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Principal Investigator: Cheri Alicia Levinson
Organization: UNIVERSITY OF LOUISVILLE
Fiscal Year: 2024
Award: $234,750
Funding agency: National Institute of Mental Health
PROJECT SUMMARY/ABSTRACT
Eating disorders (EDs) are serious mental illness, with the second highest mortality rate of any
psychiatric disorder and carry high societal, personal, and economic costs. Treatment response
for EDs are suboptimal, with only 50% of adults responding to evidence based treatments and
no evidence-based treatment for anorexia nervosa (AN) or Other Specified Feeding or Eating
Disorder (OSFED) in existence. Part of the reason EDs are so difficult to treat is the high
heterogeneity in symptom presentation, making it difficult to identify what to target in treatment,
as two individuals, even with the same diagnosis, substantially vary. Personalized treatments for
EDs are urgently needed that can improve treatment response and minimize the suffering
associated with these illnesses. Our scientific premise, developed from our past work, is that
treatment personalized based on idiographic models (termed Network Informed Personalized
Treatment; NA-PT) will outperform the current gold-standard treatment (Enhanced Cognitive
Behavioral Therapy: CBT-E). Our study goals are to (1) develop and test the acceptability,
feasibility, and preliminary efficacy of a randomization of NA-PT versus CBT-E and (2) to test if
network-identified precision targets are the mechanism of change. These goals will ultimately
lead to the very first personalized treatment for ED and can be extended to additional
psychiatric illnesses. The proposed research uses highly innovative methods; intensive
longitudinal data collected with mobile technology is combined with state-of-the art idiographic
modeling methods to deliver a virtual, personalized treatment. Specific aims are (1) To collect
preliminary data on the feasibility and acceptability of the randomization of NA-PT (n=40) for
EDs versus CBT-E (n=40), (2) To test the initial clinical efficacy of NA-PT versus CBT-E on
clinical outcomes (e.g., ED symptoms, body mass index, quality of life) and (3) To examine if
changes in NA-identified, precision targets, as well as in dynamic network structure, are
associated with change in clinical outcomes. The proposed research has clinical impact.
Ultimately, this proposal will lead directly to the creation and dissemination of an evidence-
based personalized treatment for EDs, as well as will serve as an exemplar for personalized
treatment development across the entire field of psychiatry.
Terms: <21+ years old><Active Follow-up><Address><Adult><Adult Human><After Care><After-Treatment><Aftercare><Anorexia Nervosa><BMI><BMI percentile><BMI z-score><Behavior Disorders><Binge Eating><Binge eating disorder><Body mass index><Bulimia><Bulimia Nervosa><Caring><Cell Phone><Cellular Phone><Cellular Telephone><Cessation of life><Clinical><Cognition Therapy><Cognitive Psychotherapy><Cognitive Therapy><Cognitive treatment><Complex><Data><Death><Death Rate><Development><Diagnosis><Diagnostic><Dropout><Eating Disorders><Evidence based treatment><Fear><Fright><Goals><Heterogeneity><Impairment><Individual><Intervention><Intervention Strategies><Investigation><Judgment><Lead><Left><Mental disorders><Mental health disorders><Methodology><Methods><Mobile Phones><Modeling><NIH><National Institutes of Health><Network Analysis><Outcome><Participant><Pathology><Pathway Analysis><Pattern><Pb element><Population><Precision therapeutics><Prediction of Response to Therapy><Psychiatric Disease><Psychiatric Disorder><Psychiatry><Psychotherapy><QOL><Quality of life><Quetelet index><Randomized><Research><Specific qualifier value><Specified><Structure><Symptoms><Testing><Time><Translating><Treatment outcome><United States National Institutes of Health><Visualization><Weight Gain><Weight Increase><Work><acceptability and feasibility><active followup><adulthood><behavioral disorder><body weight gain><body weight increase><bulimic><chronic mental illness><clinical efficacy><co-morbid><co-morbidity><cognitive behavior intervention><cognitive behavior modification><cognitive behavior therapy><cognitive behavioral intervention><cognitive behavioral modification><cognitive behavioral therapy><cognitive behavioral treatment><cognitive enhancement><comorbidity><compulsive eating><compulsive feeding><compulsive overeating><customized therapy><customized treatment><develop therapy><developmental><economic cost><evidence base><feeding><follow up><follow-up><followed up><followup><heavy metal Pb><heavy metal lead><iPhone><improved><individualized medicine><individualized patient treatment><individualized therapeutic strategy><individualized therapy><individualized treatment><innovate><innovation><innovative><intervention development><interventional strategy><long term recovery><mental illness><mobile assessment><mobile based assessment><mobile computing><mobile platform><mobile technology><mortality rate><mortality ratio><novel><patient specific therapies><patient specific treatment><persistent mental illness><personalization of treatment><personalized medicine><personalized therapy><personalized treatment><post treatment><precision therapies><precision treatment><predict therapeutic response><predict therapy response><prevent><preventing><psychiatric illness><psychological disorder><public health relevance><randomisation><randomization><randomly assigned><response><response to therapy><response to treatment><serious mental disorder><serious mental illness><severe mental disorder><severe mental illness><smart phone><smart phone based assessment><smartphone><smartphone based assessment><societal costs><standard care><standard treatment><tailored medical treatment><tailored therapy><tailored treatment><theories><therapeutic response><therapy development><therapy optimization><therapy prediction><therapy response><treatment development><treatment optimization><treatment planning><treatment prediction><treatment response><treatment response prediction><treatment responsiveness><unique treatment><user friendly computer software><user friendly software><virtual><wt gain>