Cara Bohon, PhD

  • Cara M Bohon



Work and Education


UCLA Semel Institute, Los Angeles, CA, 2010


UCLA Semel Institute, Los Angeles, CA, 2012

All Publications

Aberrant Dynamic Connectivity for Fear Processing in Anorexia Nervosa and Body Dysmorphic Disorder FRONTIERS IN PSYCHIATRY Rangaprakash, D., Bohon, C., Lawrence, K. E., Moody, T., Morfini, F., Khalsa, S. S., Strober, M., Feusner, J. D. 2018; 9
Comorbid depressive symptoms and self-esteem improve after either cognitive-behavioural therapy or family-based treatment for adolescent bulimia nervosa EUROPEAN EATING DISORDERS REVIEW Valenzuela, F., Lock, J., Le Grange, D., Bohon, C. 2018; 26 (3): 25358


This study examined the effect of family-based treatment for bulimia nervosa (FBT-BN) and cognitive behavioral therapy for adolescents (CBT-A) on depressive symptoms and self-esteem in adolescents with BN. Data were collected from 110 adolescents, ages 12-18, who met Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition, text revision criteria for BN or partial BN. Participants were randomly assigned to FBT-BN or CBT-A and completed measures of depressive symptoms and self-esteem before and after treatment and at 6- and 12-month follow-up assessments. Depressive symptoms and self-esteem significantly improved in both treatments, and neither treatment appeared superior on these clinical outcomes. Parents often worry whether FBT-BN addresses comorbid depressive symptoms and low self-esteem. Our findings address this concern, as they demonstrate that FBT-BN does not differ from CBT-A in improving depressive symptoms and self-esteem, and both treatments result in symptom improvement. These findings can help clinicians guide families to choose a treatment that addresses BN and depressive symptoms and low self-esteem.

View details for DOI 10.1002/erv.2582

View details for Web of Science ID 000430661300008

View details for PubMedID 29446174

Changes in Cerebral Cortical Thickness Related to Weight Loss Following Bariatric Surgery. Obesity surgery Bohon, C., Garcia, L. C., Morton, J. M. 2018


Cerebral cortical thickness is associated with memory and intelligence test scores and serves as a measure for changes in cortical gray matter. Previous studies suggest reduced cortical thickness in patients with obesity. This study aimed to investigate changes in cortical thickness following bariatric surgery. Magnetic resonance imaging (MRI) data of five patients were analyzed preoperatively and 6months postoperatively to assess changes in global measures of cortical thickness. No patients were lost to follow-up. This study provides preliminary evidence of brain change following surgery, suggests increases in cerebral cortical thickness in patients with greater excess weight loss, and indicates the need for further investigation using larger samples and correlation with neurocognitive measures, such as memory recall.

View details for DOI 10.1007/s11695-018-3317-6

View details for PubMedID 29876838

An interoceptive model of bulimia nervosa: A neurobiological systematic review. Journal of psychiatric research Klabunde, M., Collado, D., Bohon, C. 2017; 94: 3646


The objective of our study was to examine the neurobiological support for an interoceptive sensory processing model of bulimia nervosa (BN). To do so, we conducted a systematic review of interoceptive sensory processing in BN, using the PRISMA guidelines. We searched PsychInfo, Pubmed, and Web of Knowledge databases to identify biological and behavioral studies that examine interoceptive detection in BN. After screening 390 articles for inclusion and conducting a quality assessment of articles that met inclusion criteria, we reviewed 41 articles. We found that global interoceptive sensory processing deficits may be present in BN. Specifically there is evidence of abnormal brain function, structure and connectivity in the interoceptive neural network, in addition to gastric and pain processing disturbances. These results suggest that there may be a neurobiological basis for global interoceptive sensory processing deficits in BN that remain after recovery. Data from taste and heart beat detection studies were inconclusive; some studies suggest interoceptive disturbances in these sensory domains. Discrepancies in findings appear to be due to methodological differences. In conclusion, interoceptive sensory processing deficits may directly contribute to and explain a variety of symptoms present in those with BN. Further examination of interoceptive sensory processing deficits could inform the development of treatments for those with BN.

