W. Stewart Agras

All Publications

• Picky eating during childhood: A longitudinal study to age 11 years EATING BEHAVIORS Mascola, A. J., Bryson, S. W., Agras, W. S. 2010; 11 (4): 253-257

  Abstract

  Picky eating is a common disorder during childhood often causing considerable parental anxiety. This study examined the incidence, point prevalence, persistence and characteristics of picky eating in a prospective study of 120 children and their parents followed from 2 to 11 years. At any given age between 13% and 22% of the children were reported to be picky eaters. Incidence declined over time whereas point prevalence increased indicating that picky eating is often a chronic problem with 40% having a duration of more than 2 years. Those with longer duration differed from those with short duration having more strong likes and dislikes of food and not accepting new foods. Parents of picky eaters were more likely to report that their children consumed a limited variety of foods, required food prepared in specific ways, expressed stronger likes and dislikes for food, and threw tantrums when denied foods. They were also more likely to report struggles over feeding, preparing special meals, and commenting on their child's eating. Hence, picky eating is a prevalent concern of parents and may remain so through childhood. It appears to be a relatively stable trait reflecting an individual eating style. However no significant effects on growth were observed.

  View details for DOI 10.1016/j.eatbeh.2010.05.006

  View details for Web of Science ID 000283484700008

  View details for PubMedID 20850060

  View details for PubMedCentralID PMC2943861

• Psychological Treatments of Binge Eating Disorder ARCHIVES OF GENERAL PSYCHIATRY Wilson, G. T., Wilfley, D. E., Agras, W. S., Bryson, S. W. 2010; 67 (1): 94-101

  Abstract

  Interpersonal psychotherapy (IPT) is an effective specialty treatment for binge eating disorder (BED). Behavioral weight loss treatment (BWL) and guided self-help based on cognitive behavior therapy (CBTgsh) have both resulted in short-term reductions in binge eating in obese patients with BED.To test whether patients with BED require specialty therapy beyond BWL and whether IPT is more effective than either BWL or CBTgsh in patients with a high negative affect during a 2-year follow-up.Randomized, active control efficacy trial.University outpatient clinics.Two hundred five women and men with a body mass index between 27 and 45 who met DSM-IV criteria for BED. Intervention Twenty sessions of IPT or BWL or 10 sessions of CBTgsh during 6 months.Binge eating assessed by the Eating Disorder Examination.At 2-year follow-up, both IPT and CBTgsh resulted in greater remission from binge eating than BWL (P < .05; odds ratios: BWL vs CBTgsh, 2.3; BWL vs IPT, 2.6; and CBTgsh vs IPT, 1.2). Self-esteem (P < .05) and global Eating Disorder Examination (P < .05) scores were moderators of treatment outcome. The odds ratios for low and high global Eating Disorder Examination scores were 2.8 for BWL, 2.9 for CBTgsh, and 0.73 for IPT; for self-esteem, they were 2.4 for BWL, 1.9 for CBTgsh, and 0.9 for IPT.Interpersonal psychotherapy and CBTgsh are significantly more effective than BWL in eliminating binge eating after 2 years. Guided self-help based on cognitive behavior therapy is a first-line treatment option for most patients with BED, with IPT (or full cognitive behavior therapy) used for patients with low self-esteem and high eating disorder psychopathology.clinicaltrials.gov Identifier: NCT00060762.

  View details for Web of Science ID 000273262800012

  View details for PubMedID 20048227

  View details for PubMedCentralID PMC3757519

• Risk factors for childhood overweight: A prospective study from birth to 9.5 years JOURNAL OF PEDIATRICS Agras, W. S., Hammer, L. D., McNicholas, F., Kraemer, H. C. 2004; 145 (1): 20-25

  Abstract

  To ascertain risk factors for the development of overweight in children at 9.5 years of age.This was a prospective study of 150 children from birth to 9.5 years of age, with assessment of multiple hypothesized risk factors drawn from research reports.Five independent risk factors for childhood overweight were found. The strongest was parent overweight, which was mediated by child temperament. The remaining risk factors were low parent concerns about their child's thinness, persistent child tantrums over food, and less sleep time in childhood. Possible mechanisms by which each of these factors influence weight gain are outlined. Two different pathways to childhood overweight/obesity were found, depending on degree of parental overweight.There is evidence of considerable interaction between parent and child characteristics in the development of overweight. Several of the identified risk factors are amenable to intervention possibly leading to the development of early prevention programs.

  View details for DOI 10.1016/j.jpeds.2004.03.023

  View details for Web of Science ID 000222738500018

  View details for PubMedID 15238901

• Mediators and moderators of treatment effects in randomized clinical trials ARCHIVES OF GENERAL PSYCHIATRY Kraemer, H. C., Wilson, G. T., Fairburn, C. G., Agras, W. S. 2002; 59 (10): 877-883

  Abstract

  Randomized clinical trials (RCTs) not only are the gold standard for evaluating the efficacy and effectiveness of psychiatric treatments but also can be valuable in revealing moderators and mediators of therapeutic change. Conceptually, moderators identify on whom and under what circumstances treatments have different effects. Mediators identify why and how treatments have effects. We describe an analytic framework to identify and distinguish between moderators and mediators in RCTs when outcomes are measured dimensionally. Rapid progress in identifying the most effective treatments and understanding on whom treatments work and do not work and why treatments work or do not work depends on efforts to identify moderators and mediators of treatment outcome. We recommend that RCTs routinely include and report such analyses.

  View details for Web of Science ID 000178493800002

  View details for PubMedID 12365874

• Feasibility Study Combining Art Therapy or Cognitive Remediation Therapy with Family-based Treatment for Adolescent Anorexia Nervosa EUROPEAN EATING DISORDERS REVIEW Lock, J., Fitzpatrick, K., Agras, W. S., Weinbach, N., Jo, B. 2018; 26 (1): 62–68

  Abstract

  Adolescents with anorexia nervosa who have obsessive-compulsive (OC) features respond poorly to family-based treatment (FBT). This study evaluated the feasibility of combining FBT with either cognitive remediation therapy (CRT) or art therapy (AT) to improve treatment response in this at-risk group. Thirty adolescents with anorexia nervosa and OC features were randomized to 15 sessions of FBT + CRT or AT. Recruitment rate was 1 per month, and treatment attrition was 16.6% with no differences between groups. Suitability, expectancy and therapeutic relationships were acceptable for both combinations. Correlations between changes in OC traits and changes in cognitive inefficiencies were found for both combinations. Moderate changes in cognitive inefficiencies were found in both groups but were larger in the FBT + AT combination. This study suggests that an RCT for poor responders to FBT because of OC traits combining FBT with either CRT or AT is feasible to conduct. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

  View details for PubMedID 29152825

  View details for PubMedCentralID PMC5732028

• Follow-up of selective eaters from childhood to adulthood. Eating behaviors Van Tine, M. L., McNicholas, F., Safer, D. L., Agras, W. S. 2017; 26: 61-65

  Abstract

  The aim of this study was to examine the prevalence and course of selective eating, the stability of its behavioral profile over time, and the presence of eating disorder psychopathology among selective eaters in a non-treatment seeking cohort of young adults followed longitudinally from birth to age 23.A prospective design tracking a subset of the original participants from the Stanford Infant Growth Study (n=216) who had been followed since birth. At age 11, 120 participants had completed all assessments. The current study included a subset of the original participants who, at age 11, had completed all assessments (n=120) and, at age 23, had current contact information available (n=62) and agreed to participate (n=61).Of the 61 young adults, 17 (28%) were identified as selective eaters at age 23. The selective eating-related behaviors reported during adulthood were similar to those endorsed during childhood. New onset selective eating cases were reported during adolescence or young adulthood by 35% of the selective eating sample. Participants who were selective eaters for >6years prior to age 11 remained selective at age 23. There was no evidence of increased eating disorder psychopathology, excessive thinness, or obesity in selective eaters compared with non-selective eaters.These results suggest that a proportion of selective eaters continue from childhood into adulthood with similar eating patterns; new onset selective eating occurs in adolescence or young adulthood; and selective and non-selective eaters at age 23 do not differ with regard to weight or eating psychopathology.

  View details for DOI 10.1016/j.eatbeh.2017.01.003

  View details for PubMedID 28152419

• Evolution of cognitive-behavioral therapy for eating disorders BEHAVIOUR RESEARCH AND THERAPY Agras, W. S., Fitzsimmons-Craft, E. E., Wilfley, D. E. 2017; 88: 26-36

  Abstract

  The evolution of cognitive-behavioral therapy (CBT) for the treatment of bulimic disorders is described in this review. The impacts of successive attempts to enhance CBT such as the addition of exposure and response prevention; the development of enhanced CBT; and broadening the treatment from bulimia nervosa to binge eating disorder are considered. In addition to developing advanced forms of CBT, shortening treatment to guided self-help was the first step in broadening access to treatment. The use of technology such as computer-based therapy and more recently the Internet, promises further broadening of access to self-help and to therapist guided treatment. Controlled studies in this area are reviewed, and the balance of risks and benefits that accompany the use of technology and lessened therapist input are considered. Looking into the future, more sophisticated forms of treatment delivered as mobile applications ("apps") may lead to more personalized and efficacious treatments for bulimic disorders, thus enhancing the delivery of treatments for eating disorders.

  View details for DOI 10.1016/j.brat.2016.09.004

  View details for Web of Science ID 000392356600005

  View details for PubMedID 28110674

• A test to identify persistent picky eaters EATING BEHAVIORS Toyama, H., Agras, W. S. 2016; 23: 66-69

  Abstract

  Picky eating is common and usually relatively brief as new foods are accepted. Persistent picky eating, however, is often associated with comorbid psychopathology.The aim of this study was to use parent-reported child feeding behaviors to identify which picky eaters persist.Participants were a subsample from the Stanford Infant Growth Study a prospective study of child development. Out of the 216 infants, 86 were identified as picky eaters. Picky eaters were separated into two groups using a median split: short-term (n=40) and persistent picky eaters (n=46).Recursive Partitioning detected three significant parent-reported feeding questions that may identify persistent picky eaters at an early age: Is your child a picky eater? (yes), does s/he have strong likes with regard to food (yes), does your child accept new foods readily? (no).These results provide a first step allowing providers to identify persistent picky eaters and possibly enable intervention at an early age. Further studies are needed to replicate and extend these findings in another sample of picky eaters.

  View details for DOI 10.1016/j.eatbeh.2016.07.003

  View details for Web of Science ID 000389999800012

  View details for PubMedID 27504983

  View details for PubMedCentralID PMC5124503

• Does family-based treatment reduce the need for hospitalization in adolescent anorexia nervosa? International journal of eating disorders Lock, J., Agras, W. S., Bryson, S. W., Brandt, H., Halmi, K. A., Kaye, W., Wilfley, D., Woodside, B., Pajarito, S., Jo, B. 2016; 49 (9): 891-894

  Abstract

  We examined the timing and number of days of hospitalization during the course of treatment, hospitalization effects on outcome, and predictors and moderators of the use of hospitalization in adolescents with anorexia nervosa (AN).Data used in this study were collected from 158 adolescents (ages 12 to 18 years of age) who met DSM-IVTR criteria for AN (exclusive of the amenorrhea criteria) randomized to receive either Family Based Treatment (FBT) or Systemic Family Therapy (SyFT) in a 7 site study.The trajectory of hospital day use is similar in the first 5 weeks irrespective of treatment allocation. However, days of hospitalization continued to increase throughout SyFT but leveled off in FBT after ∼5 weeks of treatment. Early hospitalization was a negative predictor for improvements in percent weight change for both treatment groups (t(1)=2.6, p = 0.011). Co-morbid psychopathology predicted early hospital use in both treatments. Higher levels of eating related obsessions and depression moderated hospitalization rates suggesting that FBT reduces early hospitalization rates compared to SyFT for these subgroups.These data support and extend findings from previous studies by identifying patterns of hospital use, and predictors and moderators of treatment effect for early hospitalization use in adolescent AN. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2016; 49:891-894).

  View details for DOI 10.1002/eat.22536

  View details for PubMedID 27062400

• Randomized Clinical Trial of Family-Based Treatment and Cognitive-Behavioral Therapy for Adolescent Bulimia Nervosa. Journal of the American Academy of Child and Adolescent Psychiatry Le Grange, D., Lock, J., Agras, W. S., Bryson, S. W., Jo, B. 2015; 54 (11): 886-894 e2

  View details for DOI 10.1016/j.jaac.2015.08.008

  View details for PubMedID 26506579

• Can adaptive treatment improve outcomes in family-based therapy for adolescents with anorexia nervosa? Feasibility and treatment effects of a multi-site treatment study. Behaviour research and therapy Lock, J., Le Grange, D., Agras, W. S., Fitzpatrick, K. K., Jo, B., Accurso, E., Forsberg, S., Anderson, K., Arnow, K., Stainer, M. 2015; 73: 90-95

  Abstract

  Adolescents with Anorexia Nervosa (AN), treated with family-based treatment (FBT) who fail to gain 2.3 kg by the fourth week of treatment have a 40-50% lower chance of recovery than those who do. Because of the high risk of developing enduring AN, improving outcomes in this group of poor responders is essential. This study examines the feasibility and effects of a novel adaptive treatment (i.e., Intensive Parental Coaching-IPC) aimed at enhancing parental self-efficacy related to re-feeding skills in poor early responders to FBT.45 adolescents (12-18 years of age) meeting DSM TR IV criteria for AN were randomized in an unbalanced design (10 to standard FBT; 35 to the adaptive arm). Attrition, suitability, expectancy rates, weight change, and psychopathology were compared between groups.There were no differences in rates of attrition, suitability, expectancy ratings, or most clinical outcomes between randomized groups. However, the group of poor early responders that received IPC achieved full weight restoration (>95% of expected mean BMI) by EOT at similar rates as those who had responded early.The results of this study suggest that it is feasible to use an adaptive design to study the treatment effect of IPC for those who do not gain adequate weight by session 4 of FBT. The results also suggest that using IPC for poor early responders significantly improves weight recovery rates to levels comparable to those who respond early. A sufficiently powered study is needed to confirm these promising findings.

  View details for DOI 10.1016/j.brat.2015.07.015

  View details for PubMedID 26276704

  View details for PubMedCentralID PMC4573312

• Rapid Response in Psychological Treatments for Binge Eating Disorder JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY Hilbert, A., Hildebrandt, T., Agras, W. S., Wilfley, D. E., Wilson, G. T. 2015; 83 (3): 649-654

  Abstract

  Analysis of short- and long-term effects of rapid response across 3 different treatments for binge eating disorder (BED).In a randomized clinical study comparing interpersonal psychotherapy (IPT), cognitive-behavioral therapy guided self-help (CBTgsh), and behavioral weight loss (BWL) treatment in 205 adults meeting Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; APA, 1994) criteria for BED, the predictive value of rapid response, defined as ≥70% reduction in binge eating by Week 4, was determined for remission from binge eating and global eating disorder psychopathology at posttreatment, 6-, 12-, 18-, and 24-month follow-ups.Rapid responders in CBTgsh, but not in IPT or BWL, showed significantly greater rates of remission from binge eating than nonrapid responders, which was sustained over the long term. Rapid and nonrapid responders in IPT and rapid responders in CBTgsh showed a greater remission from binge eating than nonrapid responders in CBTgsh and BWL. Rapid responders in CBTgsh showed greater remission from binge eating than rapid responders in BWL. Although rapid responders in all treatments had lower global eating disorder psychopathology than nonrapid responders in the short term, rapid responders in CBTgsh and IPT were more improved than those in BWL and nonrapid responders in each treatment. Rapid responders in BWL did not differ from nonrapid responders in CBTgsh and IPT.Rapid response is a treatment-specific positive prognostic indicator of sustained remission from binge eating in CBTgsh. Regarding an evidence-based, stepped-care model, IPT, equally efficacious for rapid and nonrapid responders, could be investigated as a second-line treatment in case of nonrapid response to first-line CBTgsh.

  View details for DOI 10.1037/ccp0000018

  View details for Web of Science ID 000355167300021

  View details for PubMedID 25867446

• Comparison of 2 Family Therapies for Adolescent Anorexia Nervosa A Randomized Parallel Trial JAMA PSYCHIATRY Agras, W. S., Lock, J., Brandt, H., Bryson, S. W., Dodge, E., Halmi, K. A., Jo, B., Johnson, C., Kaye, W., Wilfley, D., Woodside, B. 2014; 71 (11): 1279-1286

  Abstract

  Anorexia nervosa (AN) is a serious disorder with high rates of morbidity and mortality. Family-based treatment (FBT) is an evidence-based therapy for adolescent AN, but less than half of those who receive this approach recover. Hence, it is important to identify other approaches to prevent the development of the chronic form of AN for which there is no known evidence-based treatment.To compare FBT with systemic family therapy (SyFT) for the treatment of adolescent-onset AN.Research in Anorexia Nervosa (RIAN) is a 2-group (FBT and SyFT) randomized trial conducted between September 2005 and April 2012. Interviewers were blinded to the treatment condition. A total of 564 adolescents receiving care at 6 outpatient clinics experienced in the treatment of AN were screened. Of these, 262 adolescents did not meet the inclusion criteria and 138 declined to participate; hence, 164 adolescents (aged 12-18 years) of both sexes meeting the criteria for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, AN (except for amenorrhea) were enrolled. Three participants were withdrawn from FBT and 7 were withdrawn from SyFT after serious adverse events occurred.Two manualized family therapies with 16 one-hour sessions during 9 months. Family-based therapy focuses on the facilitation of weight gain, whereas SyFT addresses general family processes.The primary outcomes were percentage of ideal body weight (IBW) and remission (≥95% of IBW). The a priori hypothesis was that FBT would result in faster weight gain early in treatment and at the end of treatment (EOT).There were no statistically significant differences between treatment groups for the primary outcome, for eating disorder symptoms or comorbid psychiatric disorders at the EOT or follow-up. Remission rates included FBT, 33.1% at the EOT and 40.7% at follow-up and SyFT, 25.3% and 39.0%, respectively. Family-based therapy led to significantly faster weight gain early in treatment, significantly fewer days in the hospital, and lower treatment costs per patient in remission at the EOT (FBT, $8963; SyFT, $18 005). An exploratory moderator analysis found that SyFT led to greater weight gain than did FBT for participants with more severe obsessive-compulsive symptoms.The findings of this study suggest that FBT is the preferred treatment for adolescent AN because it is not significantly different from SyFT and leads to similar outcomes at a lower cost than SyFT. Adolescents with more severe obsessive-compulsive symptoms may receive more benefits with SyFT.clinicaltrials.gov Identifier NCT00610753.

  View details for DOI 10.1001/jamapsychiatry.2014.1025

  View details for Web of Science ID 000344989100010

• Relapse From Remission at Two- to Four-Year Follow-Up in Two Treatments for Adolescent Anorexia Nervosa JOURNAL OF THE AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY le Grange, D., Lock, J., Accurso, E. C., Agras, W. S., Darcy, A., Forsberg, S., Bryson, S. W. 2014; 53 (11): 1162-1167

  Abstract

  Long-term follow-up studies documenting maintenance of treatment effects are few in adolescent anorexia nervosa (AN). This exploratory study reports relapse from full remission and attainment of remission during a 4-year open follow-up period using a convenience sample of a subgroup of 65% (n = 79) from an original cohort of 121 participants who completed a randomized clinical trial comparing family-based therapy (FBT) and adolescent-focused individual therapy (AFT).Follow-up assessments were completed up to 4 years posttreatment (average, 3.26 years). Available participants completed the Eating Disorder Examination as well as self-report measures of self-esteem and depression at 2 to 4 years posttreatment.Two participants (6.1%) relapsed (FBT: n = 1, 4.5%; AFT: n = 1, 9.1%), on average 1.98 years (SD = 0.14 years) after remission was achieved at 1-year follow-up. Ten new participants (22.7%) achieved remission (FBT: n = 1, 5.9%; AFT: n = 9, 33.3%). Mean time to remission for this group was 2.01 years (SD = 0.82 years) from 1-year follow-up. There were no differences based on treatment group assignment in either relapse from full remission or new remission during long-term follow-up. Other psychopathology was stable over time.There were few changes in the clinical presentation of participants who were assessed at long-term follow-up. These data suggest that outcomes are generally stable posttreatment regardless of treatment type once remission is achieved. Clinical trial registration information-Effectiveness of Family-Based Versus Individual Psychotherapy in Treating Adolescents With Anorexia Nervosa; http://www.clinicaltrials.gov/; NCT00149786.

  View details for DOI 10.1016/j.jaac.2014.07.014

  View details for Web of Science ID 000343620600005

  View details for PubMedCentralID PMC4254507

• A Randomized Pilot Study of a Brief Outpatient Problem-Solving Intervention to Promote Healthy Eating and Activity Habits in Adolescents CLINICAL PEDIATRICS Gee, L., Agras, W. S. 2014; 53 (3): 293-296

  View details for DOI 10.1177/0009922813497093

  View details for Web of Science ID 000331369100015

  View details for PubMedID 23897759

• Do end of treatment assessments predict outcome at follow-up in eating disorders? International journal of eating disorders Lock, J., Agras, W. S., Le Grange, D., Couturier, J., Safer, D., Bryson, S. W. 2013; 46 (8): 771-778

  Abstract

  To examine the predictive value of end of treatment (EOT) outcomes for longer term recovery status.We used signal detection analysis to identify the best predictors of recovery based on outcome at EOT using five different eating disorder samples from randomized clinical treatment trials. We utilized a transdiagnostic definition of recovery that included normalization of weight and eating related psychopathology.Achieving a body weight of 95.2% of expected body weight by EOT is the best predictor of recovery for adolescents with anorexia nervosa (AN). For adults with AN, the most efficient predictor of weight recovery (BMI > 19) was weight gain to greater than 85.8% of ideal body weight. In addition, for adults with AN, the most efficient predictor of psychological recovery was achievement of an eating disorder examination (EDE) weight concerns score below 1.8. The best predictor of recovery for adults with Bulimia Nervosa (BN) was a frequency of compensatory behaviors less than two times a month. For adolescents with BN, abstinence from purging and reduction in the EDE restraint score of more than 3.4 from baseline to EOT were good predictors of recovery. For adults with binge eating disorder, reduction of the Global EDE score to within the normal range (<1.58) was the best predictor of recovery.The relationship between EOT response and recovery remains understudied. Utilizing a transdiagnostic definition of recovery, no uniform predictors were identified across all eating disorder diagnostic groups. © 2013 Wiley Periodicals, Inc. (Int J Eat Disord 2013; 46:771-778).

