PDF(Pubmed)
Abstract：
BACKGROUND: Patients with anorexia nervosa tend to experience an inner \"eating disorder\" voice. They struggle to recognise and assert their own identity over the illness\'s identity and relate to it from a powerless and subordinate position. AVATAR therapy was developed to help patients with psychosis to gain greater power and control over distressing voices. The goal of this study was to test the feasibility, acceptability, safety and preliminary efficacy of an adaptation of AVATAR therapy for anorexia nervosa.
METHODS: Twelve adult patients with anorexia nervosa were recruited. Ten completed an assessment session and between five to seven therapy sessions. The assessment session consisted in the creation of an avatar to represent the \"eating disorder\". This was accomplished by manipulating auditory and visual characteristics through a specialist computer software. During the therapy sessions, patients interacted with the avatar to assert their own desires and will. Patients completed baseline, end of intervention and follow-up (4-week) online questionnaires. A non-concurrent multiple baselines single case experimental design (SCED) was used (A1BA2). Feasibility, acceptability, safety and preliminary efficacy of the intervention were assessed.
RESULTS: The therapy met pre-specified criteria relating to (1) Feasibility: sample recruited within three months; retention rate at the end of the treatment phase = 81.9%; therapy completion rate = 90.1%. (2) Safety: no serious adverse events associated with the intervention. (3) Acceptability: mean ratings = 7.5 (SD = 2.61) out of ten, on a 0-10 scale of acceptability (10 = complete satisfaction). With regards to efficacy, participants reported significantly lower levels of distress associated with the eating disorder voice and higher levels of self-compassion at the end of treatment. No other significant changes were observed in frequency of the eating disorder voice, voice\'s characteristics, such as omnipotence and malevolence, eating disorder symptoms and symptoms of anxiety, depression and stress. Patients\' feedback indicated that the therapy had helped with their ability to stand up to the illness, make positive changes around eating, and increase their motivation to recover and self-compassion.
CONCLUSIONS: AVATAR therapy for anorexia nervosa is feasible, acceptable and safe for patients. Larger studies are needed to test clinical efficacy.
BACKGROUND: The study was pre-registered on the clinicaltrials.gov registry (https://clinicaltrials.gov/ct2/show/NCT04778423).
People with anorexia nervosa often struggle with connecting to their identity beyond the illness. They tend to relate to the eating disorder from a powerless and submissive position. The aim of this study was to test AVATAR therapy for anorexia nervosa. The goal of the intervention was to help patients to assert themselves, their identity, will, power and desires, when confronted with the “voice” of the illness. Twelve patients with anorexia nervosa were recruited and 10 completed one assessment session and five to seven therapy sessions. During the assessment session, patients were guided by the therapist to create a representation of their illness (“the avatar”) by manipulating visual and auditory characteristics through a computer software. During treatment, they were supported by the therapist to assert themselves over the illness, responding to the abusive and critical comments of the eating disorder delivered by “the avatar”. Patients’ qualitative feedback indicated that the therapy was meaningful to them, and that it helped to recognise their own voice as distinct from the illness. The distress perceived in relation to the eating disorder voice decreased over time, and feelings of self-compassion increased at the end of therapy. Findings point towards the acceptability and usefulness of AVATAR therapy for anorexia nervosa. Larger studies are needed expand these results.
METHODS: Twelve adult patients with anorexia nervosa were recruited. Ten completed an assessment session and between five to seven therapy sessions. The assessment session consisted in the creation of an avatar to represent the \"eating disorder\". This was accomplished by manipulating auditory and visual characteristics through a specialist computer software. During the therapy sessions, patients interacted with the avatar to assert their own desires and will. Patients completed baseline, end of intervention and follow-up (4-week) online questionnaires. A non-concurrent multiple baselines single case experimental design (SCED) was used (A1BA2). Feasibility, acceptability, safety and preliminary efficacy of the intervention were assessed.
RESULTS: The therapy met pre-specified criteria relating to (1) Feasibility: sample recruited within three months; retention rate at the end of the treatment phase = 81.9%; therapy completion rate = 90.1%. (2) Safety: no serious adverse events associated with the intervention. (3) Acceptability: mean ratings = 7.5 (SD = 2.61) out of ten, on a 0-10 scale of acceptability (10 = complete satisfaction). With regards to efficacy, participants reported significantly lower levels of distress associated with the eating disorder voice and higher levels of self-compassion at the end of treatment. No other significant changes were observed in frequency of the eating disorder voice, voice\'s characteristics, such as omnipotence and malevolence, eating disorder symptoms and symptoms of anxiety, depression and stress. Patients\' feedback indicated that the therapy had helped with their ability to stand up to the illness, make positive changes around eating, and increase their motivation to recover and self-compassion.
CONCLUSIONS: AVATAR therapy for anorexia nervosa is feasible, acceptable and safe for patients. Larger studies are needed to test clinical efficacy.
BACKGROUND: The study was pre-registered on the clinicaltrials.gov registry (https://clinicaltrials.gov/ct2/show/NCT04778423).
People with anorexia nervosa often struggle with connecting to their identity beyond the illness. They tend to relate to the eating disorder from a powerless and submissive position. The aim of this study was to test AVATAR therapy for anorexia nervosa. The goal of the intervention was to help patients to assert themselves, their identity, will, power and desires, when confronted with the “voice” of the illness. Twelve patients with anorexia nervosa were recruited and 10 completed one assessment session and five to seven therapy sessions. During the assessment session, patients were guided by the therapist to create a representation of their illness (“the avatar”) by manipulating visual and auditory characteristics through a computer software. During treatment, they were supported by the therapist to assert themselves over the illness, responding to the abusive and critical comments of the eating disorder delivered by “the avatar”. Patients’ qualitative feedback indicated that the therapy was meaningful to them, and that it helped to recognise their own voice as distinct from the illness. The distress perceived in relation to the eating disorder voice decreased over time, and feelings of self-compassion increased at the end of therapy. Findings point towards the acceptability and usefulness of AVATAR therapy for anorexia nervosa. Larger studies are needed expand these results.
摘要：
背景：神经性厌食症患者往往会出现内心的“进食障碍”声音。他们努力识别和维护自己的身份，而不是疾病的身份，并从无能为力和从属的位置与之联系起来。开发AVATAR疗法是为了帮助精神病患者获得更大的力量和控制痛苦的声音。这项研究的目的是测试可行性，可接受性,适应AVATAR治疗神经性厌食症的安全性和初步疗效。
方法：招募12名患有神经性厌食症的成年患者。10人完成了评估会议，并在5至7个治疗会议之间完成。评估会议包括创建一个化身来代表“饮食失调”。这是通过专业计算机软件操纵听觉和视觉特性来实现的。在治疗期间，患者与化身互动以表达自己的愿望和意愿。患者完成基线，结束干预和随访（4周）在线问卷。使用非并发多基线单例实验设计(SCED)(A1BA2)。可行性,可接受性,评估了干预措施的安全性和初步疗效.
