Be Body Brave: Digital Written Exposure Therapy for Eating Disorders (BBB)
A Randomized Controlled Trial of Digital Written Exposure Therapy for Eating Disorders: Improving Access to Care
Current eating disorder (ED) treatment options are both inaccessible (80% of people with EDs do not access treatment) and not entirely successful (most people with an ED do not reach full remission). Imaginal exposure therapy, or what the investigators call Be Body Brave (BBB), is self-guided treatment that offers a solution to both of these issues: online modules reduce barriers to access treatment, and exposure therapy has the potential to shift cognitive beliefs in eating disorders, creating lasting change. This study aims to determine the effectiveness of BBB and identify the optimal timing for implementation of exposure therapy for eating disorders. Participants will complete five sessions of digital imaginal exposure and complete posttreatment, 1-month, 6-month, and 12-month follow-up questionnaires assessing eating disorder symptoms, quality of life, and clinical impairment.
Přehled studie
Postavení
Postavení
Podmínky
Podmínky
Intervence / Léčba
Intervence / Léčba
Typ studie
Typ studie
Zápis (Odhadovaný)
Zápis
Fáze
Fáze
- Nelze použít
Kontakty a umístění
Studijní kontakt
Studijní kontakt
- Jméno: Cheri A Levinson, Ph.D.
- Telefonní číslo: 502-852-7795
- E-mail: cheri.levinson@louisville.edu
Studijní záloha kontaktů
- Jméno: Rachel Butler
- E-mail: rachel.butler@louisville.edu
Kritéria účasti
Kritéria způsobilosti
Kritéria způsobilosti
Věk způsobilý ke studiu
Přijímá zdravé dobrovolníky
Pohlaví způsobilá ke studiu
Popis
Inclusion Criteria:
- Current diagnosis of any active eating disorder except ARFID
- Ages 18-65
Exclusion Criteria:
- Active Suicidality
- Active Mania
- Active psychosis
Studijní plán
Jak je studie koncipována?
Detaily designu
- Primární účel: Léčba
- Přidělení: Randomizované
- Intervenční model: Paralelní přiřazení
- Maskování: Žádné (otevřený štítek)
Počet zbraní
Zbraně a zásahy
Skupina účastníků / ArmSkupina účastníků / Arm |
Intervence / LéčbaIntervence / Léčba |
|---|---|
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Aktivní komparátor: Eating Disorder Journaling Condition
Participants in the ED Journaling condition will receive five sessions of treatment, one week apart. They will be given general psychoeducation on eating disorders during the first session and will write about anything having to do with their ED during the remaining four sessions. Participants in the ED Journaling condition will also receive feedback and reminders between sessions. |
Generic journaling about eating disorders allows for a comparable condition to the imaginal exposure condition. |
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Experimentální: Be Body Brave Condition
Participants randomly assigned to BBB will receive 5 weeks of exclusively remote treatment addressing ED-related fears, one week apart, delivered via REDCap. They will be given psychoeducation on exposure therapy during the first session and will write about and imagine an ED fear during the remaining four sessions. Between sessions, participants receive feedback and notifications reminding them to complete the next session and encouraging them to continue facing their fear. |
Imaginal exposure related to eating disorders allows participants to be "exposed" to their eating disorder fear by imagining fear-based scenarios. |
Co je měření studie?
Primární výstupní opatření
Primární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
|
Eating disorder behaviors
Časové okno: 6 weeks
|
Eating Disorder Examination Questionnaire 6.0 (EDE-Q) will be used to measure change in eating disorder symptoms. The EDE-Q has a minimum global score of 0 and a maximum global score of 132. Higher scores indicate more severe eating pathology. |
6 weeks
|
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Fear of weight gain
Časové okno: 6 weeks
|
Fear of weight gain will be assessed via the Fear of Food Measure, which assesses three cognitive-behavioral dimensions of fear of food: anxiety about food, avoidance behaviors, and fear of weight gain. The fear of weight gain has a minimum global score of 0 and a maximum global score of 2,900. Higher scores indicate worse fear of weight gain. |
6 weeks
|
|
Body image disturbance (State Body Disturbances)
Časové okno: 6 weeks
|
Body Disturbances will be collected via the Eating Disorder-15 (ED-15), which is a 15-item measure of eating disorder cognitions and behaviors, which will be collected at the beginning of each treatment session. The ED-15 includes ten questions that together have a minimum global score of 0 and a maximum global score of 60. There are also 5 items that are open-ended integer questions. Higher scores indicate worse body and eating disturbances. |
6 weeks
|
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Food avoidance
Časové okno: 6 weeks
|
Avoidance will be measured with the Fear Approach and Avoidance Measure (FAAM), a measure that quantifies approach and avoidance behaviors related to food, body, and weight. The FAAM has a minimum global score of 0 and a maximum global score of 495. Higher scores indicate worse food avoidance. |
6 weeks
|
|
Fear of food
Časové okno: 6 weeks
|
The Fear of Food Measure (FOFM) assesses three cognitive-behavioral dimensions of fear of food: anxiety about food, avoidance behaviors, and fear of weight gain. It has strong factor, convergent, divergent, and construct validity. The FOFM includes 23 questions that have a minimum global score of 23 and a maximum global score of 161. There are also ten items that together have a minimum global score of 0 and a maximum global score of 1000. All together, the scale has a minimum global score of 23 and a maximum global score of 1,161. Higher scores indicate worse fear of food. |
