MICBT for Non-underweight Adults With Eating Disorders

Cognitive Dysfunction Clinical Trial

— MICBT-ED  

Official title:

CBT-E vs CBT-F+Metacognitive Interpersonal Therapy for Non-underweight Adults With Eating Disorders: Study Protocol for a Pilot Randomised Controlled Trial

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT05503745
• Other study ID #: 0000781
• Status: Recruiting
• Phase: N/A
• Start date: May 31, 2022
• Est. completion date: November 30, 2024

Study information

• Verified date: August 2022
• Source: Centro Trattamento Integrato: Disturbi Alimentari e Obesita
• Contact: Gloria Fioravanti
• Phone: +39 348 9255483
• Email: info[@]gloriafioravanti.it
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Eating disorders (ED) are severe but treatable conditions, but there are large margin for improvements in terms of efficacy and adherence. There is room to explore new treatment options who are either more capable to retain patients in therapy, more effective. Alternative their efficacy may match the ones of current available treatments but offer new options to ones that did not respond to available therapies. Here the investigators explored if a combination of CBT-focused plus Metacognitive Interpersonal Therapy (MIT) is an empirically supported therapy for personality disorders and could be a new viable treatment option for non-underweight ED. MIT targets some aspects of ED such as poor awareness of mental states and maladaptive interpersonal schemas that are not included in the transdiagnostic model underlying the most investigated empirically supported treatment for ED that is CBT-E. It is reasonable therefore that targeting these aspects of psychopathology can be a path to treatment adherence and effectiveness

Description:

The study is a pilot randomized controlled trial that aims to evaluate the feasibility and effectiveness of weekly MIT in addiction to CBT-F in a group of adults diagnosed with ED. Specifically, the investigators will investigate in a sample of non-underweight adults presenting with ED whether once compared to CBT-E, a treatment combining MIT and CBT-F is a) feasible, b) well-tolerated and c) potentially effective on eating disorders symptoms and other outcomes. The investigators expect that the experimental group CBT-F+MIT would be able to have high treatment adherence and retention on the ground of previous studies of MIT for personality disorders. They will also expect good outcomes in the primary outcome. Given the small sample this is just a pilot study so any conclusions about other outcomes will be considered preliminary. Results will provide new evidence that may lead to consider CBT-F+MIT a treatment option for ED deserving investigations in larger trials.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 20
• Est. completion date: November 30, 2024
• Est. primary completion date: May 31, 2023
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• ED diagnosed in the past 6 months
• Seeking treatment for eating disorder
• Able to provide written, informed consent
• BMI > 18.5

Exclusion Criteria:

• Acute psychotic episode, psychotic symptoms, Bipolar I disorder; antisocial personality disorder
• Suicidal ideation
• Substance abuse
• Previous psychological intervention for other eating disorders
• Currently involved in other ongoing treatment

Related Conditions & MeSH terms

• Cognitive Dysfunction
• Disease
• Eating Disorders
• Emotion Regulation
• Feeding and Eating Disorders
• Perfectionism
• Personality
• Personality Disorders
• Problem Behavior
• Self Esteem
• Social Interaction

Intervention

Other:
• CBT-F+MIT
The aim is to develop healthier strategies for managing negative thoughts and feelings antecedent to ED and for engaging patients in social interactions that meet their relational basic wishes. They will thus understand that perfectionism and the need for control they experience through ED are coping strategies developed within interpersonal patterns of interaction with significant others, where low self-esteem and emotive dysregulation play a central role. MIT aims to improve individuals' capacity to make sense of their own affect and cognitions and become aware of being driven by maladaptive, rigid and biased schemas about self and others, to form a richer understanding of the mind of the others and use this knowledge to react in more adaptive ways to social difficulties or evolutionary selected wishes. MIT also enables individuals to reflect on how these schemas may act as triggers for ED behavior and to develop more effective coping strategies in face of interpersonal stressors.
• CBT-E
In the first Stage, the treatment will be focused on achieving a shared understanding of the patient's eating disorder and the related maintenance factors. In this phase the patient will be helped to regulate and stabilize his eating habits and so to address his weight concerns. In the second stage, progress made is reviewed in detail. In the third stage, the sessions will be focused on the central processes that are maintaining the psychopathology of the patient's eating disorder. In particular, this involves in addressing concerns about weight and body shape, cognitive and caloric dietary restriction, events and emotions that affect nutrition. In phase three and four clinical perfection, low global self-esteem, intolerance of emotions and interpersonal difficulties are also addressed. Towards the end of the third stage and during the fourth stage, procedures will be also implemented to minimize the risk of short- and long-term relapse.

