The purpose of this study is to test the feasibility, acceptability, and preliminary efficacy of a novel couple-based intervention for binge-eating disorder (BED).
Although current individual treatments exist for BED (e.g., cognitive-behavior therapy and interpersonal psychotherapy) about 20% of individuals who complete treatment and who are abstinent from binge eating post-treatment relapse within one year. In addition, dropout of BED treatment is high (approximately 10 - 33%), indicating that a significant number of individuals with BED fail to achieve relief from their symptoms. Couple-based interventions, which enlist the support of a partner into the treatment setting, are effective for treating anxiety and depression--frequently comorbid conditions with BED. Preliminary findings of couple-based treatment for anorexia nervosa suggests it assists in reducing drop out and improving outcome. Thus, the investigators developed a novel couple-based intervention for adult BED (UNITE-BED Edition) and plan to investigate it in an open treatment trial to examine it's feasibility, acceptability, and preliminary efficacy. Both patients and partners will be involved in all psychotherapy sessions of the treatment. Couples' progress will be followed for three months after completion of active treatment.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
11
UNITE is a manualized, 22-session CBCT (cognitive behavioral couples therapy) intervention that engages the couple to target the core psychopathology of BED and address the uniquely challenging stress that BED places on intimate relationships.
UNC Center of Excellence for Eating Disorders
Chapel Hill, North Carolina, United States
Total score at Post-treatment of the Client Satisfaction Questionnaire-8 (CSQ-8)- Patient
8-item self-report scale assessing the effectiveness of, and satisfaction with, content and format of treatment.
Time frame: Post-treatment (on average 6 months after beginning treatment)
Total score at Post-treatment of the Client Satisfaction Questionnaire-8 (CSQ-8)- Partner
8-item self-report scale assessing the effectiveness of, and satisfaction with, content and format of treatment.
Time frame: Post-treatment (on average 6 months after beginning treatment)
Number of patients with binge-eating remission (0 objective binge episodes over last 28 days) at post-treatment determined by Eating Disorder Examination (EDE)
Clinical interview used to establish the diagnosis of BED and eating disorder severity. It inquires about the number of objective and subjective binge episodes and days over the 28 days prior to the assessment period.
Time frame: Post-treatment (on average 6 months after beginning treatment)
Number of patients with binge eating remission (0 objective binge-eating episodes in last 28 days) at 3-month follow-up determined by the Eating Disorder Examination (EDE)
Clinical interview used to establish the diagnosis of BED and eating disorder severity. It inquires about the number of objective and subjective binge episodes and days over the 28 days prior to the assessment period.
Time frame: 3-Month Follow-up
Change from Baseline to Post-Treatment in the Eating Disorder Examination (EDE) Binge Eating Episode Frequency Score- Patient
Clinical interview used to establish the diagnosis of BED and eating disorder severity. It inquires about the number of objective and subjective binge episodes and days over the 28 days prior to the assessment period.
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Time frame: Baseline, Post-Treatment (on average 6 months after beginning treatment)
Change from Baseline to 3-Month Follow-up in the Eating Disorder Examination (EDE) Binge Eating Episode Frequency Score- Patient
Clinical interview used to establish the diagnosis of BED and eating disorder severity. It inquires about the number of objective and subjective binge episodes and days over the 28 days prior to the assessment period.
Time frame: Baseline, 3-Month Follow-up
Change from Baseline to Post-Treatment in the Eating Disorder Examination (EDE) Number of Days Binge Eating Score- Patient
Clinical interview used to establish the diagnosis of BED and eating disorder severity. It inquires about the number of objective binge and subjective episodes and days over the 28 days prior to the assessment period.
Time frame: Baseline, Post-Treatment (on average 6 months after beginning treatment)
Change from Baseline to 3-Month Follow-up in the Eating Disorder Examination (EDE) Number of Days Binge Eating Score- Patient
Clinical interview used to establish the diagnosis of BED and eating disorder severity. It inquires about the number of objective and subjective binge episodes and days over the 28 days prior to the assessment period.
Time frame: Baseline, 3-Month Follow-up
Change from Baseline to Post-Treatment in the Binge Eating Scale (BES) Binge Eating Symptom Severity- Patient
16-item self-report scale assessing the presence of specific binge-eating behaviors commonly observed in individuals with BED.
