Disorders - Eating Disorders
Watson, H. J., Joyce, T., French, E., Willan, V., Kane, R. T., Tanner-Smith, E. E., McCormack, J., Dawkins, H., Hoiles, K. J., Egan, S. J.
OBJECTIVE: This systematic review evaluated the efficacy of universal, selective, and indicated eating disorder prevention.
METHOD: A systematic literature search was conducted in Medline, PsycINFO, Embase, Scopus, and the Cochrane Collaboration Library databases to January 2016. Studies were included if they were randomized, controlled trials (RCT) and tested an eating disorder prevention program. We retrieved 13 RCTs of universal prevention (N=3,989 participants, 55% female, M age=13.0 years), 85 RCTs of selective prevention (N=11,949 participants, 99% female, M age=17.6 years), and 8 RCTs of indicated prevention (N=510 participants, 100% female, M age=20.1 years). Meta-analysis was performed with selective prevention trials. As there were a limited number of universal and indicated trials, narrative synthesis was conducted.
RESULTS: Media literacy had the most support for universal prevention. Most universal approaches showed significant modest effects on risk factors. Dissonance-based was the best supported approach for selective prevention. Cognitive-behavior therapy (CBT), a healthy weight program, media literacy, and psychoeducation, were also effective for selective prevention and effects were maintained at follow-up. CBT was supported for indicated prevention and effects were maintained at follow-up.
DISCUSSION: The modest effects for universal prevention were likely due to floor effects. The evidence for selective prevention suggests that empirically supported approaches should be disseminated on a wider basis. Our findings suggest CBT should be offered for indicated populations. Overall, results suggest efficacy of several prevention programs for reducing risk for eating disorders, and that wider dissemination is required. © 2016 Wiley Periodicals, Inc.
Copyright © 2016 Wiley Periodicals, Inc.
International Journal of Eating Disorders, 49(9) : 833-62
- Year: 2016
- Problem: Eating Disorders (any)
- Type: Systematic reviews
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Service Delivery & Improvement, Psychological Interventions (any)
, Technology, interventions delivered using technology (e.g. online, SMS), Technology, comparing delivery mode (e.g. online vs. face-to-face)
Sanchez-Carracedo, D., Fauquet, J., Lopez-Guimera, G., Leiva, D., Punti, J., Trepat, E., Pamias, M., Palao, D.
Challenges in the prevention of disordered eating field include moving from efficacy to effectiveness and developing an integrated approach to the prevention of eating and weight-related problems. A previous efficacy trial indicated that a universal disordered eating prevention program, based on the social cognitive model, media literacy educational approach and cognitive dissonance theory, reduced risk factors for disordered eating, but it is unclear whether this program has effects under more real-world conditions. This effectiveness trial tested whether this program has effects when previously trained community providers in an integrated approach to prevention implement the intervention. The research design involved a multi-center non-randomized controlled trial with baseline, post-test and 1-year follow-up measures. The sample included girls in the 8th grade from six schools (n = 152 girls) in a city near Barcelona (intervention group), and from eleven schools (n = 413 girls) in four neighboring towns (control group). The MABIC risk factors of disordered eating were assessed as main outcomes. Girls in the intervention group showed significantly greater reductions in beauty ideal internalization, disordered eating attitudes and weight-related teasing from pretest to 1-year follow-up compared to girls in the control group, suggesting that this program is effective under real-world conditions. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Behaviour Research and Therapy, 77 : 23-33
- Year: 2016
- 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
Aardoom, J. J., Dingemans, A. E., Spinhoven, P., van-Ginkel, J. R., de-Rooij, M., van-Furth, E. F.
BACKGROUND: Despite the disabling nature of eating disorders (EDs), many individuals with ED symptoms do not receive appropriate mental health care. Internet-based interventions have potential to reduce the unmet needs by providing easily accessible health care services.
OBJECTIVE: This study aimed to investigate the effectiveness of an Internet-based intervention for individuals with ED symptoms, called "Featback." In addition, the added value of different intensities of therapist support was investigated.
