본문 바로가기
KERD
논문KCI 등재

Characteristics of Binge Eating Disorder and the Effectiveness of Cognitive Behavioral Therapy with College Students Prone to BED

손정락|박누리
한국건강심리학회 (Korean Health Psychological Association)|2012.09|한국심리학회지: 건강 (Korean Journal of Health Psychology)|제17권 제3호|pp. 609-642|DOI 10.17315/kjhp.2012.17.3.004

0

조회

0

다운로드

5

인용

0

참고문헌

키워드

Self-esteem인지행동치료충동성폭식장애Impulsiveness정서적 섭식비만ObesityCognitive Behavioral TherapyBinge Eating DisorderSocial DiscomfortEmotional Eating자아-존중감사회적 불편감
주제분류심리과학

초록

Purpose of this study is to demonstrate severity of Binge Eating Disorder (BED) is different from that of general obesity and to examine the effects of Cognitive Behavioral Therapy (CBT) on BED-prone college students. To do this, the following scales were used: Binge Eating Scale, Rosenberg Self-Esteem Scale, Social Discomfort Scale, Barratt Impulsiveness Scale and Dutch Eating Behavior Questionnaire. Study I investigated pathological eating behaviors as well as psychological distress in three different groups: two obese groups with and without BED and a healthy control group. Ten participants for each group were selected: two obese groups among 50 obese women from a weight clinic in South Korea and the healthy control group with normal weight among a college population in South Korea. The findings showed that BED patients had more pathological eating behaviors and psychological distress than the other two groups. Most BED patients want weight-loss treatment when they seek help. However, the study suggests that treatment for BED should first be directed at the disordered eating and associated psychopathology rather than the obesity itself, even though BED patients are found in obese population. In Study II, 24 BED-prone college students among 600 college students were randomly assigned to CBT(eight weekly sessions during active treatment) or to no-treatment control group. At the end of the active treatment, binge eating was significantly reduced among those actively treated relative to those on no-treatment control group. Furthermore, CBT produced significant or at least marginally significant improvements in all psychological variables (self-esteem, impulsiveness, and social discomfort) relative to baseline, and they even improved more at the 6-week follow-up. The results support the efficacy of CBT as a preventive intervention for BED-prone college students. In spite of its several limitations, the present study clarifies the distinctiveness of BED from obesity in psychological factors along with pathological eating problems and recommends CBT as an effective treatment for BED-prone individuals.

Abstract

Purpose of this study is to demonstrate severity of Binge Eating Disorder (BED) is different from that of general obesity and to examine the effects of Cognitive Behavioral Therapy (CBT) on BED-prone college students. To do this, the following scales were used: Binge Eating Scale, Rosenberg Self-Esteem Scale, Social Discomfort Scale, Barratt Impulsiveness Scale and Dutch Eating Behavior Questionnaire. Study I investigated pathological eating behaviors as well as psychological distress in three different groups: two obese groups with and without BED and a healthy control group. Ten participants for each group were selected: two obese groups among 50 obese women from a weight clinic in South Korea and the healthy control group with normal weight among a college population in South Korea. The findings showed that BED patients had more pathological eating behaviors and psychological distress than the other two groups. Most BED patients want weight-loss treatment when they seek help. However, the study suggests that treatment for BED should first be directed at the disordered eating and associated psychopathology rather than the obesity itself, even though BED patients are found in obese population. In Study II, 24 BED-prone college students among 600 college students were randomly assigned to CBT(eight weekly sessions during active treatment) or to no-treatment control group. At the end of the active treatment, binge eating was significantly reduced among those actively treated relative to those on no-treatment control group. Furthermore, CBT produced significant or at least marginally significant improvements in all psychological variables (self-esteem, impulsiveness, and social discomfort) relative to baseline, and they even improved more at the 6-week follow-up. The results support the efficacy of CBT as a preventive intervention for BED-prone college students. In spite of its several limitations, the present study clarifies the distinctiveness of BED from obesity in psychological factors along with pathological eating problems and recommends CBT as an effective treatment for BED-prone individuals.