  View details for DOI 10.1002/eat.22175

  View details for PubMedID 23946139

• Do in-vivo behaviors predict early response in family-based treatment for anorexia nervosa? Behaviour research and therapy Darcy, A. M., Bryson, S. W., Agras, W. S., Fitzpatrick, K. K., Le Grange, D., Lock, J. 2013; 51 (11): 762-766

  Abstract

  The aim of the study is to explore whether identified parental and patient behaviors observed in the first few sessions of family-based treatment (FBT) predict early response (weight gain of 1.8 kg by session four) to treatment. Therapy film recordings from 21 adolescent participants recruited into the FBT arm of a multi-site randomized clinical trial were coded for the presence of behaviors (length of observed behavior divided by length of session recording) in the first, second and fourth sessions. Behaviors that differed between early responders and non-early responders on univariate analysis were entered into discriminant class analyses. Participants with fewer negative verbal behaviors in the first session and were away from table during the meal session less had the greatest rates of early response. Parents who made fewer critical statements and who did not repeatedly present food during the meal session had children who had the greatest rates of early response. In-vivo behaviors in early sessions of FBT may predict early response to FBT. Adaptations to address participant resistance and to decrease the numbers of critical comments made by parents while encouraging their children to eat might improve early response to FBT.

  View details for DOI 10.1016/j.brat.2013.09.003

  View details for PubMedID 24091274

• Is outpatient cognitive remediation therapy feasible to use in randomized clinical trials for anorexia nervosa? International journal of eating disorders Lock, J., Agras, W. S., Fitzpatrick, K. K., Bryson, S. W., Jo, B., Tchanturia, K. 2013; 46 (6): 567-575

  Abstract

  OBJECTIVE: There are limited data supporting specific treatments for adults with anorexia nervosa (AN). Randomized clinical trials (RCTs) for adults with AN are characterized by high attrition limiting the feasibility of conducting and interpreting existing studies. High dropout rates may be related to the inflexible and obsessional cognitive style of patients with AN. This study evaluated the feasibility of using cognitive remediation therapy (CRT) to reduce attrition in RCTs for AN. METHOD: Forty-six participants (mean age of 22.7 years and mean duration of AN of 6.4 years) were randomized to receive eight sessions of either CRT or cognitive behavioral therapy (CBT) over 2 months followed by 16 sessions of CBT for 4 months. RESULTS: During the 2-month CRT vs. CBT treatment, rates of attrition were lower in CRT (13%) compared with that of CBT (33%). There were greater improvements in cognitive inefficiencies in the CRT compared with that of the CBT group at the end of 2 months. There were no differences in other outcomes. DISCUSSION: These results suggest that CRT is acceptable and feasible for use in RCTs for outpatient treatment of AN. CRT may reduce attrition in the short term. Adequately powered future studies are needed to examine CRT as an outpatient treatment for AN.

  View details for DOI 10.1002/eat.22134

  View details for PubMedID 23625628

• Is outpatient cognitive remediation therapy feasible to use in randomized clinical trials for anorexia nervosa? INTERNATIONAL JOURNAL OF EATING DISORDERS Lock, J., Agras, W. S., Fitzpatrick, K. K., Bryson, S. W., Jo, B., Tchanturia, K. 2013; 46 (6): 567-575

  Abstract

  OBJECTIVE: There are limited data supporting specific treatments for adults with anorexia nervosa (AN). Randomized clinical trials (RCTs) for adults with AN are characterized by high attrition limiting the feasibility of conducting and interpreting existing studies. High dropout rates may be related to the inflexible and obsessional cognitive style of patients with AN. This study evaluated the feasibility of using cognitive remediation therapy (CRT) to reduce attrition in RCTs for AN. METHOD: Forty-six participants (mean age of 22.7 years and mean duration of AN of 6.4 years) were randomized to receive eight sessions of either CRT or cognitive behavioral therapy (CBT) over 2 months followed by 16 sessions of CBT for 4 months. RESULTS: During the 2-month CRT vs. CBT treatment, rates of attrition were lower in CRT (13%) compared with that of CBT (33%). There were greater improvements in cognitive inefficiencies in the CRT compared with that of the CBT group at the end of 2 months. There were no differences in other outcomes. DISCUSSION: These results suggest that CRT is acceptable and feasible for use in RCTs for outpatient treatment of AN. CRT may reduce attrition in the short term. Adequately powered future studies are needed to examine CRT as an outpatient treatment for AN.

  View details for DOI 10.1002/eat.22134

  View details for Web of Science ID 000323436800005

• Reducing the burden of eating disorders: A model for population-based prevention and treatment for university and college campuses INTERNATIONAL JOURNAL OF EATING DISORDERS Wilfley, D. E., Agras, W. S., Taylor, C. B. 2013; 46 (5): 529-532

  View details for DOI 10.1002/eat.22117

  View details for Web of Science ID 000318779000032

  View details for PubMedID 23658106

• A cost effectiveness analysis of stepped care treatment for bulimia nervosa INTERNATIONAL JOURNAL OF EATING DISORDERS Crow, S. J., Agras, W. S., Halmi, K. A., Fairburn, C. G., Mitchell, J. E., Nyman, J. A. 2013; 46 (4): 302-307

  Abstract

  The cost effectiveness of various treatment strategies for bulimia nervosa (BN) is unknown.To examine the cost effectiveness of stepped care treatment for BN.Randomized trial conducted at four clinical centers with intensive measurement of direct medical costs and repeated measurement of subject quality of life and family/significant other time involvement. Two hundred ninety-three women who met DSM-IV criteria for BN received stepped care treatment or cognitive behavioral therapy. Cost effectiveness ratios were compared.The cost per abstinent subject was $12,146 for stepped care, and $20,317 for cognitive behavioral therapy. Quality of life ratings improved significantly with treatment, and family/significant other time burden diminished substantially.In this trial, stepped care for BN appeared cost effective in comparison to cognitive behavioral therapy. Treatment was associated with improved quality of life and diminished time costs of illness.

  View details for DOI 10.1002/eat.22087

  View details for Web of Science ID 000317298900002

  View details for PubMedID 23354913

• Defining Recovery in Adult Bulimia Nervosa EATING DISORDERS Yu, J., Agras, W. S., Bryson, S. 2013; 21 (5): 379-394

  Abstract

  To examine how different definitions of recovery lead to varying rates of recovery, maintenance of recovery, and relapse in bulimia nervosa (BN), end-of-treatment (EOT) and follow-up data were obtained from 96 adults with BN. Combining behavioral, physical, and psychological criteria led to recovery rates between 15.5% and 34.4% at EOT, though relapse was approximately 50%. Combining these criteria and requiring abstinence from binge eating and purging when defining recovery may lead to lower recovery rates than those found in previous studies; however, a strength of this definition is that individuals who meet this criteria have no remaining disordered behaviors or symptoms.

  View details for DOI 10.1080/10640266.2013.827536

  View details for Web of Science ID 000337503300001

• Longitudinal stability of binge-eating type in eating disorders INTERNATIONAL JOURNAL OF EATING DISORDERS Peterson, C. B., Swanson, S. A., Crow, S. J., Mitchell, J. E., Agras, W. S., Halmi, K. A., Crosby, R. D., Wonderlich, S. A., Berg, K. C. 2012; 45 (5): 664-669

  Abstract

  The purpose of this study was to examine the 2-year longitudinal stability of objective bulimic (binge eating) episodes (OBEs) and subjective bulimic (binge eating) episodes (SBEs) in a multisite eating disorders sample.Participants included 288 females with eating disorder symptoms who were assessed every 6 months using the Eating Disorder Examination.Markov modeling revealed considerable longitudinal variability between types of binge eating over 6-month time intervals with relatively higher probability estimates for consistency between OBEs and SBEs than specific transitions between types for the overall sample as well as for eating disorder diagnostic groups. Transition patterns examining all five time points indicated notable variability in binge-eating patterns among participants.These findings suggest that although longitudinal patterns of binge types are variable among individuals with eating disorders, consistency in OBEs and SBEs was the most common pattern observed.

  View details for DOI 10.1002/eat.22008

  View details for Web of Science ID 000304993700005

  View details for PubMedID 22407944

  View details for PubMedCentralID PMC3645844

• The Mississippi Years (1969-1974) BEHAVIOR MODIFICATION Agras, W. S. 2012; 36 (4): 436-443

  View details for DOI 10.1177/0145445512443979

  View details for Web of Science ID 000307335500002

• Moderators and mediators of remission in family-based treatment and adolescent focused therapy for anorexia nervosa BEHAVIOUR RESEARCH AND THERAPY le Grange, D., Lock, J., Agras, W. S., Moye, A., Bryson, S. W., Jo, B., Kraemer, H. C. 2012; 50 (2): 85-92

  Abstract

  Few of the limited randomized controlled trails (RCTs) for adolescent anorexia nervosa (AN) have explored the effects of moderators and mediators on outcome. This study aimed to identify treatment moderators and mediators of remission at end of treatment (EOT) and 6- and 12-month follow-up (FU) for adolescents with AN (N = 121) who participated in a multi-center RCT of family-based treatment (FBT) and individual adolescent focused therapy (AFT). Mixed effects modeling were utilized and included all available outcome data at all time points. Remission was defined as ≥ 95% IBW plus within 1 SD of the Eating Disorder Examination (EDE) norms. Eating related obsessionality (Yale-Brown-Cornell Eating Disorder Total Scale) and eating disorder specific psychopathology (EDE-Global) emerged as moderators at EOT. Subjects with higher baseline scores on these measures benefited more from FBT than AFT. AN type emerged as a moderator at FU with binge-eating/purging type responding less well than restricting type. No mediators of treatment outcome were identified. Prior hospitalization, older age and duration of illness were identified as non-specific predictors of outcome. Taken together, these results indicate that patients with more severe eating related psychopathology have better outcomes in a behaviorally targeted family treatment (FBT) than an individually focused approach (AFT).

  View details for DOI 10.1016/j.brat.2011.11.003

  View details for Web of Science ID 000301019200001

  View details for PubMedID 22172564

  View details for PubMedCentralID PMC3260378

• Examining the Stability of DSM-IV and Empirically Derived Eating Disorder Classification: Implications for DSM-5 JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY Peterson, C. B., Crow, S. J., Swanson, S. A., Crosby, R. D., Wonderlich, S. A., Mitchell, J. E., Agras, W. S., Halmi, K. A. 2011; 79 (6): 777-783

  Abstract

  The purpose of this investigation was to derive an empirical classification of eating disorder symptoms in a heterogeneous eating disorder sample using latent class analysis (LCA) and to examine the longitudinal stability of these latent classes (LCs) and the stability of DSM-IV eating disorder (ED) diagnoses.A total of 429 females with ED symptoms were assessed using the Eating Disorder Examination every 6 months for 2 years. LCA was used to derive empirical classification at baseline. Latent transition analysis (LTA) was used to examine the longitudinal stability of LCs, and Markov modeling procedures were used to examine DSM-IV ED diagnoses over all the time points.LCA yielded a 3-class solution: binge eating and purging, binge eating only, and low body mass index. LTA indicated that these LCs showed greater stability over 2 years than DSM-IV diagnoses with the probability of remaining in the same class ranging from 0.69 to 0.91 for LCs and from 0.40 to 0.75 for DSM-IV diagnoses. Transition patterns also revealed more stability for LCs with only 21% changing classes compared with 63% of the DSM-IV diagnostic categories.Empirically derived classes of ED symptoms showed greater longitudinal stability than DSM-IV diagnoses over a 2-year time period, suggesting that modifying the criteria to be consistent with empirically based classification (e.g., reducing frequency requirements of binge eating and purging) may reduce ED diagnostic crossover in DSM-5.

  View details for DOI 10.1037/a0025941

  View details for Web of Science ID 000297548600007

  View details for PubMedID 22040286

• A 1-year follow-up of a multi-center treatment trial of adults with anorexia nervosa EATING AND WEIGHT DISORDERS-STUDIES ON ANOREXIA BULIMIA AND OBESITY Yu, J., Agras, W. S., HALMI, K. A., Crow, S., Mitchell, J., Bryson, S. W. 2011; 16 (3): E177-E181

  Abstract

  To examine maintenance of recovery following treatment in an adult anorexia nervosa (AN) population.One year follow-up of a randomized clinical trial with 122 participants treated with: cognitive behavioral therapy (CBT), drug therapy (fluoxetine), or a combination (CBT+fluoxetine) for 12 months. Participants were assessed at baseline, end of treatment, and follow-up. The primary outcomes were weight and the global scores from the Eating Disorder Examination (EDE) separately and combined.Fifty-two participants completed the follow-up. Mean weight increased from end of treatment to follow-up. Seventy-five percent (75%) of those weight recovered at end of treatment maintained this recovery at follow-up. Recovery of eating disorder psychopathology was stable from end of treatment to follow-up, with 40% of participants with a global EDE score within normal range. Using the most stringent criteria for recovery, only 21% of the completer sample was recovered.The findings suggest that while adults with AN improve with treatment and maintain these improvements during follow-up, the majority is not recovered. Additionally, further research is needed to understand barriers to treatment and assessment completion.

  View details for Web of Science ID 000303170600005

  View details for PubMedID 22290033

• Allegiance Bias and Therapist Effects: Results of a Randomized Controlled Trial of Binge Eating Disorder CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE Wilson, G. T., Wilfley, D. E., Agras, W. S., Bryson, S. W. 2011; 18 (2): 119-125

  View details for Web of Science ID 000291755900005

• Randomized Clinical Trial Comparing Family-Based Treatment With Adolescent-Focused Individual Therapy for Adolescents With Anorexia Nervosa ARCHIVES OF GENERAL PSYCHIATRY Lock, J., Le Grange, D., Agras, S., Moye, A., Bryson, S. W., Jo, B. 2010; 67 (10): 1025-1032

  Abstract

  Evidence-based treatment trials for adolescents with anorexia nervosa are few.To evaluate the relative efficacy of family-based treatment (FBT) and adolescent-focused individual therapy (AFT) for adolescents with anorexia nervosa in full remission.Randomized controlled trial.Stanford University and The University of Chicago (April 2005 until March 2009).One hundred twenty-one participants, aged 12 through 18 years, with DSM-IV diagnosis of anorexia nervosa excluding the amenorrhea requirement. Intervention Twenty-four outpatient hours of treatment over 12 months of FBT or AFT. Participants were assessed at baseline, end of treatment (EOT), and 6 months' and 12 months' follow-up posttreatment.Full remission from anorexia nervosa defined as normal weight (≥95% of expected for sex, age, and height) and mean global Eating Disorder Examination score within 1 SD of published means. Secondary outcome measures included partial remission rates (>85% of expected weight for height plus those who were in full remission) and changes in body mass index percentile and eating-related psychopathology.There were no differences in full remission between treatments at EOT. However, at both the 6- and 12-month follow-up, FBT was significantly superior to AFT on this measure. Family-based treatment was significantly superior for partial remission at EOT but not at follow-up. In addition, body mass index percentile at EOT was significantly superior for FBT, but this effect was not found at follow-up. Participants in FBT also had greater changes in Eating Disorder Examination score at EOT than those in AFT, but there were no differences at follow-up.Although both treatments led to considerable improvement and were similarly effective in producing full remission at EOT, FBT was more effective in facilitating full remission at both follow-up points.clinicaltrials.gov Identifier: NCT00149786.

  View details for Web of Science ID 000282917400005

  View details for PubMedID 20921118

• Heterogeneity Moderates Treatment Response Among Patients With Binge Eating Disorder JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY Sysko, R., Hildebrandt, T., Wilson, G. T., Wilfley, D. E., Agras, W. S. 2010; 78 (5): 681-690

  Abstract

  The purpose of the study was to explore heterogeneity and differential treatment outcome among a sample of patients with binge eating disorder (BED).A latent class analysis was conducted with 205 treatment-seeking, overweight or obese individuals with BED randomized to interpersonal psychotherapy (IPT), behavioral weight loss (BWL), or guided self-help based on cognitive behavioral therapy (CBTgsh). A latent transition analysis tested the predictive validity of the latent class analysis model.A 4-class model yielded the best overall fit to the data. Class 1 was characterized by a lower mean body mass index (BMI) and increased physical activity. Individuals in Class 2 reported the most binge eating, shape and weight concerns, compensatory behaviors, and negative affect. Class 3 patients reported similar binge eating frequencies to Class 2, with lower levels of exercise or compensation. Class 4 was characterized by the highest average BMI, the most overeating episodes, fewer binge episodes, and an absence of compensatory behaviors. Classes 1 and 3 had the highest and lowest percentage of individuals with a past eating disorder diagnosis, respectively. The latent transition analysis found a higher probability of remission from binge eating among those receiving IPT in Class 2 and CBTgsh in Class 3.The latent class analysis identified 4 distinct classes using baseline measures of eating disorder and depressive symptoms, body weight, and physical activity. Implications of the observed differential treatment response are discussed.

  View details for DOI 10.1037/a0019735

  View details for Web of Science ID 000282393800008

  View details for PubMedID 20873903

• Psychological treatments of binge eating disorder Archives of General Psychiatry Wilson, G. T.,, Wilfley D. E., Agras, W. S. 2010; 67: 94-101
• A 4-Year Prospective Study of Eating Disorder NOS Compared with Full Eating Disorder Syndromes INTERNATIONAL JOURNAL OF EATING DISORDERS Agras, W. S., Crow, S., Mitchell, J. E., Halmi, K. A., Bryson, S. 2009; 42 (6): 565-570

  Abstract

  To examine the course of Eating Disorder NOS (EDNOS) compared with anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED).Prospective study of 385 participants meeting DSM-IV criteria for AN, BN, BED, and EDNOS at three sites. Recruitment was from the community and specialty clinics. Participants were followed at 6-month intervals during a 4-year period using the Eating Disorder Examination as the primary assessment.EDNOS remitted significantly more quickly that AN or BN but not BED. There were no differences between EDNOS and full ED syndromes, or the subtypes of EDNOS, in time to relapse following first remission. Only 18% of the EDNOS group had never had or did not develop another ED diagnosis during the study; however, this group did not differ from the remaining EDNOS group.EDNOS appears to be a way station between full ED syndromes and recovery, and to a lesser extent from recovery or EDNOS status to a full ED. Implications for DSM-V are examined.

  View details for DOI 10.1002/eat.20708

  View details for Web of Science ID 000269224000012

  View details for PubMedID 19544557

  View details for PubMedCentralID PMC2862563

• Is Picky Eating an Eating Disorder? INTERNATIONAL JOURNAL OF EATING DISORDERS Jacobi, C., Schmitz, G., Agras, W. S. 2008; 41 (7): 626-634

  Abstract

  To examine the prevalence of picky eating and the relationship between picky eating, previously supported correlates of picky eating, other child eating and behavioral problems and maternal eating problems in children aged 8-12 years.In a cohort study, 426 8- to 12-year-old children and their primary caretakers (91% mothers) were assessed in a small town community. Potential child eating behaviors associated with picky eating were reported by mothers using the Stanford Feeding Questionnaire. Child eating attitudes and disturbances were obtained from the McKnight Risk Factor Survey, food preferences and avoidances from a food preference list, child behavioral problems were assessed by the Child Behavior Checklist. To assess maternal eating disturbances EDI-subscales 1-3 as well as TFEQ-subscales "disinhibition" and "restraint" were used.Picky and nonpicky eaters differed significantly on all of the child eating behaviors found to be correlates of picky eating in a previous study with younger children. Overall, picky children were reported to avoid foods in general more often than nonpicky eaters. Picky children did not differ from nonpicky children with regard to their own and maternal eating disturbances. However, picky children displayed more problem behaviors comprising both internalizing and externalizing behaviors.The present study does not support the concept that picky eating is associated with disordered eating but rather with a range of behavioral problems.

  View details for DOI 10.1002/eat.20545

  View details for Web of Science ID 000260317100007

  View details for PubMedID 18454484

• Interactions Between Disturbed Eating and Weight in Children and Their Mothers JOURNAL OF DEVELOPMENTAL AND BEHAVIORAL PEDIATRICS Jacobi, C., Schmitz, G., Agras, W. S. 2008; 29 (5): 360-366

  Abstract

  This study assessed the interaction between disturbed eating behavior and body mass index (BMI) in children aged 8 to 12 and maternal eating problems and BMI.In a cohort study, four hundred twenty-six 8- to 12-year-old children and their primary caretakers (91% mothers) were assessed in a small city. Disturbed eating behavior in children was measured by the "IEG-IEG-Child-Questionnaire," a validated German self-report instrument for children. Disturbed eating behavior in mothers was assessed by TFEQ-subscale disinhibition.Children's BMI was a significant covariate of disturbed eating. Older girls with higher BMI endorsed more problems with eating and weight, and more body dissatisfaction than boys and younger children. Daughters of overweight mothers restrained their own eating behavior more than daughters of normal weight mothers and sons regardless of mothers' weight. Older daughters of overweight mothers were more dissatisfied with their own bodies than younger daughters and children of normal weight mothers. Children of mothers with elevated disinhibition showed more body dissatisfaction than children of mothers with lower disinhibition.The results illustrate the complex and differential relationships between age, gender, BMI, and maternal variables and eating disturbances in children. Preventive interventions for the reduction of disturbed eating in children should be targeted at overweight mothers and mothers with disinhibited eating.

  View details for Web of Science ID 000260147500005

  View details for PubMedID 18766115

• Costs of remission and recovery using family therapy for adolescent anorexia nervosa: a descriptive report. Eating disorders Lock, J., Couturier, J., Agras, W. S. 2008; 16 (4): 322-330

  Abstract

  This paper reports on the costs of overall treatment for a cohort of adolescent patients with AN treated with a similar regimen consisting of inpatient medical stabilization, outpatient family therapy, and psychiatric medications for co-morbid psychiatric conditions. Most of the costs associated with outcome were secondary to medical hospitalization. However, the overall costs per remission varied widely depending on the threshold used. However, compared to costs described for adults with AN, adolescent treatment costs appear to be lower when families are used effectively to aid in treatment.

