Predictors of rapid and sustained response to cognitive-behavioral therapyfor bulimia nervosa

Objective: To examine characteristics of individuals who show a rapid and s ustained response to cognitive-behavioral therapy (CBT) for bulimia nervosa (BN). Method: As part of a randomized clinical trial designed to dismantle CBT for BN, we compared 19 individuals who exhibited complete abstinence f rom binging and purging after only eight sessions of CBT and maintained abs tinence throughout the duration of treatment and the 1-year follow-up inter val, to 79 individuals who had a more variable response to treatment. Demog raphics, baseline clinical characteristics, lifetime comorbidity, and perso nality disorder symptoms and profiles from the Temperament and Character In ventory were examined. Results: In univariate analyses, frequency of bingin g and purging at baseline, low scores on the Eating Disorders Inventory (ED I) Bulimia subscale, lower harm avoidance, and higher self-directedness wer e associated with rapid response. In multiple regression analyses, frequenc y of binging at baseline (OR = 0.87; 95% CI 0.77-0.98) and self-directednes s (OR = 1.12; 95% CI 1.04-1.21) independently predicted rapid and sustained treatment response. Conclusion: Frequency of binging and the character qua lity of self-directedness may be useful predictors of those individuals who are likely to respond positively to a brief course of CBT for BN. (C) 1999 by John Wiley & Sons, Inc.