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Patients with bulimia nervosa who fail to engage in cognitive behavior therapy
Author(s) -
Coker Siǎn,
Vize Christine,
Wade Tracey,
Cooper Peter J.
Publication year - 1993
Publication title -
international journal of eating disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.785
H-Index - 138
eISSN - 1098-108X
pISSN - 0276-3478
DOI - 10.1002/1098-108x(199301)13:1<35::aid-eat2260130105>3.0.co;2-n
Subject(s) - bulimia nervosa , psychology , borderline personality disorder , mood , psychiatry , cognition , personality , clinical psychology , group psychotherapy , cognitive therapy , partial hospitalization , depressed mood , psychotherapist , eating disorders , mental health , social psychology
Although cognitive behavioral treatment is the treatment of choice in bulimia nervosa, patients' response is variable. A minority of patients do not respond at all and some never engage in treatment. This paper concerns the latter group. A case series of six such patients with whom treatment could not be initiated is compared with a group who received a full course of treatment. The group with whom treatment could not begin were found to have a longer history of disorder, to report excessive laxative abuse, to have more severe depressed mood and a greater dissatisfaction with their body weight. In addition, they were more likely to have abused psychoactive substances, engaged in episodes of self‐harm, and have a lower self‐esteem. They were also more likely to be diagnosed as having borderline personality disorder. Patients presenting with the wide range of difficulties characteristic of this group require a more intensive form of treatment than standard outpatient cognitive behavior therapy. © 1993 by John Wiley & Sons, Inc.