A Pilot Investigation of Network-Informed Personalized Treatment for Eating Disorders versus Enhanced Cognitive Behavioral Therapy and Dynamic Mechanisms of Change

饮食失调的网络信息个性化治疗与增强认知行为疗法和动态变化机制的试点研究

• 批准号: 10542414
• 负责人: Cheri Alicia Levinson
• 金额: $ 23.48万
• 依托单位: UNIVERSITY OF LOUISVILLE
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-12-17 至 2024-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10542414
• 关键词: Address; Adult; Aftercare; Anorexia Nervosa; Behavior Disorders; Binge Eating; Binge eating disorder; Body mass index; Bulimia; Caring; Cellular Phone; Cessation of life; Clinical; Cognitive Therapy; Complex; Data; Development; Diagnosis; Diagnostic; Dropout; Eating Disorders; Evidence based treatment; Fright; Goals; Heterogeneity; Impairment; Individual; Intervention; Investigation; Judgment; Lead; Left; Mental disorders; Methodology; Methods; Modeling; Outcome; Participant; Pathology; Pathway Analysis; Pattern; Population; Precision therapeutics; Prediction of Response to Therapy; Psychiatry; Psychotherapy; Quality of life; Randomized; Research; Specific qualifier value; Structure; Symptoms; Testing; Time; Translating; Treatment outcome; United States National Institutes of Health; Visualization; Weight Gain; Work; acceptability and feasibility; clinical efficacy; cognitive enhancement; comorbidity; economic cost; evidence base; feeding; follow-up; improved; individualized medicine; innovation; long term recovery; mobile computing; mortality; novel; personalized medicine; prevent; public health relevance; response; severe mental illness; smartphone based assessment; societal costs; standard care; theories; therapy development; treatment optimization; treatment planning; treatment response; user friendly software; virtual

PROJECT SUMMARY/ABSTRACT Eating disorders (EDs) are serious mental illness, with the second highest mortality rate of any psychiatric disorder and carry high societal, personal, and economic costs. Treatment response for EDs are suboptimal, with only 50% of adults responding to evidence based treatments and no evidence-based treatment for anorexia nervosa (AN) or Other Specified Feeding or Eating Disorder (OSFED) in existence. Part of the reason EDs are so difficult to treat is the high heterogeneity in symptom presentation, making it difficult to identify what to target in treatment, as two individuals, even with the same diagnosis, substantially vary. Personalized treatments for EDs are urgently needed that can improve treatment response and minimize the suffering associated with these illnesses. Our scientific premise, developed from our past work, is that treatment personalized based on idiographic models (termed Network Informed Personalized Treatment; NA-PT) will outperform the current gold-standard treatment (Enhanced Cognitive Behavioral Therapy: CBT-E). Our study goals are to (1) develop and test the acceptability, feasibility, and preliminary efficacy of a randomization of NA-PT versus CBT-E and (2) to test if network-identified precision targets are the mechanism of change. These goals will ultimately lead to the very first personalized treatment for ED and can be extended to additional psychiatric illnesses. The proposed research uses highly innovative methods; intensive longitudinal data collected with mobile technology is combined with state-of-the art idiographic modeling methods to deliver a virtual, personalized treatment. Specific aims are (1) To collect preliminary data on the feasibility and acceptability of the randomization of NA-PT (n=40) for EDs versus CBT-E (n=40), (2) To test the initial clinical efficacy of NA-PT versus CBT-E on clinical outcomes (e.g., ED symptoms, body mass index, quality of life) and (3) To examine if changes in NA-identified, precision targets, as well as in dynamic network structure, are associated with change in clinical outcomes. The proposed research has clinical impact. Ultimately, this proposal will lead directly to the creation and dissemination of an evidence- based personalized treatment for EDs, as well as will serve as an exemplar for personalized treatment development across the entire field of psychiatry.

项目摘要/摘要 饮食失调（EDS）是严重的精神疾病，任何人的死亡率第二高 精神病障碍并带来高昂的社会，个人和经济成本。治疗反应 对于ED次优，只有50％的成年人对基于证据的治疗做出反应 没有循证治疗神经性厌食症（AN）或其他指定的喂养或进食 疾病（OSFED）存在。 ED如此难以治疗的部分原因是高 症状表现中的异质性，使得难以确定治疗中要靶向的目标， 作为两个人，即使有相同的诊断，也有很大的变化。个性化治疗 迫切需要ED，可以改善治疗反应并最大程度地减少苦难 与这些疾病有关。我们过去工作开发的科学前提是 基于本科模型的个性化处理（称为网络知情的个性化 治疗; NA-PT）将胜过当前的金色标准处理（增强的认知 行为疗法：CBT-E）。我们的研究目标是（1）发展和测试可接受性， NA-PT与CBT-E随机化的可行性和初步功效，以及（2）测试是否 网络识别的精度目标是变化的机制。这些目标最终将 导致ED的首次个性化治疗方法，可以扩展到其他 精神病。拟议的研究使用了高度创新的方法。密集的 用移动技术收集的纵向数据与最先进 建模方法可提供虚拟的个性化处理。具体目标是（1）收集 关于NA-PT的可行性和可接受性的初步数据（n = 40） EDS与CBT-E（n = 40），（2）测试NA-PT与CBT-E的初始临床功效 临床结果（例如ED症状，体重指数，生活质量）和（3）检查是否是否 NA已识别的精确目标以及动态网络结构的变化是 与临床结果的变化有关。拟议的研究具有临床影响。 最终，该提议将直接导致证据的创造和传播 - 基于EDS的个性化处理，并将作为个性化的典范 整个精神病学领域的治疗发展。