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Background: Despite several decades of treatment research for anorexia nervosa (AN), many of the same questions remain: how to boost enrollment, engage participants, prevent attrition, and meet the needs of a diverse patient population within the rigorous framework of a randomized controlled trial (RCT). Methods: In this research forum, we highlight some of the challenges and opportunities observed over the course of TRIANGLE, the largest RCT for severe AN treatment in the UK to date. We discuss strategies for addressing common challenges and avoiding common pitfalls and propose solutions to future researchers seeking to conduct treatment research in AN. Results: Our experience underscores the value of involving people with lived experience at every stage of intervention research. We offer additional recommendations for treatment researchers, including, (1) early qualitative research to identify patient barriers and obstacles, (2) clear, systematic collaboration with clinical sites for patient recruitment and passive data collection, (3) careful consideration of assessment metrics, including repeated measurement of quality of life, (4) adopting a flexible, patient‐centered approach to clinical trial research, and (5) considering the unique needs and obstacles that might impact carer participation in research and their ability to provide support to their loved ones. Discussion: We hope that these lessons learned will prove fruitful for the next generation of researchers embarking on treatment research for AN. Public Significance: Using the TRIANGLE trial as an illustrative case study, we highlight the value of lived experience and codesign for developing and testing interventions for AN. We offer several lessons learned over the course of the trial, pertaining to trial enrollment, retention and engagement, measurement of outcomes, and research adaptations for real‐world settings, and hope that these recommendations facilitate future treatment research for AN. [ABSTRACT FROM AUTHOR]

Introduction: Ensuring adequate representation and the active, meaningful and visible involvement of groups likely to be most impacted by research findings and/or the lack of research inquiry are increasingly acknowledged. This is particularly relevant for Black racially minoritised groups who are less visible as research participants and in patient and public involvement and engagement (PPIE) roles. Our viewpoint article sought to discuss reflections and insights on their involvement experience, with particular attention to perceived barriers and enablers to PPIE involvement. Methods: Qualitative data were collected as part of facilitated group discussions from nine Black racially minoritised experts‐by‐experience involved in a PPIE advisory group. Data were subjected to thematic analysis to identify key themes. Results: Five main themes were identified that reflected factors linked to practicalities: role unfamiliarity, benefits for the larger community, acknowledgement of previous harm and mental health stigma. Conclusion: Given the existence and importance of the direct links between research and service and treatment innovations in health and social care, ensuring that those from underrepresented Black racial communities are meaningfully and equitably supported to have roles in advising and influencing research programmes should be prioritised and an ongoing consideration for different stakeholders, including research funders, researchers, healthcare providers and community leaders/representatives. Patient or Public Contribution: This viewpoint article is a collaboration between lived experience stakeholders and researchers, comprising conceiving the original idea for the paper, its conceptualisation and data generation and the coproduction including editing of the manuscript. [ABSTRACT FROM AUTHOR]

Objective: Patients with eating disorders report the experience of living with an eating disorder voice, a second‐ or third‐person, negative commentary about eating, weight, shape and their implications for self‐esteem. Qualitative and cross‐sectional studies suggest that the severity and characteristics of the eating disorder voice might play a role in the maintenance of eating disorder symptoms. The goal of this study was to expand the evidence base as to how the eating disorder voice changes over time and whether the characteristics of the voice are associated with changes in eating disorder symptoms during treatment. Method: Seventy‐two patients with anorexia nervosa receiving intensive eating disorder treatment were recruited. They completed self‐report measures of eating disorder symptoms, psychological distress and eating disorder voice's severity and characteristics (e.g., malevolence, benevolence and omnipotence) at baseline and approximately 6 months later. Results: Over time, patients reported lower levels of eating and weight concern (small effect size), shape concern (large effect size) and anxiety (small effect size). They also reported a reduction in the severity, perceived malevolence (medium effect size) and omnipotence (small effect size) of the eating disorder voice. Greater severity and malevolence of the voice, and lower benevolence at baseline predicted greater reductions in eating disorder symptoms (i.e., restraint and shape concern). Conclusion: Beliefs about the eating disorder voice (i.e., malevolence) and severity of the voice appear to be malleable to treatment and are associated with a reduction of eating disorder symptoms. The potential of using dialogical approaches to target the eating disorder voice is discussed. [ABSTRACT FROM AUTHOR]

Childhood and adolescence psychopathology is associated with an increased risk of psychological difficulties in adulthood. Early interventions for youth should provide carers and teachers with knowledge and skills to respond to adolescents' risky behaviours. This study evaluated the acceptability and effectiveness of a single 3-h workshop, combining psychoeducation and skills training to promote knowledge about, and confidence to address, adolescents' risky behaviours in carers and teachers of adolescents aged 10–14. Demographics and perceived self-efficacy in the parental or teaching role were collected at baseline using self-report questionnaires. Motivation and confidence to respond to adolescents' risky behaviours were measured before and after the workshop using motivational rulers. Participants provided written feedback about their experience about the workshop. Twenty-seven carers and 27 teachers attended the workshops. Teachers reported a significant increase in both importance (p = 0.021) and confidence (p < 0.001) to respond to risky behaviours following the workshop. This change was associated with baseline self-efficacy levels (importance: p = 0.011; confidence: p = 0.002). Carers also reported greater confidence to address risky behaviours following the workshop (p = 0.002). Participants found the contents and methods of the workshop highly acceptable. Online and multiple-session workshops might increase reach and effectiveness. [ABSTRACT FROM AUTHOR]

Objective: A biased attentional processing of food stimuli may represent a disorder maintenance factor in patients with anorexia nervosa (AN). The present study aimed at investigating the temporal course of attentional deployment towards both high‐calorie and low‐calorie foods in patients with AN using eye‐tracking. Method: Fifty‐two patients with restrictive AN and 54 healthy controls (HC) performed a dot‐probe task while their gaze was recorded with an eye‐tracking system. The direction bias (percentage of trials in which the gaze was directed towards the food at first fixation, 500, and 1500 ms), and the duration bias (percentage of time spent looking at the food) were extracted. Results: Regarding the direction bias, a group by time interaction emerged (F = 3.29, p = 0.038): while in the control group the bias continued to increase over the course of the trial, patients with AN showed a reduction of the bias between the 500 and 1500 ms. No group differences were observed on the duration bias. Conclusions: In advanced stages of attentional deployment patients with AN start to differ from HC by diverting their attention away from food stimuli, a strategic process that may contribute to food avoidance and calorie restriction. Highlights: Both patients with anorexia nervosa (AN) and healthy controls (HC) displayed an initial avoidance of low‐calorie foods.No differences between patients and controls emerged in the initial phases of attentional deployment.At advanced stages of attentional processing patients with AN start to differ from HC by diverting their attention away from food stimuli. [ABSTRACT FROM AUTHOR]