Bio

Clinical Focus


  • Psychology

Academic Appointments


Honors & Awards


  • Mentored Patient-Oriented Research Career Development Award, National Institutes of Health (2010-present)

Professional Education


  • Fellowship:Stanford University School of Medicine (2009) CA
  • Internship:VA Medical Center (2006) CA
  • Medical Education:UCSD (2006) CA

Research & Scholarship

Current Research and Scholarly Interests


My current research interests include investigation into the nature and treatment of eating disorders. In particular, the development and dissemination of guided self-help treatments for eating disorders and the role emotion dysregulation plays in the etiology and maintenance of disordered eating behaviors. In 2010, I received a Mentored Patient-Oriented Career Development Award from NIH whose primary aim is to compare the efficacy of two guided self-help treatments for binge eating disorder.

Clinical Trials


  • Guided Self-Help for Binge Eating Disorder Not Recruiting

    The proposed study will employ a randomized design to evaluate the efficacy of two group-based guided self-help treatments: Integrative Response Therapy (IRT) and Cognitive Behavior Therapy Guided Self-Help, a treatment of known efficacy, in group-format (CBT-GSHg) in the treatment of Binge Eating Disorder (BED), and explore (1) moderators and mediators of treatment, (2) the relative cost-effectiveness of the two treatments, and (3) between group differences on secondary measures (e.g., eating disorder and general psychopathology).

    Stanford is currently not accepting patients for this trial. For more information, please contact Athena Robinson, PhD, 650-736-0943.

    View full details

Teaching

2013-14 Courses


Publications

Journal Articles


  • Integrative Response Therapy for Binge Eating Disorder COGNITIVE AND BEHAVIORAL PRACTICE Robinson, A. 2013; 20 (1): 93-105
  • Integrative Response Therapy for Binge Eating Disorder Cognitive and Behavioral Practice Robinson, A. 2013; 20 (1): 93-105
  • Moderators of dialectical behavior therapy for binge eating disorder: Results from a randomized controlled trial INTERNATIONAL JOURNAL OF EATING DISORDERS Robinson, A. H., Safer, D. L. 2012; 45 (4): 597-602

    Abstract

    Investigate moderators of a randomized clinical trial of group Dialectical Behavior Therapy for Binge Eating Disorder (DBT-BED) compared to an active comparison group control (ACGT) on the post-treatment outcome of binge frequency after twenty 2-h weekly sessions.Moderation analyses.Participants were 101 adults with BED [mean (SD) age, 52.2 (10.6) years and BMI, 36.4 (8.6)]. Analyses identified two moderators of post-treatment outcome. Participants with (1) Avoidant Personality Disorder or (2) an earlier onset of overweight and dieting (<15 years old) evidenced significantly worsened outcome when treated with ACGT versus DBT-BED.Participants with certain indicators of higher baseline pathology respond better to DBT-BED than ACGT at post-treatment.

    View details for DOI 10.1002/eat.20932

    View details for Web of Science ID 000302546500016

    View details for PubMedID 21500238

  • Outcome From a Randomized Controlled Trial of Group Therapy for Binge Eating Disorder: Comparing Dialectical Behavior Therapy Adapted for Binge Eating to an Active Comparison Group Therapy BEHAVIOR THERAPY Safer, D. L., Robinson, A. H., Jo, B. 2010; 41 (1): 106-120

    Abstract

    Dialectical Behavior Therapy for Binge Eating Disorder (DBT-BED) aims to reduce binge eating by improving adaptive emotion-regulation skills. Preliminary findings have been promising but have only compared DBT-BED to a wait-list. To control for the hypothesized specific effects of DBT-BED, the present study compared DBT-BED to an active comparison group therapy (ACGT). Men and women (n=101) meeting DSM-IV BED research criteria were randomly assigned to 20 group sessions of DBT-BED (n=50) or ACGT (n=51). DBT-BED had a significantly lower dropout rate (4%) than ACGT (33.3%). Linear Mixed Models revealed that posttreatment binge abstinence and reductions in binge frequency were achieved more quickly for DBT-BED than for ACGT (posttreatment abstinence rate=64% for DBT-BED vs. 36% for ACGT) though differences did not persist over the 3-, 6-, and 12-month follow-up assessments (e.g., 12-month follow-up abstinence rate=64% for DBT-BED vs. 56% for ACGT). Secondary outcome measures revealed no sustained impact on emotion regulation. Although both DBT-BED and ACGT reduced binge eating, DBT-BED showed significantly fewer dropouts and greater initial efficacy (e.g., at posttreatment) than ACGT. The lack of differential findings over follow-up suggests that the hypothesized specific effects of DBT-BED do not show long-term impact beyond those attributable to nonspecific common therapeutic factors.

