Eating Disorders Clinical and Research Program Update Winter 2014/2015 Teen Mentor Program Drs. Thomas and Eddy Letter from the Directors The year of 2014 has been an exciting time at the Eating Disorders Clinical and Research Program (EDCRP) at Massachusetts General Hospital (MGH) – filled with research developments, clinical growth, talented trainees, and groundbreaking education initiatives. Our team has been awarded funding from the National Institutes of Health in support of innovative research to advance understanding of the biological mechanisms of eating and feeding disorders. We have increased the program’s treatment offerings to include a full spectrum of outpatient options serving individuals, groups, and families. More importantly, we’ve provided consultation and treatment to more than 150 patients, supported in part by our new comprehensive online assessment tool. We are delighted to share some of the highlights of this work during the past year with you! Kamryn T. Eddy, PhD and Jennifer J. Thomas, PhD The Teen Mentor Program, established in 2010, offers adolescent girls the opportunity to promote positive self-image and become peer leaders in their own communities. Over the course of the 2013-2014 school year, our teen mentors participated in the evidencebased Body Project eating disorder prevention program, and also spearheaded their own original mentorship projects. One such teen-led initiative, the “Blackboard Project,” invited a candid discussion about where body ideals come from (see photo below). Culminating their mentorship, the teens presented their work at the EDCRP’s Summer 2014 Event at the MGH Paul S. Russell Museum to celebrate the Teen Mentor Program and Summer Research Fellowship. We are excited to continue this program during the 2013-2014 Teen Mentors: 2014-2015 school from left, Sophie Taibl, Dr. Emily Gray, year under Dr. Gray’s Sarah Dahl dedicated leadership. We are now accepting nominations for the 2015-2016 mentorship program. To nominate a teen, please e-mail Dr. Emily Gray at [email protected]. Eating Disorders Clinical and Research Program Update Newest Members of Our Team We are pleased to welcome Laurie Manzo and Chris Mancuso to the EDCRP! Laurie and Chris have proven to be wonderful assets to our team and we are looking forward to our continued work with them. Laurie D. Manzo, MEd, RD, LDN Laurie Manzo joined the EDCRP team as a staff dietitian in January 2014. Laurie has been at MGH for nine years working with pediatric and adult patients with a variety of nutritional issues. She specializes in nutrition care for patients with disordered eating. Laurie’s goals include helping patients get in touch with hunger and satiety cues to better nourish their bodies. Christopher J. Mancuso, BA This year, we have also welcomed a new clinical research coordinator, Chris Mancuso, to our team. Chris coordinates the “Brain Study,” in conjunction with the MGH Neuroendocrine Unit and Pediatrics Department. His research interests include biological predictors of eating disorder trajectories. Recovery Record In 2013, the EDCRP became one of the first clinics nationwide to adopt Recovery Record, a mobile eating disorder treatment “app,” to support our cognitive behavioral program. With an integrative and interactive platform, the app provides both group and individual therapy patients with critical between-session tools. To learn more about Recovery Record, which is free for patients, visit recoveryrecord.com. meaningful steps toward recovery, and equip treating clinicians with the data and tools they need to do their best work.” Dr. Jenna Tregarthen shared with us why she founded Recovery Record and some pro tips for using the app: Pro tip number one: customize reminder times, messages, and tones in the “Settings” section of your app. This takes less than a minute and will set you up for success! “I care deeply about unlocking access to evidence-based care for every person who needs and wants it. This passion was ignited by seeing my sister’s daily struggles with the ups and downs of recovery, and a desire to “be there” for her in these moments that matter. A mobile app can be a proactive expression of empathy, providing the right support at the right time. By bringing evidence-based treatment components together with a gold-class user experience, Recovery Record aims to empower people to take