Journal article
Latent trajectories of symptom change during cognitive-behavior therapy predict post-treatment worsening of symptoms: a preliminary examination among outpatients with bulimia-spectrum eating disorders
Eating and weight disorders, v 27(6), pp 2257-2264
2022
PMID: 34981464
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Purpose
Up to 44% of individuals with bulimia nervosa (BN) experience worsening of symptoms after cognitive behavior therapy (CBT). Identifying risk for post-treatment worsening of symptoms using latent trajectories of change in eating disorder (ED) symptoms during treatment could allow for personalization of treatment to improve long-term outcomes
Methods
Participants (
N
= 56) with BN-spectrum EDs received 16 sessions of CBT and completed digital self-monitoring of eating episodes and ED behaviors. The Eating Disorder Examination was used to measured ED symptoms at post-treatment and 3-month follow-up. Latent growth mixture modeling of digital self-monitoring data identified latent growth classes. Kruskal–Wallis
H
tests examined effect of trajectory of change in ED symptoms on post-treatment to follow-up symptom change.
Results
Multi-class models of change in binge eating, compensatory behaviors, and regular eating improved fit over one-class models. Individuals with high frequency-rapid response in binge eating (
H
(1) = 10.68,
p
=0 .001,
η
2
= 0.24) had greater recurrence of compensatory behaviors compared to individuals with low frequency-static response. Individuals with static change in regular eating exhibited greater recurrence of binge eating than individuals with moderate response (
H
(1) = 8.99,
p
= 0.003,
η
2
= 0.20).
Conclusion
Trajectories of change in ED symptoms predict post-treatment worsening of symptoms. Personalized treatment approaches should be evaluated among individuals at risk of poor long-term outcomes.
Level of evidence
IV, evidence obtained from multiple time series.
Trial registration
ClinicalTrials.gov registration number NCT03673540, registration date: September 17, 2018.
Metrics
Details
- Title
- Latent trajectories of symptom change during cognitive-behavior therapy predict post-treatment worsening of symptoms: a preliminary examination among outpatients with bulimia-spectrum eating disorders
- Creators
- Emily K. Presseller - Drexel UniversityElizabeth W. Lampe - Drexel UniversityMegan L. Michael - Drexel UniversityClaire Trainor - Drexel UniversityStephanie C. Fan - Drexel UniversityAdrienne S. Juarascio - Drexel University
- Publication Details
- Eating and weight disorders, v 27(6), pp 2257-2264
- Publisher
- Springer International Publishing
- Grant note
- R34MH116021 / National Institute of Mental Health
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Psychological and Brain Sciences (Psychology); Center for Weight, Eating and Lifestyle Science (WELL) [Historical]
- Web of Science ID
- WOS:000737686300001
- Scopus ID
- 2-s2.0-85122189484
- Other Identifier
- 991019168050304721
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- Web of Science research areas
- Psychiatry