Cognitive and neural mechanisms of cognitive-behavioral therapy for avoidant/restrictive food intake disorder
Cognitive and neural mechanisms of cognitive-behavioral therapy for avoidant/restrictive food intake disorder
批准号:
10570372
负责人:
Kamryn T Eddy
金额:
$108.3万
依托单位国家:
美国
项目类别:
财政年份:
2023
资助国家:
美国
项目状态:
未结题
起止时间:
2023-09-07 至 2025-08-31
关键词:
AdolescentAdultAdvocateAffectAftercareAgeAmygdaloid structureAnteriorBrain regionCentral Nervous SystemChildChronicClinicalClinical TrialsCognitiveCognitive TherapyCounselingCuesDataDependenceDevelopmentDisease remissionDoseEatingEating DisordersEvidence based treatmentExhibitsFoodFrightFunctional Magnetic Resonance ImagingHyperactivityImpairmentIndividualInterventionInterviewInvestigational TherapiesLearningMalnutritionManualsMeasuresMediatingMedicalMotivationNational Institute of Mental HealthOccupational TherapyOutcomePatientsPersonsPhasePica DiseasePreventionRandomizedRandomized, Controlled TrialsRecommendationRiskRumination DisordersStandardizationStatistical Data InterpretationTestingTherapeutic InterventionThinkingValidationWorkYouthactive controlarmavoidant restrictive food intake disorderbehavior changecingulate cortexclinical trial analysisdietary supplementseffectiveness trialefficacy trialfood avoidancemultidisciplinaryneuromechanismnovelnutritionpressurepreventpsychologicpsychosocialresponsesevere mental illnesstelehealthtreatment of anxiety disorderstrend
中文摘要
摘要
英文摘要
ABSTRACT
Avoidant/restrictive food intake disorder (ARFID) affects 3% of children and adolescents and results
in nutritional deficiencies, supplement dependence, and psychosocial impairment. ARFID follows a chronic
course, and has no evidence-based treatment. The hallmark feature of ARFID is food avoidance, which may
be maintained by extreme levels of food neophobia and/or hyperactivation of fear circuitry in response to
food cues. Our team has developed a manualized cognitive-behavioral therapy (CBT-AR) that directly targets
both food neophobia (cognitive mechanism) and fear circuitry (neural mechanism) to reduce food avoidance
(clinical outcome). In line with NIMH’s experimental therapeutics approach, in this exploratory/developmental
phased R61/R33, we will leverage a multidisciplinary team of experts in the treatment of ARFID, neural
mechanisms of food motivation, and statistical analysis of clinical trials to conduct a mechanistic randomized
controlled trial of CBT-AR. First, to establish target engagement, we will randomize 50 youth (ages 10-18yo)
with ARFID in a 1:1 ratio to 15 weekly sessions (via telehealth) of CBT-AR vs. nutrition counseling to establish
target engagement. We chose nutrition counseling as our active control because it does not include the
crucial CBT-AR intervention of exposure, and is therefore unlikely to engage our target mechanisms. We
hypothesize that, compared to nutrition counseling, patients randomized to CBT-AR will show significantly
greater decreases in food neophobia (cognitive mechanism) and fear circuitry (neural mechanism) in
response to food cues during a standardized fMRI food cue paradigm (primary ROI: anterior cingulate cortex
[ACC]; secondary ROIs: amygdala, orbitofrontal cortex [OFC]). We will also examine weekly change in food
neophobia (cognitive mechanism) to identify the number of sessions at which further benefit ceases, and use
this optimized dose of CBT-AR for the R33. We will move on to the R33 if we are able to demonstrate a
reduction of at least d=.40 in the CBT-AR group from pre- to post-treatment AND a post-treatment between-
group difference of at least d=.40 in CBT-AR vs. nutrition counseling in either food neophobia (cognitive
mechanism) OR fear circuitry (Go/No-Go ROI: ACC; neural mechanism). Next, we will randomize 70 youth
(ages 10-18yo) with ARFID in a 1:1 fashion to the optimized dose of CBT-AR or the same number of sessions
of nutrition counseling to replicate target engagement and establish target validation. We hypothesize that,
compared to nutrition counseling, patients randomized to CBT-AR will exhibit significantly greater reductions
in food avoidance, and that these reductions in food avoidance will be mediated by reductions in food
neophobia (cognitive mechanism) and fear circuitry (neural mechanism) activation. If successful, the
proposed intervention (CBT-AR) could fill an important unmet need for those living with ARFID and pave the
way for larger-scale efficacy and effectiveness trials.