People sometimes have a “love-hate” relationship with Recovery Record reminder alarms. These serve as a powerful nudge to help routinize regular eating, but default times may be out of sync with your routine, making them bothersome. Although it is ideal to make entries as close to meal times as possible, there are a whole range of reasons that life can sometimes get in the way. You need not give up if this happens! Pro tip number two: you can backlog meals for up to three days, allowing you to catch-up on missed entries and get back on track in no time. Research Collaborators Andrea S. Hartmann, PhD Dr. Hartmann, now an assistant professor at the Universität Osnabrück in Germany, continues her international research collaboration with the EDCRP. This work has involved a field trial of DSM-5 eating disorder diagnoses, yielding four publications this year. In collaboration with Drs. Thomas and Eddy, Dr. Hartmann is interested in investigating the neurobiological underpinnings of a subgroup of patients with anorexia nervosa who deny fear of fatness. Franziska Plessow, PhD Dr. Plessow is a Neurology research fellow at Beth Israel Deaconess Medical Center and Harvard Medical School and a research collaborator on the “Brain Study.” Her focus is on the the complex functions that regulate impulses, habits, intentional behavior, and personal autonomy. Dr. Plessow contributes to this work by investigating the role of cognitive control in the longitudinal trajectories of eating disorders, and determining whether competencies and weaknesses in cognitive control may be targets for novel prevention and early-stage treatment strategies. Jason R. Yee, PhD Dr. Yee is a principal research scientist in the Center for Translational Neuroimaging at Northeastern University, and is a research collaborator with the EDCRP and the MGH Neuroendocrine Unit. His lab is using prairie voles to develop an activity-based model of anorexia (ABA) in a rodent with a monogamous social system and human-like autonomic function. This research, which identifies hallmark features of anorexia nervosa (e.g., habitual food avoidance and excessive exercise) in prairie voles, suggests that such features may be a consequence, rather than a cause, of starvation. Nassim Tabri, PhD Dr. Tabri recently completed a Postdoctoral Research Fellowship in the EDCRP at Massachusetts General Hospital/Harvard Medical School. His research at the EDCRP involved examining the role of overvaluation of body shape/weight in the transdiagnostic CBT model of eating disorders, assessing the long-term weight outcomes of people with eating disorders, and conducting a meta-analysis of the relationship between therapeutic alliance and outcome in eating disorders. Dr. Tabri is currently a Postdoctoral Research Fellow in the Department of Psychology at Carleton University in Ottawa, Canada, and he continues to collaborate on research with the EDCRP. Charumathi Baskaran, MD Dr. Baskaran is a pediatric endocrinologist at Massachusetts General Hospital and a research collaborator on the Brain Study. She completed her research fellowship at Joslin Diabetes Center exploring obesity and body composition in children with Type 1 Diabetes and her research interests include eating disorders, obesity, exercise, and appetite regulation. Katherine A. Koh, MD Dr. Koh is a first-year psychiatry resident in the MGH/McLean Hospital residency program. She graduated from Harvard Medical School in the spring of 2014 and took the opportunity to work with the EDRCP on a paper about the prevalence of eating disorders in individuals with obesity. Using data from the EDCRP’s DSM-5 field trial, Dr. Koh found that adding binge eating disorder as a new psychiatric diagnosis did not significantly increase the overall prevalence of eating disorders among individuals with obesity. Eating Disorders Clinical and Research Program New Research Announcements! We are delighted to announce that the EDCRP, in conjunction with the MGH Neuroendocrine Unit, received a grant from the National Institute of Mental Health, supporting a longitudinal research project investigating hunger, satiety, and reward in adolescent and young adult females with low-weight eating disorders. Under the direction of Drs. Kamryn Eddy, Madhusmita Misra, and Elizabeth Lawson, the “Brain Study” uses cross-disciplinary techniques including functional brain