结果：治疗符合与以下相关的预先指定标准：（1）可行性：在三个月内招募样本；治疗期结束时的保留率=81.9%；治疗完成率=90.1%。（2）安全性：无与干预相关的严重不良事件。（3）可接受性：10个中的平均评级=7.5（SD=2.61），在0-10的可接受性量表(10=完全满意度)上。关于功效，参与者报告在治疗结束时,与进食障碍相关的痛苦程度显著较低,自我同情程度显著较高.饮食失调的声音频率没有观察到其他显着变化，声音的特点，比如全能和恶毒，饮食失调症状和焦虑症状，抑郁和压力。患者的反馈表明，该疗法有助于他们抵御疾病的能力，在饮食方面做出积极的改变，并增加他们恢复和自我同情的动力。
结论：AVATAR治疗神经性厌食症是可行的，患者可接受且安全。需要更大的研究来测试临床疗效。
背景：该研究已在clinicaltrials.gov注册表（https://clinicaltrials.gov/ct2/show/NCT04778423）上预先注册。
患有神经性厌食症的人经常在疾病之外与自己的身份联系上挣扎。他们倾向于从无能为力和顺从的立场与饮食失调有关。这项研究的目的是测试AVATAR治疗神经性厌食症。干预的目的是帮助患者维护自己，他们的身份,威尔,权力和欲望，当面对疾病的“声音”时。招募了12名神经性厌食症患者，其中10名完成了一次评估会议和5至7次治疗会议。在评估会议期间，患者在治疗师的指导下，通过计算机软件操纵视觉和听觉特征来创建其疾病的表征（“化身”）。治疗期间,他们在治疗师的支持下坚持自己的疾病，回应“化身”对饮食失调的辱骂和批评。患者的定性反馈表明治疗对他们有意义，这有助于识别他们自己的声音与疾病不同。随着时间的推移，与进食障碍声音相关的痛苦感逐渐减少，在治疗结束时，自我同情的感觉增加了。研究结果表明AVATAR治疗神经性厌食症的可接受性和实用性。需要更大的研究来扩大这些结果。
方法：招募12名患有神经性厌食症的成年患者。10人完成了评估会议，并在5至7个治疗会议之间完成。评估会议包括创建一个化身来代表“饮食失调”。这是通过专业计算机软件操纵听觉和视觉特性来实现的。在治疗期间，患者与化身互动以表达自己的愿望和意愿。患者完成基线，结束干预和随访（4周）在线问卷。使用非并发多基线单例实验设计(SCED)(A1BA2)。可行性,可接受性,评估了干预措施的安全性和初步疗效.
结果：治疗符合与以下相关的预先指定标准：（1）可行性：在三个月内招募样本；治疗期结束时的保留率=81.9%；治疗完成率=90.1%。（2）安全性：无与干预相关的严重不良事件。（3）可接受性：10个中的平均评级=7.5（SD=2.61），在0-10的可接受性量表(10=完全满意度)上。关于功效，参与者报告在治疗结束时,与进食障碍相关的痛苦程度显著较低,自我同情程度显著较高.饮食失调的声音频率没有观察到其他显着变化，声音的特点，比如全能和恶毒，饮食失调症状和焦虑症状，抑郁和压力。患者的反馈表明，该疗法有助于他们抵御疾病的能力，在饮食方面做出积极的改变，并增加他们恢复和自我同情的动力。
结论：AVATAR治疗神经性厌食症是可行的，患者可接受且安全。需要更大的研究来测试临床疗效。
背景：该研究已在clinicaltrials.gov注册表（https://clinicaltrials.gov/ct2/show/NCT04778423）上预先注册。
患有神经性厌食症的人经常在疾病之外与自己的身份联系上挣扎。他们倾向于从无能为力和顺从的立场与饮食失调有关。这项研究的目的是测试AVATAR治疗神经性厌食症。干预的目的是帮助患者维护自己，他们的身份,威尔,权力和欲望，当面对疾病的“声音”时。招募了12名神经性厌食症患者，其中10名完成了一次评估会议和5至7次治疗会议。在评估会议期间，患者在治疗师的指导下，通过计算机软件操纵视觉和听觉特征来创建其疾病的表征（“化身”）。治疗期间,他们在治疗师的支持下坚持自己的疾病，回应“化身”对饮食失调的辱骂和批评。患者的定性反馈表明治疗对他们有意义，这有助于识别他们自己的声音与疾病不同。随着时间的推移，与进食障碍声音相关的痛苦感逐渐减少，在治疗结束时，自我同情的感觉增加了。研究结果表明AVATAR治疗神经性厌食症的可接受性和实用性。需要更大的研究来扩大这些结果。
