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Efficacy of a transdiagnostic cognitive-behavioral intervention for eating disorder psychopathology delivered through a smartphone app: a randomized controlled trial

Published online by Cambridge University Press:  25 September 2020

Jake Linardon ,
Adrian Shatte ,
John Rosato  and
Matthew Fuller-Tyszkiewicz
Jake Linardon*
Affiliation:
School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, VIC 3220, Australia
Adrian Shatte
Affiliation:
Federation University, School of Science, Engineering & Information Technology, Melbourne, Australia
John Rosato
Affiliation:
School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, VIC 3220, Australia
Matthew Fuller-Tyszkiewicz
Affiliation:
School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, VIC 3220, Australia Center for Social and Early Emotional Development, Deakin University, Burwood, Victoria 3125, Australia
*
Author for correspondence: Jake Linardon, E-mail: Jake.linardon@deakin.edu.au
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Abstract

Background

Although effective treatments exist for diagnostic and subthreshold-level eating disorders (EDs), a significant proportion of affected individuals do not receive help. Interventions translated for delivery through smartphone apps may be one solution towards reducing this treatment gap. However, evidence for the efficacy of smartphones apps for EDs is lacking. We developed a smartphone app based on the principles and techniques of transdiagnostic cognitive-behavioral therapy for EDs and evaluated it through a pre-registered randomized controlled trial.

Methods

Symptomatic individuals (those who reported the presence of binge eating) were randomly assigned to the app (n = 197) or waiting list (n = 195). Of the total sample, 42 and 31% exhibited diagnostic-level bulimia nervosa and binge-eating disorder symptoms, respectively. Assessments took place at baseline, 4 weeks, and 8 weeks post-randomization. Analyses were intention-to-treat. The primary outcome was global levels of ED psychopathology. Secondary outcomes were other ED symptoms, impairment, and distress.

Results

Intervention participants reported greater reductions in global ED psychopathology than the control group at post-test (d = −0.80). Significant effects were also observed for secondary outcomes (d's = −0.30 to −0.74), except compensatory behavior frequency. Symptom levels remained stable at follow-up. Participants were largely satisfied with the app, although the overall post-test attrition rate was 35%.

Conclusion

Findings highlight the potential for this app to serve as a cost-effective and easily accessible intervention for those who cannot receive standard treatment. The capacity for apps to be flexibly integrated within current models of mental health care delivery may prove vital for addressing the unmet needs of people with EDs.

Keywords

Binge eatingdigital interventioneating disordersrandomized controlled trialsmartphone app
Type
Original Article
Information
Psychological Medicine , Volume 52 , Issue 9 , July 2022 , pp. 1679 - 1690
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Copyright
Copyright © The Author(s) 2020. Published by Cambridge University Press

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