Pure and guided self-help for full and sub-threshold bulimia nervosa and binge eating disorder.
OBJECTIVE
The study compared the efficacy of self-help without and with guidance (referred to as 'pure' and 'guided' self-help), using a cognitive behavioral self-help manual (Fairburn, 1995) for binge eating.


METHODS
A sample of 31 participants with bulimia nervosa, subthreshold bulimia nervosa and binge-eating disorder were assigned randomly to one of the self-help levels for 16 weeks, after four weeks of baseline observations.


RESULTS
The results indicated that both forms of self-help treatments had a modestly positive and sustained effect on the participants' eating problems. Intention-to-treat analyses showed that participants reduced their mean number of objective bulimic episodes and purging behaviour by 33% and 17% over the course of the treatment. The corresponding reduction levels for the treatment completers (N = 18) were 58% and 61%, respectively. Furthermore, there were no significant differences between the pure and guided self-help groups in terms of outcome, reflecting the probable insignificance of guidance for the broader group of individuals with binge-eating problems. At follow-up, no further significant improvement or deterioration was observed in the ensuing six months compared with the post-treatment data.


CONCLUSIONS
Given the heterogeneity of the diagnostic groups in the present study, resulting in high external validity, and the conservative nature of the analyses, self-help is discussed as a viable means of initial treatment for binge eating.
Ghaderi
Ata
A
Department of Psychology, Uppsala University, Uppsala, Sweden. ata.ghaderi@psyk.uu.se
Scott
Berit
B
D000328:Adult; D015992:Body Mass Index; D002032:Bulimia / Q000175:diagnosis* / Q000517:prevention & control*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003863:Depression / Q000175:diagnosis; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008370:Manuals as Topic; D010352:Patient Dropouts / Q000706:statistics & numerical data; D020377:Self Efficacy; D012720:Severity of Illness Index; D012917:Social Adjustment; D011795:Surveys and Questionnaires; D016896:Treatment Outcome