Running head should be a maximum of 50 characters, counting letters, punctuation, and spaces. Katie’s title takes up 94 characters. Therefore, she has condensed the full title to just “ANOREXIA NERVOSA” for the running head (p. 229).

Running head: ANOREXIA NERVOSA 1

Beyond Cognitive-Behavioral Therapy:

Alternative Options for the Treatment of Anorexia Nervosa

Katie A. Rider

Asbury University

From URL: http://asbury.libguides.com/apaguide

Title page is always page one

Title, author, institution is about 1/3 from top, centered, not bolded, length no more than 12 words. Do not include anything else (e.g., date, course, professor, etc.).

Title should summarize main idea of paper (with style). Be concise. Identify variables or theoretical issues under investigation and relationship between them.

Avoid words that serve no purpose (e.g., Method, Results, A Study of, An Experimental Investigation of).

Allowed fonts: Arial 11 Tahoma 11 Calibri 12 Times New Roman 12

Note that the entire paper should be double-spaced (even the title page).

Never use single spacing or 1.5 spacing except in tables or figures (p. 229).

This Literature Review is the first of the set of three papers (Literature Review, Ethics Paper, & Integration Paper) required

of PSY475 Senior Seminar students.

All comments are by Dr. Gay L. Holcomb.

Updated January 20, 2014

ANOREXIA NERVOSA 2

ANOREXIA NERVOSA 3

Abstract

Cognitive-behavioral therapy traditionally has been the treatment of choice for anorexia nervosa.

However, in recent years researchers have presented several new treatment options in response to

cognitive-behavioral therapy’s dismal success rate with anorexic patients. Three of the most

prominent models include schema compensation theory, cognitive-emotional-behavioral therapy,

and multi-step cognitive behavior therapy. Each represents a refinement or extension of

cognitive-behavioral theory and shows promise in remediating features of anorexia nervosa that

standard cognitive-behavioral therapy neglects. Nevertheless, all three models currently lack

empirical evidence demonstrating their validity. Therefore, researchers must conduct further

studies before clinicians utilize these models to treat patients.

Abstract Essentials (see p. 26-27 for more specifics)

1. The abstract is THE most important single paragraph in the paper! Researchers who are scanning through hundreds of database articles will only skim the abstracts. Readers frequently decide on the basis of the abstract whether to read the entire article or not.

2. The abstract needs to be DENSE with information. In other words, forget everything your English teachers taught you about writing beautiful prose. Instead, eliminate all non-essential, superfluous language. Only include verbiage that is absolutely essential to communicate the gist of your article.

3. Write in clear and concise language. Cut the fluff!! Get rid of extraneous words. Write in active rather than passive voice

4. Include thesis (argument of paper), discussion (how you’ll support argument), conclusions, implications of conclusions. Include only the four or five most important concepts, findings, or implications.

5. Compare abstract with your headings and subheadings. Have you included the most salient points?

6. Use specific words that your audience is likely to use in their electronic searches.

7. Report rather than evaluate what’s in the paper.

8. Use present tense to describe conclusions drawn or results with continuing applicability.Use past tense to describe specific variables manipulated or outcomes measured.

9. Word length must be 100 words or less.

The words “Running head” are NO T included on this and all subsequent pages – just the actual running head, “ANOREXIA NERVOSA.

The word “Abstract” is centered, not bolded.No indentation of paragraph

Implications

Discussion

Conclusion

Issues / thesis

T

ANOREXIA NERVOSA 4

Beyond Cognitive-Behavioral Therapy:

Alternative Options for the Treatment of Anorexia Nervosa

Of the over 300 disorders listed in the American Psychiatric Association’s (APA, 2000)

Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, anorexia

nervosa (AN), a disorder characterized by the maintenance of weight at least 15% below normal

and an intense fear of gaining weight, has the highest mortality rate (Cumella, Eberly, & Wall,

2008). Furthermore, recent research indicates that the incidence of AN among the female

population is steadily rising (Hoek & van Hoeken, 2003; Lucas, Crowson, O’Fallon, & Melton,

1999). For instance, Hoek and van Hoeken (2003) found that the number of women ages 15 to

19 diagnosed with AN increased every year between the years 1935 and 1989 and the South

Carolina Department of Mental Health (2006) determined that one out of every 200 American

women suffers from the disorder. Therefore, as is evident, the number of women struggling with

AN, when coupled with an awareness of the deadliness of the disorder, points towards crisis and

calls for the swift emergence of a treatment model that clinicians can employ to consistently

remedy the malady in an efficacious manner.

