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Trajectories of therapeutic skills use and their dynamic relations to symptom change during cognitive-behavioral therapy for bulimia nervosa
Journal article   Open access   Peer reviewed

Trajectories of therapeutic skills use and their dynamic relations to symptom change during cognitive-behavioral therapy for bulimia nervosa

Laura D'Adamo, Jake Linardon, Stephanie M. Manasse and Adrienne S. Juarascio
The International journal of eating disorders
20 Nov 2023
DOI: https://doi.org/10.1002/eat.24099
PMID: 37986629
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10842056View
Accepted (AM)Open Access (License Unspecified),  Open

Abstract

Life Sciences & Biomedicine Nutrition & Dietetics Psychiatry Psychology Psychology, Clinical Science & Technology Social Sciences
Objective: To examine trajectories of therapeutic skills use and weekly relations between skills use and symptom change during the enhanced version of cognitive-behavioral therapy (CBT-E) for bulimia nervosa (BN).Method: Fifty-five adults (M age: 39.0 +/- 14.1; 83.9% female; 64.3% White, 93.6% non-Hispanic/Latino) receiving CBT-E for BN-spectrum eating disorders (EDs) self-monitored their use of five therapeutic skills (i.e., regular eating, eating enough to prevent excessive hunger and eating a range of macronutrients, breaking dietary rules, urge management strategies, and mood management strategies) several times per day during treatment. Patients also self-reported their ED symptoms (i.e., frequency of binge eating, compensatory behaviors, and dietary restraint) weekly. We examined trajectories of use of each CBT-E skill and temporal relations between skills use and ED symptoms from week-to-week during treatment.Results: Participants showed significant increases in eating enough to prevent excessive hunger and eating a range of macronutrients from week-to-week (p < .05). Regular eating, eating enough to prevent excessive hunger, and eating a range of macronutrients 1 week predicted lower binge eating and compensatory behaviors the same week and the following week, and urge management strategy use predicted greater binge eating the same week and the following week (p < .05).Conclusions: Results showed temporal relationships between therapeutic skills use and symptom change on a weekly level, with evidence that using skills targeting dietary restraint was associated with lower BN symptoms. Findings highlight the promise of future work to elucidate the most potent CBT-E skills for symptom improvement and inform more targeted interventions.Public Significance: Findings showed weekly relationships between therapeutic skills use and symptom change during treatment, with evidence that using CBT-E skills aimed to reduce dietary restraint (i.e., regular eating, eating enough to prevent excessive hunger, and eating a range of macronutrients) was associated with lower BN symptoms. Future work has the potential to identify the most potent CBT-E skills for symptom improvement and inform more targeted interventions.

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18 Record Views
4 citations in Web of Science
4 citations in Scopus

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being
#5 Gender Equality

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Collaboration types
Domestic collaboration
International collaboration
Web of Science research areas
Nutrition & Dietetics
Psychiatry
Psychology
Psychology, Clinical
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