    View details for Web of Science ID 000275349100010

    View details for PubMedID 20171332

  • Orlistat as a method of purging in Binge Eating Disorder: Letter to the Editor Psychosomatics Robinson, A. 2009; 50: 177-178
  • Validating stage of change measures for physical activity and dietary behaviors for overweight women INTERNATIONAL JOURNAL OF OBESITY Robinson, A. H., Norman, G. J., Sallis, J. F., Calfas, K. J., Rock, C. L., Patrick, K. 2008; 32 (7): 1137-1144

    Abstract

    To investigate the construct, concurrent and predictive validity of stage of change measures for physical activity (PA), and intakes of fruit and vegetables (FVs), dietary fiber (FB) and dietary fat (DF) among a sample of overweight women.Subjects were 401 women (mean age=41, s.d.=8.7 years; mean body mass index=32.35, s.d.=4.6) recruited to participate in a 12-month weight loss intervention trial. Concurrent validity tests included (1) self-report of current behavior, (2) decisional balance (for example, pros and cons of behavior change), (3) self-efficacy, (4) the MTI Actigraph accelerometer (for the PA staging measure), and (5) a food-frequency questionnaire (for all dietary staging measures). Predictive validity was assessed through tests of the relationship between the baseline stage of change measures and their corresponding behavior 1-year later.Coefficient alpha-tests of internal consistency exceeded 0.70 on the majority of scales. Concurrent validity tests indicated strong validity evidence for three staging measures and little validity for the DF staging measure (eta(2) range, 0.02-0.18). All staging algorithms demonstrated predictive validity (eta(2) range, 0.04-0.126).Staging measures can determine motivational readiness for overweight women, contribute to the standardization of stage of change assessment and facilitate cross-study comparisons.

    View details for DOI 10.1038/ijo.2008.65

    View details for Web of Science ID 000257607400014

    View details for PubMedID 18490930

  • Forty years of progress in the treatment of the eating disorders NORDIC JOURNAL OF PSYCHIATRY Agras, W. S., Robinson, A. H. 2008; 62: 19-24

    Abstract

    This paper reviews progress in the treatment of the eating disorders between 1968 and 2008. In 1968, no evidence-based treatments were available for any of the eating disorders, and binge eating disorder had not yet been described. In 2008, there are still no evidence-based treatments for anorexia nervosa, although a specific form of family therapy (based on the Maudsley model) appears promising. Both psychotherapeutic and psychopharmacological evidence-based treatments are now available for bulimia nervosa and binge eating disorder. Therapist-assisted self-help is a promising approach to treatment because it may reduce the costs of treatment, allow for more adequate dissemination to areas lacking specialty resources and also provide a basis for algorithm-driven approaches to treatment.

    View details for DOI 10.1080/08039480802315632

    View details for Web of Science ID 000260298500004

    View details for PubMedID 18752114

  • Randomized control trial of a behavioral intervention for overweight women: Impact on depressive symptoms DEPRESSION AND ANXIETY Kerr, J., Patrick, K., Norman, G., Stein, M. B., Calfas, K., Zabinski, M., Robinson, A. 2008; 25 (7): 555-558

    Abstract

    Phone and Internet-based interventions can improve the management of depression in primary care, and interventions using these communication channels are increasingly used to improve behaviors such as diet and physical activity. Increased physical activity has been shown to improve depressive symptoms, but to date there are no reports of the effects of a phone and Internet diet and exercise intervention on symptoms of depression in patients seen in primary care. This study assessed depressive symptoms in 401 participants in a randomized control trial of a 12-month primary care, phone and Internet-based behavioral intervention for overweight women. A one-way analysis of variance examining the mean change in Center for Epidemiological Studies Depression (CESD) score from baseline to 12 months, controlling for age, education, marital status, and employment showed that those receiving the intervention significantly decreased their CESD scores (P=.03) more than those receiving standard care. Although the intervention did not target depressed individuals or present material relating to mood management, those with probable depression (27% of the whole sample) showed clinically important improvements-a mean five-point change on the CESD short form. Participants who engaged more readily with the intervention were more likely to reduce their depression scores. A 1-year primary care based phone and Internet diet and exercise intervention can improve depressive symptoms in overweight women. Given the promise of phone and Internet-based interventions to improve both depression and lifestyle-related behaviors, and given that such interventions could extend the reach of primary care to many individuals at relatively low cost, these results suggest the need for further research, including the effects of additional mood management components.

    View details for DOI 10.1002/da.20320

    View details for Web of Science ID 000258279700001

    View details for PubMedID 17557319

  • Psychosocial correlates of dietary intake among overweight and moderately obese men American Journal of Health Behavior Hagler, A., Norman GJ, Zabinski MF, Sallis JF, Calfas KJ, Patrick K 2007; 31: 3-12
  • Construct validity of physical activity and sedentary behaviors staging measures for adolescents ANNALS OF BEHAVIORAL MEDICINE Hagler, A. S., Calfas, K. J., Norman, G. J., Sallis, J. F., Patrick, K. 2006; 31 (2): 186-193

    Abstract

    To evaluate the construct validity of physical activity (PA) and sedentary behaviors (SB) staging measures for adolescents that incorporate the current national recommendations.The Progressive Aerobic Cardiovascular Endurance Run, Actigraph accelerometer, and self-reported hours of TV viewing served as criterion measures. Participants were 878 adolescents (M age = 12.74, 53.6% girls, 39.9% non-White).The PA staging measure had mixed evidence of convergent validity and strong evidence of divergent validity. The SB staging measure had strong and generalized evidence of convergent validity but weak evidence of divergent validity, which could be related to inaccurate assumptions about the relation of SB to PA and fitness. Results were generally in the expected direction and provide preliminary evidence for the construct validity and generalizability of both staging measures. However, more research is warranted to validate the staging measures with Actigraph-measured PA and sedentary time. Effect sizes (eta(2) values) ranged from small to large (.02-.63).PA and SB stage-of-change measures that are congruent with current national recommendations and appropriate for use among adolescents were partially supported for their construct validity.

    View details for Web of Science ID 000236708600011

    View details for PubMedID 16542134

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