Nevertheless, despite the urgent need for a potent model of treatment designed

specifically for the management of AN, one has yet to materialize. In fact, researchers have

demonstrated that 35% of anorexic patients will relapse within the first 18 months of terminating

treatment (Carter, Blackmore, Sutandar-Pinnock, & Woodside, 2004), and only 30% to 40% of

anorexics report ever achieving a full recovery (South Carolina Department of Mental Health,

2006). Traditionally, the mental health community has upheld cognitive-behavioral therapy

(CBT) as the preeminent treatment for AN (Cumella et al., 2008). Indeed, both the APA (2006)

and the National Institute for Health and Clinical Excellence (2004) recognized CBT as the best

Title of paper serves as title of introduction (not the word “introduction”), centered, not bolded. Exactly the same title as that on p. 1.

The “%” sign is used when preceded by a numeral. The word percentage is used when a number is not given (p. 118).

On all subsequent Cumella citings, (Cumella et al., 2008) is listed.

Become familiar with the chart on p. 177.

This is 1st occurrence of Cumella citing. Because there are 3 authors (see chart on p. 177), all authors are listed the 1st

time.

Indentation of paragraph here.

If using an abbreviation, define it when first mentioned with abbreviation in parentheses. Then use abbreviation from then on throughout.

ANOREXIA NERVOSA 5

treatment available for AN in their latest treatment guidelines. However, the APA

acknowledged in their guidelines that the evidence supporting CBT as the treatment of choice for

AN is still “emerging” (APA, 2006, p. 17) and applies only to adults, a notable concern

considering that AN is the third most common chronic illness among adolescents (South

Carolina Department of Mental Health, 2006). For this reason, a number of researchers have

been working in recent years to determine why the model of CBT presently used with anorexic

patients is insufficient and to develop a new model that clinicians can apply to reliably remediate

the physical, emotional, and psychological effects of AN (Corstorphine, 2006; Grave, 2005;

Luck, Waller, Meyer, Ussher, & Lacey, 2005; Vanderlinden, 2008).

Cognitive-Behavioral Therapy

Although it has since become evident that the capacity of CBT to ameliorate AN is

inadequate, the establishment of CBT as the preferred treatment for the disorder did not occur

simply by chance. For not only does using CBT to treat AN appeal to common sense, but

researchers have also verified the approach to some degree through valid empirical means

(Bowers & Ansher, 2000; Carter et al., 2009; Channon, de Silva, Hemsley, & Perkins, 1989;

Pike, Walsh, Vitousek, Wilson, & Bauer, 2003). In simplified terms, those who adhere to CBT

methodology maintain that both learned responses and cognitive activity mediate human

behavior (Cumella et al., 2008). Consequently, the CBT therapist’s primary task is to help

individuals replace their inaccurate and irrational beliefs, perceptions, and cognitions with

rational ones. This replacement, in turn, is assumed to enable individuals to behave in a more

rational and healthy manner, as after CBT they are no longer driven to behave irrationally in

response to their erroneous cognitions. Considering that psychologists have long regarded AN as

stemming from the maintenance of faulty beliefs about weight and appearance, the use of CBT to

1” margin (p. 229)

1” margin 1” margin

Margins are all one inch around except for situations that would create widows/orphans (single lines of text hanging by themselves.

Level 1 Heading (p. 62)

This is the 1st time in the text that the Carter 2009 source is cited. Because the source has >=6 authors (see References), the first, and all subsequent, citations just lists it as “Carter et al., 2009”

Separate the different references with semicolons.

Be careful with apostrophes

ANOREXIA NERVOSA 6

treat the disorder is entirely rational. The logic is as follows: If clinicians help anorexics replace

their inaccurate beliefs about weight and food with accurate ones, then anorexics’ fears about

gaining weight will abate and they will resume eating in a normal manner.

