[An outpatient group behavior therapy program in bulimia nervosa].
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Biomedical subjects
Publications and source records attributed to C Jacobi.
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Controlled studies of psychological, pharmacological and combined treatments for bulimia and anorexia nervosa were examined. Only studies with random assignment to treatment groups were included. Outcome criteria differed for anorexia and bulimia nervosa. The bulimia nervosa studies were evaluated in a meta-analysis. The results of the abstinence and reduction rates as well as the magnitude of the effects confirm the superiority of psychological approaches to pharmacological treatment with antidepressants. The few combined treatment studies suggest the same results as for psychological treatment alone. Longer treatment duration turned out to be a positive predictor for the effects of purging and depression. As far as anorexia nervosa is concerned, there is a general and significant lack of controlled treatment studies. Since almost all of the existing psychological and pharmacological treatment studies involve additional treatment elements, a clear assignment to the treatment categories is difficult.
The paper presents a German version of the second revised edition of the Eating Disorder Inventory EDI-2 (Garner 1991). The EDI-2 is a self-rating inventory (self-report measure) with 91 items and 11 subscales designed for the assessment of attitudinal and behavioural dimensions relevant to anorexia and bulimia nervosa. It consists of the eight original subscales: drive for thinness, bulimia, body dissatisfaction, ineffectiveness, perfectionism, interpersonal distrust, interoception and maturity fears, and the three new subscales: asceticism, impulse regulation and social insecurity. The German EDI-2 was given to 71 patients with anorexia or bulimia nervosa, 30 patients with binge eating disorder, a control group of 186 women and a further control group of 102 men. In comparison to the female control group, patient groups showed significantly elevated means on all subscales. Item analysis revealed sufficient internal consistencies for all subscales except subscale 9 (asceticism) with Cronbachs alpha ranging from 0.58 to 0.90. Twelve of the 91 items showed poor item total scale correlations below 0.40. Factor analysis supported a six-factor-structure. Hence, the reliability and validity of the three new subscales was confirmed only partially. The use of the EDI-2 in therapy research and clinical practice is critically discussed.