Date of Award


Degree Type


Degree Name

Doctor of Philosophy


The purpose of this research was to investigate the comparative effectiveness of cognitive, behavioral, and cognitive-behavioral short-term group treatment targeted at antecedent stages in the maintenance cycle of bulimia, to clarify the additive contributions of eight cognitive and behavioral treatment components, and to evaluate the effect of adding systematic desensitization to cognitive-behavioral treatment.;The research was conducted in two stages. In the first, 21 women who met DSM-III and DSM-III-R diagnostic criteria for bulimia were assigned to either a behavioral treatment group, a cognitive treatment group, or a waiting-list control group. Treatment was conducted over eight weekly two-hour sessions. Four treatment components were introduced in each condition; the behavioral treatment consisted of self-monitoring, stimulus control, relaxation training, and systematic desensitization, and the cognitive treatment consisted of identifying cognitive distortions, combating cognitive distortions and two cognitively-oriented problem-solving components. In the second stage, the subjects in the waiting-list control group were treated with a combination cognitive-behavioral treatment package. Groups were compared to one another, and the additive contributions of the various treatment components were determined using time series analyses.;Comparisons of the three treated groups revealed few between-groups differences; all were effective in ameliorating bulimic symptomatology. However, the differences which emerged at post-treatment favored the cognitive and cognitive-behavioral treatments over the behavioral treatment, particularly on outcome measures of the cognitive manifestations of bulimia.;With respect to the impact of treatment components on symptom reduction, systematic desensitization enhanced the effectiveness of both behavioral and cognitive-behavioral treatments on the majority of dependent measures collected repeatedly over the course of treatment. Stimulus control did not contribute to successful outcome, calling into question the utility of this technique in multicomponent treatment packages.



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