Introduction: Network approaches to psychopathology posit that mental disorders emerge from interrelated symptoms, and thus connectivity among symptoms are assumed to negatively predict the treatment response and decrease with efficacious treatment. Objective: This study uniquely sought to elucidate the network structure, its change, and its predictive value in cognitive-behavioral therapy (CBT) for binge-eating disorder (BED). Methods: In a multicenter randomized trial of face-to-face and Internet-based guided self-help CBT, 178 individuals with full syndrome and subsyndromal BED, eating disorder and general psychopathology, and body mass index (BMI) were subjected to Gaussian Graphical Network and Exploratory Graph Analyses before and after treatment and at 6-month follow-up. Results: At pretreatment, 3 network communities of: eating disorder psychopathology; general psychopathology; and restraint and BMI were identified, with the latter community included in the first thereafter. Eating disorder-related impairment and self-esteem were the most central symptoms, while BMI and binge eating had the lowest centrality. Network connectivity significantly increased from pre- to posttreatment, with the greatest increases in strength centrality found in binge eating and shape concern, but it did not predict remission from binge eating. Conclusions: With decreasing symptom severity, CBT resulted in a greater integration and connectivity of the psychopathology network in BED, suggesting an increased patient understanding of relations between binge eating and other symptoms. Network connectivity was not a negative prognostic indicator of treatment outcome. These results indicate a need for further research on the predictive value of network variables in the explanation of therapeutic change for patients with BED.
Psychother Psychosom

中文翻译：

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暴食症认知行为治疗中的精神病理学网络。

简介：精神病理学的网络方法假定精神障碍源于相互关联的症状，因此假设症状之间的连通性对治疗反应产生负面预测，并随着有效治疗而减少。目的：本研究旨在阐明网络结构、其变化及其在暴食症 (BED) 认知行为疗法 (CBT) 中的预测价值。方法：在一项面对面和基于互联网的引导自助 CBT 的多中心随机试验中，178 名患有完全综合征和亚综合征 BED、饮食失调和一般精神病理学以及体重指数 (BMI) 的个体接受了高斯图形网络和治疗前后和 6 个月随访时的探索性图表分析。结果：在治疗前，3个网络社区：饮食失调精神病理学；一般精神病理学；并确定了约束和 BMI，后一个社区包含在此后的第一个社区中。与饮食失调相关的损害和自尊是最核心的症状，而 BMI 和暴饮暴食的中心性最低。从治疗前到治疗后，网络连通性显着增加，在暴食和形状关注中发现的力量中心性增加最大，但它并没有预测暴食的缓解。结论：随着症状严重程度的降低，CBT 导致 BED 中精神病理学网络的更大整合和连通性，表明患者对暴食与其他症状之间关系的理解增加。网络连接不是治疗结果的负面预后指标。这些结果表明需要进一步研究网络变量在解释 BED 患者治疗变化方面的预测价值。
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