Christopher Fairburn

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Christopher G. Fairburn
OBE
Born (1950-09-20) 20 September 1950 (age 73)
NationalityBritish
Education Malvern College
Alma mater University of Oxford (MA, BM, BCh, DM)
University of Edinburgh (MPhil)
Known forNature and treatment of eating disorders
Transdiagnostic conceptualisation of eating disorders
Guided self-help
Measures of eating disorder features
Awards Wellcome Senior Lecturer 1984, 1987, 1990
Wellcome Principal Research Fellow 1996, 2006
Royal College of Psychiatrists Fellow, 1992
Academy of Medical Sciences Fellow, 2001
Center for Advanced Study in the Behavioral Sciences (Stanford) – Fellow, 1989, 1998
Academy for Eating Disorders - Outstanding Researcher Prize, 2002; Lifetime Achievement Award, 2015
Academy of Cognitive Therapy – Beck Prize 2011
Scientific career
Fields Mental health
Website www.psych.ox.ac.uk/team/highwall

Christopher James Alfred Granville Fairburn OBE (born 20 September 1950) is a British psychiatrist and researcher. He is Emeritus Professor of Psychiatry at the University of Oxford. He is known for his research on the development, evaluation and dissemination of psychological treatments, especially for eating disorders.

Contents

Education

Fairburn was educated at Malvern College. He trained in medicine at the University of Oxford, and in psychiatry at the University of Edinburgh. [1]

Career

Fairburn has been engaged in full-time clinical research since 1981, initially funded by the Medical Research Council and subsequently by the Wellcome Trust (1984-2017). [2] Between 2007 and 2011, Fairburn was a Governor of the Wellcome Trust, [3] and from 2011 to 2016, he was a founder trustee of MQ: Transforming Mental Health. [4]

Fairburn was appointed Officer of the Order of the British Empire (OBE) in the 2021 Birthday Honours for services to psychological treatments and the treatment of eating disorders. [5]

Research

Eating disorders

Fairburn's programme of work has led to the development of three treatments for eating disorders. The first is a cognitive behavioural treatment for bulimia nervosa. [6] This was the first psychological treatment to be endorsed by England's National Institute for Health and Care Excellence (NICE). [7] The second is a self-help treatment for people with recurrent binge eating. [8] This is designed to be used either on its own or accompanied by a scalable form of support termed "guided self-help". [9] Guided self-help has been endorsed by NICE as the first step in the treatment of binge eating disorder and bulimia nervosa [10] and is used in the treatment of many other mental disorders. [11] The third treatment is transdiagnostic in its clinical range and is termed "enhanced cognitive behaviour therapy" or CBT-E. [12] In 2015 NHS England and the Chief Medical Officer recommended that this treatment be made available for all patients with an eating disorder, whatever their eating disorder diagnosis and whatever their age, [13] [14] and in 2017 it was endorsed by NICE.

Digital technology and the dissemination of psychological treatments

Fairburn is working on the conversion of therapist-delivered psychological treatments into scalable digital interventions, either delivered on their own or with remote support. [15] Fairburn has also developed a digital method for training therapists. This is capable of simultaneously training large numbers of geographically dispersed therapists. [16] Fairburn is collaborating with Vikram Patel and colleagues in India who are developing psychological interventions for common mental disorders suitable for delivery by lay counsellors. [17]

Measures of eating disorder features

Fairburn has developed several measures of eating disorder features and their effects. These include the Eating Disorder Examination (EDE), [18] the Eating Disorder Examination Questionnaire (EDE-Q) [19] and the Clinical Impairment Assessment (CIA). [20] These are in widespread use and are available in multiple languages.

Related Research Articles

<span class="mw-page-title-main">Cognitive behavioral therapy</span> Type of therapy to improve mental health

Cognitive behavioral therapy (CBT) is a psycho-social intervention that aims to reduce symptoms of various mental health conditions, primarily depression and anxiety disorders. Cognitive behavioral therapy is one of the most effective means of treatment for substance abuse and co-occurring mental health disorders. CBT focuses on challenging and changing cognitive distortions and their associated behaviors to improve emotional regulation and develop personal coping strategies that target solving current problems. Though it was originally designed to treat depression, its uses have been expanded to include many issues and the treatment of many mental health conditions, including anxiety, substance use disorders, marital problems, ADHD, and eating disorders. CBT includes a number of cognitive or behavioral psychotherapies that treat defined psychopathologies using evidence-based techniques and strategies.

