes the development of new models of treatment that target regulatory processes across disorders, as well as efforts to extend effective self-regulation skills beyond traditional clinical settings and into everyday contexts. This translational focus reflects a broader aim of building integrated, system-level approaches to mental health that can improve outcomes at population scale.
Unless otherwise indicated, scholarly articles published by Duke faculty members are made available here with a CC-BY-NC (Creative Commons Attribution Non-Commercial) license, as enabled by the Duke Open Access Policy. If you wish to use the materials in ways not already permitted under CC-BY-NC, please consult the copyright owner. Other materials are made available here through the author’s grant of a non-exclusive license to make their work openly accessible.