Inpatient Exposure Therapy and Response Prevention & Cognitive Remediation Therapy for Anorexia Nervosa
| Status: | Recruiting |
|---|---|
| Conditions: | Psychiatric |
| Therapuetic Areas: | Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | Any |
| Updated: | 10/21/2012 |
| Start Date: | November 2009 |
| Contact: | Columbia Center for Eating Disorders/ Eating Disorders Research Unit |
| Phone: | 212-543-5739 |
Randomized Controlled Trial of Inpatient Exposure Therapy and Response Prevention for Anorexia Nervosa
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.
Inclusion Criteria:
1. DSM-IV-TR™ diagnosis of anorexia nervosa (restricting or binge-purge subtype), with
or without amenorrhea at the time of inpatient admission
2. Subjects will have achieved 85% of ideal body weight (IBW)
3. Age 16-45 years
4. No acute medical condition
5. Subjects must have signed informed consent document indicating that they understand
the purpose of and procedures required for the study and are willing to participate
in the study.
Exclusion Criteria:
1. Psychotic or bipolar I disorder
2. Substance abuse or dependence in the last 6 months
3. Current Axis I disorder requiring psychotropic medication (ongoing antidepressant
treatment for stable comorbid conditions will be allowed)
4. Significant co-morbid depression
5. Significant medical problems that would introduce additional risk related to research
or interfere with participation, e.g. SBP>140, DBP>90, HR>100 for a sustained period.
6. Active suicidal intent
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New York State Psychiatric Institute The New York State Psychiatric Institute (NYSPI), established in 1895,...
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