Trajectories of therapeutic skills use and their dynamic relations to symptom change during cognitive-behavioral therapy for bulimia nervosa.
Trajectories of therapeutic skills use and their dynamic relations to symptom change during cognitive-behavioral therapy for bulimia nervosa.
复制标题
神经性贪食症认知行为治疗期间治疗技能使用轨迹及其与症状变化的动态关系。
DOI：
10.1002/eat.24099
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发表时间：
2024
期刊：
影响因子：
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通讯作者：
Juarascio,AdrienneS
中科院分区：
文献类型：
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作者：
D'Adamo,Laura;Linardon,Jake;Manasse,StephanieM;Juarascio,AdrienneS
目的探讨强化版认知行为疗法治疗神经性暴食症(BN)过程中治疗技能的使用轨迹及其与症状变化的每周关系。64.3%的白人，93.6%的非西班牙裔/拉丁裔)接受CBT-E治疗BN谱系饮食障碍(EDS)的患者在治疗期间每天多次自我监测他们五种治疗技能(即规律饮食、足够避免过度饥饿和摄入一系列大量营养素、违反饮食规则、冲动管理策略和情绪管理策略)的使用情况。患者还每周自我报告他们的ED症状(即暴饮暴食的频率、代偿行为和饮食限制)。在治疗期间，我们检查了每种CBT-E技能的使用轨迹以及技能使用与ED症状之间的时间关系。结果显示，参与者在每周摄入足够的食物以防止过度饥饿和摄入一系列大量营养素方面显著增加(p<； .05)。有规律的饮食，足够的饮食以防止过度饥饿，以及摄入一系列大量营养素1 周预示着在同一周和下一周更少的暴食和补偿行为，而冲动管理策略的使用预测在同一周和下一周更多的暴食(p<； .05)。结论结果显示治疗技能的使用与每周的症状变化之间存在时间关系，证据表明，使用针对饮食限制的技能与较低的BN症状相关。研究结果强调了未来工作的前景，即阐明改善症状的最有效的CBT-E技能，并提供更有针对性的干预措施。公共意义研究结果显示，治疗技能的使用与治疗期间症状变化之间每周存在关系，证据表明，使用CBT-E技能旨在减少饮食约束(即规律饮食、足够的饮食以防止过度饥饿，以及摄入一系列常量营养素)与较低的BN症状相关。未来的工作有可能确定改善症状的最有效的CBT-E技能，并提供更有针对性的干预措施。
ObjectiveTo 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).MethodFifty‐five adults (Mage: 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.ResultsParticipants 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).ConclusionsResults 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 SignificanceFindings 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.