This application is a request for a Mentored Patient-Oriented Research Career Development Award (K23) from the NIMH to foster the academic career development of Heather Thompson-Brenner, Ph.D., in the area of treatment outcomes research in eating disorders. The applicant will work with her primary mentor Dr. David Barlow, co-mentors Dr. David Herzog, Dr. Carlos Grilo, and Dr. Tim Brown, and consultants Dr. Christopher Fairburn, Dr. Michael Devlin, and Dr. Stephen Wonderlich to develop and test efficacious treatments for eating disorders in a severe subtype. In a five-year career development plan, the applicant has specified short-term and long-term goals to prepare her for a patient-oriented career. Short-term goals include coursework and training in biostatistics, clinical trials, translational research topics, empirically supported psychotherapies for EDs and personality disorders (PDs), and ED and PD assessment. Long term goals are to facilitate a programmatic line of research in efficacious, innovative treatments for EDs. A formal research plan is proposed to investigate a new treatment for patients with bulimia nervosa (BN) in the dysregulated subtype. The dysregulated subtype of BN is characterized by behavioral impulsivity, emotional dysregulation, interpersonal dysfunction, disturbed cognition, and poor treatment-response. No therapy has been tested to date with this specific population, and no data indicate whether therapy directly addressing the BN symptoms or a treatment addressing the co-morbid eating and personality pathologies is preferable. The goal of the research plan is to assess the efficacy of a new, enhanced, integrative treatment, """"""""Broad"""""""" cognitive-behavioral therapy, which includes interventions for mood and interpersonal dysfunction in addition to BN symptoms. The Broad treatment will be compared to a Focused treatment for BN symptoms only in a randomized controlled trial including 74 subjects. The specific goals of this project are: (1) to obtain results regarding the efficacy of CBT-Broad to reduce the symptoms of BN, relative to CBT-Focused; and (2) to obtain results regarding the efficacy of CBT-Broad to reduce the co-morbid symptoms of mood and interpersonal dysfunction, relative to CBT-Focused. The completion of the proposed training and research plans should fully prepare the applicant as an independent researcher in treatment outcomes for eating disorders. ? ? ?
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