  View details for DOI 10.1080/10640260802115969

  View details for PubMedID 18568922

• Eating disorder symptoms in pregnancy: A prospective study INTERNATIONAL JOURNAL OF EATING DISORDERS Crow, S. J., Agras, W. S., Crosby, R., Halmi, K., Mitchell, J. E. 2008; 41 (3): 277-279

  Abstract

  Previous work suggests that eating disorder symptoms diminish with pregnancy. However, little prospective study has been conducted, and little is known about pregnancy symptoms in eating disorder not otherwise specified. This research prospectively studies both eating behaviors and disordered eating cognitions in pregnant women with various eating disorder diagnoses.Forty-two participants became pregnant during 4-year follow-up of 385 women with full or subthreshold anorexia nervosa, bulimia nervosa, or binge eating disorder. Participants completed the Eating Disorders Examination (EDE) at 6-month intervals. Mixed modeling procedures were used to examine change in eating disorder cognitions, binge eating, and purging.EDE restraint, EDE shape concerns, EDE weight concerns, binge eating, and purging diminished from prepartum to intrapartum, but returned to approximately baseline levels postpartum.In this longitudinal sample of women with diverse eating disorder diagnoses, eating disorder symptoms improved during pregnancy, but worsened postpartum. These results highlight pregnancy as a potential time for eating disorder interventions.

  View details for DOI 10.1002/eat.20496

  View details for Web of Science ID 000254114400012

  View details for PubMedID 18027861

• Changes in psychopathology and symptom severity in bulimia nervosa between 1993 and 2003 INTERNATIONAL JOURNAL OF EATING DISORDERS Vaught, A. S., Agras, W. S., Bryson, S. W., Crow, S. J., Halmi, K. A., Mitchell, J. E. 2008; 41 (2): 113-117

  Abstract

  This study investigated changes in symptom severity and the psychopathology of patients with bulimia nervosa between 1993 and 2003.Pretreatment data of patients diagnosed with bulimia nervosa, collected between 1993 and 1997 from two multisite studies (N = 263), and from 2001 to 2003 from a third multisite study (N = 233) were compared for differences in psychopathology, eating disorder symptoms, and demographic characteristics.There was a significant increase in baseline age between the cohorts (1993M = 28.7 +/- 7.9, 2001M = 30.3 +/- 8.7, p = 0.036) together with a decrease in personality disorders and in several aspects of eating disorder psychopathology. After controlling for age however, significant pretreatment differences were found only in the restraint subscale on the EDE.Results suggest that the presentation of individuals with bulimia nervosa has changed between 1993 and 2003, in that participants were older and demonstrated less dietary restraint. Hence, comparisons between samples and treatment trials over time must be made with caution.

  View details for DOI 10.1002/eat.20464

  View details for Web of Science ID 000253226300002

  View details for PubMedID 18004720

• Forty years of progress in the treatment of the eating disorders NORDIC JOURNAL OF PSYCHIATRY Agras, W. S., Robinson, A. H. 2008; 62: 19-24

  Abstract

  This paper reviews progress in the treatment of the eating disorders between 1968 and 2008. In 1968, no evidence-based treatments were available for any of the eating disorders, and binge eating disorder had not yet been described. In 2008, there are still no evidence-based treatments for anorexia nervosa, although a specific form of family therapy (based on the Maudsley model) appears promising. Both psychotherapeutic and psychopharmacological evidence-based treatments are now available for bulimia nervosa and binge eating disorder. Therapist-assisted self-help is a promising approach to treatment because it may reduce the costs of treatment, allow for more adequate dissemination to areas lacking specialty resources and also provide a basis for algorithm-driven approaches to treatment.

  View details for DOI 10.1080/08039480802315632

  View details for Web of Science ID 000260298500004

  View details for PubMedID 18752114

• A comparison of ethnic groups in the treatment of bulimia nervosa. Eating behaviors Chui, W., Safer, D. L., Bryson, S. W., Agras, W. S., Wilson, G. T. 2007; 8 (4): 485-491

  Abstract

  This exploratory study investigated whether White and ethnic minority bulimic participants differ on key features of eating psychopathology and treatment outcome. Data from a randomized controlled multi-site study comparing the efficacy of either cognitive-behavioral therapy (CBT) or interpersonal therapy (IPT) for 219 women with bulimia nervosa were analyzed. A significant baseline ethnic difference for body mass index (BMI) (p<.001) was found as well as an ethnicity by center interaction for a prior history of depression (p<.05). In addition, there was a significant ethnic difference for the Weight Concerns subscale of the Eating Disorder Examination (EDE). However, once BMI was controlled, this difference did not retain significance. At post-treatment, while all ethnic groups responded with higher abstinence rates to CBT than IPT, an ethnicity by treatment effect was found for the reduction of objective binge eating episodes. Black participants, compared to other groups, showed greater reductions in binge eating episodes when treated with IPT than CBT. Other findings related to secondary outcome measures, though limited by small sample size, are discussed as providing directions for future research.

  View details for PubMedID 17950937

• Classification of eating disorders: Toward DSM-V INTERNATIONAL JOURNAL OF EATING DISORDERS Wilfley, D. E., Bishop, M. E., Wilson, G. T., Agras, W. S. 2007; 40: S123-S129

  Abstract

  A goal of the DSM-IV revision is to increase clinical and research utility by improving diagnostic validity through reliance on empirical evidence. Currently defined eating disorder (ED) categories have limited validity and require refinement based on data.The available scientific evidence is considered in evaluating the current ED nosology.Specific recommendations include modifying ED classification by retaining categories but adding a dimensional component; removing the amenorrhea criterion for anorexia nervosa (AN); removing the subtypes for AN and bulimia nervosa (BN); making binge eating disorder (BED) an official diagnosis; and unifying the frequency and duration cut-points for BN and BED to once per week for 3 months. Priority research areas should include epidemiologic studies of full-range ED symptomatology and should focus on empirical validation for individual criterion.There are significant issues to address in revising ED nosology as we move toward a more valid and useful DSM-V.

  View details for Web of Science ID 000250229900027

  View details for PubMedID 17685383

• Childhood risk factors for thin body preoccupation and social pressure to be thin JOURNAL OF THE AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY Agras, W. S., Bryson, S., Hammer, L. D., Kraemer, H. C. 2007; 46 (2): 171-178

  Abstract

  Thin body preoccupation and social pressure to be thin (TBPSP) in adolescence are risk factors for the development of full and partial bulimia nervosa and binge eating disorder. This study examined precursors of these potent risk factors.A prospective study followed 134 children from birth to 11.0 years and their parents. Recruitment began in January 1990 and ended in March 1991. The study was completed in December 2002.Two moderators identified different groups at risk for the development of TBPSP. A father with high body dissatisfaction characterized the largest group in which TBPSP was elevated for girls who were concerned about and attempted to modify their weight and for children with fathers who had a high drive for thinness. A child at risk for overweight characterized the second smaller group. Parental behaviors such as overcontrol of their child's eating, together with later pressure from parents and peers to be thin, were related to higher levels of TBPSP.Different pathways lead to the development of eating disorder psychopathology. These results suggest that prevention programs for eating disorders should begin in early childhood, possibly involving parental education and behavior change, and that different prevention programs may be required for different pathways.

  View details for DOI 10.1097/chi.0b01361802bd997

  View details for Web of Science ID 000243737900004

  View details for PubMedID 17242620

• Comparison of long-term outcomes in adolescents with anorexia nervosa treated with family therapy JOURNAL OF THE AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY Lock, J., Couturier, J., Agras, W. S. 2006; 45 (6): 666-672

  Abstract

  To describe the relative effectiveness of a short versus long course of family-based therapy (FBT) for adolescent anorexia nervosa at long-term follow-up.This study used clinical and structured interviews to assess psychological and psychosocial outcomes of adolescents (ages 12-18 years at baseline) who were previously treated in a randomized clinical trial using family therapy between 1999 and 2002.Eighty-three percent (71/86) of subjects participated in follow-up assessments of current psychological and psychosocial functioning. In addition, 49% (35) were interviewed using the Eating Disorder Examination. Mean length of follow-up was 3.96 years (range 2.3-6.0 years). There were no statistically significant differences between the two groups on any measure at long-term follow-up. As a whole, the group was doing well with 89% above 90% ideal body weight, 74% with Eating Disorder Examination scores within the normal range, and 91% of postmenarcheal females not on birth control had menstrual return.A short course of family therapy is as effective as a longer course at follow-up.

  View details for DOI 10.1097/01.chi.0000215152.61400.ca

  View details for Web of Science ID 000237788200007

  View details for PubMedID 16721316

• Weight suppression is a robust predictor of outcome in the cognitive-behavioral treatment of bulimia nervosa JOURNAL OF ABNORMAL PSYCHOLOGY Butryn, M. L., Lowe, M. R., Safer, D. L., Agras, W. S. 2006; 115 (1): 62-67

  Abstract

  This study examined weight suppression (difference between highest premorbid weight and pretreatment weight) as a predictor of outcome in 188 outpatients with bulimia nervosa enrolled in a cognitive-behavioral therapy intervention. Participants who dropped out of treatment had significantly higher levels of weight suppression than treatment completers. Of participants who completed treatment, those who continued to engage in binge eating or purging had significantly higher levels of weight suppression than those who were abstinent from bingeing and purging. Results did not change when body mass index, dietary restraint, weight and shape concerns, or other relevant variables were controlled. Relinquishing bulimic behaviors and adopting normal eating patterns may be most feasible for patients who are closest to their highest premorbid weights.

  View details for DOI 10.1037/0021-843X.115.1.62

  View details for Web of Science ID 000236055600007

  View details for PubMedID 16492096

• Patterns of eating and abstinence in women treated for bulimia nervosa INTERNATIONAL JOURNAL OF EATING DISORDERS Shah, N., Passi, V., Bryson, S., Agras, W. S. 2005; 38 (4): 330-334

  Abstract

  The current study sought to determine whether there is an optimal pattern of eating leading to cessation of binge eating and purging in bulimic women.Data on the number of meals and snacks consumed were obtained from the Eating Disorders Examination (EDE) pretreatment and posttreatment, for individuals participating in a randomized controlled study comparing cognitive-behavioral therapy and interpersonal therapy. Records were available for 158 participants.The numbers of meals and snacks eaten from pretreatment to posttreatment increased significantly. A pattern of eating with at least 80 meals combined with at least 21 afternoon snacks within a 28-day period was associated with an abstinence rate of 70%. In contrast, for subjects having 72-80 meals, those having greater than 11 evening snacks have an abstinence rate of 4%.The critical elements of the pattern of eating related to abstinence appear to be the total number of meals consumed and the timing of snacks.

  View details for DOI 10.1002/eat.20204

  View details for Web of Science ID 000233865600006

  View details for PubMedID 16231339

• Therapeutic alliance and treatment adherence in two interventions for bulimia nervosa: A study of process and outcome 10th Annual International Conference on Eating Disorders Loeb, K. L., Wilson, G. T., Labouvie, E., Pratt, E. M., Hayaki, J., Walsh, B. T., Agras, W. S., Fairburn, C. G. AMER PSYCHOLOGICAL ASSOC. 2005: 1097–1106

  Abstract

  The relationship between therapeutic alliance, therapist adherence to treatment protocol, and outcome was analyzed in a randomized trial of cognitive-behavioral therapy (CBT) and interpersonal psychotherapy for bulimia nervosa. Independent observers rated audiotapes of full-length therapy sessions. Purging frequency was the primary outcome variable. There were no significant therapist or Therapist x Treatment effects on outcome. Although results showed high levels of alliance and adherence across treatments, CBT was associated with greater adherence. Across treatments and time points, better adherence was associated with enhanced alliance. Treatment condition and baseline purging frequency, but not adherence, predicted outcome. Early alliance predicted posttreatment purging frequency. In temporal analyses, prior symptom change assessed early in treatment was significantly related to subsequent adherence at midtreatment.

  View details for DOI 10.1037/0022-006X.73.6.1097

  View details for Web of Science ID 000234576600011

  View details for PubMedID 16392983

• Risk factors for childhood overweight CURRENT OPINION IN PEDIATRICS Agras, W. S., Mascola, A. J. 2005; 17 (5): 648-652

  Abstract

  We review the 2004 literature on risk factors for childhood overweight. Given the steady increase in the prevalence of childhood overweight, the identification of risk factors is of increasing importance.A number of studies confirmed that parental overweight is the most potent risk factor for childhood overweight. Childhood temperament was found to mediate the effects of parental overweight with a difficult temperament increasing the risk of overweight. Newer findings implicate regular consumption of fast food and sweetened drinks as risk factors, as well as sedentary behavior; although a meta-analysis suggested that the effects of the latter factor are small. Other work was consistent with the finding that parental overcontrol of children's feeding behavior, particularly for those at high risk of developing overweight, may lead to overweight.Identification of groups of children at high risk for becoming overweight offers the potential for early intervention to reduce the intergenerational transfer of obesity. This is an area for future research because the nature of effective intervention is at present unclear. There is a suggestion that focused behavior change efforts on one target such as reducing the intake of sweetened beverages may be more successful than attempts to make broader dietary changes. There is also evidence that targeting parental behaviors may be more effective than interventions directed solely toward children, suggesting that modification of the environment that a child is exposed to during early development may have a lasting effect.

  View details for Web of Science ID 000231857800016

  View details for PubMedID 16160542

• A comparison of short- and long-term family therapy for adolescent anorexia nervosa JOURNAL OF THE AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY Lock, J., Agras, W. S., Bryson, S., Kraemer, H. C. 2005; 44 (7): 632-639

  Abstract

  Research suggests that family treatment for adolescents with anorexia nervosa may be effective. This study was designed to determine the optimal length of such family therapy.Eighty-six adolescents (12-18 years of age) diagnosed with anorexia nervosa were allocated at random to either a short-term (10 sessions over 6 months) or long-term treatment (20 sessions over 12 months) and evaluated at the end of 1 year using the Eating Disorder Examination (EDE) between 1999 and 2002.Although adequately powered to detect differences between treatment groups, an intent-to-treat analysis found no significant differences between the short-term and long-term treatment groups. Although a nonsignificant finding does not prove the null hypothesis, in no instance does the confidence interval on the effect size on the difference between the groups approach a moderate .5 level. However, post hoc analyses suggest that subjects with severe eating-related obsessive-compulsive features or who come from nonintact families respond better to long-term treatment.A short-term course of family therapy appears to be as effective as a long-term course for adolescents with short-duration anorexia nervosa. However, there is a suggestion that those with more severe eating-related obsessive-compulsive thinking and nonintact families benefit from longer treatment.

  View details for DOI 10.1097/01.chi.0000161647.82775.0a

  View details for Web of Science ID 000230035300010

  View details for PubMedID 15968231

• Predictors of treatment acceptance and completion in anorexia nervosa - Implications for future study designs ARCHIVES OF GENERAL PSYCHIATRY Halmi, K. A., Agras, W. S., Crow, S., Mitchell, J., Wilson, G. T., Bryson, S. W., Kraemer, H. C. 2005; 62 (7): 776-781

  Abstract

  There have been very few randomized controlled treatment studies of anorexia nervosa.To evaluate factors leading to nonacceptance and noncompletion of treatment for 2 specific therapies and their combination in the treatment of anorexia nervosa.Randomized prospective study.Weill-Cornell Medical Center, White Plains, NY; University of Minnesota, Minneapolis; and Stanford University, Stanford, Calif. Patients One hundred twenty-two patients meeting DSM-IV criteria for anorexia nervosa.Treatment with cognitive-behavioral therapy, fluoxetine hydrochloride, or their combination for 1 year.Dropout rate and acceptance of treatment (defined as staying in treatment at least 5 weeks).Of the 122 randomized cases, 21 (17%) were withdrawn; the overall dropout rate was 46% (56/122) in the remaining patients. Treatment acceptance occurred in 89 (73%) of the 122 randomized cases. Of the 41 assigned to medication alone, acceptance occurred in 23 (56%). In the other 2 groups, acceptance rate was differentiated by high and low obsessive preoccupation scores (rates of 91% and 60%, respectively). The only predictor of treatment completion was high self-esteem, which was associated with a 51% rate of treatment acceptance.Acceptance of treatment and relatively high dropout rates pose a major problem for research in the treatment of anorexia nervosa. Differing characteristics predict dropout rates and acceptance, which need to be carefully studied before comparative treatment trials are conducted.

  View details for Web of Science ID 000230352100012

  View details for PubMedID 15997019

• The relationship between parental factors at infancy and parent-reported control over children's eating at age 7 APPETITE Duke, R. E., Bryson, S., Hammer, L. D., Agras, W. S. 2004; 43 (3): 247-252

  Abstract

  The objective of this study was to determine predictors of parental control over children's eating. Data were obtained from 135 children and their parents from the Stanford Infant Growth Study. Assessments were obtained from parents at their child's birth and age 7. Parental body dissatisfaction at their child's birth predicted pressure to eat for both sons and daughters. In addition, minority status, parent being born outside of the United States, and a mother's early return to work predicted parental pressure to eat for sons. For daughters, an early maternal pushy feeding style also predicted parental pressure to eat. Parental hunger, a parental history of eating disorders and parent being born outside of the United States predicted food restriction for daughters. There were no predictors of food restriction for sons. We concluded that parental control appears not always to be simply a reaction to a child's lack of self-control or overweight, but may be present before such issues arise, particularly with the presence of certain cultural factors.

  View details for DOI 10.1016/j.appet.2004.05.006

  View details for Web of Science ID 000225236800003

  View details for PubMedID 15527926

• Prediction of outcome in bulimia nervosa by early change in treatment AMERICAN JOURNAL OF PSYCHIATRY Fairburn, C. G., Agras, W. S., Walsh, B. T., Wilson, G. T., Stice, E. 2004; 161 (12): 2322-2324

  Abstract

  The authors' goal was to identify predictors of treatment response in bulimia nervosa and, in particular, to attempt to replicate and extend the observation that early change predicts outcome.Predictors of response at the end of treatment and 8-month follow-up were sought from a group of 220 women treated with either cognitive behavior therapy or interpersonal psychotherapy.Early change in frequency of purging was the best predictor of response at the end of treatment and at 8-month follow-up.Early change in treatment is a robust and potent predictor of immediate and longer-term outcome in bulimia nervosa.

  View details for Web of Science ID 000225503500030

  View details for PubMedID 15569910

• An examination of the mechanisms of action in cognitive Behavioral therapy for bulimia nervosa BEHAVIOR THERAPY Spangler, D. L., Baldwin, S. A., Agras, W. S. 2004; 35 (3): 537-560

  View details for Web of Science ID 000223449300005

• Report of the National Institutes of Health Workshop on Overcoming Barriers to Treatment Research in Anorexia Nervosa INTERNATIONAL JOURNAL OF EATING DISORDERS Agras, W. S., Brandt, H. A., Bulik, C. M., Dolan-Sewell, R., Fairburn, C. G., HALMI, K. A., Herzog, D. B., Jimerson, D. C., Kaplan, A. S., Kaye, W. H., le Grange, D., Lock, J., Mitchell, J. E., Rudorfer, M. V., Street, L. L., Striegel-Moore, R., Vitousek, K. M., Walsh, B. T., Wilfley, D. E. 2004; 35 (4): 509-521

  Abstract

  Anorexia nervosa (AN) is associated with serious medical morbidity and has the highest mortality rate of all psychiatric disorders. The National Institutes of Health (NIH) Workshop on Overcoming Barriers to Treatment Research in Anorexia Nervosa convened on September 26-27, 2002 to address the dearth of treatment research in this area. The goals of this workshop were to discuss the stages of illness and illness severity, pharmacologic interventions, psychological interventions, and methodologic considerations.The program consisted of a series of brief presentations by moderators, each followed by a discussion of the topic by workshop participants, facilitated by the session chair.This report summarizes the major discussions of these sessions and concludes with a set of recommendations related to the development of treatment research in AN based on these findings.It is crucial that treatment research in this area be prioritized.

  View details for DOI 10.1002/eat.10261

  View details for Web of Science ID 000221120900237

  View details for PubMedID 15101067

• A trial of a relapse prevention strategy in women with bulimia nervosa who respond to cognitive-behavior therapy INTERNATIONAL JOURNAL OF EATING DISORDERS Mitchell, J. E., Agras, W. S., Wilson, G. T., Halmi, K., Kraemer, H., Crow, S. 2004; 35 (4): 549-555

  Abstract

  This study examines a relapse prevention strategy for bulimia nervosa (BN). Subjects in a multicenter BN treatment trial who initially achieved abstinence after a course of cognitive-behavioral therapy (CBT) were told to recontact the clinic if they had a recurrence of symptoms or feared such a reoccurrence so that they could receive additional therapy visits.At the end of CBT, subjects whose scores on the Eating Disorders Examination indicated that they were abstinent from binge eating and purging, and therefore considered to be treated successfully, were assigned randomly to follow-up only or to a crisis intervention model. With the crisis intervention model, subjects would receive additional visits if needed.None of the 30 subjects who relapsed during the follow-up sought additional treatment visits.Simply telling patients with BN who appear to have been successfully treated to come back if they have additional problems, or fear that they are developing such problems, may be an ineffective relapse prevention technique. Alternative strategies, such as planned return visits or phone calls, should be considered as alternative relapse prevention strategies.

  View details for DOI 10.1002/eat.10265

  View details for Web of Science ID 000221120900240

  View details for PubMedID 15101070

• Coming to terms with risk factors for eating disorders: Application of risk terminology and suggestions for a general taxonomy PSYCHOLOGICAL BULLETIN Jacobi, C., Hayward, C., de Zwaan, M., Kraemer, H. C., Agras, W. S. 2004; 130 (1): 19-65

  Abstract

  The aims of the present review are to apply a recent risk factor approach (H. C. Kraemer et al., 1997) to putative risk factors for eating disorders, to order these along a timeline, and to deduce general taxonomic questions. Putative risk factors were classified according to risk factor type, outcome (anorexia nervosa, bulimia nervosa, binge-eating disorder, full vs. partial syndromes), and additional factor characteristics (specificity, potency, need for replication). Few of the putative risk factors were reported to precede the onset of the disorder. Many factors were general risk factors; only few differentiated between the 3 eating disorder syndromes. Common risk factors from longitudinal and cross-sectional studies were gender, ethnicity, early childhood eating and gastrointestinal problems, elevated weight and shape concerns, negative self-evaluation, sexual abuse and other adverse experiences, and general psychiatric morbidity. Suggestions are made for the conceptualization of future risk factor studies.

  View details for DOI 10.1037/0033-2909.130.1.19

  View details for Web of Science ID 000187852600002

  View details for PubMedID 14717649

• Participant recruitment for an anorexia nervosa treatment study INTERNATIONAL JOURNAL OF EATING DISORDERS McDermott, C., Agras, W. S., Crow, S. J., Halmi, K., Mitchell, J. E., Bryson, S. 2004; 35 (1): 33-41

  Abstract

  To investigate the nature of differing recruitment rates for clinical treatment trials for anorexia nervosa and bulimia nervosa.Recruitment rates from a study recruiting women partially recovered from anorexia nervosa were compared with the rates from two studies conducted at the same sites recruiting women with bulimia nervosa.At all sites in the anorexia study, the total number of contacts per month rose steadily over the first 2 years of the recruitment phase then decreased to near zero with the number of participants randomized to the study practically evaporating. In contrast, the bulimia studies screened a larger group of contacts and met monthly randomization goals in the time allotted for recruitment. Participants eligible for a study but with a barrier to participation occurred at a much higher rate in the anorexia study than in the bulimia studies.These results reveal a difficulty in planning recruitment from a small population such as partially recovered anorexics. A small population's total pool size diminishes faster than it is replenished, suggesting that future studies of anorexia nervosa may recruit more successfully from many sites in a short period rather than at a few sites over a long period.

  View details for DOI 10.1002/eat.10231

  View details for Web of Science ID 000187798700005

  View details for PubMedID 14705155

• Behavioral validation, precursors, and concomitants of picky eating in childhood JOURNAL OF THE AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY Jacobi, C., Agras, W. S., Bryson, S., Hammer, L. D. 2003; 42 (1): 76-84

  Abstract

  To validate the concept of parent-reported picky eating using objective, laboratory-based measures and to identify both child and parental precursors and concomitants of picky eating.One hundred thirty-five infants were monitored from birth to 5.5 years. Behavioral measures of picky eating were obtained from standardized feedings at ages 3.5 and 5.5 years in the laboratory and at home. Child precursors were measures of infant sucking behavior; parental precursors were disinhibition of eating, restrained eating, body dissatisfaction, and body mass index. Parentally reported attitudes and behaviors thought to be related to pickiness and parental concomitants were taken from the Stanford Feeding Questionnaire. Child Temperament was assessed by the Children's Behavior Questionnaire.Picky eaters ate fewer foods and were especially more likely to avoid vegetables. Picky girls decreased their caloric intake between ages 3.5 and 5.5, whereas all other children increased their caloric intake. None of the included parental precursors was significantly related to pickiness. Picky eaters demonstrated a different sucking pattern with fewer sucks per feeding session at weeks 2 and 4. Finally, picky children displayed more parent-reported negative affect than nonpicky children.Parentally reported picky eating is associated with a consistent pattern of inhibited and selective eating beginning in infancy.

  View details for DOI 10.1097/01.CHI.0000024900.60748.2F

  View details for Web of Science ID 000180030000013

  View details for PubMedID 12500079

• The clinical significance of binge eating disorder INTERNATIONAL JOURNAL OF EATING DISORDERS Wilfley, D. E., Wilson, G. T., Agras, W. S. 2003; 34: S96-S106

  Abstract

  Current controversy exists regarding the status of binge eating disorder (BED) as a diagnostic entity. A critique of the literature is provided to address the question of whether BED represents a clinically significant syndrome.The scientific evidence is considered through addressing five questions that are key in evaluating the clinical utility of any mental disorder.Individuals with BED meaningfully differ from individuals without eating disorders, and share important similarities to, yet are distinct from, individuals with anorexia nervosa (AN) and bulimia nervosa (BN). BED is associated with co-occurring physical and mental illnesses, as well as impaired quality of life and social functioning. Questions about the course of the disorder and the optimal treatment regimen for the syndrome need to be explored further.BED's distinctive combination of core eating disorder psychopathology, and other co-occurring physical and psychiatric conditions, impaired psychosocial functioning, and overweight constitute an eating disorder of clinical severity and a significant public health problem.

  View details for DOI 10.1002/eat.10209

  View details for Web of Science ID 000184587900010

  View details for PubMedID 12900990

• Relapse predictors of patients with bulimia nervosa who achieved abstinence through cognitive behavioral therapy ARCHIVES OF GENERAL PSYCHIATRY HALMI, K. A., Agras, W. S., Mitchell, J., Wilson, G. T., Crow, S., Bryson, S. W., Kraemer, H. 2002; 59 (12): 1105-1109

  Abstract

  Little information exists on relapse in patients with bulimia nervosa who responded with complete abstinence from binge eating and purging to cognitive behavioral therapy. Identification of relapse predictors may be useful to design effective early intervention strategies for relapse of susceptible patients with bulimia nervosa.This multisite study examined relapse in 48 patients with bulimia nervosa who had responded to cognitive behavioral therapy with complete abstinence from binge eating and purging. Structured interviews and questionnaires were used to assess patients before and after treatment and at 4 months after treatment.Four months after treatment, 44% of the patients had relapsed. Those who relapsed had a higher level of preoccupation and ritualization of eating and less motivation for change, and had maintained abstinence for a shorter time during the treatment period.The predictors of relapse found in this study can be readily determined by clinicians. The effectiveness of early additional treatment interventions needs to be determined with well-designed studies of large samples.

  View details for Web of Science ID 000179710600004

  View details for PubMedID 12470126

• Full syndromal versus subthreshold anorexia nervosa, bulimia nervosa, and binge eating disorder: A multicenter study INTERNATIONAL JOURNAL OF EATING DISORDERS Crow, S. J., Agras, W. S., Halmi, K., Mitchell, J. E., Kraemer, H. C. 2002; 32 (3): 309-318

  Abstract

  The diagnostic criteria for anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED) establish symptom severity levels, which are used to separate full cases from partial cases. However, the value of these distinctions is unclear.Three hundred eighty-five women with full or partial AN, BN, or BED were assessed at entry into a longitudinal study of eating disorders.Stepwise discriminant analysis revealed that full and partial BN were discriminated by the Yale-Brown-Cornell Eating Disorders Scale total scores (kappa =.46). However, it was not possible to discriminate between full and partial AN or BED. Discriminant analysis also demonstrated clear differences between full AN, BN, and BED.Full BN can be differentiated from partial BN by more severe eating disorder symptoms, whereas both full and partial AN and full and partial BED appear quite similar. These results emphasize the distinct nature of AN, BN, and BED, as well as the similarities between full and partial cases.

  View details for DOI 10.1002/eat.10088

  View details for Web of Science ID 000177666100006

  View details for PubMedID 12210645

• A randomized secondary treatment study of women with bulimia nervosa who fail to respond to CBT INTERNATIONAL JOURNAL OF EATING DISORDERS Mitchell, J. E., Halmi, K., Wilson, G. T., Agras, W. S., Kraemer, H., Crow, S. 2002; 32 (3): 271-281

  Abstract

  Since the description of bulimia nervosa as a distinct diagnostic entity in 1979, several psychological and pharmacological interventions have been developed and empirically tested. The existence of several effective treatments, none of which is completely effective, is common to most psychiatric conditions. The research question that flows from such findings is whether second-level treatments would be effective for those who fail initial treatment.In the case of bulimia nervosa, the research findings suggest that cognitive behavioral therapy (CBT) is the first level of treatment and that both antidepressant medication and interpersonal psychotherapy (IPT) may potentially be effective second-level treatments. This was a multicenter study in which 194 patients were initially treated with CBT. Those treated unsuccessfully (n = 62) were then randomized to treatment with IPT or medication management.Of those assigned to secondary treatment, 37 completed such treatment and 25 dropped out or were withdrawn. The abstinence rate for subjects assigned to treatment with IPT was 16% and for those assigned to medication management was 10%. No significant differences were found between medication and IPT in either the intent-to-treat or completer analysis.Dropout rates were high, and response rates were low among BN patients assigned to secondary treatments who failed to achieve remission with CBT. Offering lengthy sequential treatments appears to have little value, and alternative models for therapy need to be tested.

  View details for DOI 10.1002/eat.10092

  View details for Web of Science ID 000177666100002

  View details for PubMedID 12210641

• Predictors of relapse following successful dialectical behavior therapy for binge eating disorder INTERNATIONAL JOURNAL OF EATING DISORDERS Safer, D. L., Lively, T. J., Telch, C. F., Agras, W. S. 2002; 32 (2): 155-163

  Abstract

  To identify predictors of relapse at 6-month follow-up for women with binge eating disorder (BED).Participants were 32 women with BED who had initially achieved abstinence from binge eating after 20 weeks of dialectical behavior therapy (DBT) adapted for patients with BED. Posttreatment predictor variables included the subscales Restraint, Weight Concerns, and Shape Concerns from the Eating Disorders Examination (EDE), the Emotional Eating Scale score, the Rosenberg Self-Esteem Scale, body mass index, and early versus late age of binge eating onset.The largest effect sizes for predicting relapse were found with early onset of binge eating and higher EDE Restraint scores.Previous findings that earlier age of onset (age 16 years or younger) is linked to less successful treatment outcome are now extended to the 6-month follow-up assessment. The finding that higher restraint scores after treatment predict relapse adds to the literature concerning the role of restraint in patients with BED.

  View details for DOI 10.1002/eat.10080

  View details for Web of Science ID 000177207600004

  View details for PubMedID 12210657

• Cognitive-behavioral therapy for bulimia nervosa: Time course and mechanisms of change JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY Wilson, G. T., Fairburn, C. C., Agras, W. S., Walsh, B. T., Kraemer, H. 2002; 70 (2): 267-274

  Abstract

  Cognitive-behavioral therapy (CBT) is an effective treatment of bulimia nervosa, but its mechanisms of action have not been established. In this study the authors analyzed the results of a randomized control trial comparing CBT with Interpersonal Psychotherapy (IPT) to identify possible mediators of change of CBT for BN and its time course of action. Reduction in dietary restraint as early as Week 4 mediated posttreatment improvement in both binge eating and vomiting. Measures of self-efficacy concerning eating behavior, negative affect, and body shape and weight at midtreatment were also significantly associated with posttreatment outcome at 20 weeks. No evidence was found that the therapeutic alliance mediated treatment outcome. CBT had a significantly more rapid treatment effect than IPT, with 62% of posttreatment improvement evident by Week 6.

  View details for DOI 10.1037//0022-006X.70.2.267

  View details for Web of Science ID 000174805100001

  View details for PubMedID 11952185

• Dialectical behavior therapy for binge eating disorder JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY Telch, C. F., Agras, W. S., Linehan, M. M. 2001; 69 (6): 1061-1065

  Abstract

  This study evaluated the use of dialectical behavior therapy (DBT) adapted for binge eating disorder (BED). Women with BED (N = 44) were randomly assigned to group DBT or to a wait-list control condition and were administered the Eating Disorder Examination in addition to measures of weight, mood, and affect regulation at baseline and posttreatment. Treated women evidenced significant improvement on measures of binge eating and eating pathology compared with controls, and 89% of the women receiving DBT had stopped binge eating by the end of treatment. Abstinence rates were reduced to 56% at the 6-month follow-up. Overall, the findings on the measures of weight, mood, and affect regulation were not significant. These results support further research into DBT as a treatment for BED.

  View details for DOI 10.1037//0022-006X.69.6.1061

  View details for Web of Science ID 000172841500020

  View details for PubMedID 11777110

• Early body mass index and other anthropometric relationships between parents and children INTERNATIONAL JOURNAL OF OBESITY Safer, D. L., Agras, W. S., Bryson, S., Hammer, L. D. 2001; 25 (10): 1532-1536

  Abstract

  To assess longitudinally the relationship between measures of adiposity in children over the first 8 y of life with that of their parents and to explore the role of parental adiposity in the development of childhood adiposity.Longitudinal study of measures of adiposity in children.A community sample from three health service systems including 114 children followed annually from infancy to age 8 and their 228 biological parents.Measurements were assessed at baseline for parents (6 months post-partum for mothers) and at regular intervals for children beginning at age 2 months. Measurements included weight, height, triceps skinfold, subscapular skinfold, midarm circumference, waist and hip.The major findings were: (1) significant correlations between parental body mass index (BMI), both maternal and paternal, and their biological offspring first emerged at age 7; (2) children with two overweight parents had consistently elevated BMI compared to children with either no overweight parents or one overweight parent. These differences became significant beginning at age 7.This study supports the hypothesis that familial factors (biological and/or environmental) affecting the development of adiposity emerge at specific ages and are related to the adiposity of both parents.

  View details for Web of Science ID 000171515800021

  View details for PubMedID 11673777

• Exposure to media-portrayed thin-ideal images adversely affects vulnerable girls: A longitudinal experiment JOURNAL OF SOCIAL AND CLINICAL PSYCHOLOGY Stice, E., Spangler, D., Agras, W. S. 2001; 20 (3): 270-288

  View details for Web of Science ID 000171672500003

• Subtyping binge eating-disordered women along dieting and negative affect dimensions INTERNATIONAL JOURNAL OF EATING DISORDERS Stice, E., Agras, W. S., Telch, C. F., HALMI, K. A., Mitchell, J. E., Wilson, T. 2001; 30 (1): 11-27

  Abstract

  Because etiologic and maintenance models of binge eating center around dieting and affect regulation, this study tested whether binge eating-disordered (BED) individuals could be subtyped along dieting and negative affect dimensions and whether subtypes differed in eating pathology, social functioning, psychiatric comorbidity, and response to treatment.Three independent samples of interviewer-diagnosed BED women (N = 218) were subtyped along dieting and negative affect dimensions using cluster analysis and compared on the outcomes of interest.Cluster analyses replicated across the three independent samples and revealed a dietary subtype (63%) and a dietary-depressive subtype (37%). The latter subtype reported greater eating and weight obsessions, social maladjustment, higher lifetime rates of mood, anxiety, and personality disorders, and poorer response to treatment than did the dietary subtype.Results suggest that moderate dieting is a central feature of BED and that affective disturbances occur in only a subset of cases. However, the confluence of dieting and negative affect signals a more severe variant of the disorder marked by elevated psychopathology, impaired social functioning, and a poorer treatment response.

  View details for Web of Science ID 000169077300002

  View details for PubMedID 11439405

• Private high school students are at risk for bulimic pathology. Eating disorders Lesar, M. D., Arnow, B., Stice, E., Agras, W. S. 2001; 9 (2): 125-139

  Abstract

  The objective of this study was to assess whether private high school students constitute a group that is at high risk for eating pathology. Female and male public and private high school students (N = 465) were compared on self-reported eating disordered attitudes and behaviors. Private high school students reported elevated eating disordered attitudes and behaviors when compared with students from public schools. The results were somewhat stronger for females than males. The findings suggest that private high school students are a group at high risk for eating pathology. The identification of such high risk groups may facilitate etiologic studies and aid in the implementation of targeted prevention programs.

  View details for PubMedID 16864381

• Practice guidelines for eating disorders BEHAVIOR THERAPY Wilson, G. T., Agras, W. S. 2001; 32 (2): 219-234

  View details for Web of Science ID 000171068300003

• Predicting children's reported eating disturbances at 8 years of age JOURNAL OF THE AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY Jacobi, C., Agras, W. S., Hammer, L. 2001; 40 (3): 364-372

  Abstract

  To examine differential parental influences on eating attitudes and behaviors of 8-year-old children with a specific focus on gender effects and to assess the specificity of this relationship.One hundred eight infants were monitored from birth and interviewed at age 8 for eating disturbances and negative affect with an adaptation of the McKnight Risk Factor Survey. Parental measures included the Three Factor Eating Questionnaire subscales Disinhibition and Restraint as well as body mass index, assessed at study entry.No gender differences were found for frequencies of children's self-reported eating disturbances. Higher maternal restraint scores predicted worries about being too fat in girls but not in boys. Higher maternal disinhibition scores also differentially predicted weight control behaviors in their daughters. Negative affect in the child was (weakly) predicted by higher maternal body mass index. No association between paternal predictors of disturbed eating and the child's eating disturbances and negative emotionality was found.The impact of maternal eating disorders and disturbances is much stronger than that of fathers and is specifically directed at their daughters. The clinical importance of these disturbances in terms of precursors of adolescent eating disorders has to be determined by monitoring the sample through puberty.

  View details for Web of Science ID 000167200000017

  View details for PubMedID 11288779

• Perfectionism in women with binge eating disorder 33rd Annual Meeting of the Association-for-Advancement-of-Behavior-Therapy Pratt, E. M., Telch, C. F., Labouvie, E. W., Wilson, G. T., Agras, W. S. JOHN WILEY & SONS INC. 2001: 177–86

  Abstract

  This study examined self-oriented (SOP), socially prescribed (SPP), and other-oriented (OOP) perfectionism in 127 obese women with binge eating disorder (BED).Relationships between eating disorder and general psychopathology variables and SOP, SPP, and OOP were assessed. Levels of SOP, SPP, and OOP in the BED sample were compared with those of 32 normal weight women with bulimia nervosa (BN) and 60 obese non-eating-disordered individuals (NED). Structural equation modeling (SEM) was used to test models of the maintenance of BED.Only SPP was significantly associated with eating disorder variables related to BED. All three groups demonstrated similar levels of SPP and OOP. BN and BED groups scored significantly higher than the NED group on SOP only. SEM resulted in two models with good fits.Further research is needed on the roles of SPP and SOP in BED and on weight and shape overconcern in BED maintenance models.

  View details for Web of Science ID 000166971300008

  View details for PubMedID 11429980

• The development of behavioral medicine Conference on History of the Behavioral Therapies Agras, W. S. CONTEXT PRESS. 2001: 219–232

  View details for Web of Science ID 000185028500013

• Test-retest reliability of the eating disorder examination INTERNATIONAL JOURNAL OF EATING DISORDERS Rizvi, S. L., Peterson, C. B., Crow, S. J., Agras, W. S. 2000; 28 (3): 311-316

  Abstract

  The purpose of this investigation was to determine the test-retest reliability of the Eating Disorder Examination (EDE).This study examined the test-retest and interrater reliability of the EDE in 20 adult women with a range of eating disorder symptoms. Trained assessors administered the EDE to participants on two separate occasions, ranging from 2 to 7 days apart.Test-retest correlations were.7 or greater for all subscales and measures of eating disorder behaviors except for subjective bulimic episodes and subjective bulimic days. Interrater reliability was uniformly high with correlations above.9.Results provide further support for the reliability of the EDE, but suggest that smaller binge episodes may not be reliable indicators of eating pathology.

  View details for Web of Science ID 000088936300008

  View details for PubMedID 10942917

• Outcome predictors for the cognitive behavior treatment of bulimia nervosa: Data from a multisite study AMERICAN JOURNAL OF PSYCHIATRY Agras, W. S., Crow, S. J., HALMI, K. A., Mitchell, J. E., Wilson, G. T., Kraemer, H. C. 2000; 157 (8): 1302-1308

  Abstract

  The aim of this study was to discover clinically useful predictors of attrition and outcome in the treatment of bulimia nervosa with cognitive behavior therapy.Pretreatment, course of treatment, and outcome data were gathered on 194 women meeting the DSM-III-R criteria for bulimia nervosa who were treated with 18 sessions of manual-based cognitive behavior therapy in a three-site study. Differences between dropouts and nondropouts and between recovered and nonrecovered participants were first examined descriptively, and signal detection analyses were then used to determine clinically significant cutoff points predicting attrition and abstinence.The dropouts were characterized by more severe bulimic cognitions and greater impulsivity, but it was not possible to identify clinically useful predictors. The participants with treatment failures were characterized by poor social adjustment and a lower body mass index, presumably indicating greater dietary restriction. However, early progress in therapy best predicted outcome. Signal detection analyses revealed that poor outcome was predicted by a reduction in purging of less than 70% by treatment session 6, allowing identification of a substantial proportion of prospective failures.A cutoff point based on reduction of purging by session 6 usefully differentiates patients who will and will not respond to cognitive behavior therapy for bulimia nervosa, potentially allowing early use of a second therapy.

  View details for Web of Science ID 000088520100020

  View details for PubMedID 10910795

• Fluoxetine for bulimia nervosa following poor response to psychotherapy 152nd Annual Meeting of the American-Psychiatric-Association Walsh, B. T., Agras, W. S., Devlin, M. J., Fairburn, C. G., Wilson, G. T., Kahn, C., Chally, M. K. AMER PSYCHIATRIC PUBLISHING, INC. 2000: 1332–34

  Abstract

  This was an investigation of whether treatment with fluoxetine is useful for individuals with bulimia nervosa who do not respond to psychotherapy or relapse afterward.Twenty-two patients with bulimia nervosa who had not responded to, or had relapsed following, a course of cognitive behavior therapy or interpersonal psychotherapy were randomly assigned to receive placebo (N=9) or fluoxetine (60 mg/day, N=13) for 8 weeks.The median frequency of binge eating in the previous 28 days declined from 22 to four episodes in the fluoxetine group but increased from 15 to 18 episodes in the placebo group. Similarly, purging frequency in the previous 28 days declined from 30 to six episodes in the fluoxetine group but increased from 15 to 38 episodes in the placebo group.Fluoxetine may be a useful intervention for patients with bulimia nervosa who have not responded adequately to psychological treatment.

  View details for Web of Science ID 000088520100026

  View details for PubMedID 10910801

• Group Dialectical Behavior Therapy for binge-eating disorder: A preliminary, uncontrolled trial BEHAVIOR THERAPY Telch, C. F., Agras, W. S., Linehan, M. M. 2000; 31 (3): 569-582

  View details for Web of Science ID 000166496200010

• A multicenter comparison of cognitive-behavioral therapy and interpersonal psychotherapy for bulimia nervosa ARCHIVES OF GENERAL PSYCHIATRY Agras, W. S., Walsh, B. T., Fairburn, C. G., Wilson, G. T., Kraemer, H. C. 2000; 57 (5): 459-466

  Abstract

  Research suggests that cognitive-behavioral therapy (CBT) is the most effective psychotherapeutic treatment for bulimia nervosa. One exception was a study that suggested that interpersonal psychotherapy (IPT) might be as effective as CBT, although slower to achieve its effects. The present study is designed to repeat this important comparison.Two hundred twenty patients meeting DSM-III-R criteria for bulimia nervosa were allocated at random to 19 sessions of either CBT or IPT conducted over a 20-week period and evaluated for 1 year after treatment in a multisite study.Cognitive-behavioral therapy was significantly superior to IPT at the end of treatment in the percentage of participants recovered (29% [n=32] vs 6% [n=71), the percentage remitted (48% [n=53] vs 28% [n = 31]), and the percentage meeting community norms for eating attitudes and behaviors (41% [n=45] vs 27% [n=30]). For treatment completers, the percentage recovered was 45% (n= 29) for CBT and 8% (n= 5) for IPT. However, at follow-up, there were no significant differences between the 2 treatments: 26 (40%) CBT completers had recovered at follow-up compared with 17 (27%) IPT completers.Cognitive-behavioral therapy was significantly more rapid in engendering improvement in patients with bulimia nervosa than IPT. This suggests that CBT should be considered the preferred psychotherapeutic treatment for bulimia nervosa.

  View details for Web of Science ID 000086927500005

  View details for PubMedID 10807486

• Dissonance prevention program decreases thin-ideal internalization, body dissatisfaction, dieting, negative affect, and bulimic symptoms: A preliminary experiment INTERNATIONAL JOURNAL OF EATING DISORDERS Stice, E., Mazotti, L., Weibel, D., Agras, W. S. 2000; 27 (2): 206-217

  Abstract

  Because psychoeducational primary prevention programs for eating disorders have met with little success, this preliminary experiment tested a dissonance-based targeted preventive intervention.Female undergraduates (N = 30) with elevated body image concerns were assigned to a three-session intervention, wherein they voluntarily argued against the thin ideal, or a delayed-intervention control condition. Participants completed a baseline, termination, and a 1-month follow-up survey.The intervention resulted in a subsequent decrease in thin-ideal internalization, body dissatisfaction, dieting, negative affect, and bulimic symptomatology, with most changes remaining at the 1-month follow-up.These preliminary results suggest that this dissonance-based targeted prevention intervention reduces bulimic pathology and known risk factors for eating disturbances, and provide experimental support for the claim that thin-ideal internalization contributes to body dissatisfaction, dieting, negative affect, and bulimic symptoms.

  View details for Web of Science ID 000085402800009

  View details for PubMedID 10657894

• Subtyping bulimic women along dietary restraint and negative affect dimensions 32nd Annual Meeting of the Association-for-Advancement-of-Behavior-Therapy Stice, E., Agras, W. S. AMER PSYCHOLOGICAL ASSOC. 1999: 460–69

  Abstract

  Etiologic models of bulimia center on dieting and negative affect, yet no research has subtyped bulimic individuals according to whether they fit dietary versus negative affect profiles. This study subtyped 265 bulimic women along dieting and depressive dimensions and tested whether subtypes showed differences in eating pathology, clinical correlates, and treatment response. Cluster analysis revealed a pure dietary subtype (62%) and a mixed dietary-depressive subtype (38%). Whereas dietary and dietary-depressive bulimic women showed similar levels of bulimic behaviors, the latter reported more eating and weight obsessions; social maladjustment; higher rates of mood, anxiety, eating, impulse control, and personality disorders; and poorer treatment response. Results suggest dieting is a central feature of bulimia, but depressive affect occurs in only a subset of cases. However, the combination of dieting and depressive affect seems to signal a more severe variant of bulimia.

  View details for Web of Science ID 000081881900002

  View details for PubMedID 10450616

• Can mothers influence their child's eating behavior? JOURNAL OF DEVELOPMENTAL AND BEHAVIORAL PEDIATRICS Drucker, R. R., Hammer, L. D., Agras, W. S., Bryson, S. 1999; 20 (2): 88-92

  Abstract

  This study examined the relationship between general maternal parenting style, maternal eating cues, and a child's eating behavior during mealtime. We expected that the general style would relate to the number of specific eating cues and that mothers who used more eating prompts would have children that ate more and at a faster rate. Seventy-seven children (39 girls, 38 boys), aged 3.5 years, visited the laboratory with their mothers for a videotaped lunch. Videotapes of each laboratory visit were coded for the child's eating rate and maternal parenting style, which was measured as the level of maternal control and support and the number and type of eating prompts given during a meal. Caloric intake was also calculated. The number and rate of verbal and physical encouragements and discouragements were significantly related to measures of general maternal parenting style and meal duration. The rates of food offers, food presentations, and total prompts were all significantly related to the child's rate of calorie intake. However, a mother's level of support or control was not related to the child's eating behavior. Although general maternal parenting style did not predict the child's eating behavior, these behaviors were related to the frequency of maternal eating prompts, which in turn were significantly related to the number of calories eaten and the time spent eating by the child. Children who ate the fastest had mothers who delivered eating prompts at a higher frequency. These findings may have implications for the development of obesity later in childhood, as a function of rapid eating or of poor self-regulation.

  View details for Web of Science ID 000079667500003

  View details for PubMedID 10219686

• Development of feeding practices during the first 5 years of life ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE Hammer, L. D., Bryson, S., Agras, W. S. 1999; 153 (2): 189-194

  Abstract

  To understand the transition from breast-and bottle-feeding to solid-feeding and factors that might affect the duration of breast- and bottle-feeding.Cohort followed up from birth with relatively well-educated, middle-class parents.Community sample recruited from 3 suburban newborn nurseries (a teaching hospital, community hospital, and large health maintenance organization).One hundred ninety-one healthy full-term infants.Assessment of feeding practices through the ages of complete weaning from breast- and bottle-feeding.More than 90% of participants breast-fed for at least 2 weeks. Infants of older mothers were weaned from the breast later than infants of younger mothers. First-born infants were weaned from the breast earlier than later-born infants. Eighty-four percent of infants bottle-fed at some time during the first year of life. More than 40% of the cohort was still receiving bottles at 24 months of age, 16% at 36 months, and 8% at 48 months. The duration of breast- and bottle-feeding was related to maternal work status; mothers who returned to work during the first 3 months postpartum weaned sooner from the breast and later from the bottle than women who returned to work after 3 months postpartum.The frequency of late bottle-weaning in this well-educated, middle-class cohort was unexpected and was related to the timing of the mother's return to work. The impact of prolonged bottle-feeding on later growth and adiposity deserves further investigation.

  View details for Web of Science ID 000078473900012

  View details for PubMedID 9988250

• Cognitive-behavioral therapy for the eating disorders 86th Annual Meeting of the American-Psychopathological-Association Agras, W. S. AMER PSYCHIATRIC PRESS, INC. 1999: 197–210

  View details for Web of Science ID 000084730800008

• Does the size of a binge matter? INTERNATIONAL JOURNAL OF EATING DISORDERS Pratt, E. M., Niego, S. H., Agras, W. S. 1998; 24 (3): 307-312

  Abstract

  The aim of this study was to examine whether objective and subjective binges differ significantly from each other in relation to measures of psychopathology in a sample of women who meet DSM-IV diagnostic criteria for bulimia nervosa.Baseline data from the Eating Disorder Examination (EDE) were analyzed and the average of the sum of and the difference between objective and subjective binge episodes were converted to z scores. Regressions were run with other baseline measures including the Structured Clinical Interview for Diagnosis of DSM-III-R (SCID) I and II disorders, EDE subscales, and psychological measures.We found no significant difference between the two types of binges on all but one measure, the "Can Do" subscale of the Self-Efficacy Questionnaire, in a regression with the z score of total binges.The lack of significant findings questions the diagnostic validity of the "large amount of food" criterion used to define binge eating in the DSM-IV.

  View details for Web of Science ID 000075518600008

  View details for PubMedID 9741041

• The effects of caloric deprivation and negative affect on binge eating in obese binge-eating disordered women BEHAVIOR THERAPY Agras, W. S., Telch, C. F. 1998; 29 (3): 491-503

  View details for Web of Science ID 000075732100009

• The role of emotion in group cognitive-behavioral therapy for binge eating disorder: When things have to feel worse before they get better PSYCHOTHERAPY RESEARCH Castonguay, L. G., Pincus, A. L., Agras, W. S., Hines, C. E. 1998; 8 (2): 225-238

  View details for Web of Science ID 000074076300008

• Predicting onset and cessation of bulimic behaviors during adolescence: A longitudinal grouping analysis BEHAVIOR THERAPY Stice, E., Agras, W. S. 1998; 29 (2): 257-276

  View details for Web of Science ID 000074136300006

• Subjective or objective binge: Is the distinction valid? INTERNATIONAL JOURNAL OF EATING DISORDERS Niego, S. H., Pratt, E. M., Agras, W. S. 1997; 22 (3): 291-298

  Abstract

  The aim of this study was to examine the validity of the distinction between objective and subjective binge episodes.Data were analyzed from 101 women who received 12 weeks of cognitive-behavioral therapy (CBT) for binge eating in a previous treatment study. Binges recorded by participants on daily food records were rated as either subjective or objective according to the Eating Disorder Examination rating guidelines. Unpaired t tests were performed to determine the relationship between type of binge, psychopathology, and other descriptive measures, including response to treatment.These analyses revealed no significant differences between types of binge episodes. Of note is the observation that objective binge episodes appeared to decrease more rapidly than subjective episodes during treatment.Future research should continue to investigate whether "large amount of food" is an appropriate criterion for the diagnosis of binge eating.

  View details for Web of Science ID A1997XT53100008

  View details for PubMedID 9285266

• The effects of extending cognitive-behavioral therapy for binge eating disorder among initial treatment nonresponders INTERNATIONAL JOURNAL OF EATING DISORDERS Eldredge, K. L., Agras, W. S., Arnow, B., Telch, C. F., Bell, S., Castonguay, L., Marnell, M. 1997; 21 (4): 347-352

  Abstract

  The study was designed with the aim of determining whether extending group cognitive-behavioral therapy (CBT) would enhance outcome among individuals with binge eating disorder (BED) who failed to stop binge eating after an initial 12-week CBT intervention.Forty-six participants who met diagnostic criteria for BED were randomly allocated to either a 12-week group CBT intervention or a waiting list control condition. At the end of 12 weeks, treated participants who met clinical criteria for improvement subsequently received 12 sessions of behavioral weight loss. Remaining participants received 12 additional sessions of CBT for binge eating.Fifty percent of treated participants improved with the initial 12-week course of CBT. There was a strong trend for the extension of CBT to affect improvement in binge eating among initial nonresponders (6 of 14 subjects no longer met diagnostic criteria for BED). Overall, extending CBT led to clinical improvement in 66.7% of all treated participants, with treatment gains occurring through session 20.The results suggest that an extended course of CBT (i.e., longer than 12 weeks) will likely maximize the number of potential responders to treatment.

  View details for Web of Science ID A1997WV96800007

  View details for PubMedID 9138046

• One-year follow-up of cognitive-behavioral therapy for obese individuals with binge eating disorder JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY Agras, W. S., Telch, C. F., Arnow, B., Eldredge, K., Marnell, M. 1997; 65 (2): 343-347

  Abstract

  The results of a 1-year posttreatment follow-up of 93 obese women diagnosed as having binge eating disorder (BED) and treated with group cognitive-behavioral therapy (CBT) followed by weight loss treatment are described. The group as a whole maintained both reductions in binge eating and abstinence rates fairly well. However, they regained the weight lost during treatment. Those who stopped binge eating during CBT maintained a weight loss of 4.0 kg over the follow-up period. In contrast, those who continued to binge gained 3.6 kg. Twenty-six percent of those abstinent after CBT met criteria for BED at follow-up and had gained weight, whereas the remaining 74% had lost weight. Stopping binge eating appears critical to sustained weight loss in BED.

  View details for Web of Science ID A1997WP24900019

  View details for PubMedID 9086701

• Pharmacotherapy of bulimia nervosa and binge eating disorder: Longer-term outcomes National-Institutes-of-Health (NIH) Workshop on the Development of Research Priorities in Eating Disorders/7th International Conference on Eating Disorders Agras, W. S. US GOVERNMENT PRINTING OFFICE. 1997: 433–36

  Abstract

  The longer-term effects of antidepressant medication, with and without the addition of psychotherapy, for the treatment of bulimia nervosa and binge eating disorder are reviewed. The use of a single antidepressant agent results in recovery of about 25 percent of patients entering treatment; continued treatment is accompanied by relapse in about one-third of these patients. Substituting one or more antidepressants for the initial agent in patients who fail to improve or cannot tolerate side effects improves long-term maintenance. Adding cognitive-behavioral therapy (CBT) may prevent relapse once medication is discontinued, and the combination of CBT and antidepressant treatment is more effective than a single medication. There is also evidence that antidepressant treatment combined with CBT is more effective than placebo plus CBT. The problem of how to sequence medication and CBT has not been resolved, although a recent study demonstrating that pharmacotherapy is more cost-effective than CBT suggests that treatment might begin with medication.

  View details for Web of Science ID A1997XZ32800016

  View details for PubMedID 9550889

• The aversiveness of specific emotional states associated with binge-eating in obese subjects AUSTRALIAN AND NEW ZEALAND JOURNAL OF PSYCHIATRY Kenardy, J., Arnow, B., Agras, W. S. 1996; 30 (6): 839-844

  Abstract

  The aim of this study was to examine the hypothesis that non-purge-related binge-eating in obesity is maintained by a 'trade-off' in which a highly aversive emotional state is exchanged for a less aversive state.Ninety-eight obese binge-eaters meeting the DSM-IV criteria for binge-eating disorder were contrasted with 65 non-binge-eating controls on their perceived distress associated with negative mood states usually experienced before and after binges.Binge-eaters reported significantly greater distress and lower tolerance of negative mood compared to controls. Furthermore, when compared with controls, binge-eaters reported that emotions typically reported before binges (e.g. anger) were more aversive than those reported after (e.g. guilt).These results were interpreted as supporting the 'trade-off' theory and have implications for the treatment of binge-eating disorder.

  View details for Web of Science ID A1996WC06500020

  View details for PubMedID 9034475

• Do emotional states influence binge eating in the obese? INTERNATIONAL JOURNAL OF EATING DISORDERS Telch, C. F., Agras, W. S. 1996; 20 (3): 271-279

  Abstract

  The purpose of this experimental investigation was to test the hypothesis that negative affective states trigger disinhibited eating in the form of binge eating in subjects with binge eating disorder (BED).BED subjects and weight-matched non-eating disordered subjects (NED) attended a laboratory experiment during which they were randomly assigned to a negative or neutral mood induction procedure prior to being served a multi-item buffet. The dependent variable of interest was postmood induction caloric intake.There were no significant differences in caloric intake between subjects in the negative and neutral mood conditions. However, negative affect was associated with eating episodes labeled binges, and associated with loss of control.Our findings suggest that mood may be an important factor that discriminates overeating and binge eating.

  View details for Web of Science ID A1996VP66500006

  View details for PubMedID 8912039

• The effects of short-term food deprivation on caloric intake in eating-disordered subjects APPETITE Telch, C. F., Agras, W. S. 1996; 26 (3): 221-233

  Abstract

  The primary aim of this experimental investigation was to examine the effects of short-term dietary restriction on caloric consumption in eating disordered subjects. Subjects with bulimia nervosa, binge eating disorder, and overweight non-eating disordered subjects, attended a laboratory experiment during which they were randomly assigned to either a 1 h or a 6 h food deprivation condition prior to being served a multi-item buffet. The primary measure of interest was calories consumed during the laboratory experiment. Subjects deprived of food for 6 h consumed significantly more calories at the buffet compared to subjects in the 1 h food deprivation condition. However, caloric intake during the entire laboratory day was not affected by the experimental manipulation. Subjects in the longer deprivation condition apparently compensated at the buffet for the caloric restriction, but did not overcompensate.

  View details for Web of Science ID A1996UR39100002

  View details for PubMedID 8800479

• Maintenance following a very-low-calorie diet JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY Agras, W. S., Berkowitz, R. I., Arnow, B. A., Telch, C. F., Marnell, M., Henderson, J., Morris, Y., Wilfley, D. E. 1996; 64 (3): 610-613

  Abstract

  The authors posed 2 questions in this randomized study of maintenance procedures in which participants were followed for 15 months after completion of a very-low-calorie diet: Would stimulus narrowing during the reintroduction of solid food, achieved by the use of prepackaged foods, improve weight losses and the maintenance of those losses as compared with the use of regular food? Would reintroduction of foods dependent on progress in losing or maintaining weight be superior to reintroduction on a time-dependent basis? Neither the stimulus narrowing condition nor the reintroduction procedure enhanced either maximum weight loss or maintenance of those losses. The stimulus narrowing condition appeared to be poorly tolerated; compliance and attendance were poorer in this condition than in the regular food condition.

  View details for PubMedID 8698956

• COMPARING THE COST-EFFECTIVENESS OF PSYCHIATRIC TREATMENTS - BULIMIA-NERVOSA PSYCHIATRY RESEARCH Koran, L. M., Agras, W. S., ROSSITER, E. M., Arnow, B., Schneider, J. A., Telch, C. F., Raeburn, S., Bruce, B., Perl, M., Kraemer, H. C. 1995; 58 (1): 13-21

  Abstract

  We conducted an exploratory post hoc study that compared the cost effectiveness of five treatments for bulimia nervosa: 15 weeks of cognitive behavioral therapy (CB) followed by three monthly sessions, 16 weeks (Med16) and 24 weeks (Med24) of desipramine (< or = 300 mg/day), and CB combined with desipramine for those durations (Combo16 and Combo24). We illustrate how a treatment's cost effectiveness varies according to when evaluation is done and how effectiveness and cost are defined. At 32 weeks, Med16 appears the most cost-effective treatment, and Combo16 appears the least. At 1 year, Med24 appears the most cost-effective treatment, and Combo16 appears the least. Using this post hoc analysis as an example, we discuss the pitfalls and limitations of cost-effectiveness analysis of psychiatric treatments.

  View details for Web of Science ID A1995RW58200002

  View details for PubMedID 8539308

• GENERAL POPULATION-BASED EPIDEMIOLOGIC-STUDY OF EATING DISORDERS IN NORWAY Meeting of the European-Council-of-Eating-Disorders Gotestam, K. G., Agras, W. S. JOHN WILEY & SONS INC. 1995: 119–26

  Abstract

  In a questionnaire-based study of eating disorders in a representative sample of the general female population of Norway, the lifetime prevalence of eating disorders was 8.7% with a point prevalence of 3.8%. The lifetime prevalence of binge eating disorder (BED) was 3.2%, bulimia nervosa (BN) 1.6%, and anorexia nervosa (AN) 0.4%. Eating disorders not otherwise specified (EDNOS) had a lifetime prevalence of 3.0%. Point prevalence of BED was 1.5%, BN 0.7%, AN 0.3%, and EDNOS 1.3%.

  View details for Web of Science ID A1995RN63100002

  View details for PubMedID 7581413

• THE EMOTIONAL EATING SCALE - THE DEVELOPMENT OF A MEASURE TO ASSESS COPING WITH NEGATIVE AFFECT BY EATING INTERNATIONAL JOURNAL OF EATING DISORDERS Arnow, B., Kenardy, J., Agras, W. S. 1995; 18 (1): 79-90

  Abstract

  The development of the Emotional Eating Scale (EES) is described. The factor solution replicated the scale's construction, revealing Anger/Frustration, Anxiety, and Depression subscales. All three subscales correlated highly with measures of binge eating, providing evidence of construct validity. None of the EES subscales correlated significantly with general measures of psychopathology. With few exceptions, changes in EES subscales correlated with treatment-related changes in binge eating. In support of the measure's discriminant efficiency, when compared with obese binge eaters, subscale scores of a sample of anxiety-disordered patients were significantly lower. Lack of correlation between a measure of cognitive restraint and EES subscales suggests that emotional eating may precipitate binge episodes among the obese independent of the level of restraint.

  View details for Web of Science ID A1995RE82800008

  View details for PubMedID 7670446

• DOES INTERPERSONAL THERAPY HELP PATIENTS WITH BINGE-EATING DISORDER WHO FAIL TO RESPOND TO COGNITIVE-BEHAVIORAL THERAPY JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY Agras, W. S., Telch, C. F., Arnow, B., Eldredge, K., Detzer, M. J., Henderson, J., Marnell, M. 1995; 63 (3): 356-360

  Abstract

  The aim of this quasi-experimental study was to examine the effectiveness of group interpersonal therapy (IPT) in treating overweight patients with binge eating disorder who did not stop binge eating after 12 weeks of group cognitive-behavioral therapy (CBT). Participants in this study were randomly allocated to either group CBT or to an assessment-only control group. After 12 weeks of treatment with CBT, 55% of participants met criteria for improvement and began 12 weeks of weight loss therapy, whereas the nonresponders began 12 weeks of group IPT. Over the 24-week period, participants who received treatment reduced binge eating and weight significantly more than the waiting-list control group. However, IPT led to no further improvement for those who did not improve with CBT. Predictors of poor outcome were early onset of, and more severe, binge eating.

  View details for PubMedID 7608347

• Binge eating disorder: Current state and future directions CLINICAL PSYCHOLOGY REVIEW Castonguay, L. G., Eldredge, K. L., Agras, W. S. 1995; 15 (8): 865-890

  View details for Web of Science ID A1995TK78800008

• THE LAST-SUPPER - EMOTIONAL DETERMINANTS OF PRETREATMENT WEIGHT FLUCTUATION OBESE BINGE EATERS INTERNATIONAL JOURNAL OF EATING DISORDERS Eldredge, K. L., Agras, W. S., Arnow, B. 1994; 16 (1): 83-88

  Abstract

  The tendency of some dieters to overeat and gain weight prior to beginning a diet is well known. We examined whether emotional variables might account for this phenomenon among a group of 86 obese individuals preparing to begin a treatment program for binge eating and weight loss. Whereas subjects' baseline mood state (anger, anxiety, and depression) did not influence pretreatment weight variability, the self-reported tendency to overeat in response to specific negative emotions had a significant influence. Specifically, subjects who characteristically overeat in response to anger and depression gained weight pretreatment, whereas subjects who overeat in response to anxiety lost weight. The findings are discussed in relation to the influence of specific cognitive and emotional responses to the prospect of dieting.

