Kristine L Lokken

Vanderbilt University, Nashville, Michigan, United States

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Publications (14)19.34 Total impact

  • A G Boeka, K L Lokken
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    ABSTRACT: This study examined whether severity of binge eating is associated with dysfunction in behaviors mediated by the three main areas of the prefrontal cortex (PFC). One hundred fifty-one adults (mean BMI=49.50) were classified into three groups based on the presence and severity of binge eating behaviors: Binge Eating Disorder (BED) group (N=22), Binge Eating Prone (BEP) group (N=47), and non-Eating Disorder (non-ED) group (N=82). Participants completed the Frontal Systems Behavior Scale (FrSBe), a widely used measure of neurobehavioral traits associated with the three primary regions of the PFC corresponding with the behavioral traits of apathy, disinhibition, and executive dysfunction. The BED and BEP groups scored significantly higher than the non-ED group on the three FrSBe subscales, as well as the FrSBe Total score. There were no significant correlations between the FrSBe and participant BMI. As expected, individuals who engaged in binge eating endorsed greater PFC dysfunction than those who did not binge eat. These results provide a complement to studies utilizing neuroimaging and neuropsychological methodologies and further support for the role of prefrontal systems in the regulation of eating behavior.
    Eating and weight disorders: EWD 06/2011; 16(2):e121-6. · 0.53 Impact Factor
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    ABSTRACT: Wilson's disease (WD) is characterized by hepatic, neurological, and/or psychiatric disturbances. In some cases, liver transplantation is indicated. Because psychologists and other health care workers play an increasing role in the evaluation of individuals presenting for transplant, an understanding of the heterogeneous phenotype of WD is important for mental health professionals working in medical settings. This article reviews two cases of patients with WD (one probable, one confirmed) presenting for liver transplantation and a biopsychosocial assessment approach is demonstrated. Patients are presented in terms of medical, psychiatric, and psychosocial history, neuropsychological examination results, and the subsequent indications for liver transplantation. Both patients exhibited neurocognitive and psychiatric symptoms. One patient was determined to be a marginally suitable candidate for transplantation, whereas the other was considered at high risk for negative outcome post-transplant. This article demonstrates the importance of considering phenotypic presentation, neurocognitive function, psychiatric status, and psychosocial circumstances in assessing transplant readiness in patients with WD. A comprehensive and integrative biopsychosocial assessment approach is appropriate for evaluating patients with WD presenting for liver transplantation.
    Psychology Health and Medicine 05/2011; 16(3):268-75. · 1.53 Impact Factor
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    ABSTRACT: Objective: Overweight and obesity rates are associated with chronic diseases and higher rates of disability and continue to rise in the United States and worldwide. The purpose of this study was to build on past research and further investigate demographic and lifestyle variables associated with increased body mass index (BMI: kg/m 2).Methods: Personal Information Worksheets were completed by 125 bariatric surgery candidates and 213 community dwelling individuals providing a sample size of 338. Hierarchical regression analysis was performed on three sets of independent variables (demographic characteristics, lifestyle variables and consumer response) and one dependent variable (BMI).Results: Lower levels of education and physical activity, higher levels of diet soda consumption and number of dieting attempts, and likelihood of starting a diet programme based on advertising testimonials were predictive of higher BMI.Conclusion: This research highlights the need for more education emphasizing the importance of increased healthy behaviours versus use of diet products and fad diets to improve success of weight loss efforts.
