Rapid response in psychological treatments for binge-eating disorder

Objective: Analysis of short- and long-term effects of rapid response across three different treatments for binge-eating disorder (BED). Method: In a randomized clinical study comparing interpersonal psychotherapy (IPT), cognitive-behavioral guided self-help (CBTgsh), and behavioral weight loss (BWL...

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Bibliographic Details
Main Authors: Hilbert, Anja, Hildebrandt, Thomas, Agras, W. Stewart, Wilfley, Denise E., Wilson, G. Terence
Other Authors: Universitätsklinikum Leipzig, Abteilung für Medizinische Psychologie und Medizinische Soziologie
Format: Article
Language:English
Published: Universitätsbibliothek Leipzig 2017
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Online Access:http://nbn-resolving.de/urn:nbn:de:bsz:15-qucosa-223542
http://nbn-resolving.de/urn:nbn:de:bsz:15-qucosa-223542
http://www.qucosa.de/fileadmin/data/qucosa/documents/22354/Hilbert_Rapid%20Response%20in%20psychological%20treatments%20for%20BED_2015.pdf
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Summary:Objective: Analysis of short- and long-term effects of rapid response across three different treatments for binge-eating disorder (BED). Method: In a randomized clinical study comparing interpersonal psychotherapy (IPT), cognitive-behavioral guided self-help (CBTgsh), and behavioral weight loss (BWL) treatment in 205 adults meeting DSM-IV criteria for BED, the predictive value of rapid response, defined as ≥ 70% reduction in binge-eating by week four, was determined for remission from binge-eating and global eating disorder psychopathology at posttreatment, 6-, 12-, 18-, and 24-month follow-up. Results: Rapid responders in CBTgsh, but not in IPT or BWL, showed significantly greater rates of remission from binge-eating than non-rapid responders, which was sustained over the long term. Rapid and non-rapid responders in IPT and rapid responders in CBTgsh showed a greater remission from binge-eating than non-rapid responders in CBTgsh and BWL. Rapid responders in CBTgsh showed greater remission from binge-eating than rapid responders in BWL. Although rapid responders in all treatments had lower global eating disorder psychopathology than non-rapid responders in the short term, rapid responders in CBTgsh and IPT were more improved than those in BWL and non-rapid responders in each treatment. Rapid responders in BWL did not differ from non-rapid responders in CBTgsh and IPT. Conclusions: Rapid response is a treatment-specific positive prognostic indicator of sustained remission from binge-eating in CBTgsh. Regarding an evidence-based stepped care model, IPT, equally efficacious for rapid and non-rapid responders, could be investigated as a second-line treatment in case of non-rapid response to first-line CBTgsh.