Category: Eating Disorders

Symposium

Online Imaginal Exposure Therapy for Eating Disorder Related Fears in Individuals With Anorexia Nervosa

Friday, November 17
1:45 PM - 3:15 PM
Location: Aqua 310, Level 3, Aqua Level

Keywords: Eating Disorders | Exposure | Body Image
Presentation Type: Symposium

Eating disorders are extremely impairing, with anorexia nervosa (AN) carrying the highest rate mortality rate of any mental illness (Keel et al., 2009). No empirically supported treatments for adults with AN currently exist; although; exposure therapies for adults with AN have shown promising results for the treatment of food-related fears (Steinglass et al., 2013). Some eating disorder fears cannot be recreated in real life (e.g., immediate weight gain). Only one case study has tested the use of imaginal exposure to face fears non-accessible in real life and found imaginal exposure reduced anxiety and eating disorder symptoms (Levinson et al., 2014). In the current ongoing study (current N=36 individuals with AN; 14 fully completed; estimated N=100), we tested the feasibility and effectiveness of an online version of imaginal exposure therapy. Participants completed a diagnostic structured interview via phone to determine diagnosis and eligibility. Participants were given psychoeducation on exposure therapy and identified an eating disorder related fear to focus on in imaginal exposure. Participants then completed four sessions of online imaginal exposure therapy across four weeks. Anxiety was measured before, during, and after each exposure session. Eating disorder symptoms were assessed at one-month follow up. The following eating disorder fears were identified: gaining weight n = 14; rejection/abandonment because of eating disorder n=8; calories n=3; inability to exercise n=3; fatness n=3; other fears n=6. Anxiety before the exposure decreased from Session 1 (S1) to Session 4 (S4): t(13) = 2.22, p=.083; S1 M=69.00, SD=15.05, S4 M=57.30, SD=5.99. Anxiety during the exposure decreased from S1 to S4: t(13) = 2.19, p=.060; S1 M=251.67 , SD=20.39, S4 M=228.33, SD=40.82. Anxiety at the end of the exposure decreased from S1 to S4: t(13)=1.35, p=.210, S1 M=56.50, SD=15.98, S4 M=51.10, SD=14.33. Overall, we found that an online version of imaginal exposure therapy for eating related fears was feasible and effective in individuals with AN. Imaginal exposure therapy may be an effective method to decrease anxiety stemming from eating disorder related fears (e.g., fear of weight gain) core to AN pathology and can be implemented online making this treatment widely accessible.

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