Evaluation of Practical Body Image Therapy for Anorexia Nervosa V1

NCT04064255 | Completed

• 1 other identifier: NBPBI1992
• Study Type: interventional
• Target: 40
• Locations: 0 countries
• Sites: N/A

Brief Summary

Background: Dysfunctional body image is a strong predictor of maintenance and relapse in anorexia nervosa, making treatment of such clinically and financially important. Studies have shown that cognitive behavioural based group therapies and mirror exposure interventions are effective in improving body image in adults with eating disorders; however research into individual body image treatments for adolescents with anorexia nervosa is limited. Practical Body Image (PBI) is a novel, manualised, individual treatment designed for adolescents with anorexia nervosa for which the evidence base is not yet established. This research will therefore contribute to the evidence base for the treatment of body image in adolescents with anorexia nervosa and inform the effectiveness of a new treatment. The research will be funded by Newbridge House, an inpatient unit for children and adolescents with eating disorders. Research Questions: Does Practical Body Image improve body image and psychological wellbeing in adolescent inpatients with anorexia nervosa? Does a mirror exposure intervention improve body image and psychological wellbeing in adolescent inpatients with anorexia nervosa after completion of the rest of the programme? Design: Patients aged 11-18, fulfilling DSM-V criteria for anorexia nervosa and receiving treatment at Newbridge House will be recruited for participation in the research study. Participants will be randomly allocated to either a case or control group. Allocation will be based on a non-blind randomised controlled trial. Cases will receive PBI in addition to treatment as usual and will be compared with controls who just receive treatment as usual. Both groups will complete a set of questionnaires at baseline, 7 weeks and 10 weeks.

Conditions

Body Image; Exposure

Keywords

Body Image; Anorexia Nervosa; Adolescents; Mirror exposure

Outcome Measures

Primary Outcomes (1)

• Body Image Acceptance and Action Questionnaire

  A validated self-report measure assessing change in cognitive flexibility and acceptance relatively to body image. The measure consists of 12 questions.

  Assessed at baseline, 7 weeks and 10 weeks.

Secondary Outcomes (4)

• Youth Eating Disorder Examination Questionnaire

  Assessed at baseline, 7 weeks and 10 weeks.

• Body Image Avoidance Questionnaire

  Assessed at baseline, 7 weeks and 10 weeks.

• Physical Appearance State and Trait Anxiety Scale: Trait Version

  Assessed at baseline, 7 weeks and 10 weeks.

• Healthy weight body acceptance scale

  Assessed at baseline, 7 weeks and 10 weeks.

Study Arms (2)

Case: Practical Body Image + Treatment as Usual

ACTIVE COMPARATOR

The Case arm involves Practical Body Image + treatment as usual. Practical Body Image is based on a cognitive behavioural model of body image addressing thoughts, feelings, behaviours and misperceptions. PBI is designed to be administered over 10 weeks (6 weekly sessions over 6 weeks, followed by 8 twice weekly sessions over 4 weeks). Treatment as usual refers to the standard inpatient treatment programme at Newbridge House which includes: individual therapy, occupational therapy, drama therapy, family therapy, dietetic support, nursing support, yoga and medication prescribed by a consultant psychiatrist.

Other: Practical Body Image (session 1 - 7); Other: Practical Body Image (session 8 - 14)

Control: Treatment as Usual Only

NO INTERVENTION

Control arm involves treatment as usual only. Treatment as usual refers to the standard inpatient treatment programme at Newbridge House which includes: individual therapy, occupational therapy, drama therapy, family therapy, dietetic support, nursing support, yoga and medication prescribed by a consultant psychiatrist.

Interventions

Practical Body Image (session 1 - 7) OTHER

Practical body image therapy

Case: Practical Body Image + Treatment as Usual

Practical Body Image (session 8 - 14) OTHER

Twice weekly mirror exposure plus ending session

Case: Practical Body Image + Treatment as Usual

Eligibility Criteria

• Age: 11 Years - 18 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• Inpatients at Newbridge House
• Aged 11-18
• At or above 90% of minimum healthy weight
• Primary diagnosis of Anorexia Nervosa

You may not qualify if:

• Previously received treatment at Newbridge House (readmission)
• Patients with a primary diagnosis other than Anorexia Nervosa
• Aged under 11 years
• Any patients with severe learning difficulty
• Active psychosis

Sponsors & Collaborators

• Newbridge House: lead

Related Publications (8)

• Stice E. Risk and maintenance factors for eating pathology: a meta-analytic review. Psychol Bull. 2002 Sep;128(5):825-48. doi: 10.1037/0033-2909.128.5.825.

  PMID: 12206196 BACKGROUND

• Fairburn CG, Peveler RC, Jones R, Hope RA, Doll HA. Predictors of 12-month outcome in bulimia nervosa and the influence of attitudes to shape and weight. J Consult Clin Psychol. 1993 Aug;61(4):696-8. doi: 10.1037//0022-006x.61.4.696.

  PMID: 8370866 BACKGROUND

• Keel PK, Dorer DJ, Franko DL, Jackson SC, Herzog DB. Postremission predictors of relapse in women with eating disorders. Am J Psychiatry. 2005 Dec;162(12):2263-8. doi: 10.1176/appi.ajp.162.12.2263.

  PMID: 16330589 BACKGROUND

• Morgan JF, Lazarova S, Schelhase M, Saeidi S. Ten session body image therapy: efficacy of a manualised body image therapy. Eur Eat Disord Rev. 2014 Jan;22(1):66-71. doi: 10.1002/erv.2249. Epub 2013 Sep 5.

  PMID: 24006359 BACKGROUND

• Key A, George CL, Beattie D, Stammers K, Lacey H, Waller G. Body image treatment within an inpatient program for anorexia nervosa: the role of mirror exposure in the desensitization process. Int J Eat Disord. 2002 Mar;31(2):185-90. doi: 10.1002/eat.10027.

  PMID: 11920979 BACKGROUND

• Legenbauer T, Schutt-Stromel S, Hiller W, Vocks S. Predictors of improved eating behaviour following body image therapy: a pilot study. Eur Eat Disord Rev. 2011 Mar-Apr;19(2):129-37. doi: 10.1002/erv.1017.

  PMID: 25363718 BACKGROUND

• Nye S, Cash TF. Outcomes of manualized cognitive-behavioral body image therapy with eating disordered women treated in a private clinical practice. Eat Disord. 2006 Jan-Feb;14(1):31-40. doi: 10.1080/10640260500403840.

  PMID: 16757447 BACKGROUND

• Delinsky SS, Wilson GT. Mirror exposure for the treatment of body image disturbance. Int J Eat Disord. 2006 Mar;39(2):108-16. doi: 10.1002/eat.20207.

  PMID: 16231342 BACKGROUND

MeSH Terms

Conditions

Anorexia Nervosa

Condition Hierarchy (Ancestors)

Feeding and Eating Disorders; Mental Disorders

Study Officials

• John F Morgan, Medicine

  Yorkshire Centre for Eating Disorders, Leeds and York NHS Foundation Trust

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: FACTORIAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Consultant Psychiatrist

Study Record Dates

• First Submitted: June 23, 2016
• First Posted: August 21, 2019
• Study Start: September 1, 2016
• Primary Completion: July 1, 2018
• Study Completion: July 1, 2018
• Last Updated: August 21, 2019

Record last verified: 2019-08

Data Sharing

• IPD Sharing: Will not share