A multimodal investigation of targeted treatment approaches for eating disorders

• Main Author: Turton, Robert John
• Other Authors: Hirsch, Colette Rosanne ; Treasure, Janet Linda
• Published: King's College London (University of London) 2018
• Subjects: 150
• Online Access: https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.754892

Significant progress has been made in the past few decades in understanding how to effectively treat eating disorders. However, there remain unanswered questions and limitations in the evidence-base. To enhance treatment outcomes further, a more targeted approach to key underlying cognitive maintenance factors may be beneficial. The aims of this thesis are as follows: (1) to build an accurate profile of the mechanisms underpinning eating disorder psychopathology; and (2) to consider approaches to modify these processes. Specifically, this thesis will focus on the use of two computerised cognitive training paradigms among people with eating disorders: Cognitive Bias Modification (CBM), and food-specific inhibition training. The first section of the thesis focuses on interpersonal difficulties, examining whether women with Anorexia Nervosa (AN) have a negative interpretation bias for social stimuli in comparison to healthy women. Experimental studies were then conducted to examine the effectiveness of a single session of CBM in targeting a negative interpretation bias in women and adolescents with AN. The next part of the thesis focuses on mapping the factors underlying binge-type eating disorders. This includes two reviews, and a proof of concept study of food-specific inhibitory control training for women with Bulimia Nervosa (BN) and Binge Eating Disorder (BED). The findings of this thesis highlight novel targets for the treatment of eating and weight disorders, across different age ranges and treatment settings. The findings suggest that cognitive training paradigms are acceptable for people with these illnesses, and that a single session of training produces small to moderate effects on the processes that it is aiming to modify. Further research investigating the effect of multiple sessions of cognitive training on core symptomatology, employing longer-term follow-ups and larger sample sizes, would be the next stage in the development and evaluation of new treatment enhancers for people with eating disorders.