Skip to main content
Search
Search
    Quick Search anywhere
    Quick search in Citations
Advanced Search
Skip main navigationClose Drawer MenuOpen Drawer Menu
Previous article
Next article
Themenschwerpunkt

Wirksamkeit eines angeleiteten kognitiv-verhaltenstherapeutischen Selbsthilfeprogramms zur Be­handlung der Binge-Eating-Störung

Published Online:December 20, 2018https://doi.org/10.1024/1661-4747/a000371

Abstract

Zusammenfassung. Das Hauptmerkmal der Binge-Eating-Störung (BES) sind Essanfälle, bei denen Betroffene das Gefühl des Kontrollverlusts erleben und große Mengen an Nahrung in einem abgrenzbaren Zeitraum zu sich nehmen. Essanfälle sind bei der BES nicht gefolgt von ­Kompensationsverhalten, führen zu einem hohen Leidensdruck und sind in vielen Fällen assoziiert mit Übergewicht. Manualisierte kognitiv-­verhaltenstherapeutische Behandlungsprogramme im Einzel- und Gruppensetting zur Therapie der BES haben sich in kontrollierten Studien als wirksam erwiesen. Auf der Grundlage eines etablierten Behandlungsmanuals wurde ein Selbsthilferatgeber für Betroffene publiziert und in der vorliegenden Studie in Rahmen eines buchbasierten angeleiteten Selbsthilfeprogramms (ASH-Programm) unter natürlichen klinischen ­Rahmenbedingungen überprüft. 22 Patienten (21 Frauen, 1 Mann; Durchschnittsalter 35.82 Jahre (SD = 10.35 Jahre)) nahmen am 8-wöchigen ­ASH-Programm zur Behandlung der BES gefolgt von drei Auffrischungssitzungen über 6 Monate teil. Zwei Patienten (9.1 %) beendeten das ­ASH-Programm während der aktiven Behandlungsphase vorzeitigt (Dropout). Die Anzahl wöchentlicher Essanfälle und die Essstörungspsychopathologie (restriktives Essverhalten, Figursorgen, Gewichtssorgen, essensbezogene Sorgen) reduzierten sich bis zum Ende der aktiven Behandlungsphase signifikant. In den Auffrischungssitzungen konnte eine Stabilisierung der erreichten Abnahme an wöchentlichen Essanfällen und Essstörungspsychopathologie verzeichnet werden. Bis zum Ende der Auffrischungssitzungen, 1, 3 und 6 Monate nach dem Ende der aktiven Behandlungsphase nahm zudem auch die allgemeine Psychopathologie (depressive- und Angstsymptomatik) signifikant ab. Die Ergebnisse legen nahe, dass das vorliegende ASH-Programm wirksam für die Behandlung der BES ist.


Efficacy of a cognitive-behavioral guided self-help program for the treatment of binge-eating disorder

Abstract. The main characteristics of binge-eating disorder (BED) are binge-eating episodes during which affected individuals experience loss of control, accompanied by the consumption of large amounts of food in a limited period of time. Binge-eating episodes in BED are not followed by compensatory behavior. Binge-eating is associated with a high degree of distress and in many cases accompanied by overweight. Manualized cognitive-behavioral single and group therapy programs for the treatment of BED have shown high efficacy in controlled studies. Based on a manualized face to face treatment, a self-help book was published and evaluated in the present guided self-help treatment program (gsh-program) in a naturalistic clinical study setting. 22 participants (21 female, 1 male, mean age 35.82 years (SD = 10.35)) followed the 8-week gsh-program with three booster sessions (1, 3 and 6 months after the active treatment). Two participants (9.1 %) prematurely terminated the gsh-program during the treatment phase (dropout). The number of weekly binges and eating disorder pathology (restraint eating, shape- and weight concern and eating concern) significantly decreased until the end of the active treatment. The number of weekly binges and eating disorder pathology remained stable during follow-up. General psychopathology (depressive- and anxiety symptoms) significantly decreased until the end of follow-up, 6 months after the end of active treatment. Findings suggest that the present gsh-program is an efficacious option for the treatment of BES.

