65 Dialectical behavior therapy adapted for binge eating compared to cognitive behavior therapy in obese adults with binge eating disorder 3 Emotion Regulation The urge to eat in response to negative emotions was assessed with the 13-item subscale Emotional Eating of the Dutch Eating Behavior Questionnaire (DEBQ; van Strien, 2015; van Strien et al., 1986). Higher scores indicate higher levels of emotional eating. The reliability and validity of the DEBQ are rated as good (enough) and all subscales have good internal consistency and factorial validity (e.g. Barrada et al., 2016; COTAN, 2013). The subscale Emotional Dysregulation of the Eating Disorder Inventory (EDI-3; Garner & van Strien, 2015) was used to assess the tendency toward poor impulse regulation and mood intolerance. The EDI-3 assesses psychological and behavioral eating disorder symptomatology. Higher scores indicate more psychopathology. The reliability and the validity of the EDI-3 are considered to be good for use in eating disorder patient groups (Lehmann et al., 2013). General Psychopathology General psychopathology was measured using the total score of the Symptom Checklist 90 (SCL-90). The SCL-90 consists of 90 items related to the frequency of experienced physical and psychological complaints in the last week. Higher sum scores reflect more general psychopathology. The reliability and validity of the SCL-90 are good (Arrindell & Ettema, 2003). The Beck Depression Inventory-II (BDI-II) consists of 21 questions about the severity of depressive symptoms in the last week. Higher sum scores indicate more depressive symptoms. The reliability and validity of the BDI-II are good (Beck et al., 1996). Self-esteem was assessed with the EDI-3 subscale Low Self-Esteem (Garner & van Strien, 2015). Weight, Body Mass Index Patients were measured for height and weight, through which we computed their BMI: kg/m². Patients were measured for weight on a balanced scale wearing cloths but no shoes. Dropout Dropout was defined as premature termination of treatment, either patient-initiated or staff-initiated. Patients were allowed to miss a maximum of 2 out of 20 days. If they missed more, they were excluded from treatment and were consequently considered dropout of treatment. When treatment was terminated before the 20-week period ended
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