Anorexia Nervosa (AN) is considered one of the most severe subtypes of eating disorders (EDs), characterized by significant medical complications, high mortality rates, and high comorbidity with other disorders, such as anxiety disorders. Similarly to what occurs in anxiety disorders, several studies have suggested the presence of dysfunctional body-related attentional bias (AB) in patients with EDs, and specifically in patients with AN. Individuals with AN tend to focus their attention on their body in a dysfunctional manner, engaging in body-checking behaviors and excessively scrutinizing their general appearance and weight-related body parts. This body-related AB has been associated with higher levels of body dissatisfaction, which represents one of the most important risk factors for the development and maintenance of EDs. Moreover, body-related AB may contribute to reducing the effectiveness of body exposure-based treatments used in patients with AN. For this reason, it is necessary to develop new treatment techniques by incorporating specific components aimed at reducing body-related AB. It has been proposed that attentional bias modification techniques could be integrated into body exposure therapy as an effective approach to reduce body-related AB, body dissatisfaction, and body anxiety. To date, our research group has been the first to use a combination of virtual reality (VR) and eye-tracking (ET) technologies to assess the presence of body-related AB in non-clinical samples. In order to improve treatments for AN, the present project aims to develop a novel attentional bias modification procedure using ET and VR technologies. In addition, this project seeks to integrate this AB modification procedure into a body exposure-based treatment designed to reduce the fear of weight gain experienced by patients with AN. Finally, the project aims to evaluate whether combining two distinct components-body exposure-based therapy and attentional bias modification training-results in a more effective intervention. It is expected that the inclusion of a VR-based body exposure procedure in standard AN treatment, enhanced through the illusion of ownership over a virtual body, will lead to improved treatment outcomes. Furthermore, it is anticipated that the addition of attentional bias modification training to the body exposure-based procedure will further enhance treatment effectiveness.
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Change in Drive for Thinness (EDI-DT)
Timeframe: Assessed at baseline, at the end of treatment (6 weeks), and at 6-month follow-up.
Change in Body Dissatisfaction (EDI-BD)
Timeframe: Assessed at baseline, at the end of treatment (6 weeks), and at 6-month follow-up.
Change in Body Dissatisfaction (BIAS - BD)
Timeframe: Assessed at baseline, at the end of treatment (6 weeks), and at 6-month follow-up.
Change in Body Distortion (BIAS - BD)
Timeframe: Assessed at baseline, at the end of treatment (6 weeks), and at 6-month follow-up.
Change in complete fixation time towards weight-related body parts
Timeframe: Assessed at baseline, at the end of treatment (6 weeks), and at 6-month follow-up.
Change in the number of fixations towards weight-related body parts
Timeframe: Assessed at baseline, at the end of treatment (6 weeks), and at 6-month follow-up.
Change in Body Mass Index values
Timeframe: Assessed at baseline, at the end of treatment (6 weeks), and at 6-month follow-up.
Change in Fear of Gaining Weight
Timeframe: Assessed at baseline, at the end of treatment (6 weeks), and at 6-month follow-up.
Change in Anxiety
Timeframe: Assessed at baseline (before the body exposure session); every 2 minutes during the exposure session; at the end of the exposure session; at the end of treatment (6 weeks); and at 6-month follow-up.
Change in Body-related Anxiety (PASTAS)
Timeframe: Assessed at baseline, at the end of treatment (6 weeks), and at 6-month follow-up.
Change in Body Appreciation (BAS)
Timeframe: Assessed at baseline, at the end of treatment (6 weeks), and at 6-month follow-up.