Fear of food as a treatment target: Exposure and response prevention for anorexia nervosa in an open series

Authors

  • Joanna Steinglass MD,

    Corresponding author
    1. Department of Psychiatry, Division of Clinical Therapeutics, Columbia University Medical Center, New York State Psychiatric Institute, New York, New York
    • New York State Psychiatric Institute, 1051 Riverside Drive, Unit 98, New York, New York 10032
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  • Anne Marie Albano PhD,

    1. Department of Psychiatry, Division of Clinical Therapeutics, Columbia University Medical Center, New York State Psychiatric Institute, New York, New York
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  • H. Blair Simpson MD, PhD,

    1. Department of Psychiatry, Division of Clinical Therapeutics, Columbia University Medical Center, New York State Psychiatric Institute, New York, New York
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  • Kenneth Carpenter PhD,

    1. Department of Psychiatry, Division of Clinical Therapeutics, Columbia University Medical Center, New York State Psychiatric Institute, New York, New York
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  • Janet Schebendach PhD,

    1. Department of Psychiatry, Division of Clinical Therapeutics, Columbia University Medical Center, New York State Psychiatric Institute, New York, New York
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  • Evelyn Attia MD

    1. Department of Psychiatry, Division of Clinical Therapeutics, Columbia University Medical Center, New York State Psychiatric Institute, New York, New York
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  • Disclosures: Dr. Steinglass has received support from NARSAD and the Klarman Family Foundation; Dr. Albano received royalties from Oxford University Press and The Guilford Press; Dr. Simpson has received medication at no cost from Janssen Pharmaceuticals for an NIMH funded trial; Dr. Carpenter and Dr. Schebendach have no financial disclosures to report; Dr. Attia has received medication at no cost from Eli Lilly & Co for an NIMH-funded trial.

Abstract

Objective:

Anorexia nervosa (AN) is a severe mental illness with high rates of relapse and rehospitalization. New treatment approaches are needed. We aimed to evaluate the potential utility of addressing eating-related fear in the treatment of AN using psychotherapy techniques known to be effective in the treatment of anxiety disorders and obsessive compulsive disorder, namely exposure therapy and response prevention.

Method:

We developed a brief treatment intervention for AN (AN-EXRP) and evaluated its effects in an open series of nine individuals with AN towards the end of acute weight restoration. We focused on eating behavior as the primary outcome, as it is related both to anxiety and to longer term course.

Results:

Change in anxiety with AN-EXRP was associated with greater caloric intake.

Discussion:

These findings support the anxiety-centered model of AN and suggest the potential utility of further developing this treatment approach. © 2011 by Wiley Periodicals, Inc. (Int J Eat Disord 2012)

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