Cognitive and neural mechanisms of cognitive-behavioral therapy for avoidant/restrictive food intake disorder
回避/限制性食物摄入障碍的认知行为疗法的认知和神经机制
基本信息
- 批准号:10570372
- 负责人:
- 金额:$ 108.3万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2023
- 资助国家:美国
- 起止时间:2023-09-07 至 2025-08-31
- 项目状态:未结题
- 来源:
- 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
项目摘要
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.
抽象的
回避/限制性食物摄入障碍 (ARFID) 影响 3% 的儿童和青少年及其结果
营养缺乏、补充剂依赖和心理社会障碍。 ARFID 遵循一个长期的
当然,并且没有循证治疗。 ARFID 的标志性特征是避免食物,这可能
通过极端水平的食物新恐惧症和/或恐惧电路的过度激活来应对
食物线索。我们的团队开发了一种手动认知行为疗法(CBT-AR),直接针对
食物恐惧症(认知机制)和恐惧回路(神经机制)都可以减少食物回避
(临床结果)。根据 NIMH 的实验治疗方法,在这个探索性/发展性的治疗中
分阶段 R61/R33,我们将利用多学科专家团队来治疗 ARFID、神经
食物动机的机制,以及临床试验的统计分析,以进行机制随机
CBT-AR 的对照试验。首先,为了建立目标参与度,我们将随机抽取 50 名青少年(10-18 岁)
以 1:1 的比例使用 ARFID 进行每周 15 次 CBT-AR 会议(通过远程医疗)与营养咨询,以建立
目标参与。我们选择营养咨询作为我们的主动控制,因为它不包括
暴露的关键 CBT-AR 干预,因此不太可能参与我们的目标机制。我们
假设与营养咨询相比,随机接受 CBT-AR 的患者将表现出显着的
食物恐惧症(认知机制)和恐惧回路(神经机制)显着减少
在标准化功能磁共振成像食物线索范式中对食物线索的反应(主要投资回报率:前扣带皮层
[ACC];次要 ROI:杏仁核、眶额皮质 [OFC])。我们还将检查每周的食物变化
Neophobia(认知机制)来确定进一步获益停止的会话次数,并使用
R33 的 CBT-AR 优化剂量。如果我们能够展示 R33,我们将转向 R33
CBT-AR 组从治疗前到治疗后至少减少 d=.40,并且治疗后-
CBT-AR 与营养咨询在任一食物新恐惧症(认知
机制)或恐惧电路(Go/No-Go ROI:ACC;神经机制)。接下来,我们将随机抽取70名青少年
(10-18 岁)以 1:1 的方式使用 ARFID 与 CBT-AR 的优化剂量或相同次数的疗程
营养咨询,以复制目标参与并建立目标验证。我们假设,
与营养咨询相比,随机接受 CBT-AR 的患者将表现出显着更大的减少
避免食物的减少,并且这些避免食物的减少将通过减少食物来调节
新恐惧症(认知机制)和恐惧回路(神经机制)激活。如果成功的话,
拟议的干预措施(CBT-AR)可以满足 ARFID 生活者未满足的重要需求,并为
进行更大规模功效和有效性试验的方法。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
数据更新时间:{{ journalArticles.updateTime }}
{{
item.title }}
{{ item.translation_title }}
- DOI:
{{ item.doi }} - 发表时间:
{{ item.publish_year }} - 期刊:
- 影响因子:{{ item.factor }}
- 作者:
{{ item.authors }} - 通讯作者:
{{ item.author }}
数据更新时间:{{ journalArticles.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ monograph.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ sciAawards.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ conferencePapers.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ patent.updateTime }}
Kamryn T Eddy其他文献
Kamryn T Eddy的其他文献
{{
item.title }}
{{ item.translation_title }}
- DOI:
{{ item.doi }} - 发表时间:
{{ item.publish_year }} - 期刊:
- 影响因子:{{ item.factor }}
- 作者:
{{ item.authors }} - 通讯作者:
{{ item.author }}
{{ truncateString('Kamryn T Eddy', 18)}}的其他基金
The Role of Estrogen in the Neurobiology of Eating Disorders: A Study of Cognitive Flexibility and Reward in Eating Disorders
雌激素在饮食失调神经生物学中的作用:饮食失调认知灵活性和奖励的研究
- 批准号:
9889997 - 财政年份:2019
- 资助金额:
$ 108.3万 - 项目类别:
The Role of Estrogen in the Neurobiology of Eating Disorders: A Study of Cognitive Flexibility and Reward in Eating Disorders
雌激素在饮食失调神经生物学中的作用:饮食失调认知灵活性和奖励的研究
- 批准号:
10311480 - 财政年份:2019
- 资助金额:
$ 108.3万 - 项目类别:
NOSI to The Role of Estrogen in the Neurobiology of Eating Disorders: A Study of Cognitive Flexibility and Reward in Eating Disorders
NOSI 对雌激素在饮食失调神经生物学中的作用:饮食失调认知灵活性和奖励的研究
- 批准号:
10766612 - 财政年份:2019
- 资助金额:
$ 108.3万 - 项目类别:
The Role of Estrogen in the Neurobiology of Eating Disorders: A Study of Cognitive Flexibility and Reward in Eating Disorders
雌激素在饮食失调神经生物学中的作用:饮食失调认知灵活性和奖励的研究
- 批准号:
10756236 - 财政年份:2019
- 资助金额:
$ 108.3万 - 项目类别:
The Role of Estrogen in the Neurobiology of Eating Disorders: A Study of Cognitive Flexibility and Reward in Eating Disorders
雌激素在饮食失调神经生物学中的作用:饮食失调认知灵活性和奖励的研究
- 批准号:
10492860 - 财政年份:2019
- 资助金额:
$ 108.3万 - 项目类别:
The Role of Estrogen in the Neurobiology of Eating Disorders: A Study of Cognitive Flexibility and Reward in Eating Disorders
雌激素在饮食失调神经生物学中的作用:饮食失调认知灵活性和奖励的研究
- 批准号:
10415333 - 财政年份:2019
- 资助金额:
$ 108.3万 - 项目类别:
The Role of Estrogen in the Neurobiology of Eating Disorders: A Study of Cognitive Flexibility and Reward in Eating Disorders
雌激素在饮食失调神经生物学中的作用:饮食失调认知灵活性和奖励的研究
- 批准号:
10591474 - 财政年份:2019
- 资助金额:
$ 108.3万 - 项目类别:
Homeostatic and Hedonic Food Motivation Underlying Eating Disorder Trajectories
饮食失调轨迹背后的稳态和享乐食物动机
- 批准号:
9036458 - 财政年份:2014
- 资助金额:
$ 108.3万 - 项目类别:
Homeostatic and Hedonic Food Motivation Underlying Eating Disorder Trajectories
饮食失调轨迹背后的稳态和享乐食物动机
- 批准号:
8678071 - 财政年份:2014
- 资助金额:
$ 108.3万 - 项目类别:
Homeostatic and Hedonic Food Motivation Underlying Eating Disorder Trajectories
饮食失调轨迹背后的稳态和享乐食物动机
- 批准号:
8903629 - 财政年份:2014
- 资助金额:
$ 108.3万 - 项目类别:
相似海外基金
Co-designing a lifestyle, stop-vaping intervention for ex-smoking, adult vapers (CLOVER study)
为戒烟的成年电子烟使用者共同设计生活方式、戒烟干预措施(CLOVER 研究)
- 批准号:
MR/Z503605/1 - 财政年份:2024
- 资助金额:
$ 108.3万 - 项目类别:
Research Grant
Early Life Antecedents Predicting Adult Daily Affective Reactivity to Stress
早期生活经历预测成人对压力的日常情感反应
- 批准号:
2336167 - 财政年份:2024
- 资助金额:
$ 108.3万 - 项目类别:
Standard Grant
RAPID: Affective Mechanisms of Adjustment in Diverse Emerging Adult Student Communities Before, During, and Beyond the COVID-19 Pandemic
RAPID:COVID-19 大流行之前、期间和之后不同新兴成人学生社区的情感调整机制
- 批准号:
2402691 - 财政年份:2024
- 资助金额:
$ 108.3万 - 项目类别:
Standard Grant
Elucidation of Adult Newt Cells Regulating the ZRS enhancer during Limb Regeneration
阐明成体蝾螈细胞在肢体再生过程中调节 ZRS 增强子
- 批准号:
24K12150 - 财政年份:2024
- 资助金额:
$ 108.3万 - 项目类别:
Grant-in-Aid for Scientific Research (C)
Migrant Youth and the Sociolegal Construction of Child and Adult Categories
流动青年与儿童和成人类别的社会法律建构
- 批准号:
2341428 - 财政年份:2024
- 资助金额:
$ 108.3万 - 项目类别:
Standard Grant
Understanding how platelets mediate new neuron formation in the adult brain
了解血小板如何介导成人大脑中新神经元的形成
- 批准号:
DE240100561 - 财政年份:2024
- 资助金额:
$ 108.3万 - 项目类别:
Discovery Early Career Researcher Award
Laboratory testing and development of a new adult ankle splint
新型成人踝关节夹板的实验室测试和开发
- 批准号:
10065645 - 财政年份:2023
- 资助金额:
$ 108.3万 - 项目类别:
Collaborative R&D
Usefulness of a question prompt sheet for onco-fertility in adolescent and young adult patients under 25 years old.
问题提示表对于 25 岁以下青少年和年轻成年患者的肿瘤生育力的有用性。
- 批准号:
23K09542 - 财政年份:2023
- 资助金额:
$ 108.3万 - 项目类别:
Grant-in-Aid for Scientific Research (C)
Identification of new specific molecules associated with right ventricular dysfunction in adult patients with congenital heart disease
鉴定与成年先天性心脏病患者右心室功能障碍相关的新特异性分子
- 批准号:
23K07552 - 财政年份:2023
- 资助金额:
$ 108.3万 - 项目类别:
Grant-in-Aid for Scientific Research (C)
Issue identifications and model developments in transitional care for patients with adult congenital heart disease.
成人先天性心脏病患者过渡护理的问题识别和模型开发。
- 批准号:
23K07559 - 财政年份:2023
- 资助金额:
$ 108.3万 - 项目类别:
Grant-in-Aid for Scientific Research (C)














{{item.name}}会员




