The effects of parental presence on amygdala and mPFC activation during fear conditioning: An exploratory study.

Learning safe versus dangerous cues is crucial for survival. During development, parents can influence fear learning by buffering their children's stress response and increasing exploration of potentially aversive stimuli. Rodent findings suggest that these behavioral effects are mediated through parental presence modulation of the amygdala and medial prefrontal cortex (mPFC). Here, we investigated whether similar parental modulation of amygdala and mPFC during fear learning occurs in humans. Using a within-subjects design, behavioral (final N = 48, 6-17 years, mean = 11.61, SD = 2.84, 60% females/40% males) and neuroimaging data (final N = 39, 6-17 years, mean = 12.03, SD = 2.98, 59% females/41% males) were acquired during a classical fear conditioning task, which included a CS+ followed by an aversive noise (US; 75% reinforcement rate) and a CS-. Conditioning occurred once in physical contact with the participant's parent and once alone (order counterbalanced). Region of interest analyses examined the unconditioned stress response by BOLD activation to the US (vs. implicit baseline) and learning by activation to the CS+ (vs. CS-). Results showed that during US presentation, parental presence reduced the centromedial amygdala activity, suggesting buffering of the unconditioned stress response. In response to learned stimuli, parental presence reduced mPFC activity to the CS+ (relative to the CS-), although this result did not survive multiple comparisons' correction. These preliminary findings indicate that parents modulate amygdala and mPFC activity during exposure to unconditioned and conditioned fear stimuli, potentially providing insight into the neural mechanisms by which parents act as a social buffer during fear learning. RESEARCH HIGHLIGHTS: (1)This study used a within-participant experimental design to investigate how parental presence (vs. absence) affects youth's neural responses in a classical fear conditioning task. (2)Parental presence reduced the youth's centromedial amygdala activation to the unconditioned stimulus (US), suggesting parental buffering of the neural unconditioned response (UR). (3)Parental presence reduced the youth's mPFC activation to a conditioned threat cue (CS+) compared to a safety cue (CS-), suggesting possible parental modulation of fear learning.

Probing the content of affective semantic memory following caregiving-related early adversity.

Cognitive science has demonstrated that we construct knowledge about the world by abstracting patterns from routinely encountered experiences and storing them as semantic memories. This preregistered study tested the hypothesis that caregiving-related early adversities (crEAs) shape affective semantic memories to reflect the content of those adverse interpersonal-affective experiences. We also tested the hypothesis that because affective semantic memories may continue to evolve in response to later-occurring positive experiences, child-perceived attachment security will inform their content. The sample comprised 160 children (ages 6-12 at Visit 1; 87F/73 M), 66% of whom experienced crEAs (n = 105). At Visit 1, crEA exposure prior to study enrollment was operationalized as parental-reports endorsing a history of crEAs (abuse/neglect, permanent/significant parent-child separation); while child-reports assessed concurrent attachment security. A false memory task was administered online ∼2.5 years later (Visit 2) to probe the content of affective semantic memories-specifically attachment schemas. Results showed that crEA exposure (vs. no exposure) was associated with a higher likelihood of falsely endorsing insecure (vs. secure) schema scenes. Attachment security moderated the association between crEA exposure and insecure schema-based false recognition. Findings suggest that interpersonal-affective semantic schemas include representations of parent-child interactions that may capture the quality of one's own attachment experiences and that these representations shape how children remember attachment-relevant narrative events. Findings are also consistent with the hypothesis that these affective semantic memories can be modified by later experiences. Moving forward, the approach taken in this study provides a means of operationalizing Bowlby's notion of internal working models within a cognitive neuroscience framework. RESEARCH HIGHLIGHTS: Affective semantic memories representing insecure schema knowledge (child needs + needs-not-met) may be more salient, elaborated, and persistent among youths exposed to early caregiving adversity. All youths, irrespective of early caregiving adversity exposure, may possess affective semantic memories that represent knowledge of secure schemas (child needs + needs-met). Establishing secure relationships with parents following early-occurring caregiving adversity may attenuate the expression of insecure semantic memories, suggesting potential malleability. Affective semantic memories include schema representations of parent-child interactions that may capture the quality of one's own attachment experiences and shape how youths remember attachment-relevant events.

Heterogeneity in caregiving-related early adversity: Creating stable dimensions and subtypes.

