Recent Publications
Publications By Our Lab Team Members
Combined Mindfulness-and Acceptance-Based Therapy and Cognitive Behavioral Therapy Treatments For Eating Disorders: A Narrative Review. Journal of Contemporary Psychotherapy
Moskowitz, R.*&., Schecther*, A., & Sala, M. (2022). Combined Mindfulness- and Acceptance-Based Therapy and Cognitive Behavioral Therapy Treatments for eating disorders: A narrative review. Journal of Contemporary Psychotherapy. Epub ahead of print.
This study reviewed treatments for eating disorders that incorporated both mindfulness-and acceptance-based therapy and cognitive behavioral therapy (CBT) content. Results indicate that preliminary evidence of the acceptability, feasibility, and potential efficacy of these combined treatments is promising. This research should be replicated in a larger clinical sample to further evaluate combined mindfulness-and acceptance-based therapy and CBT treatments.
Eating Disorder Psychopathology and Resilience in Iranian College Students: A Network Analysis. Journal of Clinical Psychology
Sahlan, R.* & Sala, M. (2022). Eating disorder psychopathology and resilience in Iranian college students: A network analysis. Journal of Clinical Psychology. Epub ahead of print. doi: 10.1002/jclp.23428
This study examined resilience as a protective factor against eating disorder psychopathology in Iran using network analysis to examine an eating disorder and resilience network in an Iranian college student sample. Results indicate that processes related to managing stress and binge eating appear to maintain the association between eating disorder symptoms and resilience processes.
Mindfulness and Binge Eating
Collaboration with colleagues at The University of Delaware
Sala, M., Evangelista, B.*, Lessad, L., & Pacanowski, C.R. (In press). Mindfulness and binge eating symptoms.
This study investigated the relationship between mindfulness, its five facets, and binge eating symptoms in female college students. Results demonstrated that higher levels of acting with awareness, non-judgment, and non-reactivity were correlated with lower levels of binge eating symptoms. The observing and describing facets were not significantly correlated with binge eating symptoms. This research should be replicated in a larger clinical sample to further understand the relationship between mindfulness and binge eating symptoms.
Momentary Predictors of Dietary Lapse From a Mobile Weight Loss Intervention.
Crochiere, R.J.*, Abber, S.R.*, Taylor, L.*, Sala, M., Schumacher, L.M., Goldstein, S.P., & Forman, E.M. (2022). Momentary predictors of dietary lapse from a mobile weight loss intervention. Journal of Behavioral Medicine. 45(2), 324-330. doi: 10.1007/s10865-021-00264-4
This study prospectively assessed risk factors of dietary lapse in the context of a commercial mobile health intervention. Resulted indicated that the likelihood of lapse increased by 73% for every incremental increase in urges and cravings, 65% for alcohol consumption, and 21% for tiredness, and decreased by 23% and 16% for every incremental increase in confidence and in planning, respectively.
Mindfulness and Eating Disorders - Network Analysis
Collaboration with colleagues at The university of Louisville and Yale University
Sala, M., Vanzhula, I., Roos, C., & Levinson, C.A. (2022). Mindfulness and eating disorders: A network analysis. Behavior Therapy. Epub ahead of print. doi: 10.1016/j.beth.2021.07.002
In this study, we used a network analysis to assess which specific mindfulness processes connect to specific ED symptoms. We identified that bridge nodes connecting higher mindfulness processes with lower ED symptoms included: the eating disorder symptom, being uncomfortable about others seeing one eat, and the mindfulness process, not criticizing oneself for having irrational/inappropriate emotions. Bridge nodes connecting higher mindfulness processes with higher ED symptoms included: noticing sensations of the body moving when walking and noticing how food/drinks affect thoughts, bodily sensations, and emotions. These findings suggest that emotion regulation processes may drive the link between mindfulness and ED symptoms.. Check out the full-study here.
The Treatment of Compulsive Exercise in Individuals With Eating Disorders and Muscle Dysmorphia: Where Do We Go From Here?
