Kathryn E Smith1, Tyler B Mason2, Lauren M Schaefer3, Lisa M Anderson4, Vivienne M Hazzard3, Ross D Crosby3,5, Scott G Engel3,5, Scott J Crow4,6, Stephen A Wonderlich3,5, Carol B Peterson4,6. 1. Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, California, US. 2. Department of Preventive Medicine, University of Southern California, Los Angeles, California, USA. 3. Center for Bio-behavioral Research, Sanford Research, Fargo, North Dakota, USA. 4. Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, Minnesota, USA. 5. Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA. 6. The Emily Program, Saint Paul, Minnesota, USA.
Abstract
BACKGROUND: While negative affect reliably predicts binge eating, it is unknown how this association may decrease or 'de-couple' during treatment for binge eating disorder (BED), whether such change is greater in treatments targeting emotion regulation, or how such change predicts outcome. This study utilized multi-wave ecological momentary assessment (EMA) to assess changes in the momentary association between negative affect and subsequent binge-eating symptoms during Integrative Cognitive Affective Therapy (ICAT-BED) and Cognitive Behavior Therapy Guided Self-Help (CBTgsh). It was predicted that there would be stronger de-coupling effects in ICAT-BED compared to CBTgsh given the focus on emotion regulation skills in ICAT-BED and that greater de-coupling would predict outcomes. METHODS: Adults with BED were randomized to ICAT-BED or CBTgsh and completed 1-week EMA protocols and the Eating Disorder Examination (EDE) at pre-treatment, end-of-treatment, and 6-month follow-up (final N = 78). De-coupling was operationalized as a change in momentary associations between negative affect and binge-eating symptoms from pre-treatment to end-of-treatment. RESULTS: There was a significant de-coupling effect at follow-up but not end-of-treatment, and de-coupling did not differ between ICAT-BED and CBTgsh. Less de-coupling was associated with higher end-of-treatment EDE global scores at end-of-treatment and higher binge frequency at follow-up. CONCLUSIONS: Both ICAT-BED and CBTgsh were associated with de-coupling of momentary negative affect and binge-eating symptoms, which in turn relate to cognitive and behavioral treatment outcomes. Future research is warranted to identify differential mechanisms of change across ICAT-BED and CBTgsh. Results also highlight the importance of developing momentary interventions to more effectively de-couple negative affect and binge eating.
BACKGROUND: While negative affect reliably predicts binge eating, it is unknown how this association may decrease or 'de-couple' during treatment for binge eating disorder (BED), whether such change is greater in treatments targeting emotion regulation, or how such change predicts outcome. This study utilized multi-wave ecological momentary assessment (EMA) to assess changes in the momentary association between negative affect and subsequent binge-eating symptoms during Integrative Cognitive Affective Therapy (ICAT-BED) and Cognitive Behavior Therapy Guided Self-Help (CBTgsh). It was predicted that there would be stronger de-coupling effects in ICAT-BED compared to CBTgsh given the focus on emotion regulation skills in ICAT-BED and that greater de-coupling would predict outcomes. METHODS: Adults with BED were randomized to ICAT-BED or CBTgsh and completed 1-week EMA protocols and the Eating Disorder Examination (EDE) at pre-treatment, end-of-treatment, and 6-month follow-up (final N = 78). De-coupling was operationalized as a change in momentary associations between negative affect and binge-eating symptoms from pre-treatment to end-of-treatment. RESULTS: There was a significant de-coupling effect at follow-up but not end-of-treatment, and de-coupling did not differ between ICAT-BED and CBTgsh. Less de-coupling was associated with higher end-of-treatment EDE global scores at end-of-treatment and higher binge frequency at follow-up. CONCLUSIONS: Both ICAT-BED and CBTgsh were associated with de-coupling of momentary negative affect and binge-eating symptoms, which in turn relate to cognitive and behavioral treatment outcomes. Future research is warranted to identify differential mechanisms of change across ICAT-BED and CBTgsh. Results also highlight the importance of developing momentary interventions to more effectively de-couple negative affect and binge eating.
Authors: Carol B Peterson; Scott G Engel; Ross D Crosby; Timothy Strauman; Tracey L Smith; Marjorie Klein; Scott J Crow; James E Mitchell; Ann Erickson; Li Cao; Kayla Bjorlie; Stephen A Wonderlich Journal: Int J Eat Disord Date: 2020-06-25 Impact factor: 4.861
Authors: Lindsay P Bodell; Carolyn M Pearson; Kathryn E Smith; Li Cao; Ross D Crosby; Carol B Peterson; Scott J Crow; Kelly C Berg Journal: Eat Behav Date: 2018-12-28
Authors: Carol B Peterson; Kelly C Berg; Ross D Crosby; Jason M Lavender; Erin C Accurso; Anna C Ciao; Tracey L Smith; Marjorie Klein; James E Mitchell; Scott J Crow; Stephen A Wonderlich Journal: Int J Eat Disord Date: 2017-01-24 Impact factor: 4.861
Authors: S A Wonderlich; C B Peterson; R D Crosby; T L Smith; M H Klein; J E Mitchell; S J Crow Journal: Psychol Med Date: 2013-05-23 Impact factor: 7.723
Authors: Joshua M Smyth; Stephen A Wonderlich; Kristin E Heron; Martin J Sliwinski; Ross D Crosby; James E Mitchell; Scott G Engel Journal: J Consult Clin Psychol Date: 2007-08