Disorders - Eating Disorders
Stice, E., Rohde, P., Durant, S., Shaw, H., Wade, E.
Objective: The present preliminary trials tested whether undergraduate peer leaders can effectively deliver a dissonance-based eating disorder prevention program, which could facilitate broad dissemination of this efficacious intervention. Method: In Study 1, female undergraduates (N = 171) were randomized to peer-led groups, clinician-led groups, or an educational brochure control condition. In Study 2, which improved a design limitation of Study 1 by using completely parallel outcome measures across conditions, female undergraduates (N = 148) were randomized to either immediate peer-led groups or a waitlist control condition. Results: In Study 1, participants in peer- and clinician-led groups showed significantly greater pre-post reductions in risk factors and eating disorder symptoms than controls (M d = .64 and .98 respectively), though clinician- versus peer-led groups had higher attendance and competence ratings, and produced stronger effects at posttest (M d = .32) and at 1-year follow-up (M d = .26). In Study 2, participants in peer-led groups showed greater pre-post reductions in all outcomes than waitlist controls (M d = .75). Conclusions: Results provide novel evidence that dissonance-based eating disorder prevention groups led by undergraduate peers are feasible and produce greater reductions in eating disorder risk factors and symptoms than minimal-intervention control conditions, but indicate that effects are smaller for peer- versus clinician-led groups. (copyright) 2013 Elsevier Ltd.
Behaviour Research & Therapy, 51(4-5) : 197-206
- Year: 2013
- Problem: Eating Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Cognitive dissonance therapy, Other service delivery and improvement interventions
Stice, E., Rohde, P., Shaw, H., Marti, C. N.
Objective: Evaluate the effects of a prevention program targeting both eating disorders and obesity at 1-and 2-year follow-ups. Method: Female college students at risk for these outcomes because of body image concerns (N = 398) were randomized to the Healthy Weight 2 group-based 4-hr prevention program, which promotes lasting healthy improvements to dietary intake and physical activity and nutrition science health behavior change principles, or an educational brochure control condition. Results: Intervention participants showed significantly less body dissatisfaction and eating disorder symptoms and lower eating disorder onset through 2-year follow-up versus controls, but the former 2 effects were small. There were no main effects for body mass index (BMI), depressive symptoms, dieting, caloric intake, physical activity, or obesity onset. Moderator analyses revealed stronger eating disorder symptom effects for youths with initially elevated symptoms and lower pressure to be thin, stronger BMI effects for youths with initially elevated symptoms and BMI scores, and weaker eating disorder symptom effects for youths with initially elevated pressure to be thin. Conclusions: The 60% reduction in eating disorder onset over the 2-year follow-up was clinically significant and a novel effect for a prevention program, but the main effects on continuous outcomes were small, suggesting that adding nutrition science principles weakened the intervention efficacy. Effects on both eating disorder symptoms and BMI were greater for those with elevated eating disorder symptoms and BMI at pretest, implying that it might be useful to target these individuals in future trials. (copyright) 2012 American Psychological Association.
Journal of Consulting & Clinical Psychology, 81(1) : 183-189
- Year: 2013
- Problem: Eating Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Psychological Interventions (any)
, Psychoeducation, Dietary advice, dietary change
Stice, Eric, Rohde, Paul, Shaw, Heather, Marti, C. Nathan
Objective: Evaluate a selective prevention program targeting both eating disorder symptoms and unhealthy weight gain in young women.; Method: Female college students at high-risk for these outcomes by virtue of body image concerns (N = 398; M age = 18.4 years, SD = 0.6) were randomized to the Healthy Weight group-based 4-hr prevention program, which promotes gradual lasting healthy improvements to dietary intake and physical activity, or an educational brochure control condition.; Results: Compared to controls, intervention participants showed significantly greater reductions in body dissatisfaction and eating disorder symptoms, and greater increases in physical activity, at posttest and significantly greater reductions in body mass index (BMI) and self-reported dieting at 6-month follow-up. Moderator analyses revealed significantly greater reductions in eating disorder symptoms for those with initially elevated symptoms and pressure to be thin and significantly greater reductions in BMI for those with initially elevated eating disorder symptoms.; Conclusions: Results indicate that this intervention reduced both eating disorder symptoms and unhealthy weight gain, but suggest it should be improved to produce stronger and more persistent effects, and that it may be useful to target young women with both body image and eating disturbances.; (PsycINFO Database Record (c) 2012 APA, all rights reserved).
Journal of Consulting & Clinical Psychology, 80(1) : 164-170
- Year: 2012
- Problem: Eating Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Psychological Interventions (any)
, Psychoeducation, Dietary advice, dietary change
Stice, Eric, Rohde, Paul, Durant, Shelley, Shaw, Heather
Objective: A group dissonance-based eating disorder prevention program, in which young women critique the thin ideal, reduces eating disorder risk factors and symptoms, but it can be difficult to identify school clinicians with the time and expertise to deliver the intervention. Thus, we developed a prototype Internet version of this program and evaluated it in a preliminary trial.; Method: Female college students with body dissatisfaction (N = 107; M age = 21.6 years, SD = 6.6) were randomized to the Internet intervention, group intervention, educational video condition, or educational brochure condition.; Results: Internet and group participants showed greater pre-post reductions in eating disorder risk factors and symptoms than video controls (M ds = 0.47 and 0.54, respectively) and brochure controls (M ds = 0.75 and 0.72, respectively), with many effects reaching significance. Effects did not differ significantly for Internet versus group participants (M ds = -0.13) or for video versus brochure controls (M d = 0.25). Effect sizes for the Internet intervention were similar to those previously observed for group versions of this intervention.; Conclusions: Results suggest that this prototype Internet intervention is as efficacious as the group intervention, implying that there would be merit in completing this intervention and evaluating it in a fully powered trial.; (PsycINFO Database Record (c) 2012 APA, all rights reserved).
Journal of Consulting & Clinical Psychology, 80(5) : 907-916
- Year: 2012
- Problem: Eating Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Cognitive dissonance therapy, Technology, comparing delivery mode (e.g. online vs. face-to-face)
Stiles-Shields, Colleen, Hoste, Renee Rienecke, Doyle, Peter M., le Grange, Daniel
This review focuses on the use of family-based treatment (FBT) for adolescents with eating disorders, including anorexia nervosa (AN) and bulimia nervosa (BN). AN and BN are serious disorders with significant psychiatric and medical morbidity. Data support the use of family treatments for adolescents with eating disorders. Developed at the Maudsley Hospital, FBT is a theoretically agnostic approach that externalizes the illness from the patient and empowers families to actively work to bring about recovery in their relative with an eating disorder. FBT appears to be an effective treatment for adolescents with AN and support is developing for the treatment of adolescents with BN. Manual development is currently underway for the implementation of FBT for young adults with eating disorders, overweight adolescents, and those with subsyndromal AN. Further research is needed to determine the effectiveness of FBT with other populations. In this review, we will provide a critical overview of the literature by focusing upon empirical findings regarding FBT, with particular emphasis on studies conducted with adolescents.;
Reviews on Recent Clinical Trials, 7(2) : 133-140
- Year: 2012
- Problem: Eating Disorders (any), Anorexia Nervosa, Bulimia Nervosa
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Family therapy
Onnis, L., Barbara, E., Bernardini, M., Caggese, A., Di Giacomo, S., Giambartolomei, A., Leonelli, A., Mule, A. M., Nicoletti, P. G., Vietri, A.
This article presents the results of a broader clinical research into the effectiveness of integrated treatments in teenage eating disorders, carried out at the Complex Operative Unit of Psychotherapy (Unita Operativa Complessa or U.O.C.) of the Department of Psychiatric Sciences and Psychological Medicine in collaboration with the Department of Neuropsychiatric Science for Child Development (Dipartimento di Scienze Neuropsichiatriche dell'Eta Evolutiva), both at the "La Sapienza" University of Rome. The hypothesis of this research project is that in diagnosticable situations such as anorexia or bulimia, an integrated and multidisciplinary treatment, which combines medical-nutritional interventions and family psychotherapy, allows better results than a single kind of treatment, which is the usual medical-nutritional intervention supported by psychiatric counselling. Twenty-eight cases (16 of bulimia and 12 of anorexia) were selected and then subdivided, with a randomized distribution, into two (experimental and control) homogeneous groups of 14 patients. The grouping variables were the diagnosis, the disorder's seriousness and duration, BMI, gender, age, family composition and social status. The variables which have been examined in this article are the clinical parameters, which were valuated in accordance with the DSM IV-TR criteria, and relational parameters which were explored through the use of the W.F.T. Test (Wiltwyck Family Tasks). These parameters were tested at beginning as well as at the end of the therapies, in both the experimental group and the control group. Statistical analysis has shown that the experimental group, which was followed with the integrated treatment, experienced a significant improvement of the parameters as related to dysfunctional family interaction modalities, and that this improvement was correlated to the positive evolution of the clinical parameters. This improvement was not present or not of the same degree in the control group. The results, moreover, demonstrate the effectiveness of an integrated systemic treatment based on a complex approach compared to a reductionist approach. (copyright)2012, Editrice Kurtis.
Eating & Weight Disorders, 17(1) : e36-e48
- Year: 2012
- Problem: Eating Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Psychological Interventions (any)
, Family therapy, Other Psychological Interventions, Dietary advice, dietary change
Ramirez, A. L., Perez, M., Taylor, A.
The purpose of the current study was to investigate a new dissonance-based prevention program that is based on the dual pathway model of eating disorders within the context of an individual's romantic relationship. A total of 209 dating couples participated in a couple-based prevention program or an assessment-only condition and completed measures of body dissatisfaction, thin-ideal internalization, disordered eating, negative affect, and relationship satisfaction at two time points (approximately one week apart) and approximately half of the sample completed 1-month follow-up measures. The prevention program significantly reduced several key risk factors for eating disorders such as environmental pressures to be thin, internalization of the thin and athletic ideals, state body dissatisfaction, and actual-ideal body discrepancy. Initial support was found for the inclusion of couples in eating disorder prevention programs as a successful way of addressing the thin ideal and its detrimental effects for women. (copyright) 2012 Elsevier Ltd.
Body Image, 9(3) : 324-333
- Year: 2012
- Problem: Eating Disorders (any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive dissonance therapy
Jacobi, Corinna, Volker, Ulrike, Trockel, Mickey T., Taylor, Craig Barr
Background: Women reporting initial eating disorder (ED) symptoms are at highest risk for the development of an eating disorder. Preventive interventions should, therefore, be specifically tailored for this subgroup.; Aims: To adapt and evaluate the effects of the Internet-based prevention program "Student Bodies™" for women with symptoms of disordered eating and/or subthreshold eating disorder (ED) syndromes.; Method: 126 women, reporting subthreshold ED symptoms (high weight and shape concerns and below threshold bingeing, purging, chronic dieting or several of these symptoms) were randomly assigned to a Student Bodies™+ (SB+) intervention or a wait-list control group and assessed at pre-intervention, post-intervention, and 6-month follow-up. "Student Bodies™" was adapted to be suitable for subthreshold EDs. Main outcome measures were attitudes and symptoms of disordered eating. Pre-follow-up data were analyzed by ANCOVAS with mixed effects.; Results: At 6-month follow-up, compared to participants in the control group, participants in the intervention group showed significantly greater improvements on ED-related attitudes. Intervention participants also showed 67% (95% CI = 20-87%) greater reductions in combined rates of subjective and objective binges, and 86% (95% CI = 63-95%) greater reduction in purging episodes. Also, the rates of participants abstinent from all symptoms of disordered eating (restrictive eating, binge eating and any compensatory behavior) were significantly higher in the intervention group (45.1% vs. 26.9%). Post-hoc subgroup analyses revealed that for participants with binge eating the effect on EDE-Q scores was larger than in the pure restricting subgroup.; Conclusion: The adapted "SB+" program represents an effective intervention for women with subthreshold EDs of the binge eating subtype.; Copyright © 2011 Elsevier Ltd. All rights reserved.
Behaviour Research & Therapy, 50(2) : 93-99
- Year: 2012
- Problem: Eating Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Self-help
, Technology, interventions delivered using technology (e.g. online, SMS)
Meule, Adrian, Freund, Rebecca, Skirde, Ann Kathrin, Vogele, Claus, Kubler, Andrea
Heart rate variability (HRV) biofeedback has been reported to increase HRV while decreasing symptoms in patients with mental disorders. In addition, associations between low HRV and lowered self-regulation were found in non-clinical samples, e.g., in individuals with strong chocolate cravings or unsuccessful dieting. The current study aimed at decreasing food cravings with HRV-biofeedback in individuals frequently experiencing such cravings. Participants (N = 56) with strong or low food cravings associated with a lack of control over eating were selected from the local community. Half of the participants with strong cravings (craving-biofeedback; n = 14) performed 12 sessions of HRV-biofeedback while the other half (craving-control; n = 14) and a group with low cravings (non-craving-control; n = 28) received no intervention. Subjective food cravings related to a lack of control over eating decreased from pre- to post-measurement in the craving-biofeedback group, but remained constant in the control groups. Moreover, only the craving-biofeedback group showed a decrease in eating and weight concerns. Although HRV-biofeedback was successful in reducing food cravings, this change was not accompanied by an increase in HRV. Instead, HRV decreased in the craving-control group. This study provides preliminary evidence that HRV-biofeedback could be beneficial for attenuating dysfunctional eating behavior although specific mechanisms remain to be elucidated.;
Applied Psychophysiology & Biofeedback, 37(4) : 241-251
- Year: 2012
- Problem: Eating Disorders (any)
- Type: Controlled clinical trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Biofeedback, neurofeedback, audio/video feedback
House, J., Schmidt, U., Craig, M., Landau, S., Simic, M., Nicholls, D., Hugo, P., Berelowitz, M., Eisler, I.
Objective: To explore the role of specialist outpatient eating disorders services and investigate how direct access to these affects rates of referral, admissions for inpatient treatment, and continuity of care. Method: Services beyond primary care in Greater London retrospectively identified adolescents who presented with an eating disorder over a 2-year period. Data concerning service use were collected from clinical casenotes. Results: In areas where specialist outpatient services were available, 2-3 times more cases were identified than in areas without such services. Where initial outpatient treatment was in specialist rather than nonspecialist services, there was a significantly lower rate of admission for inpatient treatment and considerably higher consistency of care. Discussion: Developing specialist outpatient services with direct access from primary care is likely to lead to improvements in treatment and reduce overall costs. (copyright) 2012 by Wiley Periodicals, Inc. (Int J Eat Disord 2012) Copyright (copyright) 2012 Wiley Periodicals, Inc.
International Journal of Eating Disorders, 45(8) : 949-956
- Year: 2012
- Problem: Eating Disorders (any)
- Type: Controlled clinical trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Other service delivery and improvement interventions
Boothroyd, L. G., Tovee, M. J., Pollet, T. V.
Systematic differences between populations in their preferences for body size may arise as a result of an adaptive 'prepared learning' mechanism, whereby cues to health or status in the local population are internalized and affect body preferences. Alternatively, differences between populations may reflect their 'visual diet' as a cognitive byproduct of mere exposure. Here we test the relative importance of these two explanations for variation in body preferences. Two studies were conducted where female observers were exposed to pictures of high or low BMI women which were either aspirational (healthy, attractive models in high status clothes) or non-aspirational (eating disordered patients in grey leotards), or to combinations thereof, in order to manipulate their body-weight preferences which were tested at baseline and at post-test. Overall, results showed good support for visual diet effects (seeing a string of small or large bodies resulted in a change from pre- to post-test whether the bodies were aspirational or not) and also some support for the associative learning explanation (exposure to aspirational images of overweight women induced a towards preferring larger bodies, even when accompanied by equal exposure to lower weight bodies in the non-aspirational category). Thus, both influences may act in parallel. (copyright) 2012 Boothroyd et al.
PLoS ONE, 7(11) :
- Year: 2012
- Problem: Eating Disorders (any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Atkinson, Melissa J., Wade, Tracey D.
Objective: To investigate engagement in metacognitive acceptance and subsequent efficacy with respect to decreasing 2 risk factors for disordered eating, body dissatisfaction (BD), and negative affect (NA).; Method: In a pilot experiment, 20 female undergraduates (Mage = 24.35, SD = 9.79) underwent a BD induction procedure, received acceptance training using brief written instructions, and were then assessed on engagement in the technique. In a second experiment in which acceptance training was enhanced through the use of video format and a guided experiential exercise, 80 female undergraduates (mean age = 23.59, SD = 8.98) were randomized to an acceptance or control group following the same BD induction. Outcome measures were taken at baseline, postinduction, and posttreatment and consisted of separate visual analogue scales for weight and appearance satisfaction and the NA subscale of the Positive and Negative Affect Scale. Baseline assessments included the Eating Disorder Inventory-BD, Difficulties in Emotion Regulation Scale, Ways of Coping Questionnaire, and the Five Facet Mindfulness Questionnaire.; Results: Enhanced training significantly increased engagement in acceptance. Nonengagement was associated with NA, emotion regulation difficulties, and avoidant coping. Acceptance training significantly increased weight and appearance satisfaction and reduced NA relative to control, with no significant differences between those who did and did not engage. Intervention effects were moderated by mindfulness, emotion regulation difficulty, and avoidant coping.; Conclusions: Findings provide clarification regarding engagement and lend further support for the utility of acceptance, with particular benefit identified for those "at risk" for emotion regulation difficulty.;
Journal of Consulting & Clinical Psychology, 80(3) : 416-425
- Year: 2012
- Problem: Eating Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions