Disorders - Eating Disorders
Stice, Eric, Rohde, Paul, Gau, Jeff, Shaw, Heather
Efficacy trials indicate that an eating disorder prevention program involving dissonance-inducing activities that decrease thin-ideal internalization reduces risk for current and future eating pathology, yet it is unclear whether this program produces effects under real-world conditions. The present effectiveness trial tested whether this program produced effects when school staff recruit participants and deliver the intervention. Adolescent girls with body image concerns (N = 306; M age = 15.7, SD = 1.1) randomized to the dissonance intervention showed significantly greater decreases in thin-ideal internalization, body dissatisfaction, dieting attempts, and eating disorder symptoms from pretest to posttest than did those assigned to a psychoeducational brochure control condition, with the effects for body dissatisfaction, dieting, and eating disorder symptoms persisting through 1-year follow-up. Effects were slightly smaller than those observed in a prior efficacy trial, suggesting that this program is effective under real-world conditions, but that facilitator selection, training, and supervision could be improved.; (c) 2009 APA, all rights reserved.
Journal of Consulting & Clinical Psychology, 77(5) : 825-834
- Year: 2009
- Problem: Eating Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Psychoeducation, Cognitive dissonance therapy
Wilksch, Simon M., Wade, Tracey D.
Objective: Method: Results: Conclusion: Recent eating disorder prevention efforts have targeted high-risk females in late adolescence (>15 years). Methodologically rigorous evaluations of prevention programs directed to younger, mixed-sex, universal audiences are largely absent. The primary objective was to evaluate a theoretically informed media literacy program delivered to a mixed-sex, universal, young adolescent audience.Five hundred forty Grade 8 students (mean age 13.62 years, SD 0.37 years) from 4 schools participated with a total of 11 classes receiving the 8-lesson media literacy program (126 girls and 107 boys) and 13 comparison classes receiving their normal school lessons (147 girls and 160 boys). Shape and weight concern (primary outcome variable) and seven additional eating disorder risk factors (e.g., dieting, media internalization) were measured with validated questionnaires at baseline, postprogram, and 6- and 30-month follow-up.Linear mixed model analyses were conducted using a 2 (group: media literacy program, control) x 3 (time: postprogram, 6-month follow-up, 30-month follow-up) x 2 (sex: girls, boys) mixed within-between design, with baseline entered as a covariate. Main effects for group, favoring the media literacy program, were found for shape and weight concern (effect size [ES] = 0.29), dieting (ES = 0.26), body dissatisfaction (ES = 0.20), ineffectiveness (ES = 0.23), and depression (ES = 0.26).Media literacy can be an effective intervention for reducing shape and weight concern and other eating disorder risk factors long-term in a universal mixed-sex, young adolescent population. More evaluations of methodologically sound prevention programs are required with this demographic.
Journal of the American Academy of Child & Adolescent Psychiatry, 48(6) : 652-661
- Year: 2009
- Problem: Eating Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Yager, Zali, O'Dea, Jennifer A.
Body dissatisfaction, dieting, eating disorders and exercise disorders are prevalent among male and female university students worldwide. Male students are also increasingly adopting health-damaging, body-image-related behaviors such as excessive weight lifting, body building and steroid abuse. Given the severity and difficulty of treating eating disorders, prevention of these problems is a recognized public health goal. Health promotion and health education programs have been conducted in the university setting since the mid 1980s, but few have achieved significant improvements in target health attitudes and behaviors. In this paper, 27 large, randomized and controlled health promotion and health education programs to improve body dissatisfaction, dieting and disordered eating and exercise behaviors of male and female college students are reviewed. In general, health education programs to improve body image and prevent eating disorders in the university setting have been limited by small sample sizes and the exclusion of male students. The majority of studies were conducted among either female undergraduate psychology students or women that were recruited using on-campus advertising. The latter reduces the ability to generalize results to the whole university population, or the general community. In addition, there has been a paucity of longitudinal studies that are methodologically sound, as only 82% (22/27) of interventions included in the review used random assignment of groups, and only 52% (n = 14) included follow-up testing. Information-based, cognitive behavioral and psycho-educational approaches have been the least effective at improving body image and eating problems among university students. Successful elements for future initiatives are identified as taking a media literacy- and dissonance-based educational approach, incorporating health education activities that build self-esteem, and using computers and the internet as a delivery medium. A newly designed program for Australian university students is described. [References: 79]
Health Promotion International, 23(2) : 173-89
- Year: 2008
- Problem: Eating Disorders (any)
- Type: Systematic reviews
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
Ridolfi, D. R., Vander Wal, J. S.
The purpose of this study was to assess the effectiveness of a body image dissatisfaction prevention session that provided information on body image and media literacy to college women. Participants were 81 undergraduates who were randomly assigned to attend either a body image intervention or a control intervention. Participants completed measures at pre- and post-intervention and at 4-week follow-up. The body image group improved significantly more than the control group on body shape concerns, but not on the other outcome variables. Efficacious interventions capable of reaching large numbers of women are necessary to help dispel the "normative discontent" prevalent today.
Eating Disorders., 16(5) : 428-443
- Year: 2008
- Problem: Eating Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Stice, Eric, Marti, C. Nathan, Spoor, Sonja, Presnell, Katherine, Shaw, Heather
Adolescent girls with body dissatisfaction (N = 481, SD = 1.4) were randomized to a dissonance-based thin-ideal internalization reduction program, healthy weight control program, expressive writing control condition, or assessment-only control condition. Dissonance participants showed significantly greater decreases in thin-ideal internalization, body dissatisfaction, negative affect, eating disorder symptoms, and psychosocial impairment and lower risk for eating pathology onset through 2- to 3-year follow-up than did assessment-only controls. Dissonance participants showed greater decreases in thin-ideal internalization, body dissatisfaction, and psychosocial impairment than did expressive writing controls. Healthy weight participants showed greater decreases in thin-ideal internalization, body dissatisfaction, negative affect, eating disorder symptoms, and psychosocial impairment; less increases in weight; and lower risk for eating pathology and obesity onset through 2- to 3-year follow-up than did assessment-only controls. Healthy weight participants showed greater decreases in thin-ideal internalization and weight than did expressive writing controls. Dissonance participants showed a 60% reduction in risk for eating pathology onset, and healthy weight participants showed a 61% reduction in risk for eating pathology onset and a 55% reduction in risk for obesity onset relative to assessment-only controls through 3-year follow-up, implying that the effects are clinically important and enduring. PsycINFO Database Record (c) 2008 APA, all rights reserved.
Journal of Consulting & Clinical Psychology, 76(2) : 329-40
- Year: 2008
- Problem: Eating Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions, Cognitive dissonance therapy
Raich, Rosa M., Sanchez-Carracedo, David, Lopez-Guimera, Gemma, Portell, Mariona, Moncada, Albert, Fauquet, Jordi
This study assesses the impact of an eating disorders universal preventive program on a representative sample of Spanish adolescents in the area of Barcelona, Spain. 323 adolescent girls were assigned to three experimental conditions: complete intervention, partial intervention, and non-treatment. The program obtained a significant change in reducing the influences of the aesthetic body ideal and in improving the knowledge of nutrition. Nevertheless, attained post-treatment changes dissipate at the 6 month follow-up. In our opinion, the lack of lasting effects should be attributed to a series of considerations such as format, tests not validated for this age, or insufficient research.
Brunner-Mazel Eating Disorders Monograph Series, 16(3) : 255-72
- Year: 2008
- Problem: Eating Disorders (any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Psychological Interventions (any)
, Psychoeducation, Dietary advice, dietary change
Doyle, Angela Celio, Goldschmidt, Andrea, Huang, Christina, Winzelberg, Andrew J., Taylor, C. Barr, Wilfley, Denise E.
