Augmenting cognitive behavioral therapy with inhibitory control training

通过抑制控制训练增强认知行为疗法

基本信息

  • 批准号:
    9805416
  • 负责人:
  • 金额:
    $ 23.48万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2019
  • 资助国家:
    美国
  • 起止时间:
    2019-08-01 至 2022-05-31
  • 项目状态:
    已结题

项目摘要

PROJECT SUMMARY A large body of research demonstrates that deficits in inhibitory control, i.e., the ability to withhold, delay, or interrupt an automatic response, are a crucial maintaining factor for a large swath of rewarding maladaptive behaviors, such as binge eating, purging, self-injury, and substance abuse. While many patients with these behaviors benefit from cognitive behavioral therapies (CBTs), a large subset of patients experience suboptimal outcomes, likely because CBTs do not target directly inhibitory control. As such, there is growing interest whether inhibitory control trainings (ICTs; i.e., computer tasks in which participants are prompted to repeatedly withhold keypress responses to relevant stimuli) can produce improvements in inhibitory control and be a useful augmentation to CBT. Available data suggest that ICTs can produce changes in inhibitory control on the behavioral and neural circuitry levels (target engagement), and that improvements in inhibitory control can produce decreases in lab-based or short-term behavior (target validation). Yet, findings regarding ICT’s ability to produce sustained changes in behavior outside the laboratory remain mixed and limited. However, investigations of ICT that (1) utilize repeated, intensive trainings over a sustained time period; (2) are adaptive to an individual’s performance; and (3) are personalized to an individual’s behavior, have not been conducted. Additionally, we have insufficient understanding of the conditions (e.g., in clinical samples, moderators of response) under which ICTs are effective. As such, there is strong scientific premise for a test of target engagement, validation, and initial efficacy of a repeated, personalized ICT. While ICTs may improve outcomes for a number of disorders, patients with binge eating (i.e., episodes of eating large amounts of food in a discrete time period with a sense of loss of control), specifically those with a diagnosis of bulimia nervosa (BN) and binge eating disorder (BED), are well-suited for a test of ICT as an adjunct to CBT. We will evaluate whether a personalized, repeated computerized ICT can improve inhibitory control and outcomes from CBT for BN and BED. We will randomize individuals with BN (n=40) and BED (n=40; total n=80) to receive a daily, at- home adjunctive ICT or a sham training condition during the first four weeks of CBT. Our primary aims include: (1) Confirm target engagement, i.e., that ICT produces improvements in inhibitory control; (2) Test the hypothesis that CBT+ICT will produce greater improvements in binge eating frequency compared to CBT + sham and (3) Test the hypothesis that improvements in inhibitory control will be associated with changes in binge eating (i.e., target validation). Our secondary aims include: (1) Test the hypothesis that the effect of ICT on binge eating frequency will be strongest for individuals with poorer baseline levels of inhibitory control, greater approach tendencies to highly palatable food, and higher dietary restraint; (2) Test the feasibility and acceptability of a repeated ICT protocol in individuals with binge eating to inform a full-scale effectiveness RCT. As an exploratory aim, we will examine whether diagnosis (BN or BED) moderates the effect of ICT.
项目摘要 大量的研究表明,抑制控制的缺陷,即,保留、延迟或 打断自动反应,是一个关键的维持因素,为大量的奖励适应不良 行为,如暴饮暴食,净化,自伤,和药物滥用。虽然许多患有这些疾病的患者 行为受益于认知行为疗法(CBT),一个大的患者子集经历次优 结果,可能是因为CBTs不直接针对抑制控制。因此,越来越多的人 抑制控制训练(ICT;即,一种计算机任务,要求参与者反复 对相关刺激的按键反应)可以改善抑制控制, 对CBT的有益补充。现有数据表明,信息和通信技术可以改变对环境的抑制控制, 行为和神经回路水平(目标参与),以及抑制控制的改善可以 产生基于实验室或短期行为的减少(目标验证)。然而,关于信息和通信技术能力的调查结果 在实验室外产生持续的行为变化仍然是混合和有限的。然而,在这方面, 对信息和通信技术的调查,(1)在持续的时间内利用重复的密集培训;(2)是适应性的 个人的表现;(3)个性化的个人的行为,没有进行。 此外,我们对条件的了解不足(例如,在临床样本中, 信息和通信技术在其中发挥作用。因此,靶向试验有很强的科学前提 重复的、个性化的ICT的参与、验证和初步功效。虽然信息和通信技术可以改善 许多疾病的结果,暴饮暴食的患者(即,大量进食的情况 在一个离散的时间段与失去控制的感觉),特别是那些与神经性贪食症的诊断 (BN)和暴食症(BED),非常适合作为CBT的辅助测试ICT。我们将评估 个性化的、重复的计算机化ICT是否可以改善CBT的抑制控制和结果, BN和床。我们将随机分配BN(n=40)和BED(n=40;总计n=80)患者,每天接受- 在CBT的前四周内进行家庭辅助ICT或假训练条件。我们的主要目标包括: (1)确认目标交战,即,ICT产生抑制控制的改善;(2)测试 假设与CBT +相比,CBT+ICT将更好地改善暴饮暴食的频率 (3)检验抑制控制的改善与以下因素的变化相关的假设: 暴饮暴食(即,目标验证)。我们的次要目的包括:(1)检验ICT的影响假设, 暴饮暴食的频率对于抑制控制的基线水平较差的个体将是最强的, 更大的方法倾向于高可口的食物,和更高的饮食限制;(2)测试的可行性, 对暴饮暴食者重复ICT方案的可接受性,以告知全面有效性 RCT。作为一个探索性的目标,我们将检查诊断(BN或BED)是否会调节ICT的效果。

