The Effectiveness of Cognitive-Behavioral Therapy versus Schema Therapy on Emotional Adjustment and Sense of Loneliness in Women with Binge Eating Disorder with Perception of Parental Rejection

Binge eating disorder (BED), manifested as persistent and compulsive eating, could be the result of affects created due to people's evaluation and perception of their relationships with their parents. This study aimed to compare the effectiveness of cognitive-behavioral therapy (CBT) and schema therapy (ST) on emotional adjustment and the sense of loneliness in women with BED who perceived parental rejection.

This was a controlled semi-pilot study with a pretest-posttest-follow-up design. The statistical population comprised all individuals with BED visiting diet clinics in Naein, Iran (2020-2021). Using convenience sampling and based on the inclusion and exclusion criteria, a sample of 45 was selected. The participants filled out the Emotional Adjustment Questionnaire (Rubio et al., 2007), the UCLA Loneliness Scale (Russell and Pilva, 1980), and the Parental Acceptance-Rejection Questionnaire (Abdul Khaleque and Rohner, 2010). They were then randomly allocated to two experimental groups and one control group. The experimental groups received CBT (one 90-minute session per week for 12 weeks) or ST (one 90-minute session per week for 12 weeks), while the control group received no treatment. The data were analyzed using two-way repeated-measures ANCOVA.

There was a significant difference between the ST and CBT groups, on the one hand, and the control group, on the other hand, in terms of emotional adjustment (Eta= 0.59, p≤ 0.01, F= 60.63) and the sense of loneliness (Eta= 0.26, p≤ 0.01, F=16.03). The ST was more effective in the emotional adjustment and the sense of loneliness of the participants with perceived parental rejection. On the follow-up, the effects of this intervention were more persistent than those of CBT (p≤ 0.01).

Based on these results, ST appears to be a more effective intervention for improving emotional adjustment and alleviating the sense of loneliness in women with BED and perceived parental rejection.