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1. Family-Based Treatment for Anorexia Nervosa Symptoms in High-Risk Youth: A Partially-Randomized Preference-Design Study

Author

Loeb, Katharine L, Weissman, Ruth Striegel, Marcus, Sue, Pattanayak, Cassandra, Hail, Lisa, Kung, Kelly C, Schron, Diana, Zucker, Nancy, Le Grange, Daniel, Lock, James, Newcorn, Jeffrey H, Taylor, C Barr, and Walsh, B Timothy

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Clinical Research, Eating Disorders, Brain Disorders, Mental Health, Pediatric, Anorexia, Clinical Trials and Supportive Activities, Serious Mental Illness, Nutrition, Evaluation of treatments and therapeutic interventions, 6.6 Psychological and behavioural, Mental health, Good Health and Well Being, anorexia nervosa, early identification, early intervention, family-based treatment, partially-randomized preference design, Public Health and Health Services, Psychology, Clinical sciences
Abstract

This pilot study adapted family-based treatment (FBT) for youth with potentially prodromal anorexia nervosa (AN). Fifty-nine youth with clinically significant AN symptom constellations, but who never met full Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.) (DSM-IV) criteria for AN, were enrolled in a partially randomized preference design study. Participants were offered randomization to FBT or supportive psychotherapy (SPT); those who declined to be randomized because of a strong treatment preference were entered into a parallel, non-randomized self-selected intervention study. Without accessing outcome data, an observational analysis with three diagnostic subclasses was designed based on AN symptom severity profiles, combining randomized and non-randomized participants, such that participants receiving FBT and SPT within each subclass were similar on key baseline characteristics. Outcomes of this pilot study were explored by calculating effect sizes for end-of-treatment values within each subclass, and also with a longitudinal mixed effect model that accounted for subclass. Weight trajectory was measured by percent expected body weight. Psychological outcomes were fear of weight gain, feeling fat, importance of weight, and importance of shape. Results show that the pattern of symptom observations over time was dependent on subclass of SAN (least symptomatic, moderately symptomatic, or most symptomatic) and on the target outcome variable category (weight or psychological). Results from this study, which should be considered in the context of the small sample sizes overall and within groups, can generate hypotheses for future, larger research trials on early treatment strategies. Feasibility findings illustrate how the innovative partially randomized preference design has potential broader application for AN intervention research.Clinical trial registrationClinicalTrials.gov, identifier NCT00418977.

Published
2020

2. Evaluation of nasal septum deviation via reformatted computed tomography (CT) imaging following expansion using RPE and MARPE

Author

Schron, Diana Hsu

Subjects
Dentistry, CBCT, miniscrew assisted rapid palatal expansion, nasal septum, Nasal septum deviation, orthodontic expansion, Rapid palatal expansion
Abstract

Objective: To evaluate whether rapid palatal expansion (RPE) or miniscrew-assisted rapid palatal expansion (MARPE) affects nasal septum deviation (NSD). Materials and Methods: The study population includes 15 RPE patients ages 9.5 +/- 1.4 years and 15 MARPE patients ages 17.39 +/- 5.71 years with initial diagnostic cone-beam computed tomography (CBCT) scans (T0). Another CBCT scan (T1) was taken after patients underwent RPE or MARPE expansion treatment alone. NSD was evaluated three-dimensionally using a custom landmark analysis on T0 and T1 CBCT scans. Principal component analysis (PCA) and canonical variate analysis (CVA) were used to identify nasal septum shape differences before and after expansion treatment. Results: PCA and CVA showed that while there was change in nasal septum shape from T0 to T1 for MARPE and RPE treatments, the general pattern in morphological change was not found when comparing the variety of phenotypes between individuals. The Procrustes ANOVA regression found p-values for MARPE centroid size and shape were 0.75 and 1, and RPE centroid size and shape were 0.64 and 0.25, respectively, suggesting that there were no significant differences in nasal septum size and shape following expansion. CVA found p-values were 0.99 for MARPE and 1 for RPE after 10,000 permutation tests for Procrustes distances, indicating that there were no significant differences between T0 and T1 group means for both treatment groups.Conclusions: MARPE and RPE expansion treatments had no effect on nasal septum deviation from T0 to T1.

Published
2022

3. Family-Based Treatment for Anorexia Nervosa Symptoms in High-Risk Youth: A Partially-Randomized Preference-Design Study

Author

Loeb, Katharine L., primary, Weissman, Ruth Striegel, additional, Marcus, Sue, additional, Pattanayak, Cassandra, additional, Hail, Lisa, additional, Kung, Kelly C., additional, Schron, Diana, additional, Zucker, Nancy, additional, Le Grange, Daniel, additional, Lock, James, additional, Newcorn, Jeffrey H., additional, Taylor, C. Barr, additional, and Walsh, B. Timothy, additional

Published
2020
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4. Family-Based Treatment for Anorexia Nervosa Symptoms in High-Risk Youth: A Partially-Randomized Preference-Design Study.

Author

Loeb, Katharine L, Loeb, Katharine L, Weissman, Ruth Striegel, Marcus, Sue, Pattanayak, Cassandra, Hail, Lisa, Kung, Kelly C, Schron, Diana, Zucker, Nancy, Le Grange, Daniel, Lock, James, Newcorn, Jeffrey H, Taylor, C Barr, Walsh, B Timothy, Loeb, Katharine L, Loeb, Katharine L, Weissman, Ruth Striegel, Marcus, Sue, Pattanayak, Cassandra, Hail, Lisa, Kung, Kelly C, Schron, Diana, Zucker, Nancy, Le Grange, Daniel, Lock, James, Newcorn, Jeffrey H, Taylor, C Barr, and Walsh, B Timothy

Abstract

This pilot study adapted family-based treatment (FBT) for youth with potentially prodromal anorexia nervosa (AN). Fifty-nine youth with clinically significant AN symptom constellations, but who never met full Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.) (DSM-IV) criteria for AN, were enrolled in a partially randomized preference design study. Participants were offered randomization to FBT or supportive psychotherapy (SPT); those who declined to be randomized because of a strong treatment preference were entered into a parallel, non-randomized self-selected intervention study. Without accessing outcome data, an observational analysis with three diagnostic subclasses was designed based on AN symptom severity profiles, combining randomized and non-randomized participants, such that participants receiving FBT and SPT within each subclass were similar on key baseline characteristics. Outcomes of this pilot study were explored by calculating effect sizes for end-of-treatment values within each subclass, and also with a longitudinal mixed effect model that accounted for subclass. Weight trajectory was measured by percent expected body weight. Psychological outcomes were fear of weight gain, feeling fat, importance of weight, and importance of shape. Results show that the pattern of symptom observations over time was dependent on subclass of SAN (least symptomatic, moderately symptomatic, or most symptomatic) and on the target outcome variable category (weight or psychological). Results from this study, which should be considered in the context of the small sample sizes overall and within groups, can generate hypotheses for future, larger research trials on early treatment strategies. Feasibility findings illustrate how the innovative partially randomized preference design has potential broader application for AN intervention research.Clinical trial registrationClinicalTrials.gov, identifier NCT00418977.

Published
2019

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