Impact of virtual adjunctive cognitive remediation therapy on cognitive flexibility and treatment outcomes in comorbid anorexia nervosa and exercise dependence as quantified using novel biomarkers: A stage 1 registered report.
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| Title: | Impact of virtual adjunctive cognitive remediation therapy on cognitive flexibility and treatment outcomes in comorbid anorexia nervosa and exercise dependence as quantified using novel biomarkers: A stage 1 registered report. |
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| Authors: | Miller, McKenzie L., Sanzari, Christina M., Timko, C. Alix, Hormes, Julia M. |
| Source: | International Journal of Eating Disorders. Jul2023, Vol. 56 Issue 7, p1449-1460. 12p. 1 Diagram, 1 Chart. |
| Subjects: | Anorexia nervosa treatment, Cognitive flexibility, Executive function, Oxytocin, Biomarkers, Convalescence, Cognition, Treatment effectiveness, Suicidal ideation, Exercise, Heart beat, Research funding, Cognitive remediation |
| Abstract: | Objective: Anorexia nervosa (AN) is associated with significant individual mental and physical suffering and public health burden and fewer than half of patients recover fully with current treatments. Comorbid exercise dependence (ExD) is common in AN and associated with significantly worse symptom severity and treatment outcomes. Research points to cognitive inflexibility as a prominent executive function inefficiency and transdiagnostic etiologic and maintaining mechanism linking AN and ExD. This study will evaluate the initial efficacy of adjunctive Cognitive Remediation Therapy (CRT), which has been shown to produce cognitive improvements in adults with AN, in targeting cognitive inflexibility in individuals with comorbid AN and ExD. As an exploratory aim, this study also addresses the current lack of quick and cost‐effective assessments of cognitive flexibility by establishing the utility of two proposed biomarkers, heart rate variability and salivary oxytocin. Method: We will conduct a single‐group, within‐subjects trial of an established CRT protocol delivered remotely as an adjunct to inpatient or intensive outpatient treatment as usual (TAU) to adult patients (n = 42) with comorbid AN and ExD. Assessments, including self‐report, neuropsychological, and biomarker measurements, will occur at three time points. Results: We expect CRT to increase cognitive flexibility transdiagnostically and consequently, along with TAU, positively impact AN and ExD compulsivity and symptom severity, including weight gain. Discussion: Findings will inform the development of more effective integrative interventions for AN and ExD targeting shared mechanisms and facilitate the routine assessment of cognitive flexibility as a transdiagnostic risk and maintaining factor across psychopathologies in clinical and research settings. Public Significance: Patients with anorexia nervosa often engage in excessive exercise, leading to harmful outcomes, including increased suicidal behavior. This study examines the preliminary efficacy of an intervention that fosters flexible and holistic thinking in patients with problematic eating and exercise to, along with routine treatment, decrease harmful exercise symptoms. This study also examines new biological markers of the inflexible thinking style thought to be characteristic of anorexia nervosa and exercise dependence. [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.) | |
| Database: | Psychology and Behavioral Sciences Collection |
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| Header | DbId: pbh DbLabel: Psychology and Behavioral Sciences Collection An: 165046322 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: Impact of virtual adjunctive cognitive remediation therapy on cognitive flexibility and treatment outcomes in comorbid anorexia nervosa and exercise dependence as quantified using novel biomarkers: A stage 1 registered report. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Miller%2C+McKenzie+L%2E%22">Miller, McKenzie L.</searchLink><br /><searchLink fieldCode="AR" term="%22Sanzari%2C+Christina+M%2E%22">Sanzari, Christina M.</searchLink><br /><searchLink fieldCode="AR" term="%22Timko%2C+C%2E+Alix%22">Timko, C. Alix</searchLink><br /><searchLink fieldCode="AR" term="%22Hormes%2C+Julia+M%2E%22">Hormes, Julia M.</searchLink> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22International+Journal+of+Eating+Disorders%22">International Journal of Eating Disorders</searchLink>. Jul2023, Vol. 56 Issue 7, p1449-1460. 12p. 1 Diagram, 1 Chart. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Anorexia+nervosa+treatment%22">Anorexia nervosa treatment</searchLink><br /><searchLink fieldCode="DE" term="%22Cognitive+flexibility%22">Cognitive flexibility</searchLink><br /><searchLink fieldCode="DE" term="%22Executive+function%22">Executive function</searchLink><br /><searchLink fieldCode="DE" term="%22Oxytocin%22">Oxytocin</searchLink><br /><searchLink fieldCode="DE" term="%22Biomarkers%22">Biomarkers</searchLink><br /><searchLink fieldCode="DE" term="%22Convalescence%22">Convalescence</searchLink><br /><searchLink fieldCode="DE" term="%22Cognition%22">Cognition</searchLink><br /><searchLink fieldCode="DE" term="%22Treatment+effectiveness%22">Treatment effectiveness</searchLink><br /><searchLink fieldCode="DE" term="%22Suicidal+ideation%22">Suicidal ideation</searchLink><br /><searchLink fieldCode="DE" term="%22Exercise%22">Exercise</searchLink><br /><searchLink fieldCode="DE" term="%22Heart+beat%22">Heart beat</searchLink><br /><searchLink fieldCode="DE" term="%22Research+funding%22">Research funding</searchLink><br /><searchLink fieldCode="DE" term="%22Cognitive+remediation%22">Cognitive remediation</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Objective: Anorexia nervosa (AN) is associated with significant individual mental and physical suffering and public health burden and fewer than half of patients recover fully with current treatments. Comorbid exercise dependence (ExD) is common in AN and associated with significantly worse symptom severity and treatment outcomes. Research points to cognitive inflexibility as a prominent executive function inefficiency and transdiagnostic etiologic and maintaining mechanism linking AN and ExD. This study will evaluate the initial efficacy of adjunctive Cognitive Remediation Therapy (CRT), which has been shown to produce cognitive improvements in adults with AN, in targeting cognitive inflexibility in individuals with comorbid AN and ExD. As an exploratory aim, this study also addresses the current lack of quick and cost‐effective assessments of cognitive flexibility by establishing the utility of two proposed biomarkers, heart rate variability and salivary oxytocin. Method: We will conduct a single‐group, within‐subjects trial of an established CRT protocol delivered remotely as an adjunct to inpatient or intensive outpatient treatment as usual (TAU) to adult patients (n = 42) with comorbid AN and ExD. Assessments, including self‐report, neuropsychological, and biomarker measurements, will occur at three time points. Results: We expect CRT to increase cognitive flexibility transdiagnostically and consequently, along with TAU, positively impact AN and ExD compulsivity and symptom severity, including weight gain. Discussion: Findings will inform the development of more effective integrative interventions for AN and ExD targeting shared mechanisms and facilitate the routine assessment of cognitive flexibility as a transdiagnostic risk and maintaining factor across psychopathologies in clinical and research settings. Public Significance: Patients with anorexia nervosa often engage in excessive exercise, leading to harmful outcomes, including increased suicidal behavior. This study examines the preliminary efficacy of an intervention that fosters flexible and holistic thinking in patients with problematic eating and exercise to, along with routine treatment, decrease harmful exercise symptoms. This study also examines new biological markers of the inflexible thinking style thought to be characteristic of anorexia nervosa and exercise dependence. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>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.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1002/eat.23942 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 12 StartPage: 1449 Subjects: – SubjectFull: Anorexia nervosa treatment Type: general – SubjectFull: Cognitive flexibility Type: general – SubjectFull: Executive function Type: general – SubjectFull: Oxytocin Type: general – SubjectFull: Biomarkers Type: general – SubjectFull: Convalescence Type: general – SubjectFull: Cognition Type: general – SubjectFull: Treatment effectiveness Type: general – SubjectFull: Suicidal ideation Type: general – SubjectFull: Exercise Type: general – SubjectFull: Heart beat Type: general – SubjectFull: Research funding Type: general – SubjectFull: Cognitive remediation Type: general Titles: – TitleFull: Impact of virtual adjunctive cognitive remediation therapy on cognitive flexibility and treatment outcomes in comorbid anorexia nervosa and exercise dependence as quantified using novel biomarkers: A stage 1 registered report. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Miller, McKenzie L. – PersonEntity: Name: NameFull: Sanzari, Christina M. – PersonEntity: Name: NameFull: Timko, C. Alix – PersonEntity: Name: NameFull: Hormes, Julia M. IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 07 Text: Jul2023 Type: published Y: 2023 Identifiers: – Type: issn-print Value: 02763478 Numbering: – Type: volume Value: 56 – Type: issue Value: 7 Titles: – TitleFull: International Journal of Eating Disorders Type: main |
| ResultId | 1 |
