Look at Food and Lose Your Fear - Evaluation of a Computerized Attention Training (CAT) for Anorexia Nervosa Patients

Phase 1

• Conditions: Anorexia Nervosa
• Interventions: Behavioral: Sham computerized attention training (control condition); Behavioral: Computerized attention training (CAT)

• Registration Number: NCT02484599
• Lead Sponsor: King's College London

Brief Summary

The purpose of this study is to test the therapeutic effects of a computerized attention training for patients with Anorexia Nervosa (AN). The primary aim is to determine if a computerized attention training can modify attention towards food and ameliorate eating disorder symptoms and related difficulties, such as anxiety. The secondary aim is to explore underlying mechanisms that contribute to these improvements. The stability of potentially observed effects over a one-month period will also be determined.

Detailed Description

Recently, attention bias modification (ABM) has successfully been applied in the field of anxiety disorders and emerging evidence suggests that attention bias modification can ameliorate attention bias for threatening stimuli. ABM is based on the premise that if biased attention maintains disorder symptoms, a modification of the bias should reduce symptoms. The advantage of ABM is that it operates implicitly, thereby offering a more indirect, less deliberate procedure. This requires less cognitive control compared to the effortful and explicit psychotherapeutic treatment of cognitive biases. As food-related fears and avoidance in AN patients have been recognized as important anxiety-related symptoms, ABM seems particularly suitable to treat food-related fears and avoidance, especially because AN patients might be unaware of their avoidance strategy. The aim of this study is to test if food-related fears and food avoidance can be changed by experimentally modifying attention towards food in Anorexia Nervosa patients using an innovative computerized training paradigm (computerized attention training - CAT) and to evaluate related change in symptoms.

The investigators hypothesize that the active CAT will change attentional processing of food cues (research aim 1), transfer to changes in food-related fears and food avoidance, and to improvements in AN symptoms and weight in the short term (research aim 2) and longer term (research aim 3).

Study Timeline

• Study Start: 2015-06
• Study First Submitted: 2015-06-25
• Study First Submitted QC: 2015-06-26
• Study First Posted: 2015-06-29
• Status Verified: 2015-07
• Last Update Submitted: 2015-07-07
• Last Update Posted: 2015-07-08
• Primary Completion: 2016-10
• Study Completion: 2016-11

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: Female
• Target Recruitment: 50

Inclusion Criteria

• BMI < 18.5 5 kg/m2
• Current diagnosis of AN-restricting type, AN-Binge/purging type or Eating Disorder Not Otherwise Specified (EDNOS) - Anorexia type
• Fluent in English

Exclusion Criteria

• Currently taking a dose of any psychoactive medication that has not been stable for at least 14 days prior to participation in the study
• Currently meeting the diagnostic criteria of another major psychiatric disorder (e.g., major depressive disorder, substance dependence, schizophrenia or bipolar disorder) needing treatment in its own right
• Learning and developmental impairments
• If the disorder is currently life threatening
• If patients are currently suicidal
• If patients are currently having extreme physiological complications or co-morbid alcohol and drug-abuse disorders

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
CAT sham bias modification	Sham computerized attention training (control condition)	Sham computerized attention training. Attention training via repeated trials of a modified anti-saccade task with concurrent assessment of eye-movements not intended to change attention processing of food stimuli using pictures of two different non-food stimuli categories (e.g. household and musical instruments).
CAT active attention bias modification	Computerized attention training (CAT)	Active computerized attention training (CAT). Attention training via repeated trials of a modified anti-saccade task with concurrent assessment of eye-movements intended to direct attention towards food stimuli using pictorial food and non-food stimuli (see Werthmann, Field, Roefs, Nederkoorn, \& Jansen, 2014).

Primary Outcome Measures

Name	Time	Method
Attention bias	max. 2 weeks (pre and post attention bias modification training)	The dot-probe task with concurrent assessment of eye-movements will be used for the assessment of attention bias at baseline and post-treatment.

Secondary Outcome Measures

Name	Time	Method
Body Mass Index	max. 2 (pre and post attention bias modification training) and after 4 weeks (follow-up).	Weight and height will be assessed to calculate BMI and assess whether BMI changes occurred during the study period due to CAT
Eating Disorder symptoms	max. 2 week (pre and post attention bias modification training) and at 4 weeks follow-up	The Eating Disorder Examination Questionnaire (EDE-Q, Fairburn \& Belgin, 1994) is a commonly used index for AN symptoms and will be assessed at baseline and post-treatment and at 4 weeks follow-up.

Trial Locations

Locations (1)

Institute of Psychiatry, Psychology and Neuroscience; 🇬🇧 London, United Kingdom