Estudo de desfecho e manutenção dos efeitos de uma intervenção baseada na terapia comportamental dialética para pessoas com obesidade

Abstract

(Artigo 2: Análise qualitativa de uma intervenção para obesos com dificuldades na regulação emocional) Este estudo teve como objetivo explorar a percepção das participantes acerca de suas experiências na participação em uma intervenção baseada no Treinamento de Habilidades da Terapia Comportamental Dialética (TCD). O protocolo foi aplicado por dois terapeutas em um grupo de três participantes obesas com dificuldades na regulação emocional (n = 3). A coleta de dados foi realizada através de uma entrevista semidirigida com foco em três áreas: (1) experiência da participação em um protocolo adaptado de TCD; (2) impacto do tratamento; (3) aspectos que ajudaram ou não ajudaram. As entrevistas foram transcritas e uma análise temática foi realizada para avaliar o resultado do tratamento na amostra pesquisada. (Artigo 2: Análise qualitativa de uma intervenção para obesos com dificuldades na regulação emocional) The present study aimed to explore the perceptions of the participants about their experiences participating in an intervention based on Dialectical Behavior Therapy (DBT) Skills Training. The protocol was conducted by two therapists in a group of three obese participants with difficulties in emotion regulation (n = 3). Data collection was performed through a semi structured interview focusing on three areas: (1) experience of participating in an adapted DBT protocol; (2) treatment impact; (3) helpful or unhelpful aspects. The interviews were transcribed and a thematic analysis was performed to evaluate treatment outcome in the sample. (Artigo 2: Análise qualitativa de uma intervenção para obesos com dificuldades na regulação emocional) Este estudio tuvo como objetivo explorar la percepción de las participantes acerca de sus experiencias en una intervención basada en el Entrenamiento de Habilidades de la Terapia Dialéctico-comportamental (TDC). El protocolo fue aplicado por dos terapeutas en un grupo de tres participantes obesas con dificultades en la regulación emocional (n = 3). La recogida de datos se llevó a cabo a través de una entrevista semiestructurada centrada en tres áreas: (1) la experiencia de participar en un protocolo adaptado de TDC; (2) impacto del tratamiento; (3) aspectos que ayudaron y los que no ayudaron. Las entrevistas fueron transcritas y un análisis temático fue realizado para evaluar el resultado del tratamiento en la muestra investigada.

(Artigo 1: Problematic and adaptive eating in obese people after a DBT based skills training intervention: 3 and 8-month follow-up) Background and Objectives: Dialectical Behavior Therapy conceptualizes problematic behaviors as attempts to regulate emotions, occurring when the individuals has a lack of effective skills to manage emotions and to cope with distress. Binge eating is one kind of problematic behaviors that may serve to alleviate aversive emotional states. DBT skills training has been proved effective to reduce binge eating in several clinical studies. Few studies have shown the effect of DBT on adaptive eating behaviors, and in the stability of the outcomes. Objectives: this study aimed at testing the effect of a brief DBT based skills training intervention, and the stability of the outcomes at 3 and 8 month follow-up. Methods: self-report measures of Binge Eating, Emotional Eating, Intuitive Eating and Mindful Eating were taken on 5 timepoints before and after a 10-session DBT skills training intervention (two baseline measures, one post-test and two follow-ups). Data were analyzed with a mixed model intention-to-treat approach. Results: after the intervention, intuitive eating and mindful eating scores were significantly higher than before the intervention, while emotional eating and binge eating scores were lower. Results remained stable during the first follow-up outtake, with minor fluctuations and small trends towards returning to baseline values in binge eating and emotional eating at the 8 month follow-up. Limitations: given that results are entirely based on self-report measures, that and some instruments showed poor reliability, besides the high attrition rates, results should be taken cautiously. Conclusions: the results give support to the hypothesis that a DBT brief intervention is effective not only in reducing problematic eating, but also in increasing adaptive eating, achieving reasonably stable results. Yet, more research is needed, especially using different assessment methods and mediational designs in order to draw stronger conclusions regarding effectiveness and mechanisms of action of DBT for problematic eating.