Hanna Melles, PhD
Anorexia nervosa is a severe and disabling eating disorder and a huge challenge to treat. Intense fears of, for example, food, eating, weight gain and social evaluation are core features of anorexia nervosa and obstacles during treatment. The perceived threats trigger avoidance and safety behaviors like highly restrictive eating, strict eating rules, vomiting or body checking, to minimize feared outcomes. Therefore, anxiety and avoidance behaviors can be regarded as disorder-maintaining factors that should be targeted during treatment. Exposure therapy, known as an effective intervention in the treatment of anxiety-related disorders might also be suitable in the treatment of fears in anorexia nervosa. During her PhD project, under the supervision of Prof. Anita Jansen, Hanna researches anxiety and avoidance behaviors in anorexia nervosa as well as their treatment with exposure therapy using inhibitory learning principles, i.e. expectancy violation.
Publications that I’m most proud of
Inhibitory Learning during Exposure Treatment in Anorexia Nervosa: A Practical Guide. Behavioral Sciences, 2023.
This practical guide outlines how exposure therapy is supposed to work according to the inhibitory learning model and how the exposure intervention can be designed for individuals with anorexia nervosa. Practical examples are provided through the case presentation of a patient with anorexia nervosa who completed 31 exposure sessions.
Avoidance in Anorexia Nervosa: Towards a research agenda. Physiology & Behavior, 2021.
This article provides a new transdiagnostic research agenda featuring both basic and clinical experimental research into avoidance as an important mechanism maintaining anorexia nervosa. Avoidance learning and the generalization of learned avoidance behaviors are discussed, as well as safety behaviors and the need for exposure therapy focusing on inhibitory learning.
Transdiagnostic fears and avoidance behaviors in self-reported eating disorders. Journal of Eating Disorders, 2023.
Fears and avoidance behaviors are common symptoms of eating disorders. In this study, it was investigated whether different eating disorder diagnoses are equally characterized by similar fears and avoidance behaviors.
