Interoceptive mechanisms of body image disturbance in anorexia nervosa - PROJECT ABSTRACT/SUMMARY Dr. Emily Choquette is applying for the Mentored Patient-Oriented Career Development Award (K23) to support her growth as an independent researcher focusing on understanding the pathophysiology of body image disturbance (BID). BID is a key diagnostic feature of AN that is associated with poor outcomes including relapse following hospital discharge. Perceptual BID is a complex process involving the integration of bodily signals (interoception), afferent visual stimuli, and mental representations of one's body. Specifically, there is evidence that BID is related to an imbalance of sensitivity to interoceptive and exteroceptive signaling in AN, which facilitates self-objectification (seeing one's body as an object) and results in an inaccurate representation of the body (i.e., perceiving one's body as larger than its true size). The proposed study will be the first to systematically examine associations between BID and interoception using several levels of analysis (i.e., self- report and behavioral assays) combined with perturbations of interoceptive (i.e., Reduced Environmental Stimulation Therapy via floatation) and cognitive (i.e., acceptance based cognitive principles) processing to examine the causal role of interoception on perceptual BID. The aims of the current project are to (1) examine how a cognitive versus interoceptive intervention paired with cognitive manipulation acutely changes BID in AN; (2) determine cross-sectional multimodal associations between interoception and BID in AN; and (3) explore longitudinal associations and mechanistic mediators of BID change in AN. The current project will use a randomized parallel-group experimental therapeutic design to explore a mechanistic framework suggesting disrupted interoceptive processing produces disturbed body image. This project will advance current scientific knowledge of the relationship between BID and interoception and pave the way for future mechanistically informed treatment techniques for BID in eating disorders. The rigorous training plan proposed by Dr. Choquette includes formal course work, didactics, and mentorship from a team of highly qualified mentors and consultants. These training activities will allow Dr. Choquette to develop an expertise in psychophysiology research methodology, advanced statistics, and content area expertise needed to progress towards independence as a clinical scientist. The training location, Laureate Institute for Brain Research (LIBR), is a state-of-the-art research institution with a history of supporting early career scientists transition to independence. Further, LIBR is home to the Float Clinic and Research Lab and co-located with the Laureate Eating Disorder Program which will facilitate completion of the proposed project. The current project will be the next logical and imperative step in Dr. Choquette's career and will support her pursuit of her career goal of developing mechanistically informed treatments for BID in eating disorders.