imaging and measurement of hormone secretion to examine appetite regulation and brain circuitry to better understand eating disorder symptoms and change over time. This important research has the potential to help us refine and develop new treatments for these complex illnesses. We want to extend our thanks to all of the patients and families who have participated so far! Members of the Brain Study Team In addition, Emily Gray, MD, received a grant from the American Academy of Child and Adolescent Psychiatry to support her research on social cognition in these adolescents. Dr. Gray’s grant will support an in-depth examination of social anxiety and emotion processing in low-weight eating disorders. Update 2014 Summer Research Fellowship We established an annual Summer Research Fellowship in 1997 to promote the academic development of earlycareer clinical scientists. Over the past 18 years with the support of the Rubenstein Foundation and Matina S. Horner, PhD, our program has sponsored 53 undergraduate and graduate students for independent research projects. This year, the EDCRP From left, Lisa Anderson, had the pleasure of supporting 3 talented Cindy Schmelkin, Suzanne Straeble and Dr. Matina Horner young research fellows. As a testament to their hard work, all three will be giving talks related to their summer projects at the 2015 International Conference on Eating Disorders in Boston! Lisa Anderson, BA Lisa, a third year doctoral student in the Clinical Psychology program at the University at Albany, State University of New York, completed her Master’s thesis during the fellowship. She examined the relative contributions of fear and disgust to eating disorder symptomatology in order to inform future exposure interventions. Cindy Schmelkin, BS Cindy is a second year medical student at Harvard Medical School. In conjunction with both the EDCRP and the MGH Neuroendocrine Unit, she studied the effects of oxytocin dysregulation and weight recovery on social cognition in women with anorexia nervosa (AN). Suzanne Straebler, BA, MSN Suzanne is final year doctoral student in Psychiatry at The University of Oxford (UK). As part of a larger program of work being carried out by the Centre for Research on Dissemination at Oxford, her EDCRP project aimed to develop and evaluate scalable methods for improving the dissemination and implementation of evidence based treatments, especially cognitive behavioral therapy for eating disorders. The EDCRP is now accepting applications for the 2015 Summer Research Fellowship! Applications are due March 1, 2015. For more information and to apply, please visit http://www.massgeneral. org/psychiatry/services/eating_disorders_fellowships.aspx Recent Publications Here are examples of EDCRP’s 2013 research articles: Eddy, K. T., Thomas, J. J., Hastings, E., Edkins, K., Lamont, E., Nevins, C. M., Patterson, R. M., Murray, H. B., BryantWaugh, R., & Becker, A. E. (2014). Prevalence of DSM-5 avoidant/restrictive food intake disorder in a pediatric gastroenterology healthcare network. International Journal of Eating Disorders. [epub ahead of print] Eddy, K. T., Lawson, E. A., Meade, C., Meenaghan, E., Horton, S. E., Misra, M., Klibanski, A., & Miller, K. K. (2014). Appetite regulatory hormones in women with anorexia nervosa: binge-eating/purging versus restricting type. Journal of Clinical Psychiatry. [epub ahead of print] Thomas, J. J., Koh, K. A., Eddy, K. T., Hartmann, A. S., Murray, H. B., Gorman, M. J., Sogg, S., & Becker, A. E. (2014). Do DSM-5 feeding and eating disorder criteria over-pathologize normative eating patterns among individuals with obesity? Journal of Obesity, 320803, 1-8. Delaney, C. B., Eddy, K. T., Hartmann, A. S., Becker, A. E., Murray, H. B., & Thomas, J. J. (2014). Pica and rumination behavior among individuals seeking treatment for eating disorders or obesity. International Journal of Eating Disorders. [epub ahead of print] Garnett, B.R., Buelow, R., Franko, D.L., Becker, C., Rodgers, R.F., & Austin, S.B. (2014). The importance of campaign saliency as a predictor of attitude and behavior change: Apilot evaluation of social marketing campaign Fat Talk Free Week.