A case series to test the acceptability, feasibility and preliminary efficacy of AVATAR therapy in anorexia nervosa

Journal of Eating Disorders

Research

Chiara Calissano¹  Alistair Thompson¹  Valentina Cardi²  Janet Treasure³  Thomas Ward⁴  Hannah Ball⁵  Alice Montague⁶ 

[1] Department of General Psychology, University of Padova, Padova, Italy;Department of General Psychology, University of Padova, Padova, Italy;Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, SE5 8AF, London, UK;Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, SE5 8AF, London, UK;Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, SE5 8AF, London, UK;South London and Maudsley NHS Foundation Trust, London, UK;Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, M13 9NT, Manchester, UK;Manchester Mental Health NHS Foundation Trust, M25 3BL, Manchester, UK;North East London Foundation NHS Trust, E17 3HP, London, UK;Department of Psychology, Department of Clinical, Educational, and Health Psychology, University College London, WC1E 7HB, London, UK;

关键词: Anorexia nervosa;    AVATAR;    Distress;    Eating disorders;    Feasibility;    Self-compassion;    Single-case experimental design;    Thematic analysis;    Voice;   

DOI  :  10.1186/s40337-023-00900-1

 received in 2023-03-28, accepted in 2023-09-26,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundPatients with anorexia nervosa tend to experience an inner “eating disorder” voice. They struggle to recognise and assert their own identity over the illness’s identity and relate to it from a powerless and subordinate position. AVATAR therapy was developed to help patients with psychosis to gain greater power and control over distressing voices. The goal of this study was to test the feasibility, acceptability, safety and preliminary efficacy of an adaptation of AVATAR therapy for anorexia nervosa.MethodsTwelve adult patients with anorexia nervosa were recruited. Ten completed an assessment session and between five to seven therapy sessions. The assessment session consisted in the creation of an avatar to represent the “eating disorder”. This was accomplished by manipulating auditory and visual characteristics through a specialist computer software. During the therapy sessions, patients interacted with the avatar to assert their own desires and will. Patients completed baseline, end of intervention and follow-up (4-week) online questionnaires. A non-concurrent multiple baselines single case experimental design (SCED) was used (A1BA2). Feasibility, acceptability, safety and preliminary efficacy of the intervention were assessed.ResultsThe therapy met pre-specified criteria relating to (1) Feasibility: sample recruited within three months; retention rate at the end of the treatment phase = 81.9%; therapy completion rate = 90.1%. (2) Safety: no serious adverse events associated with the intervention. (3) Acceptability: mean ratings = 7.5 (SD = 2.61) out of ten, on a 0–10 scale of acceptability (10 = complete satisfaction). With regards to efficacy, participants reported significantly lower levels of distress associated with the eating disorder voice and higher levels of self-compassion at the end of treatment. No other significant changes were observed in frequency of the eating disorder voice, voice’s characteristics, such as omnipotence and malevolence, eating disorder symptoms and symptoms of anxiety, depression and stress. Patients’ feedback indicated that the therapy had helped with their ability to stand up to the illness, make positive changes around eating, and increase their motivation to recover and self-compassion.ConclusionAVATAR therapy for anorexia nervosa is feasible, acceptable and safe for patients. Larger studies are needed to test clinical efficacy.Trial registration The study was pre-registered on the clinicaltrials.gov registry (https://clinicaltrials.gov/ct2/show/NCT04778423).

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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