An Investigation of Cognitive Remediation Therapy as an Inpatient Intervention for Adolescents With Anorexia Nervosa
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 50
- 试验地点
- 2
- 主要终点
- Change in adolescent treatment engagement via questionnaire
研究概览
简要总结
The purpose of the current study is to investigate the role of Cognitive Remediation Therapy (CRT) as a pre-treatment intervention for adolescents who are hospitalized for Anorexia Nervosa (AN). The primary aims are to determine if CRT can result in greater treatment engagement post-discharge, increased rate of weight gain post-discharge, reduction in symptom accommodation, and increased behavioral flexibility in adolescents and parents.
详细描述
Anorexia Nervosa (AN) is a severe psychiatric condition; the hallmark features are low body weight and difficulties gaining weight. We are in need of new methods to jump start treatment, while targeting relevant processes in individuals with AN.
Study Design:
This is a randomized controlled trial looking to address these concerns, with a focus on three distinct aims:
- To evaluate the feasibility and acceptability (by patients and staff) of CRT in a medical hospitalization setting.
- Compare the impact of CRT to CRT + Teach the Parent on adolescent treatment engagement post-discharge, rate of weight gain post-discharge, and reduction of symptom accommodation.
- To evaluate cognitive and behavioral flexibility 6 months post-discharge.
Setting/Participants:
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 12 Years 至 18 Years（Child, Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Adolescent is between 12-18 years of age and living at home, parent or primary caregiver willing to participate in condition they are randomized into
- •Adolescent meets diagnostic criteria of anorexia nervosa (either restricting or binge/purge subtype), or sub threshold AN according to Diagnostic and Statistical Manual-5 criteria
- •Consent of all family members who will be participating in treatment
- •Adolescent is not currently receiving outpatient treatment for the eating disorder
排除标准
- •Caregiver or adolescent with a co-morbid diagnosis of psychotic disorder, substance dependence, substance abuse, or bi-polar disorder
- •caregiver or adolescent with diagnosis of mental retardation, pervasive developmental disorder, or autism spectrum disorder
- •Adolescent with a diagnosis of feeding or eating concerns not elsewhere classified with the primary symptoms of bingeing and purging, binging without compensatory behaviors or spitting food or with restricting patterns
- •Adolescent with diagnosis of avoidant/restrictive food intake disorder.
- •Adolescent or caregiver with acute suicide risk.
- •Concurrent psychosocial treatment for another condition
- •Adolescent or parent not fluent in English
研究组 & 干预措施
CRT +Teach the Parent
The Teach the Parent (TtP) addition to CRT is designed to increase parental understanding of their adolescents' thinking styles. We hypothesize that by doing so, parents will be more likely to challenge eating disorder behaviors and be less likely to accommodate behavioral symptoms of the eating disorder (e.g., make something low-fat for dinner because it will be easier). In this arm, adolescents will explain what they learned during CRT and walk their parents though at least 4 tasks during each TtP session. Parents and child will not be permitted to speak about the eating disorder during these sessions. TtP sessions will occur 3-4 times during hospitalization and will be guided by the adolescent.
干预措施: CRT + Teach the Parent (Behavioral)
CRT + Family Fun Time
In order to assess for any non-specific effects of spending non-eating disorder driven time with family, adolescents in the CRT+ Contact Control condition will be asked to spend 3-4 sessions with their parents engaging in fun activities (games, coloring, trivia). We refer to this condition as CRT + Family Fun Time (CRT+FFT). Adolescents will be asked to complete a series of fun tasks (some standardized, some are choice driven) with their parents. During these sessions, they will not be permitted to discuss CRT or the eating disorder.
干预措施: CRT + Contact Control (Behavioral)
Treatment as Usual (TAU)
Adolescents in this condition will not receive any additional treatment. They will have a standard hospital stay with all normal contact with health professionals.
结局指标
主要结局
Change in adolescent treatment engagement via questionnaire
时间窗: Baseline to 3 months post baseline
The Motivational Stages of Change for Adolescents Recovering from an Eating Disorder (MSCARED) is a questionnaire designed to assess readiness to change among individuals with eating disorders. It is administered via interview, discussing motivation, actions that qualify for making changes, and asking what stage of change the patient is in. The patient then checks off those actions they are doing that contribute to their recovery from a provided checklist.
次要结局
- Change in adolescent cognitive flexibility via questionnaire(Baseline to 6 months post baseline)
- Change in parental symptom accommodation, via questionnaire(Baseline to 3 months post baseline)