Literatur

  • Aardoom, J. J., Dingemans, A. E., Spinhoven, P. & Van Furth, E. F. (2013). Treating eating disorders over the internet: a systematic review and future research directions. International Journal of Eating Disorders, 46, 539 – 552. First citation in articleCrossref, Google Scholar

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author. First citation in articleGoogle Scholar

  • Beintner, I., Jacobi, C. & Schmidt, U. H. (2014). Participation and outcome in manualized self-help for bulimia nervosa and binge eating disorder – a systematic review and metaregression analysis. Clinical Psychology Review, 34, 158 – 176. First citation in articleCrossref, Google Scholar

  • Carrard, I., Crepin, C., Rouget, P., Lam, T., Golay, A. & Van der Linden, M. (2011). Randomised controlled trial of a guided self-help treatment on the Internet for binge eating disorder. Behaviour Research and Therapy, 49, 482 – 491. First citation in articleCrossref, Google Scholar

  • Carrard, I., Crepin, C., Rouget, P., Lam, T., Van der Linden, M. & Golay, A. (2011). Acceptance and efficacy of a guided internet self-help treatment program for obese patients with binge eating dis­order. Clinical Practice & Epidemiology in Mental Health, 7, 8 – 18. First citation in articleCrossref, Google Scholar

  • Davis, C., Levitan, R. D., Smith, M., Tweed, S. & Curtis, C. (2006). ­Associations among overeating, overweight, and attention deficit / hyperactivity disorder: a structural equation modelling ­approach. Eating Behaviors, 7, 266 – 274. First citation in articleCrossref, Google Scholar

  • de Zwaan, M., Herpertz, S., Zipfel, S., Svaldi, J., Friederich, H. C., Schmidt, F., … Hilbert, A. (2017). Effect of Internet-Based Guided Self-help vs Individual Face-to-Face Treatment on Full or Subsyndromal Binge Eating Disorder in Overweight or Obese Patients: The INTERBED Randomized Clinical Trial. JAMA Psychiatry, 74, 987 – 995. First citation in articleCrossref, Google Scholar

  • de Zwaan, M., Herpertz, S., Zipfel, S., Tuschen-Caffier, B., ­Friederich, H. C., Schmidt, F., … Hilbert, A. (2012). INTERBED: ­internet-based guided self-help for overweight and obese ­pa­tients with full or subsyndromal binge eating disorder. A ­multicenter randomized controlled trial. Trials, 13, 220. First citation in articleCrossref, Google Scholar

  • DGPM & DKPM. (2011). S3-Leitlinie. Diagnostik und Therapie der Essstörungen. Kurzfassung . Retrieved from AWMF Online. First citation in articleGoogle Scholar

  • Fairburn, C. G., Cooper, Z., Doll, H. A., Norman, P. & O'Connor, M. (2000). The natural course of bulimia nervosa and binge eating disorder in young women. Archives of General Psychiatry, 57, 659 – 665. First citation in articleCrossref, Google Scholar

  • Fischer, S., Meyer, A. H., Dremmel, D., Schlup, B. & Munsch, S. (2014). Short-term Cognitive-Behavioral Therapy for Binge Eating Disorder: Long-term efficacy and predictors of long-term treatment success. Behaviour Research and Therapy, 58, 36 – 42. First citation in articleCrossref, Google Scholar

  • Friborg, O., Martinussen, M., Kaiser, S., Overgard, K. T., Martinsen, E. W., Schmierer, P. & Rosenvinge, J. H. (2014). Personality disorders in eating disorder not otherwise specified and binge eating disorder: a meta-analysis of comorbidity studies. The Journal of Nervous and Mental Disease, 202, 119 – 125. First citation in articleCrossref, Google Scholar

  • Greenberg, R. P., Constantino, M. J. & Bruce, N. (2006). Are patient expectations still relevant for psychotherapy process and outcome? Clinical Psychology Review, 26, 657 – 678. First citation in articleCrossref, Google Scholar

