Disorders - Eating Disorders
Eickman, L., Betts, J., Pollack, L., Bozsik, F., Beauchamp, M., Lundgren, J.
Short-term outcomes associated with participation in REbeL, a peer-led dissonance-based eating disorder prevention program for high school students, were evaluated. Seventy-one students across the three high schools were enrolled in the study (REbeL N = 48; Control N = 23) and were assessed on measures of eating attitudes and behaviors, body image, weight bias, self-esteem, empowerment, and mood at the beginning of the school year; 37 REbeL students and 20 control students completed assessments at the end of the school year. Mixed effects GLM compared groups on outcomes at the end of the academic year. When controlling for baseline scores, students in both REbeL schools, compared to control school students, demonstrated statistically significantly lower scores at post-test on the EDE-Q Global score, the EDE-Q Restraint, Eating Concern, Shape Concern and Weight Concern subscales, and the Body Checking Questionnaire (all ps < .05). This study provides preliminary empirical support for the REbeL program. Copyright © 2017 Taylor & Francis
Eating Disorders, : 1-16
- Year: 2017
- Problem: Eating Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive dissonance therapy
Gledhill, L. J., Cornelissen, K. K., Cornelissen, P. L., Penton-Voak, I. S., Munafo, M. R., Tovee, M. J.
OBJECTIVES: Anorexia nervosa (AN) is a life-threatening mental health condition. A core feature is a disturbance of body image, such that sufferers see themselves as fatter than they actually are.
DESIGN: We tested the effectiveness of a novel training programme to recalibrate our participants' perception of body size.
METHODS: In a novel adaptation of a cognitive bias training programme, participants judged the body size of a series of female bodies and were given feedback to improve their accuracy over four daily training sessions. In Study 1, we recruited young women with high concerns about their body size for a randomized controlled study. In Study 2, we then applied the training programme to a case series of women with atypical AN.
RESULTS: In Study 1, the training programme significantly improved the body size judgements of women with high body concerns compared to controls. We also found evidence of improved body image and reduced eating concerns in this group. In Study 2, the programme again recalibrated the body size judgements of women with atypical AN. We also saw evidence of a clinically meaningful reduction in their body size and eating-disordered concerns.
CONCLUSIONS: This training has the potential to be a valuable treatment used together with more traditional talking therapies. Statement of contribution What is already known on this subject? A core feature of anorexia nervosa (AN) is an overestimation of body size; sufferers believe themselves to be larger than they are in reality. This study shows that an individual's perceptual boundary between what they classify as a fat versus a thin body is not immutable; it can be changed through a cognitive bias training programme. What does this study add? This means that body size overestimation may now be treatable. Critically, as well as improving the accuracy of body size judgements, we also found a clinically significant improvement in participants' eating-disordered concerns. This demonstrates that a targeted behavioural training regime can change body perception, and the central role that body overestimation has in eating-disordered beliefs.
Copyright © 2016 The Authors. British Journal of Health Psychology published by John Wiley & Sons Ltd on behalf of the British Psychological Society.
British journal of health psychology, 22(1) : 60-76
- Year: 2017
- Problem: Eating Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Attention/cognitive bias modification
, Technology, interventions delivered using technology (e.g. online, SMS)
Green, M. A., Willis, M., Fernandez-Kong, K., Reyes, S., Linkhart, R., Johnson, M., Thorne, T., Kroska, E., Woodward, H., Lindberg, J.
Objective: We conducted a randomized, controlled preliminary trial to examine the effect of a dissonance-based eating disorder program on eating disorder symptoms and cardiac risk indices in a community sample of women with subclinical and clinical symptoms (N = 47), examining the efficacy of the program in both the indicated prevention and treatment realms. Method: Eating disorder symptoms, body mass index, and biomarkers of cardiac risk were examined in dissonance and assessment-only control conditions at baseline, postintervention, and 2-month follow-up. Specifically, we assessed mean R wave amplitude, QT interval length, vagal tone (high frequency spectral power of heart rate variability), and sympathetic tone (low/high frequency spectral power ratio) via electocardiography (ECG) at each assessment period. Results: We predicted a statistically significant 2 (condition: control, dissonance) x 3 (time: baseline, postintervention, 2-month follow-up) interaction in the mixed factorial MANOVA results. Results confirmed this hypothesis. Eating disorder symptoms and cardiac risk indices decreased significantly among participants in the dissonance condition at postintervention and 2-month follow-up compared with baseline. Conclusion: Results provide support for the efficacy of a dissonance-based program in the reduction of eating disorder symptoms and cardiac risk indices among women with subclinical and clinical eating disorder symptoms. Findings establish the efficaciousness of this dissonance-based approach in the indicated prevention and treatment realms and establish its efficacy in reducing cardiac risk indicators. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Health Psychology, 36(4) : 346-355
- Year: 2017
- Problem: Eating Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive dissonance therapy
Gumz, A., Weigel, A., Daubmann, A., Wegscheider, K., Romer, G., Lowe, B.
