Predictors of therapy dropout and psychometric changes in personality in binge eating disorder following cognitive behavioural therapy

Abstract

Binge eating disorder (BED) is a recent addition to the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). There is limited clinical data in research literature about this disorder and how it is treated. Several studies have been done to examine predictors of therapy dropout for other eating disorders but very few have been done on BED specifically. The current study sought to better understand which factors would predict therapy dropout in a population of BED clients. A group with BED took part in a 20-week course of group-based CBT in an eating disorders program and approximately two thirds of these clients did not complete the full course. The clients’ self-reported levels of depression, anxiety, coping strategy preferences for stressful situations, and eating disorder symptomology were measured before and after the CBT course and the goal of this study was to examine if differing levels of pre-treatment symptoms could predict a client’s likelihood for successfully completing CBT. This study also examined the post-treatment changes in binge eating frequency, coping strategies, state and trait anxiety, eating disorder symptomology and depression. Overall, no significant predictors of therapy dropout were identified. Other findings showed that after their treatment the clients who remained in treatment reported less eating disorder symptomology, depression, endorsed fewer emotional coping strategies and more task-oriented coping strategies, and reported fewer binge eating episodes. A correlation between time spent in treatment and a reduction in binge eating episodes was also found. While no predictors of therapy dropout were found in these pre-treatment measures, this study suggests that clients who completed treatment had several positive outcomes, and it highlights the need for further investigation into alternative screening methods for treatment retention beyond quantitative tests.