Feasibility and Acceptability of AVATAR Therapy in Eating Disorders.

NCT04778423 | Completed

• 1 other identifier: 292346
• Study Type: interventional
• Target: 12
• Locations: 1 country
• Sites: 1

Brief Summary

This project will answer the overarching research question "What is the feasibility of developing and implementing AVATAR therapy to reduce the power of the eating disorder voice in patients with eating disorders?". AVATAR therapy for eating disorders has been developed based on AVATAR therapy for psychosis. The feasibility of using AVATAR therapy in eating disorders will be tested using non-concurrent multiple baselines single case experimental design. The first stage (A1) will involve participants being randomly allocated to either a two, three or four week-baseline. The second will be the intervention phase (B) where participants will receive the AVATAR treatment which will last approximately 6 weeks. The third stage (A2) will be a 4-week follow-up period after the intervention phase, where participants will also complete a qualitative interview.

Conditions

Eating Disorders

Outcome Measures

Primary Outcomes (1)

• Feasibility of AVATAR therapy for eating disorder

  Recruitment of 80% or more of the targeted sample size in 18 months and 80% retention to the study protocol at 6-8 weeks (end of therapy).

  18 months

Secondary Outcomes (6)

• Adherence

  18 months

• Acceptability

  18 months

• Eating disorder voice characteristics

  12 to 15 weeks depending on the baseline allocation

• Eating disorder symptoms

  12 to 15 weeks depending on the baseline allocation

• Anxiety and depression

  12 to 15 weeks depending on the baseline allocation

Study Arms (1)

Avatar Therapy

EXPERIMENTAL

AVATAR therapy for eating disorders

Other: Avatar Therapy

Interventions

Avatar Therapy OTHER

In the first session (assessment), participants will create a computerised representation of the eating disorder voice (avatar) on a computer. They will be able to manipulate the facial and voice characteristics of the avatar and will be asked to provide examples of the critical eating disorder comments most often spoken by the avatar. In the following sessions (6-8 therapy sessions), participants will interact with the avatar displayed on the computer screen for 5-10 minutes.The main goal during the interaction with the avatar is for participants to stand up to the critical comments made by the avatar and build a sense of power, control and self-awareness in the context of the eating disorder voice. The sessions will be conducted remotely, using a personal laptop or computer. This will provide patients with the opportunity to practise answering back to the eating disorder voice during a meal, a time at which the eating disorder voice is loudest.

Avatar Therapy

Eligibility Criteria

• Age: 16 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• diagnosis of anorexia nervosa or atypical anorexia nervosa (e.g. restored weight but presence of abnormal eating disorder cognitions and behaviors), bulimia nervosa or binge eating disorder
• availability of a laptop and internet connection for the assessments and sessions

You may not qualify if:

• diagnosis of psychosis, alcohol use disorder, substance use disorder
• insufficient level of English to engage in the therapy

Sponsors & Collaborators

• King's College London: lead

Study Sites (1)

King's College London

London, United Kingdom

Location

Related Publications (7)

• Noordenbos G, Aliakbari N, Campbell R. The relationship among critical inner voices, low self-esteem, and self-criticism in eating disorders. Eat Disord. 2014;22(4):337-51. doi: 10.1080/10640266.2014.898983. Epub 2014 Mar 28.

  PMID: 24678635 BACKGROUND

• Pugh M, Waller G. The anorexic voice and severity of eating pathology in anorexia nervosa. Int J Eat Disord. 2016 Jun;49(6):622-5. doi: 10.1002/eat.22499. Epub 2016 Feb 15.

  PMID: 26875724 BACKGROUND

• Falconer CJ, King JA, Brewin CR. Demonstrating mood repair with a situation-based measure of self-compassion and self-criticism. Psychol Psychother. 2015 Dec;88(4):351-65. doi: 10.1111/papt.12056. Epub 2015 Feb 5.

  PMID: 25663161 BACKGROUND

• Fairburn CG, Beglin SJ. Assessment of eating disorders: interview or self-report questionnaire? Int J Eat Disord. 1994 Dec;16(4):363-70.

  PMID: 7866415 BACKGROUND

• Lovibond PF, Lovibond SH. The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behav Res Ther. 1995 Mar;33(3):335-43. doi: 10.1016/0005-7967(94)00075-u.

  PMID: 7726811 BACKGROUND

• Craig TK, Rus-Calafell M, Ward T, Leff JP, Huckvale M, Howarth E, Emsley R, Garety PA. AVATAR therapy for auditory verbal hallucinations in people with psychosis: a single-blind, randomised controlled trial. Lancet Psychiatry. 2018 Jan;5(1):31-40. doi: 10.1016/S2215-0366(17)30427-3. Epub 2017 Nov 23.

  PMID: 29175276 BACKGROUND

• Thompson A, Calissano C, Treasure J, Ball H, Montague A, Ward T, Cardi V. A case series to test the acceptability, feasibility and preliminary efficacy of AVATAR therapy in anorexia nervosa. J Eat Disord. 2023 Oct 13;11(1):181. doi: 10.1186/s40337-023-00900-1.

  PMID: 37833732 DERIVED

MeSH Terms

Conditions

Feeding and Eating Disorders

Condition Hierarchy (Ancestors)

Signs and Symptoms, Digestive; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Mental Disorders

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: February 19, 2021
• First Posted: March 3, 2021
• Study Start: August 5, 2021
• Primary Completion: January 31, 2022
• Study Completion: January 31, 2022
• Last Updated: March 2, 2022

Record last verified: 2021-02

Locations

GB (1)