TY  - JOUR
AB  - The PRIDE protocol described by Brown et al. adapts enhanced cognitive behavioural therapy (CBT-E) for sexual minority individuals by addressing minority-stress processes while preserving the core CBT-E treatment. Although its uncontrolled design precludes firm conclusions about efficacy, the study supports feasibility and acceptability and raises a key theoretical question: how to incorporate additional maintaining mechanisms without compromising the coherence of a transdiagnostic, mechanism-based intervention such as CBT-E. 
This paper argues that minority stress can be conceptualised as an additional maintaining domain within the broad form of CBT-E rather than as the integration of a separate therapeutic model. Internalised stigma, sexual-orientation concealment, and rejection-related hypervigilance may reinforce the overvaluation of shape and weight, dysfunctional emotion regulation, and interpersonal avoidance, thereby operating through the central mechanisms of the CBT-E model. Framing minority stress in this way would preserve treatment integrity, support individualised case formulation, and allow the development of a module to be activated only when clinically relevant, consistent with the mechanism-focused evolution of CBT-E.
AU  - Marco, Massa
DA  - 2026-03-16
DO  - 10.32044/ijedo.2026.03
KW  - CBT-E
Eating Disorders
Minority Stress
Transdiagnostic Model
Therapeutic Drift
Treatment Fidelity
L1  - internal-pdf://0308221663/202603.pdf
LA  - English
M3  - Commentary
PY  - 2026
SE  - 19
SP  - 3
ST  - Additional Maintaining Mechanisms and the Coherence of the Transdiagnostic CBT-E Model: Reflections on Brown et al. and the Role of Minority Stress
T2  - IJEDO
TI  - Additional Maintaining Mechanisms and the Coherence of the Transdiagnostic CBT-E Model: Reflections on Brown et al. and the Role of Minority Stress
UR  - https://onlineijedo.positivepress.net/articoli/10.32044/ijedo202603/?lang=en
VL  - 8
ID  - 6
ER  -