View details for DOI 10.1016/j.jpsychires.2017.06.009

View details for PubMedID 28651098

Differences in Emotion Regulation Difficulties Across Types of Eating Disorders During Adolescence. Journal of abnormal child psychology Weinbach, N., Sher, H., Bohon, C. 2017


Emotion regulation appears to play a key role in eating disorders. However, prior attempts to associate specific emotion regulation abilities with specific types of eating disorders resulted in inconsistent findings. Moreover, far less is known about emotion regulation in eating disorders during adolescence, a critical period of emotional development. The current study addresses this gap, comparing emotion regulation characteristics between adolescents with restrictive types of eating disorders and those with binge eating or purging types of eating disorders. Ninety-eight adolescents with eating disorders (49 with restrictive and 49 with binge eating/purging eating disorders) completed a set of questionnaires including the Difficulties in Emotion Regulation Scale (DERS). The results revealed that binge eating/purging types of eating disorders were associated with greater difficulties in a variety of emotion regulation dimensions including impulse control, goal-directed behavior and access to effective emotion regulation strategies. Awareness and clarity of emotions were also worse in the binge eating/purging types of eating disorders, but this difference did not remain when comorbid psychopathology measures were controlled for. Moreover, the emotion regulation profile of adolescents with anorexia nervosa-binging/purging type was more similar to that of adolescents with bulimia nervosa than to that of adolescents with anorexia nervosa-restrictive type. While both restrictive and binge eating/purging eating disorders have been associated with emotion regulation difficulties, the current study shows that the presence of binge eating or purging episodes is linked with greater severity of emotion regulation deficits among adolescents with eating disorders.

View details for DOI 10.1007/s10802-017-0365-7

View details for PubMedID 29101588

Brain response to taste in overweight children: A pilot feasibility study. PloS one Bohon, C. 2017; 12 (2)


Understanding the neural response to food and food cues during early stages of weight gain in childhood may help us determine the drive processes involved in unhealthy eating behavior and risk for obesity. Healthy weight and overweight children ages 6-8 (N = 18; 10 with BMI between 5th and 85th %ile and 8 with BMI >85th %ile) underwent fMRI scans while anticipating and receiving tastes of chocolate milkshake. Parents completed a Children's Eating Behaviour Questionnaire. Results reveal greater response to milkshake taste receipt in overweight children in the right insula, operculum, precentral gyrus, and angular gyrus, and bilateral precuneus and posterior cingulate. No group differences were found for brain response to a visual food cue. Exploratory analyses revealed interactions between self-report measures of eating behavior and weight status on brain response to taste. This pilot study provides preliminary evidence of feasibility of studying young children's taste processing and suggests a possible developmental shift in brain response to taste.

View details for DOI 10.1371/journal.pone.0172604

View details for PubMedID 28235080

Functional connectivity for face processing in individuals with body dysmorphic disorder and anorexia nervosa PSYCHOLOGICAL MEDICINE Moody, T. D., Sasaki, M. A., Bohon, C., Strober, M. A., Bookheimer, S. Y., Sheen, C. L., Feusner, J. D. 2015; 45 (16): 3491-3503

View details for DOI 10.1017/S0033291715001397

View details for Web of Science ID 000364937200010

View details for PubMedID 26219399

Anorexia nervosa and body dysmorphic disorder are associated with abnormalities in processing visual information PSYCHOLOGICAL MEDICINE Li, W., Lai, T. M., Bohon, C., Loo, S. K., McCurdy, D., Strober, M., Bookheimer, S., Feusner, J. 2015; 45 (10): 2111-2122
Deep brain stimulation for obesity: rationale and approach to trial design. Neurosurgical focus Ho, A. L., Sussman, E. S., Pendharkar, A. V., Azagury, D. E., Bohon, C., Halpern, C. H. 2015; 38 (6): E8-?


Obesity is one of the most serious public health concerns in the US. While bariatric surgery has been shown to be successful for treatment of morbid obesity for those who have undergone unsuccessful behavioral modification, its associated risks and rates of relapse are not insignificant. There exists a neurological basis for the binge-like feeding behavior observed in morbid obesity that is believed to be due to dysregulation of the reward circuitry. The authors present a review of the evidence of the neuroanatomical basis for obesity, the potential neural targets for deep brain stimulation (DBS), as well as a rationale for DBS and future trial design. Identification of an appropriate patient population that would most likely benefit from this type of therapy is essential. There are also significant cost and ethical considerations for such a neuromodulatory intervention designed to alter maladaptive behavior. Finally, the authors present a consolidated set of inclusion criteria and study end points that should serve as the basis for any trial of DBS for obesity.