Research Supporting the Effectiveness of CBT Treatment

Empirical research has validated this oversimplified line of reasoning concerning the use

of CBT to treat AN to a limited extent. For instance, Carter et al. (2009) investigated the

capacity of CBT to prevent relapse among 88 anorexic patients during the first year following

their discharge from the Toronto General Hospital Eating Disorders Program. Forty-six of the

88 patients received 50 sessions of “manualized individual CBT” (p. 204) with a highly qualified

psychologist. The remaining 42 patients received “maintenance treatment as usual (MTAU)”

(p. 203), meaning that they were permitted to select the aftercare program of their choice from

options available in the community. Patients in the MTAU group chose to pursue a variety of

different types of aftercare, such as weekly visits to a therapist, support group attendance, and

consultation with a dietician. After one year, 65% of the patients in the CBT group had not

relapsed. In contrast, only 35% of the patients in the MTAU group had not relapsed. As they

explained, these results are significant, for they indicate that CBT “may be helpful in. . .

preventing relapse” (p. 202) among anorexic patients who have successfully completed a course

of inpatient treatment.

Several other studies have also borne out the assumption maintained by many in the

mental health community that CBT is the foremost treatment for AN. Pike et al. (2003)

established that CBT was far more effective than nutritional counseling in preventing relapse

among 33 anorexic patients during the year immediately following their discharge from an

inpatient eating disorders program. Similarly, Channon et al. (1989) found that CBT was

Level 2 Heading (p. 62)

Numbers (p. 111-114) Use words to express the numbers one through nine (e.g., seven, nine). Use numerals to express numbers 10 and above (e.g., 13, 235). Use numerals to express any number that comes before a % sign (e.g., 2%, 15%). Use words to express any number that begins a sentence, title, or text heading. If comparing two numbers, write both in same format (e.g., “only 8 of the 15 studies”).

ANOREXIA NERVOSA 7

superior to standard behavior therapy (SBT) as a treatment for AN, with patients assigned to the

CBT group attending more therapy sessions than patients assigned to the SBT group. In 2000,

Bowers and Ansher determined that anorexic patients who received CBT while on an inpatient

treatment unit achieved significant positive changes in their eating disorder schemas and

cognitive distortions by time of discharge.

Limitations of CBT Research

As is apparent, researchers have provided some evidence to support the assertion that

CBT is the preeminent treatment for AN (Bowers & Ansher, 2000; Carter et al., 2009; Channon

et al., 1989; Pike et al., 2003). However, closer examination reveals that the studies that supplied

this evidence are not without limitation. For instance, researchers completed the vast majority of

these studies utilizing extremely small samples. In fact, of the four studies explicated above, the

largest sample used was composed of only 88 patients (Carter et al., 2009), a reality that severely

limits the generalizability of the results that were acquired. Second, many of these studies

focused upon the use of CBT as a relapse prevention mechanism after patients’ weight had been

restored (Carter et al., 2009; Pike et al., 2003). While it is helpful for clinicians to be aware that

CBT is an effective relapse prevention tool, such information is not sufficient to establish CBT

as the designated treatment for all anorexic patients, for relapse prevention is necessary only

after patients’ psychological and nutritional stability has already been re-established. Finally, the

majority of these studies employed non-equivalent control groups only (e.g., Carter et al., 2009;

Channon et al., 1989; Pike et al., 2003). Consequently, it is impossible to determine if the higher

recovery rates achieved by those anorexics who received CBT are reflective of the effectiveness

of CBT itself, or if they are the result of differences that existed between the patients who were

When two or more authors are referenced in the text, their names are joined with the word “and.”

But when their names are used in a parenthetical citation (a citation within parentheses), use an ampersand (“&”).

“e.g.,” means “for example”

“i.e.,” means “that is”

ANOREXIA NERVOSA 8

administered CBT and those who were administered alternative treatment forms prior to

commencement of the studies.

Schema Compensation Theory

Recognizing the evident shortcomings of the traditional CBT methods used to treat AN, a

number of psychologists have been laboring to devise alternative treatment options. Luck et al.

