Journal of Consulting and Clinical Psychology, 2015, Vol.83(3), pp.649-654
Objective: Analysis of short- and long-term effects of rapid response across 3 different treatments for binge eating disorder (BED). Method: In a randomized clinical study comparing interpersonal psychotherapy (IPT), cognitive–behavioral therapy guided self-help (CBTgsh), and behavioral weight loss (BWL) treatment in 205 adults meeting Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM–IV ; APA, 1994 ) criteria for BED, the predictive value of rapid response, defined as ≥70% reduction in binge eating by Week 4, was determined for remission from binge eating and global eating disorder psychopathology at posttreatment, 6-, 12-, 18-, and 24-month follow-ups. Results: Rapid responders in CBTgsh, but not in IPT or BWL, showed significantly greater rates of remission from binge eating than nonrapid responders, which was sustained over the long term. Rapid and nonrapid responders in IPT and rapid responders in CBTgsh showed a greater remission from binge eating than nonrapid responders in CBTgsh and BWL. Rapid responders in CBTgsh showed greater remission from binge eating than rapid responders in BWL. Although rapid responders in all treatments had lower global eating disorder psychopathology than nonrapid responders in the short term, rapid responders in CBTgsh and IPT were more improved than those in BWL and nonrapid responders in each treatment. Rapid responders in BWL did not differ from nonrapid responders in CBTgsh and IPT. Conclusion: Rapid response is a treatment-specific positive prognostic indicator of sustained remission from binge eating in CBTgsh. Regarding an evidence-based, stepped-care model, IPT, equally efficacious for rapid and nonrapid responders, could be investigated as a second-line treatment in case of nonrapid response to first-line CBTgsh. ; This study provides evidence for rapid response as a treatment-specific positive prognostic indicator of long-term remission in cognitive–behavioral guided self-help (CBTgsh), a low-intensity, low-cost treatment for binge eating disorder. ; In contrast, interpersonal psychotherapy (IPT), a specialty treatment, was comparably efficacious for both rapid and nonrapid responders, whereas nonrapid responders in CBTgsh and rapid and nonrapid responders in behavioral weight loss treatment showed the lowest remission rates. ; Monitoring rapid response can provide guidance regarding a switch from a low-intensity treatment (e.g., CBTgsh) to a more intensive treatment (e.g., IPT) to promote successful outcomes in individuals diagnosed with binge eating disorder.
Binge Eating Disorder ; Rapid Response ; Self-Help Treatment ; Interpersonal Psychotherapy ; Behavioral Weight Loss
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