1. Predictors and Moderators of Treatment Outcome in a Randomized Clinical Trial for Binge-Eating Disorder.
- Author
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Anderson, Lisa M., Smith, Kathryn M., Schaefer, Lauren M., Crosby, Ross D., Cao, Li, Engel, Scott G., Crow, Scott J., Wonderlich, Stephen A., and Peterson, Carol B.
- Subjects
BINGE-eating disorder ,TREATMENT effectiveness ,CLINICAL trials ,COGNITIVE therapy ,SELF-discrepancy - Abstract
Objective: The current study examined predictors and moderators of two interventions for binge-eating disorder (BED). Method: Participants were 112 adults with BED (M
age = 39.7 ± 13.4 years; MBMI = 35.1 ± 13.4 kg/m2 ; 82% female; 91% Caucasian) randomly assigned to integrative cognitive-affective therapy for BED (ICAT-BED) or guided self-help cognitive–behavioral therapy (CBTgsh). Generalized linear models examined predictors and moderators of objective binge-eating episode (OBE) frequency and OBE abstinence at end-of-treatment (EOT) and 6-month follow-up (FU). Results: Lower levels of baseline dietary restraint and emotion regulation difficulties predicted greater reductions in OBE frequency at EOT and FU, respectively. At EOT, greater pretreatment self-control predicted greater reductions in OBE frequency in ICAT-BED than CBTgsh (ps <.05). In addition, low shape/weight overvaluation predicted greater reductions in OBE frequency in ICAT-BED than CBTgsh, whereas high shape/weight overvaluation predicted comparable reductions in OBE frequency across treatments at EOT (ps <.02). At EOT and FU, greater baseline actual-ideal self-discrepancy predicted significantly greater reductions in OBE frequency in ICAT-BED, than CBTgsh (ps <.02). No significant predictor or moderator effects were observed for models examining OBE abstinence. Conclusion: This study identified two general predictors and four moderators of BED treatment response. However, only one predictor (actual-ideal self-discrepancy) interacted with treatment type to differentially predict OBE frequencies at both EOT and FU. Altogether, findings suggest that ICAT-BED may confer specific and durable improvements in OBE frequencies among individuals with high actual-ideal self-discrepancy. Therefore, patients demonstrating these characteristics may be more likely to benefit from ICAT-BED. What is the public health significance of this article?: This study suggests that ICAT-BED is an efficacious treatment for BED and may be particularly effective for reducing binge-eating frequency among individuals with certain symptom presentations. This study highlights the potential importance of assessing pretreatment patient characteristics, particularly actual-ideal self-discrepancy, to inform treatment plans and selection of targeted intervention approaches. [ABSTRACT FROM AUTHOR]- Published
- 2020
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