"Dialectical Behavior Therapy for Adolescent Bulimia Nervosa and Co-Occurring Deliberate Self Injury and Depression" Sarah Fischer, Ph. D. Sarah Fischer, Ph. D. is an assistant professor of Psychology at the University of Georgia. She completed her B. A. in Psychology at the University of Kentucky in 1999 and her Ph. D. in Clinical Psychology at the University of Kentucky in 2007. Dr. Fischer completed her internship and postdoctoral training at the University of Chicago Medical Center. Currently, she supervises a Dialectical Behavior Therapy program at the UGA Psychology Clinic, with a focus on co-occurring Bulimia Nervosa, Borderline Personality Disorder, and substance abuse. The focus of Dr. Fischer's program of research is on personality traits and psychosocial factors influencing the maintenance of Bulimia Nervosa and co-occurring substance abuse and dependence. Specifically, her research investigates how different aspects of the broad trait impulsivity affect substance use and eating disordered behavior, such as binge eating and purging. She is especially interested in how the personality trait of impulsivity affects these behaviors in the context of negative mood states and in conjunction with outcome expectancies for addictive behaviors. Current projects include a longitudinal study of the influence of negative urgency and sexual assault on bulimic symptoms, alcohol abuse, and self harm behavior in young adult women, and a cross sectional study utilizing fMRI to investigate differences in reward processing of bulimic women, obese women, and non- eating disordered, normal weight women under stress. While Bulimia Nervosa (BN) typically onsets in adolescence, only two randomized controlled trials have been published which examine treatment for adolescent BN (Schmidt et al., 2007; le Grange et al., 2007). BN symptoms in adolescence are often associated with deliberate self harm, suicidality, and depression. While recent RCTs for adolescent BN are promising, no published reports address management of co-occurring depression and self harm in the context of treatment of BN. Dialectical behavior therapy is the most effective treatment to date for recurring suicidality, deliberate self harm, and co-occurring Axis I disorders (Harned et al., 2008). DBT targets reduction in specific behaviors, (i. e. self harm), while teaching emotion regulation and distress tolerance skills. Components of DBT include individual therapy, group skills training, and a 24 hour crisis paging system. It has been applied successfully in suicidal adolescent populations and adult women with BN, Binge Eating Disorder, and co-occurring eating disorders and Borderline Personality Disorder (Chen et al., 2008, Safer et al.,2001), yielding significant reductions in symptoms. However, the effectiveness of DBT has not yet been examined in adolescents with BN and co-occurring suicidal behavior. Our goal is to conduct a pilot test of the effectiveness of a six month DBT program for adolescents with BN and co- occurring deliberate self injury and depressive symptoms. Parent training will be included in addition to the traditional components of DBT described above, with follow up assessments at six months post-treatment. Our goal is to significantly reduce self harm and depressive symptoms while successfully treating symptoms of BN.
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