Table 2.
Secondary analyses
| References | Population focus | Focus | Key data collected | Sample n | Gender | Age | Ethnicity | Summary findings |
|---|---|---|---|---|---|---|---|---|
| Anderson [74] | BN (BTS) | Temperament and character ratings at the beginning of CBT intervention and one year later | TCI, HDRS, B-ERP, P-ERP | 135 (91 for this report) | F | 17–45 | BTS sample | Decreases in harm avoidance temperament and increase in self-directedness |
| Bourke [75] | BN (BTS) | Neuropsychological function in BN with comorbid psychological conditions | Diagnostic interviews, neuropsychological testing | 41 | F | 17–45 | BTS sample | Borderline personality disorder and MD together associated with impaired cognitive function |
| Bulik [76] | BN (BTS) | Examined BN sample with and without personality disorders, and self-directedness in predicting presence of personality disorders | SCID for DSM-III-R, HDRS, custom structured interview of BN symptoms, GAF | 76 | F | > 16 | BTS sample | 63% had 1or more personality disorder diagnoses, which were associated with greater depressive symptoms, laxative use, greater body dissatisfaction, worse global functioning, and lower self-directedness |
| Bulik [77] | BN (BTS) | Examining histories of anxiety disorders in those with BN | SCID I (DSM-III-R), age onset, Self-report ED symptoms | 114 | F | 17–45 | BTS sample | Anxiety disorders onset earlier than BN |
| Bulik [78] | BN (BTS) | Salivary reactivity to palatable food before, during, and after treatment | SCID (DSM-III-R), HDRS, Physiological responses | 31 | F | 18–40 | BTS sample | After treatment, salivation increased significantly (p = .002) over baseline after presentation of the same foods |
| Bulik [79] | BN (BTS) | Comparing onset of binge eating, dieting and BN in relation to clinical characteristics and personality traits | SCID modified, SCID II, HDRS, TCI | 108 | F | 17–45 | BTS sample | Dieting preceded binge eating in the majority of women with BN. In the minority of women where binge eating precedes dieting, markedly higher novelty seeking and lower harm avoidance are displayed |
| Bulik [80] | BN (BTS) | Comparing BN participants with/without comorbid alcohol dependence | SCID (DSM-III-R), HDRS, GAFS, EDI-2, TCI, BIS, Défense Style Questionnaire | 114 | F | 17–45 | BTS Sample | Women with comorbid BN and alcohol dependence have increased psychopathology, impulsivity and novelty seeking |
| Bulik [81] | BN, AN, MD | Comparing prevalence and ago of onset of adult and childhood anxiety disorders relative to primary diagnosis of BN, AN, MD and NC controls | Diagnostic Interview for Genetic Studies, SCID for DSM-III-R | 68 (AN), 116 (BN), 56 (MD), 98 (NC) | F | AN: M 31.3, BN: 26.0, MD: M 30.6, NC: M 35.5 | Not stated | Certain anxiety disorders (specific phobia, overanxious disorder) were non-specific risk factors for later affective and eating disorders, while others more specific (e.g. AN and antecedent OCD) |
| Bulik [82] | BN (BTS) | Predictors of successful BN treatment | SCID and SCID-II HDRS, GAFS, EDI-2, Bulimia Cognitive Distortions Scale TCI | 98 | F | 17–45 | BTS sample | Baseline symptomatology and personality factors predicted rapid and sustained treatment response |
| Bulik [83] | BN, AN (BTS, Christchurch Outcome of Depression Study, Sullivan et al. [84] study) | Personality traits and history of suicidal behaviour in BN, AN and MD | TCI |
269 (AN 70; BN 152; MDD 59) |
F | 22–39 | Not stated for AN or MDD sample but BN sample was part of the BTS sample | Suicide attempts are equally common in women with eating disorders and women with depression, and were associated with the temperament dimension of high persistence and the character dimensions of low self-directedness and high self-transcendence |
