Although eating and weight-related disorders are treatable, most afflicted individuals never receive proper treatment. Despite the existence of excellent prototype cognitive-behavioral programs for the treatment of binge-eating disorder (BED) and other eating disorders, we face a crisis of dissemination. The goal of this project is to join cognitive-behavioral therapy (CBT) with novel information technology to develop an interactive CBT program that will allow individuals to experience the basics of CBT in the privacy of their own homes. This Exploratory/Development Grant for Mental Health Intervention (R21) proposes a four stage project to develop a CD-ROM-based program for the effective delivery of cognitive-behavioral therapy (CBT) to obese individuals with binge-eating disorder (OBED) and other unhealthy eating behaviors. In Phase 1 of the project, we will continue development of a CD-ROM program that we began in 1998. The program will be a rich, vivid, and interactive approach to CBT that provides helpful psychoeducation on unhealthy eating and weight-related practices; clearly introduces the basic concepts and techniques of CBT; provides rich and vivid examples of techniques; provides individualized and interactive exercises for practicing CBT principles; and enables users to contact the central web site and staff with questions. This program will be applicable to a broad range of adult women and men of all races and backgrounds. In Phase 2, we will implement a rigorous four-stage beta-testing procedure that includes: group testing sessions followed by individual and focus group debriefing for feedback; peer review by experts in the field of CBT for eating disorders; and in-home beta testing prior to final production. Phase III of the project will be a small feasibility and pilot study comparing the efficacy of the CD-ROM-based delivery of CBT to traditional manual-based group therapy for individuals with OBED and a wait list control. Data from this pilot study will be used to support Phase IV, which will develop a proposal for a large-scale clinical trial comparing CD-ROM-based intervention with traditional group therapy. We anticipate that a CD-ROM-based program will be an efficacious and cost-effective intervention. For some, this program may suffice for treating their eating and weight-related problems. For others, it may be a useful adjunct to traditional psychotherapy or an introductory step to treatment which will familiarize them with the principles and techniques of CBT and increase their comfort and motivation to seek additional professional care.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Exploratory/Developmental Grants (R21)
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Special Emphasis Panel (ZRG1-BBBP-5 (01))
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Street, Linda L
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University of North Carolina Chapel Hill
Schools of Medicine
Chapel Hill
United States
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Wolf, Markus; Sedway, Jan; Bulik, Cynthia M et al. (2007) Linguistic analyses of natural written language: unobtrusive assessment of cognitive style in eating disorders. Int J Eat Disord 40:711-7
Shapiro, Jennifer R; Reba-Harrelson, Lauren; Dymek-Valentine, Maureen et al. (2007) Feasibility and acceptability of CD-ROM-based cognitive-behavioural treatment for binge-eating disorder. Eur Eat Disord Rev 15:175-84