Integrative Cognitive-Affective Therapy for Bulimia Nervosa

描述（由申请人提供）：神经性贪食症（BN）是一种严重的慢性精神疾病，具有高发病率的医学并发症，社会障碍和共病精神病理。认知行为疗法（CBT）已被证明是一种有效的治疗BN的方法，可以显著减少核心暴食和代偿行为，以及心理障碍。然而，尽管CBT证明了它的有效性，50-70%的暴食症患者在接受CBT治疗后仍有症状，有相当多的人退出治疗，复发率很高。需要新的心理治疗方法来改善对治疗的整体反应。综合认知情感疗法（ICAT）是一种新的、基于手册的心理治疗方法。ICAT结合了来自现有动机、情感、人际功能和行为改变干预理论的概念和临床技术。ICAT是基于一个BN的概念模型，该模型包括几个核心结构，如自我差异、情感状态、人际模式和自我导向风格。ICAT包括临床医生手册、患者工作手册和基于个人数字助理的治疗模块，所有这些都以20次、16周的形式提供。测试ICAT基础模型的试点数据很有希望，并表明几个核心结构与BN显着相关。此外，两波试点试验表明，ICAT是可行的，并能够在相对较短的时间内减轻贪食症状。ICAT似乎是治疗BN的一种很有前途的方法，我们正在申请资助，以完善治疗手册，开发评估程序，并进行一项比较ICAT和CBT的小型随机对照试验。

DESCRIPTION (provided by applicant): Bulimia nervosa (BN) is a serious and often chronic psychiatric disorder with high rates of medical complications, social impairment and comorbid psychopathology. Cognitive behavioral therapy (CBT) has been shown to be an efficacious approach to the treatment of BN with substantial reductions in core binge eating and compensatory behaviors, as well as psychological impairments. However, in spite of its demonstrated efficacy, 50-70% of bulimic individuals remain symptomatic following treatment with CBT, a significant number drop out of treatment, and relapse rates are substantial. The need for new psychological treatments for BN that can improve the overall response to treatment is high. Integrative cognitive-affective therapy (ICAT) is a new, manual-based, psychological approach to the treatment of BN. ICAT incorporates both conceptual and clinical techniques from existing theories of motivation, emotion, interpersonal functioning, and behavioral change interventions. ICAT is based on a conceptual model of BN that includes several core constructs such as self-discrepancy, affective states, interpersonal patterns, and self-directed style. ICAT includes a clinician manual, patient workbook, and personal digital assistant based treatment modules, all of which are offered in a 20-session, 16-week format. Pilot data testing the model underlying ICAT are promising and suggest that several of the core constructs are significantly associated with BN. Furthermore, two waves of pilot testing indicate that ICAT is feasible to administer and is able to reduce bulimic symptomatology in a relatively short timeframe. ICAT appears to be a promising approach to the treatment of BN and we are requesting funding in this application to refine treatment manuals, develop assessment procedures, and conduct a small randomized controlled trial comparing ICAT to CBT.