{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T09:39:45Z","timestamp":1791884385197,"version":"4.3.4"},"reference-count":39,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2015,12,9]],"date-time":"2015-12-09T00:00:00Z","timestamp":1449619200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"National Institutes of Health\/National Institute of Mental Health","award":["K23MH071641"],"award-info":[{"award-number":["K23MH071641"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Intl J Eating Disorders"],"published-print":{"date-parts":[[2016,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>A subset of individuals with bulimia nervosa (BN) have borderline personality disorder (BPD) symptoms, including chronic negative affect and interpersonal problems. These symptoms predict poor BN treatment outcome in some studies. The broad version of Enhanced Cognitive Behavior Therapy (CBT\u2010E) was developed to address co\u2010occurring problems that interfere with treatment response. The current study investigated the relative effects, predictors, and moderators of CBT\u2010E for BN with BPD and co\u2010occurring mood\/anxiety disorders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Fifty patients with BN and threshold or sub\u2010threshold BPD and current or recent Axis I mood or anxiety disorders were randomly assigned to receive focused CBT\u2010E (CBT\u2010Ef) or broad CBT\u2010E (CBT\u2010Eb) specifically including an interpersonal module and additional attention to mood intolerance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010two percent of the sample reported remission from binge eating and purging at termination. Significant changes across symptom domains were observed at termination and at 6\u2010month follow\u2010up. Though CBT\u2010Ef predicted good outcomes in multivariate models, the severity of affective\/interpersonal problems moderated treatment effects: participants with higher severity showed better ED outcomes in CBT\u2010Eb, whereas those with lower severity showed better outcomes in CBT\u2010Ef. Severity of affective\/interpersonal BPD symptoms at baseline predicted negative outcomes overall. Follow\u2010up BPD affective\/interpersonal problems were predicted by baseline affective\/interpersonal problems and by termination EDE score.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>This study supports the utility of CBT\u2010E for patients with BN and complex comorbidity. CBT\u2010Ef appears to be more efficacious for patients with relatively less severe BPD symptoms, whereas CBT\u2010Eb appears to be more efficacious for patients with more severe BPD symptoms. \u00a9 2015 Wiley Periodicals, Inc. 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