Participants' experience of approach bias modification training with transcranial Direct Current Stimulation as a combination treatment for binge eating disorder

Abstract

Objective This study explored participants' experience of approach bias modification training (ABM) with transcranial Direct Current Stimulation (tDCS) for binge eating disorder (BED) within a randomised controlled trial (RCT). A subset of participants who completed the RCT were interviewed to attain feedback on treatment experience and outcomes. Method 15 participants with BED who completed the RCT were recruited, using purposive sampling. Participants received six sessions of concurrent ABM training with either real or sham tDCS. Semi‐structured interviews relating to study experience and treatment outcomes were conducted and data were analysed thematically. Results The combined ABM and tDCS intervention was deemed acceptable and worthwhile by participants interviewed across both intervention groups. Negative preconceptions of tDCS were an initial deterrent to study participation for some, yet the brain stimulation experience was found to be tolerable. Minor and transient sensations and side effects attributed to tDCS were reported by most participants during and after stimulation, in addition to less pleasant aspects of ABM training, with no significant adverse effects reported by interviewees. Positive outcomes were described by participants across both intervention groups, relating to changes in BED symptoms and to broader beneficial effects on associated cognitive and emotional factors. Two participants experienced a shift in autonomy, attributed to tDCS and the combined intervention respectively. Conclusions Adults with symptoms of BED found concurrent ABM and tDCS sessions to be acceptable, despite initial apprehension about the safety of tDCS. Findings are relevant to the neuroethics literature and may inform science communication strategies on neuromodulation treatments.

‘My dad was like “it's your brain, what are you doing?”’: Participant experiences of repetitive transcranial magnetic stimulation treatment in severe enduring anorexia nervosa

“…However, we did not specifically ask about perceived ethical issues. Of note, in a qualitative study of the experience of transcranial direct current stimulation in combination with approach bias modification training in participants with binge eating disorder (Gordon et al, 2021), autonomy was identified as a pertinent issue for a minority of participants, with one feeling the intervention was autonomy-enhancing and another autonomycompromising. Therefore, future qualitative studies may benefit from systematically exploring the ethical implications of rTMS treatment for AN.…”

Does concurrent self-administered transcranial direct current stimulation and attention bias modification training improve symptoms of binge eating disorder? Protocol for the TANDEM feasibility randomized controlled trial

“…All participants (i.e., including those who received ABMT only) will be invited to complete a semi-structured interview about the treatment experience. This interview, developed for the TANDEM trial, was based on previous semi-structured interviews about tDCS treatment by Gordon et al ( 33 ) and Smits et al ( 61 ). Questions examined seven domains of acceptability: affective attitudes, burden, ethicality, intervention coherence, opportunity costs, perceived effectiveness, and self-efficacy.…”

“…Participants were randomly allocated to one of three study groups (approach bias modification training with real tDCS, approach bias modification training with sham tDCS, or wait-list control) and outcomes were assessed at baseline, 3-weeks post-randomization, and 7-weeks post randomization. Clinical and neurocognitive outcomes are yet to be published; however, findings from a qualitative study of the treatment experience indicate that this combined approach to treatment is tolerable and acceptable ( 33 ).…”

Novel approaches to tackling emotional loss of control of eating across the weight spectrum

“…An interesting new development is to augment some of the brain training approaches described earlier with forms of neuromodulation. For example, both the eye gauze (80) and approach/avoidance training (81) have been augmented with neuromodulatory procedures.…”