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Dialectical behavior therapy for bulimia nervosa.

D L Safer1, C F Telch, W S Agras

  • 1Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94305-5722, USA. dlsafer@stanford.edu

The American Journal of Psychiatry
|April 3, 2001
PubMed
Summary

Dialectical behavior therapy significantly reduced binge and purge episodes in women with bulimia nervosa. This adapted therapy shows promise for treating eating disorders by enhancing emotion regulation skills.

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Area of Science:

  • Clinical Psychology
  • Psychiatry
  • Eating Disorder Treatment

Background:

  • Binge eating and purging behaviors are significant symptoms associated with eating disorders like bulimia nervosa.
  • Effective therapeutic interventions are crucial for managing and reducing the frequency of these behaviors.
  • Dialectical Behavior Therapy (DBT) has demonstrated efficacy in treating other emotion regulation difficulties.

Purpose of the Study:

  • To evaluate the effectiveness of dialectical behavior therapy (DBT) adapted for the treatment of binge/purge behaviors.
  • To determine if DBT skills training in emotion regulation can reduce binge and purge episodes.

Main Methods:

  • A randomized controlled trial involving 31 women with at least one binge/purge episode weekly.
  • Participants were assigned to either 20 weeks of manual-based dialectical behavior therapy or a 20-week waiting-list control.

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  • The DBT intervention specifically focused on training emotion regulation skills.

    • Main Results:

    • Intent-to-treat analysis revealed highly significant reductions in binge/purge behavior among participants receiving dialectical behavior therapy compared to the waiting list.
    • No significant differences between groups were observed for any of the secondary outcome measures.
    • The findings suggest a specific impact of DBT on the primary target behaviors.

    Conclusions:

    • Dialectical behavior therapy, when adapted for binge/purge behaviors, is associated with a promising and significant decrease in these symptoms.
    • The results support the utility of DBT as a potential treatment for individuals experiencing binge and purge episodes, particularly within the context of bulimia nervosa.
    • Further research may explore the mechanisms of change and long-term effects.