| Carter [85] | BN (BTS) | Examining changes in information processing speed following CBT | Stroop test performance, self-reported recent binge, vomiting, and other purging | 98 | F | 17–45 | BTS sample | Information processing speed not associated with change across BN treatment |
| Carter [86] | BN (BTS) | How performance on cue reactivity test predicted outcome of psychotherapy for BN | Clinician interview, EDI, HDRS, GAF, blood pressure, heart rate, salivation | 135 | F | 17–45 | BTS sample | Abstention during pre-treatment cue reactivity task was associated with better outcome at 6-month follow-up |
| Carter [87] | BN (BTS) | How CBT for BN changed cue reactivity and associations with self-report measures | Clinician interview, EDI, HDRS, GAF, blood pressure, heart rate, salivation | 135 | F | 17–45 | BTS sample | Association between favourable treatment outcome and low cue reactivity on self-report measures at posttreatment |
| Carter [88] | BN (BTS) | Evaluating specific hypotheses on the relationship of cue reactivity and outcome in BN women | Structured interview, EDI, HDRS, Axis V of DSM-III-R, self-report, physiological measures | 135 | F | 17–45 | BTS sample | Pre-treatment cue reactivity could not predict most effective treatment modality |
| Carter [89] | BN (BTS) | Whether having a child after BN treatment puts women at increased risk for ED or depression | SCID (DSM-III-R), life charts (key life events, e.g. pregnancy), menstrual + weight history, pregnancy/childbirth | 135 | F | 17–45 | BTS sample | Childbirth was not specifically associated with symptomatology following treatment for bulimia nervosa |
| Carter [90] | BN (BTS) | Factors related to childbirth reported at BN treatment follow-up | SCID, EDI, HDRS, BMI, GAF, BDI, SCL | 125 | F | 17–45 | BTS sample | Demographic variables and poor functioning following treatment predictive of non-conception |
| Carter [91] | BN (BTS) | Influence of pre-treatment weight across treatment and five-year follow-up |
Pre-treatment BMI, BMI at follow-up |
134 | F | 17–45 | BTS sample | Participants who were overweight at baseline gained more weight than those in low and normal weight groups |
| Carter [92] | BN (BTS) | 5-year follow-up of those who participated in BTS RCT for BN | SCID (DSM-III-R), EDI, HDRS, GAF, BMI | 80 | F | 17–45 at treatment | ATS sample | Five years after treatment, approximately one half of the participants had changed substantially in weight. Patients who gained weight were more likely to have been heavier and more dissatisfied with their body |
| Carter [93] | BN (BTS) | Testing whether able to assess cue reactivity with a self-report questionnaire | Adapted Situational Appetite Measure (SAM) | 135 (complete data for 82) | F | 17–45 | BTS sample | A self-report questionnaire provided useful information regarding cue reactivity among women treated for bulimia nervosa. Greater improvements in cue reactivity associated with favourable treatment outcomes |
| Carter [94] | BN (BTS, Christchurch Outcome of Depression Study, postpartum study [95]) | Sex frequency, enjoyment, and issues in women with AN, MD, or in postpartum period | Social Adjustment Scale | 76 (10 AN) | F | AN: 28.4 (SD 6.1) | Various samples | AN and MD groups more likely to have had sex in prior two weeks, but also more likely to report sexual problems, than postpartum group |
| Carter [96] | BN (BTS) | Relationship between weight suppression prior to treatment and treatment outcomes | BMI | 132 | F | 17–45 | BTS sample | Found that weight suppression did not predict treatment outcome but did predict weight gain |