Time frame: Baseline, Post-Treatment (on average 6 months after beginning treatment)
Change from Baseline to 3-Month Follow-up in the Binge Eating Scale (BES) Binge Eating Symptom Severity- Patient
16-item self-report scale assessing the presence of specific binge-eating behaviors commonly observed in individuals with BED.
Time frame: Baseline, 3-Month Follow-up
Change from Baseline to Post-Treatment in the Yale-Brown Obsessive Compulsive Scale Modified for Binge Eating (YBOCS-BE) Total Score- Patient
Clinical interview used to assess obsessiveness of binge-eating thoughts and compulsiveness of binge-eating behaviors.
Time frame: Baseline, Post-Treatment (on average 6 months after beginning treatment)
Change from Baseline to 3-Month Follow-up in the Yale-Brown Obsessive Compulsive Scale Modified for Binge Eating (YBOCS-BE) Total Score- Patient
Clinical interview used to assess obsessiveness of binge-eating thoughts and compulsiveness of binge-eating behaviors.
Time frame: Baseline, 3-Month Follow-up
Change from Baseline to Post-Treatment in the Eating Disorder Examination (EDE) Total Score- Patient
Clinical interview used to establish the diagnosis of BED and eating disorder severity. It inquires about eating disorder symptoms and severity over the 28 days prior to the assessment period.
Time frame: Baseline, Post-Treatment (on average 6 months after beginning treatment)
Change from Baseline to 3-Month Follow-up in the Eating Disorder Examination (EDE) Total Score- Patient
Clinical interview used to establish the diagnosis of BED and eating disorder severity. It inquires about eating disorder symptoms and severity over the 28 days prior to the assessment period.
Time frame: Baseline, 3-Month Follow-up
Change from Baseline to Post-Treatment in the Beliefs about Obese People Scale (BAOP) Total Score- Patient
8-item self-report scale assessing beliefs about the controllability of obesity.
Time frame: Baseline, Post-Treatment (on average 6 months after beginning treatment)
Change from Baseline to 3-Month Follow-up in the Beliefs about Obese People Scale (BAOP) Total Score- Patient
8-item self-report scale assessing beliefs about the controllability of obesity.
Time frame: Baseline, 3-Month Follow-up
Change from Baseline to Post-Treatment in the Attitudes Towards Obese People (ATOP) Total Score- Patient
20-item self-report scale assessing perceptions and attitudes about obese people.
Time frame: Baseline, Post-Treatment (on average 6 months after beginning treatment)
Change from Baseline to 3-Month Follow-up in the Attitudes Towards Obese People (ATOP)
20-item self-report scale assessing perceptions and attitudes about obese people.
Time frame: Baseline, 3-Month Follow-up
Change from Baseline to Post-Treatment in the Beck Depression Inventory-II Scale (BDI) Total Score- Patient
21-item self-report scale assessing severity of current depressive symptoms.
Time frame: Baseline, Post-Treatment (on average 6 months after beginning treatment)
Change from Baseline to 3-Month Follow-up in the Beck Depression Inventory-II (BDI-II) Total Score- Patient
21-item self-report scale assessing severity of current depressive symptoms.
Time frame: Baseline, 3-Month Follow-up
Change from Baseline to Post-Treatment in the Beck Anxiety Inventory Scale (BAI) Total Score- Patient
21-item self-report scale assessing severity of current anxiety symptoms.
Time frame: Baseline, Post-Treatment (on average 6 months after beginning treatment)
Change from Baseline to 3-Month Follow-up in the Beck Anxiety Inventory Scale (BAI) Total Score- Patient
21-item self-report scale assessing severity of current anxiety symptoms.
Time frame: Baseline, 3-Month Follow-up
Change from Baseline to Post-Treatment in the Difficulties in Emotion Regulation Scale (DERS) Total Score- Patient
36-item self-report scale assessing four key areas in emotion regulation: 1) awareness and understanding, 2) acceptance of emotions, 3) ability to control impulsive behaviors when having negative emotions, and 4) ability to use emotion regulation strategies.