Locations

Country	Name	City	State
Italy	Centro di Trattamento Integrato. Disturbi Alimentari e Obesità (CTI) di Gloria Fioravanti	Verona	VR

Sponsors (1)

Lead Sponsor	Collaborator
Centro Trattamento Integrato: Disturbi Alimentari e Obesita

Country where clinical trial is conducted

Italy, 

References & Publications (98)

Agras WS, Walsh T, Fairburn CG, Wilson GT, Kraemer HC. A multicenter comparison of cognitive-behavioral therapy and interpersonal psychotherapy for bulimia nervosa. Arch Gen Psychiatry. 2000 May;57(5):459-66. — View Citation

Allen KL, Fursland A, Raykos B, Steele A, Watson H, Byrne SM. Motivation-focused treatment for eating disorders: a sequential trial of enhanced cognitive behaviour therapy with and without preceding motivation-focused therapy. Eur Eat Disord Rev. 2012 May;20(3):232-9. doi: 10.1002/erv.1131. Epub 2011 Jul 26. — View Citation

Aloi M, Rania M, Carbone EA, Caroleo M, Calabrò G, Zaffino P, Nicolò G, Carcione A, Coco GL, Cosentino C, Segura-Garcia C. Metacognition and emotion regulation as treatment targets in binge eating disorder: a network analysis study. J Eat Disord. 2021 Feb 15;9(1):22. doi: 10.1186/s40337-021-00376-x. — View Citation

Aloi M, Rania M, Caroleo M, Carbone EA, Fazia G, Calabrò G, Segura-Garcia C. How are early maladaptive schemas and DSM-5 personality traits associated with the severity of binge eating? J Clin Psychol. 2020 Mar;76(3):539-548. doi: 10.1002/jclp.22900. Epub 2019 Nov 16. — View Citation

Anderson DA, Maloney KC. The efficacy of cognitive-behavioral therapy on the core symptoms of bulimia nervosa. Clin Psychol Rev. 2001 Oct;21(7):971-88. Review. — View Citation

Basile B, Novello C, Calugi S, Dalle Grave R, Mancini F. Childhood Memories in Eating Disorders: An Explorative Study Using Diagnostic Imagery. Front Psychol. 2021 Jul 22;12:685194. doi: 10.3389/fpsyg.2021.685194. eCollection 2021. — View Citation

Bastiani AM, Rao R, Weltzin T, Kaye WH. Perfectionism in anorexia nervosa. Int J Eat Disord. 1995 Mar;17(2):147-52. — View Citation

Bauer, B. G., & Anderson, W. P. (1989). Bulimic beliefs: Food for thought. Journal of Counseling & Development, 67(7), 416-419.

BECK AT, WARD CH, MENDELSON M, MOCK J, ERBAUGH J. An inventory for measuring depression. Arch Gen Psychiatry. 1961 Jun;4:561-71. — View Citation

Bohn, K., & Fairburn, C. G. (2008). The clinical impairment assessment questionnaire (CIA). Cognitive behavioral therapy for eating disorders, 315-317.

Boone L, Braet C, Vandereycken W, Claes L. Are maladaptive schema domains and perfectionism related to body image concerns in eating disorder patients? Eur Eat Disord Rev. 2013 Jan;21(1):45-51. doi: 10.1002/erv.2175. Epub 2012 May 3. — View Citation

Bruch, H. (1973). Psychiatric aspects of obesity. Psychiatric Annals, 3(7), 6-9.

Button EJ, Loan P, Davies J, Sonuga-Barke EJ. Self-esteem, eating problems, and psychological well-being in a cohort of schoolgirls aged 15-16: a questionnaire and interview study. Int J Eat Disord. 1997 Jan;21(1):39-47. — View Citation

Button EJ, Sonuga-Barke EJ, Davies J, Thompson M. A prospective study of self-esteem in the prediction of eating problems in adolescent schoolgirls: questionnaire findings. Br J Clin Psychol. 1996 May;35(2):193-203. — View Citation

Canals J, Carbajo G, Fernández J, Martí-Henneberg C, Domènech E. Biopsychopathologic risk profile of adolescents with eating disorder symptoms. Adolescence. 1996 Summer;31(122):443-50. — View Citation

Casper, R. C. (1983). On the emergence of bulimia nervosa as a syndrome a historical view. International Journal of Eating Disorders, 2(3), 3-16.

