Predictors and moderators of outcome in family-based treatment for adolescent bulimia nervosa.

OBJECTIVE

To explore the predictors and moderators of treatment outcome for adolescents with bulimia nervosa (BN) who participated in family-based treatment or individual supportive psychotherapy.

METHOD: Data derived from a randomized controlled trial (n = 80) of family-based treatment of BN and supportive psychotherapy were used to explore possible predictors and moderators of treatment outcome.

RESULTS

Participants with less severe Eating Disorder Examination eating concerns at baseline were more likely to have remitted (abstained from binge eating and purging) after treatment (odds ratio [OR] 0.47; p <.01) and follow-up (OR 0.53; p <.01), regardless of the treatment that they received. Participants with lower baseline depression scores were more likely to have partial remission (no longer meeting study entry criteria) after treatment (OR 0.93; p <.01), whereas those with fewer binge-eating/purging episodes at baseline were more likely to have partial remission at follow-up (OR 0.98; p <.05). In terms of moderators, participants with less severe eating disorder psychopathology (Eating Disorder Examination global score), receiving FBT-BN, were more likely to meet criteria for partial remission at follow-up (OR 0.44; p <.05).

CONCLUSIONS

Lower eating concerns are the best predictor of remission for adolescents with BN, and family-based treatment of BN may be most effective in those cases with low levels of eating disorder psychopathology.