Table 1 Treatment trials
From: Eating disorders, disordered eating, and body image research in New Zealand: a scoping review
References | Population focus | Focus | Key data collected | Sample n | Gender | Age | Ethnicity | Summary findings |
|---|---|---|---|---|---|---|---|---|
Babbott [59]* | Non-clinical (NC) | Non-concurrent multiple baseline: Trialling acceptance and commitment therapy for disordered eating | EAT-26, AAQ, SWLS, SA-45 | 17 | 12% M 88% F | 18–64 | 64.7% European, 5.9% Māori, 11.8% Indian, 11.8% Latin American, 5.9% South African | Significant decrease in eating pathology, but not general pathology |
Bulik [18] | BN (BTS) | RCT: Results from end of RCT and follow-up at 6 and 12 months. Therapies were CBT + then randomisation to 1) exposure with response prevention to binges (B-ERP), 2) to purging (P-ERP) or 3) relaxation | Physiological, biological measures, self-report measures, SCID I and II, HDRS, GAF, EDI | 135 | F | 17–45 | BTS sample 91% European 6% Maori, Pasifika, Asian | All therapies were effective and did not differ on abstinence or binge purge frequency. B-ERP had advantage for other ED symptoms, and mood but this was not maintained over follow-up |
Carter [60] | BN (BTS) | RCT: 3-year follow up of BTS | Structured interview of ED symptoms, EDI, HDRS, GAF | 135 (113 at follow up) | F | 17–45 | BTS sample | At the 3-year follow-up, 85% of the sample had no current diagnosis of bulimia nervosa. Failure to complete CBT was associated with inferior outcome. No differential effects were found for exposure versus nonexposure-based treatment |
Carter [61] | AN (ATS) | RCT: long-term efficacy of three psychotherapies for AN (ATS) | SCID (DSM-IV). Global AN symptom status,, physical, cognitive and behavioural ED measures, EDE, EDI-2, GAF, HDRS | 43 | F | 17–40 | ATS sample 100% European | SSCM advantage over CBT and IPT during treatment was not sustained. All effective bus no significant differences among treatments at follow-up |
Clyne [62] | BED | Single case design with multiple baseline evaluation: preliminary trial of a psychoeducational group programme of emotion regulation for treatment of BED | Daily Log of Eating and Emotions, BES, QEWP, DASS, PSS, The COPE, EIS, TAS-20, ATSS | 11 | F | 18–69 | 100% European | Reduced binge-eating, alexithymia, stress, and depression. Improvements in cognition. At 2/3 month follow up, all participants no longer met criteria for BED |
Clyne [63] | BED | Non-randomised with waitlist control group: regulation of negative emotion as a possible BED treatment | QEWP, EDE, EDE-Q, BES, EES | 23 | F | 18–65 | 91.3% European, 4.3% Māori, 4.3% Other | Treatment outcomes comparable to existing therapies for BED |
Davey [64]* | BN, AN, EDNOS, NC | Quasi-experimental (non-randomised) 2-group comparison: Efficacy of two pre-treatment interventions focused on motivation. Groups were motivation + education versus motivation alone | EDE-Q4, BDI-II, Dflex, MSOC, Change Continuum | 252 | 97% F, 3%M | 11–62 | 88.5% European, 4.8% Māori, 4.8% Asian, 0.8% Pasifika, 0.4% South American, 0.8% Middle Eastern | Improvements in motivational stage of change were observed in both groups, while improvements in patient readiness, confidence and importance to change as well as treatment attendance were identified in the pure Motivation Group |
de Hoedt Norgrove [65]* | Emotional eaters | Multiple baseline design: Acceptance and commitment therapy (ACT) for emotional eating using a multiple baseline | Feedback questionnaire, MEAQ, valuing questionnaire, AAO, CES, GHQ, journal entries (e.g. frequency of unhealthy eating) | 8 | 6 F 2 M | 18–52 | 75% European, 12.5% European/Māori, 12.5% Māori/ Pasifika | Reduction in binge eating, associated with decreased experiential avoidance and cognitive inflexibility |