Chan AW, Tetzlaff JM, Altman DG, Laupacis A, Gøtzsche PC, Krleža-Jeric K, Hróbjartsson A, Mann H, Dickersin K, Berlin JA, Doré CJ, Parulekar WR, Summerskill WS, Groves T, Schulz KF, Sox HC, Rockhold FW, Rennie D, Moher D. SPIRIT 2013 statement: defining standard protocol items for clinical trials. Ann Intern Med. 2013 Feb 5;158(3):200-7. doi: 10.7326/0003-4819-158-3-201302050-00583. — View Citation

Cheli S, Cavalletti V, Flett GL, Hewitt PL. Perfectionism unbound: An integrated individual and group intervention for those hiding imperfections. J Clin Psychol. 2022 Aug;78(8):1624-1636. doi: 10.1002/jclp.23365. Epub 2022 Apr 29. — View Citation

Claes L, Vandereycken W, Vertommen H. Self-injurious behaviors in eating-disordered patients. Eat Behav. 2001 Autumn;2(3):263-72. — View Citation

Cooper Z, Fairburn CG. The Evolution of "Enhanced" Cognitive Behavior Therapy for Eating Disorders: Learning From Treatment Nonresponse. Cogn Behav Pract. 2011 Aug;18(3):394-402. — View Citation

Dalle Grave R, Calugi S, Conti M, Doll H, Fairburn CG. Inpatient cognitive behaviour therapy for anorexia nervosa: a randomized controlled trial. Psychother Psychosom. 2013;82(6):390-8. doi: 10.1159/000350058. Epub 2013 Sep 20. — View Citation

Dalle Grave R, Calugi S, Doll HA, Fairburn CG. Enhanced cognitive behaviour therapy for adolescents with anorexia nervosa: an alternative to family therapy? Behav Res Ther. 2013 Jan;51(1):R9-R12. doi: 10.1016/j.brat.2012.09.008. Epub 2012 Oct 4. — View Citation

Dalle Grave R, Calugi S, El Ghoch M, Conti M, Fairburn CG. Inpatient cognitive behavior therapy for adolescents with anorexia nervosa: immediate and longer-term effects. Front Psychiatry. 2014 Feb 12;5:14. doi: 10.3389/fpsyt.2014.00014. eCollection 2014. — View Citation

Davis C, Claridge G, Fox J. Not just a pretty face: physical attractiveness and perfectionism in the risk for eating disorders. Int J Eat Disord. 2000 Jan;27(1):67-73. — View Citation

Davis C. Normal and neurotic perfectionism in eating disorders: an interactive model. Int J Eat Disord. 1997 Dec;22(4):421-6. — View Citation

Derogatis, L. R., Lipman, R. S., & Covi, L. (1977). SCL-90. Administration, scoring and procedures manual-I for the R (revised) version and other instruments of the Psychopathology Rating Scales Series. Chicago: Johns Hopkins University School of Medicine.

Dimaggio G, D'Urzo M, Pasinetti M, Salvatore G, Lysaker PH, Catania D, Popolo R. Metacognitive interpersonal therapy for co-occurrent avoidant personality disorder and substance abuse. J Clin Psychol. 2015 Feb;71(2):157-66. doi: 10.1002/jclp.22151. Epub 2014 Dec 31. — View Citation

Dimaggio, G, Ottavi, P, Popolo, R, & Salvatore, G. Metacognitive interpersonal therapy: Body, imagery and change. Routledge. 2020

Dimaggio, G, Semerari, A, Carcione, A, Nicolo, G, & Procacci, M. Psychotherapy of personality disorders: Metacognition, states of mind and interpersonal cycles. 2007; Routledge.

Dimaggio, G., & Lysaker, P. H. (Eds.). (2010). Metacognition and severe adult mental disorders: From research to treatment. Routledge.

Dimaggio, G., Salvatore, G., MacBeth, A., Ottavi, P., Buonocore, L., & Popolo, R. (2017). Metacognitive interpersonal therapy for personality disorders: A case study series. Journal of Contemporary Psychotherapy, 47(1), 11-21.

