Overcoming fear of eating: A case study of a novel use of exposure and response prevention.
Even after successful weight restoration, many patients with anorexia nervosa (AN) continue to exhibit maladaptive eating including repetitive behaviors (i.e., food rituals) used to decrease anxiety about food, and to describe fears related to food content, including its effect on shape and weight. Although there are important differences between eating disorders and anxiety disorders, the shared clinical phenomena suggest potentially useful overlap in treatment strategies. This case study will describe treatment of a woman with AN using Exposure and Response Prevention for Anorexia Nervosa (AN-EXRP) as an adjunct to concurrent inpatient treatment. This is a novel use of a treatment approach with established efficacy in the treatment of anxiety disorders. AN-EXRP specifically targets eating-related anxiety with the intent to improve the restrictive eating patterns that persist after acute weight restoration. The case study described includes descriptions of (a) the treatment rationale and its phases of implementation, (b) illustrative sample dialogue between the patient and therapist, (c) pre- and posttreatment data on outcome measures of interest (e.g., food intake at a laboratory meal, self-report anxiety ratings, self-report eating-related rituals, and preoccupations), and (d) therapist considerations (e.g., maintaining alliance, adhering to treatment frame). (PsycINFO Database Record
Division of Clinical Therapeutics, New York State Psychiatric Institute.
Deborah R
DR
Glasofer
Department of Psychiatry, College of Physicians and Surgeons of Columbia University.
Anne Marie
AM
Albano
Division of Clinical Therapeutics, New York State Psychiatric Institute.
H Blair
HB
Simpson
Division of Clinical Therapeutics, New York State Psychiatric Institute.
Joanna E
JE
Steinglass
D000223:Adaptation, Psychological; D000856:Anorexia Nervosa / Q000523:psychology* / Q000628:therapy*; D001008:Anxiety Disorders / Q000523:psychology* / Q000628:therapy*; D001521:Behavior Therapy / Q000379:methods; D001828:Body Image; D001835:Body Weight; D003131:Combined Modality Therapy; D015897:Comorbidity; D003469:Culture; D004435:Eating; D005239:Fear; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D007171:Implosive Therapy / Q000379:methods*; D010343:Patient Admission; D055815:Young Adult