(PS8-B44) Do Pre-treatment Factors Predict Self-monitoring Adherence?

Self-monitoring of eating behaviors, eating disorder (ED) symptoms and related contexts is an integral component of enhanced cognitive behavioral therapy for bulimia nervosa and has been associated with improved ED symptoms. Despite the importance of self-monitoring, the factors that predict self-monitoring adherence are not well understood. Knowledge of predictors of self-monitoring adherence may inform treatment planning and implementation to maximize self-monitoring compliance and improve clinical outcomes. The current study explored whether demographic factors influence self-monitoring adherence and examined how pre-treatment factors, such as increased levels of comorbid psychopathology, severity of Eating Disorder (ED) psychopathology, and self-regulation deficits, may predict adherence to self-monitoring. Comorbid psychopathology included measures of depressive symptomatology and anxiety, as measured by the Beck Depression Inventory-II total score and State-Trait Anxiety Inventory total score, respectively. ED psychopathology severity was measured using the Eating Disorder Examination global score, loss of control eating episodes in the past month, and purging episodes in the past month. Self-regulation deficits included impulsivity and emotion regulation deficits, as measured by the UPPS-P Impulsive Behavior Scale and the Difficulty in Emotion Regulation Scale, respectively. This study included data from two completed clinical trials evaluating enhanced cognitive and behavioral therapies for BN (N = 99). In both trials, participants reported on their eating behaviors through weekly self-monitoring forms over the course of treatment. These forms were rated for completion by therapists and the mean of these ratings made throughout treatment were used to determine self-monitoring adherence. Results indicated that females are more likely to demonstrate greater adherence to self-monitoring (b = .53, SE = .21, p = .01). Results of regression analyses indicated that comorbid increased levels of depressive symptomatology, but not anxiety, significantly predicted poorer self-monitoring adherence (b = -0.02, SE = 0.01, p = 0.02). Age, severity of ED psychopathology, and self-regulation deficits did not significantly predict self-monitoring adherence (all ps > .05).