{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T09:47:49Z","timestamp":1791798469222,"version":"4.3.4"},"reference-count":49,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000016","name":"U.S. Department of Health and Human Services","doi-asserted-by":"publisher","award":["R34MH124799"],"award-info":[{"award-number":["R34MH124799"]}],"id":[{"id":"10.13039\/100000016","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":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Imaginal exposure therapy facilitates the approach of feared stimuli (e.g., fear of weight gain) not accessible in everyday life (e.g., rapidly gaining weight) and has initial promising data for the treatment of eating disorders (EDs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In the current randomized controlled trial (RCT) participants (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u2009130) were randomly assigned to a five\u2010session digital imaginal exposure condition or a control online journaling condition within 4\u2009months of discharge from intensive (e.g., inpatient) treatment. We examined the feasibility and acceptability of the treatment conditions, target engagement, and initial clinical efficacy. This study was pre\u2010registered.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Imaginal exposure therapy significantly outperformed the control condition on our primary outcome and target mechanism: fear of weight gain. Imaginal exposure therapy also outperformed the control condition on overall ED symptoms, fear of food, food avoidance, clinical impairment, and PTSD symptoms, suggesting initial clinical efficacy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This RCT suggests that the active ingredient (i.e., exposure to feared stimuli) in imaginal exposure leads to significant decreases in fear of weight gain and associated clinical outcomes. This work supports imaginal exposure therapy as an effective intervention for fear of weight gain, a primary maintenance factor of EDs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>NCT04862247<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/eat.70147","type":"journal-article","created":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T01:30:56Z","timestamp":1781227856000},"page":"2317-2331","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Randomized Controlled Trial of Self\u2010Guided Digital Written Imaginal Exposure Therapy for Eating Disorders in Patients Recently Discharged From Higher Level Specialty Eating Disorder Care"],"prefix":"10.1002","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2359-5206","authenticated-orcid":false,"given":"Cheri A.","family":"Levinson","sequence":"first","affiliation":[{"name":"Department of Psychological &amp; Brain Sciences University of Louisville  Louisville Kentucky USA"},{"name":"Department of Pediatrics, Division of Child and Adolescent Psychiatry and Psychology University of Louisville  Louisville Kentucky USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2959-0986","authenticated-orcid":false,"given":"Taylor","family":"Penwell","sequence":"additional","affiliation":[{"name":"Department of Psychological &amp; Brain Sciences University of Louisville  Louisville Kentucky USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9166-6056","authenticated-orcid":false,"given":"Luis E.","family":"Sandoval\u2010Araujo","sequence":"additional","affiliation":[{"name":"Department of Psychological &amp; Brain Sciences University of Louisville  Louisville Kentucky USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8396-2777","authenticated-orcid":false,"given":"Morgan","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Psychological &amp; Brain Sciences University of Louisville  Louisville Kentucky USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5240-2966","authenticated-orcid":false,"given":"Allison","family":"Grady","sequence":"additional","affiliation":[{"name":"Department of Psychological &amp; Brain Sciences University of Louisville  Louisville Kentucky USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-8666-1341","authenticated-orcid":false,"given":"Jayson","family":"Stancil","sequence":"additional","affiliation":[{"name":"Department of Psychological &amp; Brain Sciences University of Louisville  Louisville Kentucky USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7313-9084","authenticated-orcid":false,"given":"Maiying","family":"Kong","sequence":"additional","affiliation":[{"name":"Department of Biostatistics University of Louisville  Louisville Kentucky USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,11]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beth.2013.03.003"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11920-017-0796-4"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00406-021-01324-1"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2009.11.001"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11920-018-0932-9"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1037\/t00742-000"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocrd.2019.100474"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.20164"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/0005-7967(96)00033-2"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2008.06.012"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/10401230802017068"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291717002604"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.23728"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beth.2023.07.008"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2020.101851"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2012.04.037"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.5127\/jep.026511"},{"key":"e_1_2_13_19_1","unstructured":"Deloitte Access Economics.2020. \u201cThe Social and Economic Cost of Eating Disorders in the United States of America: A Report for the Strategic Training Initiative for the Prevention of Eating Disorders and the Academy for Eating Disorders.\u201dhttps:\/\/www.hsph.harvard.edu\/striped\/report-economic-costs-of-eating-disorders\/."},{"key":"e_1_2_13_20_1","volume-title":"Cognitive Behavior Therapy and Eating Disorders","author":"Fairburn C. G.","year":"2008"},{"key":"e_1_2_13_21_1","volume-title":"Structured Clinical Interview for DSM\u20105 Disorders, Clinician Version (SCID\u20105\u2010CV)","author":"First M. B.","year":"2016"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/erv.2449"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1080\/10640266.2018.1499297"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eatbeh.2017.11.004"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.22344"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2020.07.075"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.23603"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.22952"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eatbeh.2019.101320"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.1037\/abn0000254"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.5498\/wjp.v5.i1.147"},{"key":"e_1_2_13_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cct.2020.105990"},{"key":"e_1_2_13_33_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291718002088"},{"key":"e_1_2_13_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2018.10.013"},{"key":"e_1_2_13_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2016.08.017"},{"key":"e_1_2_13_36_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.20230193"},{"key":"e_1_2_13_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.appet.2023.107181"},{"key":"e_1_2_13_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2020.101952"},{"key":"e_1_2_13_39_1","first-page":"22","article-title":"The Mini\u2010International Neuropsychiatric Interview (M.I.N.I.): The Development and Validation of a Structured Diagnostic Psychiatric Interview for DSM\u2010IV and ICD\u201010","volume":"59","author":"Sheehan D. V.","year":"1998","journal-title":"Journal of Clinical Psychiatry"},{"key":"e_1_2_13_40_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.22214"},{"key":"e_1_2_13_41_1","doi-asserted-by":"publisher","DOI":"10.1037\/1040-3590.16.1.60"},{"key":"e_1_2_13_42_1","doi-asserted-by":"publisher","DOI":"10.1037\/1040-3590.12.2.123"},{"key":"e_1_2_13_43_1","doi-asserted-by":"publisher","DOI":"10.2196\/57577"},{"key":"e_1_2_13_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2014.11.004"},{"key":"e_1_2_13_45_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2021.21010026"},{"key":"e_1_2_13_46_1","doi-asserted-by":"publisher","DOI":"10.1590\/1516-4446-2012-1048"},{"key":"e_1_2_13_47_1","volume-title":"PTSD Checklist\u2014Civilian Version (PCL\u2010C)","author":"Weathers F. W.","year":"1993"},{"key":"e_1_2_13_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2024.01.265"},{"key":"e_1_2_13_49_1","doi-asserted-by":"publisher","DOI":"10.1080\/16506073.2024.2341807"},{"key":"e_1_2_13_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(15)00356-9"}],"container-title":["International Journal of Eating Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/eat.70147","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/eat.70147","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/eat.70147","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T09:10:34Z","timestamp":1791796234000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/eat.70147"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,11]]},"references-count":49,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1002\/eat.70147"],"URL":"https:\/\/doi.org\/10.1002\/eat.70147","archive":["Portico"],"relation":{},"ISSN":["0276-3478","1098-108X"],"issn-type":[{"value":"0276-3478","type":"print"},{"value":"1098-108X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,11]]},"assertion":[{"value":"2026-03-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-11","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}