An eating disorder is a mental disorder defined by abnormal eating behaviors that adversely affect a person's physical or mental health. Types of eating disorders include binge eating disorder, where the patient eats a large amount in a short period of time; anorexia nervosa, where the person has an intense fear of gaining weight and restricts food or overexercises to manage this fear; bulimia nervosa, where individuals eat a large quantity (binging) then try to rid themselves of the food (purging); pica, where the patient eats non-food items; rumination syndrome, where the patient regurgitates undigested or minimally digested food; avoidant/restrictive food intake disorder (ARFID), where people have a reduced or selective food intake due to some psychological reasons; and a group of other specified feeding or eating disorders. Anxiety disorders, depression and substance abuse are common among people with eating disorders. These disorders do not include obesity. People often experience comorbidity between an eating disorder and OCD. It is estimated 20–60% of patients with an ED have a history of OCD.

<span class="mw-page-title-main">Bulimia nervosa</span> Type of eating disorder

Bulimia nervosa, also known as simply bulimia, is an eating disorder characterized by binge eating followed by purging or fasting, and excessive concern with body shape and weight. This activity aims to expel the body of calories eaten from the binging phase of the process. Binge eating refers to eating a large amount of food in a short amount of time. Purging refers to the attempts to get rid of the food consumed. This may be done by vomiting or taking laxatives.

Binge eating disorder (BED) is an eating disorder characterized by frequent and recurrent binge eating episodes with associated negative psychological and social problems, but without the compensatory behaviors common to bulimia nervosa, OSFED, or the binge-purge subtype of anorexia nervosa.

Binge eating is a pattern of disordered eating which consists of episodes of uncontrollable eating. It is a common symptom of eating disorders such as binge eating disorder and bulimia nervosa. During such binges, a person rapidly consumes an excessive quantity of food. A diagnosis of binge eating is associated with feelings of loss of control. Binge eating disorder is also linked with being overweight and obesity.

Cognitive restructuring (CR) is a psychotherapeutic process of learning to identify and dispute irrational or maladaptive thoughts known as cognitive distortions, such as all-or-nothing thinking (splitting), magical thinking, overgeneralization, magnification, and emotional reasoning, which are commonly associated with many mental health disorders. CR employs many strategies, such as Socratic questioning, thought recording, and guided imagery, and is used in many types of therapies, including cognitive behavioral therapy (CBT) and rational emotive behaviour therapy (REBT). A number of studies demonstrate considerable efficacy in using CR-based therapies.

Unspecified feeding or eating disorder (UFED) is a DSM-5 category of eating disorders that, along with other specified feeding or eating disorder (OSFED), replaced eating disorder not otherwise specified (EDNOS) in the DSM-IV-TR.

Therapy interfering behaviors or "TIBs" are, according to dialectical behavior therapy (DBT), things that get in the way of therapy. These are behaviors of either the patient or the therapist. More obvious examples include being late to sessions, not completing homework, cancelling sessions, and frequently contacting the therapist out-of-session. More subtle examples can include sobbing uncontrollably, venting, criticizing the therapist, threatening to quit therapy, shutting down, yelling, only reporting negative information, saying "I don't know" repeatedly, and pushing the therapist's limits. Behaviors that "burn out the therapist" are included, and thus, vary from therapist to therapist. These behaviors can occur in session, group, between sessions, and on the phone.

The Eating Attitudes Test, created by David Garner, is a widely used 26-item, standardized self-reported questionnaire of symptoms and concerns characteristic of eating disorders. The EAT is useful in assessing "eating disorder risk" in high school, college and other special risk samples such as athletes. EAT has been extremely effective in screening for anorexia nervosa in many populations.

<span class="mw-page-title-main">Anorexia nervosa</span> Type of eating disorder

Anorexia nervosa (AN), often referred to simply as anorexia, is an eating disorder characterized by food restriction, body image disturbance, fear of gaining weight, and an overpowering desire to be thin.

