title: Race/ethnicity, education, and treatment parameters as moderators and predictors of outcome in binge eating disorder.
abstract: OBJECTIVE
  Binge eating disorder (BED) is prevalent among individuals from minority racial/ethnic groups and among individuals with lower levels of education, yet the efficacy of psychosocial treatments for these groups has not been examined in adequately powered analyses. This study investigated the relative variance in treatment retention and posttreatment symptom levels accounted for by demographic, clinical, and treatment variables as moderators and predictors of outcome.
  
  
  METHODS
  Data were aggregated from 11 randomized, controlled trials of psychosocial treatments for BED conducted at treatment sites across the United States. Participants were N = 1,073 individuals meeting criteria for BED including n = 946 Caucasian, n = 79 African American, and n = 48 Hispanic/Latino participants. Approximately 86% had some higher education; 85% were female. Multilevel regression analyses examined moderators and predictors of treatment retention, Eating Disorder Examination (EDE) global score, frequency of objective bulimic episodes (OBEs), and OBE remission.
  
  
  RESULTS
  Moderator analyses of race/ethnicity and education were nonsignificant. Predictor analyses revealed African Americans were more likely to drop out of treatment than Caucasians, and lower level of education predicted greater posttreatment OBEs. African Americans showed a small but significantly greater reduction in EDE global score relative to Caucasians. Self-help treatment administered in a group showed negative outcomes relative to other treatment types, and longer treatment was associated with better outcome.
  
