UCAN2: Uniting Couples in the Treatment of Anorexia Nervosa

No single, conventional treatment has been shown to significantly benefit adults with AN,
which ranks among the leading causes of disability and premature death in young women. The
investigators propose to test the hypothesis that a novel, couple-based intervention
developed for adult AN (UCAN) significantly enhances treatment outcome and reduces risk of
relapse compared with treatment conducted entirely on an individual basis, the standard mode
of treatment delivery in the community. The investigators plan to compare UCAN with
individual treatment in a randomized controlled trial (RCT). All participants with AN will
receive a common set of core interventions, including medical management, nutrition
counseling, and a base level of individual cognitive-behavioral therapy (CBT), with
randomization either to: 1) UCAN couple-based intervention or 2) a higher "dose" of
individual CBT. The partners are involved in varying ways and to varying degrees in
treatment. In addition, progress will be followed for one year after completion of active
treatment.

Inclusion Criteria

1. Participant with AN must have:

1. Current Diagnostic and Statistical Manual of Mental Disorders Fourth Edition
(Text Revision) (DSM-IV-TR) criteria for AN, restricting or binge/purge subtype;
BMI between 15.0-19.0 currently or sometime in the past 3 months.

2. Adequate insurance coverage to support a higher level of care including but not
limited to partial hospitalization or inpatient treatment.

2. Both members of couple must be:

1. At least 18 years of age.

2. English speaking.

3. Involved in a committed relationship for at least 6 months, regardless of sexual
orientation.

4. Wiling to participate in treatment.

Exclusion Criteria

1. Participant with AN cannot be: Unwilling to suspend other treatment for AN for the
duration of the study.

2. Partner cannot meet: Current DSM-IV-TR criteria for AN, restricting or binge/purge
subtype. We will exclude couples in which both partners have a diagnosis of AN.

3. Neither member of couple can have:

1. Alcohol or drug dependence in the past year.

2. Current significant suicidal ideation (from interview or depression assessment).

3. Severe depression that would seriously interfere with functional capacity, as
judged by the PIs or study physician.

4. Developmental disability that would impair the ability to benefit from the
intervention.

5. Any psychosis, schizophrenia, or bipolar I disorder, unless stably remitted on
maintenance therapy for at least 1 year.

6. Moderate to high levels of physical violence from participant/partner as reported
during baseline interview.

7. Previously participated in the UCAN couple treatment condition in the preliminary
couples treatment study (#07-1429. UCAN: Uniting Couples (in the treatment of)
Anorexia Nervosa)