참고문헌 (78)

  1. Abraham, S. F., "How patients describe bulimia or binge eating", Psychological Medicine, 12, pp.625~635 (1982)
  2. American Psychiatric Association, "Diagnostic and statistical manual of mental disorders" (1994), American Psychiatric Association
  3. Arnow, B., "Binge eating among the obese: a descriptive study", Journal of Behavioral Medicine, 15(2), pp.155~170 (1992)
  4. Barnes, R. D., "Comparison of methods for identifying and assessing obese patients with binge eating disorder in primary care settings", International Journal of Eating Disorders, 44(2), pp.157~163 (2011)
  5. Barratt, E. S., "Impulsivity: Integrating cognitive, behavioral, biological, and environmental data, In The Impulsive Client: Theory, Research, and Treatment", pp.39~56 (1993), American Psychological Association
  6. Blomquist, K. K., "Exploring weight gain in year before treatment for binge eating disorder: A different context for interpreting limited weight losses in treatment studies", International Journal of Eating Disorders, 44(5), pp.435~439 (2011)[DOI]
  7. Brown, L. S., "Socially driven eating and restriction in the eating disorders", Eating Behaviors, 4(3), pp.221~228 (2003)
  8. Brownell, K. D., "Etiology and Treatment of Obesity: Understanding a Serious, Prevalent, and Refractory Disorder", Journal of Consulting and Clinical Psychology, 60(4), pp.505~517 (1992)
  9. Bruce, B., "Binge eating in females: A population-based investigation", International Journal of Eating Disorders, 12(4), pp.365~373 (1992)
  10. Castonguay, L. G., "Binge eating disorder : Current stateand future directions", Clinical PsychologyReview, 15(8), pp.865~890 (1995)
  11. Cheng, H., "Parental bonds, anxious attachment, media internalization, and body image dissatisfaction: Exploring a mediation model", Journal of Counseling Psychology, 56, pp.365~375 (2009)[DOI]
  12. Cooper, Z., "Refining the definition of binge eating disorder and nonpurging bulimia nervosa", International Journal of Eating Disorders, 34(S1), pp.89~95 (2003)[DOI]
  13. Davis, R., "Assessing the functional nature of binge eating in the eating disorders", Eating Behaviors, 6(4), pp.345~354 (2005)
  14. De Zwaan, M., "Eating related and general psychopathology in obese females with binge-eating disorder", International Journal of Eating Disorders, 15, pp.43~52 (1994)
  15. Delinsky, S. S., "Weight gain, dietary restraint, and disordered eating in the freshman year of college", Eating Behaviors, 9(1), pp.82~90 (2008)
  16. Dingemans, A. E., "Maladaptive core beliefs and eatingdisorder symptoms", Eating Behaviors, 7(3), pp.258~265 (2006)[DOI]
  17. Drewnowski, A., "Eating pathology and DSM-III-R : A continuum of bulimic behaviors", American Journal of Psychiatry, 151, pp.1217~1219 (1994)
  18. Eldredge, K. L., "The effects of extending cognitive-behavioral therapy for binge eating disorder among initial treatment nonresponders", International Journal of Eating Disorders, 21, pp.347~352 (1997)
  19. Elmore, D. K., "Self-rated moods and hunger in relation to spontaneous eating behavior in bulimics, recovered bulimics, and normals", International Journal of Eating Disorders, 9, pp.179~190 (1990)
  20. Evenden, J. L., "Varieties of impulsivity", pp.146~ (1999), Psychopharmacology
  21. Fairburn, C. G., "The Eating Disorder Examination, In Binge eating: Nature, assessment, and treatment", pp.317~360 (1993), Guilford
  22. Fassino, S., "Mood, eating attitudes, and anger in obese women with and without binge eating disorder", Journal of Psychosomatic Rearch, 54, pp.559~566 (2003)
  23. Friedman, K., "Weight stigmatization and ideological beliefs : Relation to psychological functioning in obese adults", Obesity Research, 13, pp.907~916 (2005)
  24. Gluck, M. E., "Night eating syndrome is associated with depression, low self-esteem, reduced daytime hunger, and less weight loss in obese outpatients", Obesity Research, 9(4), pp.264~267 (2001)[DOI]
  25. Goldstein, R. B., "Antisocial behavioral syndromes and body mass index among adults in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions", Comprehensive Psychiatry, 49, pp.225~237 (2008)
