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Record W4409087283 · doi:10.1002/eat.24429

Patterns of Symptom Change in Behaviors and Cognitions During 10‐Session Cognitive Behavioral Therapy (<scp>CBT</scp>‐T) for Non‐Underweight Eating Disorders

2025· article· en· W4409087283 on OpenAlexaff
P. Evelyna Kambanis, Haley Graver, Lilian P. Palmer, Casey M. Stern, Nassim Tabri, Ashley Dunford, Helen Burton Murray, Lauren Breithaupt, Shirley B. Wang, Setareh M. Rossman, Christopher J. Mancuso, Alexandra M. Andrea, Glenn Waller, Cathryn M. Freid, Kamryn T. Eddy, Jennifer J. Thomas, Kendra R. Becker

Bibliographic record

VenueInternational Journal of Eating Disorders · 2025
Typearticle
Languageen
FieldPsychology
TopicEating Disorders and Behaviors
Canadian institutionsCarleton University
FundersNational Institute of Diabetes and Digestive and Kidney DiseasesNational Institute of Mental HealthNational Institutes of Health
KeywordsCognitionPsychologyCognitive behavioral therapyMultilevel modelClinical psychologyCognitive therapyUnderweightCognitive restructuringEating disordersPsychiatryMedicineBody mass index

Abstract

fetched live from OpenAlex

OBJECTIVE: Little is known about the timing of behavioral versus cognitive change in 10-session cognitive-behavioral therapy for non-underweight eating disorders (CBT-T). We aimed to: (a) evaluate the magnitude of behavioral and cognitive symptom reduction across treatment; and (b) investigate the relation between early behavioral change and subsequent cognitive change. We hypothesized: (a) large and significant reductions in behavioral and cognitive symptoms from pre- to mid-treatment and from pre- to post-treatment; and (b) that early behavioral change would predict subsequent cognitive change over the course of treatment. METHOD: Patients (N = 63) were offered CBT-T and completed the Eating Disorder-15 on a weekly basis. We used intent-to-treat analyses. For Aim 1, we conducted a series of fixed-effect multilevel models for each outcome variable, accounting for repeated measures (pre-, mid-, and post-treatment) within individuals. For Aim 2, we conducted a linear regression using early behavioral change as the predictor and subsequent cognitive change as the outcome. RESULTS: We observed large and significant reductions in most behavioral and all cognitive symptoms pre- to mid-treatment and pre- to post-treatment. Early changes in behavioral symptoms did not significantly predict subsequent cognitive changes. DISCUSSION: Behavioral improvements occurred rapidly and were sustained throughout treatment, whereas cognitive changes followed a more gradual trajectory. The absence of a significant predictive relationship between early behavioral change and subsequent cognitive change suggests that these domains may improve independently. Future research should investigate the mechanisms linking behavioral and cognitive changes.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.005
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.005
Threshold uncertainty score0.009

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0010.005
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0010.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.001
Insufficient payload (model declined to judge)0.0010.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.028
GPT teacher head0.372
Teacher spread0.344 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations2
Published2025
Admission routes1
Has abstractyes

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