View details for DOI 10.3171/2015.3.FOCUS1538

View details for PubMedID 26030708

Deep Brain Stimulation for Obesity. Cureus Ho, A. L., Sussman, E. S., Zhang, M., Pendharkar, A. V., Azagury, D. E., Bohon, C., Halpern, C. H. 2015; 7 (3)


Obesity is now the third leading cause of preventable death in the US, accounting for 216,000 deaths annually and nearly 100 billion dollars in health care costs. Despite advancements in bariatric surgery, substantial weight regain and recurrence of the associated metabolic syndrome still occurs in almost 20-35% of patients over the long-term, necessitating the development of novel therapies. Our continually expanding knowledge of the neuroanatomic and neuropsychiatric underpinnings of obesity has led to increased interest in neuromodulation as a new treatment for obesity refractory to current medical, behavioral, and surgical therapies. Recent clinical trials of deep brain stimulation (DBS) in chronic cluster headache, Alzheimer's disease, and depression and obsessive-compulsive disorderhave demonstrated the safety and efficacy of targeting the hypothalamus and reward circuitry of the brain with electrical stimulation, and thus provide the basis for a neuromodulatory approach to treatment-refractory obesity. In this study, we review the literature implicating these targets for DBS in the neural circuitry of obesity. We will also briefly review ethical considerations for such an intervention, and discuss genetic secondary-obesity syndromes that may also benefit from DBS. In short, we hope to provide the scientific foundation to justify trials of DBS for the treatment of obesity targeting these specific regions of the brain.

View details for DOI 10.7759/cureus.259

View details for PubMedID 26180683

View details for PubMedCentralID PMC4494510

Greater emotional eating scores associated with reduced frontolimbic activation to palatable taste in adolescents. Obesity Bohon, C. 2014; 22 (8): 1814-1820


This study examined the relation between self-reported emotional eating scores and frontolimbic brain response to palatable taste in adolescents.Participants included 162 adolescents (mean BMI percentile=52.7, range 3-90). Participants completed a self-report survey assessing emotional eating and underwent functional magnetic resonance imaging (fMRI) while viewing pictures signaling subsequent delivery of a chocolate milkshake or a control taste and receiving the corresponding taste.Results revealed no significant relation between emotional eating scores and brain response to anticipation of receipt of milkshake. In response to milkshake taste receipt, emotional eating scores were negatively related to activation in the right thalamus, the left insula and orbitofrontal cortex, and bilateral putamen and caudate. These findings remained significant after controlling for body mass index and body fat percentage.The current results are discussed in the context of findings of reduced reward activation to palatable taste receipt in obese adults and adolescents.

View details for DOI 10.1002/oby.20759

View details for PubMedID 24715468

Visual processing in anorexia nervosa and body dysmorphic disorder: Similarities, differences, and future research directions. Journal of psychiatric research Madsen, S. K., Bohon, C., Feusner, J. D. 2013; 47 (10): 1483-1491


Anorexia nervosa (AN) and body dysmorphic disorder (BDD) are psychiatric disorders that involve distortion of the experience of one's physical appearance. In AN, individuals believe that they are overweight, perceive their body as "fat," and are preoccupied with maintaining a low body weight. In BDD, individuals are preoccupied with misperceived defects in physical appearance, most often of the face. Distorted visual perception may contribute to these cardinal symptoms, and may be a common underlying phenotype. This review surveys the current literature on visual processing in AN and BDD, addressing lower- to higher-order stages of visual information processing and perception. We focus on peer-reviewed studies of AN and BDD that address ophthalmologic abnormalities, basic neural processing of visual input, integration of visual input with other systems, neuropsychological tests of visual processing, and representations of whole percepts (such as images of faces, bodies, and other objects). The literature suggests a pattern in both groups of over-attention to detail, reduced processing of global features, and a tendency to focus on symptom-specific details in their own images (body parts in AN, facial features in BDD), with cognitive strategy at least partially mediating the abnormalities. Visuospatial abnormalities were also evident when viewing images of others and for non-appearance related stimuli. Unfortunately no study has directly compared AN and BDD, and most studies were not designed to disentangle disease-related emotional responses from lower-order visual processing. We make recommendations for future studies to improve the understanding of visual processing abnormalities in AN and BDD.

View details for DOI 10.1016/j.jpsychires.2013.06.003

View details for PubMedID 23810196

Nonlinear relationships between anxiety and visual processing of own and others' faces in body dysmorphic disorder PSYCHIATRY RESEARCH-NEUROIMAGING Bohon, C., Hembacher, E., Moller, H., Moody, T. D., Feusner, J. D. 2012; 204 (2-3): 132-139


Individuals with body dysmorphic disorder (BDD) often experience anxiety, as well as perceptual distortions of appearance. Anxiety has previously been found to impact visual processing. This study therefore tested the relationship between anxiety and visual processing of faces in BDD. Medication-free participants with BDD (N=17) and healthy controls (N=16) viewed photographs of their face and a familiar face during functional magnetic resonance imaging. Blood-oxygen-level dependent signal changes in regions involved in anxiety (amygdala) and detailed visual processing (ventral visual stream-VVS) were regressed on anxiety scores. Significant linear relationships between activity in the amygdala and VVS were found in both healthy controls and individuals with BDD. There was a trend of a quadratic relationship between anxiety and activity in the right VVS and a linear relationship between anxiety and activity in the left VVS for the BDD sample, and this was stronger for own-face stimuli versus familiar-face. Results suggest that anxiety symptoms in BDD may be associated with activity in systems responsible for detailed visual processing. This may have clinical implications related to heightened perceptual distortions associated with anxiety.

