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Experimental Methodologies: Bulimia Nervosa
Annotated Bibliography in Abnormal Psychology
Bara-Carril, Nuria, Williams, Christopher J., Pombo-Carril, Maria G., Reid, Yael, Murray, Kathryn, Aubin, Susan et al. (2004). A preliminary investigation into the feasibility and efficacy of a CD-ROM-based cognitive-behavioral self-help intervention for bulimia nervosa. International Journal of Eating Disorders, 35(4), 538-548.
A quasi-experimental study was carried out to test the efficacy of a CD-ROM-based CBT self-help intervention for bulimia. Subjects with a diagnosis of bulimia (N = 36) or eating disorder not otherwise specified (EDNOS; N = 9) were recruited as they presented at an eating disorders clinic in South London. The EDNOS patients met all the criteria for bulimia except for the frequency of binge eating and purging behavior. The exclusion criteria included an inability to understand English, anorexia nervosa, psychosis, acutely suicidal, current substance abuse, severe learning disability, and an inability to attend sessions. Treatment consisted of eight sessions interacting with the CBT material on the CD-ROM. Motivational and educational strategies were also incorporated into the material. The outcome measure was the Short Evaluation of Eating Disorders Symptoms.
Of the 39 subjects for which outcome data was available, a significant reduction in binging and purging occurred with treatment. The decrease in over-exercise was not statistically significant, but the sample size very small. Decreases were also noted for laxative/diuretic use and food restriction. The main limitations of the study were small sample size and the use of antidepressant medications by many of the test subjects. The authors also discussed their concern that a CD-ROM treatment modality may not be widely accepted by patients, especially...
The dropout and compliance rate was also high, with only 19 subjects completing all eight sessions.
Hay, Phillipa P.J., Bacaltchuk, Josue, Stefano, Sergio, and Kashyap, Priyanka. (2009). Psychological treatments for bulimia nervosa and binging. Cochrane Database of Systematic Reviews, Issue 4, Article No. CD000562.
Hay and colleagues sought to determine the relative efficacy of a number of different psychological approaches to treating the eating disorders, bulimia nervosa and binge eating, by using a meta-analysis approach. The meta-analysis included 3,054 study participants from 48 separate studies. The inclusion criteria were adults above the age of 16, males and females, patients, and healthy controls. The diagnoses included purging and non-purging bulimia, binge eating disorder, and EDNOS. The treatments modalities included in this study were cognitive-behavioral therapy (CBT), cognitive-behavioral therapy for bulimia nervosa (CBT-BN), nutritional counseling, interpersonal therapy, hypnotherapy, psychoanalytic/psychodynamic, self-help, and several others.
The primary result from the meta-analysis is that CBT generally, and CBT-BN specifically, was shown to be an effective treatment for bulimia and related eating disorders. Interpersonal psychotherapy and other forms of psychotherapy were found to be effective, but these treatment modalities took longer to achieve statistically significant remission rates. However, psychotherapy alone was found to be insufficient to achieve significant results. The authors concluded that larger and better-controlled studies are needed to discriminate between the relative efficacy of each treatment approach. In addition, despite the large collective patient population examined in the meta-analysis, effect sizes were still apparent when…
Schapman-Williams, Ann M. And Lock, James. (2007). Using cognitive-behavioral therapy to treat adolescent-onset bulimia nervosa: A case study. Clinical Case Studies, 6(6), 508-524.
In an effort to provide a rationale for future large studies, Schapman-Williams and Lock presented a case study of a 16-year-old female Caucasian with bulimia being treated with CBT. The symptoms began 18 months prior to appearing at the clinic, starting with a concern about the need to lose weight. Food restriction and over-exercise was followed by purging through vomiting. Body image distortion and binge eating also developed. By the time she presented at the clinic, the binge-purge cycle was occurring 2-3 times per day. When given a choice between CBT and interpersonal therapy, the patient and parent chose CBT. A standard course of 20 therapy sessions for treating bulimia was prescribed.
By the second therapy session the eating pattern had begun to normalize, a process that was completed by session 12. The binge-purge cycles ended immediately, with only one relapse reported at session 13. Although the patient experienced a slight weight gain between sessions 5 and 6, weight was stable throughout treatment. Self-reports of eating associated distress declined rapidly and was gone by session 9. The study limitations mentioned by the authors included the use of a treatment protocol intended for adults, but the treating therapists were able to adapt by involving the patient's mother, in an effort to make the home environment more conducive to treatment goals. The results of this study suggest that treating adolescent-onset bulimia using CBT for adults is effective.
Bulimics can be under, over, or of normal weight. Bulimia is also distinguished from binge eaters who do not engage in compensatory behavior afterwards. The numbers of people suffering from bulimia is difficult to determine. "Research suggests that about four percent (4%), or four out of one hundred, college-aged women have bulimia. About 50% of people who have been anorexic develop bulimia or bulimic patterns" ("Statistics: How many people have
Bulimia is a serious eating disorder, but it does not get the same media coverage or understanding as anorexia. One of the reasons for that is that bulimic patients are typically a normal weight. People around them may not realize they have a problem or that they suffer from disordered eating of any kind. Those who have bulimia are characterized by a cycle of binging on food and then purging
" (National Institute of Mental Health, 2009) III. RISK FACTORS and COMPLICATIONS Factors playing a role in Bulimia are stated to be those as follows: cultural pressures; family, as bulimia tends to run in families; life changes or stressful events; The individual's psychological makeup; Biological aspects such as genes, hormones, and brain chemicals. (U.S. Department of Health and Human Services, 2007) IV. EFFECTS Individuals with bulimia often have "swollen cheeks or jaw area" as well as rough skin on
Taylor et al. (2006) investigated the effectiveness of an internet-based psychological intervention for the prevention of eating disorders among young women who may be at-risk due to their pronounced body weight and shape concerns. The results of the study indicated that individuals were less concerned about their weight following participation in the online program. Specifically, the 8-week, internet-based cognitive-behavioral intervention was found to significantly reduce concerns regarding shape and
Treatments of Bulimia Nervosa THE BEST OPTION Evaluation of Combined Therapy for Bulimia Nervosa Description and Significance Bulimia nervosa, simply bulimia or BN, refers to uncontrolled overeating or binging and then eliminating what has been eaten (SJH, 2012; Grange et al., 2004). Recent reports show alarming increases in the incidence, which now adolescents and pre-adolescents. The latest population statistics say that about 27.3 of the U.S. population is between 12 and 19 years old.
Clinical Psychology / Bulimia Nervosa The beginnings of clinical psychology date back to the year 1492, and it has changed from the mere treatment of mental illness to an entire field of research and experimentation, which has helped those individuals who have been affected by any form of mental disorders, like for example, the eating disorders like bulimia nervosa and anorexia nervosa prevalent among adolescent and twenty-year-old women all over the