{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T13:56:24Z","timestamp":1780494984542,"version":"3.54.1"},"reference-count":26,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,2,24]],"date-time":"2022-02-24T00:00:00Z","timestamp":1645660800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["R34MH116021"],"award-info":[{"award-number":["R34MH116021"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Eating Disorders"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Just\u2010in\u2010time adaptive interventions (JITAIs), momentary interventions delivered at identified times of risk, may improve skill utilization during cognitive\u2010behavioral therapy (CBT\u2010E) for bulimia\u2010spectrum eating disorders (BN\u2010EDs). JITAIs may be especially helpful for individuals with self\u2010regulation deficits, including emotion regulation deficits and elevated impulsivity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Participants (<jats:italic>N<\/jats:italic>\u00a0=\u00a055 with BN\u2010EDs) received 16 sessions of CBT\u2010E with electronic self\u2010monitoring and were randomized to receive JITAIs (JITAIs\u2010On) or not receive JITAIs (JITAIs\u2010Off). Baseline Difficulties in Emotion Regulation Scale (DERS) and UPPS\u2010P Impulsive Behavior Scale (UPPS\u2010P) total scores were examined as moderators of baseline to post\u2010treatment change in binge episodes, compensatory behaviors, and Eating Disorder Examination (EDE) global score using repeated measures ANOVAs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Emotion regulation difficulties significantly moderated compensatory behavior change (<jats:italic>F<\/jats:italic>[1, 51]\u00a0=\u00a04.31, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.04, \u03b7<jats:sub>p<\/jats:sub><jats:sup>2<\/jats:sup>\u00a0=\u00a00.08) such that individuals with emotion regulation deficits demonstrated greater improvements in the JITAIs\u2010On condition. Impulsivity moderated change in binge episodes (<jats:italic>F<\/jats:italic>[1, 51]\u00a0=\u00a08.94, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.004, \u03b7<jats:sub>p<\/jats:sub><jats:sup>2<\/jats:sup>\u00a0=\u00a00.15) and compensatory behaviors (<jats:italic>F<\/jats:italic>[1, 51]\u00a0=\u00a07.83, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.007, \u03b7<jats:sub>p<\/jats:sub><jats:sup>2<\/jats:sup>\u00a0=\u00a00.13), such that individuals with high impulsivity showed greater improvement in the JITAIs\u2010On condition. Neither DERS nor UPPS\u2010P scores moderated EDE global score change.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>JITAIs appear particularly beneficial for facilitating skill use during treatment for BN\u2010EDs for individuals with self\u2010regulation deficits, yielding improved treatment outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Public Significance Statement<\/jats:title><jats:p>Reminders to use therapy skills that are delivered via smartphone as an individual goes about their daily life may improve treatment response among individuals with bulimia nervosa who have difficulty coping with emotions or who tend to act impulsively. Results from this study indicate that individuals with these difficulties benefitted more from cognitive\u2010behavioral therapy when it was accompanied by in\u2010the\u2010moment reminders to use therapeutic skills, which may facilitate long\u2010term recovery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical Trials.gov Registration Number<\/jats:title><jats:p>NCT03673540.<\/jats:p><\/jats:sec>","DOI":"10.1002\/eat.23695","type":"journal-article","created":{"date-parts":[[2022,2,25]],"date-time":"2022-02-25T07:53:01Z","timestamp":1645775581000},"page":"709-716","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["<scp>Self\u2010regulation<\/scp> deficits moderate treatment outcomes in a clinical trial evaluating <scp>just\u2010in\u2010time<\/scp> adaptive interventions as an augmentation to <scp>cognitive\u2010behavioral<\/scp> therapy for <scp>bulimia\u2010spectrum<\/scp> eating disorders"],"prefix":"10.1002","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6854-1207","authenticated-orcid":false,"given":"Emily K.","family":"Presseller","sequence":"first","affiliation":[{"name":"Department of Psychological and Brain Sciences Drexel University  Philadelphia Pennsylvania USA"},{"name":"Center for Weight, Eating, and Lifestyle Science Drexel University  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan L.","family":"Wilkinson","sequence":"additional","affiliation":[{"name":"Department of Psychological and Brain Sciences Drexel University  Philadelphia Pennsylvania USA"},{"name":"Center for Weight, Eating, and Lifestyle Science Drexel University  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Trainor","sequence":"additional","affiliation":[{"name":"Department of Psychological and Brain Sciences Drexel University  Philadelphia Pennsylvania USA"},{"name":"Center for Weight, Eating, and Lifestyle Science Drexel University  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6737-7027","authenticated-orcid":false,"given":"Elizabeth W.","family":"Lampe","sequence":"additional","affiliation":[{"name":"Department of Psychological and Brain Sciences Drexel University  Philadelphia Pennsylvania USA"},{"name":"Center for Weight, Eating, and Lifestyle Science Drexel University  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrienne S.","family":"Juarascio","sequence":"additional","affiliation":[{"name":"Department of Psychological and Brain Sciences Drexel University  Philadelphia Pennsylvania USA"},{"name":"Center for Weight, Eating, and Lifestyle Science Drexel University  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,2,24]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beth.2019.07.002"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.10116"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1159\/000329358"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/erv.1136"},{"key":"e_1_2_8_6_1","volume-title":"Cognitive behavior therapy and eating disorders","author":"Fairburn C. G.","year":"2008"},{"key":"e_1_2_8_7_1","first-page":"1","article-title":"The eating disorder examination","volume":"6","author":"Fairburn C. G.","year":"1993","journal-title":"International Journal of Eating Disorders"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.10165"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1023\/B:JOBA.0000007455.08539.94"},{"key":"e_1_2_8_10_1","unstructured":"Juarascio A. S. Presseller E. K. Srivastava P. Manasse S. M. &Forman E. M.(Under review).A randomized controlled trial of CBT+: A clinician\u2010controlled just\u2010in\u2010time adjunctive intervention for bulimia\u2010spectrum disorders."},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.2196\/18261"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2015.05.010"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/erv.2288"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.22838"},{"key":"e_1_2_8_15_1","first-page":"10","volume-title":"The UPPS\u2010P: Assessing five personality pathways to impulsive behavior","author":"Lynam D. R.","year":"2006"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12160-016-9830-8"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.22669"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.appet.2019.104438"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/1098-108X(200011)28:3<311::AID-EAT8>3.0.CO;2-K"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/1073191106295527"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2011.11.009"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.appet.2017.01.005"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijpsycho.2020.11.009"},{"key":"e_1_2_8_24_1","unstructured":"Trainor C. Michael M. L. Lampe E. W. Presseller E. K. Juarascio A. S. &Manasse S. M.(Under review).Associations between emotion regulation and remission following cognitive behavioral therapy for adults with bulimia nervosa."},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.23609"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/erv.952"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10802-017-0365-7"}],"container-title":["International Journal of Eating Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/eat.23695","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/eat.23695","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/eat.23695","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,25]],"date-time":"2023-08-25T08:34:34Z","timestamp":1692952474000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/eat.23695"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,24]]},"references-count":26,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2022,5]]}},"alternative-id":["10.1002\/eat.23695"],"URL":"https:\/\/doi.org\/10.1002\/eat.23695","archive":["Portico"],"relation":{},"ISSN":["0276-3478","1098-108X"],"issn-type":[{"value":"0276-3478","type":"print"},{"value":"1098-108X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,24]]},"assertion":[{"value":"2021-12-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-02-14","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-02-24","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}