Objective To review the literature examining the efficacy and effectiveness of enhanced cognitive behavioral therapy (CBT‐E) for adults and older adolescents with eating disorders. Method A systematic search of the literature (using PsycINFO and PubMed) was conducted in order to identify relevant publications (randomized controlled trials [RCTs] and uncontrolled trials) up to June 2019. Effect sizes were reported for outcomes including treatment attrition and remission rates, eating disorder behaviors, body mass index (BMI), and core eating disorder psychopathology. The Downs and Black checklist was used to assess the quality of included studies. Results Twenty studies (10 RCTs and 10 uncontrolled trials) met criteria for inclusion. Support was found for the efficacy and effectiveness of CBT‐E for the full spectrum of eating disorders, with respect to reducing eating disorder behaviors and core psychopathology. BMI also increased, with large effects, for individuals with AN. However, the majority of the randomized trials included in this review did not demonstrate superiority of CBT‐E over comparison treatments, particularly in the longer‐term. Furthermore, rates of attrition and remission for CBT‐E among individuals without AN did not appear to differ from rates for CBT‐BN. Discussion There is evidence to support CBT‐E as an efficacious and effective treatment for adults and older adolescents with a range of eating disorder diagnoses. Future research would benefit from directly comparing CBT‐E to CBT‐BN, expanding measured outcomes to include driven exercise and subjective binge eating, increasing consistency in the definition and measurement of outcomes, and exploring factors associated with treatment retention.

Bariatric surgery patients often experience physical and psychosocial stressors, and difficulty adjusting to significant lifestyle changes. As a result, social support groups that provide patients with support, coping skills, and nutritional information are valuable components of bariatric care. Support group attendance at bariatric centers is associated with greater post-surgery weight loss; however, several barriers hinder attendance at in-person support groups (e.g., travel distance to bariatric centers). Consequently, online support forums are an increasingly utilized resource for patients both before and after surgery. This study examined and described the type and frequency of social support provided on a large online bariatric surgery forum. A total of 1,412 messages in the pre- (n = 822) and post-surgery (n = 590) sections of the forum were coded using qualitative content analysis according to Cutrona and Suhr's (1992) Social Support Behavior Code model (i.e., including informational, tangible, esteem, network, and emotional support types). The majority of messages provided informational and emotional support regarding: a) factual information about the bariatric procedure and nutrition; b) advice for coping with the surgery preparation process, and physical symptoms; and c) encouragement regarding adherence to surgical guidelines, and weight loss progress. Network, esteem, and tangible support types were less frequent than informational and emotional support types. The results inform healthcare providers about the types of social support available to bariatric patients on online support forums and, thus, encourage appropriate referrals to this resource.

No studies have investigated whether those with poor sleep are aware of being uncomfortable in the dark via subjective inquiry, and no study has evaluated whether poor sleepers have increased fear in the dark using objective indices (e.g., a validated startle paradigm). Good and poor sleepers (N = 108) completed questionnaires about their level of discomfort with the dark and were evaluated for an increased startle reflex by measuring eyeblink latency via electrooculogram in response to unexpected noise in the dark and the light. Participants listened to bursts of unexpected white noise, while in counterbalanced light/dark conditions. Relative to good sleepers, more poor sleepers reported increased discomfort in the dark. There was a significant lighting × time × sleeper status interaction for eyeblink latency. Relative to the first trial in the dark, eyeblink latency in good sleepers increased in the second dark exposure; suggesting habituation in the dark. Eyeblink latency in poor sleepers did not decrease. Thus, poor sleepers reported being uncomfortable in the dark and they remained more easily startled in the dark over the course of the study. It is unclear if the dark may predispose people to sleep problems, or if sleep problems sensitize poor sleepers to fear darkness.

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