Depressive Symptoms Rather Than Executive Functioning Predict Group Cognitive Behavioural Therapy Outcome in Binge Eating Disorder

Overview

Journal Eur Eat Disord Rev

Publisher Wiley

Specialty Nutritional Sciences

Date 2020 Jul 22

PMID 32692421

Citations 10

Authors

Alexandra E Dingemans

Gabrielle E van Son

Christine B Vanhaelen

Eric F van Furth

Affiliations

Soon will be listed here.

Abstract

Executive functions play an important role in mediating self-control and self-regulation. It has been suggested that the inability to control eating in Binge Eating Disorder (BED) may indicate inefficiencies in executive functioning. This study investigated whether executive functioning predicted cognitive behavioural therapy outcome in BED while accounting for other possible predictors: depressive symptoms, interpersonal factors, eating disorder psychopathology, and self-esteem. Executive functioning and other predictors were assessed in 91 patients with BED by means of neuropsychological tests and questionnaires at baseline. Eating disorder (ED) symptoms were assessed during treatment at variable time points. Potential predictor variables were investigated using multivariate Cox regression models. Recovery was defined by means of two different indicators based on the Eating Disorder Examination-Questionnaire: (a) showing a 50% reduction in baseline symptom ED severity and/or reaching the clinical significance cut-off; and (b) achieving abstinence of objective binge eating. Severity of depressive symptoms was a significant predictor for outcome on both indicators. Patients with no or mild depressive symptoms recovered faster (i.e., 50% reduction in ED symptoms and abstinence of objective binge eating) than those with severe depressive symptoms, which is in line with previous studies. Executive functioning was not related to treatment outcome in this study.

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References

Hilbert A, Bishop M, Stein R, Tanofsky-Kraff M, Swenson A, Welch R . Long-term efficacy of psychological treatments for binge eating disorder. Br J Psychiatry. 2012; 200(3):232-7. PMC: 3290797. DOI: 10.1192/bjp.bp.110.089664. View

Keller M, Lavori P, Friedman B, Nielsen E, Endicott J, Andreasen N . The Longitudinal Interval Follow-up Evaluation. A comprehensive method for assessing outcome in prospective longitudinal studies. Arch Gen Psychiatry. 1987; 44(6):540-8. DOI: 10.1001/archpsyc.1987.01800180050009. View

Engel S, Crosby R, Thomas G, Bond D, Lavender J, Mason T . Ecological Momentary Assessment in Eating Disorder and Obesity Research: a Review of the Recent Literature. Curr Psychiatry Rep. 2016; 18(4):37. DOI: 10.1007/s11920-016-0672-7. View

Penas-Lledo E, Aguera Z, Sanchez I, Gunnard K, Jimenez-Murcia S, Fernandez-Aranda F . Differences in cognitive behavioral therapy dropout rates between bulimia nervosa subtypes based on drive for thinness and depression. Psychother Psychosom. 2013; 82(2):125-6. DOI: 10.1159/000339620. View

Schmitt D, Allik J . Simultaneous administration of the Rosenberg Self-Esteem Scale in 53 nations: exploring the universal and culture-specific features of global self-esteem. J Pers Soc Psychol. 2005; 89(4):623-42. DOI: 10.1037/0022-3514.89.4.623. View

Lena S, Fiocco A, Leyenaar J . The role of cognitive deficits in the development of eating disorders. Neuropsychol Rev. 2004; 14(2):99-113. DOI: 10.1023/b:nerv.0000028081.40907.de. View

Bechara A, Damasio A, Damasio H, Anderson S . Insensitivity to future consequences following damage to human prefrontal cortex. Cognition. 1994; 50(1-3):7-15. DOI: 10.1016/0010-0277(94)90018-3. View

Dahlgren C, Hage T, Wonderlich J, Stedal K . General and Eating Disorder Specific Flexibility: Development and Validation of the Eating Disorder Flexibility Index (EDFLIX) Questionnaire. Front Psychol. 2019; 10:663. PMC: 6454114. DOI: 10.3389/fpsyg.2019.00663. View

Keel P, Brown T . Update on course and outcome in eating disorders. Int J Eat Disord. 2010; 43(3):195-204. DOI: 10.1002/eat.20810. View

10.

Dingemans A, Vanhaelen C, Aardoom J, van Furth E . The influence of depressive symptoms on executive functioning in binge eating disorder: A comparison of patients and non-obese healthy controls. Psychiatry Res. 2019; 274:138-145. DOI: 10.1016/j.psychres.2019.02.033. View

11.

Dingemans A, Spinhoven P, van Furth E . Predictors and mediators of treatment outcome in patients with binge eating disorder. Behav Res Ther. 2007; 45(11):2551-62. DOI: 10.1016/j.brat.2007.06.003. View

12.

Blijd-Hoogewys E, Bezemer M, van Geert P . Executive functioning in children with ASD: an analysis of the BRIEF. J Autism Dev Disord. 2014; 44(12):3089-100. DOI: 10.1007/s10803-014-2176-9. View

13.

Bjork T, Clinton D, Norring C . The impact of different outcome measures on estimates of remission in a 3-year follow-up of eating disorders. Eur Eat Disord Rev. 2010; 19(1):2-11. DOI: 10.1002/erv.1031. View

14.

Voon V . Cognitive biases in binge eating disorder: the hijacking of decision making. CNS Spectr. 2015; 20(6):566-73. PMC: 4697296. DOI: 10.1017/S1092852915000681. View

15.

Manasse S, Juarascio A, Forman E, Berner L, Butryn M, Ruocco A . Executive functioning in overweight individuals with and without loss-of-control eating. Eur Eat Disord Rev. 2014; 22(5):373-7. PMC: 4133293. DOI: 10.1002/erv.2304. View

16.

Grilo C, Masheb R, Crosby R . Predictors and moderators of response to cognitive behavioral therapy and medication for the treatment of binge eating disorder. J Consult Clin Psychol. 2012; 80(5):897-906. PMC: 3342441. DOI: 10.1037/a0027001. View

17.

Castellini G, Mannucci E, Lo Sauro C, Benni L, Lazzeretti L, Ravaldi C . Different moderators of cognitive-behavioral therapy on subjective and objective binge eating in bulimia nervosa and binge eating disorder: a three-year follow-up study. Psychother Psychosom. 2011; 81(1):11-20. DOI: 10.1159/000329358. View

18.

Van den Eynde F, Guillaume S, Broadbent H, Stahl D, Campbell I, Schmidt U . Neurocognition in bulimic eating disorders: a systematic review. Acta Psychiatr Scand. 2011; 124(2):120-40. DOI: 10.1111/j.1600-0447.2011.01701.x. View

19.

Hybel K, Mortensen E, Lambek R, Hojgaard D, Thomsen P . Executive function predicts cognitive-behavioral therapy response in childhood obsessive-compulsive disorder. Behav Res Ther. 2017; 99:11-18. DOI: 10.1016/j.brat.2017.08.009. View

20.

Jacobson N, Truax P . Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. J Consult Clin Psychol. 1991; 59(1):12-9. DOI: 10.1037//0022-006x.59.1.12. View