  • Grilo, C. M. & Masheb, R. M. (2005). A randomized controlled comparison of guided self-help cognitive behavioral therapy and behavioral weight loss for binge eating disorder. Behaviour Research and Therapy, 43, 1509 – 1525. First citation in articleCrossref, Google Scholar

  • Grilo, C. M., Masheb, R. M., Wilson, G. T., Gueorguieva, R. & White, M. A. (2011). Cognitive-behavioral therapy, behavioral weight loss, and sequential treatment for obese patients with binge-eating disorder: a randomized controlled trial. Journal of Consulting and Clinical Psychology, 79, 675 – 685. First citation in articleCrossref, Google Scholar

  • Grilo, C. M., White, M. A. & Masheb, R. M. (2009). DSM-IV psychiatric disorder comorbidity and its correlates in binge eating disorder. International Journal of Eating Disorders,42, 228 – 234. First citation in articleCrossref, Google Scholar

  • Hart, L. M., Granillo, M. T., Jorm, A. F. & Paxton, S. J. (2011). Unmet need for treatment in the eating disorders: a systematic review of eating disorder specific treatment seeking among community cases. Clinical Psychology Review, 31, 727 – 735. First citation in articleCrossref, Google Scholar

  • Hautzinger, M., Keller, F. & Kühner, C. (2006). BDI-II. Beck ­Depressions-Inventar. Revision . Frankfurt am Main: Harcourt Test Services GmbH. First citation in articleGoogle Scholar

  • Hilbert, A., de Zwaan, M. & Braehler, E. (2012). How frequent are eating disturbances in the population? Norms of the eating ­disorder examination-questionnaire. PLoS One, 7, e29125. First citation in articleCrossref, Google Scholar

  • Hilbert, A. & Tuschen-Caffier, B. (2016). Eating Disorder Examina­tion-Questionnaire: Deutschsprachige Übersetzung (2. Auflage). Münster: Verlag für Psychotherapie. First citation in articleGoogle Scholar

  • Hilbert, A., Tuschen-Caffier, B., Karwautz, A., Niederhofer, H. & Munsch, S. (2007). Eating Disorder Examination-Questionnaire – Evaluation der deutschsprachigen Übersetzung. Diagnostica, 53, 144 – 154. First citation in articleLink, Google Scholar

  • Hudson, J. I., Hiripi, E., Pope, H. G. Jr. & Kessler, R. C. (2007). The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biological Psychiatry, 61, 348 – 358. First citation in articleCrossref, Google Scholar

  • Iacovino, J. M., Gredysa, D. M., Altman, M. & Wilfley, D. E. (2012). Psychological treatments for binge eating disorder. Current Psychiatry Reports, 14, 432 – 446. First citation in articleCrossref, Google Scholar

  • Jones, M., Luce, K. H., Osborne, M. I., Taylor, K., Cunning, D., Doyle, A. C., … Taylor, C. B. (2008). Randomized, controlled trial of an internet-facilitated intervention for reducing binge eating and overweight in adolescents. Pediatrics, 121, 453 – 462. First citation in articleCrossref, Google Scholar

  • Keski-Rahkonen, A. & Mustelin, L. (2016). Epidemiology of eating disorders in Europe: prevalence, incidence, comorbidity, course, consequences, and risk factors. Current Opinion in Psychiatry, 29, 340 – 345. First citation in articleCrossref, Google Scholar

  • Kessler, R. C., Berglund, P. A., Chiu, W. T., Deitz, A. C., Hudson, J. I., Shahly, V., … Xavier, M. (2013). The prevalence and correlates of binge eating disorder in the World Health Organization World Mental Health Surveys. Biological Psychiatry, 73, 904 – 914. First citation in articleCrossref, Google Scholar

  • Linden, M. (2017). Placebo: Unsolved Problems for Science, and Simple Conclusions for Clinical Practice. American Journal of Psychiatry, 174, 91 – 92. First citation in articleCrossref, Google Scholar

