Uniting Couples in the Treatment of Binge-Eating Disorder
Condition: Binge-Eating Disorder
MeSH terms: Bulimia; Feeding and Eating Disorders; Binge-Eating Disorder
Study type: Interventional

Summary: 
      The purpose of this study is to test the feasibility, acceptability, and preliminary
      effectiveness of a novel couple-based intervention for binge-eating disorder (BED) relative
      to an established evidence-based individual treatment (cognitive-behavioral therapy-enhanced;
      CBT-E) in a community clinic setting.
    

Detailed description: 
      Clinicians' options for BED treatment are inadequate. Treatments for BED have demonstrated
      efficacy in controlled settings with specialist therapists and expert supervision, but much
      less in known about the effectiveness of BED interventions and whether the transition of
      evidence-based treatments to the community results in poorer outcomes. UNITE activates a key
      resource by incorporating an important part of the patient's social environment (the partner)
      into treatment. The investigators hypothesize that UNITE will show preliminary evidence of
      being superior to CBT-E in achieving binge abstinence via engaging ED-related relationship
      targets, including improved (a) communication around the disorder, (b) disorder-specific
      interpersonal problem-solving/ behavioral change skills, and (c) partner-assisted emotion
      regulation. The investigators will assess targeted relationship domains with observational
      and speech prosody measures during clinic interactions and self-reports reflecting
      experiences outside the clinic. Because the couple is learning how to work together to
      address BED, the investigators hypothesize that maintenance of gains will show evidence
      consistent with superiority in UNITE.
    

Intervention name(s): UNITE; CBT-E
Intervention type(s): Behavioral; Behavioral
Intervention description(s): UNITE includes three stages: early treatment (psychoeducation and understanding the couple's experience of BED within the relationship); mid-treatment (effective communication, interpersonal problem-solving, and emotion regulation skills), and late treatment (relapse prevention). Additional relevant topics may be covered including body image, weight stigma, weight and health concerns, and intimacy and sexuality issues.; CBT-E includes four stages: an introductory stage (psychoeducation, normalization of eating patterns, and symptom self-monitoring); a second, brief stage (review progress and formulate plans for the subsequent treatment phase); a third stage (elimination of dieting, reducing shape checking and avoidance behaviors, educating about mood tolerance, and targeting overevaluation of shape and weight); and the fourth stage (maintaining progress and minimizing relapse risk).
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Participants will be randomized to either couple therapy (UNITE) or individual therapy (CBT-E) for binge-eating disorder and will receive 16 1-hour sessions of the respective treatment. All study hypotheses will be tested using recommended Intent-To-Treat (ITT) methods. Differential treatment effects in individual functioning variables will be tested using 2 (time) x 2 (treatment) mixed-effect ANOVAs for binge-purge frequency and eating disorder outcomes and 2 (partner) x 3 (time) x 2 (treatment) mixed-effect ANOVAs for psychological outcomes. (Some variables will have 4 time points). Differential treatment effects in target relationship variables will be tested using 2 (partner) x 2 (time) x 2 (treatment) mixed-effect ANOVAs for all outcomes except vocally encoded emotional arousal. Differential treatment effects of vocally encoded emotional arousal will be tested using repeated-measures Actor Partner Interdependence Models (RM-APIMS).
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Binge-Eating Disorder; Eating disorders; Couple therapy; CBT