Disorders - Eating Disorders
Paxton, Susan J., McLean, Sian A., Gollings, Emma K., Faulkner, Cathy, Wertheim, Eleanor H.
OBJECTIVE: The aim of this study was to compare the outcomes following an eight-session, small group, therapist-led, intervention for body dissatisfaction, and disordered eating in adult women, delivered either in face-to-face or synchronous, internet mode. METHOD: Community women with high body dissatisfaction and internet access were randomly assigned to either face-to-face delivery (N = 42), internet delivery (N = 37), or delayed treatment control (N = 37). All groups were assessed at baseline and 8-9 weeks later. The intervention groups were reassessed at 6-months follow-up. RESULTS: Both intervention groups showed large improvements in body dissatisfaction compared with the delayed treatment control and these improvements were maintained at follow-up. However, posttreatment improvements were greater in the face-to-face than internet intervention. CONCLUSION: In adult women, it is desirable to deliver the body image intervention in a face-to-face mode, but the internet mode is effective and has the potential to increase access to therapy. (c) 2007 by Wiley Periodicals, Inc.
International Journal of Eating Disorders, 40(8) : 692-704
- 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)
, Cognitive & behavioural therapies (CBT)
, Technology, interventions delivered using technology (e.g. online, SMS)
O'Brien, Karina M., LeBow, Michael D.
Previous research has addressed the issues of behavior change and eating disorder prevention among adolescents and young women. The current study was designed to evaluate: (a) whether an 8-week psychoeducational intervention can reduce maladaptive weight-management practices in women (University females, N=24) with sub-clinical levels of eating pathology; and (b) whether its implementation reduces the risk of developing more severe eating pathology across time. Participants were randomly assigned to an experimental (EX) group or a self-monitoring control (SMC) group. Statistically significant changes on measures of eating pathology, including the Eating Attitudes Test-26 [Garner, D. M., Olmsted, M. P., Bohr, Y., & Garfinkel, P. (1982). The Eating Attitudes Test: psychometric features and clinical correlates. Psychological Medicine, 12, 871-878]; Forbidden Food Survey [Ruggerio, L., Williamson, D. A., Davis, C. J., Schlundt, D. G., & Carey, M. P. (1988). Forbidden Food Survey: Measure of bulimic's anticipated emotional reactions to specific foods. Addictive Behaviors, 13, 267-274]; and Bulimia Test-Revised [Thelen, M. H., Farmer, J., Wonderlich, S., & Smith, M. (1991). A revision of the bulimia test: The BULIT-R. Journal of Consulting and Clinical Psychology, 3(1), 119-124] were observed, as were changes in body image, as measured by the Body Shape Questionnaire [Cooper, P. J., Taylor, M. J., Cooper, Z., & Fairburn, C. G. (1987). The development and validation of the body shape questionnaire. International Journal of Eating Disorders, 6(4), 485-494]. Additional significant between-group differences in eating behavior, as measured by daily meal records, were also seen. Participants in the EX group evidenced improvements in scores which were significantly different from those observed in the SMC group. Unfortunately, attrition limited the utility of follow up data.
Eating Behaviors, 8(2) : 195-210
- Year: 2007
- Problem: Eating Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Psychoeducation
Stock, Suzanne, Miranda, Charmaine, Evans, Stacey, Plessis, Suzanne, Ridley, Julia, Yeh, Sophia, Chanoine, Jean-Pierre
OBJECTIVE: We designed and tested a novel health promotion program for elementary schools that was based on peer teaching from older to younger schoolchildren ("Healthy Buddies"). SUBJECTS AND METHODS: This prospective pilot study compared the effect of our program (2-3 hours/week, 21 weeks) in 2 Canadian elementary schools (intervention: n = 232 children, the whole school implementing the program; control: n = 151). Older students (4th through 7th grade) were given direct instruction from 1 intervention teacher and were paired with younger students (kindergarten through 3rd grade) for the whole school year. Students in 4th through 7th grade then acted as teachers for their younger "buddies." All lessons included 3 components of healthy living: nutrition, physical activity, and healthy body image. The students first learned how to be positive buddies and learned the 3 components of a healthy life. Thereafter, they learned how to overcome challenges to living a healthy life. Outcome measures (intervention and control schools at the beginning and end of the school year) included validated questionnaires that assessed healthy-living knowledge, behavior and attitude, a 9-minute fitness run, self-competence, body satisfaction, disordered eating symptoms, and anthropometry (BMI, blood pressure, and heart rate). RESULTS: Compared with control students, both older and younger intervention students showed an increase in healthy-living knowledge, behavior, and attitude scores and a smaller increase in systolic blood pressure. BMI and weight increased less in the intervention students in 4th through 7th grade and height more in the intervention students in kindergarten through 3rd grade. CONCLUSIONS: Our student-led curriculum improved knowledge not only in older schoolchildren but also in their younger buddies. It also decreased weight velocity in the older students. Student-led teaching may be an efficient, easy-to-implement way of promoting a healthy lifestyle from kindergarten to 7th grade.