Fairburn CG, Bailey-Straebler S, Basden S, Doll HA, Jones R, Murphy R, O'Connor ME, Cooper Z. A transdiagnostic comparison of enhanced cognitive behaviour therapy (CBT-E) and interpersonal psychotherapy in the treatment of eating disorders. Behav Res Ther. 2015 Jul;70:64-71. doi: 10.1016/j.brat.2015.04.010. Epub 2015 Apr 22. — View Citation

Fairburn CG, Beglin SJ. Assessment of eating disorders: interview or self-report questionnaire? Int J Eat Disord. 1994 Dec;16(4):363-70. — View Citation

Fairburn CG, Cooper Z, Doll HA, O'Connor ME, Bohn K, Hawker DM, Wales JA, Palmer RL. Transdiagnostic cognitive-behavioral therapy for patients with eating disorders: a two-site trial with 60-week follow-up. Am J Psychiatry. 2009 Mar;166(3):311-9. doi: 10.1176/appi.ajp.2008.08040608. Epub 2008 Dec 15. — View Citation

Fairburn CG, Cooper Z, Doll HA, O'Connor ME, Palmer RL, Dalle Grave R. Enhanced cognitive behaviour therapy for adults with anorexia nervosa: a UK-Italy study. Behav Res Ther. 2013 Jan;51(1):R2-8. doi: 10.1016/j.brat.2012.09.010. Epub 2012 Oct 22. — View Citation

Fairburn CG, Cooper Z, Doll HA, Welch SL. Risk factors for anorexia nervosa: three integrated case-control comparisons. Arch Gen Psychiatry. 1999 May;56(5):468-76. — View Citation

Fairburn CG, Cooper Z, Shafran R. Cognitive behaviour therapy for eating disorders: a "transdiagnostic" theory and treatment. Behav Res Ther. 2003 May;41(5):509-28. — View Citation

Fairburn CG, Doll HA, Welch SL, Hay PJ, Davies BA, O'Connor ME. Risk factors for binge eating disorder: a community-based, case-control study. Arch Gen Psychiatry. 1998 May;55(5):425-32. — View Citation

Fairburn CG, Norman PA, Welch SL, O'Connor ME, Doll HA, Peveler RC. A prospective study of outcome in bulimia nervosa and the long-term effects of three psychological treatments. Arch Gen Psychiatry. 1995 Apr;52(4):304-12. — View Citation

Fairburn CG, Patel V. The global dissemination of psychological treatments: a road map for research and practice. Am J Psychiatry. 2014 May;171(5):495-8. doi: 10.1176/appi.ajp.2013.13111546. — View Citation

Fairburn CG, Peveler RC, Jones R, Hope RA, Doll HA. Predictors of 12-month outcome in bulimia nervosa and the influence of attitudes to shape and weight. J Consult Clin Psychol. 1993 Aug;61(4):696-8. — View Citation

Fairburn CG, Shafran R, Cooper Z. A cognitive behavioural theory of anorexia nervosa. Behav Res Ther. 1999 Jan;37(1):1-13. Review. — View Citation

Fairburn CG, Welch SL, Doll HA, Davies BA, O'Connor ME. Risk factors for bulimia nervosa. A community-based case-control study. Arch Gen Psychiatry. 1997 Jun;54(6):509-17. — View Citation

Fairburn, C. G. (2008). Cognitive behavior therapy and eating disorders. Guilford Press.

Fairburn, C. G., & Beglin, S. J. (2008). Eating disorder examination questionnaire. Cognitive behavior therapy and eating disorders, 309, 313.

Fairburn, CG. Interpersonal psychotherapy for bulimia nervosa. 1997

First, M. B., Williams, J. B., Karg, R. S., & Spitzer, R. L. (2016). User's guide for the SCID-5-CV Structured Clinical Interview for DSM-5® disorders: Clinical version. American Psychiatric Publishing, Inc..

Frostad S, Calugi S, Engen CBN, Dalle Grave R. Enhanced cognitive behaviour therapy (CBT-E) for severe and extreme anorexia nervosa in an outpatient eating disorder unit at a public hospital: a quality-assessment study. J Eat Disord. 2021 Nov 2;9(1):143. doi: 10.1186/s40337-021-00499-1. — View Citation

Frostad S, Danielsen YS, Rekkedal GÅ, Jevne C, Dalle Grave R, Rø Ø, Kessler U. Implementation of enhanced cognitive behaviour therapy (CBT-E) for adults with anorexia nervosa in an outpatient eating-disorder unit at a public hospital. J Eat Disord. 2018 May 29;6:12. doi: 10.1186/s40337-018-0198-y. eCollection 2018. — View Citation

Garner, D. M., & Garfinkel, P. A. (1979). Eating attitudes test (EAT-26): Scoring and interpretation. EAT-26 self-test.

