Anorexia Nervosa
Conditions
Brief summary
This study aims to optimize a treatment package for the relapse prevention treatment of AN. In the Preparation Phase, we examined accessibility and feasibility of the treatment package. In the current Optimization Phase, we will identify which components of treatment contribute to positive outcomes after acute hospitalization. We will carefully evaluate maintenance of remission, measured by rate of weight loss and end-of-trial status.
Detailed description
While many approaches to reducing relapse after hospital care have been tried, there is little information about which treatment elements confer benefit. This trial, Relapse Prevention and Changing Habits (REACH+), targets the habitual control of maladaptive behavior to support patients with AN in the 6 months after acute treatment, a time of high vulnerability to relapse. Each component of REACH+ addresses a question that is critical to answer in order to identify and optimize a relapse prevention treatment package that balances efficacy and burden. We will test the acceptability and feasibility of 5 components that together target habits: 1) Behavioral, 2) Cognitive, 3)Motivation, 4) Food Monitoring, and 5) Skill Consolidation. In the Preparation Phase, 10 participants were enrolled, and accessibility and feasibility of the treatment package was examined. The current Optimization Phase includes a finalized treatment manual (including an online platform) and will test each component's contribution to weight maintenance after acute treatment.
Interventions
BEHAVIORALRelapse Prevention and Changing Habits (REACH+)
Psychotherapy
Sponsors
New York State Psychiatric Institute
Columbia University
Brown University
National Institute of Mental Health (NIMH)
Study design
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* Diagnosis of Anorexia Nervosa at hospital admission * Medically Stable * Internet capability with videoconferencing * Weight restored (BMI \> 19 kg/m2) at New York State Psychiatric Institute
Exclusion criteria
* Current substance use or other comorbid disorder requiring specialized treatment * Pregnancy * Imminent risk of suicide * Serious medical illness * Daily psychotropic medication other than antidepressants (medications that are known effect weight are exclusionary, i.e. stimulants, olanzapine, mirtazapine) * Participation in outside psychotherapy or structured treatment program (support groups will be allowed). Individuals who are discharged on medications would need to have a non-study psychiatrist.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Weight maintenance | 6-month end of treatment | Measured via rate of weight loss (in lbs) following discharge from inpatient unit |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Habit strength | 6-month end of treatment | Measured via Self-Report Habit Index (SRHI) |
| Weight/shape distortion | 6-month end of treatment | Measured via Eating Disorder Examination, Questionnaire Version (EDE-Q) |
| Intrinsic motivation | 6-month end of treatment | Measured via General Self-Efficacy Scale (GSES) |
| Dietary restriction | 6-month end of treatment | Measured via Food Choice Task |
| Skill consolidation | 6-month end of treatment | Measured via platform utilization time |
Countries
United States
Contacts
CONTACTJoanna Steinglass, MD
Outcome results
None listed