METHODS: Participants (N=354) were aged 16 years or older with self-reported ED symptoms, including symptoms of anorexia nervosa, bulimia nervosa, and binge eating disorder. Participants were recruited via the website of Featback and the website of a Dutch pro-recovery-focused e-community for young women with ED problems. Participants were randomized to: (1) Featback, consisting of psychoeducation and a fully automated self-monitoring and feedback system, (2) Featback supplemented with low-intensity (weekly) digital therapist support, (3) Featback supplemented with high-intensity (3 times a week) digital therapist support, and (4) a waiting list control condition. Internet-administered self-report questionnaires were completed at baseline, post-intervention (ie, 8 weeks after baseline), and at 3- and 6-month follow-up. The primary outcome measure was ED psychopathology. Secondary outcome measures were symptoms of depression and anxiety, perseverative thinking, and ED-related quality of life. Statistical analyses were conducted according to an intent-to-treat approach using linear mixed models.
RESULTS: The 3 Featback conditions were superior to a waiting list in reducing bulimic psychopathology (d=-0.16, 95% confidence interval (CI)=-0.31 to -0.01), symptoms of depression and anxiety (d=-0.28, 95% CI=-0.45 to -0.11), and perseverative thinking (d=-0.28, 95% CI=-0.45 to -0.11). No added value of therapist support was found in terms of symptom reduction although participants who received therapist support were significantly more satisfied with the intervention than those who did not receive supplemental therapist support. No significant differences between the Featback conditions supplemented with low- and high-intensity therapist support were found regarding the effectiveness and satisfaction with the intervention.
CONCLUSIONS: The fully automated Internet-based self-monitoring and feedback intervention Featback was effective in reducing ED and comorbid psychopathology. Supplemental therapist support enhanced satisfaction with the intervention but did not increase its effectiveness. Automated interventions such as Featback can provide widely disseminable and easily accessible care. Such interventions could be incorporated within a stepped-care approach in the treatment of EDs and help to bridge the gap between mental disorders and mental health care services.
TRIAL REGISTRATION: Netherlands Trial Registry: NTR3646; http://www.trialregister.nl/trialreg/admin/ rctview.asp?TC=3646 (Archived by WebCite at http://www.webcitation.org/6fgHTGKHE).
Journal of Medical Internet Research, 18(6) : e159
- Year: 2016
- Problem: Eating Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Psychoeducation, Other Psychological Interventions, Personalised feedback, normative feedback
, Technology, interventions delivered using technology (e.g. online, SMS), Other service delivery and improvement interventions
Friedman, K., Ramirez, A. L., Murray, S. B., Anderson, L. K., Cusack, A., Boutelle, K. N., Kaye, W. H.
OBJECTIVE: The objective of this study was to review the current eating disorders outcome literature after residential or partial hospitalization programme (PHP) treatment.
METHOD: Articles were identified through a systematic search of PubMed and PsycINFO.
RESULTS: Twenty-two PHP and six residential treatment studies reported response at discharge and tended to find improvement. Fewer studies (nine PHP and three residential) reported outcome at some interval after discharge from treatment. These tended to find sustained improvement. A substantial proportion of patients were lost to follow-up, particularly for residential treatment. Only two follow-up studies used controlled trials; both showed efficacy for PHP compared with inpatient treatment with regard to maintaining symptom remission.
CONCLUSIONS: Improvement at discharge may not predict long-term outcome. Long-term follow-up studies were confounded by high dropout rates. While higher levels of care may be essential for reversing malnutrition, there remains a lack of controlled trials showing long-term efficacy, particularly for residential treatment settings. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.
European Eating Disorders Review, 24(4) : 263-76
- Year: 2016
- Problem: Eating Disorders (any)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement
Kilpela, L. S., Blomquist, K., Verzijl, C., Wilfred, S., Beyl, R., Becker, C. B.
