- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05799872
Neuroscience-informed Treatment to Remotely Target Reward Mechanisms in Post-acute Anorexia Nervosa
January 4, 2024 updated by: Virginia Commonwealth University
The investigators will recruit individuals with broadly-defined AN (n = 80) who are currently in or have recently participated in higher-level eating disorder treatment (e.g., residential, partial hospitalization/day treatment, intensive outpatient treatment).
Interested participants will sign consent, complete eligibility assessments, and will be randomized to receive Positive Affect Treatment for Anorexia Nervosa (PAT-AN) or Psychoeducation and Behavioral Therapy (PBT) through teletherapy shortly following discharge from higher level of care.
Participants can participate in most other forms of outpatient treatment while receiving the research intervention.
Participants will engage in 24 weeks of PAT-AN or PBT starting in the first 3 months post-discharge.
At each session, the investigators will complete brief measures assessing treatment acceptability, affect, and eating disorder symptoms.
Participants will also complete an assessment battery of self-report, EMA, and neurocognitive measures evaluating primary outcomes (BMI; eating disorder symptoms), secondary outcomes (depression, anxiety, and suicidality), and presumed treatment mechanisms at baseline, end of treatment (EOT), and 3-month follow-up (FU).
All assessments will be remotely delivered via HIPAA-compliant platforms.
Study Overview
Status
Recruiting
Conditions
Study Type
Interventional
Enrollment (Estimated)
90
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: Kira Venables
- Phone Number: (804)828-2658
- Email: venableskg@vcu.edu
Study Contact Backup
- Name: Ann Haynos, PhD
- Phone Number: (804)828-1193
- Email: haynosa@vcu.edu
Study Locations
-
-
Virginia
-
Richmond, Virginia, United States, 23298
- Recruiting
- Virginia Commonwealth University
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Description
Inclusion Criteria:
- Age > or = 18 years old
- Ability to read and speak in English
- DSM-5 diagnosis of AN or atypical AN at admission to higher-level care
- In higher-level care discharging to outpatient care or discharged to outpatient care within the past 3 months
- Current BMI > or = 18.5 kg/m2 (or will be by time of discharge)
- BMI increase of > or = 0.5 kg/m2 while in higher-level care
- Ability to designate and sign a release of information for a primary physical or mental health provider for study duration
- Willingness to participate in weekly assessments (e.g., weight monitoring) and audio or video recording of study therapy sessions for study duration
- Access to a smartphone and/or computer permitting engagement in remote therapy and assessment.
Exclusion Criteria:
- Medical instability for outpatient care;
- Pregnancy
- Lifetime DSM-5 primary psychotic or bipolar-I disorder
- Current DSM-5 substance use disorder
- Enrollment in outpatient therapy with highly overlapping content to PAT-AN
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Positive Affect Treatment for Anorexia Nervosa (PAT-AN):
|
PAT-AN is an adaptation of the cognitive-behavioral outpatient individual therapy for anhedonia (17, 68).
The overarching aim of PAT-AN is to enhance reward sensitivity (reward anticipation, experiencing, and learning) to non-eating disorder experiences and to decrease or replace reward sensitivity to weight-loss experiences (26).
PAT-AN includes 6 sequential modules, each designated to target specific reward sensitivity disturbances (26, 68).
Homework and experiential practice during sessions are essential components of PAT-AN, and participants are provided a workbook to assist with this practice.
During each session, collaborative homework review is followed by skill development and homework assignments.
|
Active Comparator: Psychoeducational and Behavioral Therapy (PBT):
|
The comparison treatment is modeled off of educational and behavioral interventions used in prior clinical trials for AN and common elements of standard behavioral eating disorder treatments.
The treatment is structured to parallel the modular format of PAT-AN.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in Body Mass Index (BMI) from Baseline to End of Treatment
Time Frame: Baseline to End of treatment (week 24)
|
Objective height will be captured through guided measurement at baseline.
Objective weight will be measured throughout on a blind smartscale, which will transfer weight data directly to the research team by wireless internet without providing an outward display of weight to participants.
