Exposure and response prevention (AN-EXRP) will help individuals with anorexia nervosa improve their eating behavior.
Anorexia nervosa (AN) is a serious illness associated with substantial morbidity and a mortality rate among the highest of any psychiatric illness. The rate of relapse is disturbingly high, with up to 50% of patients requiring re-hospitalization within a year of discharge. Current treatments are inadequate in helping older adolescents and adults achieve sustained recovery. Importantly, eating behavior remains disturbed after weight restoration: patients demonstrate restrictive eating in their self-selected foods and in standardized meals, and caloric intake in standardized meals is inversely related to pre-meal anxiety. Emerging data suggest that eating behavior is particularly important in post-hospital course, and that significantly altering eating behavior is critical in improving outcome for these individuals. Furthermore, caloric intake in standardized meals has been shown to be related to pre-meal anxiety. This study evaluates the potential utility of two psychotherapeutic interventions in improving eating behavior prior to hospital discharge. Each individual receives, in random order, Cognitive Remediation Therapy for 4 weeks and Exposure and Response Prevention for AN for 4 weeks. The investigators hypothesize that these interventions will lead to improvement in eating behavior, measured by food diaries and standardized meals.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
40
12 Sessions, 3 times per week. 90 minute sessions. Group therapy twice per week.
12 Sessions, 3 times per week. 45 minute sessions. Group therapy twice per week.
New York State Psychiatric Institute
New York, New York, United States
Eating Behavior
Eating behavior will be measured as both intake patterns in food records and in a laboratory based meal.
Time frame: 4 weeks
Psychological Improvement
The impact of these interventions on psychological state, including anxiety and thinking patterns, will be measured.
Time frame: 4 weeks
Psychological Improvement
The impact of these interventions on psychological state, including anxiety and thinking patterns, will be measured.
Time frame: 8 weeks
Eating Behavior
Laboratory meal after crossover condition.
Time frame: 8 weeks
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