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Patients also self\u2010reported their ED symptoms (i.e., frequency of binge eating, compensatory behaviors, and dietary restraint) weekly. We examined trajectories of use of each CBT\u2010E skill and temporal relations between skills use and ED symptoms from week\u2010to\u2010week during treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Participants showed significant increases in eating enough to prevent excessive hunger and eating a range of macronutrients from week\u2010to\u2010week (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05). Regular eating, eating enough to prevent excessive hunger, and eating a range of macronutrients 1\u2009week predicted lower binge eating and compensatory behaviors the same week and the following week, and urge management strategy use predicted greater binge eating the same week and the following week (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Results showed temporal relationships between therapeutic skills use and symptom change on a weekly level, with evidence that using skills targeting dietary restraint was associated with lower BN symptoms. Findings highlight the promise of future work to elucidate the most potent CBT\u2010E skills for symptom improvement and inform more targeted interventions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Public Significance<\/jats:title><jats:p>Findings showed weekly relationships between therapeutic skills use and symptom change during treatment, with evidence that using CBT\u2010E skills aimed to reduce dietary restraint (i.e., regular eating, eating enough to prevent excessive hunger, and eating a range of macronutrients) was associated with lower BN symptoms. Future work has the potential to identify the most potent CBT\u2010E skills for symptom improvement and inform more targeted interventions.<\/jats:p><\/jats:sec>","DOI":"10.1002\/eat.24099","type":"journal-article","created":{"date-parts":[[2023,11,22]],"date-time":"2023-11-22T18:27:21Z","timestamp":1700677641000},"page":"173-183","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Trajectories of therapeutic skills use and their dynamic relations to symptom change during cognitive\u2010behavioral therapy for bulimia nervosa"],"prefix":"10.1002","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9963-7316","authenticated-orcid":false,"given":"Laura","family":"D'Adamo","sequence":"first","affiliation":[{"name":"Department of Psychological and Brain Sciences and Center for Weight, Eating, and Lifestyle Science (WELL Center) Drexel University  Philadelphia Pennsylvania USA"},{"name":"Department of Psychiatry Washington University School of Medicine  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4475-7139","authenticated-orcid":false,"given":"Jake","family":"Linardon","sequence":"additional","affiliation":[{"name":"School of Psychology Deakin University  Geelong Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4666-588X","authenticated-orcid":false,"given":"Stephanie M.","family":"Manasse","sequence":"additional","affiliation":[{"name":"Department of Psychological and Brain Sciences and Center for Weight, Eating, and Lifestyle Science (WELL Center) Drexel University  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6377-4212","authenticated-orcid":false,"given":"Adrienne S.","family":"Juarascio","sequence":"additional","affiliation":[{"name":"Department of Psychological and Brain Sciences and Center for Weight, Eating, and Lifestyle Science (WELL Center) Drexel University  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,11,20]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40519-016-0264-x"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/bs7030039"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0037403"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/10503307.2020.1845414"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbct.2023.02.003"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.154.6.807"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/1098-108X(198701)6:1<1::AID-EAT2260060102>3.0.CO;2-9"},{"key":"e_1_2_9_10_1","volume-title":"Cognitive behavior therapy and eating disorders","author":"Fairburn C. 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