View details for DOI 10.1016/j.pscychresns.2012.09.003

View details for Web of Science ID 000314329200010

View details for PubMedID 23137801

Negative affect and neural response to palatable food intake in bulimia nervosa APPETITE Bohon, C., Stice, E. 2012; 58 (3): 964-970


Binge eating is often preceded by reports of negative affect, but the mechanism by which affect may lead to binge eating is unclear. This study evaluated the effect of negative affect on neural response to anticipation and receipt of palatable food in women with bulimia nervosa (BN) versus healthy controls. We also evaluated connectivity between the amygdala and reward-related brain regions. Females with and without BN (n=26) underwent functional magnetic resonance imaging (fMRI) during receipt and anticipated receipt of chocolate milkshake and a tasteless solution. We measured negative affect just prior to the scan. Women with BN showed a positive correlation between negative affect and activity in the putamen, caudate, and pallidum during anticipated receipt of milkshake (versus tasteless solution). There were no significant relations between negative affect and receipt of milkshake. Connectivity analyses revealed a greater relation of amygdala activity to activation in the left putamen and insula during anticipated receipt of milkshake in the bulimia group relative to the control group. The opposite pattern was found for the taste of milkshake; the control group showed a greater relation of amygdala activity to activation in the left putamen and insula in response to milkshake receipt than the bulimia group. Results show that as negative affect increases, so does responsivity of reward regions to anticipated intake of palatable food, implying that negative affect may increase the reward value of food for individuals with bulimia nervosa or that negative affect has become a conditioned cue due to a history of binge eating in a negative mood.

View details for DOI 10.1016/j.appet.2012.02.051

View details for Web of Science ID 000304336800030

View details for PubMedID 22387716

Effects of cranial electrotherapy stimulation on resting state brain activity. Brain and behavior Feusner, J. D., Madsen, S., Moody, T. D., Bohon, C., Hembacher, E., Bookheimer, S. Y., Bystritsky, A. 2012; 2 (3): 211-220


Cranial electrotherapy stimulation (CES) is a U.S. Food and Drug Administration (FDA)-approved treatment for insomnia, depression, and anxiety consisting of pulsed, low-intensity current applied to the earlobes or scalp. Despite empirical evidence of clinical efficacy, its mechanism of action is largely unknown. The goal was to characterize the acute effects of CES on resting state brain activity. Our primary hypothesis was that CES would result in deactivation in cortical and subcortical regions. Eleven healthy controls were administered CES applied to the earlobes at subsensory thresholds while being scanned with functional magnetic resonance imaging in the resting state. We tested 0.5- and 100-Hz stimulation, using blocks of 22 sec "on" alternating with 22 sec of baseline (device was "off"). The primary outcome measure was differences in blood oxygen level dependent data associated with the device being on versus baseline. The secondary outcome measures were the effects of stimulation on connectivity within the default mode, sensorimotor, and fronto-parietal networks. Both 0.5- and 100-Hz stimulation resulted in significant deactivation in midline frontal and parietal regions. 100-Hz stimulation was associated with both increases and decreases in connectivity within the default mode network (DMN). Results suggest that CES causes cortical brain deactivation, with a similar pattern for high- and low-frequency stimulation, and alters connectivity in the DMN. These effects may result from interference from high- or low-frequency noise. Small perturbations of brain oscillations may therefore have significant effects on normal resting state brain activity. These results provide insight into the mechanism of action of CES, and may assist in the future development of optimal parameters for effective treatment.

View details for DOI 10.1002/brb3.45

View details for PubMedID 22741094

Reward Abnormalities among Women with Full and Subthreshold Bulimia Nervosa: A Functional Magnetic Resonance Imaging Study INTERNATIONAL JOURNAL OF EATING DISORDERS Bohon, C., Stice, E. 2011; 44 (7): 585-595


To test the hypothesis that women with full and subthreshold bulimia nervosa show abnormal neural activation in response to food intake and anticipated food intake relative to healthy control women.Females with and without full/subthreshold bulimia nervosa recruited from the community (N = 26) underwent functional magnetic resonance imaging (fMRI) during receipt and anticipated receipt of chocolate milkshake and a tasteless control solution.Women with bulimia nervosa showed trends for less activation than healthy controls in the right anterior insula in response to anticipated receipt of chocolate milkshake (vs. tasteless solution) and in the left middle frontal gyrus, right posterior insula, right precentral gyrus, and right mid dorsal insula in response to consumptions of milkshake (vs. tasteless solution).Bulimia nervosa may be related to potential hypofunctioning of the brain reward system, which may lead these individuals to binge eat to compensate for this reward deficit, though the hypo-responsivity might be a result of a history of binge eating highly palatable foods.