Pediatrics, 120(4) : e1059-68
- Year: 2007
- 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
Jacobi, Corinna, Morris, Lisette, Beckers, Christina, Bronisch-Holtze, Janina, Winter, Jana, Winzelberg, Andrew J., Taylor, Craig Barr
OBJECTIVE: Excessive weight or shape concerns and dieting are among the most important and well-established risk factors for the development of symptoms of disordered eating or full-syndrome eating disorders. Prevention programs should therefore target these factors in order to reduce the likelihood of developing an eating disorder. The aims of this study were to determine the short-term and maintenance effects of an internet-based prevention program for eating disorders. METHOD: One hundred female students at two German universities were randomly assigned to either an 8-week intervention or a waiting-list control condition and assessed at preintervention, postintervention, and 3-month follow-up. RESULTS: Compared with the control group, the intervention produced significant and sustained effects for high-risk women. CONCLUSION: Internet-based prevention is effective and can be successfully adapted to a different culture. 2006 by Wiley Periodicals, Inc.
International Journal of Eating Disorders, 40(2) : 114-9
- 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)
, Self-help
, Technology, interventions delivered using technology (e.g. online, SMS)
Rutherford, L., Couturier, J.
Objective: Psychotherapeutic interventions for child and adolescent eating disorders have recently received increasing attention in the research literature. This article attempts to summarize these studies. Method: The current literature was reviewed using the PubMed and Embase databases under the search terms eating disorders, child, adolescent, and psychotherapy. Here we will present a practical overview of the current evidence for psychotherapeutic interventions in this clinical population. Results: There have been some very promising findings with regards to specific types of therapy for anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (BED). Conclusions: The best evidence available suggests that family-therapy models are most effective for treating adolescents with AN, and that CBT models are most effective for adolescent BN, although family-based treatment may also be effective for adolescents with BN. Too few studies have been done on BED in adolescents to draw any conclusions; however CBT, IPT and DBT are all theoretically promising.
Canadian Child & Adolescent Psychiatry Review, 16(4) : 153-157
- Year: 2007
- Problem: Eating Disorders (any)
- Type: Systematic reviews
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Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
Russell-Mayhew, S., Arthur, N., Ewashen, C.
This study examines the effectiveness of a wellness-based prevention program on elementary and junior high students' body image, personal attitudes, and eating behaviors. Group differences in measures of student attitudes and eating behaviors are examined to determine the effect of targeting different participant combinations (students, parents, and teachers) in 10 groups. For elementary schools, student participants consisted of control (no intervention) (n = 36), student only (n = 81), student/parent (n = 124), student/parent/teacher (n = 103), and parent/teacher (n = 149). For junior high schools, student participants consisted of control (n = 143), student only (n=215), student/parent (n=65), student/parent/teacher (n = 14), and parent/teacher (n = 177). Overall, complete data was available for 1,095 students, 114 parents and 92 teachers. Results indicate that self-concept and eating attitudes and behaviors were positively affected by participation in the program. For example, in elementary schools posttest scores on the behavior subscale of the self-concept measure are significantly higher for the student/parent/teacher group than for the control group. Results indicate that a one-time wellness-based eating disorder prevention program with students, which have in the past shown to be minimally effective, may be more effective in changing attitudes and behaviors when teachers and parents are involved.