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会议论文
The Role of Estrogen in the Neurobiology of Eating Disorders: A Study of Cognitive Flexibility and Reward in Eating Disorders
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批准号:9889997
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项目类别:
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资助金额:$81.48万
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财政年份:2019
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负责人:Kamryn T Eddy
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依托单位:
The Role of Estrogen in the Neurobiology of Eating Disorders: A Study of Cognitive Flexibility and Reward in Eating Disorders
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批准号:10311480
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项目类别:
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资助金额:$78.31万
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财政年份:2019
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负责人:Kamryn T Eddy
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依托单位:
NOSI to The Role of Estrogen in the Neurobiology of Eating Disorders: A Study of Cognitive Flexibility and Reward in Eating Disorders
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批准号:10766612
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项目类别:
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资助金额:$46.3万
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财政年份:2019
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负责人:Kamryn T Eddy
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依托单位:
The Role of Estrogen in the Neurobiology of Eating Disorders: A Study of Cognitive Flexibility and Reward in Eating Disorders
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批准号:10756236
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项目类别:
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资助金额:$4.99万
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财政年份:2019
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负责人:Kamryn T Eddy
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依托单位:
The Role of Estrogen in the Neurobiology of Eating Disorders: A Study of Cognitive Flexibility and Reward in Eating Disorders
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批准号:10492860
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项目类别:
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资助金额:$9.06万
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财政年份:2019
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负责人:Kamryn T Eddy
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依托单位:
The Role of Estrogen in the Neurobiology of Eating Disorders: A Study of Cognitive Flexibility and Reward in Eating Disorders
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批准号:10415333
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项目类别:
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资助金额:$4.32万
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财政年份:2019
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负责人:Kamryn T Eddy
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依托单位:
The Role of Estrogen in the Neurobiology of Eating Disorders: A Study of Cognitive Flexibility and Reward in Eating Disorders
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批准号:10591474
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项目类别:
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资助金额:$80.86万
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财政年份:2019
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负责人:Kamryn T Eddy
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依托单位:
Homeostatic and Hedonic Food Motivation Underlying Eating Disorder Trajectories
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批准号:9036458
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项目类别:
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资助金额:$66.32万
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财政年份:2014
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负责人:Kamryn T Eddy
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依托单位:
Homeostatic and Hedonic Food Motivation Underlying Eating Disorder Trajectories
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批准号:8678071
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项目类别:
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资助金额:$67.54万
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财政年份:2014
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负责人:Kamryn T Eddy
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依托单位:
Homeostatic and Hedonic Food Motivation Underlying Eating Disorder Trajectories
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批准号:8903629
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项目类别:
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资助金额:$4.44万
-
财政年份:2014
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负责人:Kamryn T Eddy
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依托单位:
Homeostatic and Hedonic Food Motivation Underlying Eating Disorder Trajectories
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批准号:8826182
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项目类别:
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资助金额:$69.49万
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财政年份:2014
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负责人:Kamryn T Eddy
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依托单位:
Defining Recovery for Anorexia and Bulimia Nervosa: A 25-Year Outcome Study
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批准号:8267009
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项目类别:
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资助金额:$8.85万
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财政年份:2011
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负责人:Kamryn T Eddy
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依托单位:
Empirical identification and validation of eating disorder phenotypes
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批准号:7796771
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项目类别:
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资助金额:$5.05万
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财政年份:2009
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负责人:Kamryn T Eddy
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依托单位:
Empirical identification and validation of eating disorder phenotypes
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批准号:7670708
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项目类别:
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资助金额:$5.15万
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财政年份:2009
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负责人:Kamryn T Eddy
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依托单位:
Eating pathology among youth with obesity
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批准号:6925499
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项目类别:
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资助金额:$3.0万
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财政年份:2004
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负责人:Kamryn T Eddy
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依托单位:
Eating pathology among youth with obesity
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批准号:6836328
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项目类别:
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资助金额:$3.0万
-
财政年份:2004
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负责人:Kamryn T Eddy
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依托单位:
海外基金