{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T13:27:02Z","timestamp":1789392422565,"version":"build-2803163510"},"reference-count":38,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2017,1,24]],"date-time":"2017-01-24T00:00:00Z","timestamp":1485216000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["R01DK61912, R01DK 61973, and P30 DK 60456;"],"award-info":[{"award-number":["R01DK61912, R01DK 61973, and P30 DK 60456;"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Intl J Eating Disorders"],"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The purpose of this investigation was to examine the indirect effects of Integrative Cognitive\u2010Affective Therapy (ICAT\u2010BN) and Cognitive\u2010Behavioral Therapy\u2010Enhanced (CBT\u2010E) on bulimia nervosa (BN) treatment outcome through three hypothesized maintenance variables: emotion regulation, self\u2010directed behavior, and self\u2010discrepancy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Eighty adults with <jats:bold>BN<\/jats:bold> were randomized to 21 sessions of ICAT\u2010BN or CBT\u2010E. A regression\u2010based bootstrapping approach was used to test the indirect effects of treatment on outcome at end of treatment through emotion regulation and self\u2010directed behavior measured at mid\u2010treatment, as well as the indirect effects of treatment at follow\u2010up through emotion regulation, self\u2010directed behavior, and self\u2010discrepancy measured at end of treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>No significant differences in outcome between treatment conditions were observed, and no significant direct or indirect effects were found. Examination of the individual paths within the indirect effects models revealed comparable treatment effects. Across treatments, improvements in emotion regulation and self\u2010directed behavior between baseline and mid\u2010treatment predicted improvements in global eating disorder scores but not <jats:bold>binge eating and purging frequency<\/jats:bold> at end of treatment. Baseline to end of treatment improvements in emotion regulation and self\u2010directed behavior also predicted improvements in global eating disorder scores at follow\u2010up. Baseline to end of treatment improvements in emotion regulation predicted improvements in binge eating and baseline to end of treatment increases in positive self\u2010directed behavior predicted improvements in purging at follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>These findings suggest that emotion regulation and self\u2010directed behavior are important treatment targets and that ICAT\u2010BN and CBT\u2010E are comparable in modifying these psychological processes among individuals with BN.<\/jats:p><\/jats:sec>","DOI":"10.1002\/eat.22669","type":"journal-article","created":{"date-parts":[[2017,1,24]],"date-time":"2017-01-24T16:23:12Z","timestamp":1485274992000},"page":"636-647","source":"Crossref","is-referenced-by-count":41,"title":["The effects of psychotherapy treatment on outcome in bulimia nervosa: Examining indirect effects through emotion regulation, self\u2010directed behavior, and self\u2010discrepancy within the mediation model"],"prefix":"10.1002","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9152-4552","authenticated-orcid":false,"given":"Carol B.","family":"Peterson","sequence":"first","affiliation":[{"name":"Department of Psychiatry University of Minnesota Medical School Minneapolis Minnesota"},{"name":"The Emily Program St. Paul Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly C.","family":"Berg","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Minnesota Medical School Minneapolis Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ross D.","family":"Crosby","sequence":"additional","affiliation":[{"name":"Department of Clinical Research Neuropsychiatric Research Institute, University of North Dakota School of Medicine and Health Sciences Fargo North Dakota"},{"name":"Department of Psychiatry and Behavioral Science University of North Dakota School of Medicine and Health Sciences Fargo North Dakota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason M.","family":"Lavender","sequence":"additional","affiliation":[{"name":"Department of Clinical Research Neuropsychiatric Research Institute, University of North Dakota School of Medicine and Health Sciences Fargo North Dakota"},{"name":"Department of Psychiatry and Behavioral Science University of North Dakota School of Medicine and Health Sciences Fargo North Dakota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5521-6381","authenticated-orcid":false,"given":"Erin C.","family":"Accurso","sequence":"additional","affiliation":[{"name":"Department of Psychiatry UCSF Weill Institute for Neurosciences, University of California San Francisco California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna C.","family":"Ciao","sequence":"additional","affiliation":[{"name":"Department of Psychology Western Washington University Bellingham Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracey L.","family":"Smith","sequence":"additional","affiliation":[{"name":"VA South Central Mental Illness Research, Education and Clinical Center at the Center for Innovations in Quality, Effectiveness and Safety (IQuEST; CIN 13\u2010413) Michael E. 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