Early psychosocial adversities exist at many levels, including caregiving-related, extrafamilial, and sociodemographic, which despite their high interrelatedness may have unique impacts on development. In this paper, we focus on caregiving-related early adversities (crEAs) and parse the heterogeneity of crEAs via data reduction techniques that identify experiential cooccurrences. Using network science, we characterized crEA cooccurrences to represent the comorbidity of crEA experiences across a sample of school-age children (n = 258; 6-12 years old) with a history of crEAs. crEA dimensions (variable level) and crEA subtypes (subject level) were identified using parallel factor analysis/principal component analysis and graph-based Louvain community detection. Bagging enhancement with cross-validation provided estimates of robustness. These data-driven dimensions/subtypes showed evidence of stability, transcended traditional sociolegally defined groups, were more homogenous than sociolegally defined groups, and reduced statistical correlations with sociodemographic factors. Finally, random forests showed both unique and common predictive importance of the crEA dimensions/subtypes for childhood mental health symptoms and academic skills. These data-driven outcomes provide additional tools and recommendations for crEA data reduction to inform precision medicine efforts in this area.

Within-person Changes in Co-rumination and Rumination in Adolescence: Examining Heterogeneity and the Moderating Roles of Gender and Time.

Although previous work has consistently identified positive associations between co-rumination and rumination during adolescence, little to no research has examined how this relationship operates on the person-specific level. The current study aimed to extend current developmental theories of co-rumination and rumination by examining within-person associations between these constructs. Survey data was collected from 1502 adolescents (Mage = 13.20; 52% girls; 52% non-Hispanic White) every six-months across the span of 3.5 years. The results showed that at time-points when adolescents reported co-ruminating more than their usual level, they reported concurrent increases in rumination. This association was stronger for boys and strengthened over time. Despite substantial between-person heterogeneity, 97% of adolescents showed positive associations between co-rumination and rumination. This research has important implications for mental health professionals, school systems, and parents who may look to teach adolescents about effective emotion-regulation.

Adolescent Psychological Functioning and Membership in Latent Adolescent-Parent Communication Dual Trajectory Classes.

The primary goal of this study was to examine the relationship between adolescents' psychological functioning (as indicated by depressive symptoms) and substance use (alcohol and drug use) and membership in adolescent-parent communication trajectory subgroups in a large, diverse community sample of adolescents from the United States (n = 1,057; 53% female; 51% Caucasian; Age: M = 16.15, SD = .75). Adolescents completed questionnaires at three annual assessments. Fit indices from parallel process growth mixture models suggested three dual trajectory classes: (1) Average communication with both parents (Average-Both); (2) Good adolescent-mother and poor adolescent-father communication (Good-Mom/Poor-Dad); and (3) Poor adolescent-mother and good adolescent-father communication (Poor-Mom/Good-Dad). The trajectory classes differed by gender. In addition, psychological functioning and substance use were differentially related to the trajectory classes.

Social media use and risky behaviors in adolescents: A meta-analysis.

INTRODUCTION: This systematic review and meta-analysis examined the associations between social media use and risky behaviors during adolescence, and evaluated study characteristics (e.g., sample age, type of social media platform assessed) that may moderate these relationships. METHODS: A comprehensive search strategy identified relevant studies from PsycInfo, PubMed, Google Scholar, and Proquest Dissertations and Theses Global. RESULTS: The final sample included 27 independent cross-sectional studies with a total of 67,407 adolescents (Mage = 15.5, range: 12.6-18.0 years; 51.7% girls; 57.2% White). Results from random effects models indicated that there were positive, small-to-medium correlations between social media use and engagement in risky behaviors generally (r = 0.21, 95% CI = 0.16-0.25), substance use (r = 0.19, 95% CI = 0.12-0.26), and risky sexual behaviors (r = 0.21, 95% CI = 0.15-0.28). There were an insufficient number of independent samples available to conduct a random effect models for violence-related behaviors (k = 3). Moderator analyses suggested that studies assessing solely early social media platforms (e.g., Facebook/MySpace only) in relation to substance use had smaller effect sizes than substance use studies assessing a broader range of contemporary social media platforms. In addition, younger samples had larger effect sizes for studies focused on social media use and risky sexual behaviors. CONCLUSIONS: The positive links identified between social media and risky behaviors during adolescence in this meta-analysis suggest that developmental theories of risk taking would benefit from incorporating the social media context. Longitudinal studies are needed to clarify directionality and make more specific practice and policy recommendations so that social media is a safe place in which adolescents can thrive.

