Cognitive Behavior Therapy of DSM-IV-TR Personality Disorders

2006 ◽  
Author(s):  
Len Sperry
Keyword(s):  
Personality Disorders ◽  
Behavior Therapy ◽  
Cognitive Behavior Therapy ◽  
Cognitive Behavior ◽  
Dsm Iv

scholarly journals An adaptive randomized trial of dialectical behavior therapy and cognitive behavior therapy for binge-eating

2016 ◽  
Vol 47 (4) ◽  
pp. 703-717 ◽  
Author(s):  
E. Y. Chen ◽  
J. Cacioppo ◽  
K. Fettich ◽  
R. Gallop ◽  
M. S. McCloskey ◽  
...  
Keyword(s):  
Binge Eating ◽  
Behavior Therapy ◽  
Dialectical Behavior Therapy ◽  
Cognitive Behavior Therapy ◽  
Initial Response ◽  
Early Response ◽  
Cognitive Behavior ◽  
Additional Group ◽  
Dsm Iv

BackgroundEarly weak treatment response is one of the few trans-diagnostic, treatment-agnostic predictors of poor outcome following a full treatment course. We sought to improve the outcome of clients with weak initial response to guided self-help cognitive behavior therapy (GSH).MethodOne hundred and nine women with binge-eating disorder (BED) or bulimia nervosa (BN) (DSM-IV-TR) received 4 weeks of GSH. Based on their response, they were grouped into: (1) early strong responders who continued GSH (cGSH), and early weak responders randomized to (2) dialectical behavior therapy (DBT), or (3) individual and additional group cognitive behavior therapy (CBT+).ResultsBaseline objective binge-eating-day (OBD) frequency was similar between DBT, CBT+ and cGSH. During treatment, OBD frequency reduction was significantly slower in DBT and CBT+ relative to cGSH. Relative to cGSH, OBD frequency was significantly greater at the end of DBT (d = 0.27) and CBT+ (d = 0.31) although these effects were small and within-treatment effects from baseline were large (d = 1.41, 0.95, 1.11, respectively). OBD improvements significantly diminished in all groups during 12 months follow-up but were significantly better sustained in DBT relative to cGSH (d = −0.43). At 6- and 12-month follow-up assessments, DBT, CBT and cGSH did not differ in OBD.ConclusionsEarly weak response to GSH may be overcome by additional intensive treatment. Evidence was insufficient to support superiority of either DBT or CBT+ for early weak responders relative to early strong responders in cGSH; both were helpful. Future studies using adaptive designs are needed to assess the use of early response to efficiently deliver care to large heterogeneous client groups.

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