Identifying and understanding mechanisms in an inhibitory control training in patients with binge-eating-disorder - an exploratory analysis.

Cognitive processes play a central role in the development, maintenance, and remission of mental disorders, like Binge Eating Disorder (BED). Cognitive trainings aim to alter those cognitive processes to achieve amelioration of psychopathology. Regardless, little is known about the underlying mechanisms that can explain effective treatment in BED. Therefore, we analyzed findings from a clinical randomized-controlled trial (RCT) (Giel, Schag et al., 2023) which used an individualized computer-based inhibitory control training programme enhanced by transcranial direct current stimulation (tDCS). At the beginning of the treatment, for each person the 20 highest-rated food stimuli concerning valence, appetite, liking and wanting out of 40 high-calorie food stimuli were selected. In total, 41 patients were included in the study, 39 of those completed the training. Overall, we identified a devaluation effect for food stimuli used in the training programme: after completion of the six training sessions a significant reduction of valence, appetite, liking, and wanting of food stimuli being used in the training were observed whereas this effect was absent of food stimuli not being used in the training programme. However, the individual devaluation effect did not predict the degree of binge eating frequency reduction. As predictor variables for effective treatment, we found specific dimensions of food valence at the baseline- or follow-up-measurement to be predictive for the binge eating frequency reduction. Lastly, we found a reduction of eating concerns as well as an increase in general well-being as a predictor for binge eating frequency reduction which might indicate a potential mechanism of the inhibitory control training. Future studies might focus additionally on emotion, affect and affect regulation to complete the multifaceted clinical picture of BED to target its underlying processes to achieve effective treatment with cognitive trainings.