Self-Competence and Depressive Symptoms in Middle-Late Adolescence: Disentangling the Direction of Effect.

This study examined the temporal relation between self-competence (academic, social, athletic, physical appearance, and close friend) and depressive symptoms in a large, diverse community sample of 636 adolescents. Surveys were administered to all 10th- and 11th-grade students at participating high schools at baseline (mean age = 16.10, SD = .71) and 1 year later. Girls reported higher levels of self-competence in close friendships and more depressive symptoms, whereas boys reported higher levels of self-competence in athletics and physical appearance. However, there were no gender differences in the associations between self-competence and depressive symptoms. Results from autoregressive, cross-lagged path analyses indicated that depressive symptoms predicted self-competence more consistently than self-competence predicted depressive symptoms during middle-late adolescence. Implications for prevention are discussed.

Social Media Use Subgroups Differentially Predict Psychosocial Well-Being During Early Adolescence.

Despite the salience of the social media context to psychosocial development, little is known about social media use patterns and how they relate to psychological and social functioning over time during early adolescence. This longitudinal study, therefore, identified subgroups of early adolescents based on their social media use and examined whether these subgroups predicted psychosocial functioning. Adolescents (N = 1205; 11-14 years; 51% female; 51% white) completed surveys at baseline and a six-month follow-up. There were three social media use subgroups at baseline: high overall social media use (8%); high Instagram/Snapchat use (53%); and low overall social media use (39%). The high social media use subgroup predicted higher depressive symptoms, panic disorder symptoms, delinquent behaviors, family conflict, as well as lower family and friend support, than the High-Instagram/Snapchat and low social media use subgroups. The high Instagram/Snapchat use subgroup predicted higher delinquent behaviors and school avoidance than the low social media use subgroup, but also higher close friendship competence and friend support as compared to both the high social media use and low social media use subgroups. Social media use patterns appear to differentially predict psychosocial adjustment during early adolescence, with high social media use being the most problematic and patterns of high Instagram/Snapchat use and low social media use having distinct developmental tradeoffs.

Protective Factors Associated with Daily Affective Reactivity and Instability During Adolescence.

The daily emotional experiences of adolescents are dynamic, vary significantly across individuals, and are crucial to their psychological adjustment, warranting a need to identify factors that promote adaptive affective responses to stressors and attenuated affective instability. The objective of this study, therefore, was to examine protective factors linked to individual differences in daily affective reactivity and instability utilizing a daily diary design in a national sample of 100 U.S. adolescents (13-17 years; 40% girls; 79% White). Adolescents completed a baseline survey and then 14 daily online surveys. Better mother-adolescent communication predicted lower negative affect reactivity, whereas greater use of problem-focused coping strategies predicted higher positive affect reactivity. Greater trait resilience and instrumental support seeking predicted lower negative affect instability. Conversely, more emotional support seeking predicted higher negative affect instability. No factors were associated with positive affect instability, and father-adolescent communication was unrelated to daily affective reactivity and instability. The findings implicate specific protective factors associated with distinct aspects of affective reactivity and instability.

Psychometric properties of the brief loss of control over eating scale (LOCES-B) in early adolescents.

OBJECTIVE: The purpose of this study was to evaluate the psychometric properties of the brief loss of control over eating scale (LOCES-B) in a community sample of adolescents. METHOD: Participants were 1,116 adolescents (11-15 years; 53% girls; 53% non-Hispanic White) recruited from middle schools in the Northeast United States. Participants were administered self-report surveys during school in the fall of 2016. RESULTS: Confirmatory factor analyses indicated that the LOCES-B total score was unidimensional, which was invariant across gender and weight status. The LOCES-B had excellent internal consistency (α = .92). The LOCES-B total score had large, positive relationships with the frequency of LOC eating episodes, objective bulimic episodes, and subjective bulimic episodes, and a small, positive relationship with objective overeating episode frequency. After adjusting for demographics, anthropometrics, and LOC eating frequency, adolescents reporting higher scores on the LOCES-B total score had greater body image dissatisfaction, more internalizing symptoms, and lower trait effortful control. DISCUSSION: Findings suggested that the LOCES-B is a reliable and valid measure of LOC eating in early adolescents. The availability of the LOCES-B has the potential to elucidate the developmental trajectories, predictors, and outcomes of LOC eating across the full severity spectrum in large cohort studies of youth.

