Cognitive bias modification training of attention and interpretation to reduce expectations of social rejection in adolescents with eating disorders: A small efficacy randomized controlled trial

TY - JOUR

T1 - Cognitive bias modification training of attention and interpretation to reduce expectations of social rejection in adolescents with eating disorders

T2 - A small efficacy randomized controlled trial

AU - Rowlands, Katie

AU - Beaty, Taryn

AU - Simic, Mima

AU - Grafton, Ben

AU - Hirsch, Colette

AU - Treasure, Janet

AU - Cardi, Valentina

N1 - Funding Information: We thank participants and staff at South London and Maudsley NHS Foundation Trust and North East London Foundation Trust for facilitating recruitment and data collection. We are also grateful to the Maudsley Biomedical Research Centre's Young Person's Mental Health Advisory Group. Ben Grafton is supported by Australian Research Council grant DE200101570. Colette Hirsch, Valentina Cardi, and Janet Treasure receive salary support from the National Institute for Health Research (NIHR) Specialist Biomedical Research Centre for Mental Health award to the South London and Maudsley NHS Foundation Trust and the Institute of Psychiatry, King's College London. This work was carried out within the scope of the project “use‐inspired basic research,” for which the Department of General Psychology of the Università degli Studi di Padova has been recognized as “Dipartimento di eccellenza” by the Ministry of University and Research (MIUR). Funding Information: Centre of Excellence in Cognition and its Disorders, Australian Research Council, Grant/Award Number: DE200101570; MIUR, Dipartimenti di Eccellenza, Grant/Award Number: 262; National Institute for Health Research (NIHR) Biomedical Research Centre at South London Funding information Funding Information: We thank participants and staff at South London and Maudsley NHS Foundation Trust and North East London Foundation Trust for facilitating recruitment and data collection. We are also grateful to the Maudsley Biomedical Research Centre's Young Person's Mental Health Advisory Group. Ben Grafton is supported by Australian Research Council grant DE200101570. Colette Hirsch, Valentina Cardi, and Janet Treasure receive salary support from the National Institute for Health Research (NIHR) Specialist Biomedical Research Centre for Mental Health award to the South London and Maudsley NHS Foundation Trust and the Institute of Psychiatry, King's College London. This work was carried out within the scope of the project “use-inspired basic research,” for which the Department of General Psychology of the Università degli Studi di Padova has been recognized as “Dipartimento di eccellenza” by the Ministry of University and Research (MIUR). Publisher Copyright: © 2022 The Authors. International Journal of Eating Disorders published by Wiley Periodicals LLC.

PY - 2022/11

Y1 - 2022/11

N2 - Objective: This study aimed to investigate whether a computerized cognitive bias modification training delivered remotely would reduce expectations of rejection in adolescents with eating disorders. Method: Sixty-seven adolescents aged 12–18 (99.5% female) with an eating disorder diagnosis (94% anorexia nervosa) and receiving specialist treatment were recruited. Participants were randomized to an intervention condition (n = 37) which included treatment as usual (TAU) supplemented by nine sessions of online cognitive bias modification training for social stimuli (CBMT + TAU), or a control condition (n = 30), which included TAU only. Participants were invited to complete assessments at baseline and post-intervention. Results: In the intervention condition, 22/37 participants completed six or more training sessions and post-intervention measures, the pre-defined criteria to be considered “completers.” In the control condition, 28/30 participants completed the post-intervention measures. Participants who completed the intervention displayed a significantly greater reduction in negative interpretations of ambiguous social scenarios, with a medium effect size (p =.048, ηp2 =.090), and eating disorder psychopathology, with a medium effect size (p =.027, ηp2 =.105), compared to participants in the control condition. No significant between-group differences were found on emotional response to criticism, and anxiety and depression symptoms post-intervention (ps >.05; small effect sizes). Discussion: Enhancing treatment as usual with CBMT targeting expectations of social rejection might be feasible and effective to reduce expectations of social rejection and eating disorder psychopathology in adolescents with eating disorders. Training adaptations might be necessary to impact on emotional processing and comorbid psychological distress. Public Significance: Adolescents with eating disorders who completed a brief (4-week) online cognitive training intervention, alongside their usual treatment, reported greater reductions in expectations of social rejection and eating disorder psychopathology after the intervention, compared to a separate group of patients who received their usual treatment only. This brief and accessible intervention may be a helpful treatment adjunct for adolescents with eating disorders.

AB - Objective: This study aimed to investigate whether a computerized cognitive bias modification training delivered remotely would reduce expectations of rejection in adolescents with eating disorders. Method: Sixty-seven adolescents aged 12–18 (99.5% female) with an eating disorder diagnosis (94% anorexia nervosa) and receiving specialist treatment were recruited. Participants were randomized to an intervention condition (n = 37) which included treatment as usual (TAU) supplemented by nine sessions of online cognitive bias modification training for social stimuli (CBMT + TAU), or a control condition (n = 30), which included TAU only. Participants were invited to complete assessments at baseline and post-intervention. Results: In the intervention condition, 22/37 participants completed six or more training sessions and post-intervention measures, the pre-defined criteria to be considered “completers.” In the control condition, 28/30 participants completed the post-intervention measures. Participants who completed the intervention displayed a significantly greater reduction in negative interpretations of ambiguous social scenarios, with a medium effect size (p =.048, ηp2 =.090), and eating disorder psychopathology, with a medium effect size (p =.027, ηp2 =.105), compared to participants in the control condition. No significant between-group differences were found on emotional response to criticism, and anxiety and depression symptoms post-intervention (ps >.05; small effect sizes). Discussion: Enhancing treatment as usual with CBMT targeting expectations of social rejection might be feasible and effective to reduce expectations of social rejection and eating disorder psychopathology in adolescents with eating disorders. Training adaptations might be necessary to impact on emotional processing and comorbid psychological distress. Public Significance: Adolescents with eating disorders who completed a brief (4-week) online cognitive training intervention, alongside their usual treatment, reported greater reductions in expectations of social rejection and eating disorder psychopathology after the intervention, compared to a separate group of patients who received their usual treatment only. This brief and accessible intervention may be a helpful treatment adjunct for adolescents with eating disorders.

KW - anorexia nervosa

KW - attention

KW - interpretation bias

KW - bias

KW - online

KW - social rejection

UR - http://www.scopus.com/inward/record.url?scp=85138536120&partnerID=8YFLogxK

U2 - 10.1002/eat.23809

DO - 10.1002/eat.23809

M3 - Article

C2 - 36147018

AN - SCOPUS:85138536120

SN - 1098-108X

VL - 55

SP - 1506

EP - 1520

JO - The International journal of eating disorders

JF - The International journal of eating disorders

IS - 11

ER -