Text based internet intervention of Binge Eating Disorder (BED): Words per message is associated with treatment adherence

• Published in: Internet interventions : the application of information technology in mental and behavioural health Vol. 28; p. 100538
• Main Authors: Linnet, Jakob, Jensen, Esben Skov, Runge, Eik, Hansen, Marina Bohn, Hertz, Søren Peter Thygesen, Mathiasen, Kim, Lichtenstein, Mia Beck
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.04.2022; Elsevier
• Subjects: Binge-Eating Disorder; Cognitive behavioral therapy; Full length; Internet-based intervention; Sensitivity and specificity; Treatment adherence and compliance; Sensitivity and specificity; Internet-based intervention; Binge-Eating Disorder; Treatment adherence and compliance; Cognitive behavioral therapy
• ISSN: 2214-7829; 2214-7829
• DOI: 10.1016/j.invent.2022.100538

Some evidence suggests that in internet-based cognitive behavioral therapy (iCBT) the likelihood of adherence is increased when patients write longer messages to the therapist in the program. This association has not previously been investigated in iCBT for Binge Eating Disorder (BED). In this study, we hypothesized that the number of words written by patients with mild to moderate BED was associated with increased likelihood of treatment completion in a text-based iCBT program. We compared 143 BED patients (92 completers and 51 non-completers) on the number of messages and words written to their therapist during the treatment. Completers wrote significantly more words per message (words/message) than non-completers. The results remained significant after controlling for gender, age, educational level, marital status, children, source of income and intake measures of BED, BMI and depression symptoms (Wald = 14.48, p < .001). The odds ratio of completion increased by 1.5% for each additional word patients wrote per message (OR = 1.015). The model showed a 72.4% classification accuracy, and an optimal cut-off point of 68.99 words/message for differentiating completers and non-completers. The model accurately identified 80.9% of completers (sensitivity) and 54.9% of non-completers (specificity). The number of words/message patients write may have important implications for ascertaining likelihood of adherence and improving adherence rates. From a clinical perspective, therapists should encourage patients to use the option of writing messages to the therapist. Words/message may prove to be a transdiagnostic predictor of treatment adherence in text based iCBT. •Internet-based interventions easily capture quantitative measures of treatment.•We used words/message (WM) to test adherence in Binge Eating Disorder patients.•Binary logistic regression compared WM in completers vs. non-completers•WM significantly predicted adherence with 72.4% classification accuracy.•This may have transdiagnostic implications for predicting adherence to treatment.