Exposure-Based CBT for Avoidant/Restrictive Food Intake in Functional Dyspepsia
A Randomized Controlled Trial of Exposure-Based Cognitive Behavioral Treatment for Avoidant/Restrictive Food Intake in Functional Dyspepsia
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Blythe Peterson, BS
- Phone Number: 617-643-7884
- Email: GIbehavioralresearch@mgh.harvard.edu
Study Locations
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Massachusetts
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Boston, Massachusetts, United States, 02114
- Recruiting
- Massachusetts General Hospital
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Contact:
- Helen Burton Murray, PhD
- Phone Number: 617-643-7884
- Email: GIbehavioralresearch@mgh.harvard.edu
-
Principal Investigator:
- Helen Burton Murray, PhD
-
Contact:
- Blythe Peterson, BS
- Phone Number: 617-643-7884
- Email: GIbehavioralresearch@mgh.harvard.edu
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria
- Age at least 18 years at screening visit
- Rome IV Functional Dyspepsia post-prandial distress type (with or without epigastric pain syndrome)
- Negative upper endoscopy or upper radiographic GI series to rule out structural/organic cause for FD
- Avoidant/Restrictive Food Intake Disorder (ARFID) diagnosis (by the Structured Clinical Interview for DSM-5; SCID-5 at Screening visit)
- ≥5% weight loss from weight after functional dyspepsia symptom onset (at Screening visit)
- Stable for outpatient care (based on the American Psychiatric Association Practice Guideline for the Treatment of Patients with Eating Disorders)
- No previous history of CBT for functional dyspepsia or ARFID
- Computer/internet webcam access
- Fluency in English
- Stable dose for 30 days if on any medication
Exclusion Criteria
- Inability to provide informed consent
- Presence of other conditions that could explain the patient's symptoms by chart:
Pyloric or intestinal obstruction (by EGD, UGI, or Abdominal CT) Active H.pylori infection (by CLO test or stool antigen test) Active inflammatory bowel disease Eosinophilic gastroenteritis or eosinophilic esophagitis Acute renal failure Chronic renal failure (serum creatinine >3 mg/dL) and/or on hemodialysis or peritoneal dialysis Acute liver failure Any acute gastrointestinal process Any plausible structural or metabolic causes Heartburn as predominant symptom History of peptic ulcer
- Symptom resolution with antisecretory therapy (PPI use for other reasons that did not resolve FD symptoms will be allowed)
- History of gastrointestinal tract surgery (including gastrectomy, gastric bypass surgery, and small or large bowel resection)
- History of any serious medical condition (e.g., cancer)
- Use of narcotic analgesics greater than three days per week
- Current pregnancy or breastfeeding within the last 8 weeks
- Uncontrolled diabetes (indicated by HbA1c ≥7%) by chart
- Intellectual disability by history
- Current substance/alcohol use disorder within the past month
- Current/history of psychosis (by Mini-International Neuropsychiatric Interview (MINI-Screen)
- Current mania (by Mini-International Neuropsychiatric Interview (MINI-Screen) (defined as any manic episodes within the past 12 months)
- Active suicidal ideation (by MINI-Screen)
- Psychiatric disorder that would warrant independent attention (by Mini-International - Neuropsychiatric Interview (MINI-Screen))
- Current enteral or parenteral feeding
- Plans to initiate another psychotherapy or pregnancy in the concurrent study period
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Other
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Cognitive Behavioral Therapy
Subjects will receive cognitive behavioral therapy for functional dyspepsia with avoidant restrictive food intake disorder.
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Eight 1-hour sessions delivered weekly via the MGH-approved secure video platform Enterprise Zoom.
Skills include: education about gut-brain regulation and weight loss, and regularizing eating to improve hunger and satiety cues; techniques to facilitate weight gain with targets of increased food volume and variety; and plan for maintenance of treatment gains.
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No Intervention: Usual Care
In the usual care condition, participants will be allowed to continue with treatment they are already receiving at the time of randomization, and we will collect detailed data on the nature of these interventions.
Participants will be allowed to pursue non study treatments in this condition.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Enrollment
Time Frame: Throughout study completion, an average of 3 years
|
At the end of the study, we will calculate the percentage of participants who consent to initiate the study from the total who are offered.
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Throughout study completion, an average of 3 years
|
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Assessment completion
Time Frame: Throughout study completion, an average of 3 years
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At the end of the study, we will calculate the percentage of participants who complete all assessments in each CBT and usual care groups.
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Throughout study completion, an average of 3 years
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Retention
Time Frame: Throughout study completion, an average of 3 years
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At the end of the study, we will calculate the percentage of participants who complete at least 6 of the 8 CBT sessions.
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Throughout study completion, an average of 3 years
|
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Interventionist Fidelity ratings
Time Frame: Throughout study completion, an average of 3 years
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At the end of the study, we will calculate fidelity, which measures the percentage of sessions that 100% of the CBT content was delivered.
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Throughout study completion, an average of 3 years
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Client Satisfaction
Time Frame: Week 12
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The Client Satisfaction Questionnaire (CSQ) is an 8 item self-report measure that assesses treatment satisfaction.
Higher scores indicate greater treatment satisfaction.
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Week 12
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Short Form Nepean Dyspepsia Inventory (SF-NDI)
Time Frame: Weeks 0, 6, and 12
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The Short Form Nepean Dyspepsia Inventory (SF-NDI) includes a 15 item symptoms checklist to assess functional dyspepsia symptom severity.
It also includes 10 items scored on a 5-point Likert scale measuring functional dyspepsia-related quality of life; subscales include interference with daily activities, knowledge/control, tension, work/study, and eating/drinking.
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Weeks 0, 6, and 12
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Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Helen Burton Murray, PhD, Massachusetts General Hospital
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Estimated)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 2022P001765
- K23DK131334-01 (U.S. NIH Grant/Contract)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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