Cognitive behavioral therapy (CBT) is derived from both the cognitive and behavioral schools of psychology and focuses on the alteration of thoughts and actions with the goal of treating various disorders. The cognitive behavioral treatment of eating disorders emphasizes on the minimization of negative thoughts about body image and the act of eating, and attempts to alter negative and harmful behaviors that are involved in and perpetuate eating disorders. It also encourages the ability to tolerate negative thoughts and feelings as well as the ability to think about food and body perception in a multi-dimensional way. The emphasis is not only placed on altering cognition, but also on tangible practices like making goals and being rewarded for meeting those goals. CBT is a "time-limited and focused approach" which means that it is important for the patients of this type of therapy to have particular issues that they want to address when they begin treatment. CBT has also proven to be one of the most effective treatments for eating disorders.

Anke Ehlers is a German psychologist and expert in post-traumatic stress disorder (PTSD). She is a Fellow of the major science academies of the UK and Germany.

Cognitive emotional behavioral therapy (CEBT) is an extended version of cognitive behavioral therapy (CBT) aimed at helping individuals to evaluate the basis of their emotional distress and thus reduce the need for associated dysfunctional coping behaviors. This psychotherapeutic intervention draws on a range of models and techniques including dialectical behavior therapy (DBT), mindfulness meditation, acceptance and commitment therapy (ACT), and experiential exercises.

Other specified feeding or eating disorder (OSFED) is a subclinical DSM-5 category that, along with unspecified feeding or eating disorder (UFED), replaces the category formerly called eating disorder not otherwise specified (EDNOS) in the DSM-IV-TR. It captures feeding disorders and eating disorders of clinical severity that do not meet diagnostic criteria for anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), avoidant/restrictive food intake disorder (ARFID), pica, or rumination disorder. OSFED includes five examples:

Metacognitive therapy (MCT) is a psychotherapy focused on modifying metacognitive beliefs that perpetuate states of worry, rumination and attention fixation. It was created by Adrian Wells based on an information processing model by Wells and Gerald Matthews. It is supported by scientific evidence from a large number of studies.

Chew and spit is a compensatory behavior associated with several eating disorders that involves chewing food and spitting it out before swallowing, often as an attempt to avoid ingesting unwanted or unnecessary calories. CS can be used as a way to taste food viewed as “forbidden” or unhealthy. Individuals who partake in CS typically have an increased desire for thinness, increased loss of control (LOC) and body dissatisfaction. CS can replace vomiting and/or binging behaviors, or serve as an additional behavior to many eating disorders.

Paul E. Garfinkel is a Canadian psychiatrist, researcher and an academic leader. He is a professor at the University of Toronto and a staff psychiatrist at Centre for Addiction and Mental Health (CAMH).

Body image disturbance (BID) is a common symptom in patients with eating disorders and is characterized by an altered perception of one's own body.

Body checking is a compulsive behaviour related but not exclusive to various forms of body dysmorphic disorders. It involves frequently collecting various information about one’s own body in terms of size, shape, appearance or weight. Frequent expressions of this form of behaviour entails for example mirror checking, trying to feel one’s own bones, pinching the abdomen, frequent body weight measurement and comparing your own body to that of others. Studies have shown that an increased rate of body checking correlates with an overall increased dissatisfaction with the own body.

Virginia Violet Williams McIntosh is a New Zealand clinical psychologist, and is a full professor at the University of Canterbury, specialising in improving therapy outcomes for disorders such as anorexia nervosa, bulimia nervosa, depression and anxiety.

References

  1. ↑ "FAIRBURN, Prof. Christopher Granville". Who's Who. 2018. doi:10.1093/ww/9780199540884.013.U2000176.
  2. ↑ Wellcome. "Principal Research Fellowships: People we've funded" . Retrieved 1 December 2018.
  3. ↑ Wellcome Trust Annual Report and Financial Statements, 2011
  4. ↑ "Trustees". MQ: Transforming Mental Health. Retrieved 22 December 2015.
  5. ↑ "No. 63377". The London Gazette (Supplement). 12 June 2021. p. B12.
  6. ↑ Fairburn, Christopher (1981). "A cognitive behavioural approach to the treatment of bulimia". Psychological Medicine. 11 (4): 707–711. doi:10.1017/S0033291700041209. ISSN   0033-2917. PMID   6948316. S2CID   11422055.
  7. ↑ NICE (2004). Eating Disorders: Core interventions in the treatment and management of anorexia nervosa, bulimia nervosa and related eating disorders. London: Royal College of Psychiatrists and British Psychological Society.
  8. ↑ Fairburn, Christopher (2013). Overcoming binge eating (2 ed.). New York: The Guilford Press.
  9. ↑ Carter, JC; Fairburn, CG (1 November 1995). "Treating binge eating problems in primary care". Addictive Behaviors. 20 (6): 765–772. doi:10.1016/0306-4603(95)00096-8. ISSN   0306-4603. PMID   8820529.
  10. ↑ National Institute for Health and Care Excellence (2017). Eating disorders: recognition and treatment | Guidance and guidelines | NICE. National Institute for Health and Care Excellence. Retrieved 1 December 2018.
  11. ↑ "guided self help | Evidence search | NICE". www.evidence.nhs.uk. Retrieved 1 December 2018.
  12. ↑ Fairburn, CG; Cooper, Z; Shafran, R (1 May 2003). "Cognitive behaviour therapy for eating disorders: a "transdiagnostic" theory and treatment". Behaviour Research and Therapy. 41 (5): 509–528. doi:10.1016/S0005-7967(02)00088-8. ISSN   0005-7967. PMID   12711261. S2CID   13059162.
  13. ↑ National Collaborating Centre for Mental Health (2015). Eating Disorders: Access and Waiting Time Standard for Children and Young People with an Eating Disorder. London: NHS England. p. 25.
  14. ↑ Annual Report of the Chief Medical Officer (2014). The Health of the 51%: Women. London: Department of Health. p. 11.
  15. ↑ Fairburn, CG; Patel, V (1 January 2017). "The impact of digital technology on psychological treatments and their dissemination". Behaviour Research and Therapy. 88: 19–25. doi:10.1016/j.brat.2016.08.012. ISSN   0005-7967. PMC   5214969 . PMID   28110672.
  16. ↑ Fairburn, Christopher G; Allen, Elizabeth; Bailey-Straebler, Suzanne; O'Connor, Marianne E; Cooper, Zafra (16 June 2017). "Scaling Up Psychological Treatments: A Countrywide Test of the Online Training of Therapists". Journal of Medical Internet Research. 19 (6): e214. doi: 10.2196/jmir.7864 . PMC   5493785 . PMID   28623184.
  17. ↑ Fairburn, Christopher G.; Kirkwood, Betty R.; Velleman, Richard; Wilson, Terry; McDaid, David; Park, A.-La; Vijayakumar, Lakshmi; King, Michael; Hollon, Steve D.; Araya, Ricardo; Dimidjian, Sona; Katti, Basavraj; Bhat, Bhargav; Anand, Arpita; Weiss, Helen A.; Weobong, Benedict; Patel, Vikram (14 January 2017). "The Healthy Activity Program (HAP), a lay counsellor-delivered brief psychological treatment for severe depression, in primary care in India: a randomised controlled trial". The Lancet. 389 (10065): 176–185. doi:10.1016/S0140-6736(16)31589-6. ISSN   1474-547X. PMC   5236064 . PMID   27988143.
  18. ↑ Cooper, Z; Fairburn, CG (1987). "The Eating Disorder Examination: a semi-structured interview for the assessment of the specific psychopathology of eating disorders". International Journal of Eating Disorders. 6: 1–8. doi:10.1002/1098-108X(198701)6:1<1::AID-EAT2260060102>3.0.CO;2-9.
  19. ↑ Fairburn, CG; Beglin, SJ (1994). "Assessment of eating disorder psychopathology: interview or self-report questionnaire?". International Journal of Eating Disorders. 16: 363–370. doi:10.1002/1098-108X(199412)16:4<363::AID-EAT2260160405>3.0.CO;2-#. S2CID   24916438 . Retrieved 12 December 2018.
  20. ↑ Bohn, K; Doll, HA; Cooper, Z; O'Connor, ME; Fairburn, CG (1 October 2008). "The measurement of impairment due to eating disorder psychopathology". Behaviour Research and Therapy. 46 (10): 1105–1110. doi:10.1016/j.brat.2008.06.012. ISSN   0005-7967. PMC   2764385 . PMID   18710699.
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