ABSTRACT Although Cognitive Behavioral Therapy (CBT-E) for eating disorders has the most empirical support for the outpatient treatment of adult eating disorders (EDs), this model does not include a focus on intense emotion dysregulation, suicidality, and non-suicidal self-injury (NSSI). Furthermore, a subset of patients do not achieve sustained remission with CBT-E. Given that Dialectical Behavior Therapy (DBT) was designed for treatment refractory, complex patients, clinicians must be able to use assessment information to determine which type of treatment to use. The aims of this manuscript are to 1) describe a DBT-based and research-informed conceptual model for treatment decision making for an outpatient non-academic setting, 2) present a case example of a client with significant ED symptoms and complex medical and psychiatric comorbidities, using this decision making model and 3) present descriptive data from a private practice setting in which patients are referred to DBT vs. CBT-E according to this decision making model.

中文翻译：

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成人复杂饮食失调和合并症的门诊治疗：决策模型和案例

摘要 尽管进食障碍的认知行为疗法 (CBT-E) 对成人进食障碍 (ED) 的门诊治疗有最实证的支持，但该模型不包括对强烈情绪失调、自杀和非自杀性自我的关注。伤害（NSSI）。此外，一部分患者无法通过 CBT-E 实现持续缓解。鉴于辩证行为疗法 (DBT) 是为难治性、复杂患者设计的，临床医生必须能够使用评估信息来确定使用哪种治疗类型。这份手稿的目的是 1) 描述一个基于 DBT 和研究知情的概念模型，用于门诊非学术环境的治疗决策，2) 展示一个具有显着 ED 症状和复杂医疗和精神疾病的客户的案例合并症，