This application for a "Mentored Patient-Oriented Research Career Development Award" (K23) is to train the candidate, a child psychiatrist, to become an independent clinical researcher with the expertise in the treatment of pediatric binge eating and other pediatric eating disorders. Binge eating disorder (BED), a proposed diagnostic category in DSM-IV, is the most prevalent eating disorder in adults. Children who develop BED early in life tend to remain overweight as adults and their weight gain represents an important public health problem that may persist into adulthood. Of the possible inter-related mechanisms that contribute to pediatric BED, the candidate is most interested in the contributing role of impulsivity, and poor response inhibition, as a subset of executive function in children with BED. Under the sponsorship of Dr. Mark Riddle, with his expertise in clinical pediatric intervention trials, a panel of nationally-renowned mentors and consultants will each provide the candidate with specialized training in an area critical to her development. Training will be sought in: 1) the phenomenology of feeding behavior, pediatric obesity and BED, 2) the neurobehavioral assessment of impulsivity and response inhibition, 3) clinical trials methodology, including biostatistics, and 4) pediatric eating disorders. The proposed research plan focuses on a preliminary investigation characterizing impulsivity in pediatric binge eating, and a second pilot feasibility study targeting impulsivity in pediatric BED.
Specific Aims of the two inter-related studies are to: 1) characterize impulsivity and response inhibition of pediatric binge eating and 2) conduct an open-label pilot feasibility study in pediatric BED of atomoxetine, a selective norepinephrine reuptake inhibitor used to treat attention-deficit hyperactivity disorder. The proposed research has the potential to inform our understanding of the nature of pediatric BED and to enhance our knowledge of treatments of overweight pediatric binge eaters. Together, the training and research plans will prepare the candidate to meet long-term career goals of becoming an independent investigator conducting pediatric clinical trials for disordered eating, particularly in BED.
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