Digital Mindfulness Meditation-enhanced Cognitive Behavioral Therapy (CBT-MM) for Binge Eating Disorder

项目摘要/摘要 暴饮暴食障碍(Bed)是一种普遍存在的疾病，影响3.5%的美国人。床是由两个人维护的- 途径：(1)饮食过度限制；(2)情绪失调。目前对床的治疗方法，如 认知行为疗法(CBT)产生不太理想的结果，因为它们只针对过度限制。 正念冥想(MM)针对情绪失调，因此可能是CBT的重要补充 进食障碍。此外，床上MMT的数字交付将提供前所未有的可扩展性，但 目前没有用于床上的数字MMT。目前的K23提案涉及开发数字正念 冥想增强认知行为疗法(CBT-MM)床上分两个阶段进行。CBT-MM的目标是 睡眠的两种不同机制(饮食过度限制和情绪失调)。在第一阶段，我将最终确定 通过基于访谈的用户测试来开发数字CBT-MM。在第二阶段，我将进行试点可行性 随机对照试验(RCT)。在随机对照试验中，40名在全国招募的患有BED的人将被随机分配 数字化：1)CBT-MM(n=20)；或2)仅已开发的数字化CBT治疗(ITakeControl)(n=20)。 随机对照试验将以虚拟方式进行，在基线、中期和治疗后进行基于视频的评估，以及 随访3个月。目标一是发展数字CBT-MM。目标2是评估可行性和可接受性。目标3 是衡量从治疗前到治疗后暴饮暴食缓解、暴饮暴食的组内变化 频率，体重，生活质量，抑郁症状，情绪失调，饮食过度限制，以及 专心致志。该项目具有开发创新的、理论驱动的、有效的和 可扩展的基于正念的床上治疗，可能会对公共健康产生重大影响。要实现这一点 K23，我将得到一个正念领域的领先专家团队的指导，CBT饮食 疾病、以技术为基础的治疗发展和定性方法。这款K23将特别 促进我在以下方面的培训：(1)发展和完善以正念为基础的进食和体重障碍治疗； (2)以技术为基础的治疗开发；(3)进行临床试验的正规培训；及(4) 干预发展的定性方法。这个奖项将成为我职业生涯的一个起点，因为我 利用该奖项提供的培训和研究技能，成为数字领域的领导者 以正念为基础的饮食和体重障碍治疗进展。

PROJECT SUMMARY/ABSTRACT Binge eating disorder (BED) is a prevalent disorder, affecting 3.5% of Americans. BED is maintained by two- pathways: (1) dietary over-restriction and (2) emotion dysregulation. Current treatments for BED, such as Cognitive Behavioral Therapy (CBT) produce suboptimal results because they only target over-restriction. Mindfulness meditation (MM) targets emotion dysregulation and could thus be an important addition to CBT for Eating Disorders. Furthermore, digital delivery of an MMT for BED would offer unprecedented scalability, but there are no current digital MMTs for BED. The current K23 proposal involves developing a digital Mindfulness Meditation-enhanced Cognitive Behavioral Therapy (CBT-MM) for BED via two phases. CBT-MM will target the two different mechanisms of BED (dietary over-restriction and emotion dysregulation). In Phase 1, I will finalize the development of digital CBT-MM via interview-based user testing. In Phase 2, I will conduct a pilot feasibility randomized controlled trial (RCT). For the RCT, 40 individuals with BED recruited nationally will be randomized to digital: 1) CBT-MM (n = 20); or 2) an already developed digital CBT treatment (iTakeControl) only (n = 20). The RCT will be conducted virtually, with video-based assessments at baseline, mid- and post-treatment, and 3-month follow up. Aim 1 is to develop digital CBT-MM. Aim 2 is to evaluate feasibility and acceptability. Aim 3 is to measure within-group changes from pre-to post treatment on binge eating remission, binge eating frequency, weight, quality of life, depressive symptoms, emotion dysregulation, dietary over-restriction, and trait mindfulness. This project has the potential for developing an innovative, theory-driven, efficacious, and scalable mindfulness-based treatment for BED that can have a large public health impact. To carry out this K23, I will receive mentorship from a leading team of experts in the areas of mindfulness, CBT for eating disorders, technology-based treatment development, and qualitative methods. This K23 will specifically facilitate my training in: (1) developing and refining mindfulness-based eating and weight disorder treatments; (2) technology-based treatment development, (3) formalized training in conducting clinical trials, and (4) qualitative methods for intervention development. This award will serve as a launching point for my career as I leverage the training and research skills afforded by this award to become a leader in the field of digital mindfulness-based treatment development for eating and weight disorders.