| Carter [97] | AN (ATS) | Whether severity of weight suppression predicted total rate and amount of weight gain during AN recovery | BMI | 56 | F | 17–45 | BTS sample | Weight suppression was positively associated with total weight gain and rate of weight gain over treatment |
| Falloon [98]* | BED, BN (BEP) | Focused on how closely therapists in the BEP RCT adhered to each of three psychotherapies for binge eating | Collaborative Study Psychotherapy Rating Scale-Binge Eating (CSPRS-BE) | 112 participants, 4 therapists | F | M 35.3 (SD 12.6) | 67% NZ European, 17% other European, 9.8% Māori, 3.6% Asian, 2.7% other | Therapy modalities were distinguishable by raters blind to treatment |
| Gendall [99] | BN (BTS) | Comparing nutrient intake of women with BN regarding recommended dietary allowances, and to population sample | Food diaries |
50 (BN) 468 (Population sample) |
F |
BN:17–45 Population: 19–44 |
BTS sample | Food eaten outside of binges episodes associated with low iron, calcium and zinc, and overall energy intake. Overcompensation for this during binge episodes |
| Gendall [100] | BN (BTS), MD (Christchurch Outcome of Depression study) | Comparison of visceral protein and haematological status between BN and depression controls | SCID, HDRS, structured interview of recent BN symptomatology Bloodwork (visceral protein and haematological status) |
152 (BN) 68 (MD) |
F |
BN: 17–45 MD: 18–46 |
BTS and MD samples | BN and MD groups did not differ on visceral protein or haematological measures. Low prealbumin and albumin levels were associated with more frequent vomiting. High frequency of vomiting and alcohol abuse/dependence, may increase the risk of subclinical malnutrition |
| Gendall [101] | BN (BTS) | Factors association with BMI and weight change in BN, before, during, and after CBT treatment | HDRS, GAFS, EDI, physical measurements | 94 | F | 17–45 | BTS Sample | CBT is not usually accompanied by substantial weight gain |
| Gendall [102] | BN (BTS) | Menstrual cycle and associated factors in BN patients. How this changed across and after CBT treatment | Blood sampling, self-reported food/drink intake, BMI, SCID, GAFS, HDRS | 82 | F | 17–45 | BTS sample | Association between menstrual irregularity and indices of nutritional restriction, not reflected by energy intake or body weight |
| Gendall [103] | BN (BTS) | Blood lipid and glucose changes during and after CBT for BN (BTS) | Blood tests, BMI, SCID, HDRS | 135 | F | 17–45 | BTS sample | At 3-year follow up, plasma HDL-cholesterol increased and total cholesterol decreased significantly in the group as a whole |
| Gendall [104] | BN (BTS) | Thyroid hormone levels in women before and after CBT for BN | SCI for DSM-III-R, HDRS, BMI, blood samples (serum T4 and free T4) | 107 | F | 17–45 | BTS sample | Lower pre-treatment T4 associated with persisting ED at follow up |
| Gendall [105] | BN (BTS) | Childhood gastrointestinal (GI) issues and BN psychopathology | SCID, structured interview questions about childhood GI complaints | 135 | F | 17–45 | BTS sample | Individuals with childhood GI complaints and other risk factors for BN may be at greater risk of developing a more severe eating disorder at an earlier age |
| Gendall [106] | AN (ATS) | Factors associated with amenorrhea in AN | SCID (DSM-IV), HDRS, TCI, additional questions on eating/weight/treatment/menstrual status, food diary, physical measurements | 39 | F | 23.3 ± 6.2 | ATS sample | The use of exercise to control weight, low novelty seeking scores, and low systolic blood pressure were predictors of amenorrhea independent of body mass index |