Objective: The Body Project is a cognitive dissonance-based body image improvement program with ample research support among female samples. More recently, researchers have highlighted the extent of male body dissatisfaction and disordered eating behaviors; however, boys/men have not been included in the majority of body image improvement programs. This study aims to explore the efficacy of a mixed-gender Body Project compared with the historically female-only body image intervention program. Method: Participants included male and female college students (N = 185) across two sites. We randomly assigned women to a mixed-gender modification of the two-session, peer-led Body Project (MG), the two-session, peer-led, female-only (FO) Body Project, or a waitlist control (WL), and men to either MG or WL. Participants completed self-report measures assessing negative affect, appearance-ideal internalization, body satisfaction, and eating disorder pathology at baseline, post-test, and at 2- and 6-month follow-up. Results: Linear mixed effects modeling to estimate the change from baseline over time for each dependent variable across conditions were used. For women, results were mixed regarding post-intervention improvement compared with WL, and were largely non-significant compared with WL at 6-month follow-up. Alternatively, results indicated that men in MG consistently improved compared with WL through 6-month follow-up on all measures except negative affect and appearance-ideal internalization. Discussion: Results differed markedly between female and male samples, and were more promising for men than for women. Various explanations are provided, and further research is warranted prior to drawing firm conclusions regarding mixed-gender programming of the Body Project. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
International Journal of Eating Disorders, 49(6) : 591-602
- Year: 2016
- 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
Melioli, T., Bauer, S., Franko, D. L., Moessner, M., Ozer, F., Chabrol, H., Rodgers, R. F.
OBJECTIVE: The purpose of this meta-analytic review was, first, to evaluate the efficacy of Internet-based programs in decreasing eating disorder (ED) symptoms, and, second, to identify moderator variables these effects.
METHOD: Twenty studies were identified and between-group effect sizes were calculated for ED symptoms and risk factors.
RESULTS: Compared with control conditions, Internet-based programs successfully decreased body dissatisfaction (d = 0.28, 95% CI [0.15-0.41], p <.001), internalization of the thin ideal (d = 0.36, 95% CI [0.07-0.65], p <.05), shape and weight concern (d = 0.42, 95% CI [0.13-0.71], p <.05), dietary restriction (d = 0.36, 95% CI [0.23-0.49], p <.001), drive for thinness (d = 0.47, 95% CI [0.33-0.60], p <.001), bulimic symptoms (d = 0.31, 95% CI [0.20-0.41], p <.001), purging frequency (d = 0.30, 95% CI [0.02-0.57], p <.05), and negative affect (d = 0.32, 95% CI [0.12-0.52], p <.001). Moderator analyses revealed no impact of data analytic strategy on intervention effects. Similarly, participant risk status was not a moderator for most outcomes.
DISCUSSION: Internet-based programs are successful in decreasing ED symptoms and risk factors with small to moderate between-group effect sizes.
Copyright © 2015 Wiley Periodicals, Inc.
International Journal of Eating Disorders, 49(1) : 19-31
- Year: 2016
- Problem: Eating Disorders (any)
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Technology, interventions delivered using technology (e.g. online, SMS)
Johnson, C., Burke, C., Brinkman, S., Wade, T.
Anxiety, depression and eating disorders show peak emergence during adolescence and share common risk factors. School-based prevention programs provide a unique opportunity to access a broad spectrum of the population during a key developmental window, but to date, no program targets all three conditions concurrently. Mindfulness has shown promising early results across each of these psychopathologies in a small number of controlled trials in schools, and therefore this study investigated its use in a randomised controlled design targeting anxiety, depression and eating disorder risk factors together for the first time. Students (M age 13.63; SD = .43) from a broad band of socioeconomic demographics received the eight lesson, once weekly.b ("Dot be") mindfulness in schools curriculum (N = 132) or normal lessons (N = 176). Anxiety, depression, weight/shape concerns and wellbeing were the primary outcome factors. Although acceptability measures were high, no significant improvements were found on any outcome at post-intervention or 3-month follow-up. Adjusted mean differences between groups at post-intervention were .03 (95% CI: -.06 to -.11) for depression, .01 (-.07 to -.09) for anxiety, .02 (-.05 to -.08) for weight/shape concerns, and .06 (-.08 to -.21) for wellbeing. Anxiety was higher in the mindfulness than the control group at follow-up for males, and those of both genders with low baseline levels of weight/shape concerns or depression. Factors that may be important to address for effective dissemination of mindfulness-based interventions in schools are discussed. Further research is required to identify active ingredients and optimal dose in mindfulness-based interventions in school settings.