6 weeks
|
|
Eating disorder fears
Časové okno: 6 weeks
|
The Eating Disorder Fear Inventory (EFI) assesses ED fears, such as fear of weight gain and associated consequences. It will be used to generate the "most feared" consequence of weight gain to focus on during exposure therapy. The EFI has a minimum global score of 28 and a maximum global score of 280. Higher scores indicate worse eating disorder fears. |
6 weeks
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Sekundární výstupní opatření
Sekundární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
|
BMI
Časové okno: 6 weeks
|
We will assess BMI by measuring weight and height via scale during assessments. We will calculate BMI using the formula kg/m^2. |
6 weeks
|
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Barriers to Treatment Access
Časové okno: 6 weeks
|
The Barriers to Treatment Access measure is a 15-item questionnaire assessing factors that may have hindered or prevented participants' access to eating disorder treatment due to financial, sociocultural, geographical, and identification barriers. The BTA is a qualitative measure, so there is no range of values or a "score." |
6 weeks
|
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Quality of Life Scale
Časové okno: 6 weeks
|
Quality of Life Scale (QOLS) asks about various facets of life satisfaction. The QOLS is a valid instrument for measuring quality of life across groups and cultures. The QOLS has a minimum global score of 16 and a maximum global score of 112. Lower scores indicate worse quality of life. |
6 weeks
|
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Clinical Impairment Assessment
Časové okno: 6 weeks
|
The Clinical Impairment Assessment (CIA) assesses how eating habits, exercising, or feelings about eating, shape or weight have affected participant livelihood. The CIA is a reliable and valid global measure of psychosocial impairment secondary to ED symptoms. The CIA has a minimum global score of 0 and a maximum global score of 88. Higher scores indicate worse clinical impairment. |
6 weeks
|
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Weight suppression
Časové okno: 6 weeks
|
We will record highest adult weight to assess weight suppression (i.e., difference between highest weight since reaching adult height and current body weight), to partially account for medical, nutritional status, and the impact of weight loss and/or gain. Weight will be measured in pounds. |
6 weeks
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Spolupracovníci a vyšetřovatelé
Sponzor
Sponzor
Spolupracovníci
Spolupracovníci
Publikace a užitečné odkazy
Obecné publikace
- Levinson CA, Christian C, Ram SS, Vanzhula I, Brosof LC, Michelson LP, Williams BM. Eating disorder symptoms and core eating disorder fears decrease during online imaginal exposure therapy for eating disorders. J Affect Disord. 2020 Nov 1;276:585-591. doi: 10.1016/j.jad.2020.07.075. Epub 2020 Jul 21.
- Butler RM, Heimberg RG. Exposure therapy for eating disorders: A systematic review. Clin Psychol Rev. 2020 Jun;78:101851. doi: 10.1016/j.cpr.2020.101851. Epub 2020 Mar 21.
- Levinson CA, Rapp J, Riley EN. Addressing the fear of fat: extending imaginal exposure therapy for anxiety disorders to anorexia nervosa. Eat Weight Disord. 2014 Dec;19(4):521-4. doi: 10.1007/s40519-014-0115-6. Epub 2014 Apr 2. No abstract available.
- Reilly EE, Anderson LM, Gorrell S, Schaumberg K, Anderson DA. Expanding exposure-based interventions for eating disorders. Int J Eat Disord. 2017 Oct;50(10):1137-1141. doi: 10.1002/eat.22761. Epub 2017 Aug 16.
- Levinson CA, Ralph-Nearman C, Brown ML, Gardner T, Cardi V, Treasure J, Purves K, Eley TC. A pilot randomized control trial of online exposure for eating disorders and mechanisms of change delivered after discharge from intensive eating disorder care: A registered report. Int J Eat Disord. 2021 Nov;54(11):2066-2074. doi: 10.1002/eat.23603. Epub 2021 Sep 4.
- Glasofer DR, Albano AM, Simpson HB, Steinglass JE. Overcoming fear of eating: A case study of a novel use of exposure and response prevention. Psychotherapy (Chic). 2016 Jun;53(2):223-31. doi: 10.1037/pst0000048.
- Butler RM, Crumby EK, Christian C, Brosof LC, Vanzhula IA, Levinson CA. Facing Eating Disorder Fears: An Open Trial Adapting Prolonged Exposure to the Treatment of Eating Disorders. Behav Ther. 2024 Mar;55(2):347-360. doi: 10.1016/j.beth.2023.07.008. Epub 2023 Jul 22.
Termíny studijních záznamů
Hlavní termíny studia
Začátek studia (Odhadovaný)
Začátek studia
Primární dokončení (Odhadovaný)
Primární dokončení
Dokončení studie (Odhadovaný)
Dokončení studie
Termíny zápisu do studia
První předloženo
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První předloženo, které splnilo kritéria kontroly kvality
První zveřejněno (Aktuální)
První zveřejněno
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Aktuální)
Poslední zveřejněná aktualizace
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Naposledy ověřeno
Naposledy ověřeno
Více informací
Termíny související s touto studií
Klíčová slova
Další relevantní podmínky MeSH
Další identifikační čísla studie
Další identifikační čísla studie
- 26.0140
- 1R01MH143686-01 (Grant/smlouva NIH USA)
Plán pro data jednotlivých účastníků (IPD)
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Informace o lécích a zařízeních, studijní dokumenty
Studuje lékový produkt regulovaný americkým FDA
Studuje produkt zařízení regulovaný americkým úřadem FDA
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