Paakhi Srivastava1, Megan N Parker2,3, Emily K Presseller1,4, Olivia B Wons1,4, Kelsey E Clark1,4, Adrienne S Juarascio1,4. 1. Center for Weight Eating and Lifestyle Science (Well Center), Drexel University, Philadelphia, Pennsylvania, USA. 2. Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (Usu), Bethesda, Maryland, USA. 3. Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Division of Intramural Research, National Institutes of Health (Nih), Bethesda, Maryland, USA. 4. Department of Psychological and Brain Sciences, Drexel University, Philadelphia, Pennsylvania, USA.
Abstract
INTRODUCTION: Homework assignments are considered key components of behavioral treatments for bulimia nervosa (BN), but little is known about whether homework compliance predicts BN symptom improvement. The present study is the first to examine whether session-by-session change in homework compliance predicts session-by-session changes in BN symptoms during behavioral treatment. METHOD: Patients with BN-spectrum eating disorders (n = 42) received 20 sessions of behavioral treatment. Each session, their clinicians completed surveys assessing compliance with self-monitoring, behavioral, and written homework assignments and BN symptom frequency during the previous week. RESULTS: Significant between-persons effects of self-monitoring and behavioral homework compliance were identified, such that patients with greater compliance in the past week experienced greater reductions in binge eating and purging the following week. There were significant within-persons effects of self-monitoring compliance on binge eating and behavioral homework compliance on restrictive eating, binge eating, and purging, such that greater than one's usual compliance predicted greater improvements in BN symptoms the following week. No significant effects of written homework compliance were identified. CONCLUSION: Compliance with self-monitoring and behavioral homework predict improvements in BN symptoms during behavioral treatment. These findings reinforce the importance of self-monitoring and behavioral homework compliance as drivers of change during treatment for BN.
INTRODUCTION: Homework assignments are considered key components of behavioral treatments for bulimia nervosa (BN), but little is known about whether homework compliance predicts BN symptom improvement. The present study is the first to examine whether session-by-session change in homework compliance predicts session-by-session changes in BN symptoms during behavioral treatment. METHOD: Patients with BN-spectrum eating disorders (n = 42) received 20 sessions of behavioral treatment. Each session, their clinicians completed surveys assessing compliance with self-monitoring, behavioral, and written homework assignments and BN symptom frequency during the previous week. RESULTS: Significant between-persons effects of self-monitoring and behavioral homework compliance were identified, such that patients with greater compliance in the past week experienced greater reductions in binge eating and purging the following week. There were significant within-persons effects of self-monitoring compliance on binge eating and behavioral homework compliance on restrictive eating, binge eating, and purging, such that greater than one's usual compliance predicted greater improvements in BN symptoms the following week. No significant effects of written homework compliance were identified. CONCLUSION: Compliance with self-monitoring and behavioral homework predict improvements in BN symptoms during behavioral treatment. These findings reinforce the importance of self-monitoring and behavioral homework compliance as drivers of change during treatment for BN.
Authors: Christopher G Fairburn; W Stewart Agras; B Timothy Walsh; G Terence Wilson; Eric Stice Journal: Am J Psychiatry Date: 2004-12 Impact factor: 18.112
Authors: Glen I Spielmans; Steven G Benish; Catherine Marin; Wesley M Bowman; Maria Menster; Anthony J Wheeler Journal: Clin Psychol Rev Date: 2013-01-28