Anorexia Nervosa
Conditions
Keywords
Reduced, Environmental, Stimulation
Brief summary
The study proposed in this protocol aims to document the physiological, subjective, behavioral, and neural effects of reduced environmental stimulation (floating) in patients with current or prior anorexia nervosa The primary aim of this study is to determine the safety of this intervention. Secondary aims including determining whether floating has an impact on symptom reports such as those related to anxiety and eating disorders.
Detailed description
Floating creates an environment with minimal visual, auditory, tactile, proprioceptive, and thermal input to the brain. The float rooms used in this study are both lightproof, and thus completely dark when the entry door is sealed and the lights are turned off, reducing all visual input to the brain. Each float room was constructed with thick soundproof walls, restricting most outside noises from entering the room, thereby reducing auditory input to the brain. A high concentration Epsom salt water solution allows individuals to effortlessly float on their back while remaining completely still, reducing both proprioceptive and tactile input to the brain. The temperature of the water is calibrated to the temperature of the skin (\ 94° F) and the temperature of the air is calibrated to the temperature of the water, making it difficult to discern the boundary between air and water, thus reducing thermal input to the brain while minimizing the need for thermoregulation of the skin. While both float pools dramatically reduce external sensory information, it is important to note that participants are in full control over the experience. For example, participants can enter and exit the float pool whenever they choose. Each float pool also contains a blue LED light that can be turned on and off via an air-coupled light switch in the pool. Both float rooms contain a shower for cleaning before and after floating. In a prior study the investigators have found that healthy participants found the pool condition to be relaxing and stress relieving. The current study aims to determine the safety of floating with a clinical population, specifically individuals with a history of eating disorder who are of normal weight.
Interventions
BEHAVIORALReduced environmental stimulation
Participants will complete one arm involving four sequential float sessions. Float 1: chair float. Participants will first float in a comfortable chair in the supine position, for up to 90 minutes. The chair is in a room with sound and light attenuation. Orthostatic blood pressure (BP) will be measured before and after each float. Anxiety and body image will be measured afterwards. Float 2: open pool float. Participants will float for up to 90 minutes in an open pool (8 foot diameter, no enclosure). Orthostatic BP will be measured before and after each float. Anxiety and body image will be measured afterwards. Floats 3 & 4: domed pool float. Participants will float for up to 90 minutes in a domed pool the same size as the open pool, with an enclosure wall and 8 foot tall ceiling. Orthostatic BP will be measured before and after each float. Anxiety and body image will be measured afterwards. Each float will occur approximately 1 to 7 days apart.
Sponsors
Laureate Institute for Brain Research, Inc.
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
1. Current or prior diagnosis of anorexia nervosa (AN) 2. All AN participants must be weight-restored prior to their participation, defined as having a Body Mass Index (BMI) \> 17.5
Exclusion criteria
1. Any of the following DSM-V disorders: 1. Schizophrenia Spectrum and Other Psychotic Disorders 2. Bipolar and Related Disorders 2. Currently being treated for their psychiatric condition as an inpatient. 3. Active suicidal ideation with intent or plan (as determined by a psychiatrist or clinical psychologist for all participants who report an IDAS-II suicide score \> 10). 4. Morbid obesity (BMI \> 40) or underweight (BMI \< 17.5). 5. Orthostatic hypotension (defined as a drop of ≥20 mm Hg in systolic blood pressure or a drop of ≥10 mm Hg in diastolic blood pressure when measured shortly after transitioning from lying down to standing). 6. Certain drugs or medications consumed within the past week including any psychoactive drugs (e.g., MDMA, LSD, psilocybin, peyote, phencyclidine, ketamine), magnesium supplements (greater than 150mg) or milk of magnesia. Any antihistamine that causes drowsiness (e.g., Benadryl) or any alcohol consumed within the past 12 hours. Caffeine or nicotine consumed within the past 3 hours. For all other medications, participants must be stably medicated prior to participation (defined as having taken the medication for 6 weeks or longer). 7. History of unstable liver or renal insufficiency; glaucoma; diabetes; significant and unstable cardiac, vascular, pulmonary, gastrointestinal, endocrine, neurologic, hematologic, rheumatologic, or metabolic disturbance. 8. Pregnancy as detected by a urine test. 9. Failure to adhere to Pre-float checklist. 10. Non-correctable vision or hearing problems.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Orthostatic blood pressure | Immediately before and after each float session for 4 float sessions, spaced weekly to monthly for up to 16 weeks study duration | Defined as a drop of ≥20 mm Hg in systolic blood pressure or a drop of ≥10 mm Hg in diastolic blood pressure when measured shortly after transitioning from lying down to standing. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Eating disorder severity | Obtained during the first visit | Measured via the Eating Disorder Examination Questionnaire |
| Trauma exposure | Obtained during the first visit | Measured via the Childhood Trauma Questionnaire |
| Self-ratings of changes in emotional experience | Immediately before and after each float session for 4 float sessions, spaced weekly to monthly for up to 16 weeks study duration | Measured via self-report measure (Positive and Negative Affect Schedule X) |
| Self-ratings of changes in physical experience | Immediately before and after each float session for 4 float sessions, spaced weekly to monthly for up to 16 weeks study duration | Interoceptive and exteroceptive sensations, measured via visual analogue scale (e.g., 0 to 100) |
| Self-ratings of changes in anxiety | Obtained at baseline and immediately before and after each float session for 4 float sessions, spaced weekly to monthly for up to 16 weeks study duration | Measured via self-report measure (Spielberger State-Trait Anxiety Index) |
| EEG changes during the float experience | During the first, second, and fourth float for 4 float sessions, spaced weekly to monthly for up to 16 weeks study duration | May be measured during the first, second, and fourth float. |
| Heart rate variability during the float experience | Obtained at baseline and after the first, second, and fourth float for 4 float sessions, spaced weekly to monthly for up to 16 weeks study duration | Measured during the first, second, and fourth float. |
| Self-ratings of anxiety sensitivity | Obtained during the first visit | Measured via the Anxiety Sensitivity Index |
| Body image | Obtained at baseline and immediately after each float session for 4 float sessions, spaced weekly to monthly for up to 16 weeks study duration | Measured via Photographic Figure Rating Scale, Body Appreciation Scale, Body Image States Scale, Body Shape Questionnaire, visual analogue scale (e.g., 0 to 10). |
Countries
United States
Outcome results
None listed