Symposium 01 - Advancing Eating Disorder Treatment: Novel Interventions Targeting the Positive Valence System

Chair(s)

• 

  Ann Haynos, Ph.D. (she/her/hers)

  Assistant Professor
  Virginia Commonwealth University
  Richmond, Virginia, United States

Discussant(s)

• CP

  Carol Peterson, Ph.D. (she/her/hers)

  Professor
  University of Minnesota
  Minneapolis, Minnesota, United States

Presenter(s)

• 

  Ann Haynos, Ph.D. (she/her/hers)

  Assistant Professor
  Virginia Commonwealth University
  Richmond, Virginia, United States
• CW

  Christina E. Wierenga, Ph.D. (she/her/hers)

  Associate Professor of Psychiatry
  University of California San Diego
  SAN DIEGO, California, United States
• JS

  Joanna Steinglass, M.D. (she/her/hers)

  Columbia University/New York State Psychiatric Institute
  New York, New York, United States
• 

  Adrienne Juarascio, Ph.D. (she/her/hers)

  Associate Professor
  Drexel University
  Philadelphia, Pennsylvania, United States

Eating disorders (EDs) are serious psychiatric disorders associated with elevated medical and psychological comorbidity, as well as premature mortality. Given the severity of these disorders, there is a critical need for treatments that produce long-term recovery across the ED spectrum. Unfortunately, existing ED treatments remain insufficient at producing change in a large portion of affected individuals. Few efficacious treatments exist for anorexia nervosa and treatment drop-out and relapse rates are elevated in this population. Although cognitive behavioral therapy is empirically supported for bulimia nervosa and binge eating disorder, up to two-thirds of patients with these disorders remain symptomatic even following this gold-standard treatment. Thus, novel treatments are sorely needed to enhance treatment outcomes for EDs.

In recent years, there has been a dramatic increase in knowledge regarding the cognitive and neurobiological mechanisms of EDs. Alongside these advances have come corresponding calls to incorporate such novel mechanistic findings into ED treatments to yield more precisely-targeted interventions. Among the mechanisms that have gained recent attention in the ED literature are those pertaining to the positive valence or reward system. EDs have been associated with reward disturbances ranging from reward under-responsivity (e.g., anhedonia linked to restrictive eating) to reward over-responsivity (e.g., impulsivity linked to binge eating). Further, some evidence suggests that reward processes may maintain ED symptoms through heightened reward responsivity to ED cues (e.g., food, thinness). Traditional ED treatments have not typically focused on normalizing responses within the positive valence system. To address this gap, several innovative behavioral treatments have recently been developed to target reward processes in ED populations. These approaches hold promise to substantially enhance ED outcomes by altering the neurocognitive processes that maintain these persistent disorders.

The present symposium will provide attendees with a review of the state of the science on cutting-edge ED treatments targeting the positive valence system. The symposium chair, Dr. Ann Haynos, will first provide a brief overview of the research on reward mechanisms in EDs necessitating novel treatment development. Next, presenters will provide preliminary feasibility, acceptability, efficacy, and target engagement related to four unique interventions targeting reward: 1) Positive Affect Treatment for anorexia nervosa (Dr. Haynos); 2) Temperament-Based Therapy with Support for EDs (Dr. Christina Wierenga); 3) Relapse Prevention and Changing Habits for anorexia nervosa (Dr. Joanna Steinglass; and 4) Reward Re-Training for binge-spectrum disorders (Dr. Adrienne Juarascio). Finally, the discussant, Dr. Carol Peterson, will lend her expertise in ED treatment development to provide commentary on the potential of these approaches for advancing ED treatment, the mechanistic overlap and distinction between the presented treatments, and future directions for this impactful and compelling line of research.

Presentations:

• 8:30 AM – 10:00 AM EST

  (SYM 1) Rewiring Reward: Positive Affect Treatment as a Novel Approach for Anorexia Nervosa and Associated Comorbidities
  

  Speaker: Ann F. Haynos, Ph.D. (she/her/hers) – Virginia Commonwealth University

  Co-author: Lisa M. Anderson, Ph.D. – University of Minnesota Medical School

  Co-author: Autumn Askew, B.S. (she/her/hers) – San Diego State University

  Co-author: Chassidie Liu, B.S. – Yale University

  Co-author: Kira Venables, B.A. (she/her/hers) – Virginia Commonwealth University

  Co-author: Michelle G. Craske, Ph.D. – University of California, Los Angeles

  Co-author: Carol B. Peterson, Ph.D. (she/her/hers) – University of Minnesota
• 8:30 AM – 10:00 AM EST

  (SYM 1) Targeting Reward Processing with Temperament Based Therapy with Support (TBT-S) to Enhance Outcomes in Adults with Anorexia Nervosa
  

  Speaker: Christina E. E. Wierenga, Ph.D. (she/her/hers) – University of California San Diego

  Co-author: Stephanie Knatz Peck, Ph.D. – University of California San Diego

  Co-author: Kristin Stedal, ph.D. – Division of Mental Health and Addiction, Regional Department for Eating Disorders, Oslo University Hospital

  Co-author: Laura Hill, Ph.D. – The Ohio State University
• 8:30 AM – 10:00 AM EST

  (SYM 1) Breaking the Habit: REACH+ Intervention for Disrupting Maladaptive Eating Behaviors in Anorexia Nervosa
  

  Speaker: Joanna Steinglass, M.D. (she/her/hers) – Columbia University/New York State Psychiatric Institute

  Co-author: Deborah Glasofer, Ph.D. – Columbia University Irving Medical Center/New York State Psychiatric Institute

  Co-author: Evelyn Attia, M.D. – Columbia University Irving Medical Center/New York State Psychiatric Institute
• 8:30 AM – 10:00 AM EST

  (SYM 1) Reward Retraining: A Pilot Randomized Controlled Trial of a Novel Treatment Approach for Transdiagnostic Binge Eating
  

  Speaker: Adrienne Juarascio, Ph.D. (she/her/hers) – Drexel University

  Co-author: Stephanie Manasse, Ph.D. (she/her/hers) – Drexel University

  Co-author: Megan L. Wilkinson, M.S. – Drexel University

  Co-author: Christina Felonis, M.S. – Drexel University