Bulimia nervosa (BN) is a serious and often chronic psychiatric disorder with high rates of medical complications, social impairment and comorbid psychopathology. Cognitive behavioral therapy (CBT) has been shown to be an efficacious approach to the treatment of BN with substantial reductions in core binge eating and compensatory behaviors, as well as psychological impairments. However, in spite of its demonstrated efficacy, 50-70% of bulimic individuals remain symptomatic following treatment with CBT, a significant number drop out of treatment, and relapse rates are substantial. The need for new psychological treatments for BN that can improve the overall response to treatment is high. Integrative cognitive-affective therapy (ICAT) is a new, manual-based, psychological approach to the treatment of BN. ICAT incorporates both conceptual and clinical techniques from existing theories of motivation, emotion, interpersonal functioning, and behavioral change interventions. ICAT is based on a conceptual model of BN that includes several core constructs such as self-discrepancy, affective states, interpersonal patterns, and self-directed style. ICAT includes a clinician manual, patient workbook, and personal digital assistant based treatment modules, all of which are offered in a 20-session, 16-week format. Pilot data testing the model underlying ICAT are promising and suggest that several of the core constructs are significantly associated with BN. Furthermore, two waves of pilot testing indicate that ICAT is feasible to administer and is able to reduce bulimic symptomatology in a relatively short timeframe. ICAT appears to be a promising approach to the treatment of BN and we are requesting funding in this application to refine treatment manuals, develop assessment procedures, and conduct a small randomized controlled trial comparing ICAT to CBT. ? ? ?

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Planning Grant (R34)
Project #
Application #
Study Section
Special Emphasis Panel (ZMH1-ERB-A (02))
Program Officer
Chavez, Mark
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Neuropsychiatric Research Institute
United States
Zip Code
Peterson, Carol B; Berg, Kelly C; Crosby, Ross D et al. (2017) The effects of psychotherapy treatment on outcome in bulimia nervosa: Examining indirect effects through emotion regulation, self-directed behavior, and self-discrepancy within the mediation model. Int J Eat Disord 50:636-647
Haynos, Ann F; Pearson, Carolyn M; Utzinger, Linsey M et al. (2017) Empirically derived personality subtyping for predicting clinical symptoms and treatment response in bulimia nervosa. Int J Eat Disord 50:506-514
Mason, Tyler B; Lavender, Jason M; Wonderlich, Stephen A et al. (2016) Self-Discrepancy and Eating Disorder Symptoms Across Eating Disorder Diagnostic Groups. Eur Eat Disord Rev 24:541-545
Mason, Tyler B; Pearson, Carolyn M; Lavender, Jason M et al. (2016) Examining the role of self-discrepancy and self-directed style in bulimia nervosa. Psychiatry Res 244:294-9
Accurso, Erin C; Wonderlich, Stephen A; Crosby, Ross D et al. (2016) Predictors and moderators of treatment outcome in a randomized clinical trial for adults with symptoms of bulimia nervosa. J Consult Clin Psychol 84:178-84
Goldschmidt, Andrea B; Accurso, Erin C; Crosby, Ross D et al. (2016) Association between objective and subjective binge eating and psychopathology during a psychological treatment trial for bulimic symptoms. Appetite 107:471-477
Ellison, Jo M; Simonich, Heather K; Wonderlich, Stephen A et al. (2016) Meal patterning in the treatment of bulimia nervosa. Eat Behav 20:39-42
Accurso, Erin C; Fitzsimmons-Craft, Ellen E; Ciao, Anna et al. (2015) Therapeutic alliance in a randomized clinical trial for bulimia nervosa. J Consult Clin Psychol 83:637-42
Lavender, Jason M; Wonderlich, Stephen A; Peterson, Carol B et al. (2014) Dimensions of emotion dysregulation in bulimia nervosa. Eur Eat Disord Rev 22:212-6
Misono, Stephanie; Peterson, Carol B; Meredith, Liza et al. (2014) Psychosocial distress in patients presenting with voice concerns. J Voice 28:753-61

Showing the most recent 10 out of 31 publications