Debra Safer

Publication Details

  • Race/Ethnicity, Education, and Treatment Parameters as Moderators and Predictors of Outcome in Binge Eating Disorder JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY Thompson-Brenner, H., Franko, D. L., Thompson, D. R., Grilo, C. M., Boisseau, C. L., Roehrig, J. P., Richards, L. K., Bryson, S. W., Bulik, C. M., Crow, S. J., Devlin, M. J., Gorin, A. A., Kristeller, J. L., Masheb, R., Mitchell, J. E., Peterson, C. B., Safer, D. L., Striegel, R. H., Wilfley, D. E., Wilson, G. T. 2013; 81 (4): 710-721


    Objective: Binge eating disorder (BED) is prevalent among individuals from minority racial/ethnic groups and among individuals with lower levels of education, yet the efficacy of psychosocial treatments for these groups has not been examined in adequately powered analyses. This study investigated the relative variance in treatment retention and posttreatment symptom levels accounted for by demographic, clinical, and treatment variables as moderators and predictors of outcome. Method: Data were aggregated from 11 randomized, controlled trials of psychosocial treatments for BED conducted at treatment sites across the United States. Participants were N = 1,073 individuals meeting criteria for BED including n = 946 Caucasian, n = 79 African American, and n = 48 Hispanic/Latino participants. Approximately 86% had some higher education; 85% were female. Multilevel regression analyses examined moderators and predictors of treatment retention, Eating Disorder Examination (EDE) global score, frequency of objective bulimic episodes (OBEs), and OBE remission. Results: Moderator analyses of race/ethnicity and education were nonsignificant. Predictor analyses revealed African Americans were more likely to drop out of treatment than Caucasians, and lower level of education predicted greater posttreatment OBEs. African Americans showed a small but significantly greater reduction in EDE global score relative to Caucasians. Self-help treatment administered in a group showed negative outcomes relative to other treatment types, and longer treatment was associated with better outcome. Conclusions: Observed lower treatment retention among African Americans and lesser treatment effects for individuals with lower levels of educational attainment are serious issues requiring attention. Reduced benefit was observed for shorter treatment length and self-help administered in groups. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

    View details for DOI 10.1037/a0032946

    View details for Web of Science ID 000322353100013

    View details for PubMedID 23647283

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