Author:
BULIK C. M.,SULLIVAN P. F.,CARTER F. A.,McINTOSH V. V.,JOYCE P. R.
Abstract
Background. One hundred and thirty-five women with
bulimia nervosa participated in a randomized
clinical trial designed to determine whether the addition of
exposure with response prevention to a
core of cognitive-behavioural therapy (CBT) leads to greater
clinical improvement and lower risk
of relapse. We present results from the end of treatment and 6- and 12-month
follow-up.Methods. Participants received eight sessions of CBT and
were then randomized to either exposure
to pre-binge cues (B-ERP), exposure to pre-purge cues (P-ERP), or a
relaxation training control condition (RELAX).Results. CBT produced significant clinical change. At
the end of the behavioural treatments, there
were no significant differences across the three groups on abstinence (66%
in B-ERP, 45% in
P-ERP and 47% in RELAX), or frequency of bingeing and purging. B-ERP, but
not P-ERP,
significantly reduced anxiety on the cue reactivity assessment,
food restriction, body dissatisfaction
and depression. These differences were not maintained at 6-month follow-up.
At 12-months, B-ERP
was independently associated with lower food restriction and better global
functioning.Conclusions. CBT is a highly effective treatment for bulimia
nervosa.
B-ERP was modestly superior
to P-ERP at post-treatment; however, the advantage did not remain throughout
the follow-up
interval. ERP for bulimia nervosa is an expensive and logistically
complicated treatment that does
not appear to offer any significant additive benefits that are proportional
to the amount of effort required to implement the treatment.
Publisher
Cambridge University Press (CUP)
Subject
Psychiatry and Mental health,Applied Psychology
Cited by
123 articles.
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