® Health Communication, 29, 984-995. Gerbasi, M. E., Richards L. K., Thomas J. J., Agnew-Blais, J. C., Thompson-Brenner, H., Gilman, S. E., & Becker, A. E. (2014). Globalization and eating disorder risk: Peer influence, perceived social norms, and adolescent disordered eating in Fiji. International Journal of Eating Disorders, 47(7), 727-737. Hartmann, A. S., Thomas, J. J., Greenberg, J. L., Mattheny, N., & Wilhelm, S. (2014). A comparison of self-esteem and perfectionism, in anorexia nervosa and body dysmorphic disorder. Journal of Nervous and Mental Disease. [in press] Keshaviah, A., Edkins, K., Hastings, E. R., Krishna, M., Franko, D. L., Herzog, D. B., Thomas, J. J., Murray, H. B., & Eddy, K. T. (2014). Re-Examining Premature Mortality in Anorexia Nervosa: A Meta-Analysis Redux. Comprehensive Psychiatry. [epub ahead of print] Kwan, M.Y., Gordon, K.H., Eddy, K.T., Troop-Gordon, W., & Franko, D.L., (2014). Maladaptive coping and bulimic symptoms among undergraduate students: Gender differences. Eating Behaviors, 15, 632-637. Markowitz, J.T., Cousineau, T.M., Franko, D.L., Schultz, A.T., Trant, M., Rodgers, R.F. & Laffel, L.M.B. (2014). Text messaging intervention for teens and young adults with diabetes. Diabetes Science and Technology, 8, 1029-1034. Shingleton, R.M., Thompson-Brenner, H., Thompson, D.R., Pratt, E.R., & Franko, D.L., (in press). Gender differences in clinical trials of binge eating disorder: An analysis of aggregated data. Journal of Consulting and Clinical Psychology. Awards and Recognition In the spring, Dr. Thomas was recognized for her research and clinical contributions to the field as she became a Fellow of the Academy for Eating Disorders at the 2014 International Conference on Eating Disorders in New York. Dr. Thomas was named the Program Committee Co-Chair of the 2015 International Conference on Eating Disorders (to be held April 23-25, 2015 in Boston). Dr. Eddy will be by her side as a program committee member. In January, Dr. Becker was distinguished with an award for the Exceptional Mentorship of Women Faculty from the MGH Department of Psychiatry. Dr. Becker was awarded a generous grant from the Hilda & Preston Davis Foundation to investigate if and how entertainment media might promote healthy eating and weight. Dr. Becker also had the opportunity to vice chair the American Psychiatric Association International Council on Psychiatry. Eating Disorders Clinical and Research Program Update Presentations We are grateful for the opportunity to present our research findings all over the world. In September, Dr. Eddy presented research from our 22-year Longitudinal Study at the 431 Project and TEDx Summit in Pittsfield, VT. These findings offer hope that recovery is possible, even for individuals who have been ill for many years. Here are several other notable presentations from 2014: ➤ In the spring, Drs. Thomas, Becker, Franko, and Ms. Burton presented original research at the annual International Conference on Eating Disorders in New York. ➤ In the spring, Dr. Thomas presented a webinar on disordered eating in college students as part of the National Eating Disorders Screening Program. ➤ In the fall, Dr. Eddy presented on healthy eating and positive body image in adolescents at the MGH Department of Psychiatry’s 80th Anniversary Symposium in Boston. Dr. Franko after a research presentation in Prague ➤ At the National Institutes of Health, Dr. Becker presented on developing research capacity for youth mental health interventions in Haiti for the Frontiers in Neuroscience for Global Health. Dr. Tabri and Ms. Burton at the 2014 HMS Psychiatry Research Data poster session ➤ Dr. Gray presented on psychiatric treatment and medical management of eating disorders at a two-day training program in Caribou, ME for the Cary Medical Center in the fall. ➤ In the spring, Dr. Franko presented on the effects of physical activity interventions in overweight children as well as the implementation of a text messaging program for adolescents with type I diabetes at the World Congress on Controversies in Pediatrics in Prague. ➤ For the Hilda and Preston Davis Foundation-Global Foundation of Eating Disorders Symposium in New York, Dr. Becker presented on the challenges of the global burden of eating disorders, but also what we can do about it. ➤ For the MGH Psychiatry Academy’s Virtual Grand Rounds, Dr. Eddy presented on the new diagnosis and classification of DSM-5 feeding and eating disorders. From Our Clinician Partners in Adolescent & Young Adult Medicine Dr. Mark Goldstein, chief of MGH’s Division of Adolescent and Young