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Table 1 Efficacy of third-wave psychotherapeutic intervention for EDs in adolescents

From: Third-wave interventions for eating disorders in adolescence – systematic review with meta-analysis

Publication Sample Drop Outs Time points Intervention Outcomes Key findingsa
Accurso et al. (2018) [44] • Female only
• Age 11–18 years
(m = 15.5 ± 1.78 years)
• AN (n = 11)
36.3% EOT • Outpatient
• FBT plus DBT (ST)
• 6 months
EDE subscales and global score, PEDE-Q, DERS, DTS, CSQ-8, HAQ, BMI Significant reductions for BMI and PEDE-Q (not significant for ED patients), significant changes for DERS, DTS (patient and caregivers)
Baudinet et al. (2020) [45] • 94.6% female, 5.4% male
• Age 11–18 years (m = 15.02 ± 1.52 years)
• AN-R (n = 109), AN-BP (n = 6), AAN (n = 7), EDNOS (n = 8)
26.7% EOT • Day-care/outpatient
• Ro-DBT
• m = 13.4 weeks
EDI-3, MFQ, SCS-R, ASQ, YSR, FFOCI-SF, SNYP-Y, TEPS, ERQ Significant reductions in drive for thinness (EDI-3), depressive mood (MFQ), social connectedness (SCS-R), and emotional expressiveness (ERQ)
Fischer & Peterson (2015) [46] • Female only
• Age 14–17 years (m = 16.2 ± 1.03)
• EDNOS (n = 10)
30% EOT
6 months
• Outpatient
• DBT
• 6 months
EDE global score, frequency of NSSI and binge-purge behaviours, BMI, BDI Significant reduction in EDE scores, NSSI, frequency of binge episodes and purging; at 6-month follow-up, 3 patients in remission
Johnston et al. (2015) [47] • Female only
• Age 12–17.5 years (m = 14.8 ± 1.5)
• AN (n = 17), BN (n = 6), EDNOS (n = 28)
29% EOT      3 months 
6 months
12 months
• Outpatient
• DBT (ST) plus MFT
• m = 22.2 days (6 sessions ST á 45 min per week for 8 weeks)
EDE-Q global score, frequency of binge-purge behaviours, weight gain, BMI Significant reduction in EDE-Q scores; significant increase in BMI, no changes in binge-purge behaviours;
at 1-year follow-up full restoration in 64% of completers in menstruation and weight
Mazzeo et al. (2016) [38] • Female only
• Age 13–17 years (m = 15.4 ± 1.73)
• BED/LOC (n = 45)
35.7% EOT • Outpatient
• LIBER8 vs.2BFit
• 8–12 sessions over 3 months
EDE-Q subscales and global score, EAH-C, EES-C LIBER8: significant changes in EDE-Q subscales Eating and Shape Concern, Restraint and Global Score and on the EAH Negative Affect Scale.
2Bfit: significant reductions on all EDE-Q subscales and the Global Score and on the AAF and DEP subscales of the EES-C
Murray et al. (2015) [48] • Female only
• Age 14–17 years
• (m = 15.7 ± 1.11 years)
• BN (n = 40)
12.5% EOT • Day-care/Outpatient
• DBT elements plus FBT
• m = 77.2 days
EDE-Q subscales and global score, DERS subscales and global score, frequency of binge-purge behaviours, secretive eating frequency, BMI Significant reductions in EDE-Q subscales Shape and Weight Concern and Global Score, significant reduction in DERS scale “access to emotion regulation strategies” and in frequency of binge episodes, purging and covert eating
Peterson et al. (2019) [49] • Female only
• Age 13–18 years
• (m = 15.3 ± 1.64 years)
• AN-R (n = 11), AN-BP (n = 2), AAN (n = 4), EDNOS (n = 1)
33.3% EOT • Outpatient
• DBT (ST) plus FBT
• 6 months
EDE-Q subscales and global score, CDI2, DBT-WCCL subscales, EBW, diary card Significant reductions in EDE-Q subscale Restraint and Global Score, significant increase in adaptive skills and reduction in dysfunctional coping strategies measured with DBT-WCCL, significant reduction in CDI-2 and in OBE, significant increase in EBW
Salbach et al. (2007) [50] • Female only
• Age years (m = 16.0 ± 1.6 years)
• AN-R (n = 17), AN-BP (n = 6), BN n = (8)
3.2%  EOT • Inpatient
• 12 weeks
EDI-2, SIAB-EX (frequency of binge-purge behaviours), SCL-90-R (depression scale and GSI), BMI Significant reductions on all EDI-2 subscales except perfectionism, on SIAB domains frequency of binging and purging, avoiding calories, fasting, excessive sports, and use of laxatives; BMI increase in the AN group
Salbach-Andrae et al. (2008) [51] • Female only
• Age 12–18 years (m = 16.5 ± 1.0)
• AN-R (n = 4), AN-BP (n = 2), BN (n = 6)
7% EOT • Outpatient