Geller J, Srikameswaran S, Cockell SJ, Zaitsoff SL. Assessment of shape- and weight-based self-esteem in adolescents. Int J Eat Disord. 2000 Nov;28(3):339-45. — View Citation

Ghaderi A, Scott B. Prevalence, incidence and prospective risk factors for eating disorders. Acta Psychiatr Scand. 2001 Aug;104(2):122-30. — View Citation

Gilbert, P., & Leahy, R. L. (Eds.). (2009). La relazione terapeutica in terapia cognitivo comportamentale. Eclipsi.

Gordon-King K, Schweitzer RD, Dimaggio G. Metacognitive Interpersonal Therapy for Personality Disorders Featuring Emotional Inhibition: A Multiple Baseline Case Series. J Nerv Ment Dis. 2018 Apr;206(4):263-269. doi: 10.1097/NMD.0000000000000789. — View Citation

Gormally J, Black S, Daston S, Rardin D. The assessment of binge eating severity among obese persons. Addict Behav. 1982;7(1):47-55. — View Citation

Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of psychopathology and behavioral assessment, 26(1), 41-54.

Grenon R, Carlucci S, Brugnera A, Schwartze D, Hammond N, Ivanova I, Mcquaid N, Proulx G, Tasca GA. Psychotherapy for eating disorders: A meta-analysis of direct comparisons. Psychother Res. 2019 Oct;29(7):833-845. doi: 10.1080/10503307.2018.1489162. Epub 2018 Jun 29. — View Citation

Halmi KA, Goldberg SC, Cunningham S. Perceptual distortion of body image in adolescent girls: distortion of body image in adolescence. Psychol Med. 1977 May;7(2):253-7. — View Citation

Hatcher, R. L., & Gillaspy, J. A. (2006). Development and validation of a revised short version of the Working Alliance Inventory. Psychotherapy research, 16(1), 12-25.

Holderness CC, Brooks-Gunn J, Warren MP. Co-morbidity of eating disorders and substance abuse review of the literature. Int J Eat Disord. 1994 Jul;16(1):1-34. Review. — View Citation

Inchausti F, García-Poveda NV, Ballesteros-Prados A, Ortuño-Sierra J, Sánchez-Reales S, Prado-Abril J, Aldaz-Armendáriz JA, Mole J, Dimaggio G, Ottavi P, Fonseca-Pedrero E. The Effects of Metacognition-Oriented Social Skills Training on Psychosocial Outcome in Schizophrenia-Spectrum Disorders: A Randomized Controlled Trial. Schizophr Bull. 2018 Oct 17;44(6):1235-1244. doi: 10.1093/schbul/sbx168. — View Citation

Inchausti F, Velázquez-Basterra G, Fonseca-Pedrero E, MacBeth A, Popolo R, Dimaggio G. Metacognitive interpersonal group therapy for adolescents with avoidant personality disorder: The case of Sofia. J Clin Psychol. 2022 Aug;78(8):1579-1589. doi: 10.1002/jclp.23356. Epub 2022 Mar 31. — View Citation

Inchausti, F., Moreno-Campos, L., Prado-Abril, J., Sánchez-Reales, S., Fonseca-Pedrero, E., MacBeth, A., ... & Dimaggio, G. (2020). Metacognitive Interpersonal Therapy in group for personality disorders: Preliminary results from a pilot study in a public mental health setting. Journal of Contemporary Psychotherapy, 50(3), 197-203.

Le Grange D, Eckhardt S, Dalle Grave R, Crosby RD, Peterson CB, Keery H, Lesser J, Martell C. Enhanced cognitive-behavior therapy and family-based treatment for adolescents with an eating disorder: a non-randomized effectiveness trial. Psychol Med. 2020 Dec 3:1-11. doi: 10.1017/S0033291720004407. [Epub ahead of print] — View Citation

Lilenfeld LR, Kaye WH, Greeno CG, Merikangas KR, Plotnicov K, Pollice C, Rao R, Strober M, Bulik CM, Nagy L. A controlled family study of anorexia nervosa and bulimia nervosa: psychiatric disorders in first-degree relatives and effects of proband comorbidity. Arch Gen Psychiatry. 1998 Jul;55(7):603-10. — View Citation