Behaviour Research & Therapy, 81 : 1-11
- Year: 2016
- Problem: Anxiety Disorders (any), Depressive Disorders, Eating Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Mindfulness based therapy
Costa, M. B., Melnik, T.
Eating disorders are psychiatric conditions originated from and perpetuated by individual, family and sociocultural factors. The psychosocial approach to treatment and prevention of relapse is crucial. To present an overview of the scientific evidence on effectiveness of psychosocial interventions in treatment of eating disorders. All systematic reviews published by the Cochrane Database of Systematic Reviews - Cochrane Library on the topic were included. Afterwards, as from the least recent date of these reviews (2001), an additional search was conducted at PubMed with sensitive search strategy and with the same keywords used. A total of 101 primary studies and 30 systematic reviews (5 Cochrane systematic reviews), meta-analysis, guidelines or narrative reviews of literature were included. The main outcomes were: symptomatic remission, body image, cognitive distortion, psychiatric comorbidity, psychosocial functioning and patient satisfaction. The cognitive behavioral approach was the most effective treatment, especially for bulimia nervosa, binge eating disorder and the night eating syndrome. For anorexia nervosa, the family approach showed greater effectiveness. Other effective approaches were interpersonal psychotherapy, dialectic behavioral therapy, support therapy and self-help manuals. Moreover, there was an increasing number of preventive and promotional approaches that addressed individual, family and social risk factors, being promising for the development of positive self-image and self-efficacy. Further studies are required to evaluate the impact of multidisciplinary approaches on all eating disorders, as well as the cost-effectiveness of some effective modalities, such as the cognitive behavioral therapy. RESUMO Transtornos alimentares sao doencas psiquiatricas originadas de e perpetuadas por fatores individuais, familiares e socioculturais. A abordagem psicossocial e essencial para o tratamento e a prevencao de recaidas. Apresentar uma visao geral das evidencias cientificas sobre a efetividade das intervencoes psicossociais no tratamento de transtornos alimentares. Foram incluidas todas as revisoes sistematicas publicadas no Banco de Dados de Revisoes Sistematicas da Cochrane Library. Posteriormente, a partir da data menos recente destas revisoes (2001), realizou-se uma busca adicional no PubMed, com estrategia de busca sensibilizada e com os mesmos descritores utilizados antes. No total, foram incluidos 101 estudos primarios e 30 revisoes sistematicas (5 revisoes sistematicas da Cochrane), metanalises, diretrizes ou revisoes narrativas da literatura. Os principais desfechos foram remissao de sintomas, imagem corporal, distorcao cognitiva, comorbidade psiquiatrica, funcionamento psicossocial e satisfacao do paciente. A abordagem cognitivo-comportamental foi o tratamento mais efetivo, principalmente para bulimia nervosa, transtorno da compulsao alimentar periodica e sindrome do comer noturno. Para anorexia nervosa, a abordagem familiar demonstrou maior efetividade. Outras abordagens efetivas foram psicoterapia interpessoal, terapia comportamental dialetica, terapia de apoio e manuais de autoajuda. Alem disso, houve um numero crescente de abordagens preventivas e promocionais que contemplaram fatores de risco individuais, familiares e sociais, sendo promissoras para o desenvolvimento da autoimagem positiva e autoeficacia. Sao necessarios mais estudos que avaliem o impacto de abordagens multidisciplinares em todos transtornos alimentares, alem da relacao custo-efetividade de algumas modalidades efetivas, como a terapia cognitivo-comportamental.
