113 Dialectical behavior therapy and cognitive behavior therapy in individuals with binge eating disorder: what works for whom? 5 Method Participants Participants were referred to a Dutch community eating disorder service by their general physician or other clinician. Individuals, aged 16 years or older, who met DSM-5 criteria for BED (APA, 2013) or subthreshold BED (BED of low frequency and those with subjective binge eating episodes) were eligible. Exclusion criteria were: concurrent treatment for BED or for weight problems (but including those who had previously undergone bariatric surgery), occasional purging behavior, comorbid psychiatric conditions that require immediate attention (e.g. acute psychosis and suicidality), medical conditions that preclude treatment of the eating disorder and conditions that warrant individual rather than group treatment (e.g. intellectual disability). Following an initial telephone screening, a clinical interview resulting in a case formulation and a DSM-5 classification was conducted to verify eligibility. Participants were enrolled in either a quasirandomized controlled trial (N = 74: Lammers et al., 2020; 2021), or an effectiveness study (N = 175: Lammers et al., 2022). The first study’s design and hypotheses were registered retrospectively (see https://onderzoekmetmensen.nl/nl/trial/25741). Both trials compared intensive outpatient CBT (CBT+) and DBT-BED. The studies differed in that, in the effectiveness study, patients were not randomized to treatment, and both inclusion and exclusion criteria were less restrictive compared to the controlled trial. The pooled data set included 249 participants, 166 that received CBT+ and 83 that received DBT-BED. Participants started treatment between the beginning of 2012 and the beginning of 2017. Altogether, 214 (85.9%) participants completed treatment, including 144 (86.7%) in CBT+ and 70 (84.3%) in DBT-BED. These participants were included in the current study (see Table 1). All participants completed self-report questionnaires assessing variables of interest at baseline. EOT assessments were obtained for 203 (81.5%) participants, including 132 (79.5%) in CBT+ and 71 (85.5%) in DBT-BED. FU assessments were obtained for 142 (57.0%) participants, including 94 (56.6%) in CBT+ and 48 (57.8%) in DBT-BED. Interventions Dialectical behavior therapy for binge eating disorder (DBT-BED) DBT-BED is based on DBT as developed by Linehan (1993) and teaches mindfulness, emotion regulation and distress tolerance skills, in order to replace binge eating as a way of coping with negative affect (Safer et al., 2009; Telch et al., 2001). The therapy consists of 20 weekly, two-hour group sessions for a maximum of nine participants who start and end together (i.e. a closed group format). It includes weekly weighing and some attention
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