View details for DOI 10.1002/eat.20869

View details for Web of Science ID 000296417900003

View details for PubMedID 21997421

An fMRI study of obesity, food reward, and perceived caloric density. Does a low-fat label make food less appealing? APPETITE Ng, J., Stice, E., Yokum, S., Bohon, C. 2011; 57 (1): 65-72


We tested the hypothesis that obese individuals experience greater activation of the gustatory and somatosensory cortex, but weaker activation of the striatum, in response to intake and anticipated intake of high-fat chocolate milkshake versus an isocaloric milkshake labeled low-fat and a tasteless solution using functional magnetic resonance imaging (fMRI) with 17 obese and 17 lean young women. Obese relative to lean women showed greater activation in somatosensory (Rolandic operculum), gustatory (frontal operculum), and reward valuation regions (amgydala, ventralmedial prefrontal cortex (vmPFC) in response to intake and anticipated intake of milkshake versus tasteless solution, though there was little evidence of reduced striatal activation. Obese relative to lean women also showed greater activation in the Rolandic operculum, frontal operculum, and vmPFC in response to isocaloric milkshakes labeled regular versus low-fat. Results suggest that hyper-responsivity of somatosensory, gustatory, and reward valuation regions may be related to overeating and that top-down processing influence reward encoding, which could further contribute to weight gain.

View details for DOI 10.1016/j.appet.2011.03.017

View details for Web of Science ID 000293677900010

View details for PubMedID 21497628

Weight Gain Is Associated with Reduced Striatal Response to Palatable Food JOURNAL OF NEUROSCIENCE Stice, E., Yokum, S., Blum, K., Bohon, C. 2010; 30 (39): 13105-13109


Consistent with the theory that individuals with hypofunctioning reward circuitry overeat to compensate for a reward deficit, obese versus lean humans have fewer striatal D2 receptors and show less striatal response to palatable food intake. Low striatal response to food intake predicts future weight gain in those at genetic risk for reduced signaling of dopamine-based reward circuitry. Yet animal studies indicate that intake of palatable food results in downregulation of D2 receptors, reduced D2 sensitivity, and decreased reward sensitivity, implying that overeating may contribute to reduced striatal responsivity. Thus, we tested whether overeating leads to reduced striatal responsivity to palatable food intake in humans using repeated-measures functional magnetic resonance imaging. Results indicated that women who gained weight over a 6 month period showed a reduction in striatal response to palatable food consumption relative to weight-stable women. Collectively, results suggest that low sensitivity of reward circuitry increases risk for overeating and that this overeating may further attenuate responsivity of reward circuitry in a feedforward process.

View details for DOI 10.1523/JNEUROSCI.2105-10.2010

View details for Web of Science ID 000282571800021

View details for PubMedID 20881128

Relation of dietary restraint scores to cognitive biases and reward sensitivity APPETITE Ahern, A. L., Field, M., Yokum, S., Bohon, C., Stice, E. 2010; 55 (1): 61-68


This study tested the hypotheses that dietary restraint scores are associated with greater reward sensitivity and cognitive bias for food-related cues, which might result in chronic overeating and efforts to curb this tendency through dietary restriction. Participants (N=63) with high versus low scores on the DEBQ-R did not differ on attentional bias for pictorial food-related cues on a visual probe task, or approach tendencies elicited by food cues, as assessed with a stimulus-response compatibility (SRC) task. Restraint was also unrelated to performance on an operant task that assessed how hard participants would work for snacks, or responding during a taste habituation paradigm. Dietary restraint scores were correlated with self-reported appetitive response to food, sensitivity to reward, and sensitivity to punishment. Results provide limited support for the hypothesis that individuals with elevated dietary restraint scores show greater reward sensitivity and cognitive bias for food stimuli, though it is possible that the null findings on the behavioral task resulted because of an approach-avoidance conflict to food cues in which heightened appetitive responses to food are inhibited by food-related anxiety.