Eating Disorders., 15(2) : 159-181
- Year: 2007
- Problem: Eating Disorders (any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Stice, Eric, Shaw, Heather, Marti, C. Nathan
This meta-analytic review found that 51% of eating disorder prevention programs reduced eating disorder risk factors and 29% reduced current or future eating pathology. Larger effects occurred for programs that were selected (versus universal), interactive (versus didactic), multisession (versus single session), solely offered to females (versus both sexes), offered to participants over 15 years of age (versus younger ones), and delivered by professional interventionists (versus endogenous providers). Programs with body acceptance and dissonance-induction content and without psychoeducational content and programs evaluated in trials using validated measures and a shorter follow-up period also produced larger effects. Results identify promising programs and delineate sample, format, and design features associated with larger effects, which may inform the design of more effective prevention programs in the future. [References: 97]
Annual Review of Clinical Psychology, 3 : 207-31
- Year: 2007
- Problem: Eating Disorders (any)
- Type: Systematic reviews
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
Taylor, C. Barr, Bryson, Susan, Luce, Kristine H., Cunning, Darby, Doyle, Angela Celio, Abascal, Liana B., Rockwell, Roxanne, Dev, Pavarti, Winzelberg, Andrew J., Wilfley, Denise E.
CONTEXT: Eating disorders, an important health problem among college-age women, may be preventable, given that modifiable risk factors for eating disorders have been identified and interventions have been evaluated to reduce these risk factors. OBJECTIVE: To determine if an Internet-based psychosocial intervention can prevent the onset of eating disorders (EDs) in young women at risk for developing EDs. SETTING: San Diego and the San Francisco Bay Area in California. PARTICIPANTS: College-age women with high weight and shape concerns were recruited via campus e-mails, posters, and mass media. Six hundred thirty-seven eligible participants were identified, of whom 157 were excluded, for a total sample of 480. Recruitment occurred between November 13, 2000, and October 10, 2003.Intervention A randomized controlled trial of an 8-week, Internet-based cognitive-behavioral intervention (Student Bodies) that included a moderated online discussion group. Participants were studied for up to 3 years. MAIN OUTCOME MEASURES: The main outcome measure was time to onset of a subclinical or clinical ED. Secondary measures included change in scores on the Weight Concerns Scale, Global Eating Disorder Examination Questionnaire, and Eating Disorder Inventory drive for thinness and bulimia subscales and depressed mood. Moderators of outcome were examined. RESULTS: There was a significant reduction in Weight Concerns Scale scores in the Student Bodies intervention group compared with the control group at postintervention (P < .001), 1 year (P < .001), and 2 years (P < .001). The slope for reducing Weight Concerns Scale score was significantly greater in the treatment compared with the control group (P = .02). Over the course of follow-up, 43 participants developed subclinical or clinical EDs. While there was no overall significant difference in onset of EDs between the intervention and control groups, the intervention significantly reduced the onset of EDs in 2 subgroups identified through moderator analyses: (1) participants with an elevated body mass index (BMI) (> or =25, calculated as weight in kilograms divided by height in meters squared) at baseline and (2) at 1 site, participants with baseline compensatory behaviors (eg, self-induced vomiting, laxative use, diuretic use, diet pill use, driven exercise). No intervention participant with an elevated baseline BMI developed an ED, while the rates of onset of ED in the comparable BMI control group (based on survival analysis) were 4.7% at 1 year and 11.9% at 2 years. In the subgroup with a BMI of 25 or higher, the cumulative survival incidence was significantly lower at 2 years for the intervention compared with the control group (95% confidence interval, 0% for intervention group; 2.7% to 21.1% for control group). For the San Francisco Bay Area site sample with baseline compensatory behaviors, 4% of participants in the intervention group developed EDs at 1 year and 14.4%, by 2 years. Rates for the comparable control group were 16% and 30.4%, respectively. CONCLUSIONS: Among college-age women with high weight and shape concerns, an 8-week, Internet-based cognitive-behavioral intervention can significantly reduce weight and shape concerns for up to 2 years and decrease risk for the onset of EDs, at least in some high-risk groups. To our knowledge, this is the first study to show that EDs can be prevented in high-risk groups.