Time frame: Baseline, Post-Treatment (on average 6 months after beginning treatment)
Change from Baseline to 3-Month Follow-up in the Difficulties in Emotion Regulation Scale (DERS) Total Score- Patient
36-item self-report scale assessing four key areas in emotion regulation: 1) awareness and understanding, 2) acceptance of emotions, 3) ability to control impulsive behaviors when having negative emotions, and 4) ability to use emotion regulation strategies.
Time frame: Baseline, 3-Month Follow-up
Change from Baseline to Post-Treatment in the 12-Item Short Form Health Survey (SF-12) Physical Component Summary (PCS)- Patient
12-item self-report scale assessing eight different items of functioning over the last month: physical functioning, energy/vitality, bodily pain, social functioning, role limitations due to emotional problems, mental health, and general health.
Time frame: Baseline, Post-Treatment (on average 6 months after beginning treatment)
Change from Baseline to 3-Month Follow-up in the 12-Item Short Form Health Survey (SF-12) Physical Component Summary (PCS)- Patient
12-item self-report scale assessing eight different items of functioning over the last month: physical functioning, energy/vitality, bodily pain, social functioning, role limitations due to emotional problems, mental health, and general health.
Time frame: Baseline, 3-Month Follow-up
Change from Baseline to Post-Treatment in the 12-Item Short Form Health Survey (SF-12) Mental Component Summary (MCS)- Patient
12-item self-report scale assessing eight different items of functioning over the last month: physical functioning, energy/vitality, bodily pain, social functioning, role limitations due to emotional problems, mental health, and general health.
Time frame: Baseline, Post-Treatment (on average 6 months after beginning treatment)
Change from Baseline to 3-Month Follow-up in the 12-Item Short Form Health Survey (SF-12) Mental Component Summary (MCS)- Patient
12-item self-report scale assessing eight different items of functioning over the last month: physical functioning, energy/vitality, bodily pain, social functioning, role limitations due to emotional problems, mental health, and general health.
Time frame: Baseline, 3-Month Follow-up
Change from Baseline to Post-Treatment in the Dyadic Adjustment Scale (DAS) Total Score- Patient
32-item self-report scale assessing the quality of the relationship perceived by participants
Time frame: Baseline, Post-Treatment (on average 6 months after beginning treatment)
Change from Baseline to 3-Month Follow-up in the Dyadic Adjustment Scale (DAS) Total Score- Patient
32-item self-report scale assessing the quality of the relationship perceived by participants
Time frame: Baseline, 3-Month Follow-up
Change from Baseline to Post-Treatment in the Dyadic Adjustment Scale (DAS) Total Score- Partner
32-item self-report scale assessing the quality of the relationship perceived by participants
Time frame: Baseline, Post-Treatment (on average 6 months after beginning treatment)
Change from Baseline to 3-Month Follow-up in the Dyadic Adjustment Scale (DAS) Total Score- Partner
32-item self-report scale assessing the quality of the relationship perceived by participants
Time frame: Baseline, 3-Month Follow-up
Change from Baseline to Post-Treatment in the Communication Patterns Questionnaire Short Form (CPQ-SF) Total Score- Patient
11-item self-report scale assessing how couple communicates about eating and binge eating disorder.
Time frame: Baseline, Post-Treatment (on average 6 months after beginning treatment)
Change from Baseline to 3-Month Follow-up in the Communication Patterns Questionnaire Short Form (CPQ-SF) Total Score- Patient
11-item self-report scale assessing how couple communicates about eating and binge eating disorder.
Time frame: Baseline, 3-Month Follow-up
Change from Baseline to Post-Treatment in the Communication Patterns Questionnaire Short Form (CPQ-SF) Total Score- Partner
11-item self-report scale assessing how couple communicates about eating and binge eating disorder.
Time frame: Baseline, Post-Treatment (on average 6 months after beginning treatment)
Change from Baseline to 3-Month Follow-up in the Communication Patterns Questionnaire Short Form (CPQ-SF) Total Score- Partner
11-item self-report scale assessing how couple communicates about eating and binge eating disorder.