    Health Education Journal 12/2010; 69(4):372-380. · 0.73 Impact Factor
  • Abbe G Boeka, Steven Prentice-Dunn, Kristine L Lokken
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    ABSTRACT: An increasing body of research suggests that many patients have difficulty adopting the eating guidelines after weight-loss surgery, thereby reducing the long-term success of the procedure. Given such difficulties, it is possible that the typical preoperative education regarding post-surgical eating behavior guidelines is ineffective in motivating some individuals to comply. Presently, no accurate predictors of intentions to comply with post-bariatric surgery guidelines have been identified. In the present pilot study, a psychosocial intervention based on protection motivation theory (PMT) was presented to patients undergoing bariatric surgery. PMT is a well-established preventive health model that has been utilized in a variety of health domains. Participants for this study were recruited before undergoing bariatric surgery, and were randomly assigned to one of two groups: PMT group vs. control. In addition to routine messages from the bariatric surgeon, participants in the PMT group received an intervention based in PMT that focused on the importance of adhering to post-surgical eating behavior guidelines and how best to adhere to these guidelines. Participants in the control group received standard of care information from the bariatric surgeon. Results indicated that the PMT intervention did not have a significant impact. However, follow-up analyses revealed that two aspects of PMT, perceived self-efficacy and perceived threat of not following the guidelines, predicted patients' intentions to comply with post-surgical guidelines. Findings are discussed in terms of the methodological compromises that resulted from the applied research setting as well as promising avenues for future investigation.
    Psychology Health and Medicine 03/2010; 15(2):188-97. · 1.53 Impact Factor
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    ABSTRACT: Bariatric surgery is efficacious for the treatment of severe obesity; however, little empirical research exists describing the demographic, psychosocial, and cognitive characteristics of patients presenting for the surgery. One hundred and sixty-nine morbidly obese patients seeking bariatric surgery underwent a presurgical psychological assessment, including cognitive testing. Morbidly obese individuals seeking bariatric surgery were similar in education, income status, and IQ compared with normative data. IQ was average, did not correlate with body mass index, and reflected a normal distribution. As a group, bariatric surgery patients endorsed minimal levels of depression and low levels of psychopathology. Obese individuals did demonstrate specific cognitive deficits on tests of executive function (e.g., problem solving and planning) when compared with normative data. This data suggests that bariatric surgery patients differ very little from other surgical populations on most demographic and psychosocial variables. The data does provide evidence for specific cognitive deficits in the area of executive functions at baseline in morbidly obese adults seeking bariatric surgery.
    The American surgeon 01/2010; 76(1):55-9. · 0.92 Impact Factor
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    ABSTRACT: Obesity in children and adolescents is 1 of the most urgent and serious health threats confronting the United States. Extremely obese adolescents (body mass index >99th percentile for age and gender) are a unique subgroup of obese youth who are at considerable medical and psychosocial risk. Little is known about the cognitive function of extremely obese adolescents. The present study sought to examine the cognitive performance of a sample of extremely obese adolescents seeking primary treatment for weight loss. Adolescents were recruited during regularly scheduled medical appointments at a children's center for weight management associated with a major children's hospital in the Southeast United States. A computerized battery of cognitive tests was administered to obese adolescents (body mass index >99th percentile; n = 25). Obese adolescents exhibited deficits in many cognitive domains, including impairment in attention and executive functions (e.g., mental flexibility, disinhibition) compared with the normative data. Although preliminary, these data have provided evidence for specific cognitive deficits in extremely obese adolescents. These findings highlight a need to determine whether early weight loss interventions, such as bariatric surgery, for obese adolescents could potentially prevent or reverse cognitive deficits and/or reduce the risk of future adverse neurocognitive outcome.
    Surgery for Obesity and Related Diseases 09/2009; 5(5):547-52. · 4.94 Impact Factor
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    ABSTRACT: Research has shown that young women are negatively affected by media images representing thin female body types. Given the increasing prevalence of eating disorders among young women, it is important to look closer at this phenomenon and the role/responsibility of the media. This study examined the links among quantity of magazine exposure, preference for specific periodicals, awareness and internalization of sociocultural standards of beauty, and the presence of eating-disordered symptoms in a sample of college women. Small, but significant, correlations were found between magazine exposure and drive for thinness, and between preference for beauty and fashion magazines and internalization of sociocultural standards of appearance. Regression analyses found awareness and internalization of sociocultural standards of appearance to be significant predictors of body dissatisfaction, drive for thinness, and bulimic symptoms. The results of this study are discussed in terms of educational and social marketing strategies.
    Family and Consumer Sciences Research Journal. 07/2009; 32(4):361 - 381.
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    ABSTRACT: The authors examined bulimic symptoms and body image dissatisfaction (BID) in a sample of college women. No differences were found in comparisons of bulimic symptoms or BID between Southern and Northern White women, and both groups reported similar levels of awareness and internalization of sociocultural aesthetic standards of appearance. Southeastern Black women reported (a) significantly lower levels of bulimic symptoms in comparison with White women from the North and (b) lower levels of BID in comparison with White women from both Southern and Northern regions. Further, Southeastern Black women were significantly less likely to be aware of and endorse mainstream standards of appearance in comparison with both groups of White women. Findings support the hypothesis that having a positive body image and less susceptibility to mainstream aesthetic standards of appearance may reduce the risk of eating disorder pathology in Black women.
    The Journal of Psychology Interdisciplinary and Applied 08/2008; 142(4):386-94. · 0.86 Impact Factor
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    Abbe Gayle Boeka, Kristine Lee Lokken
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    ABSTRACT: Obesity is a leading cause of preventable death in America and its prevalence is increasing at an alarming rate. While it is known that individuals with specific obesity-related medical conditions perform poorly on neuropsychological tasks, recent evidence suggests that cognitive dysfunction in obese individuals may occur independently of medical co-morbidities. This study examined neuropsychological performance in a clinical sample of extremely obese patients. Individuals seeking surgical treatment of obesity (N=68) were administered cognitive tests as part of a standard pre-surgical evaluation. Results indicated significant differences in performances of extremely obese individuals on tests of executive functioning (planning, problem solving, mental flexibility) in comparison to normative data. No significant differences emerged between obese patients with and without co-morbid medical conditions of hypertension, type II diabetes, and obstructive sleep apnea on the neuropsychological tasks specific to executive functioning. Taken together, these results provide further evidence of specific cognitive dysfunction in extremely obese individuals.
    Archives of Clinical Neuropsychology 08/2008; 23(4):467-74. · 2.00 Impact Factor
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    ABSTRACT: Clothing use may be a behavioral avoidance strategy for individuals with body dissatisfaction and eating pathology. The authors administered the Body Image Avoidance Questionnaire (J. C. Rosen, D. Srebnik, E. Saltzberg, & S. Wendt, 1991), the Bulimia Test-Revised (M. Thelen, J. Farmer, S. Wonderlich, & M. Smith, 1991), and the Body dissatisfaction subscale of the Eating Disorder Inventory (D. M. Garner, M. P. Olmstead, & J. Polivy, 1983) to undergraduate college women from two universities (N = 540). Results indicated that women who were more dissatisfied with their bodies (beta = .396) and had greater disordered eating behaviors (beta = .378) were more likely to engage in clothing-related appearance-management behaviors (p < .001), including wearing apparel to camouflage their bodies; avoiding revealing, brightly colored, or tightly fitting clothing; and avoiding shopping for clothing. These findings suggest that the presence of certain clothing-related appearance-management behaviors may be a warning sign that an individual is at risk for developing an eating disorder or may currently have an eating disorder.
    The Journal of Psychology Interdisciplinary and Applied 09/2007; 141(5):485-98. · 0.86 Impact Factor
  • Kristine L Lokken, F Richard Ferraro
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    ABSTRACT: The authors examined the effect of menopausal status on several aspects of cognition in 4 groups of women (young premenopausal women, middle-aged premenopausal women, naturally postmenopausal women not using hormone therapy, and postmenopausal women using hormone replacement therapy). Participants (N = 48) completed questionnaires designed to assess psychological and physical health. The authors administered a test battery consisting of 10 neuropsychological tests to assess cognitive functioning. Using multivariate analyses of covariance with age as the covariate, the authors found a significant main effect of menopausal status on attention and complex processing abilities. Postmenopausal women using hormone replacement therapy significantly outperformed postmenopausal women not using hormone therapy on the Trail Making Test, Part B of the Halstead-Reitan (R. M. Reitan, 1958). This effect was significant even when the authors controlled for the effects of age, vocabulary levels, and education. Results are consistent with previous findings and may provide further evidence for an ameliorative effect of estrogen replacement therapy on specific cognitive functions.
    The Journal of Psychology Interdisciplinary and Applied 12/2006; 140(6):533-47. · 0.86 Impact Factor
  • Abbe Gayle Boeka, Kristine Lee Lokken
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    ABSTRACT: Persistent chaotic feeding behavior (i.e., bingeing and purging), despite consequent adverse health and psychosocial consequences, is central to the definition and diagnosis of bulimia nervosa (BN). Repeatedly choosing immediate short-term gratification when long-term consequences are deleterious may reflect deficits in decision-making ability. However, to date, there has been no systematic examination of decision-making ability in individuals diagnosed with BN. In the present study, 20 undergraduate women with minimal bulimic symptoms (Control Group) and 20 with a diagnosis of BN (BN Group) were administered the Iowa Gambling Task (GT). Results indicated that the BN Group performed significantly worse on the GT in comparison to the Control Group and GT performance was negatively correlated with bulimic symptomatology. The presence of BN symptoms also predicted GT performance above and beyond demographic variables and depressive symptoms. These findings provide evidence for the presence of decision-making deficits in individuals with BN.
    Journal of the International Neuropsychological Society 10/2006; 12(5):741-5. · 3.01 Impact Factor
  • K L Lokken, H M Marx, F R Ferraro
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    ABSTRACT: The goal of the current study was to further investigate whether an emotional Stroop effect exists among patients with bulimia nervosa. Performances of 30 female controls, 30 females with subclinical eating disordered symptoms, and 30 females diagnosed with bulimia nervosa were compared on an emotional Stroop color naming task using stimuli separated into three areas of concern (eating, weight, and shape words). Results indicated that overall the three groups differed significantly on the emotional Stroop task, with the interference latency for disorder salient words progressively increasing as the severity of bulimic symptoms increased. Severity of bulimic symptoms was the best predictor of interference on the emotional Stroop paradigm. Results provide further evidence that interference on the emotional Stroop is uniquely related to the symptoms of bulimia nervosa and bear credence to the possibility of its use as an additional tool in the diagnosis of bulimia nervosa.
    Eating and weight disorders: EWD 04/2006; 11(1):38-44. · 0.53 Impact Factor
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    ABSTRACT: The authors designed the present study to test whether women reported higher levels of body dissatisfaction than did men even when the 2 genders were matched on a measure of degree of body focus. Sixty undergraduates (30 men, 30 women) were screened on attention-to-body-shape scores and divided into high, medium, and low body-shape-focus groups. The participants also completed questionnaires that provided information on age, education, vocabulary ability, levels of depression, and body-image assessment. The groups did not differ (ps > .05) on age, education, vocabulary ability, or levels of depression. However, women in all 3 body-shape-focus categories indicated a larger discrepancy between their real vs. ideal body images (p < .01) than did the men. In the high-body-focus group, there was an 11:1ratio between women's and men's reported real-ideal body-shape discrepancies. Women showed greater body dissatisfaction than did men, even when the genders were matched on a measure of body focus.
    The Journal of General Psychology 07/2003; 130(3):305-10. · 1.04 Impact Factor

Publication Stats

207 Citations
19.34 Total Impact Points


  • 2011
    • Vanderbilt University
      Nashville, Michigan, United States
  • 2010
    • Yale University
      • Department of Psychiatry
      New Haven, CT, United States
  • 2006–2010
    • University of Alabama at Birmingham
      • Department of Psychiatry and Behavioral Neurobiology
      Birmingham, AL, United States
  • 2006–2009
    • University of Alabama
      Tuscaloosa, Alabama, United States
  • 2007
    • Illinois State University
      • Department of Family and Consumer Sciences
      Normal, Illinois, United States
  • 2003–2006
    • University of North Dakota
      • Department of Psychology
      Grand Forks, ND, United States