View details for DOI 10.1016/j.appet.2010.04.001

View details for Web of Science ID 000280213300010

View details for PubMedID 20399819

Reward circuitry responsivity to food predicts future increases in body mass: Moderating effects of DRD2 and DRD4 NEUROIMAGE Stice, E., Yokum, S., Bohon, C., Marti, N., Smolen, A. 2010; 50 (4): 1618-1625


To determine whether responsivity of reward circuitry to food predicts future increases in body mass and whether polymorphisms in DRD2 and DRD4 moderate these relations.The functional magnetic resonance imaging (fMRI) paradigm investigated blood oxygen level dependent activation in response to imagined intake of palatable foods, unpalatable foods, and glasses of water shown in pictures. DNA was extracted from saliva samples using standard salting-out and solvent precipitation methods.Forty-four adolescent female high school students ranging from lean to obese.Future increases in body mass index (BMI).Weaker activation of the frontal operculum, lateral orbitofrontal cortex, and striatum in response to imagined intake of palatable foods, versus imagined intake of unpalatable foods or water, predicted future increases in body mass for those with the DRD2 TaqIA A1 allele or the DRD4-7R allele. Data also suggest that for those lacking these alleles, greater responsivity of these food reward regions predicted future increases in body mass.This novel prospective fMRI study indicates that responsivity of reward circuitry to food increases risk for future weight gain, but that genes that impact dopamine signaling capacity moderate the predictive effects, suggesting two qualitatively distinct pathways to unhealthy weight gain based on genetic risk.

View details for DOI 10.1016/j.neuroimage.2010.01.081

View details for Web of Science ID 000276023500028

View details for PubMedID 20116437

A Meta-Analytic Review of Depression Prevention Programs for Children and Adolescents: Factors That Predict Magnitude of Intervention Effects JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY Stice, E., Shaw, H., Bohon, C., Marti, C. N., Rohde, P. 2009; 77 (3): 486-503


In this meta-analytic review, the authors summarized the effects of depression prevention programs for youth as well as investigated participant, intervention, provider, and research design features associated with larger effects. They identified 47 trials that evaluated 32 prevention programs, producing 60 intervention effect sizes. The average effect for depressive symptoms from pre-to-posttreatment (r = .15) and pretreatment to-follow-up (r = .11) were small, but 13 (41%) prevention programs produced significant reductions in depressive symptoms and 4 (13%) produced significant reductions in risk for future depressive disorder onset relative to control groups. Larger effects emerged for programs targeting high-risk individuals, samples with more females, samples with older adolescents, programs with a shorter duration and with homework assignments, and programs delivered by professional interventionists. Intervention content (e.g., a focus on problem-solving training or reducing negative cognitions) and design features (e.g., use of random assignment and structured interviews) were unrelated to effect sizes. Results suggest that depression prevention efforts produce a higher yield if they incorporate factors associated with larger intervention effects (e.g., selective programs with a shorter duration that include homework).

View details for DOI 10.1037/a0015168

View details for Web of Science ID 000266614800011

View details for PubMedID 19485590

Female Emotional Eaters Show Abnormalities in Consummatory and Anticipatory Food Reward: A Functional Magnetic Resonance Imaging Study INTERNATIONAL JOURNAL OF EATING DISORDERS Bohon, C., Stice, E., Spoor, S. 2009; 42 (3): 210-221


To test the hypothesis that emotional eaters show greater neural activation in response to food intake and anticipated food intake than nonemotional eaters and whether these differences are amplified during a negative versus neutral mood state.Female emotional eaters and nonemotional eaters (N = 21) underwent functional magnetic resonance imaging (fMRI) during receipt and anticipated receipt of chocolate milkshake and a tasteless control solution while in a negative and neutral mood.Emotional eaters showed greater activation in the parahippocampal gyrus and anterior cingulate (ACC) in response to anticipated receipt of milkshake and greater activation in the pallidum, thalamus, and ACC in response to receipt of milkshake during a negative relative to a neutral mood. In contrast, nonemotional eaters showed decreased activation in reward regions during a negative versus a neutral mood.Results suggest that emotional eating is related to increased anticipatory and consummatory food reward, but only during negative mood.

View details for DOI 10.1002/eat.20615

View details for Web of Science ID 000264399100005

View details for PubMedID 19040270

Maintenance Factors for Persistence of Bulimic Pathology: A Prospective Natural History Study INTERNATIONAL JOURNAL OF EATING DISORDERS Bohon, C., Stice, E., Burton, E. 2009; 42 (2): 173-178


To characterize the natural course of bulimia nervosa and identify potential maintenance factors that predict persistence of bulimic pathology in order to advance knowledge of processes that perpetuate this eating disturbance and permit the design of more efficacious treatments.We followed 96 women with threshold or subthreshold bulimia nervosa over a 1-year period with quarterly interviews.There were high rates of remission and relapse on a month-to-month basis, but remission became more likely to persist after a period of approximately 4 months of symptom abstinence. Initial elevations in thin-ideal internalization, expectations for reward from eating, and binge frequency predicted greater time to remission of binge eating. Initial elevations in dietary restraint and compensatory behavior frequency predicted greater time to remission of compensatory behaviors.Results imply that treatments for eating disorder may be more effective if they can reduce thin-ideal internalization, eating expectancies, and ineffective dieting and produce rapid cessation of binge eating and compensatory behaviors.

