Brittany Matheson, PhD, is a clinical assistant professor and licensed clinical psychologist in the Eating Disorders Clinic. She completed her undergraduate degree at Duke University, doctorate from the Joint Doctoral Program in Clinical Psychology at San Diego State University and the University of California, San Diego, and APA clinical internship at Lucile Packard Children’s Hospital Stanford/Children’s Health Council. Dr. Matheson's research interests include examining the psychosocial, neurocognitive, and familial factors related to disordered eating and excess weight gain in youth. In particular, Dr. Matheson has research and clinical expertise in the interplay among obesity, disordered eating, and autism spectrum disorder. She is interested in the development and implementation of evidence-based treatments for youth with disordered eating as well as better understanding factors that influence pediatric bariatric surgery outcomes. Her research also focuses on the use of technology to enhance treatment and reduce access to care barriers.

Clinical Focus

  • Clinical Psychology

Academic Appointments

Professional Education

  • Fellowship: Stanford University Psychiatry and Behavioral Sciences (2021) CA
  • Internship, Lucile Packard Children's Hospital Stanford/Children's Health Council (2018)
  • PhD Training: University of California San Diego School of Medicine (2018) CA
  • BS, Duke University (2010)

Clinical Trials

  • Confirming the Effectiveness of Online Guided Self-Help Family-Based Treatment for Adolescent Anorexia Nervosa Recruiting

    With an incidence rate of about 1%, Anorexia Nervosa (AN) is a serious mental disorder associated with high mortality, morbidity, and cost. AN in youth is more responsive to early treatment but becomes highly resistant once it has taken an enduring course. The first-line treatment for adolescents with AN is Family Based Treatment (FBT). While FBT can be delivered using videoconferencing (FBT-V), therapists' limited availability hampers scalability. Guided self-help (GSH) versions of efficacious treatments have been used to scale and increase access to care. The main aim of this proposed comparative effectiveness study is to confirm that clinical improvements in GSH-FBT are achieved with greater efficiency than FBT-V in generalizable clinical settings.

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Lab Affiliations

All Publications

  • Protocol for a randomized clinical trial to confirm the effectiveness of online guided self-help family-based treatment for adolescent anorexia nervosa. Contemporary clinical trials Gurcan, H., Couturier, J., Matheson, B., Jo, B., Lock, J. 2024: 107618


    The leading evidence-based treatment for anorexia nervosa (AN) in adolescents is Family-based Treatment (FBT). However, due to the intensive training requirements and lack of practitioners, it is often difficult for families to access FBT. Thus, innovations that improve access to care are needed. A pilot randomized study of a guided self-help version of Family-based Treatment (GSH-FBT) that utilized approximately 1/4 the amount of therapist time compared to FBT found that the approach was acceptable and appeared to achieve similar outcomes. The study protocol detailed in this manuscript compares the efficiency (clinician time) of GSH-FBT to Family-based Treatment via Videoconferencing (FBT-V) in a fully powered study in achieving clinical outcomes through a multi-site randomized clinical trial across the US and Ontario, Canada.This study will randomize the families of adolescents ages 12-18 (n = 200) who meet DSM-5 criteria for AN to receive either GSH-FBT or FBT-V. Participants will be randomized to 15 sixty-minute sessions of FBT-V or to 10 twenty-minute sessions of online GSH-FBT. Major assessments will be conducted by a masked assessor at baseline, within treatment, at the end of treatment (EOT), and 6 and 12 months after the end of treatment (EOT). The primary outcomes of this study are changes to body weight and eating disorder cognitions relative to clinician time used (relative efficiency of treatment modality).The findings of this study may help increase access to care by providing a time efficient, affordable, more scalable intervention for adolescent AN compared to standard FBT.

    View details for DOI 10.1016/j.cct.2024.107618

    View details for PubMedID 38971303

  • Bulimia Nervosa and Binge-Eating Disorder Across the Lifespan. Focus (American Psychiatric Publishing) Matheson, B. E. 2024; 22 (3): 278-287


    This article aims to review the current evidence-based psychotherapy and psychopharmacological treatments for adults and youths with bulimia nervosa (BN) and binge-eating disorder (BED). Treatments for adults and for children and adolescents are discussed separately, including developmental considerations in the management of these disorders among youths. Although several evidence-based psychotherapy and psychopharmacological treatment options have been established for adults with BN or BED, there is much less empirical support for the management of these eating disorders among children and adolescents. This review concludes by discussing promising modalities and innovations, highlighting the potential utility of integrating technology into treatment approaches. Despite decades of treatment development and testing, a sizable proportion of individuals with BN or BED do not respond to the current evidence-based treatments, highlighting the need for continued research in these domains. Future research should focus on testing psychotherapy treatments among diverse samples in large, randomized controlled trials, as well as on treatments that can be easily scaled and implemented in community settings.

    View details for DOI 10.1176/appi.focus.20240001

    View details for PubMedID 38988471

    View details for PubMedCentralID PMC11231461

  • Testing associations between assessments of cognitive flexibility and eating disorder symptoms in adolescent bulimia nervosa. The International journal of eating disorders Singh, S., Gorrell, S., Matheson, B. E., Reilly, E. E., Lock, J. D., Le Grange, D. 2024


    Cognitive rigidity, or difficulty adapting to changing demands, is commonly observed in anorexia nervosa. Less is known, however, about cognitive flexibility (CF) in bulimia nervosa (BN) and, particularly, adolescence. Clarifying this relation and best assessment practices may guide informed clinical decision-making. The current study compared how two measures of CF (i.e., Wisconsin Card Sort Task [WCST] and Trail Making Task [TMT]) relate to BN symptoms among adolescents.Data from a subsample (n = 78) of adolescents with BN were analyzed. Linear and hurdle regressions were used to compare the effects of WCST perseverative errors and TMT performance on Eating Disorder Examination Global Scores, objective binge episodes, and self-induced vomiting episodes (SVEs) at baseline and end-of-treatment (EOT).Neither CF measure associated with baseline BN symptoms. TMT performance positively associated with the likelihood of engaging in SVEs at EOT (𝛽 = 0.47, p = 0.01, 95% confidence interval [CI] = [0.11-0.84]) and, among adolescents who endorsed ≥1 SVE at EOT, WCST perseverative errors (𝛽 = 0.05, p = 0.005, 95% CI = [0.01-0.08]) positively associated with SVE frequency at EOT.The overall lack of associations between CF and outcomes suggests that cognitive rigidity may not be as relevant to the clinical profile of adolescent BN as for anorexia nervosa. In the few significant associations that emerged, the WCST and TMT uniquely predicted the severity of vomiting at EOT in this sample. Given the lack of CF deficits, future work should aim to test the role of other executive functions (e.g., impulsivity), in addition to CF, to determine which deficits are present in adolescent BN and may predict outcomes.Patients with eating disorders often have difficulties thinking flexibly, which may interfere with their recovery. We tested two ways of measuring flexible thinking in adolescents with BN. Overall, flexible thinking was not associated with symptom-level outcomes. However, less flexible thinking at the start of treatment predicted self-induced vomiting at EOT. If findings are replicable, then assessing and addressing flexible thinking could improve outcomes for adolescents with BN.

    View details for DOI 10.1002/eat.24235

    View details for PubMedID 38840408

  • Feasibility and acceptability of a pilot studying investigating multi-family parent-only guided self-help family-based treatment for adolescent anorexia nervosa. The International journal of eating disorders Matheson, B. E., Van Wye, E., Whyte, A., Lock, J. 2024


    Family-based treatment (FBT) is an efficacious treatment for adolescent anorexia nervosa (AN). A parent-only guided self-help version of FBT (GSH-FBT) demonstrated preliminary efficacy in pilot investigations. To address challenges in access to care, we adapted GSH-FBT into a parent-only multi-family group format (MF-GSH-FBT) delivered via videoconferencing.This report details the feasibility and acceptability of a parent-only group-based multi-family GSH-FBT (MF-GSH-FBT) for adolescent AN delivered virtually. The MF-GSH-FBT intervention consisted of 12 weekly 60-min sessions facilitated by a clinician in addition to online FBT video content and recommended readings. Adolescents and parents completed assessments at baseline and post-treatment. Parents reported their child's weight each week.A total of 13 adolescents (15.57 + 1.63 years; 92% female; 23% Hispanic) with AN and their parents enrolled and initiated treatment. Four consecutive cohorts of groups of 3-4 families were completed from April 2022 to April 2023. Across cohorts, parents attended 85% of sessions. Most parents rated the treatment sessions as helpful (79%; agree/strongly agree) and felt supported by the other group members (84%). All parents (100%) reported MF-GSH-FBT helped their child, and most (90%) reported their child had improved by end-of-treatment. On average, adolescents gained 3.53 kg (SD: 3.76) from pre- to post-treatment, with percent estimated mean body weight increasing 5% on average. Parental self-efficacy also increased from baseline to end-of-treatment.MF-GSH-FBT for AN appears feasible and acceptable to parents participating in this pilot study. Challenges with recruitment and adolescent data collection remain questions for future investigation.This study describes initial pilot testing of a virtual guided self-help family-based treatment for adolescents with anorexia nervosa delivered in a multi-family group format. This treatment aims to enhance access to family-based treatment for anorexia nervosa whilst providing additional support to parents.

