scholarly journals A Group’s Level of Defensive Functioning Affects Individual Outcomes in Group Psychodynamic-Interpersonal Psychotherapy

2022 ◽  
Author(s):  
James Christopher Wiley
Keyword(s):  
Binge Eating ◽  
Treatment Outcomes ◽  
Therapy Group ◽  
Interpersonal Psychotherapy ◽  
Post Treatment ◽  
Individual Group ◽  
Eating Frequency ◽  
Interpersonal Distress ◽  
Defensive Functioning ◽  
Group Members

We used an actor–partner interdependence model (APIM) to study the association between the individual group member and other group therapy members’ defensive functioning on an individual group member’s treatment outcome. We hypothesized that (a) more adaptive individual defensive functioning at pretreatment will be significantly related to better treatment outcomes (i.e., lower binge eating and interpersonal distress) at 6 months post-treatment; and (b) more adaptive other group members’ defensive functioning at pretreatment will be significantly related to better treatment outcomes at 6 months post-treatment. Participants (N = 136) were individuals with BED enrolled in group psychodynamic-interpersonal psychotherapy (GPIP). Participants completed attachment interviews and were assessed on interpersonal distress and days binged at pre-treatment and 6 months post-treatment. The interview audio recordings were transcribed and used to code defensive functioning. We found that individual overall defensive functioning (ODF) scores at pretreatment were not significantly associated with binge-eating frequency or interpersonal distress at 6 months post treatment. Other group members’ mean ODF scores at pretreatment were significantly associated with individual interpersonal distress at 6 months post-treatment. However, the other group members’ mean ODF scores were not significantly associated with individual binge-eating outcomes at 6 months post treatment. Defensive functioning of other members of a therapy group may be particularly important for improving interpersonal functioning in individuals with BED.

Change in impulsivity is prospectively associated with treatment outcomes for binge-eating disorder

2021 ◽  
pp. 1-9
Author(s):  
Rebecca G. Boswell ◽  
Ralitza Gueorguieva ◽  
Carlos M. Grilo
Keyword(s):  
Eating Disorder ◽  
Binge Eating ◽  
Treatment Outcomes ◽  
Binge Eating Disorder ◽  
Pharmacological Treatment ◽  
Rapid Change ◽  
Post Treatment ◽  
Controlled Clinical Trial ◽  
Eating Disorder Psychopathology

Abstract Background Impulsivity may be a process underlying binge-eating disorder (BED) psychopathology and its treatment. This study examined change in impulsivity during cognitive-behavioral therapy (CBT) and/or pharmacological treatment for BED and associations with treatment outcomes. Methods In total, 108 patients with BED (NFEMALE = 84) in a randomized placebo-controlled clinical trial evaluating the efficacy of CBT and/or fluoxetine were assessed before treatment, monthly throughout treatment, at post-treatment (16 weeks), and at 12-month follow-up after completing treatment. Patients completed established measures of impulsivity, eating-disorder psychopathology, and depression, and were measured for height and weight [to calculate body mass index (BMI)] during repeated assessments by trained/monitored doctoral research-clinicians. Mixed-effects models using all available data examined changes in impulsivity and the association of rapid and overall changes in impulsivity on treatment outcomes. Exploratory analyses examined whether baseline impulsivity predicted/moderated outcomes. Results Impulsivity declined significantly throughout treatment and follow-up across treatment groups. Rapid change in impulsivity and overall change in impulsivity during treatment were significantly associated with reductions in eating-disorder psychopathology, depression scores, and BMI during treatment and at post-treatment. Overall change in impulsivity during treatment was associated with subsequent reductions in depression scores at 12-month follow-up. Baseline impulsivity did not moderate/predict eating-disorder outcomes or BMI but did predict change in depression scores. Conclusions Rapid and overall reductions in impulsivity during treatment were associated with improvements in specific eating-disorder psychopathology and associated general outcomes. These effects were found for both CBT and pharmacological treatment for BED. Change in impulsivity may be an important process prospectively related to treatment outcome.

