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Randomized Controlled Trial
. 2013 Sep;46(6):567-75.
doi: 10.1002/eat.22134. Epub 2013 Apr 29.

Is outpatient cognitive remediation therapy feasible to use in randomized clinical trials for anorexia nervosa?

James Lock  1 , W Stewart Agras, Kathleen Kara Fitzpatrick, Susan W Bryson, Booil Jo, Kate Tchanturia
Affiliations
Randomized Controlled Trial

Is outpatient cognitive remediation therapy feasible to use in randomized clinical trials for anorexia nervosa?

James Lock et al. Int J Eat Disord. 2013 Sep.

Abstract

Objective: There are limited data supporting specific treatments for adults with anorexia nervosa (AN). Randomized clinical trials (RCTs) for adults with AN are characterized by high attrition limiting the feasibility of conducting and interpreting existing studies. High dropout rates may be related to the inflexible and obsessional cognitive style of patients with AN. This study evaluated the feasibility of using cognitive remediation therapy (CRT) to reduce attrition in RCTs for AN.

Method: Forty-six participants (mean age of 22.7 years and mean duration of AN of 6.4 years) were randomized to receive eight sessions of either CRT or cognitive behavioral therapy (CBT) over 2 months followed by 16 sessions of CBT for 4 months.

Results: During the 2-month CRT vs. CBT treatment, rates of attrition were lower in CRT (13%) compared with that of CBT (33%). There were greater improvements in cognitive inefficiencies in the CRT compared with that of the CBT group at the end of 2 months. There were no differences in other outcomes.

Discussion: These results suggest that CRT is acceptable and feasible for use in RCTs for outpatient treatment of AN. CRT may reduce attrition in the short term. Adequately powered future studies are needed to examine CRT as an outpatient treatment for AN.

Keywords: anorexia nervosa; attention to detail; cognitive flexibility; cognitive remediation; treatment.

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Conflict of interest statement

CONFLICT OF INTEREST AND FINANCIAL DISCLOSURE STATEMENT

The authors report no conflicts of interests. This study was supported by NIH grants K24 MH074467-065 and MH082706 to Dr. Lock. All authors confirm they have no financial involvement or affiliation with any organization whose financial interests may be affected by material in the manuscript or which might potentially bias it.

Figures

Figure 1
Figure 1
Consort Diagram
Figure 2
Figure 2
Longitudinal Trajectories of Cognitive Processing (based on observed means using all available cases at each assessment)
See this image and copyright information in PMC

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