Einstein, 14(2) : 235-77
- Year: 2016
- Problem: Eating Disorders (any)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
, At risk (indicated or selected prevention)
, Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
Das, J. K., Salam, R. A., Lassi, Z. S., Khan, M. N., Mahmood, W., Patel, V., Bhutta, Z. A.
Many mental health disorders emerge in late childhood and early adolescence and contribute to the burden of these disorders among young people and later in life. We systematically reviewed literature published up to December 2015 to identify systematic reviews on mental health interventions in adolescent population. A total of 38 systematic reviews were included. We classified the included reviews into the following categories for reporting the findings: school-based interventions (n = 12); community-based interventions (n = 6); digital platforms (n = 8); and individual-/family-based interventions (n = 12). Evidence from school-based interventions suggests that targeted group-based interventions and cognitive behavioral therapy are effective in reducing depressive symptoms (standard mean difference [SMD]: -.16; 95% confidence interval [CI]: -.26 to -.05) and anxiety (SMD: -.33; 95% CI: -.59 to -.06). School-based suicide prevention programs suggest that classroom-based didactic and experiential programs increase short-term knowledge of suicide (SMD: 1.51; 95% CI: .57-2.45) and knowledge of suicide prevention (SMD: .72; 95% CI: .36-1.07) with no evidence of an effect on suicide-related attitudes or behaviors. Community-based creative activities have some positive effect on behavioral changes, self-confidence, self-esteem, levels of knowledge, and physical activity. Evidence from digital platforms supports Internet-based prevention and treatment programs for anxiety and depression; however, more extensive and rigorous research is warranted to further establish the conditions. Among individual- and family-based interventions, interventions focusing on eating attitudes and behaviors show no impact on body mass index (SMD: -.10; 95% CI: -.45 to .25); Eating Attitude Test (SMD: .01; 95% CI: -.13 to .15); and bulimia (SMD: -.03; 95% CI: -.16 to .10). Exercise is found to be effective in improving self-esteem (SMD: .49; 95% CI: .16-.81) and reducing depression score (SMD: -.66; 95% CI: -1.25 to -.08) with no impact on anxiety scores. Cognitive behavioral therapy compared to waitlist is effective in reducing remission (odds ratio: 7.85; 95% CI: 5.31-11.6). Psychological therapy when compared to antidepressants have comparable effect on remission, dropouts, and depression symptoms. The studies evaluating mental health interventions among adolescents were reported to be very heterogeneous, statistically, in their populations, interventions, and outcomes; hence, meta-analysis could not be conducted in most of the included reviews. Future trials should also focus on standardized interventions and outcomes for synthesizing the exiting body of knowledge. There is a need to report differential effects for gender, age groups, socioeconomic status, and geographic settings since the impact of mental health interventions might vary according to various contextual factors. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Journal of Adolescent Health, 59(4, Suppl) : S49-S60
- Year: 2016
- Problem: Anxiety Disorders (any), Depressive Disorders, Eating Disorders (any), Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Systematic reviews
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Complementary & Alternative Interventions (CAM)
, Service Delivery & Improvement, Psychological Interventions (any)
, Technology, interventions delivered using technology (e.g. online, SMS)
Bowen, M. M., Lambert, M. J., Berkeljon, A., Orr, T. E., Berrett, M., Simon, W.