  
  CONCLUSIONS
  Observed lower treatment retention among African Americans and lesser treatment effects for individuals with lower levels of educational attainment are serious issues requiring attention. Reduced benefit was observed for shorter treatment length and self-help administered in groups.
authors: Department of Psychology, Boston University, Boston, MA 02143, USA. heatherthompsonbrenner@gmail.com
authors: Heather
authors: H
authors: Thompson-Brenner
authors: Debra L
authors: DL
authors: Franko
authors: Douglas R
authors: DR
authors: Thompson
authors: Carlos M
authors: CM
authors: Grilo
authors: Christina L
authors: CL
authors: Boisseau
authors: James P
authors: JP
authors: Roehrig
authors: Lauren K
authors: LK
authors: Richards
authors: Susan W
authors: SW
authors: Bryson
authors: Cynthia M
authors: CM
authors: Bulik
authors: Scott J
authors: SJ
authors: Crow
authors: Michael J
authors: MJ
authors: Devlin
authors: Amy A
authors: AA
authors: Gorin
authors: Jean L
authors: JL
authors: Kristeller
authors: Robin
authors: R
authors: Masheb
authors: James E
authors: JE
authors: Mitchell
authors: Carol B
authors: CB
authors: Peterson
authors: Debra L
authors: DL
authors: Safer
authors: Ruth H
authors: RH
authors: Striegel
authors: Denise E
authors: DE
authors: Wilfley
authors: G Terence
authors: GT
authors: Wilson
mesh_terms: D056912:Binge-Eating Disorder / Q000453:epidemiology / Q000208:ethnology / Q000628:therapy; D005006:Ethnicity / Q000208:ethnology*; D005544:Forecasting / Q000379:methods; D006801:Humans; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology / Q000208:ethnology
references: Am Psychol. 2007 Apr;62(3):199-216
references: 17469898
references: Obes Facts. 2010 Aug;3(4):261-6
references: 20823690
references: Int J Eat Disord. 1997 May;21(4):347-52
references: 9138046
references: Int J Eat Disord. 2005 Nov;38(3):257-62
references: 16211631
references: J Natl Med Assoc. 2011 Jul;103(7):576-84
references: 21999032
references: J Consult Clin Psychol. 2012 Apr;80(2):186-95
references: 22201327
references: Behav Res Ther. 2005 Nov;43(11):1509-25
references: 16159592
references: Cochrane Database Syst Rev. 2009 Oct 07;(4):CD000562
references: 19821271
references: Int J Eat Disord. 2004 Jan;35(1):80-5
references: 14705160
references: Depress Anxiety. 2010 May;27(5):485-94
references: 20336808
references: Ann Behav Med. 2007 Jun;33(3):269-77
references: 17600454
references: Int J Eat Disord. 2009 Dec;42(8):687-705
references: 19621466
references: Int J Eat Disord. 1994 Dec;16(4):363-70
references: 7866415
references: Demography. 1999 Nov;36(4):445-60
references: 10604074
references: Harv Rev Psychiatry. 2004 Nov-Dec;12(6):339-50
references: 15764469
references: JAMA. 2010 Jan 20;303(3):235-41
references: 20071471
references: Biol Psychiatry. 2005 Feb 1;57(3):301-9
references: 15691532
references: J Consult Clin Psychol. 2012 Oct;80(5):897-906
references: 22289130
references: Int J Group Psychother. 2009 Jul;59(3):357-83
references: 19548785
references: Appetite. 2010 Dec;55(3):656-65
references: 20870000
references: Arch Gen Psychiatry. 2002 Oct;59(10):877-83
references: 12365874
references: Behav Res Ther. 2008 Apr;46(4):428-37
references: 18328464
references: Evid Rep Technol Assess (Full Rep). 2006 Apr;(135):1-166
references: 17628126
references: Soc Sci Med. 2005 Jan;60(1):191-204
references: 15482878
references: Int J Eat Disord. 2010 Nov 1;43(7):633-47
references: 19806607
references: Obes Res. 2001 Jul;9(7):418-22
references: 11445665
references: Behav Res Ther. 2000 Mar;38(3):259-72
references: 10665159
references: Biol Psychiatry. 2005 May 15;57(10):1193-201
references: 15866560
references: J Consult Clin Psychol. 2007 Dec;75(6):992-9
references: 18085915
references: Arch Gen Psychiatry. 2002 Aug;59(8):713-21
references: 12150647
references: J Consult Clin Psychol. 2001 Apr;69(2):317-22
references: 11393608
references: J Consult Clin Psychol. 2011 Oct;79(5):675-85
references: 21859185
references: Int J Eat Disord. 2003 May;33(4):421-33
references: 12658672
references: Am J Psychiatry. 2009 Dec;166(12):1347-54
references: 19884223
references: Psychiatr Serv. 2004 Feb;55(2):167-73
references: 14762242
references: Int J Eat Disord. 2003 Mar;33(2):205-12
references: 12616587
references: Int J Eat Disord. 1998 Sep;24(2):125-36
references: 9697011
references: Behav Ther. 2010 Mar;41(1):106-20
references: 20171332
references: J Pediatr Adolesc Gynecol. 2003 Dec;16(6):349-54
references: 14642955
references: J Consult Clin Psychol. 2001 Aug;69(4):717-21
references: 11550739
references: J Consult Clin Psychol. 2010 Aug;78(4):480-9
references: 20658805
references: Arch Gen Psychiatry. 2010 Jan;67(1):94-101
references: 20048227
references: Clin Psychol Rev. 2007 Jul;27(6):682-95
references: 17328996
references: Int J Eat Disord. 2005 Nov;38(3):252-6
references: 16211628
references: Health Serv Res. 2003 Apr;38(2):613-30
references: 12785564
references: Am J Psychiatry. 2001 Sep;158(9):1455-60
references: 11532731
references: Int J Eat Disord. 2007 Nov;40 Suppl:S15-21
references: 17584870
references: J Anxiety Disord. 2012 May;26(4):488-501
references: 22417877
references: Biol Psychiatry. 2007 Feb 1;61(3):348-58
references: 16815322
references: Int J Eat Disord. 2011 Jul;44(5):412-20
references: 20665700
references: Clin Psychol Rev. 2001 Jun;21(4):521-51
references: 11413866
references: J Psychiatr Pract. 2005 Jul;11(4):231-40
references: 16041233
references: Obes Res. 2005 Jun;13(6):1077-88
references: 15976151
references: J Anxiety Disord. 2009 Jan;23(1):12-7
references: 18599263
references: Eur Eat Disord Rev. 2007 May;15(3):175-84
references: 17676687
references: Med Care. 2007 Nov;45(11):1043-51
references: 18049344
references: J Clin Oncol. 2007 Aug 10;25(23):3482-7
references: 17687153
references: Pediatr Clin North Am. 2001 Aug;48(4):1027-39
references: 11494636