Participants will have a smartscale shipped to their home.
They will measure their weight at baseline and following treatment on the scale in standard street clothes (no outer garments or shoes) while on a video call with research staff.
|
Baseline to End of treatment (week 24)
|
Change in Eating Disorder Symptoms
Time Frame: Baseline to End of treatment (week 24)
|
The Eating Disorder Examination (EDE) is an investigator-based interview assessing eating disorder psychopathology that will be used as the primary measure of eating disorder symptoms.
The EDE has extensive psychometric data to support its reliability and validity.
The EDE comprises four subscales: Restraint, Eating Concern, Shape Concern, and Weight Concern.
Each question is scored by the interviewer based on frequency over the past month from 0 (symptom not present) to 6 (symptom present every day).
Each subscale score is the average of all items in the subscale, while global EDE score is the average of the four subscale scores.
Higher EDE scores indicate greater severity and frequency of eating disorder symptoms.
|
Baseline to End of treatment (week 24)
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in Depressive Symptoms
Time Frame: Baseline to End of treatment (week 24)
|
The Depression, Anxiety, and Stress Scale-21 is a self-report measure that will assess depressive symptom severity.
The depression subscale consists of 7 items rated from 0 (did not apply to me at all) to 3 (applied to me very much or most of the time).
Scores on the DASS-21 depression subscale range from 0 to 21, with higher scores indicating greater depressive symptom severity.
|
Baseline to End of treatment (week 24)
|
Change in Anxiety Symptoms
Time Frame: Baseline to End of treatment (week 24)
|
The Depression, Anxiety, and Stress Scale-21 is a self-report measure that will assess anxiety symptom severity.
The anxiety subscale consists of 7 items rated from 0 (did not apply to me at all) to 3 (applied to me very much or most of the time).
Scores on the DASS-21 anxiety subscale range from 0 to 21, with higher scores indicating greater anxiety symptom severity.
|
Baseline to End of treatment (week 24)
|
Change in Suicidal Ideation
Time Frame: Baseline to End of treatment (week 24)
|
The Columbia - Suicide Severity Rating Scale (C-SSRS) is an interview-based measure assessing the presence and intensity of suicidal ideation and the presence of suicidal behavior.
The C-SSRS will be used to determine if treatment impacts suicidal ideation.
Intensity of suicidal ideation is rated from 0-5, with higher scores indicating more severe suicidal ideation.
|
Baseline to End of treatment (week 24)
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Collaborators
Investigators
- Principal Investigator: Ann Haynos, PhD, Principal Investigator
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
December 6, 2023
Primary Completion (Estimated)
June 30, 2025
Study Completion (Estimated)
October 30, 2025
Study Registration Dates
First Submitted
February 28, 2023
First Submitted That Met QC Criteria
March 22, 2023
First Posted (Actual)
April 5, 2023
Study Record Updates
Last Update Posted (Actual)
January 5, 2024
Last Update Submitted That Met QC Criteria
January 4, 2024
Last Verified
January 1, 2024
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- HM20025847
- R34MH129464 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
YES
IPD Plan Description
Final dataset will include information from self-report questionnaires, clinician-guided interviews, physical assessments, ecological momentary assessment, and neurocognitive tasks.
Data will be de-identified and consistent with NDA regulations.
Data will be shared via the National Database for Clinical Trials Related to Mental Illness (NDCT) in the NIMH Data Archive (NDA).
Established by NIMH, and supported by other Institutes of NIH, the NDA is a secure informatics platform for scientific collaboration and data-sharing.
All data will be collected from subjects who have broadly consented to share their data for research use or who have consented to share their data for research, with data use limitations.
All de-identified data resulting from this project will be submitted to the NDA at the item level and subject level along with appropriate supporting documentation to enable efficient use of the data.
IPD Sharing Time Frame
Descriptive/raw research data will be made available for access to other researchers within four (4) months after submission.
IPD Sharing Supporting Information Type
- ICF
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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