[PDF] BED?online: Acceptance and efficacy of an internet?based treatment

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DOI:10.1002/erv.2856

PsychologyandPsychotherapy,University

AdolescentPsychiatryandPsychotherapy,

PsychologyandEpidemiology,University

Psychology&BiologicalPsychology,

UniversityofFribourg,Fribourg,

Institute,UniversityofFribourg,Fribourg,

Switzerland

Correspondence

SimoneMunsch,Departmentof

Psychology,ClinicalPsychology&

Psychotherapy,UniversityofFribourg,

RuedeFaucigny2,1700Fribourg,

Switzerland.

Email:simone.munsch@unifr.ch

Fundinginformation

SwissanorexianervosafoundationAbstract

8-sessioninternet-basedGSHprogramin

arandomizedclinicaltrialwithan ingwaitingornot. behavioural episodesinthisstudy.

1.9%to4%inwomenand0.3%-2.5%inmen(Keski-

Thepresentinternet-basedguidedself-help

programaddstotheexistingresearch regardingonlinetreatmentofbinge-eating disorderandiscurrentlyoneofthetwoexist- ingvalidatedprogramsavailableinGerman language.Itisbasedonanestablished cognitive-behaviouraltreatmentapproach, showshighacceptancebypatientsandhigh ef?cacyaftereightguidedonlinesessions, therebyrepresentingtheshortestdurationof currentlyevaluatedtreatments

Duringtheinternet-basedtherapy,thenumber

ofweeklybinge-eatingepisodes,depressive symptoms,eatingdisorderpathologyaswellas impairmentsinpsychosocialfunctioningall weremaintainedduringfollow-up(6months).

Abstainerrate(nobinge-eatingduringlast

month)continuedtoincreaseduringfollow-up withboostersessions

Anemail-basedpre-treatmentpositiveexpec-

tationinductiondidnotalterthetemporal courseandthustreatmentsuccess,ofbinge episodes2-

WYSSENETAL.

treatment(Petersonetal.,2020). ef?cacyareneeded. etal.,2010). 2013
comparedtonon-guidedprograms(Aardoom etal.,2013). eatingintheGSHcondition,buttheguidedDBT- -3

Schnyderetal.,2017).

gramshavebeenevaluatedinRCTs,theGerman

INTERBEDprogram(deZwaanetal.,2012)andthe

Carrard,Crepin,Rouget,Lam,VanderLinden,

graminGerman,INTERBED(deZwaanetal.,2012) con?rmedtheef?cacyofsuchatreatmentwithan programswhichvarybetween5%and77%(Aardoom

GSHprograms(Aardoometal.,2013;Brauhardt

andoutcomeexpectationscanprovokeasymptom terventions(Greenbergetal.,2006;Wampold in?uencedbyexpectationsremainsunclear. inactiveandinplacebotreatments(Peerdeman

WYSSENETAL.

forBEDtreatmentsnorforGSHapproaches. approachforeatingdisorders(CBT-E;Murphy programandfurtherto0.6at6-monthfollow-up patients"acceptance. upinallthreegroupscombined(TG,CGs). waitinggroup.2|METHOD accesstheprogram(bothself-reported). treatment,17.8%atpost-treatment). -5 assessed . ( . 9 . ,xcluded (n931)

Notmeeting inclusion criteriaofage(n=2)

Withdrawalfromparticipation(n=3)

Notavailablefordiagnostic (n=3)

Notmeeting inclusion criteriaofdiagnosis(n=11)

Waiting list(programwasfullybooked)(n=12)

Signedinformedconsent(n994)

Randomizedandassessed foreligibility(n963)

,nrollment

Üllocated totheimmediate

treatmentgroup(n924)

Üllocated tothewaitlistcontrol

groups(n939)*

Üllocation(n963)

zooster1(after1month)(n944)

Ünalysis1:completeractivetreatment (n946)

zooster2(after3months)(n942) zooster3(after6months)(n940)

Viscontinuedtreatment(n92)

Lackoftime(n91)

Reasonunknown(n91)

Viscontinuedtreatment(n92)

Lackofmotivation (n91)

Reasonunknown(n91)

Ünalysis2:completerfollow-up(n940)

Viscontinuedtreatment(n92)

Reasonunknown(n92)

Viscontinuedtreatment(n98)

Lackofmotivation (n91)

Withdrawalfromparticipation (n92)

Reasonunknown (n93)

Viscontinuedtreatment(n99)

Considered programasinappropriate(n92)

Startedothertreatment (n91)

Lackofmotivation (n91)

Withdrawalfromparticipation (n92)

Reasonunknown (n92)

FIGURE Flow Notes. 8 .4 9n=

( .4 9n=A 6-

WYSSENET .

etal.,2019). analogouslytotheimmediateTG. dailylife. byAWandSMinweeklymeetings. continuouslysupervisedbyAWandSM. room). follow-up. (follow-upassessment). height(inmetres).