Archives of General Psychiatry, 63(8) : 881-8
- Year: 2006
- 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)
Stice, Eric, Shaw, Heather, Burton, Emily, Wade, Emily
In this trial, adolescent girls with body dissatisfaction (N = 481, M age = 17 years) were randomized to an eating disorder prevention program involving dissonance-inducing activities that reduce thin-ideal internalization, a prevention program promoting healthy weight management, an expressive writing control condition, or an assessment-only control condition. Dissonance participants showed significantly greater reductions in eating disorder risk factors and bulimic symptoms than healthy weight, expressive writing, and assessment-only participants, and healthy weight participants showed significantly greater reductions in risk factors and symptoms than expressive writing and assessment-only participants from pretest to posttest. Although these effects faded over 6-month and 12-month follow-ups, dissonance and healthy weight participants showed significantly lower binge eating and obesity onset and reduced service utilization through 12-month follow-up, suggesting that both interventions have public health potential. Copyright 2006 APA
Journal of Consulting & Clinical Psychology, 74(2) : 263-75
- Year: 2006
- 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, Other Psychological Interventions, Cognitive dissonance therapy, Creative expression: music, dance, drama, art
Roehrig, Megan, Thompson, J. Kevin, Brannick, Michael, van den Berg, Patricia
OBJECTIVE: A dissonance-based program aimed at reducing thin-ideal internalization has been found to significantly decrease levels of bulimic symptoms in young adult and adolescent females. Because this program is multifaceted, containing psychoeducation, counterattitudinal advocacy, and behavioral exposure components, the current study sought to investigate the mechanisms involved in symptom reduction. METHOD: The current study compared the original treatment program with a dismantled version of the full package, which consisted solely of the specific dissonance component (i.e., the counterattitudinal advocacy procedure). Seventy-eight women were randomly assigned to either the full treatment condition or the counterattitudinal advocacy condition. RESULTS: Findings suggest that both interventions significantly reduced established risk factors for eating pathology as well as bulimic symptoms at termination and at 1-month follow-up. CONCLUSION: Both treatments appear to be equally effective at reducing eating pathology in at-risk college women. Limitations of the study are discussed, and directions for future research are offered. 2005 by Wiley Periodicals, Inc.
International Journal of Eating Disorders, 39(1) : 1-10
- Year: 2006
- Problem: Eating Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive dissonance therapy
Low, Kathryn Graff, Charanasomboon, Swita, Lesser, Jill, Reinhalter, Katie, Martin, Rachel, Jones, Hannah, Winzelberg, Andy, Abascal, Liana, Taylor, C. Barr
Computer-based delivery of health-related psychoeducational programming is increasingly popular. In the present study, 72 non-symptomatic undergraduate women were randomized to an Internet-based prevention program for eating disorders with or without accompanying discussion groups, or a control group. Sixty-one of the women (84%) completed the Student Bodies program, and were assessed at short and eight-nine month follow-up. Participation in the program resulted in better outcomes across all groups compared to controls, and women in the unmoderated discussion group appeared to have the most reduction in risk. Benefits of the program continued at follow-up. Decrease in risk also was associated with time spent using the Internet-based program. The present study suggests that the use of Student Bodies may reduce risk of eating and body image concerns over the long term, and that moderation of discussion groups may not be essential for successful outcomes. Further research on larger samples will help determine the degree to which discussion groups or the Student Bodies program alone are effective.
Brunner-Mazel Eating Disorders Monograph Series, 14(1) : 17-30
- Year: 2006
- Problem: Eating Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Self-help
, Technology, interventions delivered using technology (e.g. online, SMS)
Stice, E., Orjada, K., Tristan, J.
Objective: We conducted a controlled trial of a psychoeducational eating disturbance intervention to replicate the positive findings observed in the preliminary evaluation of this intervention and to determine whether the effects persist for a longer follow-up period. Method: College women who took the psychoeducational class and a matched control sample of students (N = 95) completed pretest, posttest, and 6-month follow-up surveys. Results: Intervention participants showed significantly greater reductions in thin-ideal internalization, body dissatisfaction, dieting, and eating disorder symptoms, as well as significantly less weight gain, relative to matched controls over the study period. Intervention effects tended to be larger at 6-month follow-up than at posttest. Conclusion: These findings suggest that the intervention effects for eating disorder risk factors and eating disorder symptoms, as well as the weight gain prevention effects, are reproducible and persist over time. This intervention has both mental health and public health significance. copyright 2006 by Wiley Periodicals, Inc.
International Journal of Eating Disorders., 39(3) : 233-239
- Year: 2006
- Problem: Eating Disorders (any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Psychoeducation