Psychiatric comorbidity as predictor and moderator of binge-eating disorder treatment outcomes: an analysis of aggregated randomized controlled trials

2021 ◽  
pp. 1-9
Author(s):  
Janet A. Lydecker ◽  
Carlos M. Grilo
Keyword(s):  
Weight Loss ◽  
Eating Disorder ◽  
Binge Eating ◽  
Treatment Outcomes ◽  
Binge Eating Disorder ◽  
Psychiatric Comorbidity ◽  
Controlled Trials ◽  
Eating Frequency ◽  
Randomized Controlled ◽  
Eating Disorder Psychopathology

Abstract Background Psychiatric comorbidity is common in binge-eating disorder (BED) but effects on treatment outcomes are unknown. The current study aimed to determine whether psychiatric comorbidity predicted or moderated BED treatment outcomes. Methods In total, 636 adults with BED in randomized-controlled trials (RCTs) were assessed prior, throughout, and posttreatment by doctoral research-clinicians using reliably-administered semi-structured interviews, self-report measures, and measured weight. Data were aggregated from RCTs testing cognitive-behavioral therapy, behavioral weight loss, multi-modal (combined pharmacological plus cognitive-behavioral/behavioral), and/or control conditions. Intent-to-treat analyses (all available data) tested comorbidity (mood, anxiety, ‘any disorder’ separately) as predictors and moderators of outcomes. Mixed-effects models tested comorbidity effects on binge-eating frequency, global eating-disorder psychopathology, and weight. Generalized estimating equation models tested binge-eating remission (zero binge-eating episodes during the past month; missing data imputed as failure). Results Overall, 41% of patients had current psychiatric comorbidity; 22% had mood and 23% had anxiety disorders. Psychiatric comorbidity did not significantly moderate the outcomes of specific treatments. Psychiatric comorbidity predicted worse eating-disorder psychopathology and higher binge-eating frequency across all treatments and timepoints. Patients with mood comorbidity were significantly less likely to remit than those without mood disorders (30% v. 41%). Psychiatric comorbidity neither predicted nor moderated weight loss. Conclusions Psychiatric comorbidity was associated with more severe BED psychopathology throughout treatment but did not moderate outcomes. Findings highlight the need to improve treatments for BED with psychiatric comorbidities but challenge perspectives that combining existing psychological and pharmacological interventions is warranted. Treatment research must identify more effective interventions for BED overall and for patients with comorbidities.

The codevelopment of group relationships: The role of individual group member’s and other group members’ mutual influence and shared group environment.

2019 ◽  
Vol 66 (5) ◽  
pp. 640-649 ◽  
Author(s):  
Gianluca Lo Coco ◽  
Salvatore Gullo ◽  
Gabriele Profita ◽  
Chiara Pazzagli ◽  
Claudia Mazzeschi ◽  
...  
Keyword(s):  
Mutual Influence ◽  
Individual Group ◽  
Group Environment ◽  
Group Members ◽  
Group Relationships

The Epistemology of Groups

2020 ◽  
Author(s):  
Jennifer Lackey
Keyword(s):  
Group Level ◽  
Social Significance ◽  
Individual Group ◽  
Key Concepts ◽  
Normative Requirements ◽  
Group Members ◽  
The Individual ◽  
Belief Justification ◽  
In Virtue Of ◽  
Trump Administration

Groups are often said to bear responsibility for their actions, many of which have enormous moral, legal, and social significance. The Trump Administration, for instance, is said to be responsible for the U.S.’s inept and deceptive handling of COVID-19 and the harms that American citizens have suffered as a result. But are groups subject to normative assessment simply in virtue of their individual members being so, or are they somehow agents in their own right? Answering this question depends on understanding key concepts in the epistemology of groups, as we cannot hold the Trump Administration responsible without first determining what it believed, knew, and said. Deflationary theorists hold that group phenomena can be understood entirely in terms of individual members and their states. Inflationary theorists maintain that group phenomena are importantly over and above, or otherwise distinct from, individual members and their states. It is argued that neither approach is satisfactory. Groups are more than their members, but not because they have “minds of their own,” as the inflationists hold. Instead, this book shows how group phenomena—like belief, justification, and knowledge—depend on what the individual group members do or are capable of doing while being subject to group-level normative requirements. This framework, it is argued, allows for the correct distribution of responsibility across groups and their individual members.

