Evan Forman

The gold-standard treatment for OCD is exposure and ritual prevention (ERP), yet despite its well-established efficacy, only a small percentage of OCD patients have access to this treatment. Remote treatments (e.g., videoconferencing) are becoming increasingly popular avenues for treatment delivery and show promise in increasing patient access to evidence-based mental health care. The current pilot study utilized an open trial to examine the feasibility and preliminary efficacy of videoconference-mediated, twice weekly, ERP for adults (n=15) with OCD. Results revealed that ERP was associated with significant improvements in OCD symptoms and large within-group effect sizes. Among the 10 individuals who completed a 3-month follow-up assessment, 30% of participants no longer met DSM-IV-TR criteria for OCD and 80% of participants were rated as very much or much improved on the CGI. This study adds to the growing body of literature suggesting that videoconference-based interventions are ...

ABSTRACT This study assessed the relationship between acceptance-based constructs and quality of life (QOL) among patients with an eating disorder, as well as whether an acceptance-based treatment group could improve QOL. Patients (n=105) at a residential treatment center received treatment as usual (TAU) or TAU plus twice-weekly acceptance and commitment therapy groups (TAU+ACT), and completed assessments at admission and discharge. Higher scores on several acceptance-related constructs at admission were associated with better psychological QOL, and pre- to post-treatment improvements in the ability to defuse from distressing internal experiences were associated with improved QOL. However, no differences in pre- to post-treatment changes in QOL were observed between treatment conditions. These results suggest that while some acceptance-related variables (e.g. defusion, impulse control, access to emotion regulation skills) may contribute to QOL, ACT does not appear to incrementally improve these variables or QOL beyond standard treatment programs. Additional research is needed to evaluate whether ACT may confer greater benefit for improving QOL in an outpatient setting where patients have more opportunity to utilize ACT skills, or when a stronger dose of treatment is administered.

Deficits in executive function (EF)-including inhibitory control, cognitive flexibility, decision-making, and working memory-may be risk or maintenance factors for binge eating disorder (BED). However, there is mixed evidence regarding EF deficits in individuals with BED. Significant methodological weaknesses (e.g., use of a single EF measure, omission of relevant covariates) in the current literature represent one reason for lack of consensus. This study compared EF in a sample of overweight women with (n = 31) and without (n = 43) full or subthreshold BED, with the aim of conducting a multifaceted investigation of the neurocognitive profile of BED. A neuropsychological battery of EF was administered to all participants. After controlling for IQ and age, individuals with binge eating displayed significantly poorer performance on tasks of problem-solving and inhibitory control, and displayed higher prioritization of immediate versus delayed rewards, but the two groups did not appear...

To determine whether acceptance-based behavioral treatment (ABT) would result in greater weight loss than standard behavioral treatment (SBT), and whether treatment effects were moderated by interventionist expertise or participants' susceptibility to eating cues. Recent research suggests that poor long-term weight-control outcomes are due to lapses in adherence to weight-control behaviors and that adherence might be improved by enhancing SBT with acceptance-based behavioral strategies. Overweight participants (n = 128) were randomly assigned to 40 weeks of SBT or ABT. Both groups produced significant weight loss, and when administered by experts, weight loss was significantly higher in ABT than SBT at post-treatment (13.17% vs. 7.54%) and 6-month follow-up (10.98% vs. 4.83%). Moreover, 64% of those receiving ABT from experts (vs. 46% for SBT) maintained at least a 10% weight loss by follow-up. Moderation analyses revealed a powerful advantage, at follow-up, of ABT over SBT in those potentially more susceptible to eating cues. For participants with greater baseline depression symptomology, weight loss at follow-up was 11.18% in ABT versus 4.63% in SBT; other comparisons were 10.51% versus 6.00% (emotional eating), 8.29% versus 6.35% (disinhibition), and 9.70% versus 4.46% (responsivity to food cues). Mediation analyses produced partial support for theorized food-related psychological acceptance as a mechanism of action. Results offer strong support for the incorporation of acceptance-based skills into behavioral weight loss treatments, particularly among those with greater levels of depression, responsivity to the food environment, disinhibition, and emotional eating, and especially when interventions are provided by weight-control experts.