Smartphone-based approach-avoidance bias modification training for anorexia nervosa - A randomized clinical trial

Area of Science:

• Psychiatry
• Clinical Psychology
• Digital Health

Background:

• Anorexia nervosa (AN) has limited treatment response and high relapse rates.
• Cognitive bias modification (CBM) targets cognitive biases implicated in AN.
• A novel mobile approach-avoidance bias modification training (ABMT) with food cues was investigated for AN.

Purpose of the Study:

• To examine the efficacy of mobile ABMT with food cues as an adjunct treatment for AN.
• To assess the impact of ABMT on eating disorder psychopathology, approach-avoidance bias, fear of food, and BMI.

Main Methods:

• A randomized controlled trial (RCT) involving 90 inpatients with AN.
• Six sessions of active or sham ABMT with food cues, alongside treatment-as-usual (TAU).
• Outcomes measured at baseline, end-of-training, and 6-month follow-up.

Main Results:

• Active ABMT did not lead to greater reductions in eating disorder psychopathology compared to sham or no training.
• No significant differences were observed in BMI, approach-avoidance bias, or fear of food changes between groups.
• Approach-avoidance bias changes did not mediate training effects on any measured outcomes.

Conclusions:

• The first RCT on ABMT for AN found no superiority of active ABMT over control conditions.
• Mobile ABMT with food cues, in its current form, appears insufficient as an adjunct to inpatient TAU for AN.
• Further research is needed to explore modified protocols and personalized approaches for ABMT in AN.