Role of exposure with response prevention in cognitive-behavioral therapy for bulimia nervosa: three-year follow-up results.
BACKGROUND
Previous studies have not reported the longer-term outcome of exposure-based treatments for bulimia nervosa. The current study evaluated the 3-year outcome of a randomized clinical trial that compared the additive efficacy of exposure-based versus nonexposure-based behavioral treatments (BT) with a core of cognitive-behavior therapy (CBT).


METHODS
One hundred thirteen women participated in the original treatment trial and attended a 3-year follow-up assessment. Eating disorder diagnoses and primary, secondary, and tertiary outcome measures were assessed. The impact of treatment completion on symptomatology and the stability of treatment effects over time were evaluated.


RESULTS
At the 3-year follow-up, 85% of the sample had no current diagnosis of bulimia nervosa and 69% had no current eating disorder diagnoses of any sort. Failure to complete CBT was associated with inferior outcome. No clear advantages were evident for participants who completed BT in addition to CBT. For subjects who did complete both CBT and BT, outcome was mostly stable from posttreatment to follow-up. No differential effects were found for exposure versus nonexposure-based treatments at 3-year follow-up.


CONCLUSIONS
The results of the current study compare favorably with other treatment outcome studies for bulimia nervosa and suggest that treatment gains are maintained after 3 years.
Carter
Frances A
FA
Department of Psychological Medicine, Christchurch School of Medicine, Otago University, Christchurch, New Zealand. frances.carter@chmeds.ac.nz
McIntosh
Virginia V W
VV
Joyce
Peter R
PR
Sullivan
Patrick F
PF
Bulik
Cynthia M
CM
D000293:Adolescent; D000328:Adult; D002032:Bulimia / Q000517:prevention & control*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome