Enhancing DBT effectiveness with a mindfulness-based body image group in the treatment for eating disorders.

摘要

Research suggests that body dissatisfaction contributes significantly to onset, maintenance and relapse of eating disorders. Dialectical behavior therapy (DBT) has recently been applied to the treatment of eating disorders, with promising results. However, the effectiveness of focused body image work for patients in DBT has not been studied. This study examines the effectiveness of a 10-week mindfulness-based body image group in a later phase of DBT treatment for eating disorders. The curriculum was based on an empirically validated cognitive-behavioral treatment for body image, and was modified to reflect DBT concepts and to include greater emphasis on mindfulness. Three groups of women (N = 12) participated in the treatment; all participants completed assessments of body image, overall psychiatric functioning, and eating disorder symptoms at pre- and post-intervention. It was hypothesized that participants in the body image group would show statistically significant improvements in body image distress, overall psychiatric functioning, and eating disorder symptoms, and that reductions in body image disturbance would be positively correlated with reductions in eating disorder symptoms and overall psychological distress. Participants showed significant improvements in the importance of appearance to self-esteem as well as anxiety around fat, weight, and dieting. Large effect sizes were found for these variables, as well as for overall appearance evaluation, eating concern, and global eating pathology. There was no significant reduction in overall psychological distress. Improvements on some measures of body image disturbance showed large correlations with improvements in eating disorder symptoms, though not with overall distress. Mindfulness-based body image therapy appears to be effective for eating-disordered clients enrolled in DBT; however, research with larger sample sizes is necessary to further delineate factors contributing to a successful treatment. In addition, participant feedback indicated that a longer period of treatment would be beneficial in addressing long-term body image distress.