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Completed

NCT Number: NCT05503745

MICBT for Non-underweight Adults With Eating Disorders

Eating disorders (ED) are severe but treatable conditions, but there are large margin for improvements in terms of efficacy and adherence. There is room to explore new treatment options who are either more capable to retain patients in therapy, more effective. Alternative their efficacy may match the ones of current available treatments but offer new options to ones that did not respond to available therapies. Here the investigators explored if a combination of CBT-focused plus Metacognitive Interpersonal Therapy (MIT) is an empirically supported therapy for personality disorders and could be a new viable treatment option for non-underweight ED. MIT targets some aspects of ED such as poor awareness of mental states and maladaptive interpersonal schemas that are not included in the transdiagnostic model underlying the most investigated empirically supported treatment for ED that is CBT-E. It is reasonable therefore that targeting these aspects of psychopathology can be a path to treatment adherence and effectiveness

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Key information

About this study

The study is a pilot randomized controlled trial that aims to evaluate the feasibility and effectiveness of weekly MIT in addiction to CBT-F in a group of adults diagnosed with ED. Specifically, the investigators will investigate in a sample of non-underweight adults presenting with ED whether once compared to CBT-E, a treatment combining MIT and CBT-F is a) feasible, b) well-tolerated and c) potentially effective on eating disorders symptoms and other outcomes.

The investigators expect that the experimental group CBT-F+MIT would be able to have high treatment adherence and retention on the ground of previous studies of MIT for personality disorders. They will also expect good outcomes in the primary outcome. Given the small sample this is just a pilot study so any conclusions about other outcomes will be considered preliminary. Results will provide new evidence that may lead to consider CBT-F+MIT a treatment option for ED deserving investigations in larger trials.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • ED diagnosed in the past 6 months
  • Seeking treatment for eating disorder
  • Able to provide written, informed consent
  • BMI > 18.5

Exclusion criteria

  • Acute psychotic episode, psychotic symptoms, Bipolar I disorder; antisocial personality disorder
  • Suicidal ideation
  • Substance abuse
  • Previous psychological intervention for other eating disorders
  • Currently involved in other ongoing treatment

Treatment and study plan

CBT-F+MIT

Other

The aim is to develop healthier strategies for managing negative thoughts and feelings antecedent to ED and for engaging patients in social interactions that meet their relational basic wishes. They will thus understand that perfectionism and the need for control they experience through ED are coping strategies developed within interpersonal patterns of interaction with significant others, where low self-esteem and emotive dysregulation play a central role. MIT aims to improve individuals' capacity to make sense of their own affect and cognitions and become aware of being driven by maladaptive, rigid and biased schemas about self and others, to form a richer understanding of the mind of the others and use this knowledge to react in more adaptive ways to social difficulties or evolutionary selected wishes. MIT also enables individuals to reflect on how these schemas may act as triggers for ED behavior and to develop more effective coping strategies in face of interpersonal stressors.

CBT-E

Other

In the first Stage, the treatment will be focused on achieving a shared understanding of the patient's eating disorder and the related maintenance factors. In this phase the patient will be helped to regulate and stabilize his eating habits and so to address his weight concerns. In the second stage, progress made is reviewed in detail. In the third stage, the sessions will be focused on the central processes that are maintaining the psychopathology of the patient's eating disorder. In particular, this involves in addressing concerns about weight and body shape, cognitive and caloric dietary restriction, events and emotions that affect nutrition. In phase three and four clinical perfection, low global self-esteem, intolerance of emotions and interpersonal difficulties are also addressed. Towards the end of the third stage and during the fourth stage, procedures will be also implemented to minimize the risk of short- and long-term relapse.

Primary outcomes

  1. Eating Disorder Examination Questionnaire (EDE-Q6; Fairburn & Beglin, 1994)

    Time frame: Baseline; mid-treatment (assessed up to 20 weeks); end of treatment (assessed up to 60 weeks); 3, 6, 12, 18, and 24 months after end of treatment (assessed up to 156 weeks from baseline)

    A self report measure assessing eating disorders over the past 4 weeks, providing a measure of the range of severity of eating disorder features.