Background: Previous prevention programs in the school context have not addressed both genders, have been time-consuming, or have had deficits in the evaluation method. The aim of the present study was to evaluate the impact of a universal prevention program for female and male adolescents on eating disorder pathology and related risk factors. Methods: Between February 2012 and July 2014, 2515 students in 23 schools from 8th or 11th grade were assessed for eligibility in this longitudinal cluster-randomized controlled trial with a six months follow-up. Of those students, 2342 were cluster-randomized to the intervention condition which received a six school hours universal prevention program or to the no treatment control condition. Results: The complete case population comprised 724 students in the intervention (54.3% female, M = 14.3 years, SD = 1.61) and 728 in the control condition (57.0% female, M = 14.7 years, SD = 1.63). Random-effects analysis of covariance on the primary outcome showed no significant differences between the intervention and control groups in their eating disorder pathology change scores six months after the intervention. Regarding secondary outcomes, participants in the intervention group showed a greater increase in knowledge about eating disorders both after the intervention (p < .001, ES = 1.06) and six months later (p = .01, ES = 0.40). Greater reductions in anxiety severity were observed in the intervention group post-intervention (p = .02, ES = 0.22) which was not maintained at the six months follow-up. Results differed between participants from grade 8 and 11. Conclusion: The present universal prevention program can be particularly recommended for adolescents from grade 11. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
BMC Psychiatry Vol 17 2017, ArtID 293, 17 :
- Year: 2017
- Problem: Eating Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Imperatori, C., Valenti, E. M., Della-Marca, G., Amoroso, N., Massullo, C., Carbone, G. A., Maestoso, G., Quintiliani, M. I., Contardi, A., Farina, B.
The aim of the present study was to explore the usefulness of the alpha/theta (A/T) training in reducing Food Craving (FC) in a non-clinical sample. The modifications of electroencephalographic (EEG) power spectra associated with A/T training was also investigated. Fifty subjects were enrolled in the study and randomly assigned to receive ten sessions of A/T training [neurofeedback group (NFG) = 25], or to act as controls [waiting list group (WLG) = 25]. All participants were administered the Food Cravings Questionnaire-Trait, the Eating Disorder Examination Questionnaire and the Symptom Checklist-90-Revised. In the post training assessment, compared to the WLG, the NFG showed a significant reduction of intentions and plans to consume food (F1; 49 = 4.90; p = .033; d = 0.626) and of craving as a physiological state (F1; 49 = 8.09; p = .007; d = 803). In NFG, changes in FC persisted after 4 months follow-up. Furthermore, A/T training was associated with significant a increase of resting EEG alpha power in several brain areas involved in FC (e.g., insula) and food cue reactivity (e.g., parahippocampal gyrus, inferior and superior temporal gyrus). Taken together, our results showed that ten sessions of A/T training are associated with a decrease of self-reported FC in a non-clinical sample. These findings suggest that this brain-directed intervention may be useful in the treatment of dysfunctional eating behaviors characterized by FC. Copyright © 2016 Elsevier B.V.
International Journal of Psychophysiology, 112 : 89-97
- Year: 2017
- Problem: Eating Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Biofeedback, neurofeedback, audio/video feedback
McLean, S. A., Wertheim, E. H., Masters, J., Paxton, S. J.
