A preliminary naturalistic clinical case series study of the feasibility and impact of interoceptive exposure for eating disorders. (June 2019)

• Record Type: Journal Article
• Authors: Boswell, James F.; Anderson, Lisa M.; Oswald, Jennifer M.; Reilly, Erin E.; Gorrell, Sasha; Anderson, Drew A.
• Is Part Of: Behaviour research and therapy. Volume 117(2019)
• Page Start: 54
• Page End: 64
• Publication Date: 2019-06
• Subjects: Eating disorders -- Case series -- Interoceptive deficits -- Interoceptive exposure -- Exposure therapy; Cognitive therapy -- Periodicals; Psychotherapy -- Periodicals; 616.891
• DOI: 10.1016/j.brat.2019.02.004
• Languages: English
• ISSNs: 0005-7967

Abstract

Abstract: Recent literature suggests that individuals with eating disorders demonstrate altered interoceptive processing, which may relate to the maintenance of symptoms and thus represent a salient treatment target. Adopting treatment techniques effective for other conditions characterized by disturbed interoceptive processes (e.g., anxiety disorders) could aid in improving the outcomes of psychological interventions for eating disorders. The current investigation was a naturalistic case series ( N = 4) that examined adjunctive interoceptive exposure (IE) for eating disorders, with an emphasis on evaluating the feasibility, acceptability, and impact of this intervention on anxiety sensitivity, interoceptive deficits, and eating disorder symptoms. Results suggested that all individuals who received 4 consecutive sessions of traditional and eating-disorder-specific IE exercises demonstrated decreases in interoceptive deficits and subjective distress. Results for anxiety sensitivity and eating disorder symptoms were encouraging yet more mixed. Findings also generally suggested that the intervention was feasible and acceptable, yet between-session practice compliance varied considerably among participants. Overall, we describe how IE may be used to target interoceptive deficits in eating disorders and provide preliminary evidence of how this may be accomplished within naturalistic intensive outpatient settings. Highlights: Accumulating conceptual and empirical work highlights the relevance of interoceptive exposure for primary eating pathology. A small sample of intensive eating disorder patients received multiple sessions of interoceptive exposure. Traditional and eating disorder-specific interoceptive exposures were feasible to implement and tolerated. Improvement in interoceptive deficits was the most consistent observed result. Over time, ratings of subjective distress regarding the onset of eating and emotion-related physical sensations decreased.