View details for DOI 10.1002/eat.20600

View details for Web of Science ID 000263576700012

View details for PubMedID 18951457

Subtyping Women With Bulimia Nervosa Along Dietary and Negative Affect Dimensions: Further Evidence of Reliability and Validity JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY Stice, E., Bohon, C., Marti, C. N., Fischer, K. 2008; 76 (6): 1022-1033


Studies have found that individuals with bulimia nervosa can be classified into dietary and dietary-negative affect subtypes and that the latter exhibit greater eating pathology, psychiatric comorbidity, and functional impairment; a more protracted clinical course; and a worse treatment response. In this report, the authors describe 2 prospective studies that found that young women with threshold (n = 48) and subthreshold (n = 83) bulimic pathology can be classified into dietary and dietary-negative affect subtypes; that two subtyping approaches produced similar results (mean kappa = .94); that the subtyping distinction showed 4-week test-retest reliability (kappa = .61); and that the dietary-negative affect subtype showed greater eating pathology, emotional distress, functional impairment, treatment seeking, and lower likelihood of recovery over 6-month and 3-year follow-ups than the dietary subtype. The dieting-negative affect subtyping distinction evidenced greater test-retest reliability and concurrent and predictive validity than did the purging-nonpurging subtyping distinction. The additional evidence for the reliability and validity of this subtyping scheme, particularly the prognostic utility, suggests it is worth additional inquiry.

View details for DOI 10.1037/a0013887

View details for Web of Science ID 000261113000011

View details for PubMedID 19045970

Relation of Reward From Food Intake and Anticipated Food Intake to Obesity: A Functional Magnetic Resonance Imaging Study JOURNAL OF ABNORMAL PSYCHOLOGY Stice, E., Spoor, S., Bohon, C., Veldhuizen, M. G., Small, D. M. 2008; 117 (4): 924-935


The authors tested the hypothesis that obese individuals experience greater reward from food consumption (consummatory food reward) and anticipated consumption (anticipatory food reward) than lean individuals using functional magnetic resonance imaging (fMRI) with 33 adolescent girls (mean age = 15.7, SD = 0.9). Obese relative to lean adolescent girls showed greater activation bilaterally in the gustatory cortex (anterior and mid insula, frontal operculum) and in somatosensory regions (parietal operculum and Rolandic operculum) in response to anticipated intake of chocolate milkshake (vs. a tasteless solution) and to actual consumption of milkshake (vs. a tasteless solution); these brain regions encode the sensory and hedonic aspects of food. However, obese relative to lean adolescent girls also showed decreased activation in the caudate nucleus in response to consumption of milkshake versus a tasteless solution, potentially because they have reduced dopamine receptor availability. Results suggest that individuals who show greater activation in the gustatory cortex and somatosensory regions in response to anticipation and consumption of food, but who show weaker activation in the striatum during food intake, may be at risk for overeating and consequent weight gain.

View details for DOI 10.1037/a0013600

View details for Web of Science ID 000260974500017

View details for PubMedID 19025237

Relation between obesity and blunted striatal response to food is moderated by TaqIA A1 allele SCIENCE Stice, E., Spoor, S., Bohon, C., Small, D. M. 2008; 322 (5900): 449-452


The dorsal striatum plays a role in consummatory food reward, and striatal dopamine receptors are reduced in obese individuals, relative to lean individuals, which suggests that the striatum and dopaminergic signaling in the striatum may contribute to the development of obesity. Thus, we tested whether striatal activation in response to food intake is related to current and future increases in body mass and whether these relations are moderated by the presence of the A1 allele of the TaqIA restriction fragment length polymorphism, which is associated with dopamine D2 receptor (DRD2) gene binding in the striatum and compromised striatal dopamine signaling. Cross-sectional and prospective data from two functional magnetic resonance imaging studies support these hypotheses, which implies that individuals may overeat to compensate for a hypofunctioning dorsal striatum, particularly those with genetic polymorphisms thought to attenuate dopamine signaling in this region.