项目成果

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Stephanie Manasse其他文献

Stephanie Manasse的其他文献

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{{ truncateString('Stephanie Manasse', 18)}}的其他基金

Wellness Achieved Through Changing Habits (WATCH): An Acceptance-Based Healthy Lifestyle Intervention for Diverse Adolescents
通过改变习惯实现健康(WATCH):针对不同青少年的基于接受的健康生活方式干预
  • 批准号:
    10738846
  • 财政年份:
    2023
  • 资助金额:
    $ 23.48万
  • 项目类别:
Does aberrant decision-making prevent success in adolescent behavioral weight loss treatment?
异常决策是否会妨碍青少年行为减肥治疗的成功?
  • 批准号:
    10613901
  • 财政年份:
    2020
  • 资助金额:
    $ 23.48万
  • 项目类别:
Does aberrant decision-making prevent success in adolescent behavioral weight loss treatment?
异常决策是否会妨碍青少年行为减肥治疗的成功?
  • 批准号:
    10054854
  • 财政年份:
    2020
  • 资助金额:
    $ 23.48万
  • 项目类别:
Does aberrant decision-making prevent success in adolescent behavioral weight loss treatment?
异常决策是否会妨碍青少年行为减肥治疗的成功?
  • 批准号:
    10397648
  • 财政年份:
    2020
  • 资助金额:
    $ 23.48万
  • 项目类别:
Does aberrant decision-making prevent success in adolescent behavioral weight loss treatment?
异常决策是否会妨碍青少年行为减肥治疗的成功?
  • 批准号:
    10508085
  • 财政年份:
    2020
  • 资助金额:
    $ 23.48万
  • 项目类别:
Does aberrant decision-making prevent success in adolescent behavioral weight loss treatment?
异常决策是否会妨碍青少年行为减肥治疗的成功?
  • 批准号:
    10219244
  • 财政年份:
    2020
  • 资助金额:
    $ 23.48万
  • 项目类别:
Novel assessment of affective distress intolerance in binge eating
暴饮暴食中情感痛苦不耐受的新评估
  • 批准号:
    9229480
  • 财政年份:
    2015
  • 资助金额:
    $ 23.48万
  • 项目类别:
Novel assessment of affective distress intolerance in binge eating
暴饮暴食中情感痛苦不耐受的新评估
  • 批准号:
    9050769
  • 财政年份:
    2015
  • 资助金额:
    $ 23.48万
  • 项目类别:

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