Christopher G. Fairburn

A detailed comparison was made of two methods for assessing the features of eating disorders. An investigator-based interview was compared with a self-report questionnaire based directly on that interview. A number of important discrepancies emerged. Although the two measures performed similarly with respect to the assessment of unambiguous behavioral features such as self-induced vomiting and dieting, the self-report questionnaire generated higher scores than the interview when assessing more complex features such as binge eating and concerns about shape. Both methods underestimated body weight.

Randomized clinical trials (RCTs) not only are the gold standard for evaluating the efficacy and effectiveness of psychiatric treatments but also can be valuable in revealing moderators and mediators of therapeutic change. Conceptually, moderators identify on whom and under what circumstances treatments have different effects. Mediators identify why and how treatments have effects. We describe an analytic framework to identify and distinguish between moderators and mediators in RCTs when outcomes are measured dimensionally. Rapid progress in identifying the most effective treatments and understanding on whom treatments work and do not work and why treatments work or do not work depends on efforts to identify moderators and mediators of treatment outcome. We recommend that RCTs routinely include and report such analyses.

Introduction. Fairburn, This Book and How to Use It. Fairburn, Eating Disorders: The Transdiagnostic View and the Cognitive Behavioral Theory. Fairburn, Cooper, Shafran, Enhanced Cognitive Behavior Therapy for Eating Disorders (CBT-E): An Overview. Fairburn, Cooper, Waller, The Patients: Their Assessment, Preparation for Treatment and Medical Management. Fairburn, Cooper, Shafran, Bohn, Hawker, Murphy, Straebler, Enhanced Cognitive Behavior Therapy for Eating Disorders: The Core Protocol. Starting Well. Achieving Early Change. Taking Stock and Designing the Rest of Treatment. Shape Concern. Shape Checking. Feeling Fat and Mindsets. Dietary Restraint, Dietary Rules and Controlling Eating. Events, Moods and Eating. Underweight and Under-eating. Ending Well. Adaptations of CBT-E. Fairburn, Cooper, Shafran, Bohn, Hawker, Clinical Perfectionism, Core Low Self-esteem and Interpersonal Problems. Cooper, Stewart, CBT-E and the Younger Patient. Grave, Bohn, Hawker, Fairburn, Inpatient, Day Patient and Two Forms of Outpatient CBT-E. Fairburn, Cooper, Waller, 'Complex Cases' and Comorbidity. Postscript. Fairburn, Looking Forward. Appendices. Fairburn, Cooper, O'Connor, Appendix A: Eating Disorder Examination (16.0D). Fairburn, Beglin, Appendix B: Eating Disorder Examination Questionnaire (EDE-Q6.0). Bohn, Fairburn, Appendix C: Clinical Impairment Assessment Questionnaire (CIA 3.0).