Participants' experience of approach bias modification training with transcranial Direct Current Stimulation as a combination treatment for binge eating disorder. (30th August 2021)

• Record Type: Journal Article
• Authors: Gordon, Gemma; Williamson, Grace; Gkofa, Vasiliki; Schmidt, Ulrike; Brockmeyer, Timo; Campbell, Iain
• Is Part Of: European eating disorders review. Volume 29:Number 6(2021)
• Page Start: 969
• Page End: 984
• Publication Date: 2021-08-30
• Subjects: approach bias modification training (ABM) -- binge eating disorder -- eating disorders -- neuromodulation -- transcranial Direct Current Stimulation (tDCS); Eating disorders -- Periodicals; 616.8526
• DOI: 10.1002/erv.2859
• Languages: English
• ISSNs: 1072-4133

Abstract

Abstract: Objective: This study explored participants' experience of approach bias modification training (ABM) with transcranial Direct Current Stimulation (tDCS) for binge eating disorder (BED) within a randomised controlled trial (RCT). A subset of participants who completed the RCT were interviewed to attain feedback on treatment experience and outcomes. Method: 15 participants with BED who completed the RCT were recruited, using purposive sampling. Participants received six sessions of concurrent ABM training with either real or sham tDCS. Semi‐structured interviews relating to study experience and treatment outcomes were conducted and data were analysed thematically. Results: The combined ABM and tDCS intervention was deemed acceptable and worthwhile by participants interviewed across both intervention groups. Negative preconceptions of tDCS were an initial deterrent to study participation for some, yet the brain stimulation experience was found to be tolerable. Minor and transient sensations and side effects attributed to tDCS were reported by most participants during and after stimulation, in addition to less pleasant aspects of ABM training, with no significant adverse effects reported by interviewees. Positive outcomes were described by participants across both intervention groups, relating to changes in BED symptoms and to broader beneficial effects on associated cognitive and emotional factors. Two participants experienced a shift in autonomy, attributed to tDCS and the combined intervention respectively. Conclusions: Adults with symptoms of BED found concurrent ABM and tDCS sessions to be acceptable, despite initial apprehension about the safety of tDCS. Findings are relevant to the neuroethics literature and may inform science communication strategies on neuromodulation treatments. Key points: Novel, brain‐targeted treatment adjuncts are needed to improve clinical outcomes for patients with binge eating disorder (BED). This study is the first to explore participants' experience of multi‐session concurrent approach bias modification training (ABM) and transcranial Direct Current Stimulation (tDCS) for BED within a randomised control trial (ICARUS RCT: ISRCTN35717198) All interviewees would recommend study participation to others, which may indicate high rates of acceptability of the combined intervention. Facilitators and potential barriers to study enrolment and engagement were outlined. The perceived impact of tDCS on participants' autonomy and identity was discussed by a minority of participants interviewed. Participants reported an apprehension of, and misconceptions around, tDCS as a safe treatment modality prior to participation in the RCT Findings from this study will complement quantitative findings from the RCT in informing the development and evaluation of future studies. Additionally, participants' feedback is relevant to the discussion of the potential impact of neuromodulation on autonomy and identity, and may inform science communication strategies disseminating information about non‐invasive brain stimulation technologies to the public