Efficacy of a transdiagnostic cognitive-behavioral intervention for eating disorder psychopathology delivered through a smartphone app: a randomized controlled trial
Efficacy of a transdiagnostic cognitive-behavioral intervention for eating disorder psychopathology delivered through a smartphone app: a randomized controlled trial
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DOI：
10.1017/s0033291720003426
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发表时间：
2022-07-01
影响因子：
6.9
通讯作者：
Fuller-Tyszkiewicz, Matthew
中科院分区：
文献类型：
--
作者：
Linardon, Jake;Shatte, Adrian;Fuller-Tyszkiewicz, Matthew
虽然诊断性和阈值以下进食障碍（EDs）存在有效的治疗方法，但很大一部分受影响的个体没有得到帮助。通过智能手机应用程序提供的干预措施可能是缩小这一治疗差距的一种解决方案。然而，智能手机应用程序对ed的功效还缺乏证据。我们基于跨诊断认知行为治疗的原则和技术开发了一款智能手机应用程序，并通过预注册的随机对照试验对其进行了评估。方法有症状的个体（报告存在暴食的个体）被随机分配到应用程序（n = 197）或等待名单（n = 195）。在总样本中，分别有42%和31%的人表现出诊断水平的神经性贪食症和暴食症症状。评估在基线、随机化后4周和8周进行。分析是意向治疗。主要结果是ED精神病理的总体水平。次要结局是其他ED症状、损害和窘迫。结果在测试后，干预参与者报告的ED整体精神病理比对照组有更大的下降（d = -0.80）。除代偿行为频率外，次要结局也观察到显著影响（d's = -0.30至-0.74）。随访时症状水平保持稳定。尽管测试后的总体流失率为35%，但大部分参与者对这款应用都很满意。研究结果表明，对于那些无法接受标准治疗的人来说，这款应用程序有可能成为一种具有成本效益且易于获得的干预措施。将应用程序灵活地整合到当前的精神卫生保健提供模式中，可能对解决急诊科患者未满足的需求至关重要。
Background Although effective treatments exist for diagnostic and subthreshold-level eating disorders (EDs), a significant proportion of affected individuals do not receive help. Interventions translated for delivery through smartphone apps may be one solution towards reducing this treatment gap. However, evidence for the efficacy of smartphones apps for EDs is lacking. We developed a smartphone app based on the principles and techniques of transdiagnostic cognitive-behavioral therapy for EDs and evaluated it through a pre-registered randomized controlled trial. Methods Symptomatic individuals (those who reported the presence of binge eating) were randomly assigned to the app (n = 197) or waiting list (n = 195). Of the total sample, 42 and 31% exhibited diagnostic-level bulimia nervosa and binge-eating disorder symptoms, respectively. Assessments took place at baseline, 4 weeks, and 8 weeks post-randomization. Analyses were intention-to-treat. The primary outcome was global levels of ED psychopathology. Secondary outcomes were other ED symptoms, impairment, and distress. Results Intervention participants reported greater reductions in global ED psychopathology than the control group at post-test (d = -0.80). Significant effects were also observed for secondary outcomes (d's = -0.30 to -0.74), except compensatory behavior frequency. Symptom levels remained stable at follow-up. Participants were largely satisfied with the app, although the overall post-test attrition rate was 35%. Conclusion Findings highlight the potential for this app to serve as a cost-effective and easily accessible intervention for those who cannot receive standard treatment. The capacity for apps to be flexibly integrated within current models of mental health care delivery may prove vital for addressing the unmet needs of people with EDs.