Time frame: Baseline, 3-Month Follow-up
Change from Baseline to Post-Treatment in the Marital Satisfaction Inventory-Revised (MSI-R) Problem Solving Communication (PSC)- Patient
32-item self-report scale assessing communication between partners. The measure has two subscales: Problem Solving Communication (PSC) and Affective Communication (AFC). The 19 true-false items on the PSC reflect three domains: difficulty resolving minor differences, lack of problem solving skills, and inability to discuss sensitive issues. The 13 true-false items on the AFC reflect two dimensions: lack of support/affection and limited disclosure of feelings or lack of understanding.
Time frame: Baseline, Post-Treatment (on average 6 months after beginning treatment)
Change from Baseline to 3-Month Follow-up in the Marital Satisfaction Inventory-Revised (MSI-R) Problem Solving Communication (PSC)- Patient
32-item self-report scale assessing communication between partners. The measure has two subscales: Problem Solving Communication (PSC) and Affective Communication (AFC). The 19 true-false items on the PSC reflect three domains: difficulty resolving minor differences, lack of problem solving skills, and inability to discuss sensitive issues. The 13 true-false items on the AFC reflect two dimensions: lack of support/affection and limited disclosure of feelings or lack of understanding.
Time frame: Baseline, 3-Month Follow-up
Change from Baseline to Post-Treatment in the Marital Satisfaction Inventory-Revised (MSI-R) Problem Solving Communication (PSC)- Partner
32-item self-report scale assessing communication between partners. The measure has two subscales: Problem Solving Communication (PSC) and Affective Communication (AFC). The 19 true-false items on the PSC reflect three domains: difficulty resolving minor differences, lack of problem solving skills, and inability to discuss sensitive issues. The 13 true-false items on the AFC reflect two dimensions: lack of support/affection and limited disclosure of feelings or lack of understanding.
Time frame: Baseline, Post-Treatment (on average 6 months after beginning treatment)
Change from Baseline to 3-Month Follow-up in the Marital Satisfaction Inventory-Revised (MSI-R) Problem Solving Communication (PSC)- Partner
32-item self-report scale assessing communication between partners. The measure has two subscales: Problem Solving Communication (PSC) and Affective Communication (AFC). The 19 true-false items on the PSC reflect three domains: difficulty resolving minor differences, lack of problem solving skills, and inability to discuss sensitive issues. The 13 true-false items on the AFC reflect two dimensions: lack of support/affection and limited disclosure of feelings or lack of understanding.
Time frame: Baseline, 3-Month Follow-up
Change from Baseline to Post-Treatment in the Marital Satisfaction Inventory-Revised (MSI-R) Affective Communication (AFC)- Patient
32-item self-report scale assessing communication between partners. The measure has two subscales: Problem Solving Communication (PSC) and Affective Communication (AFC). The 19 true-false items on the PSC reflect three domains: difficulty resolving minor differences, lack of problem solving skills, and inability to discuss sensitive issues. The 13 true-false items on the AFC reflect two dimensions: lack of support/affection and limited disclosure of feelings or lack of understanding.
Time frame: Baseline, Post-Treatment (on average 6 months after beginning treatment)
Change from Baseline to 3-Month Follow-up in the Marital Satisfaction Inventory-Revised (MSI-R) Affective Communication (AFC)- Patient
32-item self-report scale assessing communication between partners. The measure has two subscales: Problem Solving Communication (PSC) and Affective Communication (AFC). The 19 true-false items on the PSC reflect three domains: difficulty resolving minor differences, lack of problem solving skills, and inability to discuss sensitive issues. The 13 true-false items on the AFC reflect two dimensions: lack of support/affection and limited disclosure of feelings or lack of understanding.
Time frame: Baseline, 3-Month Follow-up
Change from Baseline to Post-Treatment in the Marital Satisfaction Inventory-Revised (MSI-R) Affective Communication (AFC)- Partner
32-item self-report scale assessing communication between partners. The measure has two subscales: Problem Solving Communication (PSC) and Affective Communication (AFC). The 19 true-false items on the PSC reflect three domains: difficulty resolving minor differences, lack of problem solving skills, and inability to discuss sensitive issues. The 13 true-false items on the AFC reflect two dimensions: lack of support/affection and limited disclosure of feelings or lack of understanding.
