93 Dialectical behavior therapy compared to cognitive behavior therapy in binge eating disorder 4 Primary outcomes Adjusted mean scores on primary measures of outcome for CBT+ and DBT-BED groups at end of treatment and follow-up are presented in Table 2. The CBT+ group experienced greater reductions in EDE-Q Global score at end of treatment (95% CI = .231 - .949), with a medium effect size (d = - 0.62; SRD = -.35). Results of sensitivity analyses using maximum likelihood (ML) imputation produced comparable results. Based upon pairwise 95% confidence intervals, EDE-Q Global scores in both groups decreased significantly between baseline and EOT (95% CI CBT = 1.12 – 1.56; 95% CI DBT = 0.35 – 1.09) and between baseline and follow-up (95% CI CBT = 0.93 – 1.41; 95% CI DBT = 0.74 – 1.66). In DBT-BED, the decrease in scores between EOT and follow-up was also significant (95% CI = 0.15 – 0.80). Table 3 presents the percentage of participants who completed the EDE-Q that shifted from a dysfunctional level at baseline to a functional level at EOT and follow-up (cutoff EDE-Q score: 2.66; Jacobson & Truax, 1991). We found a significant difference at EOT (Fisher’s exact p = .03) favoring CBT+ (55.6%) over DBT-BED (35.7%). This difference between treatments at follow-up was not significant (CBT = 59.4%; DBT = 52.4%, Fisher’s exact p = .48). There were no differences between treatments at any time point regarding OBE episode frequency. Scores in both groups decreased significantly between baseline and EOT (95% CI CBT = 3.26 – 5.91; 95% CI DBT = 1.60 – 6.13), and between baseline and follow-up (95% CI CBT = 3.06 – 5.61; 95% CI DBT = 1.64 – 6.12). Secondary outcomes Results of secondary outcome analyses are presented in Table 2. Small effects are observed in favor of CBT+ on all secondary measures at EOT and on all but DEBQ Emotional Eating (no difference) at follow-up. However, the only difference in secondary outcome measures that reached significance was for BDI-II. The CBT+ group had significantly lower scores on the BDI-II at follow-up (95% CI = 0.15 – 6.97) with a medium effect size (d = -0.45, SRD = -.25). Results of sensitivity analyses confirmed these findings. BDI-II scores in both groups decreased significantly between baseline and EOT (95% CI CBT = 8.97 – 14.20; 95% CI DBT = 5.05 – 14.62) and between baseline and follow-up (95% CI CBT = 8.94 – 14.04; 95% CI DBT = 3.56 – 13.02), but not between EOT and follow-up.
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