Healthier and earlier through digital technology: Towards a transdiagnostic staging model of eating and sleep disorders in adolescence (S.A.N.A.): A study protocol

Background

Eating and insomnia disorders (E&IDs) are prevalent and often comorbid among adolescents. A possible explanation for their co-existence is that they share some common maintaining mechanisms, such as increased negative affect, functional impairment, and reactivity to disease-related stimuli. This longitudinal study will identify common and specific risk factors for E&IDs and will employ virtual reality to test whether increased reactivity to disease-related stimuli discriminates between individuals at risk or with clinical symptoms and healthy peers. An additional aim is to test the feasibility of virtual reality exposure to target anxiety towards disease-related stimuli.

Methods

At least 850 adolescents (14–17 years) will complete a baseline assessment and two follow-ups (at 3 and 6–9 months), along with a 4-day ecological momentary assessment via a mobile app. Individuals at high-risk or with clinical symptoms of E&IDs and healthy peers will be exposed to a virtual reality (VR) environment including sleep or eating-related stimuli in a laboratory setting. Individuals at risk or with clinical symptoms will also be invited to use a self-directed, automatised exposure intervention for a week through VR.

Results

Variables predicting the transition from prodromal to clinical stages of E&IDs will be identified. Virtual reality exposure to disease-related stimuli will be tested as a potential tool to identify and remediate eating and sleep-related difficulties.

Conclusion

This project addresses the need for earlier, better, and more accessible interventions for young people with mental health issues. The implications include the advancement of scientific and clinical knowledge, benefits for patients and families, and the promotion of technological innovation.