In order to achieve the long-term goal of establishing a strong, independent research program examining the biological bases of eating disorders, this K23 Career Development Award will provide training in new methodology and data analysis methods through mentorship, didactic education, and hands-on implementation of a research project utilizing these skills. Binge eating is a primary symptom in binge eating disorder, bulimia nervosa, and anorexia nervosa - binge/purge type, disorders that are associated with comorbid psychiatric conditions and impaired psychosocial functioning. There is a great deal of heterogeneity among individuals engaging in binge eating, which can diminish treatment efficacy. For some patients, binge eating episodes are preceded by reports of negative affect, and thus thought of as reward-seeking in effort to regulate emotion. However, little is known about basic underlying emotion regulation in individuals who engage in binge eating, nor about the relation between emotional processes and reward function. The proposed study will utilize an established paradigm to examine implicit regulation of response to acute threat (using fMRI during completion of an emotion conflict task) in women who engage in binge eating. The study will also measure resting state functional connectivity using fMRI and dopamine receptor availability in order to examine how differences in emotion and binge eating may relate to underlying brain connection and neurochemical function related to approach motivation. These data will be utilized to differentiate subtypes of binge eaters who engage in binge eating either through emotional or reward-focused pathways. Findings will improve our understanding of how ability to regulate response to acute threat may function differently in some binge eaters and put them at risk for poor prognosis. This may suggest new directions for interventions that target underlying neural processes via computer tasks or biofeedback. In addition to providing preliminary data on individual differences in underlying emotion regulation, connectivity, and dopamine function among binge eaters, the award will provide extensive training in methods, including advanced fMRI analysis and PET imaging, statistics, and approaches to studying emotion in the context of eating disorders. The specific training goals for the duration of the award include (1) achieving competence in advanced neuroimaging techniques, such as resting-state connectivity, to better understand the biological basis for emotion regulation difficulties in eating disorders; (2) developing expertise in standardized measures of of emotion and its regulation; (3) expanding training in neuroimaging by adding PET imaging to my skillset; and (4) increasing ability to conduct multi-modal, multi-level statistical modeling to analyze complex datasets. To achieve these goals, appropriate seminars, scientific conferences, and courses have been identified, as well as specific plans for mentorship over the course of the applied research project by a team of mentors and consultants with expertise in eating disorders, neuroimaging, emotion, methodology, statistics, and career development.
Binge eating is associated with distress, functional impairment, medical complications, and increased risk for future depression, suicide attempts, substance abuse, and health problems. Despite its presence in multiple psychiatric illnesses, it is not often studied independently. Current interventions may be improved by a better understanding of the pathology underlying this behavior, particularly addressing heterogeneity among individuals engaging in binge eating; thus, it is important to investigate mechanisms leading to binge eating in order to identify targets for improved individualized interventions. Because binge eating is thought to provide temporary relief from acute threat response for some people, this study examines acute threat and approach motivation and related neural function in women across a broad spectrum of binge eating severity.
| Valenzuela, Fabiola; Lock, James; Le Grange, Daniel et al. (2018) Comorbid depressive symptoms and self-esteem improve after either cognitive-behavioural therapy or family-based treatment for adolescent bulimia nervosa. Eur Eat Disord Rev 26:253-258 |
| Weinbach, Noam; Sher, Helene; Bohon, Cara (2018) Differences in Emotion Regulation Difficulties Across Types of Eating Disorders During Adolescence. J Abnorm Child Psychol 46:1351-1358 |
| Bohon, Cara (2017) Brain response to taste in overweight children: A pilot feasibility study. PLoS One 12:e0172604 |
| Klabunde, Megan; Collado, Danielle; Bohon, Cara (2017) An interoceptive model of bulimia nervosa: A neurobiological systematic review. J Psychiatr Res 94:36-46 |
