Transdiagnostic Cognitive-Behavioral Therapy for Patients With Eating Disorders: A Two-Site Trial With 60-Week Follow-Up

By C. Fairburn, Z. Cooper, H. Doll, M. O'Connor, Kristin Bohn, D. Hawker, Jackie A Wales, R. Palmer. American Journal of Psychiatry, 2008

764 citations recorded by the source corpus.

Objective The aim of this study was to compare two cognitive-behavioral treatments for outpatients with eating disorders, one focusing solely on eating disorder features and the other a more complex treatment that also addresses mood intolerance, clinical perfectionism, low self-esteem, or interpersonal difficulties. Method A total of 154 patients who had a DSM-IV eating disorder but were not markedly underweight (body mass index over 17.5), were enrolled in a two-site randomized controlled trial involving 20 weeks of treatment and a 60-week closed period of follow-up. The control condition was an 8-week waiting list period preceding treatment. Outcomes were measured by independent assessors who were blind to treatment condition. Results Patients in the waiting list control condition exhibited little change in symptom severity, whereas those in the two treatment conditions exhibited substantial and equivalent change, which was well maintained during follow-up. At the 60-week follow-up assessment, 51.3% of the sample had a level of eating disorder features less than one standard deviation above the community mean. Treatment outcome did not depend on eating disorder diagnosis. Patients with marked mood intolerance, clinical perfectionism, low self-esteem, or interpersonal difficulties appeared to respond better to the more complex treatment, with the reverse pattern evident among the remaining patients. Conclusions These two transdiagnostic treatments appear to be suitable for the majority of outpatients with an eating disorder. The simpler treatment may best be viewed as the default version, with the more complex treatment reserved for patients with marked additional psychopathology of the type targeted by the treatment.

Subfields: Clinical Psychology

View Paper: https://www.semanticscholar.org/paper/36e0fa2807a756056ec5fffce299421dd0e072da

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In Clinical Psychology

1. S. Egan
2. Roz Shafran
3. T. Wade
4. M. Gallagher
5. S. Sauer‐Zavala
6. J. Bullis
7. Jenna R Carl
8. K. Ellard

Citations in the corpus

• What is an emotional disorder? A transdiagnostic mechanistic definition with implications for assessment, treatment, and prevention (2019, background): “…of transdiagnostic treatments for anxiety (Reinholt & Krogh, 2014), anxiety and depression (McEvoy, Nathan, & Norton, 2009), and eating disorders (Fairburn et al., 2009), with evidence to suggest that outcomes obtained with transdiagnostic protocols are at least comparable to those achieved with…”
• Perfectionism as a transdiagnostic process: a clinical review. (2011, background): “Transdiagnostic CBT-E for eating disorders has been found to be effective (Fairburn et al., 2009).”
• Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: A Randomized Controlled Trial (2012, background): “In what is perhaps the most advanced effort along these lines, Fairburn and colleagues (Fairburn, 2008; Fairburn, Cooper, & Shafran, 2003; Fairburn et al., 2009 ) have developed a transdiagnostic approach to eating disorders based on shared psychological dimensions of these disorders, an approach…”
• The Eating Disorder Examination: a semi-structured interview for the assessment of the specific psychopathology of eating disorders (2014, methodology): “…within one standard deviation of EDE community norms is now being used as a criterion for remission in transdiagnostic treatment studies (e.g. Fairburn et al., 2009), it seems somewhat problematic that, in two recent trials of CBT for AN, 42% of adolescents (Dalle Grave, Calugi, Doll, &…”
• Cognitive Behavior Therapy and Eating Disorders (2008, background): “Results of a two-center treatment trial (Fairburn et al., 2009) indicate that the core CBT-E protocol is more effective for most patients than the so-called “broad” adaptation that includes additional modules.”