    View details for DOI 10.1002/eat.24182

    View details for PubMedID 38419434

  • Childhood appetitive traits and adolescent eating disorders: early risk markers. The Lancet. Child & adolescent health Matheson, B. 2024

    View details for DOI 10.1016/S2352-4642(24)00046-4

    View details for PubMedID 38395043

  • Family-based treatment (FBT) for loss of control (LOC) eating in youth: Current knowledge and future directions. Eating disorders Matheson, B. E., Bohon, C., Le Grange, D., Lock, J. D. 2024; 32 (1): 1-12


    Loss of control (LOC) eating in youth is a common disordered eating behavior and associated with negative health and psychological sequalae. Family-based treatment (FBT) is an efficacious treatment for adolescent anorexia nervosa and bulimia nervosa (BN) but has not been formally evaluated for adolescents with LOC eating. This study is a secondary data analysis from a randomized controlled clinical trial (NCT00879151) testing FBT for 12-18-year-olds with BN. Data were reanalyzed to examine outcomes for LOC eating episodes, regardless of episode size. Abstinence rates, defined as zero LOC eating episodes (objective or subjective binge episodes) in the previous month, were calculated at the end-of-treatment (EOT), 6-month, and 12-month follow-up time points. Among 51 adolescent participants (M + SD: 15.94 + 1.53 y; 92% female; 23.5% Hispanic; 76.5% Caucasian), FBT significantly reduced LOC eating episodes, with 49% achieving LOC eating abstinence at EOT. At 6-month follow-up, 41% achieved LOC eating abstinence. Of those providing 12-month follow-up data, 73% achieved abstinence. This preliminary exploration suggests that FBT may be effective for youth with LOC eating, regardless of episode size. Additional research is needed to replicate these findings and extend treatments with developmental adaptations for younger children with LOC eating.

    View details for DOI 10.1080/10640266.2023.2229091

    View details for PubMedID 38149636

    View details for PubMedCentralID PMC10753090

  • Who Responds to an Adaptive Intervention for Adolescents With Anorexia Nervosa Being Treated With Family-Based Treatment? Outcomes From a Randomized Clinical Trial. Journal of the American Academy of Child and Adolescent Psychiatry Lock, J. D., Le Grange, D., Bohon, C., Matheson, B., Jo, B. 2023


    Anorexia Nervosa (AN) is a serious psychiatric disorder with high morbidity and mortality. The current evidence supports the use of Family-Based Treatment (FBT), but recovery rates are about 40%. Improving treatment outcomes among adolescents will save lives, improve health, and prevent chronicity. This study examined the relative efficacy of adding Intensive Parental Coaching (IPC) to standard FBT for those who do not respond by weight gain of 2.4 kg by session 4, a clinical predictor of outcome at the end of treatment (EOT), to improve remission rates (>94% of expected mean body mass index (mBMI)).107 adolescents and their families were recruited, of whom 69 failed to respond early and were randomized to continue with standard FBT or to receive 3 sessions of IPC. Participants were adolescents with DSM-5 AN between the ages of 12-18 years recruited from across the US; 6.5% were male participants and 11% were Hispanic.Main outcomes were mBMI >94% expected for age, height, and sex. Secondary outcomes include change in eating-related cognitions. Adding IPC to early non-responders did not improve outcomes except for those whose parents demonstrated low parental self-efficacy at baseline (moderator). Early weight gain of 2.4kg by session 4 was replicated as a predictor of end of treatment remission.Parental self-efficacy (PSE) moderates IPC as an adaptive treatment for adolescent AN. Baseline PSE assessment can be used to identify those families most likely to benefit from adding IPC to FBT. Future studies should consider earlier interventions to improve early response rates.

    View details for DOI 10.1016/j.jaac.2023.10.012

    View details for PubMedID 38142046

  • Family-based treatment (FBT) for loss of control (LOC) eating in youth: Current knowledge and future directions EATING DISORDERS Matheson, B. E., Bohon, C., Le Grange, D., Lock, J. D. 2023
  • Psychoeducational and motivational treatment for low-weight Avoidant/Restrictive Food Intake Disorder (ARFID): Three case reports in school-aged children. Clinical child psychology and psychiatry Datta, N., Matheson, B., Walker, A. C., Van Wye, E., Lock, J. D. 2023: 13591045231169141


    BACKGROUND: Individuals with Avoidant/Restrictive Food Intake Disorder (ARFID) experience restrictive or highly selective eating problems that interfere with growth and development. Despite the increasing number of referrals for ARFID, no evidence-based treatments exist. This compilation of case composites describes a novel manualized treatment, Psychoeducational and Motivational Treatment (PMT) for children with ARFID, focusing on exploring motivation to change eating behaviors. This approach is based on motivational non-directive psychotherapy models, psychoeducational interventions, and the usefulness of play to support psychotherapeutic learning in school-age children.CASE PRESENTATIONS: Three cases of children with ARFID treated using PMT are presented: a 7-year-old, a 10-year-old, and a 12-year-old. These cases illustrate how a clinician delivers PMT interventions in the context of developmental abilities and common comorbidities associated with ARFID.CONCLUSION: PMT is a promising therapy for ARFID in school-age children. Challenges and strategies are discussed, including ways to address obstacles such as young age, comorbidities, and use of the virtual environment.

    View details for DOI 10.1177/13591045231169141

    View details for PubMedID 37032311

  • Predictors of family-based treatment for adolescent eating disorders: Do family or diagnostic factors matter? The International journal of eating disorders Datta, N., Hagan, K., Bohon, C., Stern, M., Kim, B., Matheson, B. E., Gorrell, S., Le Grange, D., Lock, J. D. 2022


    Misconceptions around which patients will and will not benefit from family-based treatment (FBT) for adolescent eating disorders (EDs) limit referrals and access to this treatment modality. The present study explored whether common demographic and clinical factors that may prevent referral to FBT predict treatment outcomes in adolescent anorexia nervosa (AN) and bulimia nervosa (BN).The following predictors of treatment outcomes were assessed: baseline family and diagnostic factors (socioeconomic status, comorbidity, illness duration, parent feelings of self-efficacy, family status, prior treatment, sex and prior hospitalizations) in a combined sample of adolescents receiving FBT compared to those randomized to other treatment conditions, across six clinical trials in the United States and Canada (total n = 724, ages 12-18, 90% female across both diagnoses). AN and BN samples were examined separately.Any prior ED treatment emerged as the only predictor of outcome in AN and BN, such that having no prior treatment predicted better outcomes in FBT for AN, and in both FBT and other treatment modalities for BN. No other sociodemographic or clinical variables predicted outcomes for AN or BN in FBT or in other evidence-based treatment modalities.The findings of this exploratory analysis suggest that commonly assumed factors do not predict outcome in FBT. Specifically socioeconomic and demographic factors or clinical variability in families seeking treatment do not predict treatment outcomes in FBT, or other evidence-based treatment modalities, with the exception of prior treatment. Providers should consider referring to FBT even when these factors are present.This manuscript reports that commonly assumed family, sociodemographic and diagnostic factors do not predict outcome in FBT or other evidence-based treatment modalities, with the exception of prior treatment. This data may be helpful for providers when considering referrals to FBT in the context of variability in these variables.

    View details for DOI 10.1002/eat.23867

    View details for PubMedID 36454189

  • Protocol for a randomized clinical trial for Avoidant Restrictive Food Intake Disorder (ARFID) in low-weight youth. Contemporary clinical trials Van Wye, E., Matheson, B., Citron, K., Yang, H., Datta, N., Bohon, C., Lock, J. D. 2022: 107036


    Background Avoidant Restrictive Food Intake Disorder (ARFID) is an eating disorder recently added to the Diagnostic and Statistical Manual, 5th Edition (DSM-5) that involves nutritional, developmental, and/or psychosocial impairment, and often presents with a lack of interest in eating, sensory-related eating concerns, and/or fear of adverse consequences related to eating. There is limited evidence on treatments for ARFID, and in particular, treatments for children in the outpatient setting. Pilot data suggest that Family-Based Treatment (FBT) modified for ARFID is efficacious, and that improvements in parental self-efficacy may be the mechanism behind its success. This manuscript describes a study protocol seeking to confirm these preliminary findings through an adequately powered, randomized clinical trial (RCT). METHODS: This trial will randomize 100 children ages 6-12 years old who meet DSM-5 criteria for ARFID and their families to receive either 14 telehealth sessions of FBT-ARFID (n = 50) or a manualized Psychoeducational Motivation Therapy (PMT) treatment (n = 50), an individual therapy addressing the child's understanding of the problems ARFID is causing and promoting non-behavioral motivation and exploration of changing their eating patterns. Masked assessments will be conducted at baseline, one and two months within treatment, end-of-treatment, and six-month follow-up. Primary outcomes include change in body weight, parental self-efficacy, and parent feeding behaviors between baseline and end-of-treatment. CONCLUSIONS: The results of this RCT will advance our understanding of effective treatments for low-weight ARFID in youth.

