# Augmenting cognitive behavioral therapy with inhibitory control training

> **NIH NIH R34** · DREXEL UNIVERSITY · 2020 · $234,750

## Abstract

PROJECT SUMMARY
A large body of research demonstrates that deficits in inhibitory control, i.e., the ability to withhold, delay, or
interrupt an automatic response, are a crucial maintaining factor for a large swath of rewarding maladaptive
behaviors, such as binge eating, purging, self-injury, and substance abuse. While many patients with these
behaviors benefit from cognitive behavioral therapies (CBTs), a large subset of patients experience suboptimal
outcomes, likely because CBTs do not target directly inhibitory control. As such, there is growing interest
whether inhibitory control trainings (ICTs; i.e., computer tasks in which participants are prompted to repeatedly
withhold keypress responses to relevant stimuli) can produce improvements in inhibitory control and be a
useful augmentation to CBT. Available data suggest that ICTs can produce changes in inhibitory control on the
behavioral and neural circuitry levels (target engagement), and that improvements in inhibitory control can
produce decreases in lab-based or short-term behavior (target validation). Yet, findings regarding ICT’s ability
to produce sustained changes in behavior outside the laboratory remain mixed and limited. However,
investigations of ICT that (1) utilize repeated, intensive trainings over a sustained time period; (2) are adaptive
to an individual’s performance; and (3) are personalized to an individual’s behavior, have not been conducted.
Additionally, we have insufficient understanding of the conditions (e.g., in clinical samples, moderators of
response) under which ICTs are effective. As such, there is strong scientific premise for a test of target
engagement, validation, and initial efficacy of a repeated, personalized ICT. While ICTs may improve
outcomes for a number of disorders, patients with binge eating (i.e., episodes of eating large amounts of food
in a discrete time period with a sense of loss of control), specifically those with a diagnosis of bulimia nervosa
(BN) and binge eating disorder (BED), are well-suited for a test of ICT as an adjunct to CBT. We will evaluate
whether a personalized, repeated computerized ICT can improve inhibitory control and outcomes from CBT for
BN and BED. We will randomize individuals with BN (n=40) and BED (n=40; total n=80) to receive a daily, at-
home adjunctive ICT or a sham training condition during the first four weeks of CBT. Our primary aims include:
(1) Confirm target engagement, i.e., that ICT produces improvements in inhibitory control; (2) Test the
hypothesis that CBT+ICT will produce greater improvements in binge eating frequency compared to CBT +
sham and (3) Test the hypothesis that improvements in inhibitory control will be associated with changes in
binge eating (i.e., target validation). Our secondary aims include: (1) Test the hypothesis that the effect of ICT
on binge eating frequency will be strongest for individuals with poorer baseline levels of inhibitory control,
greater approach tendencies to highly...

## Key facts

- **NIH application ID:** 9984537
- **Project number:** 5R34MH118353-02
- **Recipient organization:** DREXEL UNIVERSITY
- **Principal Investigator:** Stephanie Manasse
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $234,750
- **Award type:** 5
- **Project period:** 2019-08-01 → 2022-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9984537

## Citation

> US National Institutes of Health, RePORTER application 9984537, Augmenting cognitive behavioral therapy with inhibitory control training (5R34MH118353-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9984537. Licensed CC0.

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