Expanding exposure-based interventions for eating disorders

Abstract

Initial trials evaluating exposure-based interventions for eating disorders (EDs) in the 1980s demonstrated mixed results. Since that time, innovations in exposure therapy for anxiety disorders have yielded insights that can be used to refine and expand the approach to effectively target ED behaviors. This article provides a brief summary of relevant advances in exposure therapy for anxiety and outlines how these advances may be adapted and evaluated for use with ED samples. More specifically, we propose shifting to an inhibitory learning framework, considering treatment targets other than fear, and increasing variability in exposure techniques represent three important areas for future study. Overall, this article aims to provide professionals in the field with a framework for how to incorporate cutting-edge advances in exposure therapy into rigorous intervention research for EDs.

Keywords: anxiety disorders; behavioral treatments; eating disorders; exposure; treatment.

© 2017 Wiley Periodicals, Inc.

Figures

FIGURE 1

Generalized behavioral model for understanding ED behaviors in an exposure framework. The proposed exposure interventions detailed in the current manuscript focus on exposure to triggers/cues and emotions associated with feared consequences (Boxes 1–2) and prevention of ED behaviors in response (Box 3), promoting interruption of reinforcement processes (Boxes 4–5) and new learning regarding the likelihood of feared consequences without engagement in ED behaviors and/or the individual’s ability to tolerate the consequences and their associated emotional responses