Attachment anxiety moderates the relationship between growth in group cohesion and treatment outcomes in Group Psychodynamic Interpersonal Psychotherapy for women with binge eating disorder.

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.

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Binge Eating Disorder e regolazione affettiva: cibo, emozioni, relazioni

SALUTE E SOCIETÀ ◽

10.3280/ses2009-003005 ◽

2009 ◽

pp. 77-93

Author(s):

Valentina Guiducci

Keyword(s):

Eating Disorder ◽

Binge Eating ◽

Binge Eating Disorder ◽

Affect Regulation ◽

Self Regulation ◽

Emotional Dysregulation ◽

Clinical Implications ◽

Bodily Sensations ◽

Desire To Eat ◽

The Relationship

- The work aims to draw a descriptive and explanatory picture of Binge Eating Disorder, basing on the key concept of affective regulation. It is proposed, as an explanation model of the disorder, the hypothesis of Taylor, Bagby and Parker (1997, 2000), who conceptualized Eating Disorders as self-regulation disorders, focusing on the construct of affect regulation. It refers to the acts that modulate emotions experienced and expressed (Gross and Munoz, 1995; Kopp, 1989; Schor, 1994). The reference to attachment theory, as privileged theoretical framework for understanding the construct of affect regulation, is introduced to discuss pathogenetic and clinical implications (Santona and Zavattini, 2009). The review of the empirical results of the studies that examined the relationship between Binge Eating Disorder and emotional dysregulation, shows how the characteristic of this disorder is a poor capacity to modulate dysphoric feelings and to differentiate emotions from bodily sensations. The desire to eat is experienced as a compulsive craving, that represents for the patient the only possible response to emotional dysregulation (Whiteside et al., 2007).Key-words: Binge Eating Disorder, food, emotions, affective regulation, bulimia, shape.Parole-chiave: Binge Eating Disorder, cibo, emozioni, regolazione affettiva, bulemia, vergogna.

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