(2005) established their model on the supposition that schema compensation, “a process whereby

an individual thinks or behaves in complete opposition to what an underlying negative schema

would suggest, in order to avoid that negative schema being activated” (p. 719), is responsible

for provoking anorexic behavior. To elucidate this seemingly complex concept, they turned to

perfectionism, a personality trait characterized by an unrelenting drive to achieve that is common

among anorexic patients. When individuals maintain the belief that they are not capable of

success, known as a failure to achieve schema, this incites uncomfortable emotions, such as

shame and disappointment. In an attempt to avoid these emotions individuals develop

perfectionistic tendencies, for perfectionism motivates achievement, and as long as individuals

achieve, activation of the failure to achieve schema does not occur and the uncomfortable

emotions aroused by the schema remain dormant. According to Luck et al., AN results from a

nearly identical process, whereby individuals use dietary restriction to compensate for perceived

inadequacy and to prevent the activation of the painful emotions associated with their

inadequacy cognitions.

If, as Luck et al. (2005) asserted, AN is simply schema compensation gone awry, then the

flaws in anorexics’ cognitions lie not in their content but in their processes. In an effort to

validate this theory, Luck et al. administered the Young Compensatory Inventory (Young, 1998),

a psychometric instrument designed to measure the extent to which participants utilize schema

ANOREXIA NERVOSA 9

compensation, to 71 anorexics and 50 bulimics, as well as to 337 healthy female participants.

The results obtained by Luck et al. clearly support the schema compensation theory of AN.

Anorexic participants scored significantly higher on the measure of schema compensation than

either the bulimic participants or the non-clinical participants.

The findings of Luck et al. (2005) are quite instructive because they indicate that the

present ineffectiveness of the CBT methods used to treat anorexic patients stems not from the

methods themselves but from the aspect of cognition that the methods are targeting. Therefore,

assuming that AN is a disorder driven by defective schema processes, as the work of Luck et al.

suggested, simply shifting the concentration of therapeutic interventions from the alternation of

schema content to the transformation of schema processes will bolster the effectiveness of CBT

with anorexic patients. Nevertheless, before clinicians can begin to apply this understanding of

AN to their work with patients, Luck et al. must replicate their findings using a significantly

larger sample to ensure that their results are indeed worthy of generalization. Furthermore, Luck

et al. need to operationalize their theory by formulating a treatment method designed specifically

to remedy the flawed schema processes of anorexics. Otherwise, they will have produced

nothing but a novel, interesting concept.

Cognitive-Emotional-Behavioral Therapy

Corstorphine (2006) presented a further expansion of conventional CBT methodology for

the treatment of AN. Entitled cognitive-emotional-behavioral therapy (CEBT), Corstorphine’s

approach is grounded upon the supposition that AN results primarily from deficient affect

regulation. Consequently, in stark contrast to the conventional CBT methodology used to treat

AN, Corstorphine designed CEBT to focus upon anorexic patients’ emotions, and their ability to

tolerate these emotions, rather than on patients’ faulty cognitions. This distinction is essential;

ANOREXIA NERVOSA 10

anorexics do not have the emotional strength necessary to engage with their cognitions unless

they first learn how to manage the emotions elicited by these cognitions. In an effort to simplify

the implementation of CEBT, Corstorphine broke the therapeutic process into three central

components.

CEBT Component One (Psychoeducation)

The first component, and perhaps the most important, is psychoeducation. The primary

function of this portion of CEBT treatment is to provide patients with an understanding of the

origins of their affect regulation difficulties, and therefore of their AN. According to

Corstorphine (2006), the majority of anorexics develop affect regulation difficulties in response

to growing up in an invalidating environment, a term used to refer to “an environment in which

communication of emotion is ignored or responded to negatively” (p. 450). Due to living in this

type of environment, individuals come to believe that emotions are unacceptable, hazardous and

risky and should not be experienced.

