Reward Re-Training: A New Treatment to Address Reward Imbalance During the COVID-19 Pandemic
Condition: Bulimia Nervosa; Bulimia; Atypical; Binge Eating; Binge-Eating Disorder
MeSH terms: COVID-19; Bulimia; Feeding and Eating Disorders; Binge-Eating Disorder; Bulimia Nervosa
Study type: Interventional

Summary: 
      In the current study, the investigators will revise our existing 10-session group RRT
      treatment manual to specifically address the challenges in building social support and
      enhancing both momentary and sustained reward during the COVID-19 pandemic (Preliminary Aim
      1). In months 2-18, the investigators will conduct a small pilot RCT that will randomize
      individuals to receive either 10-sessions of RRT (n=30) or supportive therapy (n=30), both
      delivered as group-treatments via videoconferencing software. The specific aims of the
      current study are to confirm the feasibility and acceptability of RRT for EDs (Primary Aim
      1), evaluate the ability of RRT to engage critical targets including reward to day-to-day
      life activities, reward to palatable foods, social isolation, and loneliness (Primary Aim 2),
      and provide preliminary estimates of efficacy in reducing ED symptoms at both post-treatment
      and a 3-month follow-up (Primary Aim 3). the investigators will also evaluate the impact of
      RRT on secondary outcome variables including depression, substance use, and quality of life
      (Secondary Aim 1).
    


Intervention name(s): Reward Re-Training; Supportive Therapy
Intervention type(s): Behavioral; Behavioral
Intervention description(s): A brief, 10-session group-based behavioral treatment that is designed to indirectly change binge eating by directly focusing on building a more rewarding life. RRT hypothesizes that reductions in binge eating will occur as life becomes more rewarding because individuals will no longer need to rely on binge eating as a primary source of momentary reward. RRT notes that in order to live a satisfying life, individuals need to experience an adequate amount of reward in two overlapping yet distinguishable domains: momentary reward (i.e., the active experience of pleasure in the moment) and sustained reward (i.e., a deeper and more long-lasting sense of fulfillment and meaning that arises from building a personally valued life). A key aspect of RRT is an emphasize on building lasting and meaningful social relationships given the clear evidence that social connectedness can enhance both momentary reward and sustained reward.; A brief, 10-session group-based treatment that is designed to instill hope and optimism and to increase social connection and support through a non-directive group leader that allows the patients to determine the focus of each session. The group leader will act as an empathetic provider by using reflective listening, eliciting and validating affect, and offering empathic comments.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: Eating Disorders; Bulimia Nervosa; Binge Eating Disorder; Binge Eating; Reward Re-training; Supportive Psychotherapy