Outcome predictors for the cognitive behavior treatment of bulimia nervosa: Data from a multisite study
Outcome predictors for the cognitive behavior treatment of bulimia nervosa: Data from a multisite study
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DOI：
10.1176/appi.ajp.157.8.1302
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发表时间：
2000-08-01
影响因子：
17.7
通讯作者：
Kraemer, HC
中科院分区：
文献类型：
--
作者：
Agras, WS;Crow, SJ;Kraemer, HC
目的：本研究的目的是发现临床上有用的预测磨损和结果在治疗神经性贪食症与认知行为therapy.Method：治疗前，治疗过程中，和结果的数据收集了194名妇女符合DSM-III-R标准的神经性贪食症谁是治疗与18个会议的手动为基础的认知行为疗法在三个网站的研究。辍学和nondropouts之间的差异，恢复和nonrecovered参与者之间的第一次检查，然后使用信号检测分析，以确定临床上显着的截止点预测磨损和abstinence.Results：辍学的特点是更严重的暴食症的认知和更大的冲动，但它是不可能的，以确定临床上有用的预测。治疗失败的参与者的特点是社会适应能力差，体重指数较低，这可能表明饮食限制更大。然而，治疗的早期进展最能预测结果。信号检测分析显示，预测结果不佳的减少清洗不到70%的治疗会话6，允许识别的一个相当大的比例的前瞻性failure.Conclusions：一个截止点的基础上减少清洗会话6有效区分患者谁会和不会响应神经性贪食症的认知行为治疗，可能允许早期使用的第二种治疗。
Objective: The aim of this study was to discover clinically useful predictors of attrition and outcome in the treatment of bulimia nervosa with cognitive behavior therapy.Method: Pretreatment, course of treatment, and outcome data were gathered on 194 women meeting the DSM-III-R criteria for bulimia nervosa who were treated with 18 sessions of manual-based cognitive behavior therapy in a three-site study. Differences between dropouts and nondropouts and between recovered and nonrecovered participants were first examined descriptively, and signal detection analyses were then used to determine clinically significant cutoff points predicting attrition and abstinence.Results: The dropouts were characterized by more severe bulimic cognitions and greater impulsivity, but it was not possible to identify clinically useful predictors. The participants with treatment failures were characterized by poor social adjustment and a lower body mass index, presumably indicating greater dietary restriction. However, early progress in therapy best predicted outcome. Signal detection analyses revealed that poor outcome was predicted by a reduction in purging of less than 70% by treatment session 6, allowing identification of a substantial proportion of prospective failures.Conclusions: A cutoff point based on reduction of purging by session 6 usefully differentiates patients who will and will not respond to cognitive behavior therapy for bulimia nervosa, potentially allowing early use of a second therapy.