scholarly journals Translating Virtual Reality Cue Exposure Therapy for Binge Eating into a Real-World Setting: An Uncontrolled Pilot Study

2021 ◽  
Vol 10 (7) ◽  
pp. 1511
Author(s):  
Katherine Nameth ◽  
Theresa Brown ◽  
Kim Bullock ◽  
Sarah Adler ◽  
Giuseppe Riva ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Eating Disorder ◽  
Binge Eating ◽  
Real World ◽  
Exposure Therapy ◽  
Post Treatment ◽  
Cue Exposure ◽  
Treatment Gains ◽  
Intent To Treat

Binge-eating disorder (BED) and bulimia nervosa (BN) have adverse psychological and medical consequences. Innovative interventions, like the integration of virtual reality (VR) with cue-exposure therapy (VR-CET), enhance outcomes for refractory patients compared to cognitive behavior therapy (CBT). Little is known about the feasibility and acceptability of translating VR-CET into real-world settings. To investigate this question, adults previously treated for BED or BN with at least one objective or subjective binge episode/week were recruited from an outpatient university eating disorder clinic to receive up to eight weekly one-hour VR-CET sessions. Eleven of 16 (68.8%) eligible patients were enrolled; nine (82%) completed treatment; and 82% (9/11) provided follow-up data 7.1 (SD = 2.12) months post-treatment. Overall, participant and therapist acceptability of VR-CET was high. Intent-to-treat objective binge episodes (OBEs) decreased significantly from 3.3 to 0.9/week (p < 0.001). Post-treatment OBE 7-day abstinence rate for completers was 56%, with 22% abstinent for 28 days at follow-up. Among participants purging at baseline, episodes decreased from a mean of one to zero/week, with 100% abstinence maintained at follow-up. The adoption of VR-CET into real-world clinic settings appears feasible and acceptable, with a preliminary signal of effectiveness. Findings, including some loss of treatment gains during follow-up may inform future treatment development.

scholarly journals Can we change binge eating behaviour by interventions addressing food-related impulsivity? A systematic review

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Başak İnce ◽  
Johanna Schlatter ◽  
Sebastian Max ◽  
Christian Plewnia ◽  
Stephan Zipfel ◽  
...  
Keyword(s):  
Systematic Review ◽  
Binge Eating ◽  
Inhibitory Control ◽  
Eating Behaviour ◽  
Treatment Modalities ◽  
Computer Assisted ◽  
Food Craving ◽  
Eligibility Criteria ◽  
Eating Frequency ◽  
Close Relationship

Abstract Background An extensive amount of research has underlined the potential role of impulsivity in the development and maintenance of binge eating behaviour. Food-related impulsivity has particularly received attention given its close relationship with overeating and binge eating episodes. Besides the available evidence, our understanding regarding the effectiveness of treatment modalities for binge eating targeting impulsivity and related constructs (e.g., food craving, inhibitory control, and reward sensitivity) is limited. Thus, this systematic review aimed to investigate whether binge eating behaviour is changeable by interventions that are impulsivity-focused and food-related and whether one of these interventions is superior to the others. Method A search on PubMed and PsycINFO was performed for relevant articles published up to September 2020. Studies delivering food-related impulsivity treatment to individuals suffering from binge eating episodes and including a control condition without this treatment were investigated. Following the search, 15 studies meeting the eligibility criteria were analysed. Results Analyses revealed that available impulsivity-focused approaches can be categorised as psychotherapy, pharmacotherapy, computer-assisted cognitive training, and direct neuromodulation interventions. Regarding their effectiveness, it appeared that all of these approaches might be promising to change food-related impulsivity in individuals with binge eating episodes, particularly to decrease binge eating symptoms. However, a superior intervention approach in this early state of evidence could not be determined, although food-related cue exposure, transcranial direct current stimulation, and the combination of several interventions seem fruitful. Conclusion Efforts to treat binge eating behaviour with interventions focusing on food-related impulsivity appear to be promising, particularly concerning binge eating frequency, and also for food craving and inhibitory control. Given limited research and varying methods, it was not possible to conclude whether one impulsivity-focused intervention can be considered superior to others.

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