    View details for DOI 10.1016/j.cct.2022.107036

    View details for PubMedID 36460266

  • The COVID-19 pandemic and youth with anorexia nervosa: A retrospective comparative cohort design. The International journal of eating disorders Datta, N., Van Wye, E., Citron, K., Matheson, B., Lock, J. D. 2022


    OBJECTIVE: There is a growing body of literature suggesting the novel coronavirus pandemic (COVID-19) negatively impacts mental health in individuals self-reporting an eating disorder (ED); however, limited pediatric data is available about the impact COVID-19 has had on youth with EDs, specifically Anorexia Nervosa (AN). Our study uses a cross-sectional design to explore differences in ED symptoms between adolescents diagnosed with AN during the COVID-19 pandemic compared to a retrospective cohort of adolescents for whom these measures were previously collected, prior to the pandemic.METHOD: We report cross-sectional data assessing differences between AN behaviors and cognitions during the COVID-19 pandemic compared to a retrospective cohort (n=25 per cohort) assessed before the pandemic.RESULTS: Results suggest that individuals with a first-time diagnosis of AN during the pandemic had lower percent expected body weight, and more compulsive exercise behaviors.CONCLUSIONS: These data support existing pediatric findings in exercise and body weight differences in adolescents with AN before and during the pandemic. Findings may be helpful in informing considerations for providers treating ED patients amidst and after the pandemic.PUBLIC SIGNIFICANCE: This manuscript compares a retrospective cohort of adolescents diagnosed with AN prior to the pandemic to a cohort of adolescents diagnosed with AN during the pandemic. Results report that adolescents diagnosed with AN during the pandemic have lower weights and increased compensatory exercise behavior compared to adolescents diagnosed with AN before the pandemic despite no difference in length of illness. Findings may be helpful in informing considerations for providers treating ED patients amidst and after the pandemic.

    View details for DOI 10.1002/eat.23817

    View details for PubMedID 36125016

  • Study protocol for training providers in private practice in family-based treatment for adolescents with anorexia nervosa: A randomized controlled feasibility trial. Contemporary clinical trials Citron, K., Johnson, M., Matheson, B. E., Onipede, Z. A., Yang, H. J., Bohon, C., Le Grange, D., Lock, J. 2022: 106889


    Private practice clinicians make up approximately 50% of US mental health outpatient providers and treat a high number of eating disorder patients. While family-based treatment (FBT) is a first-line treatment for adolescent anorexia nervosa (AN), private practice clinicians experience difficulties receiving training in evidence-based treatments such as FBT. This report outlines the study protocol for a randomized control trial (RCT) training private practice clinicians in FBT for adolescent AN (NCT04428580).In this study, we intend to recruit 140 private practice mental health practitioners and randomize them to complete either a standard webinar-based online training or an enhanced online training that incorporates additional modules related to the putative mechanisms of treatment effect in FBT (i.e., use of externalization and agnosticism). Following the training, participants will begin expert case consultation for an adolescent with AN using FBT from their private practice.Based on preliminary studies suggesting the importance of enhanced skills related to agnosticism and externalization, we hypothesize that feasibility data will support a larger randomized clinical trial (RCT) and that the enhanced training arm will significantly improve FBT knowledge and skills compared to the standard webinar training arm. We also expect that patient weight gain early in treatment will be associated with clinician fidelity to the inventions used in FBT regardless of training type.

    View details for DOI 10.1016/j.cct.2022.106889

    View details for PubMedID 35998767

  • Evidence Based Update on Psychosocial Treatments for Eating Disorders in Children and Adolescents. Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53 Datta, N., Matheson, B. E., Citron, K., Van Wye, E. M., Lock, J. D. 2022: 1-12


    Eating disorders (EDs) are life-threatening psychiatric illnesses that occur in adolescents. Unfortunately, limited randomized controlled trials exist to address EDs in this vulnerable population. The current review updates a prior Journal of Clinical Child and Adolescent Psychology review from 2015. The recommendations in this review build upon those that were previously published. This update was completed through a systematic search of three major scientific databases (PsychInfo, Pubmed, and Cochrane) from 2015 to 2022 (inclusively) from three databases, employing relevant medial subject headings. Additionally, expert colleagues were asked for additional literature to include. Thirty-one new studies were added to this review. Psychosocial treatments included family therapies, individual therapy, cognitive-behavioral therapy, interpersonal psychotherapy, cognitive training, dialectical behavioral therapy, and more recently, virtual or telehealth-based practices and guided self-help modalities for carers of youth with EDs. Using the Journal of Clinical Child and Adolescent Psychology's methodological review criteria, this update found behavioral family-based treatment modalities (FBT) for both adolescent anorexia nervosa and bulimia nervosa met well-established treatment criteria. To date, there were no well-established treatments found for child and adolescent avoidant-restrictive food intake disorder, or binge eating disorder. Internet facilitated cognitive-behavioral therapy and family-based therapy were found to be possibly efficacious for binge eating disorder. Family-based treatment was found to be possibly efficacious for avoidant restrictive food intake disorder, with other clinical trials for cognitive treatment modalities under way. Ongoing research examining treatments for eating disorders in children and adolescents broadly is needed.

    View details for DOI 10.1080/15374416.2022.2109650

    View details for PubMedID 35950931

  • Effect of telehealth implementation on an adolescent metabolic and bariatric surgery program. Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery Herdes, R. E., Matheson, B. E., Tsao, D. D., Bruzoni, M., Pratt, J. S. 2022


    Pediatric severe obesity is a worldwide health concern. Treatment with metabolic and bariatric surgery can reduce morbidity and mortality. The COVID-19 pandemic not only has had a significant effect on rates of pediatric obesity but also has necessitated a rapid transition to virtual medicine.We aimed to identify and examine adolescent metabolic and bariatric surgery patient participation rates through our program's virtual telehealth programming as compared with prepandemic traditional in-person clinic appointments.This study took place at an academic pediatric quaternary care center.We evaluated 92 adolescent patients with a total of 2442 unique encounters between January 2018 and July 2021.The rate of attendance was found to be greater for telehealth visits (83.1%) than for in-person appointments (70.5%) for all clinics regardless of appointment type (preoperative versus postoperative). Cancellation rates were lower for telehealth visits (9.9%) than for in-person appointments (22.5%).This study provides evidence that telehealth can be implemented successfully in an adolescent metabolic and bariatric surgery program and can improve attendance rates for all provider and appointment subtypes.

    View details for DOI 10.1016/j.soard.2022.05.014

    View details for PubMedID 35753896

  • Is guided self-help family-based treatment for parents of adolescents with anorexia nervosa on treatment waitlists feasible? A pilot trial. The International journal of eating disorders Wade, T., Byrne, S., Fursland, A., Steele, A., Wilksch, S., Anderson, J., Zhou, Y., Datta, N., Matheson, B., Lock, J. 2022


    OBJECTIVE: The aim of the study was to assess the feasibility (recruitment and retention) of an online 12-session guided self-help family-based treatment (GSH-FBT) for families on the waitlist for face-to-face FBT utilizing trainee psychologists to assist carers of children with anorexia nervosa (AN) or atypical AN.METHOD: The primary outcomes were feasibility of GSH-FBT for families on the waitlist and secondary exploratory outcomes examined improvement of child and parental function.RESULTS: Of 187 eligible families on the waitlist, 24 (13%) expressed interest in the study; 16 (67%) of these families completed baseline, 13 (54%) completed GSH-FBT over a 6-month recruitment period. Children (mean age=13.92, SD=.86; mean body mass index [BMI] centile=29.47, SD=24.80) had an average weight gain of 6kg (BMI centile effect size=2.61, 95% CI: 1.77-3.44) and a decrease in eating disorder behaviors (effect size=1.11, 95% CI: .27-1.95). Improvements also occurred for general mood and behaviors in the child, and the impact of eating disorder symptoms on their functioning. Parents reported improvements in knowledge, skills, and confidence in managing AN.DISCUSSION: Use of this low-cost intervention while families are on the waitlist for FBT is engaging and useful but strategies to improve initial recruitment are needed.PUBLIC SIGNIFICANCE STATEMENT: Although most eligible families did not enroll in an online 12-session guided self-help family-based treatment for families on the waitlist for face-to-face FBT for anorexia nervosa, families who participated found it engaging. The children experienced improvements in BMI centile, eating and behavior. Parents reported increased confidence, knowledge, and skills. We need to examine how families can be encouraged to participate on online training when on waitlists for treatment.

