A Systematic Review of the Effectiveness of the Emotion Focused Psychotherapy School in Bulimia Nervosa Cases

Yıl 2025, Cilt: 8 Sayı: 15, 103 - 113, 31.01.2025

Merve Demiray

https://doi.org/10.56955/bpd.1500061

Öz

Abstract
Bulimia nervosa is an eating disorder characterized by binge eating episodes and compensatory behaviors. Emotional regulation difficulties play a significant role in cases of bulimia nervosa. Individuals diagnosed with bulimia nervosa are known to experience challenges in regulating their emotions, particularly during negative emotional states, leading to loss of control, binge eating, and compensatory behaviors. In this context, Emotion-Focused Therapy (EFT) offers an effective approach by targeting emotional regulation in the treatment of bulimia. This review aims to examine the findings of studies investigating the effectiveness of Emotion-Focused interventions in the treatment of bulimia nervosa. For this purpose, 928 potential articles were identified, with four studies meeting the eligibility criteria included in this review. The selected studies involved participants with bulimia nervosa and were based on various research methodologies, such as randomized controlled trials, case studies, and time series designs. Emotion-Focused interventions have been found to improve emotional regulation skills in individuals diagnosed with bulimia nervosa, thereby reducing binge eating behaviors and bulimia symptoms. However, follow-up studies have yielded inconsistent findings regarding symptom relapse. While Emotion-Focused Therapies appear to be effective in the treatment of bulimia nervosa, there is a need for further research to expand the current knowledge in this area.

Anahtar Kelimeler

Bulimia nervosa, Emotion Focused Therapy, emotion regulation

Duygu Odaklı Psikoterapi Ekolünün Bulimia Nervoza Olgularında Etkililiğine Dair Sistematik Bir Gözden Geçirme

Öz

Özet
Bulimia nervoza, tıkınırcasına yeme atakları ve telafi edici davranışlarla karakterize bir yeme bozukluğudur. Bulimia olgularında duygusal düzenleme güçlükleri önemli bir rol oynar. Bulimia nervoza tanılı bireylerin duygu düzenleme zorluğu yaşadığı, özellikle olumsuz duygulanım durumlarında kontrol kaybı yaşayarak tıkınırcasına yeme ve telafi edici davranışlar sergilediği bilinmektedir. Bu bağlamda Duygu Odaklı Psikoterapi, bulimia tedavisinde duygusal düzenlemeyi hedef alarak etkili bir yaklaşım sunmaktadır. Bu derleme, bulimia tedavisinde Duygu Odaklı müdahalelerin etkililiğini inceleyen çalışmaların bulgularını gözden geçirerek meyi amaçlamıştır. İlgili amaç doğrultusunda potansiyel olarak 928 makale tespit edilmiş, uygunluk kriterlerini karşılayan 4 çalışma bu gözden geçirmeye dahil edilmiştir. Çalışmalar bulimia nervoza bozukluğuna sahip katılımcılarda yapılan, randomize kontrollü çalışmalar, vaka çalışmaları ve zaman serisi desenleri gibi farklı araştırma metodolojilerine dayanarak seçilmiştir. Duygu Odaklı Müdahalelerin bulimia nervoza tanılı bireylerde duygu düzenleme becerilerini geliştirdiği ve bu sayede tıkanırcasına yeme davranışlarını ve bulimia belirtilerini azalttığı görülmektedir. Bununla birlikte takip çalışmaları semptom nüksü konusunda tutarsız bulgular elde etmiştir. Duygu Odaklı Terapilerin bulimia nervoza tedavisinde etkili olduğu görülmekle birlikte mevcut alanın genişletilmesine ve daha fazla araştırmaya ihtiyaç duyulmaktadır.

