Journal article
Mediators of change in cognitive behaviour therapy and interpersonal psychotherapy for eating disorders: a secondary analysis of a transdiagnostic randomised controlled trial
- Abstract:
- Objective Understanding the mechanisms of action of psychological treatments is a key first step in refining and developing more effective treatments. The present study examined hypothesized mediators of change of enhanced cognitive behavior therapy (CBT‐E) and interpersonal psychotherapy for eating disorders (IPT‐ED). Method A series of mediation studies were embedded in a randomized controlled trial (RCT) comparing 20 weeks of CBT‐E and IPT‐ED in a transdiagnostic, non‐underweight sample of patients with eating disorders (N = 130) consecutively referred to the service. Three hypothesized mediators of change in CBT‐E (regular eating, weighing frequency, and shape checking) and the key hypothesized mediator of IPT‐ED (interpersonal problem severity) were studied. Results The data supported regular eating as being a mediator of the effect of CBT‐E on binge‐eating frequency. The findings were inconclusive regarding the role of the other putative mediators of the effects of CBT‐E; and were similarly inconclusive for interpersonal problem severity as a mediator of the effect of IPT‐ED. Discussion This research highlights the potential benefits of embedding mediation studies within RCTs to better understand how treatments work. The findings supported the role of regular eating in reducing patients' binge‐eating frequency. Other key hypothesized mediators of CBT‐E and IPT‐ED were not supported, although the data were not inconsistent with them. Key methodological issues to address in future work include the need to capture both behavioral and cognitive processes of change in CBT‐E, and identifying key time points for change in IPT‐ED.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, pdf, 2.2MB, Terms of use)
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- Publisher copy:
- 10.1002/eat.23390
Authors
- Publisher:
- Wiley
- Journal:
- International Journal of Eating Disorders More from this journal
- Volume:
- 53
- Issue:
- 12
- Pages:
- 1928-1940
- Publication date:
- 2020-11-05
- Acceptance date:
- 2020-10-06
- DOI:
- EISSN:
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1098-108X
- ISSN:
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0276-3478
- Language:
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English
- Keywords:
- Pubs id:
-
1137594
- Local pid:
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pubs:1137594
- Deposit date:
-
2020-10-14
- ARK identifier:
Terms of use
- Copyright holder:
- Sivyer et al.
- Copyright date:
- 2020
- Rights statement:
- © 2020 The Authors. International Journal of Eating Disorders published by Wiley Periodicals LLC. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
- Licence:
- CC Attribution (CC BY)
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