RELAPSE PREVENTION IN TREATMENT OF ANOREXIA NERVOSA

My long-term goal in seeking an SDA is to develop a program of research focusing on the treatment of eating disorders, particularly anorexia nervosa. Specifically, I am committed to developing an outpatient clinical research program that would assess the efficacy of various treatment interventions aimed at reducing relapse rates in anorexia nervosa. Although anorexia nervosa has long been recognized as a serious and chronic disorders warranting intervention, the empirical data available to inform treatment decisions are sparse. The proposed SDA is a first step in developing a career plan that would enable me to gain the training and experience necessary to contribute substantially to this limited knowledge base in the field of eating disorders. The primary question addressed by this proposal is whether cognitive- behavioral treatment is an effective post-hospitalization, outpatient therapy as compared with Nutritional Counseling. In addition to receiving medical management of their disorder, 60 women between the ages of 16 and 45 years will be randomly assigned to one of these two outpatient treatment conditions upon discharge from the Eating Disorders Inpatient Unit at NYSPI-Columbia Presbyterian Medical Center. Participants will receive 40 sessions of treatment during a nine month period; primary points of assessment will be: 1) prior to admission to the hospital, 2) at discharge/initiation of the outpatient trial, 3) at termination of treatment; and 4) at 3, 6, and 12 months after completion of the outpatient treatment. Based on results from this study, the subsequent questions of comparative efficacy of psychotherapeutic and psychopharmacological interventions will be pursued.