Bulimia is currently a major health problem in this country. Treatment research has centered on drug therapies (particularly antidepressant therapy) and structured behavioral psychotherapy approaches. This protocol will focus on determining the elements necessary for successful group psychotherapy of bulimia. Although several controlled trials of behavioral psychotherapy have been conducted with bulimic patients, the important logistical and component variables necessary for the effective treatment of this disorder have not been delineated. In particular, the amount of emphasis which should be placed on obtaining abstinence from bulimic symptoms, and the intensity of the treatment necessary to achieve remission of bulimic symptoms, are logistical variables which have not been adequately evaluated, although they have been much debated. Also, the importance of specific behavioral/cognitive behavioral and nutritional components in successful treatment outcome has yet to be evaluated. The current protocol involves two experiments. The first experiment will examine the relative efficacy of levels of emphasis on abstinence (high emphasis, low emphasis) and level of intensity of treatment, using a group psychotherapy approach. The results of the first experiment will be analyzed to determine the efficacy of these various models. The model which is found to be most efficacious, or least costly if no model is superior, will then be continued in the second experiment, wherein component variables, in particular nutritional counseling aspects and behavioral/cognitive behavioral variables, will be varied. The long-term goal of this research is to delineate which process and content variables are necessary to achieve a high rate of success in the outpatient treatment of women with normal weight bulimia.
| Mitchell, J E; Fletcher, L; Hanson, K et al. (2001) The relative efficacy of fluoxetine and manual-based self-help in the treatment of outpatients with bulimia nervosa. J Clin Psychopharmacol 21:298-304 |
| Mitchell, J E; Pyle, R L; Pomeroy, C et al. (1993) Cognitive-behavioral group psychotherapy of bulimia nervosa: importance of logistical variables. Int J Eat Disord 14:277-87 |
| Faris, P L; Raymond, N C; De Zwaan, M et al. (1992) Nociceptive, but not tactile, thresholds are elevated in bulimia nervosa. Biol Psychiatry 32:462-6 |
| Mitchell, J E; Fletcher, L; Gibeau, L et al. (1992) Shoplifting in bulimia nervosa. Compr Psychiatry 33:342-5 |
| Salisbury, J J; Mitchell, J E (1991) Bone mineral density and anorexia nervosa in women. Am J Psychiatry 148:768-74 |
| Mitchell, J E (1991) A review of the controlled trials of psychotherapy for bulimia nervosa. J Psychosom Res 35 Suppl 1:23-31 |
| Mitchell, J E; Pyle, R L; Hatsukami, D et al. (1991) Enema abuse as a clinical feature of bulimia nervosa. Psychosomatics 32:102-4 |
| Pyle, R L; Mitchell, J E; Eckert, E D et al. (1990) Maintenance treatment and 6-month outcome for bulimic patients who respond to initial treatment. Am J Psychiatry 147:871-5 |
| Mitchell, J E; Pyle, R; Eckert, E D et al. (1990) The influence of prior alcohol and drug abuse problems on bulimia nervosa treatment outcome. Addict Behav 15:169-73 |
| Mitchell, J E; Pyle, R L; Eckert, E D et al. (1990) Bulimia nervosa with and without a history of anorexia nervosa. Compr Psychiatry 31:171-5 |
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