    View details for DOI 10.1002/eat.23720

    View details for PubMedID 35470910

  • Parent and clinician perspectives on virtual guided self-help family-based treatment (GSH-FBT) for adolescents with anorexia nervosa. Eating and weight disorders : EWD Matheson, B. E., Datta, N., Welch, H., Citron, K., Couturier, J., Lock, J. D. 2022


    PURPOSE: Guided self-help (GSH) treatments have the capacity to expand access to care, decrease costs, and increase dissemination compared to traditional therapist-directed treatment approaches. However, little is known about parent and clinician perspectives about the acceptability of GSH for adolescents with eating disorders.METHODS: This study utilized a mixed methods approach to obtain qualitative and quantitative data regarding clinician and participants' experiences with GSH. Parent participants were enrolled in a randomized trial comparing GSH family-based treatment (GSH-FBT) to family-based treatment delivered via videoconferencing (FBT-V) for adolescents (12-18years old) with a DSM-5 diagnosis of anorexia nervosa (AN). Parent participants provided qualitative feedback using the Helping Alliances Questionnaire about their experience of treatment. Clinician participants were six master's or PhD-level therapists. These clinicians were trained in and provided both treatments (GSH-FBT and FBT-V). They provided responses to questionnaires and participated in a 1-h focus group about their experience as treatment providers.RESULTS: Regardless of treatment condition, parents listed more improvement than worsening of symptoms in their child with AN. Clinicians reported lower scores on competency and comfort metrics with GSH-FBT compared to FBT-V. Qualitatively, clinicians reported both advantages and disadvantages of delivering GSH-FBT.CONCLUSION: Further studies are needed to better understand how GSH interventions can be disseminated to patients and families, particularly those with limited access to specialized eating disorder treatment centers. Level of evidence Level I, data collected as part of a randomized controlled trial.

    View details for DOI 10.1007/s40519-022-01401-x

    View details for PubMedID 35460449

  • Applying online parental guided self-help family-based treatment for adolescent anorexia nervosa: A comparison to family-based treatment delivered by videoconferencing. Clinical child psychology and psychiatry Couturier, J., Webb, C., Carson, N., Doxtdator, K., Matheson, B., Datta, N., Sami, S., Citron, K., Lock, J. 2022: 13591045221078709


    Guided self-help has become an important treatment option in the field of eating disorders as access to in person evidence-based treatments is limited. Given the scant amount of literature published on guided self-help for the treatment of eating disorders in the child and adolescent population, our aim was to describe online GSH-FBT sessions in detail as conducted as part of a larger feasibility study, examining quotations from therapists that illustrate the GSH-FBT stance and also describing how online GSH-FBT differs from FBT delivered by videoconferencing within a descriptive case report.

    View details for DOI 10.1177/13591045221078709

    View details for PubMedID 35337198

  • Feasibility of conducting a randomized controlled trial comparing family-based treatment via videoconferencing and online guided self-help family-based treatment for adolescent anorexia nervosa. The International journal of eating disorders Lock, J., Couturier, J., Matheson, B. E., Datta, N., Citron, K., Sami, S., Welch, H., Webb, C., Doxtdator, K., John-Carson, N. 2021


    OBJECTIVE: This report describes the feasibility, acceptability, and outcomes from a pilot randomized clinical trial (RCT) comparing an online guided self-help program version of family-based treatment (GSH-FBT) for parents with a child with DSM-5 anorexia nervosa (AN) to FBT delivered via videoconferencing (FBT-V).METHOD: Between August 2019 and October 2020, 40 adolescents ages 12-18years with DSM-5 AN and their families were recruited at two sites and randomized to either twelve 20-min guided sessions of GSH-FBT for parents or fifteen 60-min sessions of FBT-V for the entire family. Recruitment, retention, and acceptability of treatment were the primary outcomes. Secondary outcomes were changes in weight, eating disorder examination (EDE), parental self-efficacy, weight remission, full remission, and outcome efficiency (therapist time needed to achieve treatment outcomes).RESULTS: Descriptive data are reported. Recruitment and retention rates are similar to RCTs using in-person treatments. Both treatments received similar acceptability rates. Medium and large effect sizes (ES) related to improvements in weight, EDE, parental self-efficacy, and remission were achieved in both treatments and were maintained at a 3-month follow-up. Clinical outcomes between groups were associated with a small ES. Differences in efficiency (outcome/therapist time) were associated with a large ES difference favoring GSH-FBT.DISCUSSION: These data support the feasibility of conducting an adequately powered RCT comparing online GSH-FBT to FBT-V to determine which approach is more efficient in achieving improvements in clinical outcomes in adolescents with AN.

    View details for DOI 10.1002/eat.23611

    View details for PubMedID 34553395

  • Understanding outcomes in family-based treatment for adolescent anorexia nervosa: a network approach. Psychological medicine Hagan, K. E., Matheson, B. E., Datta, N., L'Insalata, A. M., Onipede, Z. A., Gorrell, S., Mondal, S., Bohon, C. M., Grange, D. L., Lock, J. D. 2021: 1–12


    BACKGROUND: Family-based treatment (FBT) is the first-line treatment for adolescent anorexia nervosa (AN). Yet, remission is not achieved for about half of adolescents with AN receiving FBT. Understanding patient- and parent-level factors that predict FBT response may inform treatment development and improve outcomes.METHODS: Network analysis was used to identify the most central symptoms of AN in adolescents who completed the Eating Disorder Examination (EDE) prior to FBT (N = 409). Bridge pathways between adolescent AN and parental self-efficacy in facilitating their child's recovery from AN were identified in a subset of participants (n = 184). Central and bridge symptoms were tested as predictors of early response (⩾2.4 kg weight gain by the fourth session of FBT) and end-of-treatment weight restoration [⩾95% expected body weight (EBW)] and full remission (⩾95% EBW and EDE score within 1 standard deviation of norms).RESULTS: The most central symptoms of adolescent AN included desiring weight loss, dietary restraint, and feeling fat. These symptoms predicted early response, but not end-of-treatment outcomes. Bridge symptoms were parental beliefs about their responsibility to renourish their child, adolescent discomfort eating in front of others, and adolescent dietary restraint. Bridge symptoms predicted end-of-treatment weight restoration, but not early response nor full remission.CONCLUSIONS: Findings highlight the prognostic utility of core symptoms of adolescent AN. Parent beliefs about their responsibility to renourish their child may maintain associations between parental self-efficacy and AN psychopathology. These findings could inform strategies to adapt FBT and improve outcomes.

    View details for DOI 10.1017/S0033291721001604

    View details for PubMedID 33952357

  • Pilot Evaluation of a Multidisciplinary Strategy for Laparoscopic Sleeve Gastrectomy in Adolescents and Young Adults with Obesity and Intellectual Disabilities. Obesity surgery Jones, R. E., Wood, L. S., Matheson, B. E., Pratt, J. S., Burgart, A. M., Garza, D., Shepard, W. E., Bruzoni, M. 2021

    View details for DOI 10.1007/s11695-021-05393-y

    View details for PubMedID 33797732

  • Exploring Differences in the Role of Hospitalization on Weight Gain Based on Treatment Type From Randomized Clinical Trials for Adolescent Anorexia Nervosa FRONTIERS IN PSYCHIATRY Datta, N., Matheson, B. E., Le Grange, D., Brandt, H. A., Woodside, B., Halmi, K. A., Wilfley, D. E., Lock, J. D. 2020; 11
  • Exploring Differences in the Role of Hospitalization on Weight Gain Based on Treatment Type From Randomized Clinical Trials for Adolescent Anorexia Nervosa. Frontiers in psychiatry Datta, N., Matheson, B. E., Le Grange, D., Brandt, H. A., Woodside, B., Halmi, K. A., Wilfley, D. E., Lock, J. D. 2020; 11: 609675


    Background: This study explores the impact of weight gain during medical stabilization hospitalization on weight outcomes between three outpatient treatments for adolescent anorexia nervosa (AN): Adolescent Focused Therapy (AFT), Systemic Family Therapy (SyFT), and Family Based Treatment (FBT). Methods: A secondary analysis of weight gain data (N = 215) of adolescents (12-18 years) meeting DSM-IV criteria for AN (exclusive of amenorrhea criteria) who participated in two randomized clinical trials (RCTs) was conducted. Main outcomes examined were changes in weight restoration (≥95% expected body weight or EBW) and differences in weight change attributable to hospital weight gain. Results: Weight gain resulting from hospitalizations did not substantially change weight recovery rates. Hospital weight gain contributed most to overall treatment weight gain in AFT compared to FBT and SyFT. Conclusion: Brief medical stabilization weight gain does not contribute substantially to weight recovery in adolescents with AN who participated in RCTs.