  View details for Web of Science ID A1994NU24300008

  View details for PubMedID 7920585

• ONE-YEAR FOLLOW-UP OF PSYCHOSOCIAL AND PHARMACOLOGICAL TREATMENTS FOR BULIMIA-NERVOSA JOURNAL OF CLINICAL PSYCHIATRY Agras, W. S., ROSSITER, E. M., ARNOW, Telch, C. F., Raeburn, S. D., Bruce, B., Koran, L. M. 1994; 55 (5): 179-183

  Abstract

  This study examined the outcome 1-year posttreatment of the use of desipramine, cognitive-behavioral therapy (CBT), and their combination in the treatment of bulimia nervosa.Sixty-one patients meeting DSM-III-R criteria for bulimia nervosa were randomly assigned to one of five groups--desipramine (withdrawn at 16 or 24 weeks), CBT (18 sessions), or the combined treatment (18 sessions of CBT plus desipramine withdrawn at 16 or 24 weeks)--and were followed to 1-year posttreatment.At 1-year follow-up, both the combined 24-week treatment and CBT alone were significantly superior in reducing binge eating to desipramine given for 16 weeks. The combined treatment was also superior to 16 weeks of desipramine in reducing emotionally driven eating and dietary restraint. Only 18% (2 of 11) of those receiving 16 weeks of desipramine were free of binge eating and purging at follow-up compared with 78% (7 of 9) of those receiving the combined 24-week treatment. The other groups fell between these two extremes.With the exception of the group treated for 16 weeks with desipramine alone, maintenance of improvement appeared satisfactory with all the treatments. Since the poorest results were found with 16 weeks of desipramine treatment, this study suggests that desipramine should be continued for at least 24 weeks either alone or combined with CBT. The broadest gain in reducing the psychopathology associated with bulimia nervosa was found with the combined 24-week treatment.

  View details for Web of Science ID A1994NQ97600001

  View details for PubMedID 8071266

• PSYCHOSOCIAL TREATMENT OF PHOBIA AND PANIC DISORDERS PSYCHIATRY-INTERPERSONAL AND BIOLOGICAL PROCESSES Zarate, R., Agras, W. S. 1994; 57 (2): 133-141

  Abstract

  Intervention packages combining cognitive restructuring techniques and exposure exercises have become the psychosocial treatments of choice for panic, agoraphobia, and social phobia. Exposure and related desensitization techniques are the treatment of choice for all variants of simple phobia. Combining psychotropic medication and cognitive-behavior therapy suggests strategies that offer new opportunities for increasing the number of individuals with anxiety disorders who can be effectively treated with a biobehavioral approach.

  View details for Web of Science ID A1994NX01700005

  View details for PubMedID 7938332

• WEIGHT-LOSS, COGNITIVE-BEHAVIORAL, AND DESIPRAMINE TREATMENTS IN BINGE-EATING DISORDER - AN ADDITIVE DESIGN BEHAVIOR THERAPY Agras, W. S., Telch, C. F., Arnow, B., Eldredge, K., Wilfley, D. E., Raeburn, S. D., Henderson, J., Marnell, M. 1994; 25 (2): 225-238

  View details for Web of Science ID A1994NQ42700005

• Weight loss, cognitive-behavioral, and desipramine treatments in binge eating disorder. Behavior Therapy Agras WS, Telch CF, Arnow B, Eldredge K, Wilfley DE, Raeburn SD, Henderson J, Marnell M. 1994; 25: 209-238
• OBESITY, BINGE-EATING AND PSYCHOPATHOLOGY - ARE THEY RELATED INTERNATIONAL JOURNAL OF EATING DISORDERS Telch, C. F., Agras, W. S. 1994; 15 (1): 53-61

  Abstract

  Obese female subjects with binge eating disorder BED; (N = 107) completed the Beck Depression Inventory, Symptom Checklist-90, Inventory of Interpersonal Problems, and Rosenberg Self-Esteem Scale. Subjects were divided into moderate or severe binger on the basis of scores on the Binge Eating Scale, and grouped into moderately or severely obese by performing a median split on their weights. Spearman correlational analyses were performed to determine the relationship between psychopathology and obesity and psychopathology and binge eating. Analyses of variance (ANOVAs) were then performed using scores on the psychological measures with subjects grouped both by severity of obesity and severity of binge eating. The results indicated that in our sample, obesity and scores on the measures of psychiatric symptomatology were unrelated. However, a significant positive relationship was found between binge eating severity and degree of psychiatric symptomatology. We suggest that binge eating may account for the observed relationship between obesity and psychopathology reported in previous studies. We discuss the importance of assessing BED when conducting research with obese individuals.

  View details for Web of Science ID A1994MN20100006

  View details for PubMedID 8124327

• GROUP COGNITIVE-BEHAVIORAL THERAPY AND GROUP INTERPERSONAL PSYCHOTHERAPY FOR THE NONPURGING BULIMIC INDIVIDUAL - A CONTROLLED COMPARISON JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY Wilfley, D. E., Agras, W. S., Telch, C. F., ROSSITER, E. M., Schneider, J. A., Cole, A. G., SIFFORD, L., Raeburn, S. D. 1993; 61 (2): 296-305

  Abstract

  This study evaluated the effectiveness of group cognitive-behavioral treatment (CBT) and group interpersonal psychotherapy (IPT) for binge eating. Fifty-six women with nonpurging bulimia were randomly assigned to 1 of 3 groups: CBT, IPT, or a wait-list control (WL). Treatment was administered in small groups that met for 16 weekly sessions. At posttreatment, both group CBT and group IPT treatment conditions showed significant improvement in reducing binge eating, whereas the WL condition did not. Binge eating remained significantly below baseline levels for both treatment conditions at 6-month and 1-year follow-ups. These data support the central role of both eating behavior and interpersonal factors in the understanding and treatment of bulimia.

  View details for Web of Science ID A1993KW45900016

  View details for PubMedID 8473584

• THE EFFECTS OF A VERY-LOW-CALORIE DIET ON BINGE-EATING BEHAVIOR THERAPY Telch, C. F., Agras, W. S. 1993; 24 (2): 177-193

  View details for Web of Science ID A1993LV42700001

• BINGE EATING IN FEMALES - A POPULATION-BASED INVESTIGATION INTERNATIONAL JOURNAL OF EATING DISORDERS Bruce, B., Agras, W. S. 1992; 12 (4): 365-373

  View details for Web of Science ID A1992JZ26500003

• BINGE EATING AMONG THE OBESE - A DESCRIPTIVE STUDY JOURNAL OF BEHAVIORAL MEDICINE Arnow, B., Kenardy, J., Agras, W. S. 1992; 15 (2): 155-170

  Abstract

  Nineteen obese females applying for treatment for binge eating were administered a semistructured interview assessing the presence or absence of food restrictions, thoughts, feelings and physical sensations associated with binges, typical precipitants to binges, and factors identified as useful in avoiding binge eating. Both negative mood and abstinence violations emerged as important precipitants. The results also suggested that these precipitants constitute separate, independent pathways to binge eating. Implications of these findings with respect to restraint theory are discussed.

  View details for Web of Science ID A1992HR49400004

  View details for PubMedID 1583679

• STRESS TEST REACTIVITY IN PANIC DISORDER ARCHIVES OF GENERAL PSYCHIATRY Roth, W. T., MARGRAF, J., Ehlers, A., Taylor, C. B., Maddock, R. J., Davies, S., Agras, W. S. 1992; 49 (4): 301-310

  Abstract

  The psychological and physiological reactivity of 52 patients with panic disorder to mental arithmetic, cold pressor, and 5% carbon dioxide inhalation tests was compared with that of 26 age- and sex-matched normal subjects. In general, patients with panic disorder were neither more physiologically reactive to these stressors than normal subjects nor slower to recover from them, but they were tonically more anxious and much more likely to ask to stop carbon dioxide inhalation or to report panic attacks during this test. Patients who reported panic attacks (46%) had manifested greater anticipatory anxiety before the gas was delivered, accompanied with increased beta-adrenergic cardiac tone. Thus, anticipatory anxiety can be an important factor in panic provocation. Physiological measures varied greatly in their sensitivity to phasic or tonic anxiety. Carbon dioxide stimulated large increases in respiratory minute volume, but these increases were no greater for patients than for normal subjects.

  View details for Web of Science ID A1992HM91400006

  View details for PubMedID 1558464

• THE FUTURE OF BEHAVIOR-THERAPY PSYCHOTHERAPY Wilson, G. T., Agras, W. S. 1992; 29 (1): 39-43

  View details for Web of Science ID A1992HG13500008

• THE EATING PATTERNS OF NON-PURGING BULIMIC SUBJECTS INTERNATIONAL JOURNAL OF EATING DISORDERS ROSSITER, E. M., Agras, W. S., Telch, C. F., Bruce, B. 1992; 11 (2): 111-120

  View details for Web of Science ID A1992HG85500002

• PHARMACOLOGICAL AND COGNITIVE-BEHAVIORAL TREATMENT FOR BULIMIA-NERVOSA - A CONTROLLED COMPARISON AMERICAN JOURNAL OF PSYCHIATRY Agras, W. S., ROSSITER, E. M., Arnow, B., Schneider, J. A., Telch, C. F., Raeburn, S. D., Bruce, B., Perl, M., Koran, L. M. 1992; 149 (1): 82-87

  Abstract

  This study examined the relative effectiveness of desipramine, cognitive-behavioral therapy, and their combination in the treatment of bulimia nervosa, together with the effects of withdrawing medication after two different lengths of treatment.Seventy-one patients meeting DSM-III-R criteria for bulimia nervosa, recruited from an eating disorders clinic or by advertisements, were assigned at random to one of five groups: desipramine (withdrawn at 16 or 24 weeks), combined treatment (medication withdrawn at 16 or 24 weeks), and cognitive-behavioral therapy (15 sessions). All treatments were conducted individually in an outpatient clinic. The primary outcome measures were binge eating and purging rates assessed at pretreatment, 16, 24, and 32 weeks. The results were analyzed as three groups (medication, cognitive-behavioral therapy, and combined treatment) at 16 weeks and as five groups at subsequent assessments.At 16 weeks, both cognitive-behavioral therapy and the combined treatment were superior to medication given for 16 weeks in reducing binge eating and purging. At 32 weeks, however, only the combined 24-week treatment was superior to medication given for 16 weeks. The combined treatment was also more effective in reducing dietary preoccupation and hunger. Continuing cognitive-behavioral therapy appeared to prevent relapse in patients withdrawn from medication at 16 weeks.Overall, the results favor the use of a combination of medication and cognitive-behavioral therapy in the treatment of bulimia nervosa, with medication continued for at least 24 weeks.

  View details for Web of Science ID A1992GX04000012

  View details for PubMedID 1728190

• AMBULATORY COMPUTER-ASSISTED BEHAVIOR-THERAPY FOR OBESITY - AN EMPIRICAL-MODEL FOR EXAMINING BEHAVIORAL-CORRELATES OF TREATMENT OUTCOME COMPUTERS IN HUMAN BEHAVIOR Burnett, K. F., Taylor, C. B., Agras, W. S. 1992; 8 (2-3): 239-248

  View details for Web of Science ID A1992HV92100008

• IMIPRAMINE AND ALPRAZOLAM EFFECTS ON STRESS TEST REACTIVITY IN PANIC DISORDER BIOLOGICAL PSYCHIATRY Roth, W. T., MARGRAF, J., Ehlers, A., Haddad, J. M., Maddock, R. J., Agras, W. S., Taylor, C. B. 1992; 31 (1): 35-51

  Abstract

  The reactivity of 40 panic disorder patients on mental arithmetic, cold pressor, and 5% CO2 inhalation stressors was tested before and after 8 weeks of treatment with imipramine, alprazolam, or placebo. Mean levels of subjective and physiological stress measures were compared during a baseline before any stressors were given, and at anticipation, stressor, and recovery periods for each stressor. After treatment, imipramine patients differed from the other two treatment groups on the prestressor baseline in showing higher systolic blood pressure (mean difference about 10 mmHg), higher diastolic blood pressure (10 mm Hg), higher heart rate (15 bpm), less respiratory sinus arrhythmia, shorter pulse transit time, and lower T-wave amplitude. Respiratory measures, electrodermal measures, body movement, and self-reported anxiety and excitement did not distinguish the groups. Reactivity to the stress tests was unaffected by the medications, but tonic differences present in the baseline persisted.

  View details for Web of Science ID A1992GX47400004

  View details for PubMedID 1543796

• NONPURGING BULIMIA - A DISTINCT SUBTYPE OF BULIMIA-NERVOSA INTERNATIONAL JOURNAL OF EATING DISORDERS McCann, U. D., ROSSITER, E. M., KING, R. J., Agras, W. S. 1991; 10 (6): 679-687

  View details for Web of Science ID A1991GN74900005

• ARE ANTIDEPRESSANTS APPETITE-SUPPRESSANTS IN BULIMIA-NERVOSA EUROPEAN JOURNAL OF PSYCHIATRY ROSSITER, E. M., Agras, W. S., McCann, U., Schneider, J. A., Gotestam, K. G. 1991; 5 (4): 224-231

  View details for Web of Science ID A1991HJ22400005

• IMPROVING THE EFFECTIVENESS OF COMPUTER-ASSISTED WEIGHT-LOSS BEHAVIOR THERAPY Taylor, C. B., Agras, W. S., Losch, M., Plante, T. G., Burnett, K. 1991; 22 (2): 229-236

  View details for Web of Science ID A1991FL22500006

• HOW BLIND ARE DOUBLE-BLIND STUDIES JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY MARGRAF, J., Ehlers, A., Roth, W. T., Clark, D. B., Sheikh, J., Agras, W. S., Taylor, C. B. 1991; 59 (1): 184-187

  Abstract

  Psychopharmacological studies usually attempt to eliminate "nonspecific" influences on outcome by double-blind designs. In a randomized, double-blind comparison of alprazolam, imipramine, and placebo, the great majority of panic disorder patients (N = 59) and their physicians were able to rate accurately whether active drug or placebo had been given. Moreover, physicians could distinguish between the two types of active drugs. Inasmuch as correct rating was possible halfway through treatment, concerns about the internal validity of the double-blind strategy arise.

  View details for Web of Science ID A1991EV98700024

  View details for PubMedID 2002136

• MECHANISMS OF ACTION IN COGNITIVE BEHAVIORAL AND PHARMACOLOGICAL INTERVENTIONS FOR OBESITY AND BULIMIA-NERVOSA JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY Craighead, L. W., Agras, W. S. 1991; 59 (1): 115-125

  Abstract

  In the treatment of obesity, anorexiant medication appears to enhance restraint, presumably through altering internal cues, and facilitates weight loss with behavioral treatment. However, relapse occurs once medication is withdrawn. Antidepressants appear to work similarly, and initial evidence suggests the same limitations. Long-term combined pharmacologic and behavioral treatment, however, may be useful for some individuals not responding positively to behavioral treatment alone. In the treatment of bulimia nervosa, antidepressants appear to enhance restraint, whereas cognitive behavioral treatment decreases restraint. Thus, these modalities appear to be incompatible, and highly restrictive eating is not desirable for those of normal weight. However, for individuals not responding to cognitive-behavioral treatment, long-term pharmacologic treatment may be an alternative, perhaps combined with a more compatible psychological treatment.

  View details for Web of Science ID A1991EV98700013

  View details for PubMedID 2002126

• HIGH BLOOD-PRESSURE AND MARITAL DISCORD - NOT BEING NASTY MATTERS MORE THAN BEING NICE HEALTH PSYCHOLOGY Ewart, C. K., Taylor, C. B., Kraemer, H. C., Agras, W. S. 1991; 10 (3): 155-163

  Abstract

  Theories linking anger and blood pressure (BP) reactivity to cardiovascular disease must be able to identify naturally occurring stressors that arouse emotion with sufficient frequency to cause chronic physiologic stress. We examine the impact of normal family arguments on 43 patients (24 women, 19 men) with essential hypertension. Patients and their partners discussed a threatening disagreement for 10 min while BP and conversation were recorded. Discussing problems increased BP, but the causal pathways differed by sex. In women, hostile interaction and marital dissatisfaction were associated with increased BP; "supportive" or "neutral" exchanges were unrelated to BP. In men, BP fluctuations were related only to the patient's speech rate. These findings are consistent with other research on sex differences in communication and social problem-solving styles and implicate different mechanisms (frequent anger, active coping) through which marital discord could increase risk. Implications for intervention are considered.

  View details for Web of Science ID A1991FR19200001

  View details for PubMedID 1879387

• SUCCESSFUL TREATMENT OF NONPURGING BULIMIA-NERVOSA WITH DESIPRAMINE - A DOUBLE-BLIND, PLACEBO-CONTROLLED STUDY AMERICAN JOURNAL OF PSYCHIATRY McCann, U. D., Agras, W. S. 1990; 147 (11): 1509-1513

  Abstract

  Twenty-three women with nonpurging bulimia underwent a 12-week, double-blind, placebo-controlled trial of desipramine hydrochloride. Repeated standardized rating scales, mood assessments, and self-reports of dietary habits were used to measure changes in binge frequency and cognitive processes associated with food intake. The women who received desipramine reduced their frequency of binge eating by 63%, but women receiving placebo increased their frequency of binge eating by 16%. Twelve weeks after initiating treatment, 60% of the treatment group but only 15% of the placebo group abstained from binge eating. The women who received desipramine showed significantly more dietary restraint and reported significantly less hunger, suggesting that desipramine acts to suppress appetite. These preliminary findings suggest that the therapeutic effects of desipramine established in the treatment of purging bulimia nervosa extend to patients with nonpurging bulimia.

  View details for Web of Science ID A1990EF65800013

  View details for PubMedID 2221164

• NEW PHARMACOLOGICAL APPROACHES TO OBSESSIVE-COMPULSIVE DISORDER - TREATMENT OF SOCIAL PHOBIAS - DISCUSSION JOURNAL OF CLINICAL PSYCHIATRY MICHELS, Insel, T. R., Agras, W. S., Yudofsky, S. C. 1990; 51: 56-58

  View details for Web of Science ID A1990EF22100012

• AN EMPIRICAL-TEST OF THE DSM-III-R DEFINITION OF BINGE INTERNATIONAL JOURNAL OF EATING DISORDERS ROSSITER, E. M., Agras, W. S. 1990; 9 (5): 513-518

  View details for Web of Science ID A1990DW05500005

• SKIN-CONDUCTANCE HABITUATION IN PANIC DISORDER PATIENTS BIOLOGICAL PSYCHIATRY Roth, W. T., Ehlers, A., Taylor, C. B., MARGRAF, J., Agras, W. S. 1990; 27 (11): 1231-1243

  Abstract

  Skin conductance habituation was compared between 38 patients meeting DSM-III criteria for Panic Disorder and 29 normal controls. Approximately half of each group was randomly assigned to be given 100 dB SPL tones and the other half 75 dB tones. All indices pointed to slowed habituation in patients compared with normals: number of trials to response habituation, total number of responses, and slope of decline of skin conductance level. Patient-normal differences were not significantly larger for 100 dB than for 75 dB. In addition, patients compared with normals had more nonspecific fluctuations, higher skin conductance levels, and a shorter response latency to the first stimulus. Stepwise discriminant analyses classified patients and normals better in the 100 dB than in the 75 dB condition, and showed that the various skin conductancy variables were largely redundant at the higher intensity.

  View details for Web of Science ID A1990DF72900007

  View details for PubMedID 2191728

• MOTOR-ACTIVITY AND TONIC HEART-RATE IN PANIC DISORDER PSYCHIATRY RESEARCH Clark, D. B., Taylor, C. B., Hayward, C., King, R., MARGRAF, J., Ehlers, A., Roth, W. T., Agras, W. S. 1990; 32 (1): 45-53

  Abstract

  Motor activity and tonic heart rate were monitored in 62 drug-free panic disorder patients and 40 normal control subjects. Mean daily activity, mean waking heart rate controlled for activity, and mean sleeping heart rate were determined. Panic disorder patients without phobic avoidance showed higher activity than control subjects or patients with limited or extensive avoidance. Similarly, an "inverted U", relationship between trait anxiety and activity was observed. On the other hand, neither mean waking nor sleeping heart rate showed significant differences between patients and controls, suggesting that the differences previously reported in laboratory studies result from anticipatory anxiety.

  View details for Web of Science ID A1990DC99700006

  View details for PubMedID 2349312

• DEVELOPING COMPUTER-ASSISTED THERAPY FOR THE TREATMENT OF OBESITY BEHAVIOR THERAPY Agras, W. S., Taylor, C. B., Feldman, D. E., Losch, M., Burnett, K. F. 1990; 21 (1): 99-109

  View details for Web of Science ID A1990CN01900007

• COGNITIVE-BEHAVIORAL AND RESPONSE-PREVENTION TREATMENTS FOR BULIMIA NERVOSA JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY Agras, W. S., Schneider, J. A., Arnow, B., Raeburn, S. D., Telch, C. F. 1989; 57 (2): 215-221

  Abstract

  This study was designed to assess the additive effects of major components of cognitive-behavioral treatment for bulimia nervosa. Seventy-seven female patients with bulimia nervosa were allocated at random to one of four conditions: wait-list control, self-monitoring of caloric intake and purging behaviors, cognitive-behavioral treatment, and cognitive-behavioral treatment combined with response prevention of vomiting. In the treatment conditions, participants were seen individually for fourteen 1-hr sessions over a 4-month period. All the treatment groups showed significant improvement, whereas the wait-list control group did not. Cognitive-behavioral treatment was, however, the most successful in reducing purging and in promoting positive psychological changes. Fifty-six percent of participants in this condition ceased binge eating and purging by the end of treatment, and the frequency of purging declined by 77.2% during the same period. Of the three treatment conditions, only cognitive-behavioral treatment was superior to the wait-list control. At the 6-month follow-up, 59% of the cognitive-behavioral group were abstinent, and purging had declined by 80%. Cognitive-behavioral treatment was significantly superior to the other treatment groups at this time. Thus, the addition of response prevention of vomiting did not enhance the efficacy of cognitive-behavioral treatment, and the evidence suggests that it may have had a deleterious effect.

  View details for Web of Science ID A1989T859000004

  View details for PubMedID 2708607

• ROLE OF COGNITIVE APPRAISAL IN PANIC-RELATED AVOIDANCE BEHAVIOUR RESEARCH AND THERAPY Telch, M. J., Brouillard, M., Telch, C. F., Agras, W. S., Taylor, C. B. 1989; 27 (4): 373-383

  Abstract

  The present study examined several dimensions of panic cognitions to test whether panic appraisals predict phobicity among panic sufferers. Thirty-five patients meeting DSM-III-R criteria for panic disorder with minimal or no phobic avoidance were compared to 40 patients meeting DSM-III-R criteria for panic disorder with agoraphobia (severe). The two groups looked strikingly similar on measures of panic symptoms, panic frequency and panic severity. As expected, patients diagnosed as having panic disorder with agoraphobia reported significantly more depression and phobic avoidance than patients with PD. Striking differences emerged on each of the following panic appraisal dimensions: (a) anticipated panic, (b) perceived consequences of panic, and (c) perceived self-efficacy in coping with panic. In each case, patients with panic disorder and agoraphobia reported significantly more dysfunctional panic appraisals than patients with panic disorder and no avoidance. Of those panic appraisal dimensions studied, anticipated panic emerged as the most potent correlate of agoraphobic avoidance. These findings support the hypothesis that cognitive appraisal factors may play an important role in the genesis or maintenance of phobic avoidance among panic patients.