Age-varying associations between coping and depressive symptoms throughout adolescence and emerging adulthood.

The objective of the current study was to apply the novel technique of time-varying effect modeling to examine age-varying associations between specific coping strategies and depressive symptoms across adolescence and emerging adulthood (ages 14-24). The participants were drawn from a community sample and followed across 4 years of high school and once 5 years postgraduation (N = 1,251, 53% female, 58% non-Hispanic White). Coping and depressive symptom questionnaires were administered across all data collection time points. Time-varying effect modeling used all available data (N = 5,651 measurement occasions) and adjusted for gender. Venting emotions and denial were associated with more depressive symptoms at a similar magnitude across adolescence and emerging adulthood. A positive association between problem solving oriented strategies (planning, active coping) and depressive symptoms was not observed until age 17.5, after which the magnitude of the association strengthened. More frequent instrumental and emotional support seeking were linked to fewer depressive symptoms between ages 18.8 and 23.6. More frequent use of humor was associated with greater depressive symptoms from ages 14.0 to 14.6, but with fewer depressive symptoms from ages 16.8 to 18.8. The findings illuminate when and how associations between specific coping strategies and depressive symptoms may emerge and change across developmental age, generating both theoretical and clinical implications.

A systematic review of attentional biases in disorders involving binge eating.

OBJECTIVE: Attentional bias (AB) may be one mechanism contributing to the development and/or maintenance of disordered eating. AB has traditionally been measured using reaction time in response to a stimulus. Novel methods for AB measurement include eye tracking to measure visual fixation on a stimulus, and electroencephalography to measure brain activation in response to a stimulus. This systematic review summarizes, critiques, and integrates data on AB gathered using the above-mentioned methods in those with binge eating behaviors, including binge eating, loss of control eating, and bulimia nervosa. METHOD: Literature searches on PubMed and PsycInfo were conducted using combinations of terms related to binge eating and biobehavioral AB paradigms. Studies using AB paradigms with three categories of stimuli were included: food, weight/shape, and threat. For studies reporting means and standard deviations of group bias scores, Hedges' g effect sizes for group differences in AB were calculated. RESULTS: Fifty articles met inclusion criteria and were reviewed. Individuals who binge eat in the absence of compensatory behaviors show an increased AB to food cues, but few studies have examined such individuals' AB toward weight/shape and threatening stimuli. Individuals with bulimia nervosa consistently show an increased AB to shape/weight cues and socially threatening stimuli, but findings for AB to food cues are mixed. DISCUSSION: While there are important research gaps, preliminary evidence suggests that the combination of AB to disorder-specific cues (i.e., food and weight/shape) and AB toward threat may be a potent contributor to binge eating. This conclusion underscores previous findings on the interaction between negative affect and AB to disorder-specific cues. Recommendations for future research are provided.

Body Image Dissatisfaction and Anxiety Trajectories During Adolescence.

The primary goal of this study was to examine the associations between baseline body image dissatisfaction (BID) and subsequent anxiety trajectories in a diverse, community sample of adolescent girls and boys. Participants were 581 adolescents (baseline age: M = 16.1, SD = 0.7; 58% female; 65% non-Hispanic White) from U.S. public high schools. Self-report questionnaires were administered during school at 3 annual assessment waves. Latent growth curve modeling examined the association between baseline BID and growth factors of anxiety disorder symptom trajectories. Covariates included baseline gender, age, race/ethnicity, parental education attainment, body mass index standard scores, and depressive symptoms. Higher BID at baseline was significantly associated with higher initial symptoms of generalized anxiety disorder (GAD), panic disorder (PD), social anxiety disorder (SAD), and significant school avoidance (SSA; ps = .001-.04) but was unrelated to initial separation anxiety disorder (SEP) symptoms (p = .27). Higher baseline BID also was associated with attenuated decreases in SAD symptoms across time (p = .001). Among adolescents with low baseline anxiety symptoms only, higher BID was associated with more attenuated decreases in SAD symptoms (p = .01) and greater increases in PD symptoms (p = .02). BID was unrelated to changes in GAD, SEP, and SSA symptoms (ps = .11-.94). Findings suggest that BID is associated with concurrent symptoms of multiple anxiety disorders and may have a prospective link to SAD and PD symptoms during adolescence. As such, assessing body image issues may be important to assess when identifying adolescents at risk for exacerbated SAD and PD symptoms.