    View details for DOI 10.3389/fpsyt.2020.609675

    View details for PubMedID 33304289

    View details for PubMedCentralID PMC7693434

  • Descriptive analysis of binge eating in adult and adolescent females. Eating and weight disorders : EWD Bohon, C., Matheson, B., Welch, H. 2020


    PURPOSE: Provide qualitative descriptions of context and characteristics of binge eating in adults and adolescents to explore consistency in precipitating factors.METHOD: Open-ended, qualitative interviews were administered to an adult sample (n=24) and an adolescent sample (n=20) to collect details about the context in which two binge episodes occurred.RESULTS: Factors and context of the binge episodes were similar between adults and adolescents. In contrast, the two binge episodes described by each individual were not consistent. Binge episodes were not strongly affect-driven or food cue-driven.CONCLUSIONS: Binge eating appears similar between adults and adolescents, which may have treatment implications. Similar treatment approaches may be used with both age groups and would benefit from covering a broad range of binge triggers rather than attempting to match individuals into an approach focused on particular triggers.LEVEL OF EVIDENCE: Level III, case-control analytic study.

    View details for DOI 10.1007/s40519-020-01013-3

    View details for PubMedID 32960440

  • Family-based treatment via videoconference: Clinical recommendations for treatment providers during COVID-19 and beyond. The International journal of eating disorders Matheson, B. E., Bohon, C., Lock, J. 2020


    The necessity to employ distance-based methods to deliver on-going eating disorder care due to the novel coronavirus (COVID-19) pandemic represents a dramatic and urgent shift in treatment delivery. Yet, TeleHealth treatments for eating disorders in youth have not been adequately researched or rigorously tested. Based on clinical experience within our clinic and research programs, we aim to highlight the common challenges clinicians may encounter in providing family-based treatment (FBT) via TeleHealth for children and adolescents with anorexia nervosa and bulimia nervosa. We also discuss possible solutions and offer practical considerations for providers delivering FBT in this format. Additional research in TeleHealth treatment for eating disorders in youth may lead to improved access, efficiency, and effectiveness of FBT delivered via videoconferencing.

    View details for DOI 10.1002/eat.23326

    View details for PubMedID 32533799

  • Investigating Early Response to Treatment in a Multi-Site Study for Adolescent Bulimia Nervosa. Frontiers in psychiatry Matheson, B. E., Gorrell, S., Bohon, C., Agras, W. S., Le Grange, D., Lock, J. 2020; 11: 92


    Background: This secondary data analysis seeks to replicate and extend findings that early response to treatment in adolescent bulimia nervosa (BN) predicts outcome, resulting in earlier identification of patients who might need a different treatment approach.Methods: Participants were 71 adolescents (M ± SD: 15.69 ± 1.55 years; 93% female; 75% non-Hispanic) with a Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) diagnosis of BN or partial BN enrolled in a two-site treatment study. Participants were randomized to cognitive behavioral therapy for adolescents (CBT-A), family-based treatment for BN (FBT-BN), or supportive psychotherapy (SPT). The Eating Disorder Examination was administered at baseline, end-of-treatment (EOT), 6-month, and 12-month follow-up. Binge eating and purge symptoms were self-reported at each session. Outcome was defined as abstinence of binge eating and compensatory behaviors (self-induced vomiting, laxative use, diet pills, diuretics, compensatory exercise, fasting) in the 28 days prior to assessment. Receiver operating characteristic (ROC) analyses were utilized to assess the viability of predicting treatment outcomes based on reduction of symptoms within the first 10 sessions of treatment.Results: ROC analyses suggest that reduction in purging at session 2 (AUC =.799, p < .001) and binge eating at session 4 (AUC =.750, p < .01) were independently related to abstinence of symptoms at EOT, regardless of treatment type. Symptom reduction later in treatment predicted outcome at follow-up, as change in binge eating at session 8 and purging at session 9 were the strongest predictors of abstinence at 6-month follow-up (AUCs =.726-.763, ps < .01). Change in binge eating, but not purging behaviors, was significantly related to abstinence at 12-month follow-up (AUC =.766, p < .01). Only slight differences emerged based on treatment group, such that reductions in symptoms most predictive of abstinence at EOT occurred one session sooner in FBT-BN than SPT.Conclusion: Reductions in binge eating and purge symptoms early in adolescent BN treatment suggest better outcome, regardless of treatment modality. Additional research with larger samples is needed to better understand which treatments, if any, contribute to earlier change in BN symptoms and/or likelihood of improved patient response.

    View details for DOI 10.3389/fpsyt.2020.00092

    View details for PubMedID 32184746

  • Remission in adolescents with bulimia nervosa: Empirical evaluation of current conceptual models. European eating disorders review : the journal of the Eating Disorders Association Gorrell, S. n., Matheson, B. E., Lock, J. n., Le Grange, D. n. 2020


    The few randomized clinical trials (RCTs) investigating adolescent treatment for bulimia nervosa (BN) suggest variability in both rates of, and criteria for remission. The current study examined reactivity in remission rates, relative to various conceptualizations of remission in a single RCT data set.A data set of adolescents with BN who participated in an RCT (N = 110) was used to evaluate remission models based upon behavioral symptoms (e.g., binge eating), psychological symptoms (Eating Disorder Examination [EDE] scores), and combinations of these criteria.At end-of-treatment (EOT), a remission model defined by behavioral symptom abstinence plus meaningful reduction in EDE global scores yielded comparable remission rates to a model defined by behavioral abstinence alone (i.e., 29% remitted). Participants with higher EOT EDE global scores were less likely to be abstinent from behavioral symptoms at 6- and 12-month follow-up (ps < .001).Reduction in psychological symptoms with behavioral abstinence did not inform remission status at EOT, over and above behavioral symptom change alone. However, psychological symptom improvement by EOT may predict positive prognosis in posttreatment assessment. Results underscore the necessity of including psychological symptom improvement, as well as consistency across research and practice, in defining remission in adolescent BN.

    View details for DOI 10.1002/erv.2729

    View details for PubMedID 32130757

  • Bariatric Surgery in Children and Adolescents with Cognitive Impairment and/or Developmental Delay: Current Knowledge and Clinical Recommendations. Obesity surgery Matheson, B. E., Colborn, D., Bohon, C. 2019


    Bariatric surgery is an effective treatment for children and adolescents with severe obesity. However, outcomes in youth with cognitive impairments and/or developmental delays are understudied. This paper reviewed the literature on bariatric surgery within this population. Fourteen studies published from 1975 to 2019 were identified. The majority (93%) of studies included patients with genetic disorders. Most studies reported no peri-operative complications (69%) and improved health outcomes (79%), with variable weight-loss results (29.2-86.2% excess weight loss). No significant differences were reported for youth with and without cognitive impairment and/or developmental delay in two studies. Limited available data suggest bariatric surgery may promote weight loss and improve health comorbidities for youth, irrespective of cognitive or developmental functioning. Clinical recommendations for working with patients and families are included.

    View details for DOI 10.1007/s11695-019-04219-2

    View details for PubMedID 31637672

  • A Pilot Study Investigating the Feasibility and Acceptability of a Parent-Only Behavioral Weight-Loss Treatment for Children with Autism Spectrum Disorder. Journal of autism and developmental disorders Matheson, B. E., Drahota, A., Boutelle, K. N. 2019


    Evidence-based weight-loss treatments for children with autism spectrum disorder (ASD) are lacking. Therefore, a parent-based weight-loss treatment for children with ASD (PBT-ASD) was developed. A pilot study was conducted to test the initial efficacy, feasibility, and acceptability of this intervention. Parents of 20 children with ASD and overweight/obesity (mean age=9.90 (SD=2.31) years; 90% male; 40% Hispanic) participated in a 16-session PBT-ASD. The PBT-ASD program was found to be feasible and acceptable. Both children and parents lost weight from pre- to post-treatment (p's<.05). Parent-reported child physical activity and vegetable consumption increased at post-treatment (p's<.05). This pilot study provides a proof-of-concept for PBT-ASD. Randomized controlled trials with larger samples and follow-up are needed.

    View details for DOI 10.1007/s10803-019-04178-8

    View details for PubMedID 31414266

  • Development and validation of a short form Children's power of Food Scale. Appetite Stone, M. D., Matheson, B. E., Leventhal, A. M., Boutelle, K. N. 2019: 104549


    To develop and validate a shortened form of the Children's Power of Food Scale (C-PFS), which measures anticipated reward from consuming highly palatable foods (i.e., hedonic hunger). Presently, two gaps exist with the C-PFS: the need for a shorter tighter measure, and evidence to support similar item function across populations.Ninth grade students (N = 3,277; 14.1 ± 0.4 years; 53.5% Female; 47% Hispanic) from 10 Los Angeles high schools completed the C-PFS and other surveys in class. Factor analysis, graded response modeling, and differential item functioning explored the structure of the 15 C-PFS items and identified a reduced set that parsimoniously taps hedonic hunger across the latent continuum and exhibits item-level invariance across sex, race/ethnicity, and weight status. Convergent validity was examined via associations of self-reported dietary intake, impulsivity, and body mass index (BMI) to C-PFS scores.Factor analytic models supported a single, primary dimension of hedonic hunger that accounted for 61% of the variance across all 15-items (α = 0.94). Adequate severity, discriminatory ability, and non-overlapping item-difficulty were observed for 11-items, of which 9-items were found to have item-level invariance across demographic and weight status groupings. Poor performing items were removed to create a 9-item scale (C-PFS-9; α = 0.93). Convergent validity was demonstrated as higher C-PFS-9 scores were significantly related to greater sweet (β = 0.32, [95%CI = 0.23, 0.41], p < .001) and fatty food intake (β = 0.34, [95%CI = 0.26, 0.43], p < .001) and impulsivity resulting from positive (β = 0.11, [95%CI = 0.02, 0.21], p < .05) and negative mood (β = 0.36, [95%CI = 0.28, 0.45], p < .001). Females, relative to males, reported higher C-PFS-9 scores (β = 0.10, [95%CI = 0.02, 0.17], p < .05) and associations with BMI were mixed.The C-PFS-9 possesses excellent psychometric properties and retains the original construct coverage of hedonic hunger without a marked decrease in information obtained.

