Mirror Exposure Training for Adolescents With Anorexia Nervosa (MIRADAN): Cognitive Mechanisms of Body Disturbance – A Study Protocol

Authors

  • Maarit Pelzer Orcid
    Department of Psychology, Clinical Psychology and Psychotherapy, University of Freiburg, Freiburg, Germany
  • Jessica Werthmann Orcid
    Department of Psychology, Clinical Psychology and Psychotherapy, University of Freiburg, Freiburg, Germany
  • Christian Fleischhaker Orcid
    Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Freiburg University Hospital, Freiburg, Germany
  • Jennifer Svaldi Orcid
    Faculty of Science, Clinical Psychology and Psychotherapy, Eberhard Karls University Tübingen, Tübingen, Germany
  • Brunna Tuschen-Caffier Orcid
    Department of Psychology, Clinical Psychology and Psychotherapy, University of Freiburg, Freiburg, Germany

Abstract

Background: Anorexia Nervosa (AN) is a severe mental illness, which typically develops in adolescence and, if left untreated, often becomes chronic. Body dissatisfaction is a core characteristic of AN. Mirror exposure (ME) is an effective therapeutic technique to tackle body dissatisfaction in adult patients with eating disorders, but there is limited evidence for the effects of ME in adolescence. One potential mechanism underlying effects of ME on body dissatisfaction is change in body-related attention bias. However, this mechanism remains to be empirically tested. Accordingly, the aim of the current study is twofold: primarily, we aim to test if ME can reduce body dissatisfaction and associated symptoms in adolescent patients with AN. Additionally, we aim to investigate whether change in biased body-related attention due to ME is a possible mechanism of action. Method: Adolescent patients with AN are randomized to either 12 sessions of ME (3 ME-sessions/week) or wait-list within four weeks. Main outcomes include body dissatisfaction and associated symptoms of AN. Moreover, body-related attention bias is assessed at baseline and post-treatment by means of eye-tracking with two paradigms. Further, process variables are collected weekly. In addition, 12 weeks after end of the study, the acceptability of the ME is assessed. Discussion: The main aim of the study is to evaluate high-frequency and high-intense ME for treating body dissatisfaction in adolescents with AN. In addition, we would like to clarify whether change in attentional bias for body stimuli is a mechanism underlying change in body dissatisfaction due to ME.