Regardless of the maintenance of beliefs concerning the improper nature of emotions, the

experience of normal affective arousal throughout the course of daily life is inevitable. This type

of emotion, designated by Corstorphine (2006) as primary emotion, is typically quite

unexceptional. However, individuals raised in an invalidating environment experience the

provocation of primary emotion as failure. This, in turn, leads to the emergence of secondary

emotion, which is the emotion that results from the “judging [of] primary emotion as ‘bad’”

(Corstorphine, 2006, p. 450). Because individuals raised to regard emotion as inappropriate

spend their lives attempting to avoid emotion, they never develop proper affect regulation skills.

So, when these individuals encounter the secondary emotion that results from the experience of

Limit use of direct quotes throughout your paper. Check with your professor to ascertain her or his preferences. Instead, paraphrase whenever possible, making sure to properly credit your source(s). When you do use direct quotes, you must give page numbers (if a book or journal article) or paragraph number and possibly section number (if an online reference).

Italicize words when new terms are intro’d the first time. Thereafter don’t italicize the term (p. 105)

When quoting a passage where the author highlights a word or phrase with double quotation marks, change their double quotes to single quotes in order to indicate to your readers that the original material was in double quotes.

ANOREXIA NERVOSA 11

primary emotion, they typically resort to maladaptive behavior in order to cope. In the case of

anorexics, dietary restriction is the maladaptive behavior pattern most frequently employed.

CEBT Components Two (Experiencing Emotion) and Three (Evaluation and Modification)

Introducing patients to the factors underlying their development of AN during the first

component of CEBT is one of the most propitious aspects of this particular treatment method,

because doing so serves to refute the widespread belief that individuals become anorexic because

they are weak-willed. Nevertheless, educating anorexic patients as to the source of their

difficulties is not enough to ensure full recovery. For this reason, Corstorphine (2006)

incorporated components two and three into the treatment model. Component two, the simplest

of the three treatment components, focuses upon encouraging patients to experience emotion,

with the goal of helping anorexics to become comfortable remaining in an emotional state.

To accomplish this objective, clinicians employ an assortment of therapeutic techniques,

including the use of journaling to monitor emotion and the use of the “emotional thermostat”

(p. 456), a tool designed to teach patients that emotions can be experienced to various degrees. It

is only once patients have mastered the ability to experience and interpret a range of affective

states without resorting to anorexic behavior that CEBT treatment progresses to component

three, during which patients evaluate their beliefs for accuracy and modify those beliefs found to

be in error.

Limitations of CEBT Treatment

CEBT constitutes an impressive and necessary addition to the current body of treatment

options available for AN, for it provides clinicians with techniques to specifically target the

emotional aspect of anorexics’ functioning, an aspect that standard CBT methodology typically

ignores. However, the model is not without its limitations. For instance, Corstorphine’s (2006)

Text Alignment – Word gives you 4 options: Align Text Left, Center, Align Text Right, and Justify.But APA gives you only 1 option for the body of your paper: Align Text Left. Or, in other words, be sure your left hand margins are aligned neatly and right hand margins of your pages are “ragged.” Proper settings can be made under “Paragraph,” or select body of text and Ctl+L

ANOREXIA NERVOSA 12

approach is based on the notion that AN results from affect regulation difficulties, a belief the

majority of the mental health community regards to be accurate, but that is without firm

empirical validation (Christie, Watkins, & Lask, 2000; Fairburn, Cooper, & Shafran, 2003;

Linehan, 1993). Second, Corstorphine assumed that affect regulation difficulties influence all

anorexics to an equal degree, a rather overzealous assertion requiring far more investigation.

Finally, Corstorphine has yet to test this method using controlled experimental means, a

necessity if it is to become ethically appropriate for clinicians to employ CEBT to treat anorexic

patients.

Multi-Step Cognitive Behavior Therapy

A final notable reinvention of CBT for the treatment of AN is known as Multi-Step

Cognitive Behavior Therapy (CBT-MS). Introduced by Grave (2005), the approach concentrates

less on reinventing the content of CBT and more on reinventing the manner in which clinicians

implement CBT. Recognizing that researchers have established the validity of CBT as a

treatment for AN only in adult populations, and that CBT frequently proves impotent when

employed with more advanced cases, Grave determined to create a CBT based treatment model

that clinicians could successfully use with anorexic patients of all ages and severity levels.