Linardon J, Hindle A, Brennan L. Dropout from cognitive-behavioral therapy for eating disorders: A meta-analysis of randomized, controlled trials. Int J Eat Disord. 2018 May;51(5):381-391. doi: 10.1002/eat.22850. Epub 2018 Mar 1. Review. — View Citation

Maher A, Cason L, Huckstepp T, Stallman H, Kannis-Dymand L, Millear P, Mason J, Wood A, Allen A. Early maladaptive schemas in eating disorders: A systematic review. Eur Eat Disord Rev. 2022 Jan;30(1):3-22. doi: 10.1002/erv.2866. Epub 2021 Oct 12. Review. — View Citation

McLaren L, Gauvin L, Steiger H. A two-factor model of disordered eating. Eat Behav. 2001 Spring;2(1):51-65. — View Citation

Meneguzzo P, Cazzola C, Castegnaro R, Buscaglia F, Bucci E, Pillan A, Garolla A, Bonello E, Todisco P. Associations Between Trauma, Early Maladaptive Schemas, Personality Traits, and Clinical Severity in Eating Disorder Patients: A Clinical Presentation and Mediation Analysis. Front Psychol. 2021 Mar 31;12:661924. doi: 10.3389/fpsyg.2021.661924. eCollection 2021. — View Citation

Meyer, C., Waller, G., & Waters, A. (1998). Emotional states and bulimic psychopathology. In H. W. Hoek, J. L. Treasure, & M. A. Katzman (Eds.), Neurobiology in the treatment of eating disorders (pp. 271-287). Chichester: Wiley

Monteleone, A. M., Corsi, E., Cascino, G., Ruzzi, V., Ricca, V., Ashworth, R., ... & Cardi, V. (2020). The interaction between mentalizing, empathy and symptoms in people with eating disorders: A network analysis integrating experimentally induced and self-report measures. Cognitive Therapy and Research, 44(6), 1140-1149.

Murphy R, Straebler S, Cooper Z, Fairburn CG. Cognitive behavioral therapy for eating disorders. Psychiatr Clin North Am. 2010 Sep;33(3):611-27. doi: 10.1016/j.psc.2010.04.004. Review. — View Citation

Neumark-Sztainer D, Hannan PJ. Weight-related behaviors among adolescent girls and boys: results from a national survey. Arch Pediatr Adolesc Med. 2000 Jun;154(6):569-77. — View Citation

Pasetto, A., Misso, D., Velotti, P., & Dimaggio, G. (2021). Metacognitive interpersonal therapy for intimate partner violence: A single case study. Partner abuse, 12(1), 64-79.

Paul T, Schroeter K, Dahme B, Nutzinger DO. Self-injurious behavior in women with eating disorders. Am J Psychiatry. 2002 Mar;159(3):408-11. — View Citation

Popolo R, MacBeth A, Brunello S, Canfora F, Ozdemir E, Rebecchi D, Toselli C, Venturelli G, Salvatore G, Dimaggio G. Metacognitive interpersonal therapy in group: a feasibility study. Res Psychother. 2018 Dec 18;21(3):338. doi: 10.4081/ripppo.2018.338. eCollection 2018 Dec 19. — View Citation

Popolo R, MacBeth A, Canfora F, Rebecchi D, Toselli C, Salvatore G, Dimaggio G. Metacognitive Interpersonal Therapy in group (MIT-G) for young adults with personality disorders: A pilot randomized controlled trial. Psychol Psychother. 2019 Sep;92(3):342-358. doi: 10.1111/papt.12182. Epub 2018 Apr 6. — View Citation

Popolo R, MacBeth A, Lazzerini L, Brunello S, Venturelli G, Rebecchi D, Morales MF, Dimaggio G. Metacognitive interpersonal therapy in group versus TAU + waiting list for young adults with personality disorders: Randomized clinical trial. Personal Disord. 2021 Aug 12. doi: 10.1037/per0000497. [Epub ahead of print] — View Citation

Poulsen S, Lunn S, Daniel SI, Folke S, Mathiesen BB, Katznelson H, Fairburn CG. A randomized controlled trial of psychoanalytic psychotherapy or cognitive-behavioral therapy for bulimia nervosa. Am J Psychiatry. 2014 Jan;171(1):109-16. doi: 10.1176/appi.ajp.2013.12121511. — View Citation

