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.

项目概要/摘要 饮食失调（ED）是一种严重的精神疾病，其死亡率位居所有疾病中第二高。 精神疾病并带来高昂的社会、个人和经济成本。治疗反应 ED 的治疗效果并不理想，只有 50% 的成年人对基于证据的治疗有反应 没有针对神经性厌食症 (AN) 或其他指定喂养或饮食的循证治疗 存在紊乱（OSFED）。 ED 如此难以治疗的部分原因是高 症状表现的异质性，使得很难确定治疗的目标， 因为两个人即使诊断相同，也会有很大差异。个性化治疗 迫切需要急诊室来改善治疗反应并最大程度地减少痛苦 与这些疾病有关。我们的科学前提是从我们过去的工作中发展而来的 基于具体模型的个性化治疗（称为网络知情个性化 治疗; NA-PT）将优于当前的黄金标准治疗（增强认知 行为疗法：CBT-E）。我们的研究目标是（1）开发和测试可接受性， NA-PT 与 CBT-E 随机化的可行性和初步效果，以及 (2) 测试是否 网络识别的精确目标是变化的机制。这些目标最终将 导致第一个针对 ED 的个性化治疗，并且可以扩展到其他 精神疾病。拟议的研究采用了高度创新的方法；密集的 通过移动技术收集的纵向数据与最先进的具体信息相结合 提供虚拟、个性化治疗的建模方法。具体目标是 (1) 收集 关于 NA-PT（n=40）随机化的可行性和可接受性的初步数据 ED 与 CBT-E (n=40)，(2) 测试 NA-PT 与 CBT-E 的初步临床疗效 临床结果（例如 ED 症状、体重指数、生活质量）和 (3) 检查是否 NA 识别的精确目标以及动态网络结构的变化 与临床结果的变化相关。拟议的研究具有临床影响。 最终，该提案将直接导致证据的创建和传播 基于 ED 的个性化治疗，并将作为个性化治疗的典范 整个精神病学领域的治疗发展。