WorkandSocialAdjustmentScale(WSAS;Mundt

-7 (rangeoffurthertimepointswas0.88-0.89).

EatingDisorderExamination-Questionnaire

Thefollowingtwoquestionnaireswereapplied

pointswas0.78-0.91).

WeeklyBingesQuestionnaire(WBQ;Munsch

EMAhasbeenfound(Munschetal.,2009).

up-assessment.

SessionContent

attainmentscale consequences) improvethecopingwithbinge-eatingepisodes eatingepisodes longterm withfuturedif?culties;Relapseprevention

WYSSENETAL.

WBQandBDI-FSduringthe?rst4weeksofactive

andWSAS:sqrt(x).

Packager2glmm(Jaeger,2017).3|RESULTS

(Table2).3.2|Patients"acceptanceofthe

3.3.1|Immediatetreatmentversuswaitlist

-9

Pre(n=63)Post(n=46)Follow-up(n=40)

M(SD)M(SD)M(SD)

TotalTGStandard

CGPositive

CGTotalTGStandard

CGPositiveCGTotalTGStandard

CGPositive

CG

EDE-QItem15:

EDE-Q15abstainer

AdjustmentScale.10-

WYSSENETAL.

relativetoCGsforWBQ(b=-0.156,SE=0.055, changes(p=0.779forTG,p=0.348forCGs). standardCGandthepositiveCG,neitherforWBQ b=0.040,SE=0.067,t103=0.60,p=0.549,

SE=0.091,t103=0.40,p=0.689,beta=0.017,

b=-0.080,SE=0.011,t571=-7.14,p<0.001,

SE=0.013,t578=-5.68,p<0.001,beta=-0.71,

R2beta=0.042),EDE-Q(b=-0.125,SE=0.021,

theotherthreeoutcomes).

SE=0.003t571=-1.00,p=0.318,beta=-0.04,

R2beta=0.001),BDI-FS(b=-0.002,SE=0.006,

SE=0.008,t578=-0.88,p=0.382,beta=-0.06,

linetreatmentinasteppedcareapproachtoBED

Theaimofthisstudywastoevaluatethiseight-

Group(Numberof

Allocatedpatients)Dropoutfrombaselineto

totheendoffollow-upTotal

TG(n=24)n=8(33.3%)n=3(12.5%)n=11(45.8%)

p=0.76). group.WYSSENETAL. -11 depressive ( 2 . 4 . = 8 (

8 4

FIGURE Comparing . . . 9N= Notes. : B ): . B ): 8 . B =1C . - : 4. TABLE Descriptive =1C 14 - . 9 : . . 9 ): ): WBQ 88.
4888.
48
N (SD)M(SD)M(SD)M(SD)M(SD)M(SD)

WeekA6A6

9A6 9 9 9 A9 9 AA 9 9

9A 9 69 9

= AA A 9 6 9 9 A9A 6 9A 9A 9A 9 A9A 96 69 9 Notes:= . . ):( :D : . . ): ): . . 14 -(1 - B ):( 8 . B ):( . B :( B=1C(= 1 C 12-

WYSSENET .

treatment . 4

124

6 A .4 4 4 4 9 9 :-0 96 . 4 9 4 .4 (. (124 -129

D 2129

9)() ( ( (L B . ( 6 ( 4 :-0. . 6 9)( B0 ( B

8 124

. 4 . ( 4 4 9 ()() ( ( (: (( B ( A .4 .

A .

9 4 .4 124 -( ( )1 4 4 ( . 9- ( A 4 4 :-0 = 9

A

:-0 ( R (8( 4 91
B ( B= ( 6 . 9( (. 8 4 :-0 12 9 ( FIGURE)Temporal =1C .4 9N= Notes. : B ): . B ): 8 . B=1C .

WYSSENET .

-13 coresymptomsofBEDearlyintreatment. expectedpositivetreatmenteffects.

Third,depressivesymptoms(BDI-FS)didnot

testingwereapplied(Rothman,1990).

Abstainerratesatpost-treatment(18%)andat

(Wagneretal.,2014). mentdurationofBED-Onlinemightrepresentan

WYSSENETAL.

outcomeinaCBT-GSHforBED.

Ourstudy?ndingsmustbeseenagainsttheback-

thepositiveexpectationinduction.

ACKNOWLEDGEMENTS

WethanktheSwissAnorexiaNervosaFoundation

rationofthemanuscript.

CONFLICTSOFINTEREST

Allauthorsdeclarenocon?ictsofinterest.

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