A plethora of research has linked negative affect with binge eating in people with binge eating disorder (BED). Cognitive behavioural therapy (CBT) and interpersonal therapy (IPT) have not traditionally addressed emotional regulation deficits. Failure to address emotional aspects of binge eating may explain why some individuals do not respond to CBT or IPT, and why many of those who do respond relapse shortly after finishing treatment. Dialectical behaviour therapy (DBT) specifically targets the inability to accurately recognise and regulate affect. Preliminary investigations have shown that DBT may be efficacious in treating BED. However, it can take up to 10 months, and a shorter intervention targeting affect regulation and recognition may produce similar effects. Four studies evaluating a ten session emotion-focussed group psychoeducational intervention for BED were conducted. In the first, 25 women diagnosed with subthreshold or full syndrome BED (using DSM-IV-TR criteria) were treated. The second study tested whether the specific components of the intervention, or the treatment as a whole, was required to produce positive outcomes in women. Study three, examined the efficacy of the treatment programme with three men diagnosed with subthreshold or full syndrome BED (also using DSM-IV-TR criteria). The fourth study compared the women's and men's response to treatment. Following the intervention with women, binge abstinence rates, comparable to those of CBT and IPT, and various other positive changes to eating and general pathology, were observed. These effects were well-maintained up to one-year later. Overall, it was concluded that the whole treatment programme was necessary to produce the optimum outcome for BED in women. A positive outcome was measured in the men, although the effects were not as dramatic as those found in the women. Suggestions for improvements, and suggestions for further research, are discussed. The results provide support for the Affect Regulation Model of BED in women and men.

A plethora of research has linked negative affect with binge eating in people with binge eating disorder (BED). Cognitive behavioural therapy (CBT) and interpersonal therapy (IPT) have not traditionally addressed emotional regulation deficits. Failure to address emotional aspects of binge eating may explain why some individuals do not respond to CBT or IPT, and why many of those who do respond relapse shortly after finishing treatment. Dialectical behaviour therapy (DBT) specifically targets the inability to accurately recognise and regulate affect. Preliminary investigations have shown that DBT may be efficacious in treating BED. However, it can take up to 10 months, and a shorter intervention targeting affect regulation and recognition may produce similar effects. Four studies evaluating a ten session emotion-focussed group psychoeducational intervention for BED were conducted. In the first, 25 women diagnosed with subthreshold or full syndrome BED (using DSM-IV-TR criteria) were treated. The second study tested whether the specific components of the intervention, or the treatment as a whole, was required to produce positive outcomes in women. Study three, examined the efficacy of the treatment programme with three men diagnosed with subthreshold or full syndrome BED (also using DSM-IV-TR criteria). The fourth study compared the women's and men's response to treatment. Following the intervention with women, binge abstinence rates, comparable to those of CBT and IPT, and various other positive changes to eating and general pathology, were observed. These effects were well-maintained up to one-year later. Overall, it was concluded that the whole treatment programme was necessary to produce the optimum outcome for BED in women. A positive outcome was measured in the men, although the effects were not as dramatic as those found in the women. Suggestions for improvements, and suggestions for further research, are discussed. The results provide support for the Affect Regulation Model of BED in women and men.

To evaluate psychological treatments for adolescent binge-eating disorder (BED), reliable information on therapeutic process factors is needed. This study examines therapist adherence and therapeutic alliance and their associations in cognitive-behavioural therapy (CBT) for adolescents with BED. In a randomised-controlled efficacy trial, adherence and alliance were objectively determined based on 247 audio-taped CBT sessions from a sample of N = 64 adolescents with BED. Variability of adherence and alliance, explained by treatment module, patient, and therapist were examined using multilevel modeling. Although adherence and alliance were excellent and unaffected by treatment module and therapist, there was significant between-patient variability for both concepts. Adherence was negatively associated with patient's treatment expectation. Alliance was negatively associated with the number of loss of control eating episodes and positively associated with adherence. Excellent adherence supported the internal validity of CBT for adolescent BED. Associations between process factors and patient characteristics demand adequate supervision in CBT.

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