Comparing the Effectiveness of Two Therapies to Treat Signs of Anorexia Nervosa in Adolescents
Condition: Eating Disorders
MeSH terms: Anorexia; Feeding and Eating Disorders; Anorexia Nervosa
Study type: Interventional

Summary: 
      This study will compare the effectiveness of two therapies to treat early signs of anorexia
      nervosa in adolescents.
    

Detailed description: 
      Eating disorders often result in serious illness and can lead to prolonged health
      complications, including heart and kidney problems, digestive disorders, nerve damage, and
      low blood pressure. Anorexia nervosa is a type of eating disorder in which a person does not
      eat enough for fear of becoming overweight, resulting in extreme weight loss. Women are at a
      greater risk of developing this disease, particularly when they are between the ages of 12
      and 24. Treatments for anorexia nervosa typically include nutrition counseling,
      psychotherapy, and medication. The purpose of this study is to compare the effectiveness of
      two therapies to treat adolescents who have signs of anorexia nervosa but have not fully
      developed the disease.

      Potential participants will attend 2 screening visits during which parents and children will
      complete separate questionnaires and undergo 3 interviews regarding eating behaviors and
      changes in mood. Once screening evaluations have been completed, eligible participants will
      be randomly assigned to 1 of 2 treatment groups. Participants assigned to the first group
      will receive 14 family therapy sessions. All family members living with the child will be
      asked to attend these sessions with the child. Family members will learn strategies to help
      the child eat enough at home and will address various issues concerning family relationships.
      Children will learn how to eat well on their own and will also discuss topics related to
      family dynamics. Participants assigned to the second group will receive 14 individual therapy
      sessions that will focus on the child and not include family members. Before each treatment
      session, parents will speak with the therapist to discuss progress and any new concerns or
      issues regarding the child's condition. The therapist will then work directly with the child
      to discuss what may be causing the child's signs of anorexia nervosa and how to handle
      difficult emotions associated with the disorder. Participants in both treatment groups will
      attend 1-hour therapy sessions that will occur weekly for 8 sessions, then biweekly for 4
      sessions, and monthly for the last 2 sessions. Evaluations, lasting 3 to 4 hours, will occur
      before treatment begins, immediately following treatment, and 6 and 12 months post-treatment.
      Evaluations will consist of interviews and questionnaires used to assess whether treatment
      was effective in preventing participants from developing anorexia nervosa.
    

Intervention name(s): Family-Based Therapy ("Maudsley Method"); Individual Supportive Psychotherapy
Intervention type(s): Behavioral; Behavioral
Intervention description(s): The goal of FBT is to resolve the eating disorder and return the patient to healthy psychosocial and physiological development through active family involvement across three treatment phases. In Phase I, therapy is focused on the disordered eating. The therapist primarily makes careful, persistent requests for united parental action toward re-feeding and/or regulating eating habits and directs the discussion so as to create and reinforce a strong parental alliance around their efforts at feeding their child. In Phase II, the goal is to gradually transfer control over eating back to the participant, with the parents still maintaining general oversight and responsibility for continued progression toward healthy habits. In Phase III, the central goal is establishment of a healthy child or adolescent relationship with the parents where disordered eating is not the basis of interaction.; The goal of ISP is for the patient to understand and address the psychological issues underlying the origin and maintenance of the eating disorder. This work is done directly with the child/adolescent. In this treatment, eating disorders are seen as complicated (e.g., they tend to mask other underlying difficulties). In Phase I, the aims are to establish a sound therapeutic relationship, obtain a comprehensive description of the eating problem and its development, identify underlying problems that might be responsible for the disordered eating, and inform the patient about the dangers of eating disorders. Phase II encourages participants to explore underlying emotional problems, facilitates self-disclosure and expression of feelings, and fosters independence. Phase III focuses on how other underlying issues might affect future adjustment.
Other intervention name(s): FBT; Maudsley Method; ISP
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Anorexia Nervosa