一项针对饮食和外貌负面经历主要后果的单次意象改写试点随机试验的可行性和可接受性。

Feasibility and acceptability of a pilot randomized trial of a single session of imagery rescripting targeting the primary consequences of negative experiences with eating and appearance.

作者信息

Kelly Nichole R, Doty Kelly Jean, Schrag Bonnie H C, Bryant Shaylah, Plezia Sammy, Parr Nicholas J, Budd Elizabeth L

机构信息

Counseling Psychology and Human Services, University of Oregon, Eugene, OR, 1215, USA.

The Prevention Science Institute, University of Oregon, Eugene, OR, USA.

出版信息

Pilot Feasibility Stud. 2025 Apr 23;11(1):51. doi: 10.1186/s40814-025-01630-8.

DOI:10.1186/s40814-025-01630-8

PMID:40270079

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12016433/

Abstract

BACKGROUND

Negative experiences related to eating and appearance (NEREAs), such as critical commentary from parents about food, are common and associated with depression and disordered eating. Imagery rescripting (IR) is a therapeutic process during which individuals are guided through recalling and bringing support into distressing memories, like NEREAs. Single sessions of IR demonstrate promise in shifting the primary negative consequences of NEREAs in clinical samples of women. The primary objectives of this pilot trial were to evaluate the feasibility and acceptability of a remote-delivered, single session of IR and a nutrition education control group in a community sample of adults with NEREAs.

METHODS

In this parallel two-arm pilot trial, participants completed an in-person baseline visit, one remote-delivered, single-session intervention (IR or attention-matched nutrition education control), and in-person 1- and 3-month follow-up visits between February 2023 and April 2024 in Oregon, USA. Markers of feasibility included recruitment, visit and survey completion rates, and intervention fidelity; acceptability was evaluated using participant feedback and instances of adverse events.

RESULTS

One hundred one adults completed a phone screen; 96% reported at least one NEREA. Most of these adults were ineligible because they met psychiatric disorder criteria and/or were taking medication known to influence mood and/or appetite. Thirty-two participants completed a baseline study visit; 89% of these participants (N = 27; mean age [SD] = 32.52 [15.78], range = 18-73; 56% cisgender women; 74.1% non-Hispanic White, 14.8% Asian, 11.1% Hispanic/Latine, 7.4% Black, and 3.7% multiracial) were randomly assigned (using a random number generator) to and completed an intervention condition (13 IR, 14 control). Curriculum adherence, on average, was 94% for IR and 97% for control. One-month retention was 82%, and 3-month retention was 59%. Post-intervention ratings indicated good acceptability for both arms. No adverse events occurred.

CONCLUSIONS

The delivered interventions are feasible and acceptable to a community sample of men and women; as such, a future definitive trial is recommended. Additional strategies for increasing retention are needed. Single-session interventions, like IR, have the potential for high impact and reach. They are inherently flexible and cost-effective interventions that can be delivered across systems of care, while remote delivery mitigates concerns with stigma and access.

TRIAL REGISTRATION

ClinicalTrial.gov, NCT06610318 . Registered on 23 September 2024-retrospectively registered.

摘要

背景

与饮食和外貌相关的负面经历（NEREAs），例如父母对食物的批评性评论，很常见，且与抑郁症和饮食失调有关。意象改写（IR）是一个治疗过程，在此过程中，个体被引导回忆痛苦的记忆（如NEREAs）并为其提供支持。单次IR治疗在改变女性临床样本中NEREAs的主要负面后果方面显示出前景。这项试点试验的主要目的是评估在有NEREAs的成年社区样本中，远程提供的单次IR治疗和营养教育对照组的可行性和可接受性。

方法

在这项平行双臂试点试验中，参与者于2023年2月至2024年4月在美国俄勒冈州完成了一次面对面的基线访视、一次远程提供的单次干预（IR或注意力匹配的营养教育对照）以及面对面的1个月和3个月随访访视。可行性指标包括招募、访视和调查完成率以及干预保真度；使用参与者反馈和不良事件实例评估可接受性。

结果

101名成年人完成了电话筛选；96%的人报告至少有一次NEREA。这些成年人中的大多数不符合条件，因为他们符合精神疾病标准和/或正在服用已知会影响情绪和/或食欲的药物。32名参与者完成了基线研究访视；这些参与者中的89%（N = 27；平均年龄[标准差]= 32.52[15.78]，范围 = 从18岁到73岁；56%为顺性别女性；74.1%为非西班牙裔白人，14.8%为亚洲人，11.1%为西班牙裔/拉丁裔，7.4%为黑人，3.7%为多种族）被随机分配（使用随机数生成器）到并完成了一种干预条件（13人接受IR治疗，14人接受对照治疗）。IR治疗的课程依从性平均为94%，对照治疗为97%。1个月的保留率为82%，三个月的保留率为59%。干预后的评分表明两组的可接受性都很好。没有发生不良事件。