Reclaiming Agency and Retuning Reward: Protocol for a Mixed-Methods Study on an Integrated Model of Empowered Recovery in Eating Disorders

Reclaiming Agency and Retuning Reward: Protocol for a Mixed-Methods Study on an Integrated Model of Empowered Recovery in Eating Disorders | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Study protocol Reclaiming Agency and Retuning Reward: Protocol for a Mixed-Methods Study on an Integrated Model of Empowered Recovery in Eating Disorders Alexis Gruszczynski This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6574235/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: Eating disorder (ED) recovery is challenging, with high relapse rates and frequent treatment dissatisfaction. While standard treatments address symptoms, they may not adequately target underlying issues like diminished psychological agency, reward dysfunction (anhedonia), trauma impacts, and cultural influences. There is a need for integrated models that address these multifaceted components. This study protocol outlines research designed to investigate a novel "Empowered Recovery" framework, positing that fostering agency, particularly in dietary and physical activity choices within a trauma-informed and culturally sensitive context, is linked to reduced anhedonia and improved, sustainable well-being. Methods: This study will employ a cross-sectional, mixed-methods design. Adults (18+) currently in or within 5 years postED treatment will be recruited internationally via online platforms and advocacy organizations. Data collection will involve secure online surveys assessing demographics, ED/treatment history, trauma history (e.g., PC-PTSD-5), perceived agency in diet/activity, ED symptoms (e.g., EDE-Q 12), depression (PHQ-9), anxiety (GAD-7), anhedonia (e.g., SHAPS), well-being (e.g., WHO-5), interoceptive awareness (e.g., MAIA subscale), and perceived empowerment (e.g., HES). Semi-structured qualitative interviews (~15-20 participants) will explore experiences of agency, reward, trauma, and culture in depth. Quantitative data will be analyzed using descriptive statistics, correlations, and regression analyses. Qualitative data will undergo thematic analysis. Findings will be integrated to provide a comprehensive understanding of the relationships between agency, reward, context, and recovery. Discussion: This study is expected to provide empirical support for the "Empowered Recovery" framework, potentially identifying agency as a key mechanism influencing motivation and reward-related experiences in ED recovery. Findings could inform clinical practice by highlighting the therapeutic potential of prioritizing patient autonomy, trauma-informed care, and cultural sensitivity. It may also encourage a broader definition of recovery beyond symptom reduction. Potential challenges include online recruitment biases and reliance on self-report measures. Registration: This study protocol was preregistered on OSF Registries (DOI: https://doi.org/10.17605/OSF.IO/VZCNF) on May 1, 2025, registration pending final approval. Eating Disorders ED Agency Empowerment Reward System Anhedonia Trauma Culture Recovery Motivation Neurobiology Trauma-Informed Care Self-Determination Theory Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6574235","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Study protocol","associatedPublications":[],"authors":[{"id":455965995,"identity":"72d83d89-3fe3-4577-b99c-336df710a157","order_by":0,"name":"Alexis Gruszczynski","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA7klEQVRIiWNgGAWjYLACxgYgwd4A4yYwMPDgU84G08JzgGQtEglEauGf3/7ww88d9+TkZ75Ok2D4s02evz2B8cHbNtxaJI7xGEv2nik2Nridu02Cse224YwzD5gN5+LRwnCMh0GasS0hcYM0SEvD7QQDiQQ2aV48WuSPsT/+DdRSP3/m2W1Ah4G1sP/Gp8XgGIMZyJYEhhu8QC1sEFuY8WkxPJZjZtnblmC44UzuZotEsF8eNkvOOYdbi9zh449v/GxLkJdvP7vxxoc/t4Ehlnzww5syPN5HAizQqAFHE3GA+QPRSkfBKBgFo2BEAQBZ41OOrFRbJgAAAABJRU5ErkJggg==","orcid":"","institution":"College of San Mateo","correspondingAuthor":true,"prefix":"","firstName":"Alexis","middleName":"","lastName":"Gruszczynski","suffix":""}],"badges":[],"createdAt":"2025-05-01 21:08:12","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6574235/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6574235/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":84367932,"identity":"65965f25-955c-43c8-866f-8ac940fd4a14","added_by":"auto","created_at":"2025-06-11 06:32:03","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":246491,"visible":true,"origin":"","legend":"","description":"","filename":"ResearchProtocolReclaimingAgencyandRetuningRewardByAlexisGruszczynski.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6574235/v1_covered_3066378e-e965-4ca7-8df0-3e54a5b13546.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Reclaiming Agency and Retuning Reward: Protocol for a Mixed-Methods Study on an Integrated Model of Empowered Recovery in Eating Disorders","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Eating Disorders, ED, Agency, Empowerment, Reward System, Anhedonia, Trauma, Culture, Recovery, Motivation, Neurobiology, Trauma-Informed Care, Self-Determination Theory","lastPublishedDoi":"10.21203/rs.3.rs-6574235/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6574235/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground: \u003c/strong\u003eEating disorder (ED) recovery is challenging, with high relapse rates and frequent treatment dissatisfaction. While standard treatments address symptoms, they may not adequately target underlying issues like diminished psychological agency, reward dysfunction (anhedonia), trauma impacts, and cultural influences. There is a need for integrated models that address these multifaceted components. This study protocol outlines research designed to investigate a novel \"Empowered Recovery\" framework, positing that fostering agency, particularly in dietary and physical activity choices within a trauma-informed and culturally sensitive context, is linked to reduced anhedonia and improved, sustainable well-being.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003eThis study will employ a cross-sectional, mixed-methods design. Adults (18+) currently in or within 5 years postED treatment will be recruited internationally via online platforms and advocacy organizations. 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