PURPOSE: Overweight in adolescence is a significant problem which is associated with body dissatisfaction and eating disorder (ED) behaviors. Cost-effective methods for early intervention of obesity and prevention of ED are important because of the refractory nature of both. This multisite RCT evaluated an Internet-delivered program targeting weight loss and ED attitudes/behaviors in adolescents. METHODS: A total of 80 overweight adolescents 12-17 years of age completed Student Bodies 2 (SB2), a 16-week cognitive-behavioral program, or usual care (UC). RESULTS: Body mass index (BMI) z-scores were reduced in the SB2 group compared with the UC group from baseline to post-intervention (p = .027; eta(p)(2) = .08). The SB2 group maintained this reduction in BMI z-scores at 4-month follow-up, but significant differences were not observed because of improvement in the UC group. The SB2 group evidenced greater increases in dietary restraint post-intervention (p = .016) and less improvement on shape concerns at follow-up (p = .044); however these differences were not clinically significant. No other statistically significant differences were noted between groups on ED attitudes or behaviors. The SB2 participants reported using healthy eating-related and physical activity-related skills more frequently than UC participants post-intervention (p = .001) and follow-up (p = .012). CONCLUSIONS: Findings suggest that an Internet-delivered intervention yielded a modest reduction in weight status that continued 4 months after treatment and that ED attitudes/behaviors were not significantly improved. Group differences on weight loss were not sustained at 4-month follow-up because of parallel improvements in the groups. Future studies are needed to improve program adherence and to further explore the efficacy of Internet-delivery of weight control programs for adolescents.
Journal of Adolescent Health, 43(2) : 172-9
- Year: 2008
- 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)
Dean, H. Y., Touyz, S. W., Rieger, E., Thornton, C. E.
Difficulties in fostering eating disorder (ED) patients' motivations to overcome their illness are widely considered to be a major hurdle in the course of successful treatment. However, no previous study has assessed the use of interventions specifically designed to target poor motivation amongst patients with illnesses that are severe enough to warrant hospitalisation. Objective: A brief Motivational Enhancement Therapy (MET) group programme for inpatient ED sufferers was developed and evaluated. Method: Forty two consecutive inpatients were sequentially allocated to treatment groups. Twenty three inpatients completed a four session MET group programme in addition to routine hospital care. A control group of 19 participants completed treatment as usual (TAU). Results: Despite an absence of significant differences between the MET and the TAU groups on the overall formal outcome measures, there were nevertheless differences between the groups. Specifically, the MET groups appeared to foster longer term motivation and engagement, and to promote treatment continuation. Conclusion: The results tentatively suggest that MET could be valuable for the treatment of inpatient eating disorder patients and further research is warranted. Copyright copyright 2007 John Wiley & Sons, Ltd and Eating Disorders Association.
European Eating Disorders Review., 16(4) : 256-267
- Year: 2008
- Problem: Eating Disorders (any)
- Type: Controlled clinical trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Motivational interviewing, includes Motivational Enhancing Therapy
Becker, Carolyn Black, Bull, Stephanie, Schaumberg, Katherine, Cauble, Adele, Franco, Amanda
The aim of this study was to replicate and extend results of a previous trial that investigated the effectiveness of 2 peer-led eating disorders prevention interventions in reducing eating disorder risk factors in undergraduate women (C. B. Becker, L. M. Smith, & A. C. Ciao, 2006). To extend findings from the previous study by allowing for investigation of differential response, the authors randomly assigned a larger sample of both higher and lower risk sorority members (N = 188; age M = 18.64 years, range = 18-21; 20% minority) to either a cognitive dissonance (CD) or a media advocacy (MA) intervention under naturalistic conditions. Interventions were delivered by trained sorority peer leaders and consisted of two 2-hr group sessions. Participants completed questionnaires that assessed eating disorder risk factors at pretreatment, posttreatment, 7-week follow-up, and 8-month follow-up. Results indicate that both interventions reduced thin-ideal internalization, body dissatisfaction, dietary restraint, and bulimic pathology at 8 months, although higher and lower risk participants responded somewhat differently. Both CD and MA generally appeared effective for higher risk participants; only CD, however, appeared to benefit lower risk participants. Results further support the viability of using peer leaders in dissonance-based prevention. PsycINFO Database Record (c) 2008 APA, all rights reserved.
Journal of Consulting & Clinical Psychology, 76(2) : 347-54
- Year: 2008
- Problem: Eating Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions, Cognitive dissonance therapy
Austin, S. Bryn, Kim, Juhee, Wiecha, Jean, Troped, Philip J., Feldman, Henry A., Peterson, Karen E.
