Barbara Schlup

The efficacy of a short version of a cognitive-behavioral treatment followed by booster sessions for binge eating disorder.

This waitlist-controlled study evaluated the efficacy of a short version of a group CBT for BED followed by booster sessions after the active treatment phase. Thirty-six females with BED were randomly assigned to CBT (eight weekly sessions during active treatment plus five booster sessions during follow-up) or a waitlist condition. At the end of the active treatment, binge eating was significantly reduced relative to waitlist. Furthermore, at 12-month follow-up short-term CBT produced significant improvements in binge eating symptoms relative to baseline. Findings suggest that the short-term CBT followed by booster sessions may provide a valuable treatment option for patients with BED.

Cognitive–behavioral treatment of childhood obsessive–compulsive disorder in community-based clinical practice: clinical significance and benchmarking against efficacy☆

OBJECTIVE To evaluate the feasibility and outcomes of evidence-based (EB) manualized, cognitive-behavioral treatment (CBT) for childhood obsessive-compulsive disorder (OCD), when delivered in an outpatient community-based specialist clinic. METHOD This study, conducted in an outpatient private clinic in South-East Queensland Australia, involved thirty-three children and adolescents with OCD. Children were assessed at pre- and post-treatment, by means of diagnostic interviews, symptom severity interviews, and self-report. Treatment involved 12 sessions CBT delivered either individually or in small groups and included parental involvement. RESULTS Manualized CBT could be transported to the community setting effectively, with 63% of the current sample responding positively, based on post-treatment diagnosis. Significant change was evident across a wide-range of outcomes; including, diagnostic severity, symptom severity, child reported depression and anxiety, and both child and parent reported OCD functional impairment. CONCLUSIONS This study provides evidence for the transportability of manualized CBT in clinical community practice for pediatric OCD. The next important step is larger community based dissemination and effectiveness studies to advance both research and clinical practice outcomes.

Validität des Diagnostischen Interviews bei psychischen Störungen (DIPS für DSM-IV-TR)

Zusammenfassung. Theoretischer Hintergrund: Das “Diagnostische Interview bei psychischen Storungen“ (DIPS fur DSM-IV-TR; Schneider & Margraf, 2006) ist ein strukturiertes Interview, welches erweitert und an die DSM-IV-TR Kriterien angepasst wurde. Fragestellung: Ziel dieser Studie ist die Validierung des DIPS fur DSM-IV-TR. Methode: Die Validitat der DIPS-Diagnosen wurde mit einer Fragebogenbatterie an einer Stichprobe von 194 Patienten aus unterschiedlichen klinischen Einrichtungen uberpruft. Ergebnisse: Die Ergebnisse sprechen fur eine gute Validitat der Oberklassen Angststorungen, Affektive Storungen, Somatoforme Storungen, Essstorungen, Substanz- und Alkoholmissbrauch/-abhangigkeit sowie einzelner, uberprufbarer Storungskategorien und fur den Ausschluss psychischer Storungen. Eine ungenugende Validitat ergab sich fur die Oberklasse Schlafstorungen und der Generalisierten Angststorung. Schlussfolgerungen: Das DIPS fur DSM-IV-TR zeigt auser bei der Generalisierten Angststorung und den Schlafstorungen ei...

Ecological Momentary Assessment to Evaluate Cognitive-Behavioral Treatment for Binge Eating Disorder

OBJECTIVE Cognitive-behavioral treatment (CBT) for binge eating disorder (BED) is traditionally evaluated using clinical interviews and questionnaires. These retrospective assessment methods are discussed to be problematic due to memory recall error. Ecological momentary assessment (EMA) might be promising for gathering ecologically valid and reliable data. METHOD We assessed the feasibility of and reactivity to EMA and compared the treatment efficacy measured by traditional vs. EMA-based instruments in 28 BED individuals participating in short-term CBT. RESULTS Patients were highly compliant and we found no reactivity to EMA. Estimated treatment effects for binge eating based on EMA were comparable to questionnaire-based methods. The overall concordance between methods was moderate. DISCUSSION Results suggest that binge eating over 1 week can be equally accurately assessed by EMA or by self-report questionnaires in BED treatment trials. EMA contributes to a detailed knowledge of binge eating in daily live and helps to advance treatment options.

A non-randomized direct comparison of cognitive-behavioral short- and long-term treatment for binge eating disorder.

Background: To compare treatment outcomes of a cognitive-behavioral long-term (CBT-L) and short-term (CBT-S) treatment for binge eating disorder (BED) in a non-randomized comparison and to identify moderators of treatment outcome. Methods: 76 female patients with BED participated in the study: 40 in CBT-L and 36 in CBT-S. Outcome values were compared at the end of the active treatment phase (16 sessions for CBT-L, 8 sessions for CBT-S) and at 12-month follow-up. Results: Both treatments produced significant reductions in binge eating. At the end of active treatment, but not at the end of follow-up, effects of primary outcomes (e.g. remission from binge eating, EDE shape concern) were better for CBT-L than for CBT-S. Dropout rates were significantly higher in CBT-L (35%) than in CBT-S (14%). Moderator analyses revealed that treatment efficacy for rapid responders and individuals exhibiting high scores on the mixed dietary negative affect subtype differed between the CBT-L and CBT-S with respect to objective binges, restraint eating and eating concern. Conclusion: Findings suggest that CBT in general represents an effective treatment for BED, but that subgroups of patients might profit more from a prolonged treatment. Short, lessintensive CBT treatments could nevertheless be a viable option in the treatment of BED.

Mother-Child Interactions and Childhood OCD: Effects of CBT on Mother and Child Observed Behaviors

This waitlist-controlled study investigates the impact of a group-based cognitive-behavioral therapy with family involvement (CBT-F) on observed mother and child behaviors in children with obsessive-compulsive disorder (OCD). Forty-four children and adolescents with OCD and their mothers were observed during family discussions before and after treatment/waitlist. Participants were rated on behavioral dimensions of criticism, overinvolvement, doubt, avoidance, warmth, confidence, positive problem solving, and rewarding independence. Significant differences between treatment and waitlist condition occurred from pretreatment to posttreatment, with ratings of negative behaviors decreasing and ratings of positive behaviors increasing in the treatment group. Findings suggest that CBT-F has the potential to improve mother and child interactions in families with a child diagnosed with OCD.

The Role of Cognitive Factors in the Development and Maintenance of Eating Disorders – the Concept of Thought Shape Fusion

TSF, like thought-action fusion, occurs when individuals assume that mere thoughts increase the probability of feared events, and are morally equal to real behavior. TSF occurs specifically when thinking about eating high-caloric foods. People who experience TSF report believing that they have gained weight after they merely imagine eating high-caloric or ‘fattening’ foods, report feeling fatter after thinking about eating these foods, and also report feeling as though How did theories about the role of cognitive factors in ED develop since the 2 factors theory of Connors [1996]?

Stationäre kognitiv-verhaltenstherapeutische Behandlung einer Patientin mit einer Anorexia nervosa vom Binge-Eating-/Purging-Typus

Die vorliegende Kasuistik beschreibt die stationäre Behandlung einer Patientin mit einer Anorexia nervosa vom Binge-Eating/Purging-Typus und einer komorbiden depressiven Störung. Das Oszillieren zwischen restriktivem Essverhalten, impulsiven Kontrolldurchbrüchen mit Essanfällen und Rumination sowie das deutliche Untergewicht und dessen psychologische und somatische Folgen stellen eine ausgeprägte Belastung für die Patientin dar. Spezifische Behandlungsanleitungen für die Anorexia nervosa vom Binge-Eating-/Purging-Typus, die auf evidenzbasierten Leitlinien beruhen, gibt es bislang nicht. Die Behandlungsinhalte für diesen Subtyp der Anorexia nervosa lassen sich jedoch aus bestehenden Behandlungsmanualen ableiten. Die Kasuistik beschreibt vor dem Hintergrund der individuellen Ätiologie der Störung sowie der belegten Therapieinterventionen bei Anorexia und Bulimia nervosa exemplarisch die Behandlung dieser Essstörung. Der Therapieverlauf wird mittels Messdaten zu 7 Zeitpunkten dargestellt.