Cue exposure in the treatment of resistant adolescent bulimia nervosa.
OBJECTIVE
A percentage of bulimic patients do not greatly improve with the usual treatment. Therefore, the objective was to further evaluate cue exposure (CE), in order to attain better results in clinical settings.


METHODS
Twenty-two adolescent patients who fulfilled DSM-IV diagnostic criteria for bulimia nervosa (mean age 16.7, SD 1.5) and who were resistant to the usual treatment followed a program of 12 CE sessions. Clinical characteristics were evaluated and different psychopathological scales were administered at the beginning and the end of the CE program and at 6 month follow-up. Subjective anxiety and physiological parameters were recorded during the sessions.


RESULTS
A significant decrease was observed in subjective anxiety (p = .023), heart rate (p < .001), and blood pressure (p = .001) during the first session. A decrease in these parameters was also recorded between the first and the last session. The number of binges per week (p = .005) and the mean score for the psychopathological scales decreased significantly from the beginning of the treatment, and were significantly lower at the end of the CE program and at follow-up. Purging behaviors per week only decreased significantly after the end of the CE session during the follow-up (p = .04).


CONCLUSIONS
Anxiety, binging, purging, and psychopathological scales improve with a CE program in resistant bulimia nervosa.
Martinez-Mallén
Esteban
E
Department of Child and Adolescent Psychiatry and Psychology, Institute Clinic of Neurosciences, Hospital Clínic Universitari of Barcelona, Villaroel 170, 08036 Barcelona, Spain. martinez@clinic.ub.es
Castro-Fornieles
Josefina
J
Lázaro
Luisa
L
Moreno
Elena
E
Morer
Astrid
A
Font
Elena
E
Julien
Joana
J
Vila
Montserrat
M
Toro
Josep
J
D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000503:physiopathology / Q000523:psychology; D001521:Behavior Therapy / Q000379:methods*; D001794:Blood Pressure; D052018:Bulimia Nervosa / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D003463:Cues; D005260:Female; D006339:Heart Rate; D006801:Humans