Metacognitive Interpersonal Therapy Across Transdiagnostic Eating Disorders, Including Underweight

NCT ID: NCT06693089

Last Updated: 2024-12-09

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

64 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-11-08

Study Completion Date

2026-02-07

Brief Summary

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The goal of this clinical trial is to assess if Metacognitive Interpersonal Therapy for Eating Disorders (MIT-ED) is effective for treating various forms of Eating Disorders (ED) and reducing dropout rates. The trial will also evaluate its feasibility and outcomes in a patient group including also underweight participants. The main questions it aims to answer are:

* Does MIT-ED improve eating disorder symptoms and reduce overall maintenance factors, as alexithymia, emotional dysregulation, maladaptive perfectionism, and self-esteem?
* Is MIT-ED effective in reducing the severity of personality disorders and associated global psychiatric symptoms?
* What are the dropout rates and adherence levels for patients receiving MIT-ED?

Participants will:

* Undergo an initial screening to confirm eligibility, including a comprehensive clinical interview and assessments based on inclusion and exclusion criteria for the study.
* Receive up to 40 individual sessions of MIT-ED, each lasting 50-60 minutes, over a period of approximately 10-12 months.
* Attend regular assessment focusing on eating disorder symptoms (Eating Disorder Examination Questionnaire, EDE-Q 6.0, and ED Interview, EDE), emotional dysregulation (Difficulties in Emotion Regulation Scale, DERS), alexithymia (Toronto Alexithymia Scale-20, TAS-20), and self-esteem (Rosenberg Self-Esteem Scale, RSES). Assessment will be conducted at baseline (before starting MIT-ED sessions), after 20 MIT-ED sessions (approximately after 5 months), post-treatment (approximately after 10 months), and at 3 months follow-up. A longer 12-months follow-up is planned.

Researchers will evaluate the effectiveness of MIT-ED based on treatment adherence, symptom improvement, and the reduction of maintenance mechanisms associated with Eating Disorders. Positive results could support the design of a larger, controlled Randomized Clinical Trial (RCT).

Detailed Description

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This is a single arm study. The hypotheses are that Metacognitive Interpersonal Therapy for Eating Disorders (MIT-ED) will be able to keep drop-out lower than possible, estimated \<20%; promote remission in the primary Eating Disorder (ED) measure; achieve weight gain in underweight participants.

Recruitment will stop once 64 participants have met inclusion criteria and have accepted to participate to the study. The study will recruit adults aged 18 and over, diagnosed with an ED within the past six months, from the Centro di Trattamento Integrato - Disturbi Alimentari e Obesità (CTI-Disturbi Alimentari e Obesità) in Verona and Genova. Underweight individuals will be included to evaluate MIT-ED's broader applicability.

Participants will receive up to 40 individual sessions of MIT-ED, delivered either in-person or via videoconferencing by 3 trained therapists. Therapists will receive 2 hours supervision every two weeks with 2 of Metacognitive Interpersonal Therapy designers. Therapy sessions will be randomly audio-recorded for process analysis Assessments will occur at baseline, after 20 MIT-ED sessions (approximately after 5 months), post-treatment (approximately after 10 months), and at 3 months follow-up, where publications of the results are scheduled. A longer term 12-months follow-up is planned. A research assistant will handle psychometric test administration and coordination with the clinical team.

This study will provide preliminary evidence on the feasibility and effectiveness of MIT-ED in a broader ED population, including underweight patients. The results will inform the design of a larger controlled trials to further validate MIT-ED efficacy with the hope it results as a new treatment option for patients with transdiagnostic ED.

Conditions

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Eating Disorders Maladaptive Personality Trait Personality Disorder Personality Trait Emotion Regulation Social Interaction Perfectionism Self Esteem Cognitive Dysfunction Dysfunctional Behavior Psychology

Keywords

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Mental Disorders Cognition Disorders Neurocognitive Disorders Behavioral Symptoms Feeding and Eating Disorders Personality Disorders Cognitive Dysfunction Problem Behavior

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

The study is a single arm study to evaluate MIT-ED effectiveness on a larger sample of adults with transdiagnostic ED presentations which include underweight participants. They will receive up to 40 individual sessions of MIT-ED. The study is run in an private outpatient clinic specialized in eating disorder treatment. Therapies will be delivered both in person or through videoconferencing. Three therapists will be involved in the trial, all trained in MIT.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Treatment-seeking participants will first receive an assessment screening visit. Once evaluated for inclusion/exclusion criteria, and informed written consent has been obtained, baseline measures about primary and secondary outcomes will be completed. Participants will then be proposed for inclusion in the study.

