اثربخشی درمان شناختی رفتاری بر علائم اصلی بولیمیا

Cognitive behavioral therapy (CBT) is widely regarded as the treatment of choice for bulimia nervosa (BN), with previous reviews of the CBT outcome literature claiming an approximate 40%–50% recovery rate. Most of these reviews have focused on reductions of binge eating and purging; however, the cognitive model of BN that underlies the CBT approach identifies three additional symptoms as central to the disorder: restrictive eating, concerns with shape and weight, and self-esteem. The purpose of this review was to determine the effect of CBT on the five core symptoms of BN, particularly those neglected in previous reviews. This review found that while most studies provided outcome data on binge eating, purgative behavior, and concern with shape and weight, fewer studies provided data on restraint and self-esteem. While generally favorable, evidence for the efficacy of CBT on the core symptoms of BN was mixed, depending on the outcome measures used. Shortcomings in the literature are identified and suggestions to correct these shortcomings are provided.

Cognitive behavioral therapy (CBT) is widely regarded as the treatment of choice for bulimia nervosa (BN; Chambliss et al., 1998, Vitousek, 1996, Whittal et al., 1999 and Wilson, 1999). Previous reviews of the treatment outcome literature have claimed that approximately 40%–50% of patients treated with CBT recover from the disorder Agras, 1997, Fairburn, 1997 and Keel and Mitchell, 1997, as evidenced by reductions in binge eating and purging following treatment. Bulimia nervosa, however, consists of more than the symptoms of binge eating and purging. The most recent edition of the Diagnostic and Statistical Manual of Mental Disorders also requires that an individual's self-evaluation be unduly influenced by body shape and weight for a diagnosis of BN to be given (American Psychiatric Association, 1994). The complex nature of BN is also reflected in the cognitive model of the disorder, developed by Fairburn and colleagues Fairburn, 1997, Fairburn et al., 1993, Wilson and Fairburn, 1993 and Wilson et al., 1997.