Effect of cognitive bias modification training on body image dissatisfaction in adolescents with anorexia nervosa or depression-a pilot feasibility randomized controlled crossover study.

Introduction: Body image disturbance presents transdiagnostically with an impact on the development and maintenance of psychiatric disorders. Addressing body image disturbance, a cognitive bias modification training (CBM) was developed using a two-alternative forced choice task (2-AFC) to alter patients' individual perceptual boundary between what they classify as a fat versus a thin body. This pilot study aimed to evaluate, for the first time, the paradigm's feasibility and efficacy in adolescents in a clinical context. Methods: This pilot study included adolescent inpatients aged 13-17 years diagnosed with (atypical) anorexia nervosa ( Results: Mixed ANOVAs showed that the 2-AFC CBM paradigm significantly shifted the categorical boundary over 10 days, altering patients' individual perceptual boundary but did not improve the body image specific psychometric measures. Linear regression indicated training effects on diagnosis-specific characteristics, and Discussion: These findings confirm the feasibility and effectiveness of the 2-AFC CBM paradigm in adolescent inpatients transdiagnostically with further larger randomized controlled effectiveness trials required. The study suggests including normal-weight patients with anorexia nervosa only and not using confirmatory feedback as a control condition, but as an orientation and confirmation of a healthy weight limit.