Behavioral treatment of night bingeing and rumination in an adult case of bulimia nervosa.

A 24-year-old female, diagnosed as bulimia nervosa with night bingeing and rumination, was treated by individual and group behavior therapy. A changing criterion design progressively adjusted the criterion for reinforcement as the treatment obtained diminution of night bingeing. Night bingeing was finally eliminated, without evidence of recurrence at 3 month and 2 year follow-ups. Rumination was regarded as a collateral behavior and diminished in tandem with reduction of night bingeing. Other improvements in bulimia nervosa were observed over the course of treatment.