95 Dialectical behavior therapy compared to cognitive behavior therapy in binge eating disorder 4 Table 3: Percentage of participants that went from above to below the cutoff of 2.66 on the EDE-Q global score CBT+ DBT-BED Fisher’s Exact p End of Treatment 55.6% (74/133) 35.7% (15/42) .033 Follow-up 59.4% (79/133) 52.4% (22/42) .475 Treatment adherence Mean session integrity for DBT-BED and CBT+ was 79.1% (SD = 15.0) and 63.5% (SD = 24.1) respectively, with a statistically significant difference in favor of DBT (95% CI = 7.82 – 23.38). Interrater reliability was established by five raters rating four tapes independently. The average kappa coefficient across raters and tapes was .63 (95% CI = .476 - .780) suggesting good agreement. Discussion This study evaluated whether the results of a quasi-randomized treatment trial comparing DBT-BED and CBT+ in individuals with BED (Lammers et al., 2020), would be replicated in patients who were not included in that study, but were treated at the same center over the same period. This group more closely represents everyday clinical practice, including those with both BED and subthreshold BED, BMI below 30, and lower scores on emotional eating. Overall, findings are relatively similar: both DBT-BED and CBT+ lead to significant improvements in outcomes. However, decreases in global eating disorder psychopathology were achieved faster with CBT+ and the CBT+ group showed less depressive symptomatology at six-month follow-up. Our earlier findings were not replicated: there were neither any significant differences between the groups in the number of OBE episodes, emotional dysregulation and self-esteem at end of treatment, nor in eating disorder psychopathology and self-esteem at six-month follow-up. Figure 2. EDE-Q Global and BDI-II scores for the CBT+ and DBT-BED groups
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