Self-regulation deficits moderate treatment outcomes in a clinical trial evaluating just-in-time adaptive interventions as an augmentation to cognitive-behavioral therapy for bulimia-spectrum eating disorders
Abstract
Objective: Just-in-time adaptive interventions (JITAIs), momentary interventions delivered at identified times of risk, may improve skill utilization during cognitive-behavioral therapy (CBT-E) for bulimia-spectrum eating disorders (BN-EDs). JITAIs may be especially helpful for individuals with self-regulation deficits, including emotion regulation deficits and elevated impulsivity. Method: Participants (N = 55 with BN-EDs) received 16 sessions of CBT-E with electronic self-monitoring and were randomized to receive JITAIs (JITAIs-On) or not receive JITAIs (JITAIs-Off). Baseline Difficulties in Emotion Regulation Scale (DERS) and UPPS-P Impulsive Behavior Scale (UPPS-P) total scores were examined as moderators of baseline to post-treatment change in binge episodes, compensatory behaviors, and Eating Disorder Examination (EDE) global score using repeated measures ANOVAs. Results: Emotion regulation difficulties significantly moderated compensatory behavior change (F[1, 51] = 4.31, p = .04, ηp2 = 0.08) such that individuals with emotion regulation deficits demonstrated greater improvements in the JITAIs-On condition. Impulsivity moderated change in binge episodes (F[1, 51] = 8.94, p = .004, ηp2 = 0.15) and compensatory behaviors (F[1, 51] = 7.83, p = .007, ηp2 = 0.13), such that individuals with high impulsivity showed greater improvement in the JITAIs-On condition. Neither DERS nor UPPS-P scores moderated EDE global score change. Discussion: JITAIs appear particularly…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 55 participants or records.
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