| Jenkins [107]* | AN (ATS) | Whether motivation to recover is related to treatment outcome in those with anorexia nervosa | SCID for DSM-IV, Global AN status, motivation measures, including Motivational Interviewing Skills Code Version 2.0 Outcome Rating Scale | 53 | F | 18–45 | ATS sample | Higher levels of positive change talk (and lower levels of negative) did not associate with better treatment outcome. No significant difference in treatment outcome observed between participants with different positive/negative change talk ratios |
| Jordan [108] | AN (ATS) | Comparing history of anxiety and substance use disorders in those with AN and MDD | SCID for DSM-III-R |
90 (40 AN; 58 MDD) |
F | 18–40 |
AN: 98% European MDD: 93% European |
OCD elevated in AN compared to MDD sample |
| Jordan [109] |
AN (ATS) BN (BTS) |
Comparing lifetime comorbidities in participants with AN, BN, and major depressive disorder | SCID-P, SCID II, HDRS, GAF | 56 (AN), 132 (BN), 100 (MD) | F | 17–40 | AN: 96% European, BN 91% European, MD 94% European | AN had higher OCD, AN-BP and BN elevated Cluster B personality disorders; all samples elevated Cluster C personality disorders |
| Jordan [110] | AN (ATS) | Assessing the constructs measured by YBC-EDS | YBC-EDS, BMI, HDRS, EDE-12, EDI-2 | 56 | F | 17–40 | 100% European (96% NZ European, 4% European born outside NZ) | Measured severity, YBCEDS sensitive to change following treatment |
| Jordan [111] | AN (ATS) | Clinical characteristics of participants who prematurely terminate treatment | SCID, SCID II, TCI-293, GAF, HDRS, EDE-12, EDI-2 | 56 | F | 17–40 | Predominantly European | Lower self-transcendence scores associated with premature treatment termination |
| Jordan [112] | BN (BEP) | Comparing symptoms and comorbidities across BN-P, BN-NP, and BED groups | SCID for DSM-IV, MADRS, GAF, EDE, EDI-2 | 112 | F | > 16 | BEP sample | BN-NP sits between BN and BED but some distinct features |
| Jordan [113] | AN (ATS) | Process and other factors associated with treatment non-completion in AN | Treatment Credibility Scale, TCI, VTAS-R, VPPS, therapy alliance ratings | 56 | F | 17–40 | ATS sample | Predicted by treatment credibility, lower self-transcendence, and lower early therapy alliance |
| Lacey [114] | BN, AN, OSFED, EDNOS (PRIMHD) | Comparing clinical characteristics and health service use for EDs by Māori and non-Māori |
National health database PRIMHD data |
3,835 | F | 10+ | 7% Māori | Māori were under-represented in treatment services. Once in treatment, duration was comparable. Māori more likely to be treated for BED or EDNOS |
| McIntosh [115] | AN (ATS) | Relevance of BMI cut off in diagnosing AN | SCID for DSM-IV, EDE, HDRS, GAF, EDI-2, BIAQ, TFEQ, EAT, SCL-90, anthropometric and medical measures | 56 | F | 17–40 | ATS Sample | Little difference between strict versus lenient BMI groups |
| McIntosh [116] | AN (ATS) | Therapist adherence to three different psychotherapies in ATS RCT | CSPRS-AN |
56 (AN) 3 therapists |
FF therapists | AN: 17–40, not stated for therapists | ATS sample | Good adherence to therapy types, blind raters clearly distinguished therapies |
| McIntosh [117] | AN (ATS) | Assessing distinctiveness of three therapies and change over therapy in RCT for AN | CSPRS-AN (blind raters) | 53 | F | M 23.1 | ATS sample | Therapies distinguishable, subscale measures higher for corresponding therapies, both SSCM and CBT sessions rated significantly higher in the middle stage of therapy |
| Rowe [118] | BN (BTS) | Whether poorer treatment outcome for those with comorbid borderline personality disorder (BPD) and BN compared to other personality disorders (PD) or no personality disorder | SCID-I and II for DSM-III-R, CBSI, HDRS, GAF, EDI, TCI, EDI | 135 | F | 17–45 | 91% NZ European | Those with BN and BPD more impaired at pre-treatment for BN and comorbid BPD, but treatment outcome over 3 years of follow up was not poorer for this group |