    View details for DOI 10.1016/j.appet.2019.104549

    View details for PubMedID 31809813

  • The relationship between executive functioning and weight loss and maintenance in children and parents participating in family-based treatment for childhood obesity BEHAVIOUR RESEARCH AND THERAPY Eichen, D. M., Matheson, B. E., Liang, J., Strong, D. R., Rhee, K., Boutelle, K. N. 2018; 105: 10–16


    We examined the relationship between executive function and weight loss among children (8-12 years) and parents enrolled in a behavioral weight-loss program. 150 overweight/obese children and their parents participated in a 6-month family-based weight-loss intervention and completed baseline (month 0), post-treatment (month 6) and 18-month follow-up assessments (month 24), which included Digit Span (DS), Stop Signal Task (SST), and Wisconsin Card Sorting Test (WCST). Anthropometrics were additionally measured at mid-treatment (month 3) and 6-month follow-up (month 12). Children with more baseline WCST perseverative errors regained more weight (p = .002) at 18-month follow-up. Change in child BMIz was not associated with change in child executive function (p > .05) or parent executive function (p > .05). Among parents, baseline measure of DS-backward (p < .001) and post-treatment changes in WCST perseverative errors (p < .001) were associated with post-treatment changes in parent BMI. SST was not related to parent or child weight loss. Thus, children's baseline set-shifting was associated with weight regain during follow-up whereas changes in parent set-shifting was associated with changes in parent weight. Future research is needed to examine the relationship between executive function and weight loss and how this translates to intervention success for both overweight/obese children and participating parents.

    View details for DOI 10.1016/j.brat.2018.03.010

    View details for Web of Science ID 000432501600002

    View details for PubMedID 29609102

    View details for PubMedCentralID PMC5924708

  • A Review of Childhood Behavioral Problems and Disorders in the Development of Obesity: Attention Deficit/Hyperactivity Disorder, Autism Spectrum Disorder, and Beyond CURRENT OBESITY REPORTS Matheson, B. E., Eichen, D. M. 2018; 7 (1): 19–26


    Given the high rates of pediatric and adult obesity, it is imperative to identify early risk factors that might contribute to excess weight gain. This review aims to investigate the relationship between childhood behavioral problems with the development and persistence of obesity. Specifically, this review highlights the association of obesity with (1) neurocognitive constructs, such as executive functioning and inhibition/impulsivity, and (2) disorders commonly diagnosed in childhood, including attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD).Consistent evidence supports a relationship between childhood behavioral problems, executive functioning, inhibition/impulsivity, ADHD, and ASD with obesity across the lifespan. Longitudinal studies suggest behavior problems, neurocognitive functioning deficits, and ADHD symptoms in childhood predict weight gain over time. Identifying risk factors in childhood that promote obesity may help develop targeted intervention and prevention programs. Additional research should elucidate mechanisms that account for these relationships.

    View details for DOI 10.1007/s13679-018-0293-z

    View details for Web of Science ID 000426356900003

    View details for PubMedID 29411333

  • Neurocognitive Treatments for Eating Disorders and Obesity CURRENT PSYCHIATRY REPORTS Eichen, D. M., Matheson, B. E., Appleton-Knapp, S. L., Boutelle, K. N. 2017; 19 (9): 62


    Recent research has highlighted executive function and neurocognitive deficits among individuals with eating and weight disorders, identifying a potential target for treatment. Treatments targeting executive function for eating and weight disorders are emerging. This review aims to summarize the recent literature evaluating neurocognitive/executive function-oriented treatments for eating and weight disorders and highlights additional work needed in this area.Cognitive remediation therapy (CRT) for anorexia nervosa has been the most extensively studied neurocognitive treatment for eating disorders. Results demonstrate that CRT improves executive function and may aid in the reduction of eating disorder symptomatology. Computer training programs targeting modifying attention and increasing inhibition are targeting reduction of binge eating and weight loss with modest success. Neurocognitive treatments are emerging and show initial promise for eating and weight disorders. Further research is necessary to determine whether these treatments can be used as stand-alone treatments or whether they need to be used as an adjunct to or in conjunction with other evidence-based treatments to improve outcomes.

    View details for DOI 10.1007/s11920-017-0813-7

    View details for Web of Science ID 000407672300008

    View details for PubMedID 28744627

    View details for PubMedCentralID PMC5669379

  • Behind binge eating: A review of food-specific adaptations of neurocognitive and neuroimaging tasks Berner, L. A., Winter, S. R., Matheson, B. E., Benson, L., Lowe, M. R. PERGAMON-ELSEVIER SCIENCE LTD. 2017: 59–70


    Recurrent binge eating, or overeating accompanied by a sense of loss of control, is a major public health concern. Identifying similarities and differences among individuals with binge eating and those with other psychiatric symptoms and characterizing the deficits that uniquely predispose individuals to eating problems are essential to improving treatment. Research suggests that altered reward and control-related processes may contribute to dysregulated eating and other impulsive behaviors in binge-eating populations, but the best methods for reliably assessing the contributions of these processes to binge eating are unclear. In this review, we summarize standard neurocognitive and neuroimaging tasks that assess reward and control-related processes, describe adaptations of these tasks used to study eating and food-specific responsivity and deficits, and consider the advantages and limitations of these tasks. Future studies integrating both general and food-specific tasks with neuroimaging will improve understanding of the neurocognitive processes and neural circuits that contribute to binge eating and could inform novel interventions that more directly target or prevent this transdiagnostic behavior.

    View details for DOI 10.1016/j.physbeh.2017.03.037

    View details for Web of Science ID 000402212000009

    View details for PubMedID 28363840

    View details for PubMedCentralID PMC5695923

  • Overweight and Obesity in Children with Autism Spectrum Disorder (ASD): a Critical Review Investigating the Etiology, Development, and Maintenance of this Relationship REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS Matheson, B. E., Douglas, J. M. 2017; 4 (2): 142–56
  • Mental Health Diagnostic Considerations in Racial/Ethnic Minority Youth JOURNAL OF CHILD AND FAMILY STUDIES Liang, J., Matheson, B. E., Douglas, J. M. 2016; 25 (6): 1926–40


    Misdiagnoses of racial/ethnic minority youth's mental health problems can potentially contribute to inappropriate mental health care. Therefore, we conducted a systematic review that focuses on current theory and empirical research in an attempt to answer the following two questions: 1) What evidence exists that supports or contradicts the idea that racial/ethnic minority youth's mental health problems are misdiagnosed? 2) What are the sources of misdiagnoses? Articles were reviewed from 1967 to 2014 using PsychINFO, PubMed, and GoogleScholar. Search terms included "race", "ethnicity", "minority", "culture", "children", "youth", "adolescents", "mental health", "psychopathology", "diagnosis", "misdiagnosis", "miscategorization", "underdiagnosis", and "overdiagnosis". Seventy-two articles and book chapters met criteria and were included in this review. Overall, evidence was found that supports the possibility of misdiagnosis of ethnic minority youth's emotional and behavioral problems. However, the evidence is limited such that it cannot be determined whether racial/ethnic differences are due to differences in psychopathology, mental health biases, and/or inaccurate diagnoses. Cultural and contextual factors that may influence misdiagnosis as well as recommendations for research and practice are discussed.

    View details for DOI 10.1007/s10826-015-0351-z

    View details for Web of Science ID 000376020200020

    View details for PubMedID 27346929

    View details for PubMedCentralID PMC4916917

  • Parental control and overconsumption of snack foods in overweight and obese children APPETITE Liang, J., Matheson, B. E., Rhee, I. E., Peterson, C. B., Rydell, S., Boutelle, I. N. 2016; 100: 181–88


    The associations between snack food consumption, parent feeding practices and general parenting in overweight in obese children are largely unknown. Therefore, we examined these relationships in 117 treatment-seeking overweight and obese children (10.40 ± 1.35 years; 53% female; 52% Caucasian; BMI-z: 2.06 ± .39). Children consumed a dinner meal, completed an Eating in the Absence of Hunger (EAH) free access paradigm (total EAH intake = EAH%-total; sweet food intake = EAH%-sweet), and completed the Child Report of Parent Behavior Inventory. Parents completed the Child Feeding Questionnaire. Child EAH%-total and EAH%-sweet were positively associated with dinner consumption (p's < .01). Girls had significantly higher EAH%-total compared to boys (p < .05). In separate models, higher EAH%-total was associated with greater use of maternal psychological control (p < .05) and EAH%-sweet was positively associated with parent monitoring (p < .05). In analyses examining factors associated with the consumption of specific foods, EAH snack food, parent restriction, pressure to eat, monitoring, and maternal psychological control were positively correlated with intake of Hershey's(®) chocolate bars (p's < .05). In summary, parental monitoring is associated with child sweet snack food intake and maternal psychological control is associated with child total snack food consumption. Future research should evaluate the complex relationship between child eating and parenting, especially with regard to subgroups of foods.

