Neurobiologically informed treatment for adults with anorexia nervosa: a novel approach to a chronic disorder.

Stephanie Knatz, Christina E Wierenga, Stuart B Murray, Laura Hill, Walter H Kaye

Journal: Dialogues in clinical neuroscience 2016;17(2):229-36

PMID: 26246796

Plain Language Summary

Anorexia nervosa (NA) is a serious disorder that can have significant medical and psychological impairment. The magnitude of its impact and risk to long-term health means the development of an effective treatment protocol is of critical importance. Advances in brain imaging have led to an improved understanding of the disease. Studies suggest that AN individuals tend to have specific personality traits related to neural circuit functions that can maintain the disorder. These include perfectionism, anxiety, inflexibility and harm avoidance. Imaging data suggests that anticipated anxiety may contribute to food restriction. Treatment is moving from focusing on symptoms to the psychopathology and physiology underpinning the disorder. The Neurobiologically Enhanced With Family Eating Disorder Trait Response Treatment (NEW FED TR) was developed on the basis of neurobiology and AN specific etiology. It is delivered to AN patients and their carers (friends, family, spouse, siblings) and targets their cognitions and eating behaviours.

Abstract

Anorexia nervosa (AN) is a severe and debilitating disorder with significant medical and psychological sequelae. To date, there are no effective treatments for adults, resulting in high rates of chronicity, morbidity, and mortality. Recent advances in brain imaging research have led to an improved understanding of etiology and specific neurobiological mechanisms underlying symptoms. Despite this, there are no treatments focused on targeting symptoms using this empirically supported mechanistic understanding of the illness. Updated treatment approaches focused on targeting neurobiological mechanisms underlying core AN symptomatology are necessary to improve treatment out-comes for this population. Neurobiologically Enhanced With Family Eating Disorder Trait Response Treatment (NEW FED TR) is a neurobiologically informed treatment targeting key temperament constructs associated with the illness through the delivery of psychoeducation and skills training to patients and nominated carers.

Address: University of California San Diego, Department of Psychiatry, San Diego, California, USA.; Ohio State University, Department of Psychiatry, Columbus, Ohio, USA.

DOI: 10.31887/DCNS.2015.17.2/sknatz