  26. Gormally, J., "The assessment of binge eatingseverity among obese subjects", AddictiveBehaviors, 7, pp.47~55 (1982)
  27. Grilo, C. M., "Night-time eating in men and women with binge eating disorder", Behaviour Research and Therapy, 42(4), pp.397~407 (2004)[DOI]
  28. Grilo, C. M., "Efficacy of cognitive behavioral therapy and fluoxetine for the treatment of binge eating disorder : a randomized double-blind placebocontrolled comparison", Biological Osychiatry, 57(3), pp.301~309 (2005)
  29. Grilo, C. M., "Binge eating antecedents in normalweight nonpurging females: Is thereconsistency?", International Journal of EatingDisorders, 16, pp.239~249 (1994)
  30. Grissett, N. I., "The clinical significance of binge eating in an obese population: Support for bed and questions regarding its criteria", Addictive Behaviors, 21(1), pp.57~66 (1996)[DOI]
  31. Haedt-Matt, A. A., "Revisiting the affect regulation model of binge eating: A meta-analysis of studies using ecological momentary assessment", Psychological Bulletin, 137(4), pp.660~681 (2011)[DOI]
  32. Hasler, G., "The associations between psychopathology and being overweight: A 20-year prospective study", Psychological medicine, 34(6), pp.1047~1057 (2004)
  33. Hawkins, R. C., "Binge eating: Measurement problems and a conceptual model, In The binge purge symdrome: Diagnosis, treatment, and research", pp.229~251 (1984), Springer
  34. Heatherton, T. F., "Binge eating as escape from self-awareness", Psychological Bulletin, 110, pp.86~108 (1991)[DOI]
  35. Heatherton, T. F., "The (mis)measurement of restraint: An analysis of conceptual and psychometric issues", Journal of Abnormal Psychology, 97(1), pp.19~28 (1988)[DOI]
  36. Herman, C. P., "Restrained eating, In Obesity", pp.208~225 (1980), Saunders
  37. Hewitt, J. P., "Oxford handbook of positive psychology", pp.217~224 (2009), Oxford University Press
  38. Hill, A. J., "Prevalence and demographics of dieting, In Eating disorders and obesity: A comprehensive handbook", pp.80~84 (2002), Guilford Press
  39. Hill, D. M., "Appetite-focused dialectical behavior therapy for the treatment of binge eating with purging: A preliminary trial", International Journal of Eating Disorders, 44(3), pp.249~261 (2011)[DOI]
  40. Hudson, J. I., "The prevalence and correlates of eating disorders in the national comorbidity survey replication", Biological Psychiatry, 61(3), pp.348~358 (2007)[DOI]
  41. John, F. C., "Low Self Esteem", pp.33~ (2003), Chicago Defender
  42. Johnson, L. A., "Characteristics of binge eating among women in the community seeking treatment for binge eating or weight loss", Eating Behaviors, 3, pp.295~305 (2003)
  43. Keel, P. M., "Outcome in bulimia nervosa", American Journal of Psychiatry, 154, pp.313~321 (1997)
  44. 김미리혜, "비만치료의 최신 지견 : 심리적 접근을 중심으로", 한국심리학회지: 건강, 9(2), pp.493~510 (2004), 한국건강심리학회
  45. Kopelman, P. G., "Obesity as a medical problem", Nature, 404, pp.635~643 (2000)[DOI]
  46. Kuehnel, R. H., "Binge eating disorder, weight cycling, and psychopathology", International Journal of Eating Disorders, 15(4), pp.321~329 (1994)[DOI]
  47. Layard, R., "Happiness: Lessons from a New Science" (2006), Penguin (Non-Classics)
  48. Lee, Hyun Jung, "The effects of dietary restraint, negative affect, and impulsivity on binge eating beahvior", 박사, pp.2001
  49. Lee, Ji Eun, "The effect of short-term psychoeducational program on binge eating", 석사, pp.2001
  50. Lloyd-Richardson, E. E., "Body imageevaluations in obese females with bingeeating disorder", Eating Behaviors, 1(2), pp.161~171 (2000)[DOI]
  51. Lynch, W. C., "Does binge eating play a role in the self-regulation of moods?", Integrative physiological and behavioral science: the official journal of the Pavlovian Society, 35(4), pp.298~313 (2000)
  52. Mintz, L. B., "Prevalence and correlates of eating disordered behaviors among undergraduate women", Journal of Counseling Psychology, 35, pp.463~471 (1988)
  53. Mitchell, J. E., "Characteristics of 275 patients with bulimia", American Journal of Psychiatry, 142, pp.482~185 (1985)
  54. Munsch, S., "A randomized comparison of cognitive behavioral therapy and behavioral weight loss treatment for overweight individuals with binge eating disorder", International Journal of Eating Disorders, 40, pp.102~113 (2007)
  55. Myers, A., "Obesity stigmatization and coping with weight stigma : An investigation of overweight and obese adults", Obesity, 14, pp.1802~1815 (1999)
  56. "Eating disorders: Core interventions in the treatment and management of anorexia nervosa, bulimia nervosa and related eating disorders (NICE Clinical Guideline No. 9)" (2004)[URL]
  57. Nelson, M. C., "Emerging adulthood and college-aged youth: An overlooked age for weight-related behavior change", Obesity, 16(10), pp.2205~2211 (2008)[DOI]
  58. "Obesity and Overweight for Professionals: Adult: Causes - DNPAO - CDC. (n.d.)"[URL]
  59. Patton, J. M., "Factor structure of the barrattimpulsiveness scale", Journal of Clinical Psychology, 51, pp.768~774 (1995)
  60. Peterson, C. B., "The efficacy of self-help group treatment and therapist-led group treatment for binge eating disorder", American Journal of Psychiatry, 166, pp.1347~1354 (2009)
  61. Pratt, E. M., "Perfectionism in women with binge eating disorder", International Journal of Eating Disorders, 29(2), pp.177~186 (2001)
  62. Puhl, R. M., "Stigma, obesity, and the health of the nation’s children", Psychological Bulletin, 133(4), pp.557~580 (2007)[DOI]
  63. Racette, S. B., "Changes in weight and health behaviors from freshman through senior year of college", Journal of Nutrition Education and Behavior, 40(1), pp.39~42 (2008)[DOI]
  64. Sanftner, J. L., "Variability in self-esteem, moods, shame, and guilt in women who binge", International Journal of Eating Disorders, 23(4), pp.391~397 (1998)
  65. Safer, D. L., "Dialectical behavior therapy adapted for bulimia : A case report", International Journal of Eating Disorders, 30, pp.101~106 (2001)
  66. Schlup, B., "The efficacy of a short version of a cognitive-behavioral treatment followed by booster sessions for binge eating disorder", Behaviour Research and Therapy, 47(7), pp.628~635 (2009)[DOI]
  67. Spitzer, R. L., "Binge eating disorder : Its further validation in a multisite study", International Journal of Eating Disorder, 13, pp.137~153 (1993)
  68. Steiger, H., "Hypersensitivity to social interactions in bulimic syndromes : Relationship to binge eating", Journal of Consulting and Clinical Psychology, 67, pp.765~775 (1999)
  69. Stein, R. I., "What’s driving the binge in binge eating disorder? : A prospective examination of precursors and consequences", International Journal of Eating Disorders, 40, pp.195~203 (2007)
  70. Tanco, S., "Well-being and morbid obesity in women: A controlled therapy evaluation", International Journal of Eating Disorders, 23(3), pp.325~339 (1998)
  71. Telch, C. F., "Binge eating increases with increasing adiposity", International Journal of Eating Disorders, 7(1), pp.115~119 (1988)
  72. Thompson, D. A., "The heterogeneity of bulimicsymptomatology: Cognitive and behavioraldimensions", International Journal of Eating Disorders, 6, pp.215~234 (1987)
  73. van Strien, T., "The Dutch Eating Behavior Questionnaire (DEBQ) for assessment of restrained, emotional, and external eating behavior", International Journal of Eating Disorders, 5(2), pp.295~315 (1986)
  74. Waller, G., "Anger and core beliefs in the eating disorders", International Journal of Eating Disorders, 34(1), pp.118~124 (2003)[DOI]
  75. Wilfley, D. E., "Psychological treatment of binge eating disorder, In Eating disorders and obesity", pp.350~353 (2002), Guilford Press
  76. Wilson, G. T., "Psychological treatment of eatingdisorders", American Psychologist, 62(3), pp.199~216 (2007)
  77. Womble, L., "Psychosocial variables with binge eating in obese males and females", International Journal of Eating Disorders, 30, pp.217~221 (2001)
  78. Zaslow, J., "Girls and body image: It’s apparently worse than ever", Wall Street Journal, 557~580 (2007)

관련 논문AI추천

The effects of negative emotions on binge eating among bulimics: Comparisons among anger, anxiety, and depression소원현한국건강심리학회 · 한국심리학회지: 건강2009 · 제14권 제2호폭식행동의 치료김미리혜한국건강심리학회 · 한국심리학회지: 건강2008 · 제13권 제4호마음챙김 기반 인지치료(MBCT)가 폭식 경향이 있는 대학생의 폭식행동, 정서적 섭식, 정서조절곤란 및 감정표현불능증에 미치는 효과손정락, 전소라한국건강심리학회 · 한국심리학회지: 건강2012 · 제17권 제4호수용 전념 치료(ACT)가 폭식장애 경향이 있는 대학생의 폭식행동, 경험회피, 심리적 안녕감에 미치는 효과김아름, 손정락한국건강심리학회 · 한국심리학회지: 건강2015 · 제20권 제2호폭식행동의 이해김미리혜한국심리학회 · 한국심리학회지:일반2008 · 제27권 제3호마음챙김 기반 폭식 개선 프로그램이 폭식 장애 경향 여대생의 폭식 행동, 부정적 정서, 충동성 및 억제 결함에 미치는 영향김정호, 황보인, 김미리혜한국건강심리학회 · 한국심리학회지: 건강2022 · 제27권 제1호

이 간행물의 다른 논문 (10건)

수용-전념 치료가 아동기 정서적 학대 경험이 있는 대학생의 정서인식과 표현 및 부정적 신념에 미치는 효과서민정, 김도연pp. 557-572긍정 심리치료가 사회 공포증 경향이 있는 대학생의 사회 불안, 낙관성 및 주관적 안녕감에 미치는 영향손정락, 최유연pp. 573-588마음챙김 기반 인지치료(MBCT)가 역기능적 분노에 미치는 효과전현숙, 손정락pp. 589-608스트레스와 청소년 도박행동의 관계 충동성의 매개효과와 모 애착의 중재효과남전아, 채규만pp. 643-657청소년들이 선호하는 인터넷 게임종류에 따른 인터넷 게임중독, 부모-자녀 의사소통 및 자기통제력 간의 관계에 대한 고찰박보경, 신성만, 이혜주pp. 659-676
원문 보기