Sala, M. (2022). The treatment of compulsive exercise in individuals with eating disorders and muscle dysmorphia: Where do we go from here? Clinical Psychology: Science and Practice, 29(2), 162–163. doi: 10.1037/cps0000063
In this invited commentary, Dr. Sala discusses future research goals for the treatment of compulsive exercise in individuals with eating disorders and muscle dysmorphia.
Real-Time Fluctuations In Mindful Awareness, Willingness, And Values Clarity, And Their Associations With Craving And Dietary Lapse Among Those Seeking Weight Loss
Sala, M., Roos, C.R., Crochiere, R.J.*, Butryn, M.L., Juarascio, A.S., Manasse, S.M., & Forman, E.M. (2021). Real-time fluctuations in mindful awareness, willingness, and values clarity, and their associations with craving and dietary lapse among those seeking weight loss. Journal of Contextual Behavioral Science, 22, 87-92, doi: 10.1016/j.jcbs.2021.10.002
This study used ecological momentary assessment to examine the extent to which momentary mindful awareness, willingness, and values clarity varied within-person, and were associated with craving and likelihood of dietary lapse among weight-loss-seeking individuals with overweight/obesity prior to starting a weight loss program. Results indicated that mindful awareness, willingness, and values clarity correlated with lower craving and likelihood of dietary lapse.
Awareness, Affect, & Craving - Smoking Cessation EMA Study
Collaboration with colleagues at Yale University and Brown University
Sala, M., Roos, C.R., Brewer, J.A., & Garrison, K.A. (2021). Awareness, affect, and craving during smoking cessation: an ecological momentary study. Heath Psychology, 40(9), 578-586. doi:10.1037/hea0001105
This study utilized experience sampling to test whether awareness was related to craving, positive and negative affect, and smoking among smokers who were in treatment for smoking cessation. Experience sampling is ideal for gathering systematic self-reports of behaviors, emotions, or experiences as they occur in real-time in the individual’s natural environment. Results demonstrated that higher awareness was associated with higher positive affect, lower craving, and lower negative affect. These findings suggest that learning to increase awareness, such as through mindfulness training and practice, may benefit smokers in treatment. Check out the full-study here.
Mindfulness-Based Interventions for Eating Disorders: Multiple Associative-Learning Change Mechanisms
Roos, C.R., Sala., M., Kober, H., Vanzhula, I., & Levinson, C.A. (2021). Mindfulness-based interventions for eating disorders: The potential to mobilize multiple associative-learning change mechanisms. International Journal of Eating Disorders, 54(9), 1601-1607. doi: 10.1002/eat.23564.
This study aimed to evaluate how mindfulness-based interventions (MBIs) - via increasing either mindful awareness or mindful acceptance - may mobilize eight associative-learning change mechanisms. Given that Eating Disorders (EDs) are defined as adaptive processes of child, we aimed to investigate whether Pavlovian and operant learning would be particularly effective in mobilizing change. Furthermore, we discussed similarities and differences between MBIs and CBT approaches for EDs and presented future research recommendations for the development and evaluation of MBI interventions for EDs and testing of mechanisms and patient-treatment matching hypotheses. Check out the full-study here.
Automated Digital Interventions to human-delivered weight loss treatment systematic review & meta-analysis
Collaboration with colleagues at Drexel University
Berry, M.*, Sala, M., Abber, S.*, & Forman, E.M. (2021). Incorporating automated digital interventions into coach-delivered weight loss treatment: A meta-analysis. Heath Psychology, 40(8), 534-545. doi:10.1037/hea0001106.
This is the first systematic review and meta-analysis of the effectiveness of automated digital interventions (ADIs) for improving the outcomes of human coach-delivered weight loss treatment. Results revealed a mean difference in weight change between conditions, which supports the use of ADIs to augment coach-delivered behavioral weight loss treatment. Additionally, results suggest that ADIs have the greatest impact when coaching is relatively low in either frequency or duration.
