Advertisement

Implementing a condensed dialectical behavior therapy skills group for binge-eating behaviors in adolescents

  • Rebecca C. KamodyEmail author
  • Idia B. Thurston
  • Emily I. Pluhar
  • Joan C. Han
  • E. Thomaseo Burton
Brief Report

Abstract

Purpose

Subthreshold binge-eating disorder (BED) symptoms can lead to additive physical and psychological health challenges and may put youth at risk for developing BED during the early adulthood. We examined the implementation of a condensed dialectical behavior therapy (DBT) skills intervention for subthreshold binge-eating behaviors in adolescents.

Methods

Fifteen 14–18 years old participated in a 10-week DBT skills group, which experientially introduced mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness skills in the context of emotionally driven overeating behaviors. Adolescents and caregivers completed measures of emotional eating and binge-eating behaviors at baseline and post-intervention, including the Eating Disorder Examination Questionnaire and Emotional Eating Scale for Children and Adolescents. Eleven participants were retained at 3-month follow-up.

Results

Descriptive statistics were compared at all three time points. Results suggested a reduction in emotional eating and binge-eating behaviors based on youth self-report and caregiver report. Acceptability ratings of the treatment were high among participants completing the intervention.

Conclusions

Using DBT skills to target emotionally driven overeating behaviors in youth may be useful in the treatment of subthreshold BED behaviors and potentially deter future development of full-criteria BED.

Level of evidence

Level IV, uncontrolled pilot trial.

Keywords

Group psychotherapy Child psychotherapy Eating disorders Dialectical behavior therapy Binge eating 

Notes

Acknowledgements

We would like to acknowledge Kristina Decker, M.A., Tiffany Rybak, M.S., Robin Hardin, M.A., Courtney Maclin, M.S., and Caroline Kaufman, M.S. for serving as DBT skills group facilitators and co-facilitators for the present research intervention.

Funding

This work was funded by the International Society for the Improvement and Teaching of Dialectical Behavior Therapy Student Research Grant (PI: Kamody), a Children’s Foundation Research Institute at Le Bonheur Children’s Hospital Research Grant (PI: Burton), and the Brinkley Foundation.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants (and/or their parent/legally authorized representative) included in the study.

Supplementary material

40519_2018_580_MOESM1_ESM.docx (25 kb)
Supplementary material 1 (DOCX 24 KB)
40519_2018_580_MOESM2_ESM.docx (33 kb)
Supplementary material 2 (DOCX 33 KB)
40519_2018_580_MOESM3_ESM.docx (28 kb)
Supplementary material 3 (DOCX 27 KB)

