CLINICAL PERFECTIONISM: A CASE REPORT

2004 ◽  
Vol 32 (3) ◽  
pp. 353-357 ◽  
Author(s):  
Roz Shafran ◽  
Michelle Lee ◽  
Christopher G. Fairburn
Keyword(s):  
Eating Disorder ◽  
Case Report ◽  
Binge Eating ◽  
Binge Eating Disorder ◽  
Behavioural Analysis ◽  
Cognitive Behavioural ◽  
Eating Disorder Psychopathology ◽  
The Impact

The aim of this case report is to describe the impact of an intervention for clinical perfectionism, derived from a new cognitive-behavioural analysis, in a patient with binge-eating disorder. It was hypothesized that clinical perfectionism was contributing to the maintenance of the eating disorder, and on this basis it was predicted that reducing clinical perfectionism would improve her eating disorder psychopathology. Standardized independent assessments were found to be consistent with this hypothesis, in that clinical perfectionism and eating disorder psychopathology improved over an eight-session intervention and improvements were largely maintained at 5-month follow-up.

Targeting binge eating in bulimia nervosa and binge eating disorder using inhibitory control training and implementation intentions: a feasibility trial

2020 ◽  
pp. 1-10
Author(s):  
Rayane Chami ◽  
Valentina Cardi ◽  
Natalia Lawrence ◽  
Pamela MacDonald ◽  
Katie Rowlands ◽  
...  
Keyword(s):  
Eating Disorder ◽  
Bulimia Nervosa ◽  
Binge Eating ◽  
Binge Eating Disorder ◽  
Implementation Intentions ◽  
Effect Sizes ◽  
Post Intervention ◽  
Eating Frequency ◽  
Eating Disorder Psychopathology

Abstract Background This trial examined the feasibility, acceptability, and effect sizes of clinical outcomes of an intervention that combines inhibitory control training (ICT) and implementation intentions (if-then planning) to target binge eating and eating disorder psychopathology. Methods Seventy-eight adult participants with bulimia nervosa or binge eating disorder were randomly allocated to receive food-specific, or general, ICT and if-then planning for 4 weeks. Results Recruitment and retention rates at 4 weeks (97.5% and 79.5%, respectively) met the pre-set cut-offs. The pre-set adherence to the intervention was met for the ICT sessions (84.6%), but not for if-then planning (53.4%). Binge eating frequency and eating disorder psychopathology decreased in both intervention groups at post-intervention (4 weeks) and follow-up (8 weeks), with moderate to large effect sizes. There was a tendency for greater reductions in binge eating frequency and eating disorders psychopathology (i.e. larger effect sizes) in the food-specific intervention group. Across both groups, ICT and if-then planning were associated with small-to-moderate reductions in high energy-dense food valuation (post-intervention), food approach (post-intervention and follow-up), anxiety (follow-up), and depression (follow-up). Participants indicated that both interventions were acceptable. Conclusions The study findings reveal that combined ICT and if-then planning is associated with reductions in binge eating frequency and eating disorder psychopathology and that the feasibility of ICT is promising, while improvements to if-then planning condition may be needed.

Change in impulsivity is prospectively associated with treatment outcomes for binge-eating disorder

2021 ◽  
pp. 1-9
Author(s):  
Rebecca G. Boswell ◽  
Ralitza Gueorguieva ◽  
Carlos M. Grilo
Keyword(s):  
Eating Disorder ◽  
Binge Eating ◽  
Treatment Outcomes ◽  
Binge Eating Disorder ◽  
Pharmacological Treatment ◽  
Rapid Change ◽  
Post Treatment ◽  
Controlled Clinical Trial ◽  
Eating Disorder Psychopathology

Abstract Background Impulsivity may be a process underlying binge-eating disorder (BED) psychopathology and its treatment. This study examined change in impulsivity during cognitive-behavioral therapy (CBT) and/or pharmacological treatment for BED and associations with treatment outcomes. Methods In total, 108 patients with BED (NFEMALE = 84) in a randomized placebo-controlled clinical trial evaluating the efficacy of CBT and/or fluoxetine were assessed before treatment, monthly throughout treatment, at post-treatment (16 weeks), and at 12-month follow-up after completing treatment. Patients completed established measures of impulsivity, eating-disorder psychopathology, and depression, and were measured for height and weight [to calculate body mass index (BMI)] during repeated assessments by trained/monitored doctoral research-clinicians. Mixed-effects models using all available data examined changes in impulsivity and the association of rapid and overall changes in impulsivity on treatment outcomes. Exploratory analyses examined whether baseline impulsivity predicted/moderated outcomes. Results Impulsivity declined significantly throughout treatment and follow-up across treatment groups. Rapid change in impulsivity and overall change in impulsivity during treatment were significantly associated with reductions in eating-disorder psychopathology, depression scores, and BMI during treatment and at post-treatment. Overall change in impulsivity during treatment was associated with subsequent reductions in depression scores at 12-month follow-up. Baseline impulsivity did not moderate/predict eating-disorder outcomes or BMI but did predict change in depression scores. Conclusions Rapid and overall reductions in impulsivity during treatment were associated with improvements in specific eating-disorder psychopathology and associated general outcomes. These effects were found for both CBT and pharmacological treatment for BED. Change in impulsivity may be an important process prospectively related to treatment outcome.

