Predictors of online guided self-help CBT-E for binge eating disorder

Abstract

Introduction: Online self-guided help cognitive behavioral therapy enhanced (GSH-CBT-E) is an effective treatment for patients diagnosed with Binge Eating Disorder (BED). However, due to its novelty, predictors of its outcome still remain unexplored. The aim of this study is to examine whether Body Mass Index (BMI) and Clinical Impairment at baseline predict treatment outcome at end of treatment, with regard to eating disorder pathology.

Methods: BMI was measured by the Eating Disorder Examination Questionnaire (EDE-Q), as was eating disorder pathology, whilst Clinical Impairment was measured by the Clinical Impairment Assessment questionnaire (CIA). A stepwise multiple regression analysis was performed (N=186), with BMI and CIA scores as predictors and EDE-Q scores as the dependent variable (treatment outcome). Subsequently, the analysis was repeated involving the CIA subscales instead of its total score to examine whether CIA’s different subscales (Social, Cognitive, and Personal impairment) predicted treatment outcome.

Results: Clinical Impairment was found to be a medium positive predictor of eating disorder pathology scores ([β=,422], [p<.001]), and thus, a negative predictor of treatment outcome, meaning that the higher the Clinical Impairment, the greater the eating disorder pathology, and the poorer the outcome will be. The succeeding analysis indicated that only the Personal Impairment subscale is also a medium positive predictor of eating disorder pathology ([β=.431, p<.001]), and consequently, a negative predictor of treatment outcome.

Conclusion: These encouraging results could be helpful for the clinical BED-diagnosed population, improving the efficacy of treatment by allowing therapists to know in advance which patients are at risk of a poor outcome, and decide whether or not to use this treatment for each specific patient. Since no other studies have been found to investigate Clinical Impairment as a predictor of online GSH-CBT-E treatment outcome regarding eating disorder pathology, further research is needed to generalize and consolidate these findings.