  2. Eating Attitude Test (EAT-26; Garner & Garfinkel, 1979)

    Time frame: Baseline; mid-treatment (assessed up to 20 weeks); end of treatment (assessed up to 60 weeks); 3, 6, 12, 18, and 24 months after end of treatment (assessed up to 156 weeks from baseline)

    A self-report measure for identifying the presence of "eating disorder risk" based on attitudes, feelings and behaviors related to eating. It assesses general eating behaviour and risky behaviours.

  3. Clinical Impairment Assessment Questionnaire (CIA 3.0; Bohn and Fairburn, 2008).

    Time frame: Baseline; mid-treatment (assessed up to 20 weeks); end of treatment (assessed up to 60 weeks); 3, 6, 12, 18, and 24 months after end of treatment (assessed up to 156 weeks from baseline)

    a self-report measure f assessing the severity of psychosocial impairment due to eating disorder features over the past 28 days.

  4. Binge Eating Scale (BES; Gormally et al., 1992)

    Time frame: Baseline; mid-treatment (assessed up to 20 weeks); end of treatment (assessed up to 60 weeks); 3, 6, 12, 18, and 24 months after end of treatment (assessed up to 156 weeks from baseline)

    a self-report questionnaire of the behavioral, cognitive and emotional features of objective binge eating (OBE).

Secondary outcomes

  1. State-Trait Anxiety Inventory (STAI; Spielberger, Gorsuch, Lushene, Vagg, & Jacobs, 1983)

    Time frame: Baseline; mid-treatment (assessed up to 20 weeks); end of treatment (assessed up to 60 weeks); 3, 6, 12, 18, and 24 months after end of treatment (assessed up to 156 weeks from baseline)

    A self-report measure of trait and state anxiety.

  2. Beck Depression Inventory (BDI; Beck, et al., 1961)

    Time frame: Baseline; mid-treatment (assessed up to 20 weeks); end of treatment (assessed up to 60 weeks); 3, 6, 12, 18, and 24 months after end of treatment (assessed up to 156 weeks from baseline)

    A self-report measures of depression.

  3. Symptom Check List (SCL-90)

    Time frame: Baseline; mid-treatment (assessed up to 20 weeks); end of treatment (assessed up to 60 weeks); 3, 6, 12, 18, and 24 months after end of treatment (assessed up to 156 weeks from baseline)

    A measure of psychopathology symptoms and their intensity at a specific point in time.

  4. Difficulties in Emotion Regulation Scale (DERS; Gratz & Roemer, 2004)

    Time frame: Baseline; mid-treatment (assessed up to 20 weeks); end of treatment (assessed up to 60 weeks); 3, 6, 12, 18, and 24 months after end of treatment (assessed up to 156 weeks from baseline)

    A self-report scale measuring individual differences in the ability to identify, accept and manage emotional experiences. This measure help in understanding emotional dysregulation that might underlie the disorders.

  5. Structured Clinical Interview for DSM-5 Disorders (SCID-5; Michael B. First, Janet B.W. Williams)

    Time frame: At baseline

    For assessing and defining DSM-5 Model for Personality Disorders.

  6. Toronto Alexithymia Scale (TAS - 20; Taylor & Bagby, 1992)

    Time frame: Baseline; mid-treatment (assessed up to 20 weeks); end of treatment (assessed up to 60 weeks); 3, 6, 12, 18, and 24 months after end of treatment (assessed up to 156 weeks from baseline)

    It assess difficulties in understanding, processing, or describing emotions

  7. Working Alliance Inventory-Short Revised (WAI; SR Hatcher & Gillaspy, 2006)

    Time frame: Every 4 weeks during treatment (up to approximately 6 months, until end of treatment).

    It measure the therapeutic alliance by assessing three main aspects of the therapeutic alliance: agreement on the tasks of therapy, agreement on the goals of therapy and development of an affective bond.

Sponsors and collaborators

Lead sponsor

Centro Trattamento Integrato: Disturbi Alimentari e Obesita

Other

Registry information

Official study title

CBT-E vs CBT-F+Metacognitive Interpersonal Therapy for Non-underweight Adults With Eating Disorders: Study Protocol for a Pilot Randomised Controlled Trial

Acronym: MICBT-ED

Important dates

Study start
2022
Primary completion
2023
Study completion
2024
First posted
Aug 17, 2022
Registry last updated
May 18, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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