Testing the efficacy of pure versus guided mirror exposure in women with bulimia nervosa: A combination of neuroendocrine and psychological indices

Sandra Díaz-Ferrer; Sonia Rodríguez-Ruiz; Blanca Ortega-Roldán; Silvia Moreno-Domínguez; M Carmen Fernández-Santaella

doi:10.1016/j.jbtep.2015.01.003

Testing the efficacy of pure versus guided mirror exposure in women with bulimia nervosa: A combination of neuroendocrine and psychological indices

J Behav Ther Exp Psychiatry. 2015 Sep:48:1-8. doi: 10.1016/j.jbtep.2015.01.003. Epub 2015 Jan 26.

Authors

Sandra Díaz-Ferrer¹, Sonia Rodríguez-Ruiz², Blanca Ortega-Roldán³, Silvia Moreno-Domínguez⁴, M Carmen Fernández-Santaella⁵

Affiliations

¹ Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, Campus la Cartuja s/n, 18071, University of Granada, Granada, Spain. Electronic address: sdiaz_1@ugr.es.
² Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, Campus la Cartuja s/n, 18071, University of Granada, Granada, Spain. Electronic address: srruiz@ugr.es.
³ Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, Campus la Cartuja s/n, 18071, University of Granada, Granada, Spain. Electronic address: bortega@ugr.es.
⁴ Department of Psychology, Faculty of Humanities and Educational Sciences, Campus las Lagunillas, s/n 2307, University of Jaén, Jaén, Spain. Electronic address: smoreno@ujaen.es.
⁵ Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, Campus la Cartuja s/n, 18071, University of Granada, Granada, Spain. Electronic address: mcfersan@ugr.es.

PMID: 25665513
DOI: 10.1016/j.jbtep.2015.01.003

Abstract

Background and objectives: Body exposure improves body image problems in women with eating disorders. However it has almost always been combined with other interventions. Thus, the efficacy of body exposure alone (i.e., pure exposure) remains largely unclear. We aimed to compare the efficacy of two body exposure techniques through psychological and neuroendocrine indices recorded within and between successive sessions.

Method: Twenty-nine women with high body dissatisfaction and diagnosis of bulimia nervosa were randomly assigned to one of two treatment groups: Pure Exposure (n = 14) or Guided Exposure (n = 15). Participants received 6 exposure sessions. After each session, changes in thoughts (positive/negative) and body satisfaction were assessed. Also, we assessed the body discomfort experienced by participants within and between sessions. Finally, the changes in salivary cortisol levels within and between the initial and final treatment sessions were measured.

Results: Both groups showed a reduction in negative thoughts and a progressive increase in positive thoughts throughout the treatment. However, the increase in body satisfaction and the reduction in subjective discomfort within the sessions were greater in the pure exposure group. The cortisol levels during the initial and final treatment sessions decreased in both groups.

Limitations: Methodological limitations are reported.

Conclusions: These results suggest that pure and guided exposures are effective interventions for improving thoughts and neuroendocrine responses, although pure exposure increased more body satisfaction feelings in bulimic women. Subjective discomfort also showed different patterns of change within and along sessions for each treatment. Reasons for these results are discussed.

Keywords: Body discomfort; Body dissatisfaction; Bulimia nervosa; Mirror exposure; Salivary cortisol.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Body Image / psychology*
Bulimia Nervosa / metabolism
Bulimia Nervosa / psychology
Bulimia Nervosa / therapy*
Female
Humans
Hydrocortisone / metabolism
Implosive Therapy / methods*
Outcome Assessment, Health Care*
Young Adult

Substances

Hydrocortisone