{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T03:02:32Z","timestamp":1785294152979,"version":"3.55.0"},"reference-count":30,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,1,8]],"date-time":"2024-01-08T00:00:00Z","timestamp":1704672000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Eating Disorders"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Emerging research indicates that skills acquisition may be important to behavior change in cognitive behavior therapy (CBT) for eating disorders. This study investigated whether skills use assessed in real time during the initial 4\u2009weeks of CBT\u2010based day treatment was associated with momentary eating disorder behavior change and rapid response to treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Participants with DSM\u20105 bulimia nervosa or purging disorder (<jats:italic>N\u2009=<\/jats:italic>\u200958) completed ecological momentary assessments (EMA) several times daily for the first 28\u2009days of treatment. EMA assessed skills use, the occurrence of binge eating and\/or purging, and state negative affect. Rapid response was defined as abstinence from binge eating and\/or purging in the first 4\u2009weeks of treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Greater real\u2010time skills use overall, and use of \u201cplanning ahead,\u201d \u201cdistraction,\u201d \u201csocial support,\u201d and \u201cmechanical eating\u201d skills in particular, were associated with a lower likelihood of engaging in binge eating or purging during the same period. After controlling for baseline group differences in overall difficulties with emotion regulation, rapid and non\u2010rapid responders did not differ in overall skills use, or skills use at times of higher negative affect, during the EMA period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Momentary use of skills appears to play an important role in preventing binge eating and purging, and certain skills appear to be particularly helpful. These findings contribute to the literature elucidating the processes by which CBT treatments for eating disorders work by providing empirical evidence that skills use helps to prevent binge eating and purging behaviors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Public Significance<\/jats:title><jats:p>Individuals with eating disorders learn new skills during treatment to help them improve their symptoms. This study shows that for people with eating disorders, using skills helps prevent eating disorder behaviors in the moment. Certain skills may be particularly helpful, including planning ahead, distracting activities, support from others, and focusing on eating meals and snacks regardless of how one is feeling. These findings help us better understand how treatments work.<\/jats:p><\/jats:sec>","DOI":"10.1002\/eat.24128","type":"journal-article","created":{"date-parts":[[2024,1,8]],"date-time":"2024-01-08T11:20:27Z","timestamp":1704712827000},"page":"548-557","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Momentary skills use predicts decreased binge eating and purging early in day treatment: An ecological momentary assessment study"],"prefix":"10.1002","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4543-3489","authenticated-orcid":false,"given":"Danielle E.","family":"MacDonald","sequence":"first","affiliation":[{"name":"Centre for Mental Health University Health Network  Toronto Canada"},{"name":"Department of Psychiatry University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7192-6140","authenticated-orcid":false,"given":"Kathryn","family":"Trottier","sequence":"additional","affiliation":[{"name":"Centre for Mental Health University Health Network  Toronto Canada"},{"name":"Department of Psychiatry University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2131-2276","authenticated-orcid":false,"given":"Li","family":"Cao","sequence":"additional","affiliation":[{"name":"Center for Biobehavioral Research, Sanford Research  Fargo North Dakota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9131-1629","authenticated-orcid":false,"given":"Ross D.","family":"Crosby","sequence":"additional","affiliation":[{"name":"Center for Biobehavioral Research, Sanford Research  Fargo North Dakota USA"},{"name":"School of Medicine and Health Sciences University of North Dakota  Grand Forks North Dakota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0659-153X","authenticated-orcid":false,"given":"Stephen A.","family":"Wonderlich","sequence":"additional","affiliation":[{"name":"Center for Biobehavioral Research, Sanford Research  Fargo North Dakota USA"},{"name":"School of Medicine and Health Sciences University of North Dakota  Grand Forks North Dakota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7383-7149","authenticated-orcid":false,"given":"Scott G.","family":"Engel","sequence":"additional","affiliation":[{"name":"Center for Biobehavioral Research, Sanford Research  Fargo North Dakota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0161-2426","authenticated-orcid":false,"given":"Marion P.","family":"Olmsted","sequence":"additional","affiliation":[{"name":"Centre for Mental Health University Health Network  Toronto Canada"},{"name":"Department of Psychiatry University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,1,8]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_2_11_3_1","volume-title":"The American Psychiatric Association practice guideline for the treatment of patients with eating disorders","author":"American Psychiatric Association","year":"2023"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.20931"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10608-019010006-1"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2021.102032"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbct.2023.02.003"},{"key":"e_1_2_11_8_1","volume-title":"Cognitive behavior therapy and eating disorders","author":"Fairburn C. 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