Råstam M. Anorexia nervosa in 51 Swedish adolescents: premorbid problems and comorbidity. J Am Acad Child Adolesc Psychiatry. 1992 Sep;31(5):819-29. — View Citation

Ruggiero GM, Levi D, Ciuna A, Sassaroli S. Stress situation reveals an association between perfectionism and drive for thinness. Int J Eat Disord. 2003 Sep;34(2):220-6. — View Citation

Semerari A, Colle L, Pellecchia G, Buccione I, Carcione A, Dimaggio G, Nicolò G, Procacci M, Pedone R. Metacognitive dysfunctions in personality disorders: correlations with disorder severity and personality styles. J Pers Disord. 2014 Dec;28(6):751-66. doi: 10.1521/pedi_2014_28_137. — View Citation

Semerari, A., Carcione, A., Dimaggio, G., Falcone, M., Nicolo, G., Procacci, M., & Alleva, G. (2003). How to evaluate metacognitive functioning in psychotherapy? The metacognition assessment scale and its applications. Clinical Psychology & Psychotherapy, 10(4), 238-261.

Simonsen S, Popolo R, Juul S, Frandsen FW, Sørensen P, Dimaggio G. Treating Avoidant Personality Disorder With Combined Individual Metacognitive Interpersonal Therapy and Group Mentalization-Based Treatment: A Pilot Study. J Nerv Ment Dis. 2022 Mar 1;210(3):163-171. doi: 10.1097/NMD.0000000000001432. — View Citation

Spielberger, C. D., Gorsuch, R. L., Lushene, R., Vagg, P. R., & Jacobs, G. A. (1983). Manual for the State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press.

Steiger H, Gauvin L, Jabalpurwala S, Séguin JR, Stotland S. Hypersensitivity to social interactions in bulimic syndromes: relationship to binge eating. J Consult Clin Psychol. 1999 Oct;67(5):765-75. — View Citation

Steiger H, Leung F, Thibaudeau J, Houle L, Ghadirian AM. Comorbid features in bulimics before and after therapy: are they explained by axis II diagnoses, secondary effects of bulimia, or both? Compr Psychiatry. 1993 Jan-Feb;34(1):45-53. — View Citation

Steinberg, S., Tobin, D., & Johnson, C. (1990). The role of bulimic behaviors in affect regulation: Different functions for different patient subgroups?. International Journal of Eating Disorders, 9(1), 51-55.

Stice, E. (1994). Review of the evidence for a sociocultural model of bulimia nervosa and an exploration of the mechanisms of action. Clinical psychology review, 14(7), 633-661.

Taylor GJ, Bagby RM, Parker JD. The Revised Toronto Alexithymia Scale: some reliability, validity, and normative data. Psychother Psychosom. 1992;57(1-2):34-41. — View Citation

Thompson-Brenner H, Shingleton RM, Thompson DR, Satir DA, Richards LK, Pratt EM, Barlow DH. Focused vs. Broad enhanced cognitive behavioral therapy for bulimia nervosa with comorbid borderline personality: A randomized controlled trial. Int J Eat Disord. 2016 Jan;49(1):36-49. doi: 10.1002/eat.22468. Epub 2015 Dec 9. — View Citation

Vitousek, K. B., & Hollon, S. D. (1990). The investigation of schematic content and processing in eating disorders. Cognitive therapy and research, 14(2), 191-214.

Waller, G. (2002). The psychology of binge eating. Eating disorders and obesity: A comprehensive handbook, 2, 98-102.

Westwood H, Kerr-Gaffney J, Stahl D, Tchanturia K. Alexithymia in eating disorders: Systematic review and meta-analyses of studies using the Toronto Alexithymia Scale. J Psychosom Res. 2017 Aug;99:66-81. doi: 10.1016/j.jpsychores.2017.06.007. Epub 2017 Jun 11. Review. — View Citation

Wichstrøm L. Social, psychological and physical correlates of eating problems. A study of the general adolescent population in Norway. Psychol Med. 1995 May;25(3):567-79. — View Citation

Wilson GT, Fairburn CC, Agras WS, Walsh BT, Kraemer H. Cognitive-behavioral therapy for bulimia nervosa: time course and mechanisms of change. J Consult Clin Psychol. 2002 Apr;70(2):267-74. — View Citation