Objective: This pilot study investigated the effectiveness of a social media literacy intervention for adolescent girls on risk factors for eating disorders. Method: A quasi-experimental pre- to post-test design comparing intervention and control conditions was used. Participants were 101 adolescent girls (Mage = 13.13, SD = 0.33) who were allocated to receive three social media literacy intervention lessons (n = 64) or to receive classes as usual (n = 37). Self-report assessments of eating disorder risk factors were completed one week prior to, and one week following the intervention. Results: Significant group by time interaction effects revealed improvements in the intervention condition relative to the control condition for body image (body esteem-weight; d =.19), disordered eating (dietary restraint; d =.26) and media literacy (realism scepticism; d =.32). Discussion: The outcomes of this pilot study suggest that social media literacy is a potentially useful approach for prevention of risk for eating disorders in adolescent girls in the current social media environment of heightened vulnerability. Replication of this research with larger, randomized controlled trials, and longer follow-up is needed. Copyright © 2017 Wiley Periodicals, Inc.
International Journal of Eating Disorders, 50(7) : 847-851
- Year: 2017
- Problem: Eating Disorders (any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Kollei, In., Lukas, C. A., Loeber, S., Berking, M.
Objective: As a common experience in the general population, dissatisfaction with one's body is associated with a variety of psychological problems and unhealthy behaviors, including the development of eating disorders. Therefore, the purpose of the present study was to develop and evaluate an app-based intervention to reduce body dissatisfaction. Method: Participants reporting elevated levels of body dissatisfaction were randomly allocated to an app-based intervention (n = 26) or to a wait list group (n = 27). The app-based intervention included a brief counseling session and 14 days of training with the Mindtastic Body Dissatisfaction app (MT-BD). The MT-BD app uses gamification strategies to systematically foster approach of functional and avoidance of dysfunctional stimuli. The primary outcome was body dissatisfaction as assessed with the Body Dissatisfaction scale of the Eating Disorder Inventory-2 (Garner, 1991). Secondary outcome measures included severity of eating disorder symptoms and depressive symptoms. Results: Participants in the intervention group showed significantly greater reductions in body dissatisfaction compared to the wait list group (d = -0.62). The intervention group also showed greater reductions in eating disorder symptoms compared to the wait list group (d = -0.46). Reductions in body dissatisfaction and eating disorder symptoms were sustained at a 1-month follow-up. Conclusion: We found preliminary evidence that an app-based intervention may significantly reduce body dissatisfaction. Further research using larger samples and targeting clinical populations is necessary to evaluate the potential of interventions such as MT-BD. (PsycINFO Database Record (c) 2017 APA, all rights reserved) Impact Statement What is the public health significance of this article?-The results suggest that an intervention that combines a brief counseling session and an intense app-based training may significantly reduce body dissatisfaction. Given the high prevalence of body dissatisfaction in the general population and the importance of body dissatisfaction for the development and maintenance of eating disorders, findings from the study encourage research on how app-based interventions can be used to further improve the dissemination of evidence-based treatments. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Journal of Consulting and Clinical Psychology, 85(11) : 1104-1108
- Year: 2017
- 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)
, Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Mora, M., Penelo, E., Roses, R., Gonzalez, M. L., Espinoza, P., Devi, J., Raich, R. M.
Aims As eating disorders have severe consequences, they require prevention. We aimed to compare maladaptive beliefs related to eating disorders by following two programs based on media literacy in adolescents at post-test intervention, and after 6 and 12 month-follow-ups. The Male and Female Nutrition and Media Literacy Model preventive program (NUT + MEF + MEM + ML in Spanish) and the Theater Alive program are both based on the same contents, the former being presented in a multimedia and interactive format and the latter in a drama format. Both were compared to a control group without intervention, whose participants received usual classes before the assessments. Method Participants were 178 adolescents in the second year of compulsory secondary education from fours schools of Terrassa (Catalonia, Spain). All participants in each school were assigned to the same group, depending on school schedules. A mixed 3 (group: Theater Alive, NUT + MEF + MEM + ML, control) x 3 (time: post-test, 6-month-follow-up, 12-month-follow-up) factorial design was used to evaluate the effect on maladaptive beliefs measured using a CE-TCA tool. Results When compared to the control group, both Theater Alive (d = 0.88) and NUT + MEM + MEF + ML (d = 0.60) obtained lower scores over time, the latter being not statistically significant. Discussion The Theater Alive program may produce an effect of cognitive dissonance that might eliminate the discrepancy between the contents of the play and those that are internalized, thus modifying maladaptive beliefs. Participants in the Theater Alive program, as actors in front of an audience, had to defend certain content that was rehearsed over and over again to the point until it became internalized. Copyright © 2016 Elsevier Ltd
Eating Behaviors, 25 : 51-57
- Year: 2017
- Problem: Eating Disorders (any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Stice, E., Rohde, P., Shaw, H., Gau, J. M.