Grave (2005) distinguished CBT-MS from customary CBT methodology in several ways.

First, as the name implies, five levels of treatment compose CBT-MS: outpatient CBT, intensive

outpatient CBT, day-hospital CBT, inpatient CBT, and post-inpatient CBT. Upon entering CBT-

MS treatment, clinicians evaluate patients in terms of the acuteness of their AN and place them

into the level of treatment deemed sufficient to meet their needs. Therefore, patients begin CBT-

MS treatment at various levels of care. However, once patients have entered the CBT-MS

program, their treatment team operates from the assumption that they will remain in the program

Citations are listed in alphabetical order by author (Christie, Fairburn, Linehan), then chronological within author (p. 178).

ANOREXIA NERVOSA 13

until they have successfully completed all of the following levels of treatment. The purpose of

this multi-step approach is two-fold. First, it ensures that there is a level of care appropriate for

every patient, regardless of the severity level of the AN with which a patient presents. Second, it

prevents the mixing of patients who are at varying stages of the disease during the treatment

process. This is vital, for when treatment programs incorporate patients in the earlier stages of

AN with patients in the later, more critical stages of the disease, the former often learn novel

eating disorder behaviors from the later, resulting in the aggravation rather than the improvement

of anorexic symptoms.

An additional distinguishing characteristic of CBT-MS is its employment of a

multidisciplinary, non-eclectic team of professionals to treat patients. Grave (2005) designed

CBT-MS to be carried out by a team composed of a psychiatrist, a psychologist, a medical

doctor, a dietician, and a nurse, each of whom is required to complete an intensive one-year

course in CBT philosophy and technique before engaging with patients. This aspect of CBT-MS

methodology is important for several reasons. For one, it ensures that there is a trained authority

available to treat each of the diverse symptoms of AN, whether those symptoms are physical or

psychological. Second, use of a theoretically cohesive treatment team prevents patients from

sabotaging their own treatment by capitalizing on the splitting among team members that often

occurs when each member of a treatment team is operating from a distinctive theoretical

perspective. Third, it guarantees that treatment team members communicate with patients using

the same language, regardless of the particular role they are playing in the treatment process.

Ultimately, this allows patients to benefit from more CBT intervention than they would if only

one member of their treatment team utilized CBT methodology.

ANOREXIA NERVOSA 14

The final distinguishing attribute of CBT-MS is that clinicians can tailor the model for

use with anorexic patients of all ages. Although conventional CBT treatment is “indicated only

for adult eating disorders patients” (Grave, 2005, p. 276), Grave extended the applicability of his

treatment approach by including a family therapy module for patients under the age of 18. This

module does not replace the traditional CBT techniques used throughout the various levels of

CBT-MS treatment. Instead, it supplements those techniques, taking into account the “empirical

support” (2005, p. 276) that exists for including parents in the treatment of adolescent eating

disorder patients.

Like each of the recent modifications of CBT for the treatment of AN, CBT-MS has

notable strengths and concerning weaknesses . The most important contribution of the model is

its ability to treat anorexic patients of all ages and severity levels. In contrast, the model’s most

prominent weakness is its heavy reliance on the use of conventional CBT techniques (Grave,

2005). Given the fact that researchers have found these techniques to be only mildly effective

for the treatment of AN (Gowers et al., 2007), Grave’s reorganization of the manner in which

CBT is implemented may not be sufficient to transform CBT into a potent treatment for the

disease (Carré, Iselin, Welker, Hariri, & Dodge, 2014). Finally, similar to Corstorphine (2006),

Grave must validate the efficacy of his approach through empirical means. Until that is

accomplished, it will remain unethical for clinicians to utilize CBT-MS to treat anorexic patients

(Adams & Jex, 1999; see also Ahn, Kim, & Aggarwal, 2013; Aiken & West, 1990).