    View details for DOI 10.1016/j.appet.2016.02.030

    View details for Web of Science ID 000373866200021

    View details for PubMedID 26911259

    View details for PubMedCentralID PMC4799726

  • The relationship between parent feeding styles and general parenting with loss of control eating in treatment-seeking overweight and obese children INTERNATIONAL JOURNAL OF EATING DISORDERS Matheson, B. E., Camacho, C., Peterson, C. B., Rhee, K. E., Rydell, S. A., Zucker, N. L., Boutelle, K. N. 2015; 48 (7): 1047–55


    To examine differences in parent feeding behaviors and general parenting of overweight children with and without loss of control (LOC) eating.One-hundred-and-eighteen overweight and obese children (10.40 ± 1.35 years; 53% female; 52% Caucasian; BMI-z: 2.06 ± 0.39) and their parents (42.42 ± 6.20 years; 91% female; 70% Caucasian; BMI: 31.74 ± 6.96 kg/m(2) ) were seen at a baseline assessment visit for a behavioral intervention that targeted overeating. The Eating Disorder Examination, adapted for children (ChEDE) was administered to assess for LOC eating. Parents completed the Parental Feeding Styles Questionnaire (PFSQ) and the Child Feeding Questionnaire (CFQ) to assess parent feeding styles and behaviors. Children also completed a self-report measure of general parenting (Child Report of Parent Behavior Inventory, CRPBI-30).Forty-three children (36.40%) reported at least one LOC eating episode in the month prior to assessment. Parents who reported greater restriction and higher levels of pressure to eat were more likely to have children that reported LOC eating (ps < 0.05). Parents who utilized more instrumental feeding and prompting/encouragement to eat techniques were less likely to have children that reported LOC eating (ps < 0.05). Child-reported parenting behaviors were unrelated to child LOC eating (ps > 0.05).Parent feeding styles and behaviors appear to be differentially and uniquely related to LOC eating in treatment-seeking overweight and obese children. Future research is needed to determine if implementing interventions that target parent feeding behaviors may reduce LOC eating, prevent full-syndrome eating disorders, and reduce weight gain in youth.

    View details for DOI 10.1002/eat.22440

    View details for Web of Science ID 000363460300028

    View details for PubMedID 26283589

  • The relationship between eating disorders and sexual trauma EATING AND WEIGHT DISORDERS-STUDIES ON ANOREXIA BULIMIA AND OBESITY Madowitz, J., Matheson, B. E., Liang, J. 2015; 20 (3): 281–93


    Research aimed at understanding the causes and comorbidities of eating disorders (ED) identifies sexual trauma as one potential pathway to the development and maintenance of eating disorders. Based on current literature, there are two main etiological pathways between sexual trauma and ED-body perceptions and psychological difficulties. However, previously published reviews on this topic are outdated and have not yielded consistent findings. Therefore, authors completed a literature review covering years 2004-2014 to examine the relationship between sexual trauma and ED according to both proposed pathway models. Authors utilized PubMed, GoogleScholar, and PsychINFO as search engines. Search terms included "sexual assault", "sexual abuse", "sexual trauma", and "rape" in conjunction with relevant ED terminology. Thirty-two studies met inclusion criteria for this review. Current data indicate an increased prevalence of sexual trauma for individuals with ED. Although limited, recent evidence suggests that sexual trauma precedes and contributes to the development of ED. Existing literature indicates that the body perceptions pathway may impact ED through body dissatisfaction, shame, sexual dysfunction, and fear of future sexual trauma. The psychological difficulties pathway indicates a link between ED and the desire to cope with the failure of the average expected environment, psychological diagnoses, the need for control, and the regulation of emotions. However, further research is needed to assess the potential causal role that sexual trauma may play in the etiology of ED.

    View details for DOI 10.1007/s40519-015-0195-y

    View details for Web of Science ID 000360568600001

    View details for PubMedID 25976911

  • A Brief, Intensive Application of Multi-Family-Based Treatment for Eating Disorders EATING DISORDERS Knatz, S., Murray, S. B., Matheson, B., Boutelle, K. N., Rockwell, R., Eisler, I., Kaye, W. H. 2015; 23 (4): 315–24


    There is a continued need to improve upon the efficacy and availability of treatments for anorexia nervosa. Family-based therapy for anorexia nervosa demonstrates strong empirical evidence; however, trained treatment providers are limited and a subsample of participants receiving the treatment fail to respond. The intensive family treatment program is a brief, time-limited, multi-family program that trains families of adolescents with eating disorders to oversee their adolescents' recovery at home by providing psychoeducation, skills training, and immersive practice over the course of a 5-day period. This article provide a description of the program by summarizing underlying theoretical principles and key therapeutic components.

    View details for DOI 10.1080/10640266.2015.1042318

    View details for Web of Science ID 000356267600005

    View details for PubMedID 25984656

  • Parent Binge Eating and Depressive Symptoms as Predictors of Attrition in a Family-Based Treatment for Pediatric Obesity CHILDHOOD OBESITY Braden, A. L., Madowitz, J., Matheson, B. E., Bergmann, K., Crow, S. J., Boutelle, K. N. 2015; 11 (2): 165–69


    Attrition is a significant problem in family-based treatment (FBT) for childhood obesity. Despite this, very few studies have examined factors associated with attrition. The current study examined parent symptoms of depression and binge eating as predictors of attrition in FBT.Participants included 77 parents of overweight children enrolled in FBT for childhood obesity. Data were collected at baseline and post-treatment. Binary logistic regression was used to assess associations between parent binge eating symptoms, depressive symptoms, and attrition.Results showed that parent binge eating symptoms (p=0.02), but not depressive symptoms (p=0.07), were significantly associated with attrition, after controlling for parent BMI, treatment group assignment, and family income.Higher reported parent binge eating symptoms were significantly related to attrition in FBT. Assessment of parent binge eating may be important in identifying families at risk for dropping out of FBT. Further, FBT may need to be adapted for families with parents who have a high level of psychopathology.

    View details for DOI 10.1089/chi.2014.0109

    View details for Web of Science ID 000352240100009

    View details for PubMedID 25715322

    View details for PubMedCentralID PMC4382825

  • Design and implementation of a study evaluating extinction processes to food cues in obese children: The Intervention for Regulations of Cues Trial (iROC) CONTEMPORARY CLINICAL TRIALS Boutelle, K. N., Liang, J., Knatz, S., Matheson, B., Risbrough, V., Strong, D., Rhee, K. E., Craske, M. G., Zucker, N., Bouton, M. E. 2015; 40: 95–104


    Obesity and its health sequelae affect a significant portion of children in the United States. Yet, the current gold-standard family-based behavioral weight-loss treatments are only effective for one-third of children long-term. Therefore, we developed iROC (Intervention for Regulation of Cues) to specifically target a method to decrease overeating in overweight children, based on learning theory, to inform and enhance interventions targeting diet and obesity in youth. This study will rigorously test extinction processes as a method of decreasing physiological and psychological responses to food cues in overweight and obese children. Through exposing children to their highly craved foods, and 'training the brain and body' to decrease overeating, we are hoping to produce longer-lasting weight loss or weight-gain prevention over time.

    View details for DOI 10.1016/j.cct.2014.11.011

    View details for Web of Science ID 000349732000012

    View details for PubMedID 25461494

    View details for PubMedCentralID PMC4314468

  • Neurocognitive correlates of obesity and obesity-related behaviors in children and adolescents INTERNATIONAL JOURNAL OF OBESITY Liang, J., Matheson, B. E., Kaye, W. H., Boutelle, K. N. 2014; 38 (4): 494–506


    Childhood obesity rates have risen dramatically over the past few decades. Although obesity has been linked to poorer neurocognitive functioning in adults, much less is known about this relationship in children and adolescents. Therefore, we conducted a systematic review to examine the relationship between obesity and obesity-related behaviors with neurocognitive functioning in youth. We reviewed articles from 1976 to 2013 using PsycInfo, PubMed, Medline and Google Scholar. Search terms included cognitive function, neurocognitive function/performance, executive function, impulsivity, self-regulation, effortful control, cognitive control, inhibition, delayed gratification, memory, attention, language, motor, visuo-spatial, academic achievement, obesity, overweight, body mass index, waist-hip ratio, adiposity and body fat. Articles were excluded if participants had health problems known to affect cognitive functioning, the study used imaging as the only outcome measure, they were non-peer-reviewed dissertations, theses, review papers, commentaries, or they were non-English articles. Sixty-seven studies met inclusion criteria for this review. Overall, we found data that support a negative relationship between obesity and various aspects of neurocognitive functioning, such as executive functioning, attention, visuo-spatial performance, and motor skill. The existing literature is mixed on the effects among obesity, general cognitive functioning, language, learning, memory, and academic achievement. Executive dysfunction is associated with obesity-related behaviors, such as increased intake, disinhibited eating, and less physical activity. Physical activity is positively linked with motor skill. More longitudinal research is needed to determine the directionality of such relationships, to point towards crucial intervention time periods in the development of children, and to inform effective treatment programs.