  • Loeb, K. L., Wilson, G. T., Gilbert, J. S. & Labouvie, E. (2000). Guided and unguided self-help for binge eating. Behaviour Research and Therapy, 38, 259 – 272. First citation in articleCrossref, Google Scholar

  • Margraf, J. (1994). Diagnostisches Kurz-Interview psychischer ­Störungen (Mini-DIPS). Berlin: Springer. First citation in articleCrossref, Google Scholar

  • Margraf, J. & Cwik, J. C. (2017). Mini-DIPS Open Access: Diagnostisches Kurzinterview bei psychischen Störungen . Bochum: ­Forschungs- und Behandlungszentrum für psychische Gesund­heit, Ruhr-Universität Bochum. First citation in articleGoogle Scholar

  • Margraf, J., Cwik, J. C., Pflug, V. & Schneider, S. (2017). Structured Clinical Interviews for Mental Disorders Across the Life Span: Psychometric Quality and Further Developments of the DIPS Open Access Interviews. Zeitschrift für Klinische Psychologie und Psychotherapie, 46, 176 – 186. First citation in articleLink, Google Scholar

  • Margraf, J. & Ehlers, A. (2007). Becks Angstinventar – deutsche Version (BAI) . Frankfurt: Pearson Assessment. First citation in articleGoogle Scholar

  • Mitchison, D., Rieger, E., Harrison, C., Murray, S. B., Griffiths, S. & Mond, J. M. (2018). Indicators of clinical significance among women in the community with binge-eating disorder symptoms: Delineating the roles of binge frequency, body mass index, and overvaluation. International Journal of Eating Disorders, 51, 165 – 169. First citation in articleCrossref, Google Scholar

  • Mond, J. M., Hay, P. J., Rodgers, B., Owen, C. & Beumont, P. J. (2004). Validity of the Eating Disorder Examination Questionnaire (EDE-Q) in screening for eating disorders in community samples. Behaviour Research and Therapy, 42, 551 – 567. First citation in articleCrossref, Google Scholar

  • Munsch, S., Biedert, E., Meyer, A. H., Michael, T., Schlup, B., Tuch, A. & Margraf, J. (2007). A randomized comparison of cognitive behavioral therapy and behavioral weight loss treatment for overweight individuals with binge eating disorder. International Journal of Eating Disorders, 40, 102 – 113. First citation in articleCrossref, Google Scholar

  • Munsch, S., Meyer, A. H. & Biedert, E. (2012). Efficacy and predictors of long-term treatment success for Cognitive-Behavioral Treatment and Behavioral Weight-Loss-Treatment in overweight individuals with binge eating disorder. Behaviour Research and Therapy, 50, 775 – 785. First citation in articleCrossref, Google Scholar

  • Munsch, S., Wyssen, A. & Biedert, E. (2018a). Binge Eating – Kognitive Verhaltenstherapie bei Essanfällen (3. vollst. überarb. Aufl.). Weinheim: Beltz. First citation in articleGoogle Scholar

  • Munsch, S., Wyssen, A. & Biedert, E. (2018b). Das Leben verschlingen? Hilfe für Betroffene mit Binge-Eating-Störung (3. vollst. überarb. Aufl.). Weinheim: Beltz. First citation in articleGoogle Scholar

  • NICE. (2017). Eating disorders: recognition and treatment. Retrieved fromhttps://www.nice.org.uk/guidance/ng69 First citation in articleGoogle Scholar

  • Ricca, V., Castellini, G., Mannucci, E., Lo Sauro, C., Ravaldi, C., ­Rotella, C. M. & Faravelli, C. (2010). Comparison of individual and group ­cognitive behavioral therapy for binge eating disorder. A randomized, three-year follow-up study. Appetite, 55, 656 – 665. First citation in articleCrossref, Google Scholar

  • Rief, W. & Glombiewski, J. A. (2016). Erwartungsfokussierte Psychotherapeutische Interventionen (EFPI). Verhaltenstherapie, 26, 47 – 54. First citation in articleCrossref, Google Scholar

  • Roos, J. & Werbart, A. (2013). Therapist and relationship factors influencing dropout from individual psychotherapy: A literature review. Psychotherapy Research, 23, 394 – 418. First citation in articleCrossref, Google Scholar