Anahtar Kelimeler

Blumia nervoza, Duygu Odaklı Terapi, duygu düzenleme

Kaynakça

• American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders: DSM-5 (5. Edition). Washington, DC: American Psychiatric Association.
• American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. DSM III (3. Edition). Washington, DC: American Psychiatric Association.
• Banack, K. D. (2015). A Case Study of Emotion-Focused Therapy for Bulimia Nervosa. The University of Alberta: Alberta.
• Bartlett, J. (2019). Emotion-Focused Group Psychotherapy for Bulimia Nervosa. The University of Alberta: Alberta.
• Beck, A. T., Epstein, N., Brown, G., and Steer, R. A. (1988). An inventory for measuring clinical anxiety: Psychometric properties. Journal of Consulting and Clinical Psychology, 56(6), 893-897.
• Beck, A. T., Steer, R. A., and Brown, O. K. (1996). Beck Depression Inventory Manual, (2. Edition). San Antonio. TX: Psychological Corporation.
• Berg, K. C., Crosby, R. D., Cao, L., Peterson, C. B., Engel, S. G., Mitchell, J. E., and Wonderlich, S. A. (2013). Facets of negative affect prior to and following binge-only, purge-only, and binge/purge events in women with bulimia nervosa. Journal of Abnormal Psychology, 122(1), 111.
• Brockmeyer, T., Skunde, M., Wu, M., Bresslein, E., Rudofsky, G., Herzog, W., and Friederich, H. C. (2014). Difficulties in emotion regulation across the spectrum of eating disorders. Comprehensive Psychiatry, 55(3), 565-571.
• Bulik, C. M. (2005). Exploring the gene–environment nexus in eating disorders. Journal of Psychiatry and Neuroscience, 30(5), 335-339.
• Compare, A., Maxwell, H., Brugnera, A., Zarbo, C., Dalle Grave, R., Tasca, A., and G. (2018). Change in attachment dimensions and reflective functioning following emotionally focused group therapy for binge eating disorder. International Journal of Group Psychotherapy, 68(3), 385406. https://doi.org/10.1080/00207284.2018.1429928.
• Cooper, Z., and Fairburn, C. (1987). The eating disorder examination: A semi-structured interview for the assessment of the spe- cific psychopathology of eating disorders. International Journal of Eating Disorders, 6(1), 1-8.
• Crosby, R. D., Wonderlich, S. A., Engel, S. G., Simonich, H., Smyth, J., and Mitchell, J. E. (2009). Daily mood patterns and bulimic behaviors in the natural environment. Behaviour Research and Therapy, 47(3), 181-188.
• Çelik. H. ve Aydoğdu, B. N. (2018). Duygu Odaklı Terapi: Psikoterapide yeni bir yaklaşım, Koľ kos Journal of Educational Research, 5(2), 50-69.
• Davies, H., Schmidt, U., Stahl, D., and Tchanturia, K. (2011). Evoked facial emotional expression and emotional experience in people with anorexia nervosa. International Journal of Eating Disorders, 44(6), 531-539.
• Fairburn, C. G., ve Beglin, S. J. (1994). Assessment of eating disorders: Interview or self-report questionnaire? International Jour- nal of Eating Disorders, 16(4), 363-370.
• Fischer, S., Settles, R., Collins, B., Gunn, R., and Smith, G. T. (2012). The role of negative urgency and expectancies in problem drinking and disordered eating: testing a model of comorbidity in pathological and at-risk samples. Psychology of Addictive Behaviors, 26(1), 112.
• Galmiche, M., Déchelotte, P., Lambert, G., and Tavolacci, M. P. (2019). Prevalence of eating disorders over the 2000–2018 period: A systematic literature review. The American Journal of Clinical Nutrition, 109(5), 1402–1413. https://doi.org/10.1093/ajcn/nqy 342.
• Garner, D. M., Olmsted, M. P., and Polivy, J. (1983). Development and validation of a multidimensional Eating Disorder Inventory for anorexia nervosa and bulimia. International Journal of Eating Disorders, 2(2), 15-34.
• Goss, K., Gilbert, P., and Allan, S. (1994). An exploration of shame measures—I: The other as Shamer scale. Personality and Indivi- dual Differences, 17(5), 713-717.
• Gratz, K. L., and Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of Psychopathology and Behavioral As- sessment, 26, 41-54.
• Greenberg, L. S. (2004). Emotion–focused therapy. Clinical Psychology ve Psychotherapy: An International Journal of Theory ve Practice, 11(1), 3-16.
• Greenberg, L. S. (2010). Emotion-focused therapy: A clinical synthesis. Focus, 8(1), 32-42.
• Greenberg, L.S. (2014). The therapeutic relationship in emotion-focused therapy. Psychotherapy, 51(3), 350.
• Harrison, A., O’Brien, N., Lopez, C., and Treasure, J. (2010). Sensitivity to reward and punishment in eating disorders. Psychiatry Research, 177(1-2), 1-11.
• Harrison, A., Sullivan, S., Tchanturia, K., and Treasure, J. (2009). Emotion recognition and regulation in anorexia nervosa. Clinical Psychology ve Psychotherapy: An International Journal of Theory ve Practice, 16(4), 348-356.
• Hilbert, A., and Tuschen-Caffier, B. (2007). Maintenance of binge eating through negative mood: A naturalistic comparison of binge eating disorder and bulimia nervosa. International Journal of Eating Disorders, 40(6), 521–530.
• Hinney, A., and Volckmar, A. L. (2013). Genetics of eating disorders. Current Psychiatry Reports, 15, 1-9.
• Ivanova, I., and Watson, J. (2014). Emotion-focused therapy for eating disorders: Enhancing emotional processing. Person-Cente- red & Experiential Psychotherapies, 13(4), 278-293. https://doi.org/10.1080/14779757.2014.910132.
• Koreshe, E., Paxton, S., Miskovic-Wheatley, J., Bryant, E., Le, A., Maloney, D., ... and Maguire, S. (2023). Prevention and early in- tervention in eating disorders: findings from a rapid review. Journal of Eating Disorders, 11(1), 38.
• Legenbauer, T., Vocks, S., and Rüddel, H. (2008). Emotion recognition, emotional awareness and cognitive bias in individuals with bulimia nervosa. Journal of Clinical Psychology, 64(6), 687-702.
• National Alliance for Eating Disorders. (2024). About Eating Disorders. https://www.allianceforeatingdisorders.com (Erişim Tarihi: 21 Ekim 2024).
• Osoro, A., Villalobos, D., and Tamayo, J. A. (2022). Efficacy of emotion-focused therapy in the treatment of eating disorders: A systematic review. Clinical Psychology & Psychotherapy, 29(3), 815-836.
• Rybak, C. J., and Brown, B. (1996). Assessment of internalized shame: Validity and reliability of the internalized shame scale. Alcoholism Treatment Quarterly, 14(1), 71-83.
• Smink, F. R., Van Hoeken, D., and Hoek, H. W. (2012). Epidemiology of eating disorders: incidence, prevalence and mortality rates. Current Psychiatry Reports, 14(4), 406-414.
• Smyth, J. M., Wonderlich, S. A., Heron, K. E., Sliwinski, M. J., Crosby, R. D., Mitchell, J. E., and Engel, S. G. (2007). Daily and momen- tary mood and stress are associated with binge eating and vomiting in bulimia nervosa patients in the natural environment. Journal of Consulting and Clinical Psychology, 75(4), 629.
• Svaldi, J., Griepenstroh, J., Tuschen-Caffier, B., and Ehring, T. (2012). Emotion regulation deficits in eating disorders: a marker of eating pathology or general psychopathology?. Psychiatry Research, 197(1-2), 103-111.
• Tanis, J., Martijn, C., Vroling, M. S., Maas, J., and Keijsers, G. P. (2023). Reducing binge eating through behavioral-focused versus emotion-focused implementation intentions in patients with binge eating disorder or bulimia nervosa: An experimental appro- ach. Behaviour Research and Therapy, 169, 104399.
• Timulak, L., Keogh, D., Chigwedere, C., Wilson, C., Ward, F., Hevey, D. and Irwin, B. (2018). A comparison of emotion-focused therapy and cognitive-behavioural therapy in the treatment of generalised anxiety disorder: study protocol for a randomised controlled trial. Trials, 19, 1-11.
• Volpe, U., Monteleone, A. M., and Monteleone, P. (2018). Diagnostic classification of eating disorders: The role of body image. Body Image, Eating, and Weight: A Guide to Assessment, Treatment, and Prevention, 57-66.
• Wnuk, S. M., Greenberg, L., and Dolhanty, J. (2015). Emotion-focused group therapy for women with symptoms of bulimia ner- vosa. Eating Disorders, 23(3), 253-261.