Disorders - Eating Disorders
Beintner, Ina, Jacobi, Corinna, Taylor, Craig Barr
A cross-cultural comparison of a cognitive-behavioural, Internet-based, 8-week prevention programme for eating disorders (StudentBodies™) evaluated in the USA and in Germany was performed. Six US and four German randomized controlled trials with a total (N) of 990 female high school and college students were included in the review. Two of the US and two of the German trials explicitly addressed high risk samples in a selective prevention approach. Effect sizes for main outcomes (disordered eating, weight and shape concerns) were calculated at postintervention and at follow-up. The intervention was associated with moderate improvements in eating disorder-related attitudes, especially reductions of negative body image and the desire to be thin. The reported effects remained significant at follow-up. No clear differences between US and German samples could be found on any of the outcome measures at postintervention. In conclusion, StudentBodies™ seems equally suitable and effective for American and German students.; Copyright © 2011 John Wiley & Sons, Ltd and Eating Disorders Association.
European Eating Disorders Review, 20(1) : 1-8
- Year: 2012
- Problem: Eating Disorders (any)
- Type: Systematic reviews
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Technology, interventions delivered using technology (e.g. online, SMS)
Becker, Carolyn Black, McDaniel, Leda, Bull, Stephanie, Powell, Marc, McIntyre, Kevin
Female athletes are at least as at risk as other women for eating disorders (EDs) and at risk for the female athlete triad (i.e., inadequate energy availability, menstrual disorders, and osteoporosis). This study investigated whether two evidence-based programs appear promising for future study if modified to address the unique needs of female athletes. Athletes were randomly assigned to athlete-modified dissonance prevention or healthy weight intervention (AM-HWI). ED risk factors were assessed pre/post-treatment, and 6-week and 1-year follow-up. Results (analyzed sample, N=157) indicated that both interventions reduced thin-ideal internalization, dietary restraint, bulimic pathology, shape and weight concern, and negative affect at 6 weeks, and bulimic pathology, shape concern, and negative affect at 1 year. Unexpectedly we observed an increase in students spontaneously seeking medical consultation for the triad. Qualitative results suggested that AM-HWI may be more preferred by athletes.; Copyright © 2011 Elsevier Ltd. All rights reserved.
Body Image, 9(1) : 31-42
- 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)
, Cognitive dissonance therapy, Dietary advice, dietary change
Jauregui Lobera, I., Bolanos Rios, P.
Introduction and objective: Research conducted to date into the primary prevention of eating disorders has mainly considered the provision of information regarding risk factors. Consequently, there is a need to develop new methods that go a step further, promoting a change in attitudes and behaviour in the target population. The main objective of this study was to compare two types of intervention: one based on this model and the other following the traditional approach of providing information. The ultimate aim was to implement a prevention program that reduces the risk factors and boosts the protection factors that have been empirically shown to be related to ED. Materials and methods: The research design was prospective and observational, with measurement of an active intervention (Intervention Group) and control (Control Group). The sample comprised 371 students (secondary-level and high-school), 174 girls and 197 boys, who was divided into twelve work groups, six for the Intervention Group, and six for the Control Group. Regarding the nutritional intake, all participants were instructed by a nutritionist on how to complete a 3-day food record (inclusive of beverages) covering two weekdays and one weekend day.Written and verbal guidelines were provided for the estimation of food portions. As part of the instructional session, and in order to check their understanding, participants were asked to describe the portions used and the food preparation details for a minimum of two prior meals. All participants were encouraged to depict typical food consumption. A research nutritionist reviewed the completed food records for clarification of portions and food preparation. Nutrient intakes were calculated from the 3-day food records by using the calculation program of the Centre for Advanced Studies in Nutrition and Dietetics (CESNID) of the University of Barcelona. On the basis of previous research that has indicated the need for preventive intervention to take into account recognised risk and protective factors, with regards to nutritional aspects the degree to which eating habits followed the Mediterranean diet, according to the recommendations of the Spanish Society for Community Nutrition, for the age groups considered, was assessed. Results: There was a considerable post-intervention improvement in the Intervention Group in terms of the intake of MUFA (F=7.60, P<0.01, (eta)2 partial=0.03), PUFA (F=7.56, P<0.01, (eta)2 partial=0.03), vitamin B12 (F=30.41, P<0.01, (eta)2 partial=0.10), vitamin C (F=5,025, P<0.01, (eta)2 partial=0.03), vitamin E (F=11.32, P<0.01, (eta)2 partial=0.05) and vitamin A (F=3.92, P<0.05, (eta)2 partial=0.01). In the Control Group there were no significant differences in the intake of either macro- or micronutrients. Confirming previous research, better outcomes were obtained when intervening with females. Conclusion: The present study shows that in the primary prevention of eating disorders, better outcomes are achieved by new models, which target the attitudes and behaviour of adolescents rather than focusing solely on the provision of risk information to raise awareness.
International Journal of Obesity, 35 : S156
- Year: 2011
- Problem: Eating Disorders (any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Dietary advice, dietary change
Gonzalez, M.
Objective: The present study aims to evaluate the long-term effects of a school-based prevention programme administered to adolescents; the purpose of the said programme was to reduce disordered eating attitudes and sociocultural influences on the internalisation of the aesthetical body ideal. Methods: A total of 254 girls and 189 boys were assigned to a control (n = 201) or to two experimental conditions: media literacy programme (n = 143) and media literacy plus nutrition awareness programme (n = 99). Pretest, post-test (1 month later) and 7-month and 30-month follow-up measurements were taken using the Eating Attitudes Test (EAT-40) and the questionnaire on influences of aesthetic body ideal-26/cuestionario de influencias del modelo estetico corporal (CIMEC-26). Linear mixed-model analyses were conducted with a 2 x 3 x 3 ANOVA (sex x group x phase), adjusted by the baseline level. Results: The participants from both prevention programmes scored lower than the participants in the control group at follow-up assessments on EAT-40 and CIMEC-26 scores. Discussion: Both media literacy-based programmes can be effective interventions reducing long-term self-reported disordered eating attitudes and internalisation of the aesthetic body ideal in a universal mixed-sex school-going adolescent population. Copyright (copyright) 2011 John Wiley & Sons, Ltd and Eating Disorders Association.
European Eating Disorders Review, 19(4) : 349-356
- Year: 2011
- Problem: Eating Disorders (any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Psychological Interventions (any)
, Other Psychological Interventions, Dietary advice, dietary change
Lopez-Guimera, G., Sanchez-Carracedo, D., Fauquet, J., Portell, M., Raich, R. M.
This study assessed the impact of a school-based program aimed at preventing disordered eating. The program was based on the media-literacy approach and has interactive format. The program was assessed under strong methodological conditions. Seven schools with 263 Spanish adolescent girls in the area of Barcelona, were randomly assigned to either the complete prevention program condition, the partial program condition or the non-treatment control condition, and assessed at pre, post and 6-month follow-up. The program was effective in generating positive changes at follow-up. The effects sizes (ESd = 0.29 to ESd = 0.38) were greater, on average, than that obtained up to now in selective-universal programs, and similar or greater than that achieved by targeted prevention programs. The results indicate a greater and relevant effect size of the intervention in those participants who completed the inter-session interactive activities (ESd = 0.29 to ESd = 0.45) although the differences were not significant. These results suggest the importance of monitoring adherence to the activities in all programs defined as "interactive". The implications and limitations of this study are discussed. (copyright) 2011 by The Spanish Journal of Psychology.
Spanish Journal of Psychology, 14(1) : 293-303
- Year: 2011
- Problem: Eating Disorders (any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Midgley, N., Kennedy, E.
For many years psychoanalytic and psychodynamic therapies have been considered to lack a credible evidence-base and have consistently failed to appear in lists of 'empirically supported treatments'. This study systematically reviews the research evaluating the efficacy and effectiveness of psychodynamic psychotherapy for children and young people. The researchers identified 34 separate studies that met criteria for inclusion, including nine randomised controlled trials. While many of the studies reported are limited by sample size and lack of control groups, the review indicates that there is increasing evidence to suggest the effectiveness of psychoanalytic psychotherapy for children and adolescents. The article aims to provide as complete a picture as possible of the existing evidence base, thereby enabling more refined questions to be asked regarding the nature of the current evidence and gaps requiring further exploration. (copyright) 2011 Copyright Taylor and Francis Group, LLC.
Journal of Child Psychotherapy, 37(3) : 232-260
- Year: 2011
- Problem: Anxiety Disorders (any), Depressive Disorders, Eating Disorders (any)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Psychodynamic/Psychoanalysis
Luethcke, C. A., McDaniel, L., Becker, C. B.
This study compares different versions of mirror exposure (ME), a body image intervention with research support. ME protocols were adapted to maximize control and comparability, and scripted for delivery by research assistants. Female undergraduates (N=168) were randomly assigned to receive mindfulness-based (MB; n=58), nonjudgmental (NJ; n=55), or cognitive dissonance-based (CD, n=55) ME. Participants completed the Body Image Avoidance Questionnaire (BIAQ), Body Checking Questionnaire (BCQ), Satisfaction with Body Parts Scale (SBPS), Beck Depression Inventory-II (BDI-II), and Eating Disorders Examination Questionnaire (EDE-Q) at pre-treatment, post-treatment, and 1-month follow-up. Mixed models ANOVAs revealed a significant main effect of time on all measures, and no significant time by condition interaction for any measures except the SBPS. Post-hoc analysis revealed that only CD ME significantly improved SBPS outcome. Results suggest that all versions of ME reduce eating disorder risk factors, but only CD ME improves body satisfaction. (copyright) 2011 Elsevier Ltd.
Body Image, 8(3) : 251-258
- Year: 2011
- Problem: Eating Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions, Mindfulness based therapy, Cognitive dissonance therapy
McMillan, W., Stice, E., Rohde, P.
Objective: As cognitive dissonance is theorized to contribute to the effects of dissonance-based eating disorder prevention programs, we evaluated a high-dissonance version of this program against a low-dissonance version and a wait-list control condition to provide an experimental test of the mechanism of intervention effects. Method: Female college students (N = 124, mean age = 20.9 years, SD = 3.9) with body image concerns were randomized to the 3 conditions. The high-dissonance program was designed to maximize dissonance induction, and the low-dissonance program was designed to minimize it; the substantive content of the 2 programs was matched. Results: Relative to controls, those in the high-dissonance condition showed significantly greater reductions in thin-ideal internalization, body dissatisfaction, dieting, and eating disorder symptoms by posttest, and those in the low-dissonance condition showed significantly greater reductions in the first 3 outcomes by posttest, with most of these effects persisting to 3-month follow-up. High-dissonance participants showed significantly greater reductions in eating disorder symptoms than low-dissonance participants did by posttest, but this effect was nonsignificant by 3-month follow-up. Conclusions: Results suggest that dissonance induction contributes to intervention effects but imply that the intervention content, nonspecific factors, and demand characteristics play a much more potent role in producing effects. (copyright) 2011 American Psychological Association.
Journal of Consulting & Clinical Psychology, 79(1) : 129-134
- Year: 2011
- Problem: Eating Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive dissonance therapy
Storch, Maja, Keller, Ferdinand, Weber, Julia, Spindler, Anja, Milos, Gabriella
This study examined the effects of a psychoeducational training program in affect regulation for patients with eating disorders. Nineteen female patients completed measures of affect regulation (ACS-90), alexithymia (TAS-26), and eating behavior (EDE-Q). Data were assessed at baseline and at 3 and 12 months posttreatment. Dependent on date of entering hospital, the patients were allocated consecutively to the control group (n =11), which received inpatient treatment as usual, or to the treatment group (n = 8), which received training in addition to usual inpatient treatment. At follow-up, the training was associated with statistically significant improvement in the skill of down-regulating negative affect and with a tendency towards less dietary restraint. Regarding alexithymia no clear results were found. Despite the small sample size, results showed that in addition to the general improvement due to the treatment usually provided in the clinical setting, the training program resulted in specific benefits for the patients with regard to their affect regulation skills.
American Journal of Psychotherapy, 65(1) : 81-93
- Year: 2011
- Problem: Eating Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Psychoeducation
Siemer, C. P., Fogel, J., VanVoorhees, B. W.
The authors conducted a review of the literature with regard to child and adolescent mental health intervention, from which they identified 20 unique publications and 12 separate interventions. These interventions encompassed depression, anxiety, substance abuse, eating disorders, and mental health promotion. Studies were heterogeneous, with a wide range of study designs and comparison groups creating some challenges in interpretation. However, modest evidence was found that Internet interventions showed benefits compared with controls and preintervention symptom levels. Interventions had been developed for a range of settings, but tended to recruit middle-class participants of European ethnicity. Internet interventions showed a range of approaches toward engaging children and incorporating parents and peers into the learning process. (copyright) 2011 Elsevier Inc.
Child & Adolescent Psychiatric Clinics of North America, 20(1) : 135-153
- Year: 2011
- Problem: Anxiety Disorders (any), Depressive Disorders, Eating Disorders (any)
- Type: Systematic reviews
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Technology, interventions delivered using technology (e.g. online, SMS)
Becker, Carolyn Black, Wilson, Chantale, Williams, Allison, Kelly, Mackenzie, McDaniel, Leda, Elmquist, Joanna
Research supports the efficacy of both cognitive dissonance (CD) and healthy weight (HW) eating disorders prevention, and indicates that CD can be delivered by peer-facilitators, which facilitates dissemination. This study investigated if peer-facilitators can deliver HW when it is modified for their use and extended follow-up of peer-facilitated CD as compared to previous trials. Based on pilot data, we modified HW (MHW) to facilitate peer delivery, elaborate benefits of the healthy-ideal, and place greater emphasis on consuming nutrient dense foods. Female sorority members (N=106) were randomized to either two 2-h sessions of CD or MHW. Participants completed assessment pre- and post-intervention, and at 8-week, 8-month, and 14-month follow-up. Consistent with hypotheses, CD decreased negative affect, thin-ideal internalization, and bulimic pathology to a greater degree post-intervention. Both CD and MHW reduced negative affect, internalization, body dissatisfaction, dietary restraint, and bulimic pathology at 14 months.; Copyright © 2010 Elsevier Ltd. All rights reserved.
Body Image, 7(4) : 280-288
- Year: 2010
- Problem: Eating Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Psychological Interventions (any)
, Cognitive dissonance therapy, Dietary advice, dietary change
Fairburn, Christopher G., Cooper, Zafra, Doll, Helen A., O'Connor, Marianne E., Bohn, Kristin, Hawker, Deborah M., Wales, Jackie A., Palmer, Robert L.
Objective: The aim of this study was to compare two cognitive-behavioral treatments for outpatients with eating disorders, one focusing solely on eating disorder features and the other a more complex treatment that also addresses mood intolerance, clinical perfectionism, low self-esteem, or interpersonal difficulties. Method: A total of 154 patients who had a DSM-IV eating disorder but were not markedly underweight (body mass index over 17.5), were enrolled in a two-site randomized controlled trial involving 20 weeks of treatment and a 60-week closed period of follow-up. The control condition was an 8-week waiting list period preceding treatment. Outcomes were measured by independent assessors who were blind to treatment condition. Results: Patients in the waiting list control condition exhibited little change in symptom severity, whereas those in the two treatment conditions exhibited substantial and equivalent change, which was well maintained during follow-up. At the 60-week follow-up assessment, 51.3% of the sample had a level of eating disorder features less than one standard deviation above the community mean. Treatment outcome did not depend on eating disorder diagnosis. Patients with marked mood intolerance, clinical perfectionism, low self-esteem, or interpersonal difficulties appeared to respond better to the more complex treatment, with the reverse pattern evident among the remaining patients. Conclusions: These two transdiagnostic treatments appear to be suitable for the majority of outpatients with an eating disorder. The simpler treatment may best be viewed as the default version, with the more complex treatment reserved for patients with marked additional psychopathology of the type targeted by the treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved) (journal abstract)
American Journal of Psychiatry, 166(3) : 311-319
- Year: 2009
- Problem: Eating Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)