Current Projects

Because anorexia begins in adolescence, early intervention is key to prevent a chronic course of the disorder. To date, there is only one intervention with substantial evidence-based support for treating anorexia in adolescents: Family Based Treatment (FBT). However, currently, only 50% of adolescents reach full remission after treatment. 

Studies in adults and adolescents with anorexia indicate that they have inefficiencies in cognitive flexibility (e.g., have a difficult time switching gears or topics) and may struggle with big picture thinking. In addition, they frequently exhibit reduced behavioral flexibility (e.g., extreme perfectionism, perseveration, difficulties in learning new behaviors) that researchers believe reflects this underlying neurocognitive inefficiency. Importantly, researchers hypothesize that cognitive inefficiencies are a generalized risk factor for the development of anorexia. Targeting these inefficiencies may increase the effectiveness of treatment.

Cognitive Remediation Therapy (CRT) is an adjunctive treatment known to improve cognitive flexibility by teaching individuals to think about how they think. The Shifting Perspectives Study combines FBT with CRT to determine if we can improve long-term outcomes for more adolescents with anorexia. Currently, there is little research on how best to combine CRT with FBT for adolescents. 

In the first phase of this study, we recruited adolescents ages 12-18 with anorexia and enrolled them into one of three treatment arms: FBT alone, FBT plus parent-focused CRT or FBT plus adolescent-focused CRT. We collected psychosocial, neurocognitive and behavioral measures throughout the study. The ultimate purpose of this project was to determine whether or not CRT improves cognitive flexibility in parents, adolescents or both. We found that CRT did, indeed, increase flexibility in youth with AN more rapidly than renourishment alone. 

The second phase of this study has closed enrollment. We are wrapping up data collection.  Please see our study page for more information. 

Our Microbiome study is looking at microbial diversity in females between the ages of 12 and 24 with AN-R, comparing weight restored participants to participants at the beginning of treatment. The goal of this study is to understand what role the gut microbiome plays in the development and maintenance of anorexia nervosa. We also hope to understand how the food that adolescents and young adults eat affects the gut and inflammation levels. 

Retrospective chart review (RCR) is a research methodology that uses existing patient-centered data to answer specific research questions. RCRs allow researchers to leverage data to examine clinically relevant questions – results can be used to inform practice and subsequent prospective studies. We employ best practices in RCR. We are currently conducting a number of RCRs to answer a variety of questions:

• Examining testosterone levels in males hospitalized for medical stabilization of anorexia nervosa.
• The presentation and treatment of ARFID subtypes.
• Sex differences in the prescription of atypical antipsychotics.
• The impact of COVID on the presentation of eating disorders.
• Examining clinical characteristics of comorbid of autoimmune gastrointestinal diseases and eating disorders.

A systematic review poses a research question, identifies inclusion and exclusion criteria, collects empirical evidence that fits the pre-specified eligibility criteria, all in order to answer the research question. Systematic reviews provide an overview of a particular area of research and can be used to identify research gaps.

• Scoping review of participant adherence to Ecological Momentary Assessment (EMA) research protocols.
• Review of aversive affects of highly visual social media on adolescents and young adults.