88 Chapter 4 were audio-recorded and rated for treatment adherence by five masters-level students in psychology. Treatment integrity was only assessed after the completion of the data collection so there was no feedback to the therapists during the study. For more details, see Lammers et al. (2020). Assessment All assessment instruments were administered by a research assistant, aware of the treatment condition that patients were in. All the psychopathology measures were self-report questionnaires, assessed at the start of treatment, at the end of treatment and six months after treatment. Demographic information and height were collected at baseline only. Patients’ weight was measured on a balanced scale wearing clothes but no shoes. BMI was computed by dividing bodyweight in kilograms by height in squared meters (kg/m²). Primary outcome measures The frequency of OBE episodes and the global level of eating disorder psychopathology over the past 28 days, were measured using the Dutch version of the Eating Disorder Examination Questionnaire (EDE-Q: Fairburn & Beglin, 2008). The EDE-Q consists of four subscales (dietary restraint, eating concern, shape concern and weight concern) out of which a global score can be calculated. One separate item assesses the amount of OBE’s. Higher scores indicate greater severity. The global score is valid (Aardoom et al., 2012) and the EDE-Q has acceptable to high internal consistency and test-retest reliability (Berg et al., 2012). The internal consistency of the EDE-Q global score at baseline was good (α = .88) in the present sample. Secondary outcome measures The 13-item subscale ‘emotional eating’ of the Dutch Eating Behavior Questionnaire (DEBQ: Van Strien et al., 1986) was used to assess the desire to eat in response to negative emotions. This subscale has good internal consistency and factorial validity (e.g. Barrada et al., 2016); both the reliability and validity of the DEBQ are rated as good (enough) (COTAN, 2013). Higher scores indicate higher levels of emotional eating. The internal consistency of the DEBQ emotional eating score at baseline was excellent (α = .910) in the present sample. In order to measure the tendency toward poor impulse regulation and mood intolerance, the 8-item subscale ‘emotional dysregulation’ of the Eating Disorder Inventory (EDI-3, Garner & Van Strien, 2015) was used. The EDI-3 is a reliable and valid instrument and can be used in eating disorder patients (Clausen et al., 2011; Lehmann et al., 2013; SeguraGarcia et al., 2015). Higher scores indicate more dysregulation in emotion. The internal
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