I originally intended to post this on Friday night, but I was working on a grant application on nonsuicidal self-injury and didn’t have time to post it. Better late than never, I hope!
Plenary Session II – Dissemination and Development of Psychological Treatments in Eating Disorders: Evidence-Based or How to Sell Snake Oil? Dr. James Coyne started the session by countering the commonly held belief that all types of therapy are equally effective (referred to as the Dodo Bird Verdict).
He then went on to make several additional interesting points, some of which I’ve highlighted below:
1) Cognitive-behavioral therapy clearly has the strongest evidence base in terms of treatment for bulimia nervosa.
2) Evidence suggests that treatments that have a clear rationale, are goal-oriented, time-limited, and include regularly monitoring progress tend to outperform treatments without those components.
3) Similar to rules about medication, our field would benefit from predetermined rules about when to switch therapy modalities, when to stop a type of treatment (e.g., due to client deterioration or lack of progress), and when to refer a client to another treatment provider. All of these rules should be based on decisions made from frequent assessment of client progress.
4) Part of the work of treatment dissemination includes researchers findings ways to help clinicians and physicians feel comfortable with utilizing manualized treatments.
5) Keep in mind that behaviors that look like sabotage or nonadherence from eating disorder clients could be biological reactions related to their disorder. I interpreted this as a reminder to have compassion for our clients when they exhibit behaviors that look like resistance.
Among Dr. Coyne’s many contributions is his interactional description of depression. This paper has inspired studies in our lab about interpersonal processes related to eating disorders. I was fortunate to have an opportunity to talk with Dr. Coyne after the plenary session. I quoted something to him from one of his papers, and he replied, “well said.” I said, “I got that from you.” He said, “You know the funny thing is that I never said that. Someone just said I did, and I liked it, so I went with it.” (Disclaimer: this conversation is how I remember it and may not be exact). Fellow Coyne fans might find it amusing to know that I was talking about the statement that, “Depression isn’t just what’s in your head, it’s what your head is in.” (Also paraphrased).
Dr. Carolyn Becker focused on treatments that people widely adopt ahead of data proving their effectiveness and presented a list of hypothesized factors for this phenomenon. Her idea is that the identification of these factors could lead to better strategies for evidence-based treatment dissemination in the future. Some commonalities that she suggested were treatments that:
1) have big promises for success
2) are flexible (and often blended) approaches
3) are validating and supportive of therapist frustrations (e.g., coping with comorbidity, difficult-to-treat conditions)
4) have accessible, well-packaged trainings
5) are associated with charismatic leaders/presenters who are good storytellers and marketers
As a final highlight of this session, Dr. Kelly Vitousek said (with regards to treatment promotion), “It’s naive to assume researchers can be corrupted only by money.” She proposed a more comprehensive, accurate list of disclosures that researchers should declare:
This plenary panel critically examined our field and generated specific suggestions for improving practice and treatment dissemination. Overall, it was an excellent, thought-provoking session!
Oral Scientific Paper Session I – Binge Eating Disorder & Obesity
1) The negative impact of weight bias on self-esteem and emotions appears to be magnified when a person internalizes the bias (e.g., blames themselves for being the target of weight-based discrimination).
2) Preliminary evidence suggests that first-year college weight gain may be prevented by making healthy food the optimal default (i.e., creating cafeteria menus with healthy foods featured as the default and making unhealthy food less convenient to eat).
3) A specific type of impulsivity (negative urgency; the tendency to act rashly when distressed) predicts food consumption in the lab for individuals experiencing high levels of arousal during emotional states. This presentation was especially fun to see because the presenter, Joe Wonderlich, worked in our lab before he started graduate school. He is currently in a doctoral program for clinical psychology and doing very interesting work with Dr. Sarah Fischer. Here is a blurry picture of him:
Poster Presentations Session II – I enjoyed meeting many of the current students from my alma mater, Florida State University. Most importantly, Mun Yee Kwan represented our lab very well with her poster on Social Support, Perceived Stress, and Bulimic Behaviors. Her poster displayed findings from her dissertation, which demonstrated that higher levels of social support are related to lower levels of bulimic behaviors, because of its impact on stress perception. Specifically, it seems that individuals who have people that they can count on for support tend to feel less stressed about life’s challenges, and therefore, are less prone to engaging in bulimic behaviors.
Fun This was a particularly busy day, but we did find time to take the T to Chinatown for lunch and eat some delicious Malaysian food at a restaurant Mun Yee discovered when she lived in Boston. I had the tofu curry pot and roti canai (Indian pancake). All of it was so good!