Objective: Because independent trials have provided evidence for the efficacy and effectiveness of the dissonance-based Body Project eating disorder prevention program, the present trial tested whether clinicians produce the largest intervention effects, or whether delivery can be task-shifted to less expensive undergraduate peer educators or to Internet delivery without effect size attenuation, focusing on acute effects. Method: In this study, 680 young women (Mage = 22.2 years, SD = 7.1) recruited at colleges in 2 states were randomized to clinician-led Body Project groups, peer-led Body Project groups, the Internet-based eBody Project, or an educational video control condition. Results: Participants in all 3 variants of the Body Project intervention showed significantly greater reductions in eating disorder risk factors and symptoms than did educational video controls. Participants in clinician-led and peer-led Body Project groups showed significantly greater reductions in risk factors than did eBody Project participants, but effects for the 2 types of groups were similar. Eating disorder onset over 7-month follow-up was significantly lower for peer-led Body Project group participants versus eBody Project participants (2.2% vs. 8.4%) but did not differ significantly between other conditions. Conclusions: The evidence that all 3 dissonance-based prevention programs outperformed an educational video condition, that both group-based interventions outperformed the Internet-based intervention in risk factor reductions, and that the peer-led groups showed lower eating disorder onset over follow-up than did the Internet-based intervention is novel. These acute-effects data suggest that both group-based interventions produce superior eating disorder prevention effects than does the Internet-based intervention and that delivery can be task-shifted to peer leaders. (PsycINFO Database Record (c) 2017 APA, all rights reserved) Impact Statement What is the public health significance of this article?-Clinician- and peer-led Body Project groups and the Internet-based eBody Project eating disorder prevention programs produced greater reductions in eating disorder risk factors and symptoms than did an educational video comparison condition over short-term follow-up. Both group-based versions of the Body Project eating disorder prevention program produced larger risk factor reductions than did the Internet-based eBody Project. Delivery of the Body Project can be task-shifted to delivery by more abundant and cost-effective undergraduate peer educators without loss of efficacy over short-term follow-up. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Journal of Consulting and Clinical Psychology, 85(9) : 883-895
- Year: 2017
- 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, Other service delivery and improvement interventions
Tanofsky-Kraff, M., Shomaker, L. B., Wilfley, D. E., Young, J. F., Sbrocco, T., Stephens, M., Brady, S. M., Galescu, O., Demidowich, A., Olsen, C. H., Kozlosky, M., Reynolds, J. C., Yanovski, J. A.
Objective: Interpersonal psychotherapy (IPT) prevents weight gain in adults with obesity and binge-eating-disorder, and is especially effective among those with increased psychosocial problems. However, IPT was not superior to health education (HE) to prevent excess weight gain at 1-year follow-up in 113 adolescent girls at high-risk for excess weight gain because of loss-of-control eating and high body mass index (BMI; kg/m2; Tanofsky-Kraff et al., 2014). Method: Participants from the original trial were recontacted 3 years later for assessment. At baseline, adolescent- and parent-reported social-adjustment problems and trait anxiety were evaluated. At baseline and follow-ups, BMIz and adiposity by dual-energy x-ray absorptiometry were obtained. Results: Nearly 60% were reassessed at 3 years, with no group differences in participation (ps >=.70). Consistent with 1 year, there was no main effect of group on change in BMIz/adiposity (ps >=.18). In exploratory analyses, baseline social-adjustment problems and trait-anxiety moderated outcome (ps <.01). Among girls with high self-reported baseline social-adjustment problems or anxiety, IPT, compared to HE, was associated with the steepest declines in BMIz (p <.001). For adiposity, girls with high or low anxiety in HE and girls with low anxiety in IPT experienced gains (ps <=.03), while girls in IPT with high anxiety stabilized. Parent-reports yielded complementary findings. Conclusion: In obesity-prone adolescent girls, IPT was not superior to HE in preventing excess weight gain at 3 years. Consistent with theory, exploratory analyses suggested that IPT was associated with improvements in BMIz over 3 years among youth with high social-adjustment problems or trait anxiety. Future studies should test the efficacy of IPT for obesity prevention among at-risk girls with social-adjustment problems and/or anxiety. Copyright © 2017 American Psychological Association.
