137 Summary and general discussion 6 psychopathology. However, findings favor CBT+ over the less intensive DBT-BED on several other measures. What is the effectiveness of DBT-BED compared to CBT+ in a broader group of individuals with (subthreshold) BED in everyday clinical practice? (Chapter 4) We replicated the quasi-randomized study of Chapter 3 in individuals with (subthreshold) BED who were not randomized to treatment, in order to see whether the same results would show up in a broader group, more closely reflecting everyday clinical practice. Although decreases in global eating disorder psychopathology were achieved faster with CBT+ and the CBT+ group showed less depressive symptomatology at six-month FU, the DBT-BED program also lead to robust improvements. Most importantly, there were no significant differences between the groups at both EOT and FU when looking at OBE episodes, and no significant differences between the groups on global eating disorder pathology at FU. Further, there was a trend toward relapse in global eating disorder psychopathology in CBT+ at FU. Shortly, the findings from the original study (Chapter 3) favoring CBT+ more distinctively, were not replicated. Differences between treatments were smaller in this broader group. Which patients profit most from CBT+ and which patients may be more likely to profit from DBT-BED? (Chapter 5) Irrespective of overall treatment outcome, subsets of patients with certain symptom presentations or characteristics may profit more from one treatment versus another. Moderator analyses (Chapter 5) tentatively revealed a pattern in which low baseline levels of shape/weight overvaluation, low shape concerns and low self-esteem, were related to a greater decrease in OBE episodes in CBT+ than in DBT-BED. Higher levels of these variables showed smaller to no differences between treatments. Similarly, emotional eating and difficulty in identifying feelings moderated EOT and FU outcome respectively. Here however, there was a turning point: individuals with the highest scores showed better outcome with DBT-BED than with CBT+ at EOT (for emotional eating) and FU (for difficulty in identifying feelings). Emotional eating was the only variable that moderated outcome with a large effect. All other detected effects were small. Depression levels, dietary restraint, weight concerns, emotion dysregulation and anxiety did not moderate treatment outcome, suggesting that baseline levels on these variables are not differentially related to outcome. In short, this study provides preliminary evidence that BED treatment outcome could be enhanced by matching individuals with specific symptom presentations to DBT-BED or
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