• 25 weeks
EDI-2, SIAB-EX (frequency of binge-purge behaviours), SCL-90-R (GSI), BMI AN patients: at EOT 4 restricting type and 1 purging type fully remitted; significant increase BMI
BN patients: at EOT 3 patient with BN fully remitted, 2 EDNOS, and 1 dropout
Overall: significant reductions in all EDI subscales, food restriction, vomiting and binging, and GSI
Salbach-Andrae et al. (2009) [52] • Female only
• Age 12–21 years (m = 16.9 ± 1.7)
• AN-R (n = 26), AN-BP (n = 11), BN (n = 13)
10% EOT • Outpatient
• DBT vs. CBT vs. WCG
• 25 weeks for CBT and DBT, 12 weeks for WCG
SIAB-EX (binge-purge behaviours, calorie restriction), EDI-2, GSI (SCL-90-R), BMI at EOT 42.1% of CBT group, 37.5% of DBT group, and all patients of WCG still fulfilled eating disorder criteria
CBT and DBT comparable improvements in calorie avoidance, meal frequency, current psychological distress and BMI
Schneider, et al. (2010) [50] • Female only
• Age 12.7–18.6 years (m = 16.3 ± 1.3)
• AN-R (n = 27), AN-BP (n = 6), BN (n = 8)
18% EOT • Inpatient
• DBT
• m = 12 weeks
EDI-2, SIAB-EX (frequency of binge-purge behaviours, calorie restriction, irregular eating), GSI (SCL-90-R), BMI At EOT 21 AN-R patients, 4 AN-BP patients, and 7 BN patients were fully remitted,
Significant improvements in EDI-2 scales Drive for Thinness, Bulimia, Maturity Fears, and Interoceptive Awareness; significant improvements on SIAB domains frequency of binging and purging, avoiding calories, fasting, excessive sports; significant BMI increase
Timko et al. (2015) [53] • 89% female, 11% male
• Age 12–18 years (m = 14.0 ± 1.58)
• AN/subthreshold AN (n = 47)
14.9% EOT • Outpatient
• ASFT
• 20 sessions over 24 weeks
EDE, BMI, remission status
DERS (Non-Acceptance subscale), AFQ-Y, ABOS, AAQ, FamQ (Criticism and Emotional Over-involvement scale)
Significant weight increase and significant reduction on all EDE scales, remission full (48%), partial (29.8%) or none (21.3%), significant increase in parental acceptance (AAQ-2)
  1. 2BFit Weight management group, AAQ-2 Acceptance and Action Questionnaire, AFQ-Y Action and Fusion Questionnaire-Youth, ASFT Acceptance-based Separated Family Treatment, AN Anorexia Nervosa, AAN Atypical Anorexia Nervosa, AN-BP Anorexia nervosa (binge-purging type), AN-R Anorexia nervosa (restrictive type) ASQ Attachment Style Questionnaire, BDI Beck Depression Inventory, BED Binge-eating disorder, BMI Body Mass Index, BN Bulimia Nervosa, CDI-2 Child Depression Inventory-2, CSQ-8 Client Satisfaction Questionnaire, DBT-WCCL DBT Ways of Coping Checklist, DERS Difficulties in Emotional Regulation Scale, DEP Depressive Symptoms, DTS Distress Tolerance Scale, EAH-C Eating in the Absence of Hunger Questionnaire for Children and Adolescents, EBW Expected body weight, EDE Eating Disorder Examination, EDE-Q Eating Disorder Examination-Questionnaire, EDI Eating Disorder Inventory, EDI-2 Eating Disorder Inventory-2, EDI-3 Eating Disorder Inventory-3, EDNOS Eating disorder not otherwise specified, EES-C Emotional Eating Scale-adapted for children, EOT End of treatment, ERQ Emotion Regulation Questionnaire, FamQ Family Questionnaire, FBT family-based treatment, FFOCI-SF Five-Factor Obsessive Compulsive Inventory-Short Form, GSI Global Severity Index, HAQ Helping Alliance Questionnaire, IT Individual therapy, LIBER8 Linking Individuals Being Emotionally Real, LOC Loss of Control Eating, M mean, MFT Maudsley Family Therapy, MFQ Moods and Feelings Questionnaire, NSSI Non-Suicidal Self-Injury, OBE Objective Binge Eating, PEDE-Q Parent Eating Disorder Examination, PVA Parents Versus Anorexia scale, SCL-90-R Symptom Checklist-90-R, SCS-R Social Connectedness Scale-Revised, SIAB Structured Interview for Anorexic and Bulimic Disorders, SIAB-EX Structured Interview for Anorexic and Bulimic disorders for DSM-IV and ICD-10 for expert rating, SNAP-Y Schedule for Nonadaptive and Adaptive Personality for Youth, ST only skills training, TEPS Temporal Experience of Pleasure Scale, WCG waitlist control group, YSR Youth Self Report, aall key findings based on completer analysis, none of the studies used an intention-to-treat analysis