The overarching objective of the candidate's application for an individual Research Career Award (K23) is to train the candidate to become an independent clinical researcher in an academic setting in order to develop an expertise in the treatment of individuals with eating disorders. Binge Eating Disorder (BED), a proposed diagnostic category in DSM-IV, is associated with impairments in physical, psychological, and social functioning. Cognitive behavioral therapy (CBT), based on the restraint model, has been the most studied treatment for BED. Given that the average rate of abstinence from binge eating at the end of CBT treatment approximates 50% across multiple studies, potentially more effective treatment interventions merit consideration. Dialectical Behavior Therapy (DBT), based on the affect regulation model linking binge eating with emotional distress, is one such treatment approach. Preliminary studies indicate that abstinence rates at the end of 20 weeks of manualized DBT adapted for BED in a group format range from 82-89%. At the same time that new and more efficacious treatments for BED are being developed, current BED research has not as yet demonstrated consistently significant outcome differences among existing therapies. This suggests that nonspecific therapeutic factors (e.g. therapist-patient interactions) and/or baseline factors (e.g. patient expectations) may account for much if not all of BED treatment outcome. As no studies to date have compared the outcome of a specific psychotherapeutic treatment for BED with a therapy controlling for nonspecific factors, the candidate will conduct a randomized clinical trial comparing the outcome of manualized DBT to a manualized Supportive Group Therapy for adults. Assessed will be the short (post-treatment), medium (3 mo, 6 mo) and longer term (12 mo) outcomes of these treatments as well as mediators and moderators of abstinence. The candidate's specific aims for this K23 award are: 1) to obtain training in research design, statistical analysis, and the theory and process of research through an individualized program of coursework at the Stanford University School of Medicine, with a focus on health outcomes and emotion regulation research and theory; 2) to contribute meaningfully to the understanding of efficacious treatments for BED by conducting a randomized clinical trial and 3) to expand the candidate's skills so that she can develop into a successful and independent investigator capable of obtaining future support for patient-oriented research, such as an R01.
| Robinson, Athena Hagler; Safer, Debra L (2012) Moderators of dialectical behavior therapy for binge eating disorder: results from a randomized controlled trial. Int J Eat Disord 45:597-602 |
| Safer, Debra L; Joyce, Erin E (2011) Does rapid response to two group psychotherapies for binge eating disorder predict abstinence? Behav Res Ther 49:339-45 |
| Safer, Debra L; Robinson, Athena Hagler; Jo, Booil (2010) Outcome from a randomized controlled trial of group therapy for binge eating disorder: comparing dialectical behavior therapy adapted for binge eating to an active comparison group therapy. Behav Ther 41:106-20 |
| Safer, Debra L; Hugo, Emily M (2006) Designing a control for a behavioral group therapy. Behav Ther 37:120-30 |