Conclusion

Despite the widespread nature of various mental disorders throughout the United States

population, it is arguable that none of these disorders calls for an increase in empirical studies

aimed at uncovering an effective treatment method more than AN. With an ever-increasing

ANOREXIA NERVOSA 15

incidence and a remarkably high mortality rate of 10%, it is evident that continuing to use

traditional CBT methods to treat AN is not sufficient (Hoek & van Hoeken, 2003). Thankfully,

several courageous psychologists and psychiatrists have recognized this need and have begun to

modify CBT methodology in an effort to improve its efficacy with anorexic patients

(Corstorphine, 2006; Grave, 2005; Luck et al., 2005). The focus of these new treatment models

varies widely, a fact which speaks to the complexity of AN, and ultimately only time will

determine which model is superior. Until a preeminent model does emerge, it is essential that

the exploration for a truly potent treatment continue, for far too many women have already been

lost to the ravages of AN, a mental disorder that destroys the body and withers the soul.

ANOREXIA NERVOSA 16

References

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental

disorders. (4th ed., text revision). Washington, DC: Author.

American Psychiatric Association. (2006). Treatment of patients with eating disorders (3rd ed.)

[Adobe Acrobat Reader version].

http://dx.doi.org/10.1176/appi.books.9780890423363.138660 Retrieved from

http://www.psychiatryonline.com/pracGuide/pracGuideTopic_12.aspx

Bowers, W. A., & Ansher, L. S. (2000). Cognitions in anorexia nervosa: Changes at discharge

from a cognitive therapy milieu inpatient treatment program. Journal of Cognitive

Psychotherapy, 14(4), 393-401. Retrieved from http://search.ebscohost.com/login.aspx?

direct=true&db=psyh&AN=2001-14704-004&site=ehost-live&scope=site

Carter, J. C., Blackmore, E., Sutandar-Pinnock, K., & Woodside, D. B. (2004). Relapse in

anorexia nervosa: A survival analysis. Psychological Medicine, 34(4), 671-679.

http://dx.doi.org/10.1017/S0033291703001168

Carter, J. C., McFarlane, T. L., Bewell, C., Olmsted, M. P., Woodside, D. B., Kaplan, A. S., &

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Disorders, 42(3), 202-207. http://dx.doi.org/10.1002/eat.20591

Channon, S., de Silva, P., Hemsley, D., & Perkins, R. E. (1989). A controlled trial of cognitive-

behavioral treatment of anorexia nervosa. Behavior Research and Therapy, 27(5), 529-

535. http://dx.doi.org/10.1016/0005-7967(89)90087-9

The word “References” is centered, not boldfaced.

Example of a 2nd, 3rd, 4th, etc edition.

Example of a DOI. Notice there is no period at the end.

Reference section is formatted with hanging indent style.

One space after the period of an initial in a personal name.

First word after colon is capitalized.

Put comma before the &.

Example of Permalink

ANOREXIA NERVOSA 17

Christie, D., Watkins, B., & Lask, B. (2000). Assessment. In R. Bryant-Waugh & B. Lask (Eds.),

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Corstorphine, E. (2006). Cognitive-emotional-behavioral therapy for eating disorders: Working

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http://dx.doi.org/10.1002/erv.747

Cumella, E. J., Eberly, M. C., & Wall, A. D. (2008). Eating disorders: A handbook of Christian

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Grave, R. D. (2005). A multi-step cognitive behavior therapy for eating disorders. European

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Gowers, S. G., Clark, A., Roberts, C., Griffiths, A., Edwards, V., Byran, C., . . . Barrett, B.

(2007). Clinical effectiveness of treatments for anorexia nervosa in adolescents:

Randomized controlled trial. British Journal of Psychiatry, 191(5), 427-435.

http://dx.doi.org/10.1192/bjp.bp.107.036764

Hoek, H. W., & van Hoeken, D. (2003). Review of the prevalence and incidence of eating

disorders. International Journal of Eating Disorders, 34(4), 383-396.

http://dx.doi.org/10.1002/eat.10222

Linehan, M. (1993). Cognitive behavioral treatment of borderline personality disorders. New

York, NY: Guilford.

Lucas, A. R., Crowson, C. S., O’Fallon, W. M., & Melton, L. J., III (1999). The ups and downs

of anorexia nervosa. International Journal of Eating Disorders, 26(4), 397-405.

http://dx.doi.org/10.1002 /(SICI) 1098-108X(199912)26:4<397::AID-EAT5>3.0.CO;2-0

Example of a chapter in an edited book. Bryant-Waugh & Lask are the Editors. Christie, Watkins, & Lask wrote the chapter titled “Assessment” that covers pages 105-126, (p. 184).

