Although the available treatment research literature suggests that cognitive behavioral therapy (CBT) is an effective treatment for bulimia nervosa, there is evidence that CBT is often not available to patients outside of research protocols and that most therapists are not trained to deliver this technique. This observation may well hold true for many forms of psychotherapy, and speaks to a growing discrepancy between the manual based therapies that are being developed in academic centers and what is available in clinical practice. This study is designed to examine two treatment sequences to bulimia nervosa. The first includes cognitive behavior therapy, coupled to fluoxetine treatment for those who fail to respond to CBT alone, a treatment package that is currently the state-of- the-art treatment for this condition. The second sequence will be a potentially cost-effective stepped treatment approach comprising the use of supervised self-help followed by the use of antidepressant medication (fluoxetine) if remission isn't attained with self-help, and finally followed by CBT, if remission isn't attained with drug therapy. The first two steps could be made widely available in areas where patients currently have no ready access to CBT specific for bulimia nervosa, with referral for CBT for the more treatment resistant cases. We are proposing a sample size of 324 subjects. Considering the sample size requirements for this study, we are proposing a multisite study wherein patients will be recruited and treated at 4 treatment sites, one of which includes the data center. The treatment sites chosen range from large urban areas (e.g., New York City), to small city (e.g., Fargo) which draws extensively from rural areas. This strategy will also allow us to target enhanced minority recruitment. Outcomes of interest include the relative effectiveness of the 2 intervention strategies, their cost-effectiveness, their ability to successfully hold patients in therapy and prevent attrition, and their ability to prevent the need for further treatment for those successfully treated (relapse prevention).

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH059100-02
Application #
6392580
Study Section
Special Emphasis Panel (ZMH1-ITV-D (01))
Program Officer
Niederehe, George T
Project Start
2000-06-15
Project End
2005-03-31
Budget Start
2001-04-01
Budget End
2002-03-31
Support Year
2
Fiscal Year
2001
Total Cost
$338,125
Indirect Cost
Name
Neuropsychiatric Research Institute
Department
Type
DUNS #
City
Fargo
State
ND
Country
United States
Zip Code
58103
Mason, Tyler B; Lavender, Jason M; Wonderlich, Stephen A et al. (2016) The role of interpersonal personality traits and reassurance seeking in eating disorder symptoms and depressive symptoms among women with bulimia nervosa. Compr Psychiatry 68:165-71
Smith, Christina E; Pisetsky, Emily M; Wonderlich, Stephen A et al. (2016) Is childhood trauma associated with lifetime suicide attempts in women with bulimia nervosa? Eat Weight Disord 21:199-204
Pisetsky, Emily M; Wonderlich, Stephen A; Crosby, Ross D et al. (2015) Depression and Personality Traits Associated With Emotion Dysregulation: Correlates of Suicide Attempts in Women with Bulimia Nervosa. Eur Eat Disord Rev 23:537-44
Brownstone, Lisa M; Bardone-Cone, Anna M; Fitzsimmons-Craft, Ellen E et al. (2013) Subjective and objective binge eating in relation to eating disorder symptomatology, negative affect, and personality dimensions. Int J Eat Disord 46:66-76
Brownstone, Lisa M; Fitzsimmons-Craft, Ellen E; Wonderlich, Stephen A et al. (2013) Hard exercise, affect lability, and personality among individuals with bulimia nervosa. Eat Behav 14:413-9
Mitchell, James E; Agras, Stewart; Crow, Scott et al. (2011) Stepped care and cognitive-behavioural therapy for bulimia nervosa: randomised trial. Br J Psychiatry 198:391-7
Bardone-Cone, A M; Joiner Jr, T E; Crosby, R D et al. (2008) Examining a psychosocial interactive model of binge eating and vomiting in women with bulimia nervosa and subthreshold bulimia nervosa. Behav Res Ther 46:887-94
Bardone-Cone, Anna M; Maldonado, Christine R; Crosby, Ross D et al. (2008) Revisiting differences in individuals with bulimia nervosa with and without a history of anorexia nervosa: Eating pathology, personality, and maltreatment. Int J Eat Disord 41:697-704
Peterson, Carol B; Crosby, Ross D; Wonderlich, Stephen A et al. (2007) Psychometric properties of the eating disorder examination-questionnaire: factor structure and internal consistency. Int J Eat Disord 40:386-9
Steffen, Kristine J; Mitchell, James E; Roerig, James L et al. (2007) The eating disorders medicine cabinet revisited: a clinician's guide to ipecac and laxatives. Int J Eat Disord 40:360-8

Showing the most recent 10 out of 25 publications