References

  1. 1.
    National Eating Disorder Association (2016) Binge eating disorder overview and statistics. https://www.nationaleatingdisorders.org/binge-eating-disorder. Accessed 20 Nov 2017
  2. 2.
    Taylor JY, Caldwell CH, Baser RE, Jackson NF JS (2007) Prevalence of eating disorders among blacks in the national survey of American life. Int J Eat Disord 40(S3):S10–S14.  https://doi.org/10.1002/eat.20451 CrossRefGoogle Scholar
  3. 3.
    Schlüter N, Schmidt R, Kittel R, Tetzlaff A, Hilbert A (2016) Loss of control eating in adolescents from the community. Int J Eat Disord 49 (4):413–420.  https://doi.org/10.1002/eat.22488 CrossRefGoogle Scholar
  4. 4.
    Safer DL, Robinson AH, Jo B (2010) Outcome from a randomized controlled trial of group therapy for binge eating disorder: comparing dialectical behavior therapy adapted for binge eating to an active comparison group therapy. Behav Ther 41(1):106–120.  https://doi.org/10.1016/j.beth.2009.01.006 CrossRefGoogle Scholar
  5. 5.
    Chen EY, Cacioppo J, Fettich K, Gallop R, McCloskey MS, Olino T, Zeffiro TA (2017) An adaptive randomized trial of dialectical behavior therapy and cognitive behavior therapy for binge-eating. Psychol Med 47(4):703–717.  https://doi.org/10.1017/S0033291716002543 CrossRefGoogle Scholar
  6. 6.
    Fischer S, Peterson C (2015) Dialectical behavior therapy for adolescent binge eating, purging, suicidal behavior, and non-suicidal self-injury: a pilot study. Psychotherapy 52(1):78–92.  https://doi.org/10.1037/a0036065 CrossRefGoogle Scholar
  7. 7.
    Wilkinson PO (2018) Dialectival behavior therapy—a highly effective treatment for some adolescents who self-harm. JAMA Psychiatry 75 (8):786–787.  https://doi.org/10.1001/jamapsychiatry.2018.1079 CrossRefGoogle Scholar
  8. 8.
    Cacian ACM, de Souza LAS, Liboni RPA, Machado WL, Oliveira MDS (2017) Effects of a dialectical behavior therapy-based skills group intervention for obese individuals: a Brazilian pilot study. Eat Weight Disord.  https://doi.org/10.1007/s40519-017-0461-2. (epub ahead of print) Google Scholar
  9. 9.
    Pluhar EI, Kamody RC, Sanchez J, Thurston IB, Burton EB (2018) Description of an intervention to treat binge-eating behaviors among adolescents: applying the template for intervention description and replication. Int J Eat Disord (accepted for publication) Google Scholar
  10. 10.
    Fairburn CG, Beglin SJ (1994) Assessment of eating disorders: interview or self-report questionnaire? Int J Eat Disord 16 (4):363–370.  https://doi.org/10.1002/1098-108X(199412)16:4%3C363::AID-EAT2260160405%3E3.0.CO;2-%23 Google Scholar
  11. 11.
    Tanofsky-Kraff M, Theim KR, Yanovski SZ, Bassett AM, Burns NP, Ranzenhofer LM, Glasofer DR, Yanovski JA (2007) Validation of the emotional eating scale adapted for use in children and adolescents (EES-C). Int J Eat Disord 40(3):232–240.  https://doi.org/10.1002/eat.20362 CrossRefGoogle Scholar
  12. 12.
    Lachin JM (2016) Fallacies of last observation carried forward analyses. Clin Trials (Lond, Engl) 13(2):161–168.  https://doi.org/10.1177/1740774515602688 CrossRefGoogle Scholar
  13. 13.
    Leon AC, Davis LL, Kraemer HC (2011) The role and interpretation of pilot studies in clinical research. J Psychiatr Res 45(5):626–629.  https://doi.org/10.1016/j.jpsychires.2010.10.008 CrossRefGoogle Scholar
  14. 14.
    Skelton JA, Beech BM (2011) Attrition in paediatric weight management: a review of the literature and new directions. Obes Rev 12(5):e273–e281.  https://doi.org/10.1111/j.1467-789X.2010.00803.x CrossRefGoogle Scholar
  15. 15.
    Field AE, Sonneville KR, Micali N, Crosby RD, Swanson SA, Laird NM, Treasure J, Solmi F, Horton NJ (2012) Prospective association of common eating disorders and adverse outcomes. Pediatrics 130(2):e289–e295.  https://doi.org/10.1542/peds.2011-3663 CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  • Rebecca C. Kamody
    • 1
    • 2
    Email author
  • Idia B. Thurston
    • 1
    • 3
    • 4
  • Emily I. Pluhar
    • 5
    • 6
  • Joan C. Han
    • 3
    • 4
    • 7
  • E. Thomaseo Burton
    • 3
    • 4
  1. 1.Department of PsychologyThe University of MemphisMemphisUSA
  2. 2.Yale University Child Study CenterNew HavenUSA
  3. 3.Department of PediatricsUniversity of Tennessee Health Science CenterMemphisUSA
  4. 4.Children’s Foundation Research InstituteLe Bonheur Children’s HospitalMemphisUSA
  5. 5.Division of Adolescent and Young Adult MedicineBoston Children’s HospitalBostonUSA
  6. 6.Department of PsychiatryHarvard Medical SchoolBostonUSA
  7. 7.Department of PhysiologyUniversity of Tennessee Health Science CenterMemphisUSA

Personalised recommendations