Recruitment will stop once 64 participants have met inclusion criteria and have accepted to participate to the study.

Study Groups

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Experimental: MIT-ED

Participants will receive 1 or 2 preliminary sessions focused on typical elements of Cognitive Behavioral Therapy for Eating Disorders, including psychoeducational training on eating behaviors, an introduction to tools such as monitoring forms, weight charts, and assessments of eating behaviors like physical exercise, body checking, and episodes of binging, purging, and starvation. Before treatment starts, patients meet with a dietitian to develop a nutritional plan that normalizes calorie intake, which will be reviewed throughout treatment. After these sessions, participants will receive up to 40 weekly individual sessions.

Given the inclusion of underweight patients, the protocol developed by Fioravanti and colleagues (2023) required adaptations, such as considering the effects of malnutrition on cognitive and organic functioning and extending psychotherapy for up to 40 sessions.

Group Type EXPERIMENTAL

MIT-ED

Intervention Type OTHER

The aim is to develop healthier strategies for managing negative thoughts and feelings linked to Eating Disorder (ED) and engage patients in social interactions that fulfill their relational needs. Participants will learn that perfectionism and the need for control in ED are coping strategies shaped by interpersonal patterns with significant others, where low self-esteem and emotional dysregulation play key roles. Metacognitive Intepersonal Therapy (MIT) aims to improve individuals' ability to understand their own emotions and thoughts, recognizing maladaptive, rigid, and biased schemas about self and others. This awareness helps them form a richer understanding of others' minds and use this knowledge to respond more adaptively to social challenges. MIT also helps individuals reflect on how these schemas trigger ED behaviors and develop better coping strategies for interpersonal stressors.

Interventions

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MIT-ED

The aim is to develop healthier strategies for managing negative thoughts and feelings linked to Eating Disorder (ED) and engage patients in social interactions that fulfill their relational needs. Participants will learn that perfectionism and the need for control in ED are coping strategies shaped by interpersonal patterns with significant others, where low self-esteem and emotional dysregulation play key roles. Metacognitive Intepersonal Therapy (MIT) aims to improve individuals' ability to understand their own emotions and thoughts, recognizing maladaptive, rigid, and biased schemas about self and others. This awareness helps them form a richer understanding of others' minds and use this knowledge to respond more adaptively to social challenges. MIT also helps individuals reflect on how these schemas trigger ED behaviors and develop better coping strategies for interpersonal stressors.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Adult outpatients (from age 18 years)
* Having an Eating Disorder for which they required treatment
* BMI between 17.5 and 40
* Provision of informed consent

Exclusion Criteria

* Receiving ongoing psychiatric, other psychotherapeutic treatment
* Intellectual disability
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Simone Cheli

UNKNOWN

Sponsor Role collaborator

Angus MacBeth

UNKNOWN

Sponsor Role collaborator

Francesca Travagnin

UNKNOWN

Sponsor Role collaborator

Martina Nicolis

UNKNOWN

Sponsor Role collaborator

Valentina Nicolosi

UNKNOWN

Sponsor Role collaborator

Raffaele Popolo

UNKNOWN

Sponsor Role collaborator

Giancarlo Dimaggio

UNKNOWN

Sponsor Role collaborator

GLORIA FIORAVANTI

OTHER

Sponsor Role lead

Responsible Party

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GLORIA FIORAVANTI

Gloria Fioravanti

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Giancarlo Dimaggio

Role: STUDY_CHAIR

Centro di Terapia Metacognitiva Interpersonale, Roma

Locations

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Centro Trattamento Integrato Disturbi Alimentari e Obesità

Verona, Italia, Italy

Site Status NOT_YET_RECRUITING

Centro Trattamento Integrato Disturbi Alimentari e Obesità

Verona, Verona, Italy

Site Status RECRUITING

Countries

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Italy

Central Contacts

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Gloria Fioravanti

Role: CONTACT

Phone: 348 9255483

Email: [email protected]

Facility Contacts

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Gloria Fioravanti

Role: primary

Simone C

Role: backup

Angus MacBeth

Role: backup

Francesca Travagnin

Role: backup

Martina Nicolis

Role: backup

Valentina Nicolosi

Role: backup

Raffaele Popolo

Role: backup

Gloria Fioravanti

Role: primary

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Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

HD7ABEBGC6@ADA91162

Identifier Type: -

Identifier Source: org_study_id