  View details for Web of Science ID A1989AH15600007

  View details for PubMedID 2775146

• INTERPERSONAL-BEHAVIOR AND CARDIOVASCULAR REACTIVITY IN PHARMACOLOGICALLY-TREATED HYPERTENSIVES JOURNAL OF PSYCHOSOMATIC RESEARCH Delamater, A. M., Taylor, C. B., Schneider, J., Allen, R., Chesney, M., Agras, W. S. 1989; 33 (3): 335-345

  Abstract

  This study examined the interpersonal behavior and concomitant cardiovascular reactivity (CVR) of hypertensive patients whose resting blood pressure was controlled by antihypertensive medication. Thirty hypertensive and 30 normotensive subjects matched for age, sex and occupational status were recruited from an industrial setting. The groups were compared on measures of interpersonal behavior, blood pressure and heart rate while they engaged in both role-played (RP) and naturalistic interactions (NI) requiring positive and negative assertion. Interpersonal behavior of the groups was generally similar, with two exceptions: hypertensives made fewer requests for new behavior in the negative RP and verbalized more praise statements in the positive NI. There were no differences between the groups on measures of CVR during interpersonal interactions. Overall effectiveness during scenes requiring negative assertion was associated with increased cardiovascular reactivity, especially for hypertensives. The interpersonal behavior and cardiovascular responses of patients taking beta-blocker medication did not differ from those taking diuretics. These findings are discussed with regard to methodological considerations pertinent to the assessment of interpersonal behavior and the issue of heterogeneity among hypertensives.

  View details for Web of Science ID A1989AN36600008

  View details for PubMedID 2571726

• TREATMENT OUTCOME EVALUATION METHODOLOGY - AN OVERVIEW ADVANCES IN BEHAVIOUR RESEARCH AND THERAPY Agras, W. S. 1989; 11 (3): 215-220

  View details for Web of Science ID A1989AY14800009

• CHANGES IN SELF-REPORTED FOOD-INTAKE IN BULIMICS AS A CONSEQUENCE OF ANTIDEPRESSANT TREATMENT INTERNATIONAL JOURNAL OF EATING DISORDERS ROSSITER, E. M., Agras, W. S., Losch, M. 1988; 7 (6): 779-783

  View details for Web of Science ID A1988Q996700006

• RELATIONSHIPS BETWEEN THE EATING BEHAVIORS OF PARENTS AND THEIR 18-MONTH-OLD CHILDREN - A LABORATORY STUDY INTERNATIONAL JOURNAL OF EATING DISORDERS Agras, W. S., Berkowitz, R. I., HAMMER, L. C., Kraemer, H. C. 1988; 7 (4): 461-468

  View details for Web of Science ID A1988P299400002

• AUTONOMIC CHANGES AFTER TREATMENT OF AGORAPHOBIA WITH PANIC ATTACKS PSYCHIATRY RESEARCH Roth, W. T., Telch, M. J., Taylor, C. B., Agras, W. S. 1988; 24 (1): 95-107

  Abstract

  Twenty-three patients meeting DSM-III criteria for agoraphobia with panic attacks and 14 age-, race-, and sex-matched nonanxious controls were tested in the laboratory and on a test walk in a shopping mall. The patients were tested before and after about 15 weeks of treatment with placebo and exposure therapy, imipramine and exposure therapy, or imipramine and initial antiexposure instructions. Controls were tested twice at a similar interval, but without any treatment. On test day 1, patients compared to controls showed higher average heart rate and skin conductance levels and greater numbers of skin conductance fluctuations in the laboratory, and higher heart rates before and during the test walk. Between pretreatment and posttreatment tests, clinical ratings improved and skin conductance levels decreased in all treatment groups. Heart rate levels in the laboratory, on the other hand, decreased in patients on placebo and rose in patients on imipramine. Thus, imipramine compromises the usefulness of heart rate as a measure of emotional arousal. Higher pretreatment heart rates predicted greater clinical improvement.

  View details for Web of Science ID A1988N420300012

  View details for PubMedID 3393620

• MEASURING SUCK PATTERNS - REPLY JOURNAL OF PEDIATRICS Agras, W. S., Kraemer, H. C., Berkowitz, R. I., Hammer, L. D. 1988; 112 (1): 159-159

  View details for Web of Science ID A1988L792800035

• DIETARY RESTRAINT OF BULIMIC SUBJECTS FOLLOWING COGNITIVE-BEHAVIORAL OR PHARMACOLOGICAL TREATMENT BEHAVIOUR RESEARCH AND THERAPY ROSSITER, E. M., Agras, W. S., Losch, M., Telch, C. F. 1988; 26 (6): 495-498

  View details for Web of Science ID A1988R171500008

  View details for PubMedID 3240233

• PANIC ATTACKS IN THE NATURAL-ENVIRONMENT JOURNAL OF NERVOUS AND MENTAL DISEASE MARGRAF, J., Taylor, C. B., Ehlers, A., Roth, W. T., Agras, W. S. 1987; 175 (9): 558-565

  Abstract

  Despite much recent research, there is still little systematic information about the phenomenology of panic attacks, and their possible causes remain obscure. We investigated panic attacks in the natural environment using an event sampling approach. Twenty-seven panic attack patients and 19 matched normal controls kept panic attack and self-exposure diaries for 6 days and wore an ambulatory heart rate/physical activity recorder for 3 days. Patients reported 175 attacks, generally of moderate severity. The most frequent symptoms were palpitations, dizziness/lightheadedness, dyspnea, nausea, sweating, and chest pain/discomfort. The results did not support the classification of panic attacks recently proposed by Sheehan and Sheehan, which requires three symptoms as a cutoff for panic attacks. Panic attacks classified by the patients as situational (i.e., occurring in feared situations) were more severe and occurred in situational contexts different from spontaneous attacks, but were otherwise phenomenologically similar. Heart rates did not change during spontaneous attacks and were only mildly elevated during situational attacks or during the 15 minutes preceding these attacks. These heart rate changes were interpretable as effects of anxiety, although physical activity showed a similar pattern of changes. Some normal control subjects reported on the panic diary primarily situational anxiety episodes that were phenomenologically similar to, albeit less severe than, the patients' episodes. Panic patients may sometimes fail to perceive environmental triggers for their attacks because many attacks classified as spontaneous occurred in classical "phobic" situations. Furthermore, the comparison of concurrent diary and retrospective interview and questionnaire descriptions showed that panic patients have a tendency toward retrospective exaggeration. Implications for the assessment, definition, and classification of panic attacks are discussed.

  View details for Web of Science ID A1987K221300008

  View details for PubMedID 3655782

• SO WHERE DO WE GO FROM HERE BEHAVIOR THERAPY Agras, W. S. 1987; 18 (3): 203-217

  View details for Web of Science ID A1987J502200001

• RELAXATION TRAINING FOR ESSENTIAL-HYPERTENSION AT THE WORKSITE .2. THE POORLY CONTROLLED HYPERTENSIVE PSYCHOSOMATIC MEDICINE Agras, W. S., Taylor, C. B., Kraemer, H. C., SOUTHAM, M. A., Schneider, J. A. 1987; 49 (3): 264-273

  Abstract

  This article reports the findings of a study designed to evaluate the long-term effectiveness of an industry-based relaxation training program in the treatment of hypertensives whose blood pressures were not well controlled by antihypertensive medication. Following a three-stage screening process, 137 participants were randomly allocated to either relaxation training (RT) or to blood pressure monitoring (BPM) at two worksites. Participants continued to receive medical care from their primary physicians during the course of the study. The advantage for participants receiving RT, in terms of mean blood pressure changes, was modest and of short duration. However, a larger proportion of participants in the RT group came into good control (blood pressures below 90 mm Hg) than in the BPM group following treatment (69.4% vs 41.5%, p less than 0.001). This advantage continued to 24 months' follow-up (63.9% vs 47.7%, p less than 0.05). At 30 months' follow-up there was no significant difference between the groups (75.0% vs 70.8%). Within-group analyses revealed that the BPM group also achieved significant blood pressure lowering which was maintained during the study. The largest initial difference between the two groups was for individuals whose entry diastolic blood pressures were most out of control despite several years of pharmacologic treatment. No difference was found between the two groups in the prescription of antihypertensive medication.

  View details for Web of Science ID A1987H693600005

  View details for PubMedID 3299443

• DOES A VIGOROUS FEEDING STYLE INFLUENCE EARLY DEVELOPMENT OF ADIPOSITY JOURNAL OF PEDIATRICS Agras, W. S., Kraemer, H. C., Berkowitz, R. I., Korner, A. F., Hammer, L. D. 1987; 110 (5): 799-804

  Abstract

  A prospective study of a cohort of healthy infants observed from birth to 2 years of age was carried out to investigate factors influencing the development of early adiposity. Infant suckling was measured in the laboratory twice during the first month of life. Multiple regression analyses revealed that parental educational level and a measure of feeding behavior, the interval between bursts of suckling, accounted for 18% of the variance in triceps skinfold measures at 1 year of age. A lower level of education and shorter interburst interval were associated with increased adiposity. Two feeding variables, pressure of suckling and the number of reported feeds per day, accounted for 21% of the variance in skinfold thickness at 2 years of age. Fewer, but larger, feeds and a higher sucking pressure were associated with a greater degree of adiposity. It seems that a vigorous infant feeding style, consisting of sucking more rapidly, at higher pressure, with a longer suck and burst duration, and a shorter interval between bursts of sucking, is associated with higher caloric intake and greater adiposity. The early development of this feeding style suggests that it may be a genetically endowed behavior. Breast-feeding protected against early adiposity only to the age of 6 months in this cohort of infants.

  View details for Web of Science ID A1987H158300029

  View details for PubMedID 3572635

• BULIMIA IN MALES - A MATCHED COMPARISON WITH FEMALES INTERNATIONAL JOURNAL OF EATING DISORDERS Schneider, J. A., Agras, W. S. 1987; 6 (2): 235-242

  View details for Web of Science ID A1987G176600006

• IMIPRAMINE IN THE TREATMENT OF BULIMIA - A DOUBLE-BLIND CONTROLLED-STUDY INTERNATIONAL JOURNAL OF EATING DISORDERS Agras, W. S., Dorian, B., KIRKLEY, B. G., Arnow, B., Bachman, J. 1987; 6 (1): 29-38

  View details for Web of Science ID A1987F458900004

• THE ROLE OF PERCEIVED SELF-EFFICACY IN RECOVERY FROM BULIMIA - A PRELIMINARY EXAMINATION BEHAVIOUR RESEARCH AND THERAPY Schneider, J. A., OLEARY, A., Agras, W. S. 1987; 25 (5): 429-432

  View details for Web of Science ID A1987K415700011

  View details for PubMedID 3689298

• PRIMARY CARE AND HEALTH PROMOTION - A MODEL FOR PREVENTIVE MEDICINE AMERICAN JOURNAL OF PREVENTIVE MEDICINE JOHNS, M. B., Hovell, M. F., Ganiats, T., Peddecord, K. M., Agras, W. S. 1987; 3 (6): 346-357

  Abstract

  This paper examines the potential role of the primary care physician in health promotion, specifically the use of behavioral change technologies to modify risk behavior. The primary care physician's strategic position to help people modify risk behavior is discussed, and the available data on the health promotion attitudes and services of these physicians are reviewed. The principles and procedures of behavior modification underlie not only the model proposed for risk assessment and reduction, but are applied to the task of changing and maintaining physician behavior as well. Cost-effectiveness research and the role of reimbursement for primary care prevention services are discussed. Recommendations are made for future health policies, practices, training, and research that might encourage preventive behavioral services in primary care.

  View details for Web of Science ID A1987L306900008

  View details for PubMedID 3330663

• PERSONALIZED VERSUS USUAL CARE OF PREVIOUSLY UNCONTROLLED HYPERTENSIVE PATIENTS - AN EXPLORATORY ANALYSIS PREVENTIVE MEDICINE Hovell, M. F., Black, D. R., MEWBORN, C. R., Geary, D., Agras, W. S., Kamachi, K., Kirk, R., Walton, C., Dawson, S. 1986; 15 (6): 673-684

  Abstract

  This study was conducted to explore whether the quality of provider care may contribute to blood pressure reduction and whether other factors related to the treatment of hypertension may explain decline in blood pressure. In the study, 46 uncontrolled (greater than or equal to 140/90 mm Hg), medically treated hypertensive patients who received more personalized care differed significantly in the magnitude of blood pressure reduction from 36 usual-care patients (10/7 vs 2/2 mm Hg means for systolic and diastolic blood pressure reduction, respectively). About twice as many experimental patients as controls were reclassified as having "controlled" blood pressure, and this difference reached statistical significance. A multiple regression analysis for personalized-care subjects showed that no dynamic variables were related to blood pressure changes. It was postulated that more personalized care may have accounted for the significant difference between groups in blood pressure reduction. Similar personalized monitoring services might be important additions to usual medical care in order to control blood pressure more fully in high-risk hypertensive patients.

  View details for Web of Science ID A1986E957000012

  View details for PubMedID 3797398

• AUTONOMIC CHARACTERISTICS OF AGORAPHOBIA WITH PANIC ATTACKS BIOLOGICAL PSYCHIATRY Roth, W. T., Telch, M. J., Taylor, C. B., SACHITANO, J. A., Gallen, C. C., KOPELL, M. L., MCCLENAHAN, K. L., Agras, W. S., Pfefferbaum, A. 1986; 21 (12): 1133-1154

  Abstract

  We compared electrodermal and heart rate measures of autonomic activation between patients meeting DSM-III criteria for agoraphobia with panic attacks and controls in terms of tonic level, reactivity to various types of stimuli, recovery, habituation, and spontaneous variability. The most striking differences between groups in the laboratory were higher tonic levels of skin conductance and heart rate among patients. Patients' heart rates were also tonically elevated in a test situation outside the laboratory. Certain measures of habituation and spontaneous variability also differed between groups, but there were only weak and inconsistent differences in reactivity to, or recovery from, stimuli with diverse qualities of novelty, startlingness, intensity, or phobicity. The elevated activation levels may be signs of a chronic state or may be phobic responses to the testing situations. A minority of patients failed to show these elevated levels.

  View details for Web of Science ID A1986D850400004

  View details for PubMedID 3756263

• 30 MONTH FOLLOW-UP OF COGNITIVE-BEHAVIORAL GROUP-THERAPY FOR BULIMIA BRITISH JOURNAL OF PSYCHIATRY LUKA, L. P., Agras, W. S., Schneider, J. A. 1986; 148: 614-615

  View details for Web of Science ID A1986C799300030

  View details for PubMedID 3779238

• LACTATE INFUSIONS AND PANIC ATTACKS - DO PATIENTS AND CONTROLS RESPOND DIFFERENTLY PSYCHIATRY RESEARCH Ehlers, A., MARGRAF, J., Roth, W. T., Taylor, C. B., Maddock, R. J., Sheikh, J., KOPELL, M. L., MCCLENAHAN, L., Gossard, D., BLOWERS, G. H., Agras, W. S., KOPELL, B. S. 1986; 17 (4): 295-308

  Abstract

  Ten patients with panic disorder or agoraphobia with panic attacks and 10 normal controls received infusions of normal saline (placebo) and sodium lactate in a single-blind design. The time course of changes in the dependent variables was closely monitored, and expectancy biases and demand characteristics were minimized. Lactate increased self-reported anxiety and heart rate equally in patients and controls. The only variables showing statistically different responses between the groups were systolic and diastolic blood pressure. Overall, in both groups, the effects of lactate were quite similar to states of natural panic or anxiety for both self-report measures and heart rate. Patients had a tendency to endorse somatic symptoms indiscriminately. Our data do not support response to lactate as a biological marker of proneness to panic attacks.

  View details for Web of Science ID A1986C200600006

  View details for PubMedID 3714912

• AMBULATORY HEART-RATE CHANGES IN PATIENTS WITH PANIC ATTACKS AMERICAN JOURNAL OF PSYCHIATRY Taylor, C. B., Sheikh, J., Agras, W. S., Roth, W. T., MARGRAF, J., Ehlers, A., Maddock, R. J., Gossard, D. 1986; 143 (4): 478-482

  Abstract

  Of 33 "panic" attacks reported by patients wearing an ambulatory solid-state heart rate/activity monitor for 6 days, 19 (58%) occurred at heart rates disproportionate to activity levels and different enough from surrounding heart rates to indicate a distinct physiologic state. Intense panic attacks with three or more symptoms were the most readily identified. ECG monitoring found the elevated heart rates to be sinus tachycardias. Heart rate elevation did not occur during anticipatory anxiety episodes. Ambulatory heart rate recordings confirm the presence of major physiologic changes during self-reported panic attacks.

  View details for Web of Science ID A1986A725500010

  View details for PubMedID 3953890

• AMBULATORY MONITORING OF PATIENTS WITH ANXIETY AND PANIC CLINICAL NEUROPHARMACOLOGY Taylor, C. B., Roth, W. T., Agras, W. S., MARGRAF, J., Ehlers, A. 1986; 9: 37-39

  View details for Web of Science ID A1986G254000015

• ENHANCING AGORAPHOBIA TREATMENT OUTCOME BY CHANGING COUPLE COMMUNICATION PATTERNS BEHAVIOR THERAPY Arnow, B. A., Taylor, C. B., Agras, W. S., Telch, M. J. 1985; 16 (5): 452-467

  View details for Web of Science ID A1985AVE6400002

• NUTRITIONAL INADEQUACY IN THE DIETS OF TREATED BULIMICS BEHAVIOR THERAPY KIRKLEY, B. G., Agras, W. S., Weiss, J. J. 1985; 16 (3): 287-291

  View details for Web of Science ID A1985AJN5100004

• A COGNITIVE BEHAVIORAL GROUP TREATMENT OF BULIMIA BRITISH JOURNAL OF PSYCHIATRY Schneider, J. A., Agras, W. S. 1985; 146 (JAN): 66-69

  Abstract

  This study describes a group treatment of bulimia using an adaptation of Fairburn's (1981) cognitive behavioural approach. Thirteen bulimic women with a self-reported average of 24 self-induced vomiting episodes per week were treated in two groups; each group met once a week for 16 weeks. The primary outcome measure was the number of self-reported vomiting episodes; pre- and post-treatment measures of eating attitudes, depression, assertiveness, and global level of psychological distress were also evaluated. Vomiting frequency decreased to an average 2.2 times per week (a 91% improvement) with seven patients abstinent by the end of treatment. Significant pre- to post-treatment changes were also demonstrated on measures of depression, eating attitudes, and assertiveness. Six-month follow-up data on 11 patients indicate a mean vomiting frequency of 3.8 per week; six patients maintained their progress. Although Fairburn had greater success using an individual cognitive behavioural approach, the results of the present study are promising for the development of a cost-effective treatment.

  View details for Web of Science ID A1985AEE4900012

  View details for PubMedID 3856460

• AMBULATORY COMPUTER-ASSISTED THERAPY FOR OBESITY - A NEW FRONTIER FOR BEHAVIOR-THERAPY JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY Burnett, K. F., Taylor, C. B., Agras, W. S. 1985; 53 (5): 698-703

  View details for Web of Science ID A1985ARV5500016

  View details for PubMedID 4056186

• COMBINED PHARMACOLOGICAL AND BEHAVIORAL TREATMENT FOR AGORAPHOBIA BEHAVIOUR RESEARCH AND THERAPY Telch, M. J., Agras, W. S., Taylor, C. B., Roth, W. T., Gallen, C. C. 1985; 23 (3): 325-335

  View details for Web of Science ID A1985AHA9400011

  View details for PubMedID 2860892

• COMPARISON OF 2 GROUP TREATMENTS FOR BULIMIA JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY KIRKLEY, B. G., Schneider, J. A., Agras, W. S., Bachman, J. A. 1985; 53 (1): 43-48

  View details for Web of Science ID A1985ADG6700005

  View details for PubMedID 3856582

• PHYSICAL-ACTIVITY AND ADIPOSITY - A LONGITUDINAL-STUDY FROM BIRTH TO CHILDHOOD JOURNAL OF PEDIATRICS Berkowitz, R. I., Agras, W. S., Korner, A. F., Kraemer, H. C., Zeanah, C. H. 1985; 106 (5): 734-738

  Abstract

  Physical activity was reassessed in cohort of 52 children aged 4 to 8 years whose activity had been measured during the first 3 days of life. Neonatal adiposity was not significantly correlated with parental adiposity, neonatal physical activity, or gender, nor was neonatal activity significantly correlated with adiposity in childhood. Neonatal adiposity did not predict adiposity in childhood. However, in a stepwise multiple regression, parental adiposity and the children's daytime high activity levels were significantly associated with childhood adiposity. The age or gender of the child did not significantly correlate with childhood adiposity. As parental adiposity increased or daytime high activity of a child decreased, the adiposity in a 4- to 8-year-old child was likely to increase.

  View details for Web of Science ID A1985AHF6000007

  View details for PubMedID 3998913

• THE RELATION BETWEEN NEONATAL AND LATER ACTIVITY AND TEMPERAMENT CHILD DEVELOPMENT Korner, A. F., Zeanah, C. H., Linden, J., Berkowitz, R. I., Kraemer, H. C., Agras, W. S. 1985; 56 (1): 38-42

  Abstract

  Evidence from several longitudinal studies suggests that individual activity characteristics tend to persist over time and to influence the development of temperamental style. The activity of 50 children whose motility had been monitored by an electronic activity monitor when they were neonates was again monitored by an ambulatory microcomputer when they were 4-8 years old. Additionally, the parents of these children filled out the Behavioral Style Questionnaire by McDevitt and Carey. The results showed that the level of the children's day and night activity was unrelated. The vigor of neonatal movements was later positively related to high daytime activity. Also, the least vigorous infants tended to become the most inactive children during the day. The results further showed that the most active neonates became children who, as perceived by their parents, tended to approach rather than withdraw from new experiences.