Fluoxetine and Fluvoxamine Combined with Individual Cognitive-Behaviour Therapy in Binge Eating Disorder: A One-Year Follow-Up Study

2001 ◽  
Vol 70 (6) ◽  
pp. 298-306 ◽  
Author(s):  
Valdo Ricca ◽  
Edoardo Mannucci ◽  
Barbara Mezzani ◽  
Sandra Moretti ◽  
Milena Di Bernardo ◽  
...  
Keyword(s):  
Eating Disorder ◽  
Binge Eating ◽  
Binge Eating Disorder ◽  
Cognitive Behaviour Therapy ◽  
Behaviour Therapy ◽  
Follow Up Study ◽  
Cognitive Behaviour ◽  
One Year

scholarly journals Micro-level de-coupling of negative affect and binge eating in relationship to macro-level outcomes in binge eating disorder treatment

2020 ◽  
pp. 1-9
Author(s):  
Kathryn E. Smith ◽  
Tyler B. Mason ◽  
Lauren M. Schaefer ◽  
Lisa M. Anderson ◽  
Vivienne M. Hazzard ◽  
...  
Keyword(s):  
Emotion Regulation ◽  
Eating Disorder ◽  
Negative Affect ◽  
Binge Eating ◽  
Binge Eating Disorder ◽  
Behavioral Treatment ◽  
Future Research ◽  
End Of Treatment ◽  
Pre Treatment

Abstract Background While negative affect reliably predicts binge eating, it is unknown how this association may decrease or ‘de-couple’ during treatment for binge eating disorder (BED), whether such change is greater in treatments targeting emotion regulation, or how such change predicts outcome. This study utilized multi-wave ecological momentary assessment (EMA) to assess changes in the momentary association between negative affect and subsequent binge-eating symptoms during Integrative Cognitive Affective Therapy (ICAT-BED) and Cognitive Behavior Therapy Guided Self-Help (CBTgsh). It was predicted that there would be stronger de-coupling effects in ICAT-BED compared to CBTgsh given the focus on emotion regulation skills in ICAT-BED and that greater de-coupling would predict outcomes. Methods Adults with BED were randomized to ICAT-BED or CBTgsh and completed 1-week EMA protocols and the Eating Disorder Examination (EDE) at pre-treatment, end-of-treatment, and 6-month follow-up (final N = 78). De-coupling was operationalized as a change in momentary associations between negative affect and binge-eating symptoms from pre-treatment to end-of-treatment. Results There was a significant de-coupling effect at follow-up but not end-of-treatment, and de-coupling did not differ between ICAT-BED and CBTgsh. Less de-coupling was associated with higher end-of-treatment EDE global scores at end-of-treatment and higher binge frequency at follow-up. Conclusions Both ICAT-BED and CBTgsh were associated with de-coupling of momentary negative affect and binge-eating symptoms, which in turn relate to cognitive and behavioral treatment outcomes. Future research is warranted to identify differential mechanisms of change across ICAT-BED and CBTgsh. Results also highlight the importance of developing momentary interventions to more effectively de-couple negative affect and binge eating.

Binge-eating disorder and major depressive disorder co-morbidity: Sequence and clinical significance

2016 ◽  
Vol 33 (S1) ◽  
pp. S163-S163
Author(s):  
C. Grilo ◽  
D. Becker
Keyword(s):  
Major Depressive Disorder ◽  
Eating Disorder ◽  
Depressive Disorder ◽  
Binge Eating ◽  
Binge Eating Disorder ◽  
Psychiatric Comorbidity ◽  
Consecutive Series ◽  
Major Depressive ◽  
Eating Disorder Psychopathology ◽  
Co Morbidity

IntroductionBinge-eating disorder (BED) is associated with obesity and with elevated rates of co-occurring major depressive disorder (MDD) but the significance of the diagnostic comorbidity is ambiguous—as is the significance of the onset sequence for MDD and BED.Objective and aimsWe compared eating-disorder psychopathology and psychiatric comorbidity in three subgroups of BED patients: those in whom onset of BED preceded onset of MDD, those with onset of MDD prior to onset of BED, and those without MDD or any psychiatric comorbidity.MethodsA consecutive series of 731 treatment-seeking patients meeting DSM-IV-TR research criteria for BED were assessed reliably by doctoral-clinicians with semi-structured interviews to evaluate lifetime psychiatric disorders (SCID-I/P) and ED psychopathology (EDE Interview).ResultsBased on SCID-I/P, 191 (26%) patients had onset of BED preceding onset of MDD, 114 (16%) had onset of MDD preceding onset of BED, and 426 (58%) had BED without co-occurring disorders. Three groups did not differ with respect to age, ethnicity, or education, but a greater proportion of the group without MDD was male. Three groups did not differ in body-mass-index or binge-eating frequency, but groups differed significantly with respect to eating-disorder psychopathology, with both MDD groups having significantly higher levels than the group without co-occurring disorders. The group having earlier onset of MDD had elevated rates of anxiety disorders compared to the group having earlier onset of BED.ConclusionsMDD in combination with BED—with either order of onset—has a meaningful adverse effect on ED psychopathology and overall psychiatric co-morbidity.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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