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Development of a brief cognitive‐behavioral treatment for avoidant/restrictive food intake disorder in the context of disorders of gut–brain interaction: Initial feasibility, acceptability, and clinical outcomes.

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Title: Development of a brief cognitive‐behavioral treatment for avoidant/restrictive food intake disorder in the context of disorders of gut–brain interaction: Initial feasibility, acceptability, and clinical outcomes.
Authors: Burton Murray, Helen, Weeks, Imani, Becker, Kendra R., Ljótsson, Brjánn, Madva, Elizabeth N., Eddy, Kamryn T., Staller, Kyle, Kuo, Braden, Thomas, Jennifer J.
Source: International Journal of Eating Disorders. Mar2023, Vol. 56 Issue 3, p616-627. 12p. 5 Charts.
Subjects: Treatment of eating disorders, Brief psychotherapy, Brain, Gastrointestinal system, Brain diseases, Scientific observation, Research methodology, Gastrointestinal diseases, Gastroenterology, Retrospective studies, Interviewing, Treatment effectiveness, Research funding, Descriptive statistics, Cognitive therapy, Outpatient services in hospitals, Longitudinal method, Adults
Abstract: Background: Avoidant/restrictive food intake disorder (ARFID) symptoms are common (up to 40%) among adults with disorders of gut‐brain interaction (DGBI), but treatments for this population (DGBI + ARFID) have yet to be evaluated. We aimed to identify initial feasibility, acceptability, and clinical effects of an exposure‐based cognitive‐behavioral treatment (CBT) for adults with DGBI + ARFID. Methods: Patients (N = 14) received CBT as part of routine care in an outpatient gastroenterology clinic. A two‐part investigation of the CBT included a retrospective evaluation of patients who were offered a flexible (8–10) session length and an observational prospective study of patients who were offered eight sessions. Feasibility benchmarks were ≥75% completion of sessions, quantitative measures (for treatment completers), and qualitative interviews. Acceptability was assessed with a benchmark of ≥70% patients reporting a posttreatment satisfaction scores ≥3 on 1–4 scale and with posttreatment qualitative interviews. Mixed model analysis explored signals of improvement in clinical outcomes. Results: All feasibility and acceptability benchmarks were achieved (and qualitative feedback revealed high satisfaction with the treatment and outcomes). There were improvements in clinical outcomes across treatment (all p's <.0001) with large effects for ARFID fear (−52%; Hedge's g = 1.5; 95% CI = 0.6, 2.5) and gastrointestinal‐specific anxiety (−42%; Hedge's g = 1.0; 95% CI = 0.5, 16). Among those who needed to gain weight (n = 10), 94%–103% of expected weight gain goals were achieved. Discussion: Initial development and testing of a brief 8‐session CBT protocol for DGBI + ARFID showed high feasibility, acceptability, and promising clinical improvements. Findings will inform an NIH Stage 1B randomized control trial. Public significance: While cognitive‐behavioral treatments (CBTs) for ARFID have been created in outpatient feeding and eating disorder clinics, they have yet to be developed and refined for other clinic settings or populations. In line with the recommendations for behavioral treatment development, we conducted a two‐part investigation of an exposure‐based CBT for a patient population with high rates of ARFID—adults with disorders of gut–brain interaction (also known as functional gastrointestinal disorders). We found patients had high satisfaction with treatment and there were promising improvements for both gastrointestinal and ARFID outcomes. The refined treatment includes eight sessions delivered by a behavioral health care provider and the findings reported in this article will be studied next in an NIH Stage 1B randomized controlled trial. [ABSTRACT FROM AUTHOR]
Copyright of International Journal of Eating Disorders is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Background: Avoidant/restrictive food intake disorder (ARFID) symptoms are common (up to 40%) among adults with disorders of gut‐brain interaction (DGBI), but treatments for this population (DGBI + ARFID) have yet to be evaluated. We aimed to identify initial feasibility, acceptability, and clinical effects of an exposure‐based cognitive‐behavioral treatment (CBT) for adults with DGBI + ARFID. Methods: Patients (N = 14) received CBT as part of routine care in an outpatient gastroenterology clinic. A two‐part investigation of the CBT included a retrospective evaluation of patients who were offered a flexible (8–10) session length and an observational prospective study of patients who were offered eight sessions. Feasibility benchmarks were ≥75% completion of sessions, quantitative measures (for treatment completers), and qualitative interviews. Acceptability was assessed with a benchmark of ≥70% patients reporting a posttreatment satisfaction scores ≥3 on 1–4 scale and with posttreatment qualitative interviews. Mixed model analysis explored signals of improvement in clinical outcomes. Results: All feasibility and acceptability benchmarks were achieved (and qualitative feedback revealed high satisfaction with the treatment and outcomes). There were improvements in clinical outcomes across treatment (all p&#39;s &lt;.0001) with large effects for ARFID fear (−52%; Hedge&#39;s g = 1.5; 95% CI = 0.6, 2.5) and gastrointestinal‐specific anxiety (−42%; Hedge&#39;s g = 1.0; 95% CI = 0.5, 16). Among those who needed to gain weight (n = 10), 94%–103% of expected weight gain goals were achieved. Discussion: Initial development and testing of a brief 8‐session CBT protocol for DGBI + ARFID showed high feasibility, acceptability, and promising clinical improvements. Findings will inform an NIH Stage 1B randomized control trial. Public significance: While cognitive‐behavioral treatments (CBTs) for ARFID have been created in outpatient feeding and eating disorder clinics, they have yet to be developed and refined for other clinic settings or populations. In line with the recommendations for behavioral treatment development, we conducted a two‐part investigation of an exposure‐based CBT for a patient population with high rates of ARFID—adults with disorders of gut–brain interaction (also known as functional gastrointestinal disorders). We found patients had high satisfaction with treatment and there were promising improvements for both gastrointestinal and ARFID outcomes. The refined treatment includes eight sessions delivered by a behavioral health care provider and the findings reported in this article will be studied next in an NIH Stage 1B randomized controlled trial. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of International Journal of Eating Disorders is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=162168235
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        Value: 10.1002/eat.23874
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        Text: English
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        StartPage: 616
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      – SubjectFull: Treatment of eating disorders
        Type: general
      – SubjectFull: Brief psychotherapy
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      – SubjectFull: Brain
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      – SubjectFull: Gastrointestinal system
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      – SubjectFull: Brain diseases
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      – SubjectFull: Research methodology
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      – SubjectFull: Gastrointestinal diseases
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      – SubjectFull: Gastroenterology
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      – SubjectFull: Retrospective studies
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      – SubjectFull: Adults
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              Text: Mar2023
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