Wonderlich SA, Peterson CB, Crosby RD, Smith TL, Klein MH, Mitchell JE, Crow SJ. A randomized controlled comparison of integrative cognitive-affective therapy (ICAT) and enhanced cognitive-behavioral therapy (CBT-E) for bulimia nervosa. Psychol Med. 2014 Feb;44(3):543-53. doi: 10.1017/S0033291713001098. Epub 2013 May 23. Erratum in: Psychol Med. 2014 Aug;44(11):2462-3. — View Citation

Zipfel S, Wild B, Groß G, Friederich HC, Teufel M, Schellberg D, Giel KE, de Zwaan M, Dinkel A, Herpertz S, Burgmer M, Löwe B, Tagay S, von Wietersheim J, Zeeck A, Schade-Brittinger C, Schauenburg H, Herzog W; ANTOP study group. Focal psychodynamic therapy, cognitive behaviour therapy, and optimised treatment as usual in outpatients with anorexia nervosa (ANTOP study): randomised controlled trial. Lancet. 2014 Jan 11;383(9912):127-37. doi: 10.1016/S0140-6736(13)61746-8. Epub 2013 Oct 14. — View Citation

* Note: There are 98 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Eating Disorder Examination Questionnaire (EDE-Q6; Fairburn & Beglin, 1994)	A self report measure assessing eating disorders over the past 4 weeks, providing a measure of the range of severity of eating disorder features.	Change from baseline until after 10 sessions, at the end of the treatment and in the following 3, 6, 12, 18 and 24 months after the treatment.
Primary	Eating Attitude Test (EAT-26; Garner & Garfinkel, 1979)	A self-report measure for identifying the presence of "eating disorder risk" based on attitudes, feelings and behaviors related to eating. It assesses general eating behaviour and risky behaviours.	Change from baseline until after 10 sessions, at the end of the treatment and in the following 3, 6, 12, 18 and 24 months after the treatment.
Primary	Clinical Impairment Assessment Questionnaire (CIA 3.0; Bohn and Fairburn, 2008).	a self-report measure f assessing the severity of psychosocial impairment due to eating disorder features over the past 28 days.	Change from baseline until after 10 sessions, at the end of the treatment and in the following 3, 6, 12, 18 and 24 months after the treatment.
Primary	Binge Eating Scale (BES; Gormally et al., 1992)	a self-report questionnaire of the behavioral, cognitive and emotional features of objective binge eating (OBE).	Change from baseline until after 10 sessions, at the end of the treatment and in the following 3, 6, 12, 18 and 24 months after the treatment.
Secondary	State-Trait Anxiety Inventory (STAI; Spielberger, Gorsuch, Lushene, Vagg, & Jacobs, 1983)	A self-report measure of trait and state anxiety.	At baseline, after 10 sessions, at the end of the treatment and in the following 3, 6, 12, 18 and 24 months after the treatment.
Secondary	Beck Depression Inventory (BDI; Beck, et al., 1961)	A self-report measures of depression.	At baseline, after 10 sessions, at the end of the treatment and in the following 3, 6, 12, 18 and 24 months after the treatment.
Secondary	Symptom Check List (SCL-90)	A measure of psychopathology symptoms and their intensity at a specific point in time.	At baseline, after 10 sessions, at the end of the treatment and in the following 3, 6, 12, 18 and 24 months after the treatment.
Secondary	Difficulties in Emotion Regulation Scale (DERS; Gratz & Roemer, 2004)	A self-report scale measuring individual differences in the ability to identify, accept and manage emotional experiences. This measure help in understanding emotional dysregulation that might underlie the disorders.	At baseline, after 10 sessions, at the end of the treatment and in the following 3, 6, 12, 18 and 24 months after the treatment.
Secondary	Structured Clinical Interview for DSM-5 Disorders (SCID-5; Michael B. First, Janet B.W. Williams)	For assessing and defining DSM-5 Model for Personality Disorders.	At baseline
Secondary	Toronto Alexithymia Scale (TAS - 20; Taylor & Bagby, 1992)	It assess difficulties in understanding, processing, or describing emotions	At baseline, after 10 sessions, at the end of the treatment and in the following 3, 6, 12, 18 and 24 months after the treatment.
Secondary	Working Alliance Inventory-Short Revised (WAI; SR Hatcher & Gillaspy, 2006)	It measure the therapeutic alliance by assessing three main aspects of the therapeutic alliance: agreement on the tasks of therapy, agreement on the goals of therapy and development of an affective bond.	Every 4 weeks