  View details for Web of Science ID A1985ACR7800004

  View details for PubMedID 4039245

• COMBINING BEHAVIORAL TREATMENTS TO REDUCE BLOOD-PRESSURE - A CONTROLLED OUTCOME STUDY BEHAVIOR MODIFICATION Jacob, R. G., Fortmann, S. P., Kraemer, H. C., Farquhar, J. W., Agras, W. S. 1985; 9 (1): 32-54

  View details for Web of Science ID A1985AAQ8300003

  View details for PubMedID 3977813

• REDUCING BLOOD-PRESSURE REACTIVITY DURING INTERPERSONAL CONFLICT - EFFECTS OF MARITAL COMMUNICATION TRAINING BEHAVIOR THERAPY Ewart, C. K., Taylor, C. B., Kraemer, H. C., Agras, W. S. 1984; 15 (5): 473-484

  View details for Web of Science ID A1984TU47400003

• RELAXATION TRAINING IN ESSENTIAL-HYPERTENSION - A FAILURE OF RETRAINING IN RELAXATION PROCEDURES BEHAVIOR THERAPY Agras, W. S., Schneider, J. A., Taylor, C. B. 1984; 15 (2): 191-196

  View details for Web of Science ID A1984SL08000006

• THE TREATMENT OF ANOREXIA-NERVOSA - DO DIFFERENT TREATMENTS HAVE DIFFERENT OUTCOMES PSYCHIATRIC ANNALS Agras, W. S., Kraemer, H. C. 1983; 13 (12): 928-?

  View details for Web of Science ID A1983RU47300003

• RELAXATION THERAPY IN HYPERTENSION HOSPITAL PRACTICE Agras, W. S. 1983; 18 (5): 129-137

  View details for Web of Science ID A1983QQ03000023

  View details for PubMedID 6404788

• ADHERENCE TO INSTRUCTIONS TO PRACTICE RELAXATION EXERCISES JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY Taylor, C. B., Agras, W. S., Schneider, J. A., Allen, R. A. 1983; 51 (6): 952-953

  View details for Web of Science ID A1983RS62200025

  View details for PubMedID 6361081

• THE CONTRIBUTION OF AROUSAL AND PERFORMANCE IN REDUCING SPIDER AVOIDANCE BEHAVIOURAL PSYCHOTHERAPY Katz, R. C., Stout, A., Taylor, C. B., Horne, M., Agras, W. S. 1983; 11 (2): 127-138

  View details for Web of Science ID A1983QK02300004

• BEHAVIORAL MEDICINE IN THE 1980S - NONRANDOM CONNECTIONS JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY Agras, W. S. 1982; 50 (6): 797-803

  View details for Web of Science ID A1982PS27800002

  View details for PubMedID 7174973

• EXPECTATION AND THE BLOOD-PRESSURE-LOWERING EFFECTS OF RELAXATION PSYCHOSOMATIC MEDICINE Agras, W. S., Horne, M., Taylor, C. B. 1982; 44 (4): 389-395

  Abstract

  In a study of the blood-pressure-lowering effects of relaxation training in patients with essential hypertension, instructions concerning the relaxation procedure were varied so that one group was told to expect delayed blood-pressure-lowering and the other group immediate lowering. The systolic blood pressure decrease during the training period in the immediate lowering group was 17.0 mm Hg, compared with 2.4 mm Hg for the delayed group (p = 0.001). Diastolic blood pressure changes were not significantly different. Measures of therapy credibility and perceived relaxation failed to differentiate the groups. The implications of these findings for future research and for clinical practice are considered.

  View details for Web of Science ID A1982PH26300006

  View details for PubMedID 6755527

• RELAXATION TRAINING - BLOOD-PRESSURE LOWERING DURING THE WORKING DAY ARCHIVES OF GENERAL PSYCHIATRY SOUTHAM, M. A., Agras, W. S., Taylor, C. B., Kraemer, H. C. 1982; 39 (6): 715-717

  Abstract

  Controlled studies have demonstrated that relaxation training can lead to significant in-clinic blood pressure (BP) reductions in patients with essential hypertension. We examined the BP-lowering effect of relaxation training during the working day. Forty-two patients being treated for essential hypertension with diastolic BPs greater than 90 mm Hg were randomized into either a relaxation training program or no treatment. Multiple BP measurements were made during the working hours, using an ambulatory monitoring device, before and after training. Significant work-site differences between groups were evident after treatment both for systolic and diastolic pressures. These results suggest that relaxation therapy leads to a reduction in BP that is evident in the natural environment, providing new evidence that the procedure is a useful adjunct to the treatment of hypertensive patients.

  View details for Web of Science ID A1982NT57800012

  View details for PubMedID 7046680

• THE EFFECT OF A STANDARDIZED PSYCHOLOGICAL STRESSOR ON THE CARDIOVASCULAR-RESPONSE TO PHYSICAL EFFORT SOON AFTER UNCOMPLICATED MYOCARDIAL-INFARCTION JOURNAL OF PSYCHOSOMATIC RESEARCH Taylor, C. B., Davidson, D. M., Houston, N., Agras, W. S., DeBusk, R. F. 1982; 26 (2): 263-268

  Abstract

  To determine whether a standardized psychological stressor combined with physical stress might disclose ischemic abnormalities not evident with physical stress alone, 30 men, mean age 54, were evaluated seven weeks after clinically uncomplicated myocardial infarction. In the first 20 patients, two symptom-limited treadmill tests (TM) were performed on the same day, with and without superimposed psychological quiz (Q). In the next 10 consecutive patients, the Q was administered at a submaximal level (4 METs). When TM and TM + Q responses were compared, no significant differences were noted in the maximal levels of heart rate (HR), systolic blood pressure (SBP), rate pressure product, or in the prevalence of ischemic ST segment depression or angina pectoris. The HR and double product at which ischemic ST segment depression and angina pectoris appeared were similar for the two types of testing. The psychological stress of a psychological quiz may not, of course, approximate the effect of the more severe stressors individuals may encounter in their daily routines.

  View details for Web of Science ID A1982NN60100019

  View details for PubMedID 7077557

• PLANNING RECRUITMENT CIRCULATION Agras, W. S., Marshall, G. D., Kraemer, H. C. 1982; 66 (6): 54-?

  View details for Web of Science ID A1982PR37300015

• BEHAVIORAL-APPROACHES TO THE TREATMENT OF ESSENTIAL-HYPERTENSION INTERNATIONAL JOURNAL OF OBESITY Agras, W. S. 1981; 5: 173-181

  Abstract

  The experimental literature documenting the effectiveness of relaxation training and related approaches, and the behavioral treatment of overweight, in the management of essential hypertension is briefly reviewed. In both cases the immediate outcome in terms of blood pressure lowering and the persistence of effects of therapy over time favor the use of these methods as adjuncts to the treatment of essential hypertension. Preliminary data from recent experimental work concerning the the psychological mechanisms involved in relaxation therapy and evidence for generalization of the effects to the work environment are also presented.

  View details for Web of Science ID A1981LU75100020

  View details for PubMedID 7016783

• CLINICAL RESEARCH IN BEHAVIOR-THERAPY - HALFWAY THERE BEHAVIOR THERAPY Agras, W. S., Berkowitz, R. 1980; 11 (4): 472-487

  View details for Web of Science ID A1980KG68800004

• COMPARISON OF SEX-TYPED MOTOR BEHAVIOR IN MALE-TO-FEMALE TRANSSEXUALS AND WOMEN ARCHIVES OF SEXUAL BEHAVIOR Barlow, D. H., Mills, J. R., Agras, W. S., Steinman, D. L. 1980; 9 (3): 245-253

  Abstract

  Eight presurgical male-to-female transsexuals emitted significantly more feminine behaviors on a validated sex role motor behavior checklist than eight feminine women. Transsexuals also emitted more masculine behaviors than feminine women, although the total number of masculine behaviors in each group was far less than the total number of feminine behaviors. Indications for the management of transsexuals as well as the functions of sex role motor behavior in our society are discussed.

  View details for Web of Science ID A1980JX21000007

  View details for PubMedID 7396696

• THE CALIFORNIA DROUGHT - A QUASI-EXPERIMENTAL ANALYSIS OF SOCIAL-POLICY JOURNAL OF APPLIED BEHAVIOR ANALYSIS Agras, W. S., Jacob, R. G., Lebedeck, M. 1980; 13 (4): 561-570

  Abstract

  The effect of fines for failure to conserve water during the California drought of 1976 to 1978 was evaluated in a retrospectively arranged multiple-baseline design across three San Francisco Bay area cities. The data indicated that, on a community level, significant savings of water occurred regardless of whether fines were introduced or not. However, on an individual level, fines appeared to have an effect on private, as opposed to commercial or industrial, consumers who had received at least one fine. The limitations imposed on these conclusions by the quasi-experimental nature of the design were highlighted. Possible reasons for water conservation in the absence of fines were discussed within the framework of stimulus control. It was suggested that an area for future research should be the delineation of stimulus parameters involved in producing behavior change in entire communities.

  View details for Web of Science ID A1980KU54400002

  View details for PubMedID 16795633

• RELAXATION TRAINING 24-HOUR BLOOD-PRESSURE REDUCTIONS ARCHIVES OF GENERAL PSYCHIATRY Agras, W. S., Taylor, C. B., Kraemer, H. C., Allen, R. A., Schneider, J. A. 1980; 37 (8): 859-863

  View details for Web of Science ID A1980KF13500001

• EMPIRICAL SELECTION OF MATCHING FACTORS IN MATCHED-PAIRS AND MATCHED-BLOCKS SMALL-SAMPLE RESEARCH DESIGNS BEHAVIOR THERAPY Kraemer, H. C., Jacob, R. G., Jeffery, R. W., Agras, W. S. 1979; 10 (5): 615-628

  View details for Web of Science ID A1979HX05500003

• RECRUITMENT FOR THE CORONARY PRIMARY PREVENTION TRIAL CLINICAL PHARMACOLOGY & THERAPEUTICS Agras, W. S., Marshall, G. 1979; 25 (5): 688-690

  Abstract

  A preliminary account of some aspects of recruitment for the Coronary Primary Prevention Trial is provided. Extension of recruitment sources to include various forms of community screening resulted in more rapid acquisition of potential participants than was possible when recruitment was restricted to the more traditional sources of physician and laboratory referral. Extended recruitment was supported by augmented data feedback and by the development of the job of recruitment coordinator at each participating clinic. The identification of delays in reaching the maximal recruitment rate from particular sources points to the need for detailed planning of a recruitment campaign before large-scale clinical trials are begun.

  View details for Web of Science ID A1979GV68000019

  View details for PubMedID 373955

• COMPARISON OF TREADMILL EXERCISE TESTING AND PSYCHOLOGIC STRESS-TESTING SOON AFTER MYOCARDIAL-INFARCTION AMERICAN JOURNAL OF CARDIOLOGY DeBusk, R. F., Taylor, C. B., Agras, W. S. 1979; 43 (5): 907-912

  View details for Web of Science ID A1979GT79500005

  View details for PubMedID 433773

• RELAXATION THERAPY IN TREATMENT OF HYPERTENSION - REVIEW ARCHIVES OF GENERAL PSYCHIATRY Jacob, R. G., Kraemer, H. C., Agras, W. S. 1977; 34 (12): 1417-1427

  Abstract

  The literature on the use of relaxation or relaxation-like procedures (relaxation therapy) in the treatment of hypertension was critically reviewed. Relaxation therapy resulted in greater reduction of blood pressure than placebo or other control procedures. A positive relationship was found between the average blood pressure decrease and the average pretreatment pressure. Relaxation-like therapies shared the features of muscular relaxation, regular practice, mental focusing, and task awareness. Research on the relative contributions of these components indicated that task awareness adds to the treatment effect in the laboratory setting, and that regular practice is necessary for optimal results in the clinical setting. The role of muscular relaxation and mental focusing is unclear. We concluded that relaxation therapy may become a useful adjunct to medication in the clinical management of hypertension, especially for individuals whose blood pressures remain high despite pharmacological treatment.

  View details for Web of Science ID A1977EE92400003

  View details for PubMedID 400780

• BIOFEEDBACK AND REINFORCEMENT TO INCREASE HETEROSEXUAL AROUSAL IN HOMOSEXUALS BEHAVIOUR RESEARCH AND THERAPY Barlow, D. H., Agras, W. S., ABEL, G. G., Blanchard, E. B., Young, L. D. 1975; 13 (1): 45-50

  View details for Web of Science ID A1975V683600005

• FEEDBACK AND THERAPIST PRAISE DURING TREATMENT OF PHOBIA JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY LEITENBERG, H., Agras, W. S., Allen, R., Butz, R., Edwards, J. 1975; 43 (3): 396-404

  View details for Web of Science ID A1975AF21700016

  View details for PubMedID 1159129

• EXPERIMENTAL ANALYSIS OF EXPOSURE TO EXPLICIT HETEROSEXUAL STIMULI AS AN EFFECTIVE VARIABLE IN CHANGING AROUSAL PATTERNS OF HOMOSEXUALS BEHAVIOUR RESEARCH AND THERAPY Herman, S. H., Barlow, D. H., Agras, W. S. 1974; 12 (4): 335-345

  View details for Web of Science ID A1974U767300008

  View details for PubMedID 4447571

• EXPERIMENTAL ANALYSIS OF CLASSICAL CONDITIONING AS A METHOD OF INCREASING HETEROSEXUAL AROUSAL IN HOMOSEXUALS BEHAVIOR THERAPY Herman, S. H., Barlow, D. H., Agras, W. S. 1974; 5 (1): 33-47

  View details for Web of Science ID A1974R893200004

• BEHAVIOR-MODIFICATION OF ANOREXIA-NERVOSA ARCHIVES OF GENERAL PSYCHIATRY Agras, W. S., Barlow, D. H., CHAPIN, H. N., ABEL, G. G., LEITENBE, H. 1974; 30 (3): 279-286

  View details for Web of Science ID A1974S426400001

  View details for PubMedID 4813130

• FADING TO INCREASE HETEROSEXUAL RESPONSIVENESS IN HOMOSEXUALS JOURNAL OF APPLIED BEHAVIOR ANALYSIS Barlow, D. H., Agras, W. S. 1973; 6 (3): 355-366

  Abstract

  Heterosexual responsiveness, measured by penile responses and reports of behavior, was strengthened in three homosexuals through a fading procedure. Using two slide projectors, colored slides of nude females were superimposed on colored slides of nude males. As the sexual response was emitted, the nude male was faded out and the nude female faded in. Heterosexual arousal decreased when the fading procedure was reversed or stopped and increased once again when fading was resumed. Homosexual arousal remained high during this experiment but had decreased in two subjects at follow-up. The results suggest that fading was responsible for altering stimulus control of sexual arousal and that aversive techniques may not be necessary in the treatment of sexual deviation.

  View details for Web of Science ID A1973Q925400002

  View details for PubMedID 16795417

• COMPULSIVE RITUALS TREATED BY RESPONSE PREVENTION - EXPERIMENTAL ANALYSIS ARCHIVES OF GENERAL PSYCHIATRY MILLS, H. L., Agras, W. S., Barlow, D. H., Mills, J. R. 1973; 28 (4): 524-529

  View details for Web of Science ID A1973P377400010

  View details for PubMedID 4692151

• GENDER IDENTITY CHANGE IN A TRANSSEXUAL ARCHIVES OF GENERAL PSYCHIATRY Barlow, D. H., REYNOLDS, E. J., Agras, W. S. 1973; 28 (4): 569-576

  View details for Web of Science ID A1973P377400014

  View details for PubMedID 4692154

• The contribution of therapeutic instruction of covert sensitization. Behaviour research and therapy Barlow, D. H., Agras, W. S., LEITENBERG, H. 1972; 10 (4): 411-415

  View details for PubMedID 4637499

• Time-limited desensitisation, implosion and shaping for phobic patients: a crossover study. Behaviour research and therapy Crowe, M. J., Marks, I. M., Agras, W. S., LEITENBERG, H. 1972; 10 (4): 319-328

  View details for PubMedID 4637488

• The effects of token reinforcement and feedback on the delusional verbal behavior of chronic paranoid schizophrenics. Journal of applied behavior analysis Wincze, J. P., LEITENBERG, H., Agras, W. S. 1972; 5 (3): 247-262

  Abstract

  Prior research with token reinforcement in the psychiatric population has been directed at work adjustment, more than at major symptomatic behaviors. The purpose of the present research, on the other hand, was to investigate the effects of feedback and token reinforcement on the modification of delusional verbal behavior in chronic psychotics. Six male and four female paranoid schizophrenic patients participated in the study. The results indicated that the effects of feedback were effective about half the time in reducing percentage delusional talk, but in at least three cases produced adverse reactions. Token reinforcement, however, showed more consistency and reduced the percentage of delusional verbal behavior in seven of the nine subjects exposed to this procedure. The effects of both feedback and token reinforcement were quite specific to the environment in which they were applied and showed little generalization to other situations. It would appear that using token reinforcement can reduce the percentage delusional speech of chronic paranoid schizophrenics.

  View details for PubMedID 16795347

• EFFECTS OF TOKEN REINFORCEMENT AND FEEDBACK ON DELUSIONAL VERBAL BEHAVIOR OF CHRONIC PARANOID SCHIZOPHRENICS JOURNAL OF APPLIED BEHAVIOR ANALYSIS Wincze, J. P., LEITENBE, H., Agras, W. S. 1972; 5 (3): 247-?

  View details for Web of Science ID A1972N588000004

• TIME-LIMITED DESENSITIZATION, IMPLOSION AND SHAPING FOR PHOBIC PATIENTS - CROSSOVER STUDY BEHAVIOUR RESEARCH AND THERAPY Crowe, M. J., Agras, W. S., Marks, I. M., LEITENBE, H. 1972; 10 (4): 319-?

  View details for Web of Science ID A1972N970700002

• RELAXATION IN SYSTEMATIC DESENSITIZATION ARCHIVES OF GENERAL PSYCHIATRY Agras, W. S., Barlow, D. H., Wright, D., Edwards, J., CURTIS, N. A., LEITENBE, H. 1971; 25 (6): 511-?

  View details for Web of Science ID A1971L585800005

  View details for PubMedID 5141369

• AN EXPERIMENTAL ANALYSIS OF EFFECTIVENESS OF SHAPING IN REDUCING MALADAPTIVE AVOIDANCE BEHAVIOR - AN ANALOGUE STUDY BEHAVIOUR RESEARCH AND THERAPY Barlow, D. H., Agras, W. S., LEITENBE, H., Wincze, J. P. 1970; 8 (2): 165-?

  View details for Web of Science ID A1970G359600006

  View details for PubMedID 5463459

• Experimental control of sexual deviation through manipulation of the noxious scene in covert sensitization. Journal of abnormal psychology Barlow, D. H., LEITENBERG, H., Agras, W. S. 1969; 74 (5): 597-601

  View details for PubMedID 5349402

• The transfer gap in systematic desensitization: an analogue study. Behaviour research and therapy Barlow, D. H., LEITENBERG, H., Agras, W. S., Wincze, J. P. 1969; 7 (2): 191-196

  View details for PubMedID 5817693

• TRANSFER GAP IN SYSTEMATIC DESENSITIZATION - AN ANALOGUE STUDY BEHAVIOUR RESEARCH AND THERAPY Barlow, D. H., LEITENBE, H., Agras, W. S., Wincze, J. P. 1969; 7 (2): 191-?

  View details for Web of Science ID A1969D632700008

• CONTRIBUTION OF SELECTIVE POSITIVE REINFORCEMENT AND THERAPEUTIC INSTRUCTIONS TO SYSTEMATIC DESENSITIZATION THERAPY JOURNAL OF ABNORMAL PSYCHOLOGY LEITENBE, H., Agras, W. S., HARLOW, D. H., OLIVEAU, D. C. 1969; 74 (1): 113-?

  View details for Web of Science ID A1969C753400019

  View details for PubMedID 5813694

• EXPERIMENTAL CONTROL OF SEXUAL DEVIATION THROUGH MANIPULATION OF NOXIOUS SCENE IN COVERT SENSITIZATION JOURNAL OF ABNORMAL PSYCHOLOGY Barlow, D. H., LEITENBE, H., Agras, W. S. 1969; 74 (5): 597-?

  View details for Web of Science ID A1969E428000010

• Feedback in behavior modification: an experimental analysis in two phobic cases. Journal of applied behavior analysis LEITENBERG, H., Agras, W. S., Thompson, L. E., Wright, D. E. 1968; 1 (2): 131-137

  Abstract

  Two illustrations of single-case research are described in which an isolated therapeutic variable was sequentially introduced, withdrawn, and reintroduced while changes in a clinically relevant behavior were measured. A claustrophobic patient and a knife-phobic patient received graduated practice in facing their phobic stimuli; length of time the claustrophobic patient stayed in a small dark room per trial, and length of time the knife-phobic patient kept knife exposed per trial were measured. In both experiments, when feedback of these time scores was withdrawn, ongoing progress was retarded. Reinstatement of feedback led to renewed improvement. In Experiment 2, adding and removing contingent verbal praise against a constant background of precise feedback did not significantly alter rate of progress.

  View details for PubMedID 16795169

• A sequential analysis of the effect of selective positive reinforcement in modifying anorexia nervosa. Behaviour research and therapy LEITENBERG, H., Agras, W. S., Thomson, L. E. 1968; 6 (2): 211-218

  View details for PubMedID 5734537

• FEEDBACK IN BEHAVIOR MODIFICATION - AN EXPERIMENTAL ANALYSIS IN 2 PHOBIC CASES JOURNAL OF APPLIED BEHAVIOR ANALYSIS LEITENBE, H., Agras, W. S., Thompson, L. E., Wright, D. E. 1968; 1 (2): 131-?

  View details for Web of Science ID A1968B884000005

• A SEQUENTIAL ANALYSIS OF EFFECT OF SELECTIVE POSITIVE REINFORCEMENT IN MODIFYING ANOREXIA NERVOSA BEHAVIOUR RESEARCH AND THERAPY LEITENBE, H., Agras, W. S., Thomson, L. E. 1968; 6 (2): 211-?

  View details for Web of Science ID A1968B153700009

• Improving healthy eating in families with a toddler at risk for overweight: A cluster randomized controlled trial. Journal of Developmental & Behavioral Pediatrics Agras, W.S., Hammer, L.D., Huffman, L.C., Mascola, A., Bryson, S.W., Danaher, C.