Consists of a global score as well as four subscales: Eating Concern, Restraint, Shape Concern, and Weight Concern. This self-report questionnaire assesses the presence and degree of specific psychopathology associated with eating disorders over the previous 28 days. Last 4 weekly measures before assessment point are combined to yield binge frequency in past 28 days.Įating disorder symptomatology using the Eating Disorder Examination-Questionnaire (EDE-Q)Įating disorder symptomology is measured using the Eating Disorder Examination-Questionnaire (EDE-Q). Range is 0-no upper limit, with higher frequency indicative of more severe pathology.
Last 4 weekly measures before assessment point are combined to yield binge abstinence in past 28 days.īinge-eating frequency is measured using Binge-Eating Frequency, a 1-item self-report scale assessing the frequency of binge-eating episodes in the previous 7 days. Higher values indicate less severe pathology, with abstinence as the treatment outcome and follow-up goal. Measured using Binge-Eating Frequency, a 1-item self-report scale assessing the frequency of binge-eating episodes in the previous 7 days, range 0-no upper limit. Differential treatment effects of vocally encoded emotional arousal will be tested using repeated-measures Actor Partner Interdependence Models (RM-APIMS).īinge-eating abstinence rate is measured as the percentage of participants across study time points achieving abstinence from binge eating. Differential treatment effects in target relationship variables will be tested using 2 (partner) x 2 (time) x 2 (treatment) mixed-effect ANOVAs for all outcomes except vocally encoded emotional arousal. (Some variables will have 4 time points). Differential treatment effects in individual functioning variables will be tested using 2 (time) x 2 (treatment) mixed-effect ANOVAs for binge-purge frequency and eating disorder outcomes and 2 (partner) x 3 (time) x 2 (treatment) mixed-effect ANOVAs for psychological outcomes. All study hypotheses will be tested using recommended Intent-To-Treat (ITT) methods. Participants will be randomized to either couple therapy (UNITE) or individual therapy (CBT-E) for binge-eating disorder and will receive 16 1-hour sessions of the respective treatment.
Because the couple is learning how to work together to address BED, the investigators hypothesize that maintenance of gains will show evidence consistent with superiority in UNITE. The investigators will assess targeted relationship domains with observational and speech prosody measures during clinic interactions and self-reports reflecting experiences outside the clinic.
The investigators hypothesize that UNITE will show preliminary evidence of being superior to CBT-E in achieving binge abstinence via engaging ED-related relationship targets, including improved (a) communication around the disorder, (b) disorder-specific interpersonal problem-solving/ behavioral change skills, and (c) partner-assisted emotion regulation. UNITE activates a key resource by incorporating an important part of the patient's social environment (the partner) into treatment. Treatments for BED have demonstrated efficacy in controlled settings with specialist therapists and expert supervision, but much less in known about the effectiveness of BED interventions and whether the transition of evidence-based treatments to the community results in poorer outcomes. The purpose of this study is to test the feasibility, acceptability, and preliminary effectiveness of a novel couple-based intervention for binge-eating disorder (BED) relative to an established evidence-based individual treatment (cognitive-behavioral therapy-enhanced CBT-E) in a community clinic setting.Ĭlinicians' options for BED treatment are inadequate.