State body Dissatisfaction, Positive & Negative Affect, & Weight Control Behaviors - EMA Study
Collaboration with colleagues at the University of Delaware
Sala, M., Linde, J.A., Crosby, R.D., & Pacanowski C.R (2021). State body dissatisfaction predicts positive and negative affect but not weight control behaviors: An ecological momentary assessment study. Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity, 26(6), 1957-1962. doi: 10.1007/s40519-020-01048-6
This study utilized ecological momentary assessment (EMA) to examine the momentary relationships between body dissatisfaction, affect, and weight control behaviors in female college students. EMA is an ideal methodology for studying momentary constructs in daily life. Results demonstrated that greater body dissatisfaction significantly predicted lower subsequent positive affect and higher subsequent negative affect, highlighting the importance of targeting body dissatisfaction to improve affect. Check out the full-study here.
Predictors of Weight Loss within the MOVE!® Program
Collaboration with colleagues at VA Connecticut Healthcare System
Sala., M., Quinn, N. & Freeeman, J.T. (2021) Factors Associated with Weight Loss Within a Blended Virtual and Face-to-Face MOVE!® Program: A Retrospective Study. Military Behavioral Health. doi: 10.1080/21635781.2021.1888828
We examined predictors of weight loss within VA Connecticut Healthcare System’s (VACT) behavioral weight management program, MOVE!®. A higher number of sessions attended and teleconferencing in from a community-based outpatient clinic were associated with higher weight-loss. Results suggest that a dose-response relationship within MOVE!, where participants who attended more sessions lost more weight. Teleconferencing in from CBOCs was an effective manner to deliver MOVE!. Check out the full study here.
Mindfulness-Based Physical Activity Intervention: A Randomized Pilot Study
Collaboration with colleagues at Southern Methodist University
Sala M., Geary B., & Baldwin A.S (2021). A mindfulness-based physical activity intervention: A randomized pilot study. Psychosomatic Medicine, 83(6), 615-623. doi: 10.1097/PSY.0000000000000885.
In this parallel two-arm pilot randomized control trial, we aimed to assess the feasibility and acceptability of an audio-recorded mindfulness-based intervention for physically under-active adults. We examined whether the intervention results in a clinically meaningful difference in physical activity. Results suggest that the audio-recorded mindfulness-based physical activity intervention is a promising approach to increasing physical activity. Furthermore, this audio-recorded mindfulness-based intervention has good dissemination potential. Check out the full study here.
Awareness, Affect, and Craving During Smoking Cessation: An Ecological Momentary Study
Sala, M., Roos, C.R., Brewer, J.A., & Garrison, K.A. (2021). Awareness, affect, and craving during smoking cessation: an ecological momentary study. Heath Psychology, 40(9), 578-586. doi:10.1037/hea0001105
This study used experience sampling to test the relationship between awareness and craving among smokers being treated for smoking cessation. Results indicated that higher awareness was correlated with lower craving.
Associations Between Adverse Childhood Experiences, Weight Control Behaviors, and Quality of Life
Collaboration with colleagues at VA Connecticut Healthcare System
Masheb, R.M., Sala, M., Marsh, A.G., Snow, J.L. Kutz, A.M., & Ruser, C.B (2021). Associations between adverse childhood experiences and weight, weight control behaviors, and quality of life in Veterans seeking weight management service. Eating Behaviors, 40, 101461. doi: 10.1016/j.eatbeh.2020.101461.
We examined the prevalence of adverse childhood experiences (ACEs), and analyzed associations between ACEs and measures of weight, eating behaviors and quality of life in Veterans seeking weight loss. Lower physical activity, lower quality of life, and lower quality of life associated with weight were associated with ACEs, but not weight, weight control strategies, binge eating, or alcohol use. Overall, ACEs appear to be common among Veterans looking for weight loss, especially among female Veterans. Check out the full study here.
Affect And Engagement in Healthy and Unhealthy Weight Control Behaviors in College Women: An Ecological Momentary Assessment Study
Sala, M., Linde, J. A., Crosby, R. D., & Pacanowski, C. R. (2021). Affect and engagement in healthy and unhealthy weight control behaviors in college women: An ecological momentary assessment study. Eating Behaviors, 40, 101439. doi: 10.1016/j.eatbeh.2020.101439
This study examined relationships between momentary affect and weight weight control behaviors in healthy college-age women. Resulted indicated that average daily negative affect was inversely associated with daily engagement in unhealthy weight control behaviors, but was not associated with healthy weight control behaviors. Average daily positive affect was not associated with daily engagement in healthy or unhealthy weight control behaviors.