Family functioning and adolescent internalizing symptoms: A latent profile analysis.

This study aimed to characterize adolescent family functioning typologies using latent profile analysis (LPA). A secondary aim was to examine profile associations with adolescent internalizing symptoms at one-year follow-up. Students (N = 1029; 53% female; mean age = 16.14, SD = .75 years) completed measures of family functioning, anxiety, and depressive symptoms at two time points. LPA was conducted to characterize family functioning typologies at Time 1, revealing five profiles: 1) Low Family Functioning, 2) Only Close to Father, 3) Average Family Functioning, 4) Only Close to Mother, and 5) High Family Functioning. Results indicated that the Low and Only Close to Mother profiles had greater depressive symptoms at Time 2, compared with the Average profile. The High profile had fewer depressive symptoms at Time 2. The Low and Only Close to Mother profiles also had significantly more anxiety symptoms at Time 2. Findings highlight the utility of examining family functioning profiles.

Associations between friend conflict and affective states in the daily lives of adolescents.

This study examined the associations between friend conflict, defined as arguments with friends, and affective states using a daily diary design in a community sample of adolescents. Participants were 100 U.S. adolescents (13-17 years; 40% girls; 79% white). Adolescents completed an online survey on 14 consecutive evenings. Adolescents reported significantly higher anger/hostility, confusion, and tension/anxiety and less friendliness on days during which they experienced friend conflict relative to no-conflict days. However, no same-day associations for depressed affect, fatigue, or vigor were found. Adolescents experiencing friend conflict reported increased next-day anger/hostility, depressed affect, and tension/anxiety, but not other affective states. Higher levels of anger/hostility and depressed affect predicted an increased likelihood of next-day friend conflict. Conversely, higher levels of friendliness and vigor predicted a decreased likelihood of next-day friend conflict. These findings suggest that directional relationships between adolescents' friend conflicts and their affective states vary by affective domain.

Examination of the interpersonal model of loss of control eating in the laboratory.

BACKGROUND: The interpersonal model of loss of control (LOC) eating proposes that interpersonal problems lead to negative affect, which in turn contributes to the onset and/or persistence of LOC eating. Despite preliminary support, there are no data examining the construct validity of the interpersonal model of LOC eating using temporally sensitive reports of social stress, distinct negative affective states, and laboratory energy intake. METHOD: 117 healthy adolescent girls (BMI: 75th-97th %ile) were recruited for a prevention trial targeting excess weight gain in adolescent girls who reported LOC eating. Prior to the intervention, participants completed questionnaires of recent social stress and consumed lunch from a multi-item laboratory test meal. Immediately before the test meal, participants completed a questionnaire of five negative affective states (anger, confusion, depression, fatigue, anxiety). Bootstrapping mediation models were conducted to evaluate pre-meal negative affect states as explanatory mediators of the association between recent social stress and palatable (desserts and snack-type) food intake. All analyses adjusted for age, race, pubertal stage, height, fat mass percentage, and lean mass. RESULTS: Pre-meal state anxiety was a significant mediator for recent social stress and palatable food intake (ps<.05). By contrast, pre-meal state anger, confusion, depression, and fatigue did not mediate the relationship between social stress and palatable food intake (ps>.05). DISCUSSION: Pre-meal anxiety appears to be the salient mood state for the interpersonal model among adolescent girls with LOC eating. Interventions that focus on improving both social functioning and anxiety may prove most effective at preventing and/or ameliorating disordered eating and obesity in these adolescents.

Gender Differences in Anxiety Trajectories from Middle to Late Adolescence.

Although developmental trajectories of anxiety symptomatology have begun to be explored, most research has focused on total anxiety symptom scores during childhood and early adolescence, using racially/ethnically homogenous samples. Understanding the heterogeneous courses of anxiety disorder symptoms during middle to late adolescence has the potential to clarify developmental risk models of anxiety and to inform prevention programs. Therefore, this study specifically examined gender differences in developmental trajectories of anxiety disorder symptoms (generalized anxiety disorder, panic disorder, and social anxiety disorder) from middle to late adolescence in a diverse community sample (N = 1000; 57 % female; 65 % White), assessed annually over 2 years. Latent growth curve modeling revealed that girls exhibited a slight linear decrease in generalized anxiety disorder, panic disorder, and social anxiety disorder symptoms, whereas boys exhibited a stable course. These models suggested that one trajectory was appropriate for panic disorder symptoms in both girls and boys. Growth mixture models indicated the presence of four latent generalized anxiety disorder symptom trajectory classes: low increasing, moderate decreasing slightly, high decreasing, and very high decreasing rapidly. Growth mixture models also suggested the presence of five latent social anxiety disorder symptom trajectory classes: a low stable trajectory class and four classes that were qualitatively similar to the latent generalized anxiety disorder trajectories. For both generalized anxiety disorder and social anxiety disorder symptoms, girls were significantly more likely than boys to be in trajectory classes characterized by moderate or high initial symptoms that subsequently decreased over time. These findings provide novel information regarding the developmental course of anxiety disorder symptoms in adolescents.

A Randomized Controlled Trial to Prevent Depression and Ameliorate Insulin Resistance in Adolescent Girls at Risk for Type 2 Diabetes.

BACKGROUND: Prospective data suggest depressive symptoms worsen insulin resistance and accelerate type 2 diabetes (T2D) onset. PURPOSE: We sought to determine whether reducing depressive symptoms in overweight/obese adolescents at risk for T2D would increase insulin sensitivity and mitigate T2D risk. METHOD: We conducted a parallel-group, randomized controlled trial comparing a 6-week cognitive-behavioral (CB) depression prevention group with a 6-week health education (HE) control group in 119 overweight/obese adolescent girls with mild-to-moderate depressive symptoms (Center for Epidemiological Studies-Depression Scale [CES-D] ≥16) and T2D family history. Primary outcomes were baseline to post-intervention changes in CES-D and whole body insulin sensitivity index (WBISI), derived from 2-h oral glucose tolerance tests. Outcome changes were compared between groups using ANCOVA, adjusting for respective baseline outcome, puberty, race, facilitator, T2D family history degree, baseline age, adiposity, and adiposity change. Multiple imputation was used for missing data. RESULTS: Depressive symptoms decreased (p < 0.001) in CB and HE from baseline to posttreatment, but did not differ between groups (ΔCESD = -12 vs. -11, 95 % CI difference = -4 to +1, p = 0.31). Insulin sensitivity was stable (p > 0.29) in CB and HE (ΔWBISI = 0.1 vs. 0.2, 95 % CI difference = -0.6 to +0.4, p = 0.63). Among all participants, reductions in depressive symptoms were associated with improvements in insulin sensitivity (p = 0.02). CONCLUSIONS: Girls at risk for T2D displayed reduced depressive symptoms following 6 weeks of CB or HE. Decreases in depressive symptoms related to improvements in insulin sensitivity. Longer-term follow-up is needed to determine whether either program causes sustained decreases in depressive symptoms and improvements in insulin sensitivity. TRIAL REGISTRATION NUMBER: The trial was registered with clinicaltrials.gov (NCT01425905).

Effect of adapted interpersonal psychotherapy versus health education on mood and eating in the laboratory among adolescent girls with loss of control eating.

OBJECTIVE: Interpersonal psychotherapy (IPT) is aimed at improving negative affect that is purported to contribute to the development and maintenance of loss-of-control (LOC) eating. Although youth who report LOC over eating tend to consume more snack-foods than those without LOC, it is unknown if IPT impacts objective energy intake. METHODS: To test if IPT improves mood and eating in the laboratory, we examined a sample of 88 girls with LOC eating who were randomized to either IPT (n = 46) or a standard-of-care health education (HE) group program. At baseline, and 6-month (follow-up 1) and 1-year (follow-up 2) following the initiation of the groups, girls consumed lunch from a multi-item meal with an instruction designed to model a LOC episode. Girls also reported mood state immediately before each meal. RESULTS: Girls in IPT experienced no significant changes in pre-meal state depressive affect, while girls in HE experienced a non-significant improvement by follow-up 1 and then returned to baseline by follow-up 2 (p < .04). We found no significant group difference for changes in total intake relative to girls' daily energy needs (p's ≥ .25). However, IPT reduced, while HE increased, the percentage of daily energy needs consumed from snack-foods by follow-up 2 (p = .04). Within-groups, HE increased their snack food intake from follow-up 1 to follow-up 2 (p = .01). CONCLUSIONS: In adolescent girls with LOC, IPT did not change total intake at the test meal and was associated with reduced snack-food intake. Data are required to determine if IPT effectively prevents excess weight gain in the longer-term. © 2015 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:490-498).