110 Chapter 5 Abstract Objective: To evaluate moderators and predictors of response to cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT) for binge eating disorder (BED). Method: Moderators/predictors of treatment outcome that are central to CBT and to DBT treatment models were chosen from an aggregated dataset of two clinical outcome studies (N = 214) comparing an intensive outpatient CBT-program (CBT+, n = 144) to DBT-BED (n = 70) in individuals with BED. Generalized linear models examined moderators and predictors of objective binge eating (OBE) frequency at end-of-treatment (EOT) and six-month follow-up (FU). Results: Shape/weight overvaluation, shape concerns and low self-esteem at baseline significantly predicted and moderated reductions in OBE frequency at EOT whereas difficulty in identifying feelings predicted and moderated reductions in OBE frequency at FU. Emotional eating predicted outcome at FU (medium effect) and moderated outcome at EOT (large effect). Depression levels predicted, but not moderated, treatment outcome at both EOT and FU. For shape/weight overvaluation, shape concerns and low self-esteem, low levels were related to greater reductions in outcome in CBT+ than DBT-BED, with smaller differences between treatments for higher levels. Similarly, emotional eating and difficulty in identifying feelings moderated EOT and FU outcome respectively, yet, individuals with the highest scores showed more decrease in OBE episodes with DBT-BED than with CBT+. Conclusions: Five significant moderator effects and seven significant predictor effects were identified. Findings suggest that BED treatment outcome could be enhanced by matching individuals with certain symptom presentations to treatment overall, and to DBT-BED or CBT+ specifically. Keywords Cognitive behavior therapy, dialectical behavior therapy, binge eating disorder, moderators, predictors
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