Anorexia Nervosa (AN) is a serious psychological condition with a prevalence estimated at 0.48% among adolescent females between 15-19 years. In adolescents, the illness severely affects physical, emotional, and social development. To date, there are no large-scale treatment studies of adolescents with AN. Smaller scale studies, however, suggest that a specific type of family-based treatment (FT) is an effective approach to adolescent onset AN. This multi-site study aims to compare this specific family therapy (FBT) with ego oriented individual psychotherapy (EOIT) to determine which treatment is more efficacious. The study has two specific aims: (1) To compare the relative efficacy of FBT and EOIT in adolescents with AN. We will specifically examine weight gain, psychological concerns about weight and shape and changes in family functioning. (2) To examine potential predictors, mediators and moderators of outcome. To accomplish these aims the following study is proposed: at two centers (60 per center), 120 adolescents between the ages of 12-18 meeting DSM-IV criteria for AN will be randomly assigned to one of two treatment groups: 1) FBT (manualized) for 24 planned patient hours for 12 months; or 2) EOIT (manualized) for 24 planned patient hours over 12 months. All patients will be followed for 1 year after the end of treatment. Assessment will occur at baseline, end of treatment, and six months and one-year follow-up. Primary outcome will be weight change. Secondary outcomes will be changes in weight and shape concerns as measured by the Eating Disorder Examination.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH070621-02
Application #
6879034
Study Section
Interventions Research Review Committee (ITV)
Program Officer
James, Regina Smith
Project Start
2004-04-01
Project End
2009-02-28
Budget Start
2005-03-01
Budget End
2006-02-28
Support Year
2
Fiscal Year
2005
Total Cost
$440,656
Indirect Cost
Name
Stanford University
Department
Psychiatry
Type
Schools of Medicine
DUNS #
009214214
City
Stanford
State
CA
Country
United States
Zip Code
94305
Rienecke, Renee D; Accurso, Erin C; Lock, James et al. (2016) Expressed Emotion, Family Functioning, and Treatment Outcome for Adolescents with Anorexia Nervosa. Eur Eat Disord Rev 24:43-51
Rienecke, Renee D; Sim, Leslie; Lock, James et al. (2016) Patterns of expressed emotion in adolescent eating disorders. J Child Psychol Psychiatry 57:1407-1413
Byrne, Catherine E; Accurso, Erin C; Arnow, Katherine D et al. (2015) An exploratory examination of patient and parental self-efficacy as predictors of weight gain in adolescents with anorexia nervosa. Int J Eat Disord 48:883-8
Ciao, Anna C; Accurso, Erin C; Fitzsimmons-Craft, Ellen E et al. (2015) Family functioning in two treatments for adolescent anorexia nervosa. Int J Eat Disord 48:81-90
Le Grange, Daniel; Lock, James; Accurso, Erin C et al. (2014) Relapse from remission at two- to four-year follow-up in two treatments for adolescent anorexia nervosa. J Am Acad Child Adolesc Psychiatry 53:1162-7
Accurso, Erin C; Ciao, Anna C; Fitzsimmons-Craft, Ellen E et al. (2014) Is weight gain really a catalyst for broader recovery?: The impact of weight gain on psychological symptoms in the treatment of adolescent anorexia nervosa. Behav Res Ther 56:1-6
Le Grange, Daniel; Accurso, Erin C; Lock, James et al. (2014) Early weight gain predicts outcome in two treatments for adolescent anorexia nervosa. Int J Eat Disord 47:124-9
Stiles-Shields, Colleen; Goldschmidt, Andrea B; Lock, James et al. (2013) Are adolescent treatment studies of eating disorders utilizing clinically relevant samples? A comparison of RCT and clinic treatment-seeking youth with eating disorders. Eur Eat Disord Rev 21:420-4
Forsberg, Sarah; LoTempio, Elizabeth; Bryson, Susan et al. (2013) Therapeutic alliance in two treatments for adolescent anorexia nervosa. Int J Eat Disord 46:34-8
Darcy, Alison M; Doyle, Angela Celio; Lock, James et al. (2012) The Eating Disorders Examination in adolescent males with anorexia nervosa: how does it compare to adolescent females? Int J Eat Disord 45:110-4

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