    View details for DOI 10.1038/ijo.2013.142

    View details for Web of Science ID 000334344300003

    View details for PubMedID 23913029

    View details for PubMedCentralID PMC4456183

  • Links of Adolescent- and Parent-Reported Eating in the Absence of Hunger with Observed Eating in the Absence of Hunger OBESITY Shomaker, L. B., Tanofsky-Kraff, M., Mooreville, M., Reina, S. A., Courville, A. B., Field, S. E., Matheson, B. E., Brady, S. M., Yanovski, S. Z., Yanovski, J. A. 2013; 21 (6): 1243–50


    Eating in the absence of hunger (EAH) typically was assessed by measuring snack intake after consumption of a meal. There were no validated self-report measures of EAH. The relationship of adolescent self-report and parent-reported EAH to adolescents' measured intake in the absence of hunger was examined.Ninety adolescents completed the Eating in the Absence of Hunger Questionnaire for Children and Adolescents (EAH-C) to describe eating when not hungry. Parents described children's EAH on a parallel version designed for parents (EAH-P). In a randomized crossover study, adolescent EAH in response to external cues was measured as snack intake after a lunch meal standardized to provide 50% of daily energy requirements and after a large array (>10,000 kcal).Parents' reports of children's EAH in response to external cues were associated with greater EAH after both meals, adjusting for body composition, sex, age, race, puberty, and meal intake. Adolescent-reported EAH was unrelated or showed an inverse association with observed EAH.Parent-reported EAH showed a positive association with adolescents' observed EAH and may be a useful research and clinical tool for assessing EAH in response to external cues in conditions when laboratory assessments are not feasible.

    View details for DOI 10.1002/oby.20218

    View details for Web of Science ID 000322487000027

    View details for PubMedID 23913735

    View details for PubMedCentralID PMC3740450

  • Eating patterns in youth with and without loss of control eating INTERNATIONAL JOURNAL OF EATING DISORDERS Matheson, B. E., Tanofsky-Kraff, M., Shafer-Berger, S., Sedaka, N. M., Mooreville, M., Reina, S. A., Vannucci, A., Shomaker, L. B., Yanovski, S. Z., Yanovski, J. A. 2012; 45 (8): 957–61


    To compare the characteristic meal patterns of adolescents with and without loss of control (LOC) eating episodes.The Eating Disorder Examination was administered to assess self-reported LOC and frequency of meals consumed in an aggregated sample of 574 youths (12-17 years; 66.6% female; 51.2% Caucasian; BMI-z: 1.38 ± 1.11), among whom 227 (39.6%) reported LOC eating.Compared to those without LOC, youth with LOC were less likely to consume lunch and evening meals (p's < .05), but more likely to consume morning, afternoon, and nocturnal snacks (p's ≤ .05), accounting for age, sex, race, socio-economic status, BMI-z, and treatment-seeking status.Adolescents with reported LOC eating appear to engage in different meal patterns compared to youth without LOC, and adults with binge eating. Further research is needed to determine whether the meal patterns that characterize adolescents with LOC play a role in worsening disordered eating and/or excessive weight gain.

    View details for DOI 10.1002/eat.22063

    View details for Web of Science ID 000311289700007

    View details for PubMedID 23015352

    View details for PubMedCentralID PMC3502711

  • Loss of control eating in African-American and Caucasian youth EATING BEHAVIORS Cassidy, O. L., Matheson, B., Osborn, R., Vannucci, A., Kozlosky, M., Shomaker, L. B., Yanovski, S. Z., Tanofsky-Kraff, M. 2012; 13 (2): 174–78


    Loss of control (LOC) eating, a disinhibited eating behavior shown to predict excessive weight gain in youth, has been reported by African-American children and adolescents. Yet, little is known about how LOC-eating manifests in this population. To investigate potential racial differences in LOC-eating, the Eating Disorder Examination was administered to 185 non-Hispanic African-American and Caucasian youth ages 8-17 y. Objective eating was assessed at two test meals during which youth ate ad libitum from a multi-item lunchtime food array. African-American and Caucasian youth reported a similar prevalence of LOC episodes (24.2% vs. 28.9%, p=.75). Yet, accounting for sex, age, fat-free mass, percent fat mass, height, and socioeconomic status, African-Americans consumed more total energy at both laboratory meals (1608±57 kcal vs. 1362±44 kcal; p<.001). Furthermore, African-American youth reporting LOC consumed the most total energy across both meals (1855±104 kcal) compared to African-Americans without LOC (1524±60 kcal), Caucasians with LOC (1278±68 kcal), and Caucasians without LOC (1399±46 kcal; p<.001). Future research is required to examine whether LOC-eating contributes to the high rates of obesity in African-American youth.

    View details for DOI 10.1016/j.eatbeh.2012.01.003

    View details for Web of Science ID 000301997500021

    View details for PubMedID 22365807

    View details for PubMedCentralID PMC3299485

  • Binge Eating and Weight-Related Quality of Life in Obese Adolescents NUTRIENTS Ranzenhofer, L. M., Columbo, K. M., Tanofsky-Kraff, M., Shomaker, L. B., Cassidy, O., Matheson, B. E., Kolotkin, R. L., Checchi, J. M., Keil, M., McDuffie, J. R., Yanovski, J. A. 2012; 4 (3): 167–80


    Limited data exist regarding the association between binge eating and quality of life (QOL) in obese adolescent girls and boys. We, therefore, studied binge eating and QOL in 158 obese (BMI ≥ 95th percentile) adolescents (14.5 ± 1.4 years, 68.0% female, 59% African-American) prior to weight-loss treatment. Youth completed an interview to assess binge eating and a questionnaire measure of QOL. Controlling for body composition, binge eating youth (n = 35), overall, reported poorer QOL in domains of health, mobility, and self-esteem compared to those without binge eating (ps < 0.05). Also, girls, overall, reported poorer QOL than boys in activities of daily-living, mobility, self-esteem, and social/interpersonal functioning (ps < 0.05). Girls with binge eating reported the greatest impairments in activities of daily living, mobility, self-esteem, social/interpersonal functioning, and work/school QOL (ps < 0.05). Among treatment-seeking obese adolescents, binge eating appears to be a marker of QOL impairment, especially among girls. Prospective and treatment designs are needed to explore the directional relationship between binge eating and QOL and their impact on weight outcomes.

    View details for DOI 10.3390/nu4030167

    View details for Web of Science ID 000302121200002

    View details for PubMedID 22666544

    View details for PubMedCentralID PMC3347025

  • Links between mothers' and children's disinhibited eating and children's adiposity APPETITE Zocca, J. M., Shomaker, L. B., Tanofsky-Kraff, M., Columbo, K. M., Raciti, G. R., Brady, S. M., Crocker, M. K., Ali, A. H., Matheson, B. E., Yanovski, S. Z., Yanovski, J. A. 2011; 56 (2): 324–31


    Few studies have examined relationships between parents' and children's specific disinhibited eating behaviors. We investigated links among mothers' and children's binge/loss of control eating, eating in the absence of hunger, and children's adiposity in 305 non-treatment-seeking youth, aged 8-17 years (13.62±2.65 years; 49.8% female) and their mothers. Youths' loss of control eating and eating in the absence of hunger were assessed by interview and self-report questionnaire. Children's adiposity was assessed with BMI-z and air displacement plethysmography. Maternal binge eating, eating in the absence of hunger and highest, non-pregnant BMI were self-reported. In structural equation models controlling for mothers' BMI, mothers' binge eating related to children's loss of control eating, and mothers' eating in the absence of hunger related to children's eating in the absence of hunger. Mothers' binge eating and children's eating in the absence of hunger were unrelated, as were mothers' eating in the absence of hunger and children's loss of control. Further, mothers' binge eating was indirectly related to children's adiposity through children's loss of control eating. Likewise, mothers' eating in the absence of hunger indirectly related to children's adiposity through children's eating in the absence of hunger. Mothers and children share similar, specific disinhibited eating styles.

    View details for DOI 10.1016/j.appet.2010.12.014

    View details for Web of Science ID 000289186000016

    View details for PubMedID 21182882

    View details for PubMedCentralID PMC3055954