Metacognitions about desire thinking predict the severity of binge eating in a sample of Italian women

In this study, our principal aim was to investigate whether metacognitions about desire thinking predict the severity of binge eating in women and, if so, whether this relationship is independent of age, self-reported body mass index (BMI), negative affect, irrational food beliefs and craving. One hundred and four women, consisting of 32 consecutive patients with binge eating disorder undergoing initial assessment for cognitive therapy for eating disorders, 39 moderate binge eaters, and 33 non-binge eaters (both from the general population), completed the following measures: Self-reported BMI, Hospital Anxiety and Depression Scale, Irrational Food Beliefs Scale, General Craving Scale, Metacognitions about Desire Thinking Questionnaire, and Binge Eating Scale. A series of Spearman's rho correlation analyses revealed that self-reported BMI, anxiety, depression, irrational food beliefs, craving, and all three factors of the metacognitions about desire thinking questionnaire were significantly associated with the severity of binge eating. A stepwise regression analysis identified self-reported BMI, craving, and negative metacognitions about desire thinking as significant predictors of the severity of binge eating. These results, taken together, highlight the possible role of metacognitions about desire thinking in predicting the severity of binge eating. The clinical implications of these findings are discussed

Radically open-dialectical behavior therapy for adult anorexia nervosa: feasibility and outcomes from an inpatient program

Background Anorexia Nervosa (AN) is a highly life-threatening disorder that is extremely difficult to treat. There is evidence that family-based therapies are effective for adolescent AN, but no treatment has been proven to be clearly effective for adult AN. The methodological challenges associated with studying the disorder have resulted in recommendations that new treatments undergo preliminary testing prior to being evaluated in a randomized clinical trial. The aim of this study was to provide preliminary evidence on the effectiveness of a treatment program based on a novel adaptation of Dialectical Behavior Therapy (DBT) for adult Anorexia Nervosa (Radically Open-DBT; RO-DBT) that conceptualizes AN as a disorder of overcontrol. Methods Forty-seven individuals diagnosed with Anorexia Nervosa-restrictive type (AN-R; mean admission body mass index = 14.43) received the adapted DBT inpatient program (mean length of treatment = 21.7 weeks). Results Seventy-two percent completed the treatment program demonstrating substantial increases in body mass index (BMI; mean change in BMI = 3.57) corresponding to a large effect size (d = 1.91). Thirty-five percent of treatment completers were in full remission, and an additional 55% were in partial remission resulting in an overall response rate of 90%. These same individuals demonstrated significant and large improvements in eating-disorder related psychopathology symptoms (d = 1.17), eating disorder-related quality of life (d = 1.03), and reductions in psychological distress (d = 1.34). Conclusions RO-DBT was associated with significant improvements in weight gain, reductions in eating disorder symptoms, decreases in eating-disorder related psychopathology and increases in eating disorder-related quality of life in a severely underweight sample. These findings provide preliminary support for RO-DBT in treating AN-R suggesting the importance of further evaluation examining long-term outcomes using randomized controlled trial methodology

Teoria e eficácia da terapia comportamental dialética na bulimia nervosa e no transtorno da compulsão alimentar periódica Theory and efficacy of dialectical behavior therapy of bulimia nervosa and binge eating disorder

OBJETIVOS: Procura-se analisar as atuais evidências empíricas e teóricas sobre o modo de operar nas intervenções comportamentais dialéticas. Procedeu-se igualmente à análise da eficácia dessa terapia no tratamento da bulimia nervosa e no transtorno da compulsão alimentar periódica. MÉTODO: Realizou-se uma revisão agregativa da literatura, recorrendo às palavras-chave "dialectical behavior therapy", "bulimia nervosa" e "binge eating disorder" nas bases de dados PsycInfo e MedLine e em livros da especialidade, sob o critério da atualidade e premência das publicações levantadas. RESULTADOS: A terapia comportamental dialética, inicialmente desenhada para o transtorno de personalidade borderline, tem-se estendido a outros transtornos do eixo I. Sua aplicação às perturbações alimentares sustentase num paradigma dialético com o recurso das estratégias comportamentais e cognitivas. Esse modelo permite aos pacientes uma regulação mais efetiva dos estados afetivos negativos, reduzindo a probabilidade da ocorrência de comportamentos bulímicos e de compulsão alimentar periódica. CONCLUSÃO: Embora escasseiem estudos sobre a sua eficácia, os resultados existentes parecem comprovar a eficácia da terapia comportamental dialética nas populações descritas.<br>OBJECTIVES: Current theoretical and empirical evidences on how to operate in dialectical behavioral interventions were examined. The effectiveness of these interventions in the treatment of bulimia nervosa and binge eating disorder were analyzed too. METHOD: An aggregative literature review was made, using the keywords "dialectical behavior therapy", "bulimia nervosa" and "binge eating disorder", from the database PsycInfo and MedLine and from reference books, selecting the most representative and recent scientific texts about this psychotherapy model. RESULTS: Dialectical behavior therapy, initially designed for borderline personality disorder, has been extended to other disorders of Axis I. Its application to eating disorders is sustained in a dialectic paradigm, using also behavioral and cognitive strategies. This model allows to patients a more effective regulation of negative emotional states, reducing the likelihood of occurrence of bulimic and binge behaviors. CONCLUSION: Despite the few studies published about his efficacy, the existing results seem to show dialectical behavior therapy effectiveness with populations described

Negative mood induction and unbalanced nutrition style as possible triggers of binges in binge eating disorder (BED)

OBJECTIVE: To investigate whether negative mood and unbalanced nutrition style (fat rich/carbohydrate low) synergistically trigger binge eating in overweight and obese binge eating disorder (BED) patients. METHODS: Subsequently to following an unbalanced or a balanced nutrition plan for three days, participants' food intake in a taste test was measured. During the taste test, participants were either in a negative or a neutral mood that was induced through a guided imagery task. PARTICIPANTS: Sixty-nine overweight and obese women with BED (mean age: 36.7 years, mean body mass index: 32.8 kg/m2). MEASUREMENTS: Eating behavior was assessed by measuring the amount of eaten food during the taste test. Visual analog scales were used to assess negative affect, tension, urge to eat, and hunger before and after the mood induction and after the taste test. RESULTS: Negative mood and unbalanced nutrition had neither a combined synergistic effect nor separate additive effects on the amount of food intake. Negative affect and tension decreased after the taste test in the negative mood group. CONCLUSIONS: Negative mood does not invariably enhance the risk of binge-eating behavior. Fat-rich, carbohydrate-low nutrition style did not influence food intake during a taste test. This finding questions the role of this specific nutrition style as a crucial factor in promoting binge eating. If replicated, these findings are important, since they could guide development of treatment protocols