Only one randomized clinical trial (RCT) has examined feedback-assisted (Fb) treatment in an inpatient eating disordered population. Results from this study suggested that those who received Fb treatment were more likely to recover than participants in the treatment-as-usual condition; however, long-term effects of this treatment have not been investigated. This is especially pertinent in eating disordered populations, where outcomes tend to be poor and course of illness chronic. In the current study, fifty-three women from the aforementioned RCT were contacted three to four years after leaving inpatient care to assess their current distress level and psychological functioning. Results suggested no significant difference between treatment conditions. The vast majority of women sought out multiple forms of treatment over the follow-up period, regardless of treatment condition. This is consistent with past research suggesting that women with more severe pathology (i.e. those requiring inpatient treatment) tend to experience a more chronic pattern of symptoms even after intensive treatment. Overall, the superiority of feedback-assisted treatment found at discharge diminished over time and could not be detected at follow-up. Suggestions for further research are delineated. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Cogent Psychology Vol 3(1), 2016, ArtID 1191119, 3(1) :
- Year: 2016
- Problem: Eating Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Biofeedback, neurofeedback, audio/video feedback
Atkinson, M. J., Wade, T. D.
Aim: This preliminary randomized controlled trial assessed the feasibility of a pilot mindfulness-based intervention with respect to reducing the risk of eating disorders in young women. Methods: Forty-four young adult women with body image concerns (Mage = 20.57, SD = 3.22) were randomly allocated to a mindfulness-based or a dissonance-based intervention (3 x 1 h weekly sessions), or to assessment-only control. Self-report measures of eating disorder risk factors, symptoms and related psychosocial impairment were compared at baseline, post-intervention, and at 1- and 6-month follow up. Results: At post-intervention, acceptability ratings for both interventions were high. Mindfulness participants demonstrated statistically significant improvements relative to control at post-intervention for weight and shape concern, dietary restraint, thin ideal internalization, eating disorder symptoms and related psychosocial impairment; however, these gains were largely lost over follow up. Dissonance participants did not show statistically significant improvements relative to control on any outcomes, despite small to moderate effect sizes. Conclusions: These preliminary findings demonstrate the acceptability and short-term efficacy of a mindfulness-based approach to reducing the risk of disordered eating in young women. This provides support for the continued evaluation of mindfulness in the prevention and early intervention of eating disorders, with increased efforts to produce maintenance of intervention gains. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Early Intervention in Psychiatry, 10(3) : 234-245
- Year: 2016
- Problem: Eating Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Mindfulness based therapy, Cognitive dissonance therapy
Tirlea, L., Truby, H., Haines, T. P.
PURPOSE: To test the effectiveness of an intervention delivered by health professionals outside the school environment to girls identified with issues such as poor body image, low self-esteem, low self-confidence, nonparticipation in sports, or being overweight or underweight. DESIGN: The study's design was a stepped-wedge randomized controlled trial to test the efficacy of an intervention on self-esteem, impairment induced by eating disorders, self-efficacy, body satisfaction, and dieting behaviors. SETTING: The study took place at the community health center located in a culturally diverse area of Melbourne, Victoria, Australia. SUBJECTS: Participants were 122 primary and secondary school girls between 10 and 16 years of age. INTERVENTION: Girls on the Go! is a 10-week program designed to improve self-esteem, body image, and confidence, using an empowerment model that involved interactive and experiential learning approaches. Weekly themes included body image and self-esteem, safety and assertiveness, a healthy mind, physical activity, healthy eating, trust and confidence, and connections. MEASURES: Measurements were made using Rosenberg Self-Esteem Scale, clinical interview assessment, health self-efficacy (included mental health and physical health self-efficacy scales), body esteem scale, and the Dutch Eating Behavior Questionnaire for Children. ANALYSIS: A linear mixed model was used. RESULTS: The intervention led to a significant increase (p < .05) in self-esteem and self-efficacy (mental and physical health self-efficacy subscales), for both primary and secondary school-aged participants and reduced dieting behaviors (secondary school participants). These gains were retained after 6 months of follow-up. CONCLUSION: This group-based, low-dose intervention, which, although targeting girls with a range of psychological issues and including both overweight and underweight participants, is a successful means of improving self-esteem among girls from diverse cultural backgrounds. Copyright © The Author(s) 2016.
American Journal of Health Promotion, 30(4) : 231-241
- Year: 2016
- Problem: Eating Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions