Abstract

Bulimia nervosa is a significant, perhaps growing, health problem in young women, and is associated with potentially serious medical and psychological problems. Recent controlled studies suggest that both psychotherapeutic and psychopharmacologic treatments for bulimia nervosa are effective. Thus the aim of this study is to examine the comparative and additive efficacy of these two different approaches to treatment.
A second aim i s to determine whether the more cost-effective group based treatment is as effective as individually administered treatment. Two studies are proposed. In the first, 90 women with bulimia nervosa will be allocated at random to three conditions: Cognitive-behavioral treatment individually administered; pharmacological treatment (desipramine hydrochloride); and the combination of these two treatments. After 16 weeks of treatment, a randomly chosen half of the participants receiving medication will be withdrawn, and those continuing to take medication will be withdrawn at 24 weeks. In the second study, 30 women with bulimia nervosa will, in addition, be allocated at random to group administered cognitive-behavioral treatment, the comparison of interest being between individual and group administered cognitive-behavioral treatments. A multi-level assessment will be carried out before treatment, and at 6, 16, 24, 32, 50, and 68 weeks. Measures will include self- report of binge eating and purging, direct observation of eating behavior, a computer-assisted measure of body image distortion, measures of depression, anxiety, fear of weight gain, self- efficacy, and bulimic thinking, weight change, and serum amylase levels. Selected measures will be repeated more frequently to allow the process of recovery with the different therapies to be documented. The findings from this study may throw light not only on the treatment of bulimia nervosa, but on the treatment of other eating disorders such as anorexia nervosa with bulimia, and binge eating in the obese.

  Funding Agency

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
2R01MH038637-04
Application #
3376747
Study Section
Treatment Development and Assessment Research Review Committee (TDA)
Project Start
1984-08-01
Project End
1990-07-31
Budget Start
1987-08-01
Budget End
1988-07-31
Support Year
4
Fiscal Year
1987
Total Cost
Indirect Cost

  Institution

Name
Stanford University
Department
Type
Schools of Medicine
DUNS #
800771545
City
Stanford
State
CA
Country
United States
Zip Code
94305

  Publications

Eldredge, K L; Stewart Agras, W; Arnow, B et al. (1997) The effects of extending cognitive-behavioral therapy for binge eating disorder among initial treatment nonresponders. Int J Eat Disord 21:347-52
Agras, W S (1997) Pharmacotherapy of bulimia nervosa and binge eating disorder: longer-term outcomes. Psychopharmacol Bull 33:433-6
Agras, W S; Telch, C F; Arnow, B et al. (1997) One-year follow-up of cognitive-behavioral therapy for obese individuals with binge eating disorder. J Consult Clin Psychol 65:343-7
Koran, L M; Agras, W S; Rossiter, E M et al. (1995) Comparing the cost effectiveness of psychiatric treatments: bulimia nervosa. Psychiatry Res 58:13-21
Arnow, B; Kenardy, J; Agras, W S (1995) The Emotional Eating Scale: the development of a measure to assess coping with negative affect by eating. Int J Eat Disord 18:79-90
Agras, W S; Telch, C F; Arnow, B et al. (1995) Does interpersonal therapy help patients with binge eating disorder who fail to respond to cognitive-behavioral therapy? J Consult Clin Psychol 63:356-60
Telch, C F; Agras, W S (1994) Obesity, binge eating and psychopathology: are they related? Int J Eat Disord 15:53-61
Agras, W S; Rossiter, E M; Arnow, B et al. (1994) One-year follow-up of psychosocial and pharmacologic treatments for bulimia nervosa. J Clin Psychiatry 55:179-83
Rossiter, E M; Agras, W S; Telch, C F et al. (1993) Cluster B personality disorder characteristics predict outcome in the treatment of bulimia nervosa. Int J Eat Disord 13:349-57
Agras, W S; Rossiter, E M; Arnow, B et al. (1992) Pharmacologic and cognitive-behavioral treatment for bulimia nervosa: a controlled comparison. Am J Psychiatry 149:82-7

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