Date of Award

8-2016

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Psychology

First Advisor

Kyle P. De Young

Abstract

There is great variability in personality among individuals with Bulimia Nervosa (BN; e.g., see Goldner, et al., 1999), such as on dimensions of impulsivity and emotion dysregulation. Individuals high on these traits appear to have different treatment needs compared to those who are low; however, little research has been conducted to evaluate the impact of these traits on treatment perception and success. There are several empirically supported treatments for BN, including Cognitive-Behavioral Therapy-Enhanced (CBT-E), Interpersonal Psychotherapy (IPT), and Integrative Cognitive-Affective Therapy (ICAT). Although each of these treatments may reduce eating disorder behaviors, they use different approaches to address or modify impulsivity and emotion dysregulation. In order to examine the impact of these traits on treatment perception and outcome, two studies were conducted. Study One used existing data from a randomized, controlled trial comparing CBT-E and ICAT (N = 80; Wonderlich et al., 2013). The purpose of this study was to evaluate emotion dysregulation as a moderator of treatment outcome. The hypothesis that individuals with difficulties regulating emotions would have better treatment outcome in ICAT than individuals with elevated emotion dysregulation in CBT-E was not supported. Emotion dysregulation was neither a significant predictor nor moderator of treatment outcome. The purpose of Study Two was to evaluate emotion dysregulation and impulsivity as moderators of treatment acceptability for empirically supported treatments for BN (i.e., CBT-E, ICAT, and IPT) among 287 female participants (138 with and 149 without a history of eating disorder treatment). Participants high on impulsivity, but not emotion dysregulation, rated ICAT as more acceptable than CBT-E and IPT. The results of Study Two suggest that clinicians should consider the implications of treatment acceptability when introducing psychotherapy to patients and that researchers should continue to examine the acceptability of treatments for BN.

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