Clinical characteristics, treatment course and outcome of adults treated for avoidant/restrictive food intake disorder (ARFID) at a tertiary care eating disorders program.

Background: Avoidant/restrictive food intake disorder (ARFID) is now recognized as a feeding/eating disorder that affects individuals across the lifespan, but research on ARFID in general and particularly in adults remains limited. The purpose of this study was to describe the demographic and clinical characteristics of adults with ARFID seeking treatment at a tertiary care eating disorders program, and to describe the course and outcomes of treatment at three levels of care-inpatient, intensive outpatient, and outpatient individual therapy.

Method: This retrospective chart review study examined the charts of 42 patients who received treatment for ARFID between April 2020 and March 2023.

Momentary skills use predicts decreased binge eating and purging early in day treatment: An ecological momentary assessment study.

Objective: Emerging research indicates that skills acquisition may be important to behavior change in cognitive behavior therapy (CBT) for eating disorders. This study investigated whether skills use assessed in real time during the initial 4 weeks of CBT-based day treatment was associated with momentary eating disorder behavior change and rapid response to treatment.

Methods: Participants with DSM-5 bulimia nervosa or purging disorder (N = 58) completed ecological momentary assessments (EMA) several times daily for the first 28 days of treatment.

Maintenance treatment for eating disorders following inpatient or day treatment: outcomes of intensive outpatient group and individual CBT treatments.

Relapse is a substantial problem in eating disorders. Until recently, there have been few investigations into maintenance treatments aimed at helping patients maintain improvements made in treatment. This study compared the outcomes of group-based intensive outpatient versus individual cognitive behavioural therapy (CBT)-based maintenance treatments for eating disorders, following inpatient or day treatment.

Rapid improvements in emotion regulation predict eating disorder psychopathology and functional impairment at 6-month follow-up in individuals with bulimia nervosa and purging disorder.

Objective: We previously demonstrated that early improvements in access to emotion regulation strategies during the first 4 weeks of intensive cognitive behavior therapy (CBT)-based eating disorder (ED) treatment predicted a range of post-treatment outcomes. This follow-up article examines whether early improvements in access to emotion regulation strategies continue to predict good treatment outcomes at 6 months post-treatment.

Method: Participants were 76 patients with bulimia nervosa or purging disorder who participated in the original study and the 6-month follow-up assessment.

Rapid improvements in emotion regulation predict intensive treatment outcome for patients with bulimia nervosa and purging disorder.

Objective: Rapid and substantial behavior change (RSBC) early in cognitive behavior therapy (CBT) for eating disorders is the strongest known predictor of treatment outcome. Rapid change in other clinically relevant variables may also be important. This study examined whether rapid change in emotion regulation predicted treatment outcomes, beyond the effects of RSBC.

Update on Psychological Trauma, Other Severe Adverse Experiences and Eating Disorders: State of the Research and Future Research Directions.

Purpose Of Review: This paper provides an updated review of the literature on the relationship between psychological trauma exposure, other severe adverse experiences, and eating disorders.

Recent Findings: Trauma exposure and other severe adverse experiences (e.g.

Rapid response to intensive treatment for bulimia nervosa and purging disorder: A randomized controlled trial of a CBT intervention to facilitate early behavior change.

Objective: Rapid response to cognitive behavior therapy (CBT) for eating disorders (i.e., rapid and substantial change to key eating disorder behaviors in the initial weeks of treatment) robustly predicts good outcome at end-of-treatment and in follow up.

Frontline clinicians' perspectives on and utilization of trauma-focused therapy with individuals with eating disorders.

With this study, we sought to survey clinicians regarding their perspectives and use of concurrent or integrated psychotherapy for co-occurring eating disorders (EDs) and posttraumatic stress disorder. We conducted a quantitative survey of 184 frontline ED clinicians to investigate whether, and to what extent, they view concurrent EDs and trauma-focused therapy as clinically important. We also assessed clinicians' specific concerns regarding concurrent EDs and trauma-focused treatment, as well as barriers to implementation of an evidence-based concurrent treatment.

Emotion regulation difficulties in anorexia nervosa: associations with improvements in eating psychopathology.

Background: Difficulties with emotion regulation have been established as a core deficit in anorexia nervosa (AN). However, limited research has evaluated whether weight gain is associated with improvements in emotion regulation difficulties in AN and whether improvements in emotion regulation are associated with reductions in eating disorder psychopathology. The aims of this study were threefold: 1) to examine the nature and extent of emotion regulation difficulties in AN; 2) to determine whether these difficulties improved during intensive treatment for the eating disorder; and 3) to study whether improvements in emotion regulation were associated with improvements in eating disorder psychopathology.

Empirically defining rapid response to intensive treatment to maximize prognostic utility for bulimia nervosa and purging disorder.

Rapid response (RR) to eating disorder treatment has been reliably identified as a predictor of post-treatment and sustained remission, but its definition has varied widely. Although signal detection methods have been used to empirically define RR thresholds in outpatient settings, RR to intensive treatment has not been investigated. This study investigated the optimal definition of RR to day hospital treatment for bulimia nervosa and purging disorder.

Predictors of rapid relapse in bulimia nervosa.

Objective: Relapse remains a significant concern in bulimia nervosa, with some patients relapsing within months of treatment completion. The purpose of the study was to identify predictors of relapse within the first 6 months following treatment.

Method: The 116 participants were bingeing and/or vomiting ≥ 8 times per month before day hospital (DH), and had ≤ 2 episodes per month in the last month of DH and the first month after DH.

The Family Fat Talk Questionnaire: development and psychometric properties of a measure of fat talk behaviors within the family context.

Fat talk has been well studied in female peer groups, and evidence suggests it may also be important in family contexts. However, no instrument exists to validly assess fat talk within the family. The purpose of this study was to develop a measure of fat talk within families and to establish its psychometric properties in young adult women.

The effectiveness of an individualized form of day hospital treatment.

The traditional group format of day hospital treatment for eating disorders restricts individual tailoring of treatment, which is challenging when complex cases are referred. In 2007 we introduced a new program that included individual sessions. Patients referred to this program were older, had longer illness duration, and more pre-treatment symptoms than the original group program.

Adjunctive graded body image exposure for eating disorders: A randomized controlled initial trial in clinical practice.

Objective: Graded body image exposure is a key component of CBT for eating disorders (EDs). However, despite being a highly anxiety-provoking intervention, its specific effectiveness is unknown. The aims of this initial study were to investigate the feasibility and preliminary effectiveness of individualized graded body image exposure to a range of feared/avoided body image-related situations in a sample of partially remitted ED patients.

"Diagnostic shift" from eating disorder not otherwise specified to bulimia nervosa using DSM-5 criteria: a clinical comparison with DSM-IV bulimia.

In the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the diagnostic threshold for binging and compensation in bulimia nervosa (BN) decreased from twice to once weekly for 3 months. This study investigates the validity of this change by examining whether BN patients and those whose diagnoses "shift" to BN with DSM-5 are similar in their psychological functioning. EDNOS patients whose symptoms met DSM-5 BN criteria (n=25) were compared to DSM-IV BN patients (n=146) on clinically relevant variables.

Rapid and slow responders to eating disorder treatment: a comparison on clinically relevant variables.

Objective: Speed of response to eating disorder treatment is a reliable predictor of relapse, with rapid response predicting improved outcomes. This study investigated whether rapid, slow, and nonresponders could be differentiated on clinically relevant variables, and possibly identified prior to treatment.

Method: Female patients (N = 181) were classified as rapid, slow, or nonresponders based on the speed and magnitude with which they interrupted their bingeing and/or vomiting symptoms, and were compared on eating disorder behaviors and psychopathology and general psychopathology.

Development and validation of the Fat Talk Questionnaire.

Fat talk refers to negative body-related conversations between girls or young women. This research aimed to use qualitative data from young women to guide development of a quantitative fat talk measure. In Study 1, a preliminary 62-item questionnaire was developed and administered to 200 female participants.