Early Change Trajectories in Cognitive-Behavioral Therapy for Binge-Eating Disorder. Issue 1 (January 2019)

• Record Type: Journal Article
• Authors: Hilbert, Anja; Herpertz, Stephan; Zipfel, Stephan; Tuschen-Caffier, Brunna; Friederich, Hans-Christoph; Mayr, Andreas; Crosby, Ross D.; de Zwaan, Martina
• Is Part Of: Behavior therapy. Volume 50:Issue 1(2019)
• Page Start: 115
• Page End: 125
• Publication Date: 2019-01
• Subjects: binge-eating disorder -- eating disorder -- psychotherapeutic processes -- cognitive behavior therapy -- prediction; Behavior therapy -- Periodicals; 616.8914205
• DOI: 10.1016/j.beth.2018.03.013
• Languages: English
• ISSNs: 0005-7894

Abstract

Abstract: Rapid response is considered the most well-established outcome predictor across treatments of binge-eating disorder (BED), including cognitive-behavioral therapy (CBT). This study sought to identify latent trajectories of early change in CBT and compare them to common rapid response classifications. In a multicenter randomized trial, 86 adults with BED (DSM-IV) or subsyndromal BED provided weekly self-reports of binge eating over the first 4 weeks of CBT, which were analyzed to predict binge eating, depression, and body mass index at posttreatment, 6-, and 18-month follow-up. Using latent growth mixture modeling, three patterns of early change—including moderate and low decreasing—as well as low stable binge eating were identified, which significantly predicted binge-eating remission at 6-month follow-up. Other classifications of rapid response based on Receiver Operating Characteristics curve analyses or on the literature (≥ 10% reduction in binge eating at week 1, ≥ 70% reduction in binge eating at week 4) only predicted posttreatment remission or overall depression, respectively. Latent change trajectories, but not other rapid response classifications, predicted binge-eating frequency over time. A fine-grained analysis of change over the first 4 weeks of CBT for BED revealed different trajectories of early change in binge eating that led to an improved prediction of binge-eating outcome, compared to that of common rapid response classifications. Thorough monitoring of early change trajectories during treatment may have clinical utility. Highlights: Rapid response is a predictor of treatment outcome in binge-eating disorder. Analysis found different change trajectories early in cognitive-behavioral therapy. Early change trajectories resulted in an improved prediction of treatment outcome. Common rapid response classifications revealed a lower predictive value. Thorough monitoring of early change during treatment may have clinical utility.