Days between sessions predict attrition in text-based internet intervention of Binge Eating Disorder.

Area of Science:

• Psychiatry and Behavioral Science
• Digital Health
• Clinical Psychology

Background:

• The time between psychotherapy sessions is a critical, yet often overlooked, factor influencing treatment attrition.
• In text-based internet interventions, the number of days between sessions may serve as a straightforward and potent predictor of dropout.

Purpose of the Study:

• To investigate the hypothesis that an increased number of days between sessions elevates attrition risk in individuals with Binge Eating Disorder (BED).
• To examine the predictive value of session intervals on treatment completion in a 12-session internet-based cognitive behavioral therapy (iCBT) program.

Main Methods:

• A comparative analysis of 201 adult participants (85 non-completers, 116 completers) with mild to moderate BED.
• Utilized mixed-model binomial logistic regression and receiver operating characteristic (ROC) curve analysis to assess attrition predictors.
• Controlled for demographic and clinical variables including age, gender, BMI, BED severity, overall health status (EQ VAS), and depression symptoms (MDI).

Main Results:

• Non-completers exhibited significantly more days between sessions across the initial four treatment sessions (OR = 1.042, p < .001).
• Each additional day between sessions increased attrition risk by 4.2%.
• ROC analysis demonstrated increasing classification accuracy for attrition across sessions, reaching 73.2% by session 4, with an optimal cut-off of 17.5 days.

Conclusions:

• Increased time between sessions is a significant risk factor for dropout in iCBT for BED.
• Findings suggest potential interventions like automated reminders or therapist messages to mitigate attrition.
• The predictive value of session intervals may extend to other diagnoses within text-based internet interventions.