Interoceptive Mechanisms of Body Image Disturbance in Anorexia Nervosa
The proposed study utilizes a randomized experimental therapeutics design to test a mechanistic framework linking interoceptive processing and disturbed body image, with the purpose of informing the development of future therapies for body image dissatisfaction in anorexia nervosa (AN). A sample of 102 participants will be recruited from the Laureate Eating Disorder Program (LEDP). After being randomized, participants will all receive a one-hour session of acceptance- and mindfulness-based training with a therapist (the introduction session). They will then receive either the interoceptively focused treatment (IFT) or exteroceptively focused treatment (EFT) condition based on randomization. In the IFT condition participants will engage in floatation-REST (Reduced Environmental Stimulation Therapy) while practicing acceptance and mindfulness-based principles. The EFT condition is an exteroceptive intervention in which participants will be asked to view pre-recorded videos of acceptance and mindfulness-based skills to aid in the practice of these skills. Each condition will consist of one introduction session and three experimental sessions. All participants will then return for follow-up measures. Assessed outcomes will include acute changes in body image disturbance (BID) and interoception. Further, longitudinal intervention effects on self-reported eating disorder symptoms, body image dissatisfaction, and interoception; behavioral measures of interoception and body image dissatisfaction; and resting state and interoceptive functioning during functional magnetic resonance imaging (fMRI) will be explored.
• Primary diagnosis of anorexia nervosa
• Photographic Figure Rating Scale (PFRS) body dissatisfaction score greater than or equal to 1
• Eating Disorder Examination Questionnaire (EDE-Q6) Shape Concern Subscale score greater than or equal to 3
• Weight restored to body mass index (BMI) greater than or equal to 17.5
• No current evidence of orthostatic hypotension or if there is no evidence of additional fall risk as determined by their provider
• Clinical status transition from acute to residential status
• No new psychiatric medications in the week prior to randomization
• Female sex assigned at birth
• Ages 13 to 50 years
⁃ Independently ambulatory
⁃ Ability to lay flat comfortably
⁃ English proficiency
⁃ Willingness and ability to participate in study procedures
⁃ Provision of informed consent (parent consent and minor assent if less than 18 years of age).