Adult Medicine, shares some words about our multi-disciplinary clinical partnership: “On many occasions, our Division faculty have collaborated with the clinicians of the EDCRP in the care of adolescents and young adults with eating disorders. This collaboration has allowed the Division to expand services for patients with eating disorders as well as center their care at MGH. In every case, the care provided by the EDCRP to our patients is of the highest quality, and we look forward to a continued mutually beneficial and productive relationship.” In the News On The Dr. Oz Show in February 2014, Dr. Thomas highlighted how social media has created dangerous new opportunities for body checking to get out of control, explaining that “the ‘thigh gap’ has existed for as long as eating disorders have existed, but now it has a name, it has a brand, it has a hashtag.” Dr. Eddy highlighted the critical need for new eating disorder treatments in the Medscape News magazine article, “Family-based therapy best treatment for teen anorexia.” The New York Times quoted Dr. Thomas in an article on the hazardous outcomes of competitive weight loss television shows called “A Big Reveal Touches a Nerve: Viewers of the ‘Biggest Loser’ Question a Startling Weight Loss.” Importantly, Dr. Thomas referred to the negatively reinforcing message that such shows send to individuals already struggling with disordered eating. Save the Date! EDCRP Patient Family Day June 13, 2015 We are excited to announce our plans to hold a day-long program as part of the MGH Psychiatry Academy’s Patient and Family Education series. We will feature invited talks from experts who will highlight the latest clinical and research innovations, and patients and families who will share their inspiring recovery stories. This event will take place in Boston on June 13, 2015 and will be open to the community, supported by an educational grant from the Rubenstein Foundation. We will post updates on our calendar and hope to see you there! The Academy for Eating Disorders’ International Conference will be held in Boston this spring. Please consider attending April 23-25, 2015 at the Boston Marriot Copley Place Hotel. For registration or more information, visit http://www.aedweb.org/ICED2015/ Participate in our Research “Brain Study” The Neuroendocrine Unit and Eating Disorders Clinical and Research Program at MGH have a research study for women and girls between the ages of 10 and 21 who currently have a low-weight eating disorder. If you are interested in participating or learning more, please fill out our brief online questionnaire. The link is below. Feel free to forward it along to anyone you think might be interested! https://redcap.partners.org/ redcap/surveys/?s=vXBQ2peXoD. Or call: 617-643-0267. We are also actively recruiting adolescents and adults for a number of other studies through the EDCRP and the Neuroendocrine Unit. Please visit our websites for more details: www.aneresearch.com AND www.myresearchsurvey.org. Eating Disorders Clinical and Research Program Update Eating Disorders Clinical and Research Program Massachusetts General Hospital 2 Longfellow Place Suite 200 Boston, MA 02114 Eating Disorders Clinical and Research Program Team Join Us Online Professional Staff Visit our website! Kamryn T. Eddy, PhD Co-Director Jennifer J. Thomas, PhD Co-Director Helen Burton, BA Clinical Research Coordinator Christopher Mancuso, BA Clinical Research Coordinator Clinical Teaching Faculty Anne E. Becker, MD, PhD, ScM Founding Director Judith C. Craver, PhD Audrey E. Tolman, PhD Debra L. Franko, PhD Associate Director Clinical Affiliates Emily K. Gray, MD Staff Psychiatrist; Teen Mentor Program Director Laurie D. Manzo, MEd, RD, LDN Staff Dietitian Melissa Abraham, PhD Helen Riess, MD Nicole Simi, PhD One of the most frequently visited websites in the MGH Department of Psychiatry, the EDCRP’s website includes full staff bios, more news and events, as well as frequently updated information about our treatment, education, training, and research initiatives. www.massgeneral.org/eatingdisorders WAYS TO GIVE For information about ways to support the clinical care, research, teaching and advocacy activities of the MGH Eating Disorders Clinical and Research Program, please contact Frank Soldo at (617) 724-0186 or [email protected]
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