Adapting integrative cognitive‐affective therapy for adolescents with full and subthreshold bulimia nervosa: A feasibility study. (15th August 2022)

• Record Type: Journal Article
• Authors: Lebow, Jocelyn; Sim, Leslie; Wonderlich, Stephen; Peterson, Carol B.
• Is Part Of: European eating disorders review. Volume 31:Number 1(2023)
• Page Start: 178
• Page End: 187
• Publication Date: 2022-08-15
• Subjects: adolescent -- bulimia nervosa -- feeding and eating disorders; Eating disorders -- Periodicals; 616.8526
• DOI: 10.1002/erv.2946
• Languages: English
• ISSNs: 1072-4133

Abstract

Abstract: Background: Integrative Cognitive Affective Therapy (ICAT) is an empirically supported treatment for bulimia nervosa (BN) in adults. However, it is unclear whether a modified version, Integrative Cognitive Affective Therapy–Adolescent (ICAT‐A) is feasible and beneficial for adolescents. This study evaluated the feasibility of ICAT‐A for adolescents with BN or subthreshold BN. Methods: Eight adolescents with BN or subthreshold BN (mean age = 16.1) were enroled in the study. At baseline and end of treatment, adolescents who participated in ICAT‐A completed the Eating Disorder Examination (EDE) and self‐report measures of eating disorder symptoms, depression, anxiety, self‐esteem and functional impairment. Results: Retention for the intervention (75%) suggests that the majority of participants found the intervention acceptable. Although all treatment completers participated in the clinician‐administered assessment (EDE), compliance with end of treatment self‐report questionnaires was compromised by the COVID‐19 pandemic, which occurred during the treatment course of the majority of the sample. At the end of treatment, all 6 adolescents who completed the ICAT‐A intervention were in full eating disorder remission based on EDE scores, with large effect sizes identified for reductions in EDE global scores ( d = 2.71), objective binge episodes ( d = 0.91), subjective binge episodes ( d = 1.06) and compensatory behaviours ( d = 1.72). Conclusion: Results suggest that ICAT‐A is a feasible treatment that has promise for the treatment of adolescents with BN. Future studies are necessary to establish the efficacy of ICAT‐A for adolescent BN. Key points: A modification of Integrative Cognitive‐Affective Therapy for adolescents (ICAT‐A) was evaluated in a pilot sample of 8 adolescents with BN or subthreshold BN. At end of treatment, all 6 adolescents who completed ICAT‐A were in full eating disorder remission, with large effect sizes identified for reductions in EDE scores. Results suggest that ICAT‐A is a feasible treatment that has promise for the treatment of adolescents with BN.