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Verbesserung der Impuls- und Emotionsregulation bei Binge-Eating-Störungen

Einsatzmöglichkeiten und erste Ergebnisse des Handlungsleitfadens ImpulsE

Published Online:September 03, 2019https://doi.org/10.1026/0942-5403/a000292

Abstract

Zusammenfassung. Impulsivität beeinflusst die Verarbeitung von störungsspezifischen Reizen und die Handlungskompetenz hinsichtlich der Nahrungsaufnahme. Neuere Studien adressieren daher unterschiedliche Facetten impulsiven Erlebens und Verhaltens, um eine Reduktion von Essanfällen und des Körpergewichts bei der Binge-Eating-Störung (BES) zu erzielen. ImpulsE ist ein Therapieprogramm zur Verbesserung der Impuls- und Emotionsregulationsfertigkeiten, welches mit einem computergestützten nahrungsbezogenen Inhibitionstraining kombiniert und mit einer Standardbehandlung (TAU) verglichen wurde. N = 31 Personen mit BES nahmen teil (n = 22 ImpulsE, n = 9 TAU). Die Ergebnisse zeigten Verbesserungen in der nahrungsbezogenen Verhaltensinhibition und der allgemeinen Essstörungspathologie in beiden Gruppen, während sich die Anzahl von Essanfällen nur bei ImpulsE signifikant senkte. Die Ergebnisse stellen erste Hinweise auf die Wirksamkeit eines solchen Trainings dar. Eine Adaption an Jugendliche erscheint sinnvoll.


Improving Impulse and Emotion Regulation in Binge Eating Disorder: Possible Application and First Results of the ImpulsE Manual

Abstract. Recent research has highlighted the influence of impulsivity on disorder-related information processing and food-related action competencies. This is in particular of interest among individuals with eating and weight disorders, and hence, impulsivity with its facets has become a potential target for treatment among this patient group. Currently, evidence is still scarce regarding the effectiveness of cue-specific inhibitory control trainings (ICT) and those that focus on emotion regulation. The present study investigates a combination of cognitive-behavioral training with a special focus on enhancing impulsivity-related behaviors and emotion regulation strategies (ImpulsE) and a computer-based food-specific ICT (Stop Signal task, SST) and compares this with a guideline-based treatment as usual (TAU). In total N = 31 overweight/obese individuals with binge eating disorder (BES) participated in the study (n = 22 ImpulsE, n = 9 TAU). Self-reported (UPPS Urgency) and performance-based impulsivity (SST), eating disorder pathology (EDE-Q), and weight were compared at baseline (T1), posttreatment (T2), and at the 1- or 3-month follow-up (FU). Results showed a reduction in both groups for eating pathology and inhibitory control ability (food-specific SST). Only for ImpulsE, the number of binge eating days decreased significantly from T0 to T1 and from T1 to T2. The reduction of binge eating days correlated highly significantly with the reduction of food-related inhibitory control ability. For TAU, a significant correlation between the reduction of the emotional facet of impulsivity, urgency, and reduction of global eating disorder pathology was found. The present study offers support for the effectiveness of cognitive-behavioral trainings with a special focus on impulsivity and emotion regulation. However, the evidence is preliminary and the benefit of the combination with a computer-based food-specific ICT remains unclear. Future research should perform dismantling studies to understand differentiating effects of the various modules. Despite the preliminary characteristic of the data, it seems reasonable to adapt the program to youth. Especially in the sensitive period of puberty, in which BES is often established and empirical evidence exists that deficits in inhibitory control and emotion regulation contribute to the maintenance, ImpulsE could make a valuable contribution to prevent early chronification and to avoid unfavorable weight development.

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