OBJECTIVE: To determine the effect of a school-based intervention to promote healthful nutrition and physical activity on disordered weight-control behaviors (self-induced vomiting or use of laxatives or diet pills to control weight) in early adolescent girls and boys. DESIGN: Using a group-randomized, controlled-trial design, we randomly assigned middle schools to an intervention or control condition. Multivariate logistic regression analyses were used to assess the effect of the intervention on the odds of reporting a new case of disordered weight-control behaviors at follow-up, adjusting for sex, school-level prevalence of disordered weight-control behaviors at baseline, and school clusters. Students reporting these behaviors at baseline were excluded from the analyses. SETTING: Thirteen middle schools. PARTICIPANTS: At baseline, 749 girls and 702 boys in grades 6 and 7. Intervention The 5-2-1 Go! intervention (Planet Health obesity prevention curriculum plus School Health Index for Physical Activity and Healthy Eating: A Self-Assessment and Planning Guide, Middle/High School Version) was implemented during 2 school years, from November 2002 through May 2004. Main Outcome Measure Self-reported disordered weight-control behaviors in last 30 days at follow-up. RESULTS: At follow-up in girls, 3.6% (15 of 422) in control schools compared with 1.2% (4 of 327) in intervention schools reported engaging in disordered weight-control behaviors (P = .04). Multivariate analyses indicated that the odds of these behaviors in girls in intervention schools were reduced by two thirds compared with girls in control schools (odds ratio, 0.33; 95% confidence interval, 0.11-0.97). No intervention effect was observed in boys. CONCLUSIONS: Results add compelling support for the effectiveness of an interdisciplinary, school-based obesity prevention intervention to prevent disordered weight-control behaviors in early adolescent girls.
Archives of Pediatrics & Adolescent Medicine, 161(9) : 865-9
- Year: 2007
- Problem: Eating Disorders (any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Dietary advice, dietary change
Heinicke, Brooke E., Paxton, Susan J., McLean, Sian A., Wertheim, Eleanor H.
This study evaluated a targeted intervention designed to alleviate body image and eating problems in adolescent girls that was delivered over the internet so as to increase access to the program. The program consisted of six, 90-minute weekly small group, synchronous on-line sessions and was facilitated by a therapist and manual. Participants were 73 girls (mean age=14.4 years, SD=1.48) who self-identified as having body image or eating problems and were randomly assigned to an intervention group (n=36) (assessed at baseline, post-intervention and at 2- and 6-months follow-up) or a delayed treatment control group (n=37) (assessed at baseline and 6-7 weeks later). Clinically significant improvements in body dissatisfaction, disordered eating, and depression were observed at post-intervention and maintained at follow-up. Internet delivery was enthusiastically endorsed. The program offers a promising approach to improve body image and eating problems that also addresses geographic access problems.
Journal of Abnormal Child Psychology, 35(3) : 379-91
- Year: 2007
- Problem: Eating Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Mitchell, Karen S., Mazzeo, Suzanne E., Rausch, Sarah M., Cooke, Kathryn L.
OBJECTIVE: Eating-disordered behavior is prevalent among college women. Few interventions have successfully reduced risk factors for these behaviors, however. The most promising interventions are both selective and interactive. This study compared two newer types of interventions that meet these criteria: cognitive dissonance and yoga programs. METHOD: This study advertised programs for women who were dissatisfied with their bodies. Participants (N = 93) were randomly assigned to dissonance, yoga, or control groups. RESULTS: Hierarchical regression analyses revealed that there were no significant post-intervention differences between the yoga and control groups. Dissonance group participants had significantly lower scores than the scores of both other groups on measures of disordered eating, drive for thinness, body dissatisfaction, alexithymia, and anxiety. CONCLUSION: These findings have important implications for interventions on college campuses. In particular, dissonance interventions appear to be an efficient and inexpensive approach to reducing eating disorder risk factors. Additional research regarding the value of yoga interventions is needed. 2006 by Wiley Periodicals, Inc.
International Journal of Eating Disorders, 40(2) : 120-8
- Year: 2007
- 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, Mind-body exercises (e.g. yoga, tai chi, qigong)