Journal of Consulting and Clinical Psychology, 85(3) : 218-227
- Year: 2017
- Problem: Eating Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Interpersonal therapy (IPT)
, Psychoeducation
Wade, S., Byrne, S., Allen, K.
Objective: This randomized control trial is an evaluation of the effectiveness of enhanced cognitive behavioral treatment (CBT-E) for eating disorders adapted for a group setting. The study aimed to examine the effects of group CBT-E on eating disorder psychopathology and additional maintaining pathology. Method: A transdiagnostic sample of individuals with eating disorders with a BMI >= 18 kg/m2 (N = 40) were randomized to an immediate-start or delayed-start condition so as to compare therapeutic effects of group CBT-E with a waitlist control. Global Eating Disorder Examination Questionnaire (EDE-Q) scores, BMI, and measures of Clinical Perfectionism, Self-Esteem, Interpersonal Difficulties, and Mood Intolerance were measured across the 8-week control period, throughout the group treatment and at 3-months post-treatment. Results: Over 70% of those who entered the trial completed treatment. The first eight weeks of group CBT-E were more effective at reducing Global EDE-Q scores than no treatment (waitlist control). By post-treatment, good outcome (a Global EDE-Q within 1 SD of Australian community norms plus BMI >= 18.5) was achieved by 67.9% of treatment completers and 66.7% of the total sample. Symptom abstinence within the previous month was reported by 14.3% of treatment completers and 10.3% of the total sample. Significant reductions in Clinical Perfectionism, Self-Esteem, Interpersonal Difficulties, and Mood Intolerance were also observed. Discussion: This study demonstrated that a group version of CBT-E can be effective at reducing eating disorder psychopathology in a transdiagnostic sample of individuals with eating disorders. Group CBT-E could provide a means of increasing availability of evidence-based treatment for eating disorders. Copyright © 2017 Wiley Periodicals, Inc.
International Journal of Eating Disorders, 50(8) : 863-872
- Year: 2017
- Problem: Eating Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
Taylor, C., Kass, A. E., Trockel, M., Cunning, D., Weisman, H., Bailey, J., Sinton, M., Aspen, V., Schecthman, K., Jacobi, C., Wilfley, D. E.
Objective: Eating disorders (EDs) are serious problems among college-age women and may be preventable. An indicated online eating disorder (ED) intervention, designed to reduce ED and comorbid pathology, was evaluated. Method: 206 women (M age = 20 +/- 1.8 years; 51% White/Caucasian, 11% African American, 10% Hispanic, 21% Asian/Asian American, 7% other) at very high risk for ED onset (i.e., with high weight/shape concerns plus a history of being teased, current or lifetime depression, and/or nonclinical levels of compensatory behaviors) were randomized to a 10-week, Internet-based, cognitive-behavioral intervention or waitlist control. Assessments included the Eating Disorder Examination (EDE, to assess ED onset), EDE-Questionnaire, Structured Clinical Interview for DSM Disorders, and Beck Depression Inventory-II. Results: ED attitudes and behaviors improved more in the intervention than control group (p = .02, d = 0.31); although ED onset rate was 27% lower, this difference was not significant (p = .28, NNT = 15). In the subgroup with highest shape concerns, ED onset rate was significantly lower in the intervention than control group (20% vs. 42%, p = .025, NNT = 5). For the 27 individuals with depression at baseline, depressive symptomatology improved more in the intervention than control group (p = .016, d = 0.96); although ED onset rate was lower in the intervention than control group, this difference was not significant (25% vs. 57%, NNT = 4). Conclusions: An inexpensive, easily disseminated intervention might reduce ED onset among those at highest risk. Low adoption rates need to be addressed in future research. (PsycINFO Database Record (c) 2016 APA, all rights reserved) (journal abstract).
Journal of Consulting & Clinical Psychology, 84(5) : 402-414
- Year: 2016
- Problem: Depressive Disorders, Eating Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)