A proof-of-concept study for the use of a computerised avatar to embody the eating disorder voice in anorexia nervosa

Cardi, Valentina; Ward, Thomas; Aya, Viviana; Calissano, Chiara; Thompson, Alistair; Treasure, Janet

doi:10.1007/s40519-022-01487-3

Cited by 4 publications

(1 citation statement)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The current review has shed light on how to refine the application of IPT for EDs and to address social rank issues trans-diagnostically (Rieger et al, 2010). Other novel relational and interpersonal frameworks using digital technologies, such as AVATAR therapy, which aim to improve individuals' ability to be assertive in interactions with others and toward challenging and gaining power over the disorder, may have potential (Cardi et al, 2022;Craig et al, 2018;Thompson et al, 2023). Indeed a case series to apply AVATAR therapy to patients with AN has recently been completed, which aims to establish feasibility and acceptability of this approach (Cardi et al, 2022).…”

Section: Discussionmentioning

confidence: 99%

A systematic review of social rank perception and contribution to eating disorder psychopathology in individuals with eating disorders

Calissano,

Thompson,

Treasure

et al. 2023

Mental Health Science

View full text Add to dashboard Cite

Social rank theory states that achieving enhanced social rank is an essential biosocial goal for human beings, with individuals considering themselves to be high or low social rank on the basis of how they perceive that others view them. High social rank is associated with assertiveness, competence, and talent, whereas low social rank is associated with feelings of defeat and inferiority and submissive behavior. This theory has been applied to understand the etiology and psychopathology of eating disorders (EDs). The objective of this narrative systematic review was to summarize existing literature exploring perceptions of social rank and related constructs (e.g., submissiveness and inferiority) in EDs, to shed light on how individuals with EDs perceive their social rank, and to examine the relationship between perceived social rank and ED psychopathology. A systematic search of cross‐sectional or longitudinal studies involving a clinical sample of individuals with EDs and using a validated measure of social rank or a related construct was conducted for studies published up to September 12, 2023 (PROSPERO, CRD42021227028). Five databases (Embase, Medline, PsycINFO, Web of Science, and PubMed) were systematically searched. Altogether, 1106 studies were included in the title and abstract screening. Seventeen studies (13 cross‐sectional, 3 prospective cohort studies, and 1 ecological momentary assessment study) were included in the analysis and data extraction. The methodological quality of the studies was rated as generally good. There was evidence that individuals with EDs perceive their social rank as lower compared with healthy controls (N = 5 studies) and present features indicative of perceptions of low social rank (N = 9 studies). The perception of being of low social rank was significantly associated with more severe ED psychopathology (N = 10 studies). The findings of the review are discussed alongside limitations, implications for treatment models, and directions for future research.

show abstract

Section: Discussionmentioning

confidence: 99%

A systematic review of social rank perception and contribution to eating disorder psychopathology in individuals with eating disorders

Calissano,

Thompson,

Treasure

et al. 2023

Mental Health Science

View full text Add to dashboard Cite

show abstract

The Anorexic Voice: A Dialogical Enquiry and Thematic Analysis

Burnett-Stuart,

Serpell,

Chua

et al. 2024

Journal of Constructivist Psychology

View full text Add to dashboard Cite

A case series to test the acceptability, feasibility and preliminary efficacy of AVATAR therapy in anorexia nervosa

Thompson,

Calissano,

Treasure

et al. 2023

J Eat Disord

View full text Add to dashboard Cite

Background Patients with anorexia nervosa tend to experience an inner “eating disorder” voice. They struggle to recognise and assert their own identity over the illness’s identity and relate to it from a powerless and subordinate position. AVATAR therapy was developed to help patients with psychosis to gain greater power and control over distressing voices. The goal of this study was to test the feasibility, acceptability, safety and preliminary efficacy of an adaptation of AVATAR therapy for anorexia nervosa. Methods Twelve adult patients with anorexia nervosa were recruited. Ten completed an assessment session and between five to seven therapy sessions. The assessment session consisted in the creation of an avatar to represent the “eating disorder”. This was accomplished by manipulating auditory and visual characteristics through a specialist computer software. During the therapy sessions, patients interacted with the avatar to assert their own desires and will. Patients completed baseline, end of intervention and follow-up (4-week) online questionnaires. A non-concurrent multiple baselines single case experimental design (SCED) was used (A1BA2). Feasibility, acceptability, safety and preliminary efficacy of the intervention were assessed. Results The therapy met pre-specified criteria relating to (1) Feasibility: sample recruited within three months; retention rate at the end of the treatment phase = 81.9%; therapy completion rate = 90.1%. (2) Safety: no serious adverse events associated with the intervention. (3) Acceptability: mean ratings = 7.5 (SD = 2.61) out of ten, on a 0–10 scale of acceptability (10 = complete satisfaction). With regards to efficacy, participants reported significantly lower levels of distress associated with the eating disorder voice and higher levels of self-compassion at the end of treatment. No other significant changes were observed in frequency of the eating disorder voice, voice’s characteristics, such as omnipotence and malevolence, eating disorder symptoms and symptoms of anxiety, depression and stress. Patients’ feedback indicated that the therapy had helped with their ability to stand up to the illness, make positive changes around eating, and increase their motivation to recover and self-compassion. Conclusion AVATAR therapy for anorexia nervosa is feasible, acceptable and safe for patients. Larger studies are needed to test clinical efficacy. Trial registration The study was pre-registered on the clinicaltrials.gov registry (https://clinicaltrials.gov/ct2/show/NCT04778423).

show abstract

A proof-of-concept study for the use of a computerised avatar to embody the eating disorder voice in anorexia nervosa

Cited by 4 publications

References 28 publications

A systematic review of social rank perception and contribution to eating disorder psychopathology in individuals with eating disorders

A systematic review of social rank perception and contribution to eating disorder psychopathology in individuals with eating disorders

The Anorexic Voice: A Dialogical Enquiry and Thematic Analysis

A case series to test the acceptability, feasibility and preliminary efficacy of AVATAR therapy in anorexia nervosa

Contact Info

Product

Resources

About