Time frame: Baseline, Post-Treatment (on average 6 months after beginning treatment)
Change from Baseline to 3-Month Follow-up in the Marital Satisfaction Inventory-Revised (MSI-R) Affective Communication (AFC)- Partner
32-item self-report scale assessing communication between partners. The measure has two subscales: Problem Solving Communication (PSC) and Affective Communication (AFC). The 19 true-false items on the PSC reflect three domains: difficulty resolving minor differences, lack of problem solving skills, and inability to discuss sensitive issues. The 13 true-false items on the AFC reflect two dimensions: lack of support/affection and limited disclosure of feelings or lack of understanding.
Time frame: Baseline, 3-Month Follow-up
Change from Baseline to Post-Treatment in the Accommodation and Enabling Scale for Eating Disorders (AESED)- Partner
30-item self-report scale assessing accommodating and enabling behaviors of caregivers of people with eating disorders, including subscales for avoidance, modifying routines, reassurance seeking, meal rituals, control of family, and turning a blind eye. Measure edited to be specific to the significant other.
Time frame: Baseline, Post-Treatment (on average 6 months after beginning treatment)
Change from Baseline to 3-Month Follow-up in the Accommodation and Enabling Scale for Eating Disorders (AESED)- Partner
30-item self-report scale assessing accommodating and enabling behaviors of caregivers of people with eating disorders, including subscales for avoidance, modifying routines, reassurance seeking, meal rituals, control of family, and turning a blind eye. Measure edited to be specific to the significant other.
Time frame: Baseline, 3-Month Follow-up
Change from Baseline to Post-Treatment in the Beliefs about Obese People Scale (BAOP) Total Score- Partner
8-item self-report scale assessing beliefs about the controllability of obesity.
Time frame: Baseline, Post-Treatment (on average 6 months after beginning treatment)
Change from Baseline to 3-Month Follow-up in the Beliefs about Obese People Scale (BAOP) Total Score- Partner
8-item self-report scale assessing beliefs about the controllability of obesity.
Time frame: Baseline, 3-Month Follow-up
Change from Baseline to Post-Treatment in the Attitudes Towards Obese People (ATOP) Total Score- Partner
20-item self-report scale assessing perceptions and attitudes about obese people.
Time frame: Baseline, Post-treatment (on average 6 months after beginning treatment)
Change from Baseline to 3-Month Follow-up in the Attitudes Towards Obese People (ATOP) Total Score- Partner
20-item self-report scale assessing perceptions and attitudes about obese people.
Time frame: Baseline, 3-Month Follow-up
Change from Baseline to Post-Treatment in the Beck Depression Inventory-II Scale (BDI-II) Total Score- Partner
21-item self-report scale assessing severity of current depressive symptoms.
Time frame: Baseline, Post-Treatment (on average 6 months after beginning treatment)
Change from Baseline to 3-Month Follow-up in the Beck Depression Inventory-II Scale (BDI-II) Total Score- Partner
21-item self-report scale assessing severity of current depressive symptoms.
Time frame: Baseline, 3-Month Follow-up
Change from Baseline to Post-Treatment in the Beck Anxiety Inventory Scale (BAI) Total Score- Partner
21-item self-report scale assessing severity of current anxiety symptoms.
Time frame: Baseline, Post-Treatment (on average 6 months after beginning treatment)
Change from Baseline to 3-Month Follow-up in the Beck Anxiety Inventory Scale (BAI) Total Score- Partner
21-item self-report scale assessing severity of current anxiety symptoms.
Time frame: Baseline, 3-Month Follow-up
Change from Baseline to Post-Treatment in the Difficulties in Emotion Regulation Scale (DERS) Total Score- Partner
36-item self-report scale assessing four key areas in emotion regulation: 1) awareness and understanding, 2) acceptance of emotions, 3) ability to control impulsive behaviors when having negative emotions, and 4) ability to use emotion regulation strategies.
Time frame: Baseline, Post-Treatment (on average 6 months after beginning treatment)
Change from Baseline to 3-Month Follow-up in the Difficulties in Emotion Regulation Scale (DERS) Total Score- Partner
36-item self-report scale assessing four key areas in emotion regulation: 1) awareness and understanding, 2) acceptance of emotions, 3) ability to control impulsive behaviors when having negative emotions, and 4) ability to use emotion regulation strategies.
Time frame: Baseline, 3-Month Follow-up