Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2020 Sep;53(9):1418-1427.
doi: 10.1002/eat.23324. Epub 2020 Jun 25.

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

Carol B Peterson  1 , Scott G Engel  2 , Ross D Crosby  2 , Timothy Strauman  3 , Tracey L Smith  4 , Marjorie Klein  5 , Scott J Crow  1   6 , James E Mitchell  2 , Ann Erickson  2 , Li Cao  2 , Kayla Bjorlie  2   7 , Stephen A Wonderlich  2
Affiliations
Randomized Controlled Trial

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

Carol B Peterson et al. Int J Eat Disord. 2020 Sep.

Abstract

Objective: 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.

Trial registration: ClinicalTrials.gov NCT02043496.

Keywords: binge eating; cognitive-behavioral therapy; eating disorders; psychotherapy.

PubMed Disclaimer

References

REFERENCES

    1. Agras, W. S., Fitzsimmons-Craft, E. E., & Wilfley, D. E. (2017). Evolution of cognitive behavioral therapy for eating disorders. Behaviour Research and Therapy, 88, 26-36.
    1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, D.C.: Author.
    1. Anderson, L. M., Smith, K. M., Schaefer, L. M., Crosby, R. D., Cao, L., Engel, S. G., … Peterson, C. B. (in press). Predictors and moderators of treatment outcome in a randomized clinical trial for binge-eating disorder. Journal of Consulting and Clinical Psychology. https://doi.org/10.1037/ccp0000503
    1. Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561-571. https://doi.org/10.1001/archpsyc.1961.01710120031004
    1. Benjamin, L. S. (1974). Structural analysis of social behavior. Psychological Review, 81(5), 392-425. https://doi.org/10.1037/h0037024

Publication types

Associated data

LinkOut - more resources