Bärbel Knäuper

• Dr. phil.
• Professor (Full) at McGill University

Background Identifying mechanisms of action can aid the refinement of weight management interventions. Acceptance and Commitment Therapy (ACT)-based interventions may support long-term weight management by improving self-regulation of eating behavior traits (EBTs). However, it remains unclear if changing EBTs like emotional eating, external eating,...

Background High intrapatient variability (IPV) of tacrolimus trough concentrations (SD ≥ 2, coefficient of variation (CV%) ≥ 30) is associated with rejection and graft loss and may indicate nonadherence. However, the association between tacrolimus IPV and electronically monitored or self-reported adherence is unknown. Methods This secondary analys...

Background Obesity care may benefit from precision approaches, matching patients to treatment types based on their individual characteristics, including eating behaviour traits (EBTs) like emotional eating, uncontrolled eating, external eating, internal disinhibition and restraint. Initial evidence suggests that Acceptance and Commitment Therapy (A...

While a large body of research supports the beneficial effects of mindfulness-based interventions, much less is known about the underlying mechanisms of action that explain their salutary effects. A more profound understanding of these mechanisms may further assist in enhancing the efficacy of these programs by accentuating features that are associ...

Background The close relationship processes and health model and the dyadic health influence model posit that relationship beliefs (eg, relationship satisfaction) and influence strategies (eg, provision and receipt of positive and negative social control) mediate health behavior change. However, evidence for such mediation in parent-child dyads is...

Background The COVID‐19 pandemic led to widespread adoption of virtual communication platforms. Virtual study visits were implemented in the pilot cluster randomized trial (CRT) stage of Teen Adherence in KidnEy transplant Improving Tracking To Optimize Outcomes (TAKE‐IT TOO). The present study aimed to understand study coordinators' perspectives o...

Objectives Previous research consistently indicates that individuals who experience greater obstruction to valued living report higher levels of psychological distress and are at greater risk of developing mental health problems. Equanimity, which involves a calm and balanced mental attitude towards all experiences, is thought to protect against ps...

Stress is a common negative emotion in students. Given the stress associated with doctoral studies, it is crucial to examine the influence of stress on well-being, program satisfaction, and retention in doctoral programs. This study examined stress-related issues and their relationships with intention to quit in a sample of 2,486 students enrolled...

The primary objective was to explore the effects of a body scan meditation, a form of mindfulness practice, on reducing negative affect and food cravings in emotional eaters. We also examined if rumination, perceived body boundaries, and spatial frames of reference mediated this effect. Additionally, we investigated whether trait measures of mindfu...

Previous mindful eating scales emphasize the attentional facets of eating-specific mindfulness, while placing less emphasis on the attitude elements of nonjudgment and decentering. The FFaMES was developed to assess both fundamental facets of attention and attitude in the context of mindful eating behaviors. The FFaMES consists of four facets: nonr...

Healthcare is multi-faceted and in an interconnected world, digital tools embedded into the real-world fabric of health systems and society and utilizing new data sources have the potential to better support patients in managing their health and improve the capacity of health professionals, organizations, and systems to help them do so. However, th...

Purpose: To identify the contexts in which goal setting has been used in chronic disease management interventions and to estimate the magnitude of its effect on improvement of health outcomes. Methods: The strength of evidence and extent of potential bias in the published systematic reviews of goal setting interventions in chronic conditions wer...

Objective: The COVID-19 pandemic and its associated public health measures may increase the risk for psychological distress among vulnerable older adults. This longitudinal study aimed to identify predictors of psychological distress trajectories among community-dwelling older adults in Quebec, Canada. Methods: The study spanned four time points...

Background Over fifty percent of individuals with overweight and obesity are emotional eaters. Emotional eating can be theorized as a conditioned response to eat for reasons that are not associated with physiological hunger. We conducted this proof-of-concept study to gather evidence that a mobile app that delivers a common non-meditative mindfulne...

The current study explored the phenomenology of emotional eating, that is, the descriptive knowledge of what one perceives, senses, and knows in one's immediate awareness and experience during emotional eating. Eight individuals with emotional eating were interviewed twice using explicitation interviewing. Data were analyzed using thematic analysis...

Emotional eating is the tendency to overeat in response to negative emotions and has shown to be associated with weight outcomes, both in respect to weight gain over time and difficulties with weight loss and weight loss maintenance. It is thus important to develop treatments to improve weight loss outcomes in emotional eaters. The purpose of this...

Purpose To estimate among people living with chronic HIV, to what extent providing feedback on their health outcomes will affect the number and specificity of patient-formulated self-management goals. Methods A personalized feedback profile was produced for individuals enrolled in a Canadian HIV Brain Health Now study. Goal specificity was measure...

Objectives This study applied an extended Protection Motivation Theory to investigate the relative importance of fear of falling (FoF) among motivational and intentional determinants of physical activity (PA) behavior. Methods Older U.S. adults (N = 667, 65+) were surveyed using online research panels and completed measures of self-efficacy and re...

Objectives The present study applied the Integrated Behavior Change Model to investigate how behavioral decisions are predicted, namely, intention, planning, and habits, with respect to physical activity. Methods: Participants were older adults (ages 65+) residing in the U.S. (N = 667) who completed online measures of behavioral determinants (auton...

Background Both the close relationship processes and health model and the dyadic health influence model posit that beliefs about the relationship (e.g., relationship satisfaction) and influence strategies (e.g., social control) serve as mediators of health behavior change. The evidence for such mediation is limited. Purpose This study investigated...

The current study explored the phenomenology of emotional eating, that is, the descriptive knowledge of what one perceives, senses, and knows in one's immediate awareness and experience during emotional eating. Eight individuals with emotional eating were interviewed twice using explicitation interviewing. Thematic analysis resulted in nine themes...

Objective Self-monitoring, one of the most important behaviors for successful weight loss, can be facilitated through mobile health applications (mHealth apps). Therefore, it is of interest to determine whether consistent users of these apps succeed in achieving their weight goals. This study used data from an mHealth app that enabled tracking of...

Objectives One of the primary goals of Buddhist-inspired mindfulness practice is to enable practitioners to gain insight into the nature of the self and, as a result, increase their wellbeing. To empirically investigate how mindfulness impacts the self, researchers must effectively explicate the self and hone the methods used to study it. The curre...

Objectives There remains a significant variability in the methods and techniques used to promote mindful eating for individuals with overweight and obesity. This variability in treatment programs may result in incongruent findings as well as present challenges in identifying active processes of behavior change. The purpose of the scoping review was...

This research explores the justification and implications of incorporating consumption variety into mobile-based food recommendation systems. Our study makes use of data from a popular mobile fitness app, in which we can observe large volumes of daily food logs of thousands of users. We first confirm that consumption variety is associated with lowe...

Objectives Research exploring how mindfulness is conceptualized and applied in Western psychotherapeutic settings is in its early stages. The current study examines the influence of psychotherapists’ personal practice of mindfulness meditation on their professional work. Methods Psychotherapists who identify as mindfulness teachers were interviewe...

Background An increasing number of studies have investigated the efficacy of Acceptance and Commitment Therapy (ACT) for the reduction of dysregulated eating behaviours such as binge eating and emotional eating. However, little is known about their short- and long-term efficacy and underlying mechanisms of change. Objectives To conduct a systemati...

Objective: This study sought to identify psychosocial predictors of trajectories of adherence to physical distancing alongside changes in public health measures during the COVID-19 pandemic. Design: A three-time point longitudinal survey during the first two waves of the COVID-19 pandemic. Methods: Participants (N = 1003) completed self-report meas...

Background Reaching and maintaining high global human papillomavirus (HPV) vaccine uptake has been challenging. The impact of publicly funded HPV immunization programs and the interplay of sociodemographic, psychosocial and policy factors in maximizing vaccination is poorly understood. This observational study examined the impact of introducing pub...

Objectives Previous mindful eating scales stress the attentional domains of eating-specific mindfulness, such as present-moment attention to homeostatic cues of hunger and satiety while discounting other important domains such as non-judgment and decentering. The purpose of the series of studies was to develop and evaluate a multifaceted mindful ea...

A person’s tendency to approach pleasant stimuli and to avoid unpleasant stimulireflects a basic psychological phenomenon. The present research aimed toinvestigate the extent to which mindfulness practices and trait equanimity canattenuate this motivational process. In two studies, participants were asked toperform an Approach/Avoidance Task (AAT)....

Objectives In order for physical distancing directives to be effective at lowering and flattening the epidemic peak during a pandemic, individuals must adhere to confinement guidelines. Recent reviews highlight the paucity of research on empirical correlates of adherence to physical distancing and quarantine directives.Methods In this cross-section...

Purpose Emotional eating has been defined as the tendency to overeat in response to negative emotions and is a symptom of emotion dysregulation. Interventions for emotional eating have been developed based on acceptance and commitment therapy (ACT). However, these interventions only address emotional eating in the context of weight loss programs an...

Purpose: Experiencing a fall can be a detrimental experience for older adults and may affect an individual's beliefs about participating in future physical activity (PA) behavior. The purpose of this study was to identify if determinants of PA differ between older adults who have a history of a fall (HF) and those with no history of a fall (NHF) w...

Objectives. To identify targetable psychosocial predictors of adherence to physical distancing during the COVID-19 pandemic. Methods. Using a cross-sectional sample (N = 1003) representative of the population in terms of age, gender, and urbanicity in Quebec, Canada, we examined social, cognitive, and emotional predictors of adherence to physical d...

Background: Goal setting is a crucial element in self-management of chronic diseases. Personalized outcome feedback is needed for goal setting, a requirement for behavior change. This study contributes to the understanding of the specificity of patient-formulated self-management goals by testing the effectiveness of a personalized health outcome pr...

Background Whether weight cycling (repeated weight loss and regain) is associated with cardiometabolic health is unclear. Study objective was to examine whether weight cycling since young adulthood (ie, 25 years of age) was associated with cardiometabolic markers. Methods Data from a nationally representative cross-sectional US sample (National He...

Medication non‐adherence is an important factor limiting allograft survival after kidney transplantation in AYA. Some interventions, including the TAKE‐IT, showed some success in promoting adherence but the potential for scalability and use in routine clinical practice is limited. We applied user‐centered design to gather the perspectives of recipi...

Background: Acceptance and Commitment Therapy (ACT) interventions have shown to be effective in facilitating weight loss for emotional eaters, however, the lack of accessibility of these interventions limits their impact. The present study aimed to increase the accessibility of an ACT intervention for emotional eaters through delivery by physicians...

Background: Current evidence suggests that some of the most effective weight loss approaches are changes in dietary and physical activity behaviors through lifestyle modification programs. The Group Lifestyle Balance (GLB) program is a group-based behavior modification program aimed at changing diet and physical activity for weight loss. It was de...

Background: The NIH-developed Diabetes Prevention Program (DPP) is successful in achieving clinically significant weight loss in individuals with overweight/obesity when delivered one-on-one. However, due to high cost of implementation, the long-term effectiveness remains limited. In response, a group-based version of the program, called the Nation...

Emotional eating is the tendency to overeat in response to negative emotions and has shown to be associated with weight outcomes, both in respect to weight gain over time and difficulties with weight loss and weight loss maintenance. It is thus important to develop treatments to improve weight loss outcomes in emotional eaters. The purpose of this...

Background Emotional eating, or overeating in response to negative emotions, is a behavior endorsed by both normal weight and people with overweight/obesity. For some individuals, emotional eating contributes to weight gain and difficulties losing weight. However, there are also many who engage in emotional eating who maintain a normal weight. Litt...

The aim of the present study was to examine the perceived healthiness of breakfasts and the underlying beliefs influencing that perception against expert nutritional evaluation. Women with overweight or obesity (N = 120) were asked to recall the food items they consumed during a recent “healthy” or “unhealthy” breakfast. They also reported why the...

Despite being an effective cancer prevention strategy, human papillomavirus (HPV) vaccination in Canada remain suboptimal. This study is the first to concurrently evaluate HPV vaccine knowledge, attitudes, and the decision-making stage of Canadian parents for their school-aged daughters and sons. Data were collected through an online survey from a...

Objective The NIH‐developed Diabetes Prevention Program (DPP) is successful in achieving clinically significant weight loss in individuals with overweight/obesity when delivered one‐on‐one. The group‐based DPP is less effective, with average weight losses of only 3.5%. The objective of this study was to increase weight loss outcomes of the group‐ba...

Introduction: The SAGE Working Group on Vaccine Hesitancy developed a vaccine hesitancy measure, the Vaccine Hesitancy Scale (VHS). This scale has the potential to aid in the advancement of research and immunization policy but has not yet been psychometrically evaluated. Methods: Using a cross-sectional design, we collected self-reported survey...

Attachment relationships play an important role in people's wellbeing and affliction with physical and mental illnesses, including eating disorders. Seven reviews from the clinical field have consistently shown that higher attachment insecurity-failure to form trusting and reliable relationships with others-systematically characterized individuals...

Background: An increasing number of studies are investigating the efficacy of mindfulness-based interventions (MBIs) for weight loss and obesity-related eating behaviours. However, the results of past reviews are inconsistent. Objective: To clarify these inconsistencies, we conducted a comprehensive effect-size analysis to evaluate the efficacy...

In this paper, we review different definitions and operationalization of mindfulness according to both Buddhist tradition and western conceptualizations, namely mindfulness as defined in modern mindfulness-meditation programs and Langerian mindfulness. Additionally, we compare and contrast these different approaches and propose a common link betwee...

Cognitive therapy (CT) and acceptance and commitment therapy (ACT) have been shown to be effective in treating depression. Although integrating ACT with CT is used for the treatment of anxiety, there is a paucity of integrated CT and ACT treatments for depression and/or dysthymia. The purpose of this study is to determine the feasibility of integra...

Cognitive therapy (CT) and acceptance and commitment therapy (ACT) have been shown to be effective in treating depression. Although integrating ACT with CT is used for the treatment of anxiety, there is a paucity of integrated CT and ACT treatments for depression and/or dysthymia. The purpose of this study is to determine the feasibility of integra...

Study Objectives Variation in day length is proposed to impact sleep, yet it is unknown whether this is above the influence of behavioural factors. Day length, sleep hygiene and parent-set bedtime were simultaneously explored, to investigate the relative importance of each on adolescents’ sleep. Methods An online survey was distributed in 4 countr...

Objective: Although meditation practice is an important component of many mindfulness-based interventions (MBIs), empirical findings of its effects on psychological functioning are mixed and the mechanisms for the effects remain unclear. Responding with mindfulness (i.e., returning one's attention back to a nonjudgmental, present-oriented awarenes...

Objectives: Evidence suggests that symptoms of depression and anxiety predict lower exercise behaviour and, inversely, that less exercise predicts higher symptomatology. The present longitudinal study examined this reciprocal association in adults with type 2 diabetes mellitus. We predicted that symptoms of anxiety or depression would intensify ov...

Background: Sleep is vital for adolescent functioning. Those with optimal sleep duration have shown improved capacity to learn and decreased rate of motor vehicle accidents. This study explored the influence of numerous protective and risk factors on adolescents' school night sleep (bedtime, sleep latency, total sleep time) simultaneously to asses...

A lot of information used in aging research relies on self-reports. Surveys or questionnaires are used to assess quality of life, attitudes toward aging, experiences of aging, subjective well-being, symptomatology, health behaviors, financial information, medication adherence, etc. Growing evidence suggests that older and younger respondents are di...

Cognitive Therapy (CT) and Acceptance and Commitment Therapy (ACT) have different philosophical tenets. CT targets the form and frequency of mental experiences, whereas ACT focuses on the context of thoughts and feelings. Integrating both approaches in a single therapy may prove beneficial because clients are offered greater flexibility and a vaste...

The current study evaluated the long-term effectiveness of acceptance and commitment therapy (ACT) for promoting exercise behavior in comparison with planning in the form of implementation intentions (forming situational cues and action plans as to when, where, and how to incorporate exercise). We expected both interventions to increase exercise be...

Purpose: To test the efficacy of an acute intervention derived from acceptance and commitment therapy (ACT) for increasing high-intensity constant work rate (CWR) cycle exercise tolerance in a group of low-active women age 18-45 yr. The secondary goals were to examine whether ACT would reduce perceived effort and improve in-task affect during exer...

BACKGROUND Adolescent sleepiness due to insufficient sleep is prevalent and associated with significant negative consequences on heath and well-being. Negative sleep hygiene practices have been shown to impede adequate sleep duration. Sleep promotion programs are successful in improving sleep knowledge but not at promoting positive sleep hygiene pr...

Vaccination against the human papillomavirus (HPV) is an effective primary prevention measure for HPV-related diseases. For children and young adolescents, the uptake of the vaccine is contingent on parental consent. This study sought to identify key differences between parents who obtain (acceptors) and parents who refuse (non-acceptors) the HPV v...

We assessed the potential for harmful messages in online advertisements targeted to youth, using the example of the Canadian "Light It Up" marketing campaign from a large sports corporation. We undertook a cluster randomized controlled trial of 20 secondary school classes in Montreal, Canada. Classes were randomly allocated to view a "Light It Up"...

Sleep restriction is a prevalent issue for adolescents and has been associated with negative cognitive, emotional, and physical health (e.g., poor attention, depressed mood, obesity). Existing sleep promotion programs are successful in improving adolescents’ sleep knowledge but not sleep behaviour. The aim of this randomized controlled trial is to...

The aim of the study was to test the motivation and awareness variables of the I-change model as predictors of adolescent intention to go to bed earlier. Questionnaires regarding sleep related motivational and awareness variables were administered to 127 sleep restricted (determined by actigraphy) high school students (12–17 years old). The motivat...

BACKGROUND Adolescent sleep deprivation is common and has a significant negative impact on health and well-being. Pediatric health care professionals must measure sleep timing accurately in order to identify and then treat sleep deprivation in this age group. Currently, parents often respond on behalf of their child and are inaccurate in reporting...

Background The Diabetes Prevention Program (DPP) is highly effective in promoting weight loss in overweight and obese individuals. However, one-on-one DPP sessions are costly. As a cost-saving alternative, a group version of the DPP, called Group Lifestyle Balance program (GLB), has been developed but has been shown to be less effective. The aim of...

Abstract Individual differences in uncertainty have been associated with heightened anxiety, stress and approach-oriented coping. Intolerance of uncertainty (IU) is a trait characteristic that arises from negative beliefs about uncertainty and its consequences. Researchers have established the central role of IU in the development of problematic wo...

Recent studies have suggested that sleep is associated with IQ measures in children, but the underlying mechanism remains unknown. An association between sleep spindles and IQ has been found in adults, but only two previous studies have explored this topic in children. The goal of this study was to examine whether sleep spindle frequency, amplitude...

The sudden confrontation of a potential health threat such as cancer, even after the diagnosis turns out to be benign, can have enduring adverse psychological consequences, including persistent anxiety, cancer fears, and other manifestations of psychological distress. The present study examines factors that potentially moderate psychological recove...