The Association Between Mindfulness Facets and Body Checking in Individuals With High and Low Eating Disorder Pathology
Sala, M., & Levinson, C.A. (2020). The association between mindfulness facets and body checking in individuals with high and low eating disorder pathology. Mindfulness, 11, 2199-2205. doi: 10.1007/s12671-020-01445-z
In this study, we explored the associations between mindfulness facets and body checking, and how these relationships are moderated by eating disorder psychopathology. We found that most mindfulness facets showed potential as processes that could be altered to reduce body checking, particularly for individuals higher in ED psychopathology. Check out the full study here
Trait Mindfulness and Health Behaviors - Meta-Analysis
Sala, M., Rochefort, C., Lui, P.P., & Baldwin, A.S. (2020). Mindfulness and health behaviors: A meta-analysis. Health Psychology Review, 14(3), 345-393. doi: 10.1080/17437199.2019.1650290
We conducted a meta-analysis that examined the strength of the associations between mindfulness and health behaviors. We found that mindfulness had a positive and small association with health-behaviors. Effects were larger for health promoting behaviors (e.g., eating behaviors, physical activity, sleep), the acting with awareness facet of mindfulness, and samples involving psychiatric patients. Check out the full-study here
Mindfulness and Eating Disorder Psychopathology: A Meta-Analysis
Sala, M., Shankar Ram, S.*, Vanzhula, I.A., & Levinson, C.A (2020). Mindfulness and eating disorder psychopathology: A meta-analysis. International Journal of Eating Disorders, 53(6), 834-851. doi: 10.1002/eat.23247
This meta-analysis examined the associations between mindfulness and eating disorder psychopathology using a multi-level random-effects model to estimate summary study-level effect sizes. Results indicated that mindfulness was negatively associated with eating disorder psychopathology, particularly for binge eating, emotional/external eating, and body dissatisfaction as well as the acting with awareness and nonjudging facets.
Avoidance Coping During Mealtimes and Eating Disorder Symptoms
Collaboration with colleagues at the University of Louisville
Vanzhula, I., Sala, M.,Christian, C., Hunt, R.A., Keshishian, A.C, Wong, V.Z., Ernst, S., Spoor, S.P., & Levinson, C.A (2020). Avoidance coping during mealtimes predicts higher eating disorder symptoms. International Journal of Eating Disorders, 53(6), 834-851.doi: 10.1002/eat.23254
In this study, we examined how avoidance coping (e.g., distraction, avoidance of emotions) during mealtimes predicts eating disorder symptoms in real-time. We found that although distraction during meals predicted a reduction in anxiety in the moment, both distraction and avoidance of emotions predicted increases in excessive exercise in the short-term. Additionally, higher avoidance coping predicted increases in bulimic symptoms at 1-month follow-up. Check out the full-study here
A Longitudinal Study on the Association Between Facets of Mindfulness and Eating Disorder Symptoms
Collaboration with colleagues at the University of Louisville
Sala, M., Vanzhula, I., & Levinson C.A. (2019). A longitudinal study on the association between facets of mindfulness and eating disorder symptoms in individuals diagnosed with eating disorders. European Eating Disorder Review, 27(3), 295-305. doi: 10.1002/erv.2657
In this study, we examined the association between aspects of mindfulness and eating disorder symptoms over time. We found that higher acting with awareness predicted lower eating disorder symptoms over time. Check out the full-study here
Repetitive Negative Thinking and Eating Disorder Behaviors
Collaboration with colleagues at the University of Louisville
Sala, M., Brosof, L.C., & Levinson, C.A. (2019). Repetitive negative thinking predicts eating disorder behaviors: A pilot ecological momentary assessment study in a treatment seeking eating disorder sample. Behavior Research and Therapy, 112,12-27. doi: 10.1016/j.brat.2018.11.005
In this study, we examined the real-time association between repetitive negative thinking (e.g., worry, rumination) and eating pathology in individuals with eating disorders. Using ecological momentary assessment, we found that higher momentary repetitive negative thinking predicted higher subsequent weighing. We also found that higher repetitive negative thinking predicted higher eating disorder symptoms at one-month follow-up. Check out the full study here