Effectiveness of Online Imaginal Exposure Therapy for the Treatment of Eating Disorders

Presenter Information

Caroline Brooke ChristianFollow

Grade Level at Time of Presentation

Senior

Major

Psychology/Biology

Minor

N/A

Institution

University of Louisville

KY House District #

CD4

KY Senate District #

CD4

Department

Psychological and Brain Sciences

Abstract

Eating disorders (ED) are serious mental illnesses with high mortality, impairment, and societal costs. Despite the high societal burden, there are very few empirically supported treatments for ED. Cognitive-behavioral therapy has the best success rate for ED treatment, but even in this therapy, relapse rates are reported to be as high as 60%. Novel treatments are urgently needed. This study adapted imaginal exposure (IE) therapy, which is commonly used as treatment for posttraumatic stress disorder (PTSD), to treat EDs. Participants (N=35) were recruited from ED treatment facilities across the United States. All participants met diagnostic criteria for current or past ED. Participants completed four online IE therapy sessions, during which they were asked to write about and imagine an ED-maintaining fear, as well as document their level of anxiety across therapy sessions. Participants filled out questionnaires before the first IE session, as well as one month after the final session. Participants exhibited a significant decrease in anxiety over the course of the four exposures, with additional decrease in anxiety at the one-month follow-up (f(4)=10.64, p=0.004, η2=0.35). Participants also had significant decrease in food avoidance behaviors (t(33)=2.14, p=0.04) and shape concerns (t(33)=2.20, p= 0.035). Weight concerns (t(32)=1.885, p=.069) and eating concerns (t(33)=2.009, p=.053) approached significance. These results suggest that online IE therapy has the potential to reduce anxiety, cognitive distortions, and avoidance behaviors in individuals with ED. This type of therapy may be used in conjunction with existing treatments to address high anxiety and irrational ED cognitions and has the potential to reduce the high societal burden associated with EDs.

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Effectiveness of Online Imaginal Exposure Therapy for the Treatment of Eating Disorders

Eating disorders (ED) are serious mental illnesses with high mortality, impairment, and societal costs. Despite the high societal burden, there are very few empirically supported treatments for ED. Cognitive-behavioral therapy has the best success rate for ED treatment, but even in this therapy, relapse rates are reported to be as high as 60%. Novel treatments are urgently needed. This study adapted imaginal exposure (IE) therapy, which is commonly used as treatment for posttraumatic stress disorder (PTSD), to treat EDs. Participants (N=35) were recruited from ED treatment facilities across the United States. All participants met diagnostic criteria for current or past ED. Participants completed four online IE therapy sessions, during which they were asked to write about and imagine an ED-maintaining fear, as well as document their level of anxiety across therapy sessions. Participants filled out questionnaires before the first IE session, as well as one month after the final session. Participants exhibited a significant decrease in anxiety over the course of the four exposures, with additional decrease in anxiety at the one-month follow-up (f(4)=10.64, p=0.004, η2=0.35). Participants also had significant decrease in food avoidance behaviors (t(33)=2.14, p=0.04) and shape concerns (t(33)=2.20, p= 0.035). Weight concerns (t(32)=1.885, p=.069) and eating concerns (t(33)=2.009, p=.053) approached significance. These results suggest that online IE therapy has the potential to reduce anxiety, cognitive distortions, and avoidance behaviors in individuals with ED. This type of therapy may be used in conjunction with existing treatments to address high anxiety and irrational ED cognitions and has the potential to reduce the high societal burden associated with EDs.