McIntosh [17] | AN (ATS) | RCT: comparing efficacy of CBT versus IPT versus a control therapy (nonspecific supportive clinical management | Global AN symptom status, SCID for DSM-IV, EDE, HDRS, GAF, EDI-2 | 56 | F | 17–40 | ATS sample 96% European | Nonspecific supportive clinical management (subsequently called SSCM) superior in completers and intention to treat analyses |
McIntosh [66] | BN (BTS) | RCT: Long-term follow up of participants from RCT for BN | SCID, Structured interview of ED symptoms, EDI, HDRS, GAF | 135 (109 at follow up) | F | 14–45 | BTS sample | Those in in SSCM group more likely to have a good outcome post-treatment, but no differences between groups at long-term (5 year) follow-up |
McIntosh [19] | BED, BN (BEP) | RCT: efficacy of three therapies for binge eating: Standard CBT versus CBT augmented with schema therapy versus CBT with a focus on appetite | SCID-I and II, EDE-12, EDI-2, SCL-90-R | 56 | F | 16–65 | BEP sample | All groups improved but no significant differences between therapies |
Mercier [67]* | BN | RCT: Tested intervention aiming to alter coping behaviours and cognitive processes in those with BN versus directly targeting clinical features. Wait-list control and follow-up design | General information questionnaire, DSSI-R, The Bulimia Test, Affectometer 2, BDI, RSES, STAI, TAI | 24 | F | 19.3–41.1 | Not stated | Decreased BN behaviours and cognitions following alternative intervention, little difference between intervention groups by 3 years |
Roberts [68] | BN, AN | Single arm design: Efficacy and feedback on group cognitive remediation therapy | Dflex, Autism Quotient, EDE-Q, DASS-21, BMI, qualitative questionnaire | 28 | 96% F 4% M | M 25.07 (SD 8.25) | Not stated | Intervention was effective and had positive qualitative feedback |
Then [69]* | AN | Single arm design: Efficacy of metacognitive therapy modified for the treatment of A | BMI, EDE-Q, MCQ-30, TCQ | 12 | Not stated | M 22.17 (SD 5.17) | 1 NZE, 2 Māori, 3 Samoan, 4 Cook island, 5 Tongan, 6 Niuean, 7 Chinese, 8 Indian, 9 other | Mixed results but there were reductions in patients positive beliefs about worry, depressive symptoms, worries and rumination levels following metacognitive therapy |
Wallis [70]* | BED | Quasi-experimental (non-randomised intervention) with control: Teaching emotional discrimination and management in a group programme for those with BED | EDI-2, MHO, BDI, BAI, EES, COPE, GHQ | 6 (BED n = 3, NC n = 3) | F | 25–47 | 83% European, 17% Māori | EDI-2, EES, BDI, BAI, and COPE results indicated positive results following the programme |
Wilksch [71] | NC (MS -T) | RCT: Trialling online programs for efficacy in reducing risk of disordered eating in an Australasian sample | EDE-Q | 575 | F | 18–25 | 82.2% European, 8.8% Asian, other not stated | Media Smart Targeted program reduction in DE |
Wilksch [72] | BED, BN, AN, OSFED, NC (MS—T) | RCT: Programme seeking to reduce risk of eating disorder diagnosis in NZ and Australia | EDE-Q | 316 (MS-T n = 122 (baseline ED diagnosis n = 90): CT = 194 (baseline ED diagnosis n = 130)) | F | M 20.8 (SD 2.26) | MS-T sample | At 12-month follow up MS-T participants were 75% less likely than controls to meet ED criteria, this finding was also significant amongst both non-treatment seekers and treatment seekers |
Wilksch [73] | NC | RCT: An online 9-module eating disorder risk reduction program (Media Smart—Targeted (MS-T)) and control condition (positive body-image tips) | DASS-21, Mini International Neuropsychiatric Interview (dependence on alcohol, dependence on recreational drugs, high suicidality) | 316 | F | 18–25 | States most common is European and Asian | MS-T shows positive effect on eating disorder risk, as well as other mental health factors |