Clinical trial NCT02484599: Look at Food and Lose Your Fear - Evaluation of a Computerized Attention Training (CAT) for Anorexia Nervosa Patients
Official title: Evaluation of a Computerized Attention Training (CAT) to Modify Attention Bias for Food Cues in Anorexia Nervosa Patients
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: PHASE1
Conditions: Anorexia Nervosa
Keywords: Eating Disorders
Anorexia Nervosa
Attention bias
Attention bias modification
Lead sponsor: King's College London
Sponsor class: OTHER
Collaborators: name: Netherlands Organisation for Scientific Research
First posted: 2015-06-29
Enrollment: 50
Sex: FEMALE
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

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).

Eligibility criteria: 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

Primary outcomes:
measure: Attention bias
timeFrame: max. 2 weeks (pre and post attention bias modification training)
Secondary outcomes:
measure: Eating Disorder symptoms
timeFrame: max. 2 week (pre and post attention bias modification training) and at 4 weeks follow-up
measure: Body Mass Index
timeFrame: max. 2 (pre and post attention bias modification training) and after 4 weeks (follow-up).
Other outcomes:
measure: Eating Behaviour
timeFrame: max. 2 weeks
measure: Approach and avoidance tendencies
timeFrame: max. 2 weeks
Locations:
city: London
country: United Kingdom
facility: Institute of Psychiatry, Psychology and Neuroscience
Study officials:
affiliation: Institute of Psychiatry, Psychology and Neuroscience, King's College London
name: Jessica Werthmann, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Neimeijer RA, de Jong PJ, Roefs A. Automatic approach/avoidance tendencies towards food and the course of anorexia nervosa. Appetite. 2015 Aug;91:28-34. doi: 10.1016/j.appet.2015.03.018. Epub 2015 Mar 24.
citation: Werthmann J, Field M, Roefs A, Nederkoorn C, Jansen A. Attention bias for chocolate increases chocolate consumption--an attention bias modification study. J Behav Ther Exp Psychiatry. 2014 Mar;45(1):136-43. doi: 10.1016/j.jbtep.2013.09.009. Epub 2013 Sep 29.