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Cognitive‐behavioral therapy for avoidant/restrictive food intake disorder: A proof‐of‐concept for mechanisms of change and target engagement.

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Title: Cognitive‐behavioral therapy for avoidant/restrictive food intake disorder: A proof‐of‐concept for mechanisms of change and target engagement.
Authors: Burton‐Murray, Helen, Becker, Kendra R., Breithaupt, Lauren, Gardner, Elizabeth, Dreier, Melissa J., Stern, Casey M., Misra, Madhusmita, Lawson, Elizabeth A., Ljótsson, Brjánn, Eddy, Kamryn T., Thomas, Jennifer J.
Source: International Journal of Eating Disorders. May2024, Vol. 57 Issue 5, p1260-1267. 8p.
Subjects: Treatment of eating disorders, Statistical correlation, Research funding, Pilot projects, Behavior, Treatment effectiveness, Descriptive statistics, Appetite, Motivation (Psychology), Research, Food habits, Cognitive therapy, Comparative studies, Food preferences
Abstract: Background: Cognitive‐behavioral therapy for avoidant/restrictive food intake disorder (ARFID; CBT‐AR) theoretically targets three prototypic motivations (sensory sensitivity, lack of interest/low appetite, fear of aversive consequences), aligned with three modularized interventions. As an exploratory investigation, we: (1) evaluated change in candidate mechanisms in relationship to change in ARFID severity, and (2) tested if assignment (vs. not) to a module resulted in larger improvements in the corresponding mechanism. Method: Males and females (N = 42; 10–55 years) participated in an open trial of CBT‐AR. Results: Decreases in scaled scores for each candidate mechanism had medium to large correlations with decreases in ARFID severity—sensory sensitivity: −0.7 decrease (r =.42, p =.01); lack of interest/low appetite: −0.3 decrease (r =.60, p <.0001); and fear of aversive consequences: −1.1 decrease (r =.33, p =.05). Linear mixed models revealed significant weekly improvements for each candidate mechanism across the full sample (ps <.0001). There were significant interactions for the sensory and fear of aversive consequences modules–for each, participants who received the corresponding module had significantly larger decreases in the candidate mechanism than those who did not receive the module. Discussion: Sensory sensitivity and fear of aversive consequences improved more if the CBT‐AR module was received, but lack of interest/low appetite may improve regardless of receipt of the corresponding module. Future research is needed to test target engagement in CBT‐AR with adaptive treatment designs, and to identify valid and sensitive measures of candidate mechanisms. Public Significance: The mechanisms through which components of CBT‐AR work have yet to be elucidated. We conducted an exploratory investigation to test if assignment (vs. not) to a CBT‐AR module resulted in larger improvements in the corresponding prototypic ARFID motivation that the module intended to target. Measures of the sensory sensitivity and the fear of aversive consequences motivations improved more in those who received the corresponding treatment module, whereas the lack of interest/low appetite measure improved regardless of if the corresponding module was received. [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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  Data: Cognitive‐behavioral therapy for avoidant/restrictive food intake disorder: A proof‐of‐concept for mechanisms of change and target engagement.
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22International+Journal+of+Eating+Disorders%22&quot;&gt;International Journal of Eating Disorders&lt;/searchLink&gt;. May2024, Vol. 57 Issue 5, p1260-1267. 8p.
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  Data: Background: Cognitive‐behavioral therapy for avoidant/restrictive food intake disorder (ARFID; CBT‐AR) theoretically targets three prototypic motivations (sensory sensitivity, lack of interest/low appetite, fear of aversive consequences), aligned with three modularized interventions. As an exploratory investigation, we: (1) evaluated change in candidate mechanisms in relationship to change in ARFID severity, and (2) tested if assignment (vs. not) to a module resulted in larger improvements in the corresponding mechanism. Method: Males and females (N = 42; 10–55 years) participated in an open trial of CBT‐AR. Results: Decreases in scaled scores for each candidate mechanism had medium to large correlations with decreases in ARFID severity—sensory sensitivity: −0.7 decrease (r =.42, p =.01); lack of interest/low appetite: −0.3 decrease (r =.60, p &lt;.0001); and fear of aversive consequences: −1.1 decrease (r =.33, p =.05). Linear mixed models revealed significant weekly improvements for each candidate mechanism across the full sample (ps &lt;.0001). There were significant interactions for the sensory and fear of aversive consequences modules–for each, participants who received the corresponding module had significantly larger decreases in the candidate mechanism than those who did not receive the module. Discussion: Sensory sensitivity and fear of aversive consequences improved more if the CBT‐AR module was received, but lack of interest/low appetite may improve regardless of receipt of the corresponding module. Future research is needed to test target engagement in CBT‐AR with adaptive treatment designs, and to identify valid and sensitive measures of candidate mechanisms. Public Significance: The mechanisms through which components of CBT‐AR work have yet to be elucidated. We conducted an exploratory investigation to test if assignment (vs. not) to a CBT‐AR module resulted in larger improvements in the corresponding prototypic ARFID motivation that the module intended to target. Measures of the sensory sensitivity and the fear of aversive consequences motivations improved more in those who received the corresponding treatment module, whereas the lack of interest/low appetite measure improved regardless of if the corresponding module was received. [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=177219742
RecordInfo BibRecord:
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    Identifiers:
      – Type: doi
        Value: 10.1002/eat.24126
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 8
        StartPage: 1260
    Subjects:
      – SubjectFull: Treatment of eating disorders
        Type: general
      – SubjectFull: Statistical correlation
        Type: general
      – SubjectFull: Research funding
        Type: general
      – SubjectFull: Pilot projects
        Type: general
      – SubjectFull: Behavior
        Type: general
      – SubjectFull: Treatment effectiveness
        Type: general
      – SubjectFull: Descriptive statistics
        Type: general
      – SubjectFull: Appetite
        Type: general
      – SubjectFull: Motivation (Psychology)
        Type: general
      – SubjectFull: Research
        Type: general
      – SubjectFull: Food habits
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      – SubjectFull: Cognitive therapy
        Type: general
      – SubjectFull: Comparative studies
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      – SubjectFull: Food preferences
        Type: general
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      – TitleFull: Cognitive‐behavioral therapy for avoidant/restrictive food intake disorder: A proof‐of‐concept for mechanisms of change and target engagement.
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            – D: 01
              M: 05
              Text: May2024
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