Imaginal Exposure for Disordered Eating Related Fears: An Initial Randomized Controlled Trial

Area of Science:

• Psychology
• Clinical Psychology
• Psychotherapy Research

Background:

• Exposure therapy is used for eating disorders, but often overlooks core fears like rejection and loss of control.
• Prior research has not sufficiently explored imaginal exposure (IE) for these specific underlying fears in disordered eating.

Purpose of the Study:

• To test the feasibility and acceptability of imaginal exposure (IE) for targeting core fears associated with disordered eating.
• To compare imaginal exposure (IE) with and without a brief food exposure component, against an assessment control group.

Main Methods:

• A randomized controlled trial with 47 participants with disordered eating.
• Participants were assigned to imaginal exposure (IE), imaginal exposure plus brief food exposure (IE + Food), or an assessment control group.
• Data collected via in-person visits and questionnaires at pretreatment, posttreatment, and one-month follow-up.

Main Results:

• Imaginal exposure (IE) was rated as more acceptable than IE + Food.
• High retention rates were observed across all conditions.
• Habituation of subjective distress and believability of feared outcomes occurred, indicating IE activated core fears. Distress tolerance and confidence improved.
• Disordered eating symptoms, fears, preoccupations, and rituals decreased in all groups, suggesting IE was not solely responsible for improvements.

Conclusions:

• Imaginal exposure (IE) is a feasible and acceptable intervention for targeting core fears in disordered eating.
• While IE activates core fears and improves distress tolerance, its specific efficacy beyond general treatment effects requires further investigation.
• Future research should explore how to enhance the specific therapeutic impact of IE for eating disorders.