| Rowe [119] | BN (BTS) | Impact of Avoidant personality disorder on BN treatment outcome over 3 years | SCID-I, SCID-II, CBSI, HDRS, GAF, self-report questionnaires including EDI | 134 | F | 17–45 | BTS sample | No impact on eating disorder symptoms, but worse depressive and psychosocial functioning at pre and post treatment |
| Rowe [120] | BN (BTS) | PD severity/number of PDs as a predictor of BN treatment outcome | SCID (DSM-III-R), CBSI, HDRS, GAF, EDI | 134 | F | 17–45 | BTS sample | More PDs did not impact outcome at 3 years |
| Rowe [121] | BN (BTS) | Personality dimensions as predictors of 5-year outcomes among BN women | SCID-I, SCID-II, GAF, EDI-2, TCI, personality reassessment, 12-month ED behaviours and mood disorders | 134 | F | 17–45 | BTS sample | No single personality measure predicted 5-year outcome, and so comprehensive personality assessment is desirable |
| Sullivan [122] | BN, AN (BTS) | Differences between those with BN with/without AN history | SCID, HDRS, GAFS, EDI-2, TCI, Defence Style Questionnaire | 114 | F | 17–45 | BTS sample | Some differences between those with and without prior AN, but not distinct groups |
| Sullivan [123] | BN, MD (BTS) | Comparing total serum cholesterol in women with BN versus depression versus population norms | SCID, HDRS, GAFS, structured interview to assess last 14 days ED behaviour, blood samples | 126 (AN), 57 (MD) | F | 17–45 | BTS sample | BN women had markedly higher total cholesterol than depressed women, and population norms |
| Surgenor [124] | AN (ATS) | Association between sense of control and variability of AN | SCID-P (DSM-III-R (with psychotic screen), EDI, Shapiro Control Inventory, additional information on ED history including anthropometric measures, menstrual status, and chronicity | 51 | F | M 23.4 (SD 6.4) | ATS sample | Adverse overall sense of control (along with reliance on specific means of gaining control) associated with more severe eating disturbance. Greater use of a negative-assertive style of gaining control associated with a longer time since first diagnosis, desire for control significantly associated with menstrual status |
| Talwar [125]* | Community sample | Correlates of disordered eating behaviours in a community sample of women | EDI-2, Rosenberg Self-Esteem Scale, BMI | 60 | F | 16–55 | 70.8% NZ European, 6.3% Māori | Dysfunctional eating attitudes and behaviours associated with higher perfectionism, lower self-esteem, and elevated body mass. Increased body dissatisfaction significantly predicted BN symptoms |
NC non-clinical, RCT randomised-controlled trial, MD major depression, TCI Temperament and Character Inventory, HDRS Hamilton Depression Rating Scale, B-ERP Binge—exposure to response prevention to binges, P-ERP Purge—exposure with response prevention to purging, SCID Structured Clinical Interview for DSM, GAF Global Assessment of Functioning, EDI Eating Disorder Inventory, BIS Behavioural Inhibition System, BCDS Bulimia Cognitive Distortions Scale, BMI body mass index, SAM Situational Appetite Measure, CSPRS-BE Collaborative Study Psychotherapy Rating Scale—Binge Eating, YBC-EDS Yale Brown Cornell Eating Disorders Scale, EDE Eating Disorders Examination, MADRS Montgomery and Asperg Depression Rating Scale, VTAS-R Revised Vanderbilt Therapeutic Alliance Scale, VPPS Vanderbilt Psychotherapy Process Scale, PRIMHD Programme for the Integration of Mental Health Data, BIAQ Body Image Avoidance Questionnaire, TFEQ Three Factor Eating Questionnaire, EAT Eating Attitudes Test, SCL Symptom Checklist, CSPRS-AN Collaborative Study Psychotherapy Rating Scale—Anorexia Nervosa, CBSI Comprehensive Bulimia Severity Index, SCID-P structured clinical interview for DSM with psychotic screen
*Identifies that the record is a thesis