Dialectical Behavior Therapy and Cognitive Behavior Therapy in Individuals With Binge-Eating Disorder: What Works for...

Area of Science:

• Psychiatry and Behavioral Science
• Clinical Psychology

Background:

• Binge-eating disorder (BED) is a significant mental health concern.
• Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) are established treatments for BED.
• Identifying predictors of treatment response is crucial for optimizing patient outcomes.

Purpose of the Study:

• To identify moderators and predictors of treatment response in BED patients undergoing CBT or DBT.
• To compare the efficacy of CBT and DBT based on individual symptom profiles.

Main Methods:

• Analysis of aggregated data from two clinical outcome studies (N=203) comparing DBT-BED (n=71) and intensive CBT (CBT+, n=132).
• Generalized linear models were used to examine moderators and predictors of objective binge-eating (OBE) frequency.
• Outcomes were assessed at end of treatment (EOT) and six-month follow-up (FU).

Main Results:

• Baseline shape/weight overvaluation, shape concerns, and low self-esteem predicted and moderated OBE reductions at EOT.
• Difficulty identifying feelings predicted and moderated outcome at FU.
• Emotional eating predicted FU outcome and moderated EOT outcome.
• Depression predicted outcome but did not moderate it.
• Lower levels of shape/weight overvaluation, shape concerns, and self-esteem were associated with poorer outcomes in DBT-BED compared to CBT+.
• Higher emotional eating and difficulty identifying feelings were associated with greater OBE reductions in DBT-BED versus CBT+ at EOT and FU, respectively.

Conclusions:

• Tailoring BED treatment based on symptom presentation can enhance outcomes.
• DBT-BED may be a more effective alternative to CBT+ for individuals with more severe psychopathology.
• Personalized treatment matching holds promise for improving BED recovery rates.