  • Schag, K., Schönleber, J., Teufel, M., Zipfel, S. & Giel, K. E. (2013). Food-related impulsivity in obesity and binge eating disorder – a systematic review. Obesity Reviews, 14, 477 – 495. First citation in articleCrossref, Google Scholar

  • Schlup, B., Munsch, S., Meyer, A. H., Margraf, J. & Wilhelm, F. H. (2009). The efficacy of a short version of a cognitive-behavioral treatment followed by booster sessions for binge eating disorder. Behaviour Research and Therapy, 47, 628 – 635. First citation in articleCrossref, Google Scholar

  • Schnyder, U., Milos, G., Mohler-Kuo, M. & Dermota, P. (2012). Prävalenz von Essstörungen in der Schweiz. Im Auftrag vom Bundesamt für Gesundheit (BAG). Retrieved fromhttp://www.bag.admin.ch First citation in articleGoogle Scholar

  • Singer, J. D. & Willett, J. B. (2003). Applied longitudinal data analysis: Modeling change and event occurrence. New York: Oxford University Press. First citation in articleCrossref, Google Scholar

  • Sonneville, K. R., Horton, N. J., Micali, N., Crosby, R. D., Swanson, S. A., Solmi, F. & Field, A. E. (2013). Longitudinal Associations Between Binge Eating and Overeating and Adverse Outcomes Among Adolescents and Young Adults Does Loss of Control Matter? Jama Pediatrics, 167, 149 – 155. First citation in articleCrossref, Google Scholar

  • Stice, E., Marti, C. N. & Rohde, P. (2013). Prevalence, incidence, impairment, and course of the proposed DSM-5 eating disorder diagnoses in an 8-year prospective community study of young women. Journal of Abnormal Psychology, 122, 445 – 457. First citation in articleCrossref, Google Scholar

  • Striegel-Moore, R. H., Wilson, G. T., DeBar, L., Perrin, N., Lynch, F., Rosselli, F. & Kraemer, H. C. (2010). Cognitive behavioral guided self-help for the treatment of recurrent binge eating. Journal of Consulting and Clinical Psychology, 78, 312 – 321. First citation in articleCrossref, Google Scholar

  • Vocks, S., Tuschen-Caffier, B., Pietrowsky, R., Rustenbach, S. J., Kersting, A. & Herpertz, S. (2010). Meta-analysis of the effectiveness of psychological and pharmacological treatments for binge eating disorder. International Journal of Eating Disorders, 43, 205 – 217. First citation in articleGoogle Scholar

  • Wampold, B. E. (2015). How important are the common factors in psychotherapy? An update. World Psychiatry, 14, 270 – 277. First citation in articleCrossref, Google Scholar

  • Wilfley, D. E., Welch, R. R., Stein, R. I., Spurrell, E. B., Cohen, L. R., ­Saelens, B. E., … Matt, G. E. (2002). A randomized comparison of group cognitive-behavioral therapy and group interpersonal psychotherapy for the treatment of overweight individuals with binge-eating disorder. Archives of General Psychiatry, 59, 713 – 721. First citation in articleCrossref, Google Scholar

  • Wilson, G. T., Wilfley, D. E., Agras, W. S., & Bryson, S. W. (2010). Psychological treatments of binge eating disorder. Archives of ­General Psychiatry, 67 (1), 94 – 101. doi:10.1001/­archgenpsychiatry.2009.170 First citation in articleCrossref, Google Scholar

  • Wilson, G. T. & Zandberg, L. J. (2012). Cognitive-behavioral guided self-help for eating disorders: effectiveness and scalability. ­Clinical Psychology Review, 32, 343 – 357. First citation in articleCrossref, Google Scholar

  • Yanovski, S. Z. (2003). Binge eating disorder and obesity in 2003: Could treating an eating disorder have a positive effect on the obesity epidemic? International Journal of Eating Disorders, 34, S117 – S120. First citation in articleCrossref, Google Scholar