Temperament-Informed Treatment for Anorexia Nervosa

Abstract Anorexia nervosa has been associated with certain biologically based traits, which are often seen in childhood before illness onset, and persist to some degree after recovery. Commonly observed traits include anxiety, harm avoidance, perfectionism, cognitive inflexibility, altered reward and punishment sensitivity, and interoceptive deficits. The temperament model of anorexia nervosa proposes that these are susceptibility markers that, in extreme manifestations, contribute to the pathogenesis and maintenance of illness. These traits can also be managed to facilitate recovery. This chapter explores the biological framework underlying the temperament model of anorexia nervosa, and introduces Temperament Based Therapy with Support, an emerging adjunctive treatment approach for adults with AN informed by this model. Preliminary efficacy findings from open trials of this treatment approach are presented. Alternative perspectives are discussed. Overall, the temperament model provides a useful framework for understanding and targeting the mechanisms underlying symptoms of anorexia nervosa and holds promise for improving treatment outcomes.