Proper names, names of countries, names of religions or followers of religions such as “Christian” are capitalized in the title.

This article has > 7 authors, hence the ellipsis between the 6th and last authors’ names (p. 198).

Name of article not italicized.

Journal name & volume number are italicized.

Issue number not italicized.

ANOREXIA NERVOSA 18

Luck, A., Waller, G., Meyer, C., Ussher, M., & Lacey, H. (2005). The role of schema processes

in the eating disorders. Cognitive Therapy and Research, 29(6), 717-732.

http://dx.doi.org/10.1007/s10608-005-9635-8 Retrieved from

http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2006-08535-

006&site=ehost-live&scope=site

National Institute for Health and Clinical Excellence. (2004). Eating disorders: Core

interventions in the treatment and management of anorexia nervosa, bulimia nervosa,

and related eating disorders [Adobe Acrobat Reader version]. Retrieved from

http://www.nice.org.uk/nicemedia/pdf/CG9FullGuideline.pdf

Pike, K. M., Walsh, B. T., Vitousek, K., Wilson, G. T., & Bauer, J. (2003). Cognitive behavior

therapy in the posthospitalization treatment of anorexia nervosa. The American Journal of

Psychiatry, 160(11), 2046-2049. http://dx.doi.org/10.1176/appi.ajp.160.11.2046

Retrieved from http://search.ebscohost.com/login.aspx?

direct=true&db=psyh&AN=2003-09508-024&site=ehost-live&scope=site

South Carolina Department of Mental Health. (2006). Eating disorder statistics. Retrieved from

http://www.state.sc.us/dmh/anorexia/statistics.htm

Sullivan, P. (2002). Course and outcome of anorexia nervosa and bulimia nervosa. In C. G.

Fairburn & K. D. Brownell (Eds.), Eating Disorders and Obesity (pp. 226-232). New

York, NY: Guilford.

Vanderlinden, J. (2008). Many roads lead to Rome: Why does cognitive behavioral therapy

remain unsuccessful for many eating disorder patients? European Eating Disorders

Review, 16(5), 329-333. http://dx.doi.org/10.1002/erv.889

No pp. in page numbers 717-732 for regular books and journal articles

If utilizing an online journal article (while at Asbury), ALWAYS include “Retrieved from” and the Permalink web address.

Do not include the date retrieved.

ANOREXIA NERVOSA 19

Young, J. E. (1998). The Young Compensatory Inventory [Measurement instrument]. Retrieved

from www.schematherapy.com/id42.htm

ANOREXIA NERVOSA 20

General Reference Formatting

Example of online journal article (p. 198):

Author, A. A., Author, B. B., & Author, C. C. (year). Title of article: Subtitle of article. Title of Periodical, vv(ii), pp-pp. http://dx.doi.org/xx.xxxxxxxxxxxxxx Retrieved from www.http://zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz

All words in title and subtitle of article should be lowercase except 1st word in title, 1st word in subtitle, and proper names of countries, states, religions (e.g., “Christian”), etc.

Title of Periodical and volume number (vv) are italicized. Issue number (ii) is not. Always include doi information if given. You may have to dig to find it. Include the Permalink web address with the words, “Retrieved from.” Always include the actual complete web address for any online sources.

Do not include the date you retrieved the information unless the website is one in which the content changes frequently (e.g., social media cites, blogs, etc).

Example of a book (p. 202):

Author, A. A. (year). Title of book: Subtitle of book. City, ST: Publisher.

Title of book is italicized. All words in title and subtitle of article should be lowercase except 1st word in title, 1st word in subtitle, and

proper names of countries, states, religions (e.g., “Christian”), etc. Include the City, State, and Publisher (e.g., “New York, NY: McGraw Hill.”) (p. 187)

Give the publisher’s name in as brief as form as intelligible. Write out the names of associations, corporations, and university presses, but omit superfluous terms such as Publishers, Co., and Inc. When the author is the publisher, use Author to indicate the publisher.