View details for DOI 10.1126/science.1161550

View details for Web of Science ID 000260094500049

View details for PubMedID 18927395

A prospective test of cognitive vulnerability models of depression with adolescent girls BEHAVIOR THERAPY Bohon, C., Stice, E., Burton, E., Fudell, M., Nolen-Hoeksema, S. 2008; 39 (1): 79-90


This study sought to provide a more rigorous prospective test of two cognitive vulnerability models of depression with longitudinal data from 496 adolescent girls. Results supported the cognitive vulnerability model in that stressors predicted future increases in depressive symptoms and onset of clinically significant major depression for individuals with a negative attributional style, but not for those with a positive attributional style, although these effects were small. This model appeared to be specific to depression, in that it did not predict future increases in bulimia nervosa or substance abuse symptoms. In contrast, results did not support the integrated cognitive vulnerability self-esteem model that asserts stressors should only predict increased depression for individuals with a confluence of negative attributional style and low self-esteem, and this model did not appear to be specific to depression.

View details for Web of Science ID 000257419000009

View details for PubMedID 18328873

Relations of bulilmic symptom frequency and intensity to psychosocial impairment and health care utilization: Results from a community-recruited sample INTERNATIONAL JOURNAL OF EATING DISORDERS Spoor, S. T., Stice, E., Burton, E., Bohon, C. 2007; 40 (6): 505-514


To determine the frequency and intensity of bulimic symptoms related to psychosocial impairment and health care utilization.Females (N = 1231, M age = 17.7, range 13-55) from four community-recruited samples varying in bulimic pathology completed the eating disorder examination, social adjustment scale, and health survey utilization scale.Co-occurrence of binge eating and compensatory behaviors and solely compensatory behaviors >or=1 time/month were associated with elevations in psychosocial impairment. Co-occurrence of both binge eating and compensatory behaviors and solely compensatory behaviors >or=8 times/month were related to greater service utilization. Solely binge eating and duration of bulimic behaviors were unrelated to these functional outcomes. Overvaluation of body shape and weight showed significant linear relations to the functional outcomes.Results suggest that current diagnostic thresholds for bulimia nervosa may be too high when considering functional impairment and service utilization and that different cut-points need to be considered for different bulimic symptoms.

View details for DOI 10.1002/eat.20410

View details for Web of Science ID 000248762500004

View details for PubMedID 17607700

Reciprocal relations between rumination and bulimic, substance abuse, and depressive symptoms in female adolescents JOURNAL OF ABNORMAL PSYCHOLOGY Nolen-Hoeksema, S., Stice, E., Wade, E., Bohon, C. 2007; 116 (1): 198-207


The authors examined the reciprocal relations between rumination and symptoms of depression, bulimia, and substance abuse with longitudinal data from 496 female adolescents. Rumination predicted future increases in bulimic and substance abuse symptoms, as well as onset of major depression, binge eating, and substance abuse. Depressive and bulimic, but not substance abuse, symptoms predicted increases in rumination. Rumination did not predict increases in externalizing symptoms, providing evidence for the specificity of effects of rumination, although externalizing symptoms predicted future increases in rumination. Results suggest rumination may contribute to the etiology of depressive, bulimic, and substance abuse pathology and that the former two disturbances may foster increased rumination. Results imply that it might be beneficial for prevention programs to target this cognitive vulnerability.

View details for DOI 10.1037/0021-843X.116.1.198

View details for Web of Science ID 000244162200019

View details for PubMedID 17324030

Predicting school dropout and adolescent sexual behavior in offspring of depressed and nondepressed mothers JOURNAL OF THE AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY Bohon, C., Garber, J., Horomtz, J. L. 2007; 46 (1): 15-24


To examine predictors of school dropout and adolescent sexual behavior in offspring of depressed and nondepressed mothers. Possible moderators of the relation between maternal depression and these outcomes also were explored.Participants were 240 mothers and adolescents assessed annually from 6th through 12th grade. Interviews and questionnaires measured the chronicity and severity of the mother's depressive episodes, the mother's educational attainment, socioeconomic status, the presence of a father, the adolescent's IQ, externalizing behaviors, and substance use disorders.Substance use disorders before ninth grade significantly predicted higher rates of both school dropout and adolescent sexual behavior. Lower levels of mother's educational attainment and higher rates of adolescent's externalizing behaviors in grades 6 through 8 predicted higher school dropout. Higher IQ was associated with a lower likelihood of dropping out among offspring of never or moderately depressed mothers, but not for offspring of chronic/severely depressed mothers. Among offspring of never or moderately depressed mothers, the presence of a male head of household was associated with lower rates of adolescent sexual behavior, but not among offspring of chronically/severely depressed mothers.These findings have implications for the development of programs aimed at preventing behavior problems in high-risk adolescents.

View details for DOI 10.1097/01.chi.0000246052.30426.6e

View details for Web of Science ID 000243146600005

View details for PubMedID 17195725