RecruitingNot ApplicableNCT05799872

Neuroscience-informed Treatment to Remotely Target Reward Mechanisms in Post-acute Anorexia Nervosa

Sponsor

Virginia Commonwealth University

Enrollment

90 participants

Start Date

Dec 6, 2023

Study Type

INTERVENTIONAL

Conditions

Anorexia Nervosa

Summary

The investigators will recruit individuals with broadly-defined AN (n = 80) who are currently in or have recently participated in higher-level eating disorder treatment (e.g., residential, partial hospitalization/day treatment, intensive outpatient treatment). Interested participants will sign consent, complete eligibility assessments, and will be randomized to receive Positive Affect Treatment for Anorexia Nervosa (PAT-AN) or Psychoeducation and Behavioral Therapy (PBT) through teletherapy shortly following discharge from higher level of care. Participants can participate in most other forms of outpatient treatment while receiving the research intervention. Participants will engage in 24 weeks of PAT-AN or PBT starting in the first 3 months post-discharge. At each session, the investigators will complete brief measures assessing treatment acceptability, affect, and eating disorder symptoms. Participants will also complete an assessment battery of self-report, EMA, and neurocognitive measures evaluating primary outcomes (BMI; eating disorder symptoms), secondary outcomes (depression, anxiety, and suicidality), and presumed treatment mechanisms at baseline, end of treatment (EOT), and 3-month follow-up (FU). All assessments will be remotely delivered via HIPAA-compliant platforms.

Eligibility

Min Age: 18 Years

Inclusion Criteria9

Age > or = 18 years old
Ability to read and speak in English
DSM-5 diagnosis of AN or atypical AN at admission to higher-level care
In higher-level care discharging to outpatient care or discharged to outpatient care within the past 3 months
Current BMI > or = 18.5 kg/m2 (or will be by time of discharge)
BMI increase of > or = 0.5 kg/m2 while in higher-level care
Ability to designate and sign a release of information for a primary physical or mental health provider for study duration
Willingness to participate in weekly assessments (e.g., weight monitoring) and audio or video recording of study therapy sessions for study duration
Access to a smartphone and/or computer permitting engagement in remote therapy and assessment.

Exclusion Criteria5

Medical instability for outpatient care;
Pregnancy
Lifetime DSM-5 primary psychotic or bipolar-I disorder
Current DSM-5 substance use disorder
Enrollment in outpatient therapy with highly overlapping content to PAT-AN

Interested in this trial?

Get notified about updates and connect with the research team.

Interventions

BEHAVIORALPositive Affect Treatment for Anorexia Nervosa (PAT-AN):

PAT-AN is an adaptation of the cognitive-behavioral outpatient individual therapy for anhedonia (17, 68). The overarching aim of PAT-AN is to enhance reward sensitivity (reward anticipation, experiencing, and learning) to non-eating disorder experiences and to decrease or replace reward sensitivity to weight-loss experiences (26). PAT-AN includes 6 sequential modules, each designated to target specific reward sensitivity disturbances (26, 68). Homework and experiential practice during sessions are essential components of PAT-AN, and participants are provided a workbook to assist with this practice. During each session, collaborative homework review is followed by skill development and homework assignments.

BEHAVIORALPsychoeducational and Behavioral Therapy (PBT)

The comparison treatment is modeled off of educational and behavioral interventions used in prior clinical trials for AN and common elements of standard behavioral eating disorder treatments. The treatment is structured to parallel the modular format of PAT-AN.