Target Engagement of a Novel Dissonance-Based Treatment for DSM-5 Eating Disorders
| Status: | Recruiting |
|---|---|
| Conditions: | Psychiatric, Eating Disorder |
| Therapuetic Areas: | Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 18 - 34 |
| Updated: | 8/30/2018 |
| Start Date: | July 10, 2017 |
| End Date: | June 2022 |
| Contact: | Eric Stice, PhD |
| Email: | estice@ori.org |
| Phone: | 541-484-2123 |
Most people with an eating disorder (ED) do not receive good treatment. The investigators
have developed a new brief group treatment that is supposed to work by reducing how much
women with an ED value the impossible thinness standard promoted by the media and how much
they value/crave binge foods. The investigators want to test whether the treatment actually
changes those two mechanisms using brain scan data, which is more objective than completing
questionnaires and even interviews.
In the first phase of the study (R61), the investigators will compare women in the treatment
versus those on a wait-list. If the investigators can show that the treatment "works" (does
what the investigators think it does) compared to no active treatment (women will be allowed
to seek and receive outside help but investigators will not provide it until after the
wait-list), investigators will conduct the second phase of study (R33),where they will
randomly assign women with an ED to either the new treatment or to a group treatment that
represents what many college mental health clinics provide to their clients with ED.
have developed a new brief group treatment that is supposed to work by reducing how much
women with an ED value the impossible thinness standard promoted by the media and how much
they value/crave binge foods. The investigators want to test whether the treatment actually
changes those two mechanisms using brain scan data, which is more objective than completing
questionnaires and even interviews.
In the first phase of the study (R61), the investigators will compare women in the treatment
versus those on a wait-list. If the investigators can show that the treatment "works" (does
what the investigators think it does) compared to no active treatment (women will be allowed
to seek and receive outside help but investigators will not provide it until after the
wait-list), investigators will conduct the second phase of study (R33),where they will
randomly assign women with an ED to either the new treatment or to a group treatment that
represents what many college mental health clinics provide to their clients with ED.
Only 3-20% of individuals with eating disorders (EDs) receive treatment, and those who do
rarely receive evidence-based treatments because they are very intensive and costly, few
clinicians deliver them, and they differ for the various EDs. These factors have hindered
broad implementation of evidence-based treatments, implying that a brief frontline outpatient
treatment for a range of EDs that could be easily, cheaply, and widely implemented would
address a major public health problem. There is also limited experimental evidence regarding
factors that maintain EDs and mechanisms of action for ED treatments. The investigators
propose to conduct a project that translates basic persuasion research into clinical
hypotheses and a novel treatment.
The investigators hypothesize that EDs are maintained by (1) excessive valuation of the thin
beauty ideal, which prompts caloric restriction and other unhealthy weight control behaviors
(vomiting, laxative use, excessive exercise) that increase binge eating risk, and (2)
excessive valuation of high-calorie foods, which maintains binge eating. The investigators
propose to evaluate a treatment that addresses these hypothesized maintenance processes. Two
pilot trials evaluated a novel 8-session group dissonance-based treatment (Counter
Attitudinal Therapy; CAT) wherein women with any ED appropriate for outpatient care completed
activities in which they collectively discuss costs of pursuing the thin ideal and the ED
behaviors in which they personally engage (unhealthy weight control behaviors and binge
eating), which putatively creates dissonance about engaging in those particular behaviors
that reduce valuation of the thin ideal and high-calorie binge foods.
rarely receive evidence-based treatments because they are very intensive and costly, few
clinicians deliver them, and they differ for the various EDs. These factors have hindered
broad implementation of evidence-based treatments, implying that a brief frontline outpatient
treatment for a range of EDs that could be easily, cheaply, and widely implemented would
address a major public health problem. There is also limited experimental evidence regarding
factors that maintain EDs and mechanisms of action for ED treatments. The investigators
propose to conduct a project that translates basic persuasion research into clinical
hypotheses and a novel treatment.
The investigators hypothesize that EDs are maintained by (1) excessive valuation of the thin
beauty ideal, which prompts caloric restriction and other unhealthy weight control behaviors
(vomiting, laxative use, excessive exercise) that increase binge eating risk, and (2)
excessive valuation of high-calorie foods, which maintains binge eating. The investigators
propose to evaluate a treatment that addresses these hypothesized maintenance processes. Two
pilot trials evaluated a novel 8-session group dissonance-based treatment (Counter
Attitudinal Therapy; CAT) wherein women with any ED appropriate for outpatient care completed
activities in which they collectively discuss costs of pursuing the thin ideal and the ED
behaviors in which they personally engage (unhealthy weight control behaviors and binge
eating), which putatively creates dissonance about engaging in those particular behaviors
that reduce valuation of the thin ideal and high-calorie binge foods.
Inclusion Criteria:
- DSM-5 eating disorder
- Must have a primary care doctor
Exclusion Criteria:
- Non-English speakers
- BMI <75% ideal body weight
- Current acute suicidal ideation (defined as thoughts of a specific method or plan)
We found this trial at
2
sites
Austin, Texas 78712
Principal Investigator: Andreana Haley, PhD
Phone: 512-232-2334
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