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Debra L Safer

Publications and source records attributed to Debra L Safer.

6 recordsLinked to original sources
PubMed2006

Designing a control for a behavioral group therapy.

To evaluate whether the specific techniques of a newly developed behavioral therapy exceed the effects of its common factors (e.g., therapeutic alliance), an ideal comparison control must omit the unique ingredients of the active treatment while possessing the common factors in equal measure. Reviews of the controlled-trial psychotherapy research literature show that such systematic matching is not a common practice. Addressing this gap between theory and practice, we delineate 7 steps for designing a credible control for a recently developed behavioral therapy adapted for binge eating disorder--dialectical behavior therapy (DBT). Our detailed description of matching the common factors to the extent possible and specifically measuring these offers a useful research design template for investigators of controlled behavioral treatment trials.

Behavior Therapy↗
PubMed2006

Weight suppression is a robust predictor of outcome in the cognitive-behavioral treatment of bulimia nervosa.

This study examined weight suppression (difference between highest premorbid weight and pretreatment weight) as a predictor of outcome in 188 outpatients with bulimia nervosa enrolled in a cognitive-behavioral therapy intervention. Participants who dropped out of treatment had significantly higher levels of weight suppression than treatment completers. Of participants who completed treatment, those who continued to engage in binge eating or purging had significantly higher levels of weight suppression than those who were abstinent from bingeing and purging. Results did not change when body mass index, dietary restraint, weight and shape concerns, or other relevant variables were controlled. Relinquishing bulimic behaviors and adopting normal eating patterns may be most feasible for patients who are closest to their highest premorbid weights.

Adult↗
PubMed2004

Comparing two measures of eating restraint in bulimic women treated with cognitive-behavioral therapy.

OBJECTIVE: To examine changes in dietary restraint patterns revealed by the Eating Disorders Examination Restraint subscale (EDE-R) and the Three-Factor Eating Questionnaire Cognitive Restraint scale (TFEQ-CR) in a large sample of women with bulimia nervosa (BN) who completed 18 weeks of cognitive-behavioral therapy (CBT). METHOD: Data from 134 subjects were obtained from a larger study and analyzed using repeated-measures analysis of variance (ANOVA). RESULTS: The EDE-R showed statistically and clinically significant decreases post-CBT, whereas the TFEQ-CR did not change significantly. DISCUSSION: This is the first study to directly compare the EDE-R and TFEQ-CR before and after CBT in the same population. The contrasting results suggest the two measures tap different aspects of the dietary restraint construct. The EDE-R may primarily reflect dieting to lose weight whereas the TFEQ-CR may reflect dieting to avoid weight gain. In assessing changes in dietary restraint targeted by CBT for BN, the TFEQ-CR appears less useful.

Adult↗
PubMed2002

Predictors of relapse following successful dialectical behavior therapy for binge eating disorder.

OBJECTIVE: To identify predictors of relapse at 6-month follow-up for women with binge eating disorder (BED). METHOD: Participants were 32 women with BED who had initially achieved abstinence from binge eating after 20 weeks of dialectical behavior therapy (DBT) adapted for patients with BED. Posttreatment predictor variables included the subscales Restraint, Weight Concerns, and Shape Concerns from the Eating Disorders Examination (EDE), the Emotional Eating Scale score, the Rosenberg Self-Esteem Scale, body mass index, and early versus late age of binge eating onset. RESULTS: The largest effect sizes for predicting relapse were found with early onset of binge eating and higher EDE Restraint scores. DISCUSSION: Previous findings that earlier age of onset (age 16 years or younger) is linked to less successful treatment outcome are now extended to the 6-month follow-up assessment. The finding that higher restraint scores after treatment predict relapse adds to the literature concerning the role of restraint in patients with BED.

Adult↗