Disorders - Eating Disorders
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.\rMETHOD: Twenty studies were identified and between-group effect sizes were calculated for ED symptoms and risk
factors.\rRESULTS: 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.\rDISCUSSION: Internet-based programs are successful in decreasing ED symptoms and risk factors with small to moderate
between-group effect sizes.\rCopyright © 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
Atkinson, M. J., Wade, T. D.
Objective Successful prevention of eating disorders represents an important
goal due to damaging long-term impacts on health and well-being, modest treatment outcomes, and low treatment seeking among individuals at risk.
Mindfulness-based approaches have received early support in the treatment of eating disorders, but have not been evaluated as a prevention strategy.
This study aimed to assess the feasibility, acceptability, and efficacy of a novel mindfulness-based intervention for reducing the risk of eating
disorders among adolescent females, under both optimal (trained facilitator) and task-shifted (non-expert facilitator) conditions. Method A school-
based cluster randomized controlled trial was conducted in which 19 classes of adolescent girls (N-=-347) were allocated to a three-session
mindfulness-based intervention, dissonance-based intervention, or classes as usual control. A subset of classes (N = 156) receiving expert
facilitation were analyzed separately as a proxy for delivery under optimal conditions. Results Task-shifted facilitation showed no significant
intervention effects across outcomes. Under optimal facilitation, students receiving mindfulness demonstrated significant reductions in weight and
shape concern, dietary restraint, thin-ideal internalization, eating disorder symptoms, and psychosocial impairment relative to control by 6-month
follow-up. Students receiving dissonance showed significant reductions in socio-cultural pressures. There were no statistically significant
differences between the two interventions. Moderate intervention acceptability was reported by both students and teaching staff. Discussion Findings
show promise for the application of mindfulness in the prevention of eating disorders; however, further work is required to increase both impact and
acceptability, and to enable successful outcomes when delivered by less expert providers.
International Journal of Eating Disorders, 48(7) : 1024
-1037
- Year: 2015
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Mindfulness based
therapy, Cognitive dissonance
therapy
Aspen, V., Martijn, C., Alleva, J. M., Nagel, J., Perret, C., Purvis, C., Saekow, J., Lock,
J., Taylor, C.
Objective: Body dissatisfaction in females is common and a risk factor for the development
of an eating disorder. This study tested whether body dissatisfaction could be improved using a brief conditioning intervention in which photographs
of participants' bodies were selectively paired with positive social stimuli (smiling faces) and photographs of other bodies were paired with
neutral or negative social stimuli (neutral and frowning faces). Method: 39 women (mean age=22.46; 64.1% Caucasian) with high body dissatisfaction
were randomized to either the evaluative conditioning intervention (n=22) or to a delayed waitlist control condition (n=17). Body dissatisfaction
(specifically, shape and weight concern), restraint, eating concern, and self-esteem were assessed at baseline, post treatment and again after four
and 12 weeks. Results: Compared to women in the delayed waitlist control condition, women in the treatment condition demonstrated a significant
decrease in shape and weight concern, and a significant increase in self-esteem. Similar trends were found for the control condition after they
completed the intervention. Changes at post treatment related to body dissatisfaction were maintained at 12-week follow-up. Conclusions: Repeatedly
pairing photographs of an individual's body with positive social feedback may lead to improved body image and self-esteem.
Behaviour Research &
Therapy, 69 :
- Year: 2015
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Ciao, A. C., Latner, J. D., Brown, K.
E., Ebneter, D. S., Becker, C. B.
Objective: This pilot study investigated the feasibility,
acceptability, and effectiveness of a peer-led dissonance-based eating disorders (ED) prevention/risk factor reduction program with high school
girls. Method: Ninth grade girls (n = 50) received the peer-led program within the school curriculum. A quasi-experimental design was used to assess
changes in ED risk factors pre intervention and post intervention compared with wait list control. Participants were followed through 3-month
follow-up. Results: Peer-leader adherence to an intervention manual tailored for this age group was high. The intervention was rated as highly
acceptable, with a large proportion of participants reporting that they enjoyed the program and learned and applied new information. Intervention
participants exhibited significantly greater pre-post reductions in a majority of risk-factor outcomes compared to wait list controls. When groups
were combined to assess program effects over time there were significant pre-post reductions in a majority of outcomes that were sustained through 3
-month follow-up. Discussion: This pilot study provides tentative support for the effectiveness of using peer leaders to implement an empirically
supported ED risk factor reduction program in a high school setting. Additional research is needed to replicate results in larger, better-controlled
trials with longer follow-up. (PsycINFO Database Record (c) 2016 APA, all rights reserved) (journal abstract).
International Journal of Eating Disorders, 48(6) : 779-784
- Year: 2015
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Cognitive dissonance
therapy
Brown, T. A., Keel, P. K.
Objective:
Gay males have increased risk for eating disorders compared to heterosexual males, establishing a need to develop and empirically evaluate programs
to reduce risk for this population. The present study investigated the acceptability and efficacy of a cognitive dissonance-based (DB) intervention
(The PRIDE Body Project©) in reducing eating disorder risk factors among gay males in a university-based setting. Method: Eighty-seven gay males were
randomized to either a 2-session DB intervention (n = 47) or a waitlist control condition (n = 40). Participants completed eating disorder risk
factor assessments pre-intervention, post-intervention, and at 4-week follow-up, and those receiving the intervention completed post-treatment
acceptability measures. Results: Acceptability ratings were highly favorable. Regarding efficacy, the DB condition was associated with significantly
greater decreases in body dissatisfaction, drive for muscularity, self-objectification, partner-objectification, body-ideal internalization, dietary
restraint, and bulimic symptoms compared to waitlist control from pre- to post-intervention. Improvements in the DB group were maintained at 4-week
follow-up, with the exception of body-ideal internalization. Body-ideal internalization mediated treatment effects on bulimic symptoms. Conclusion:
Results support the acceptability and efficacy of The PRIDE Body Project© and provide support for theoretical models of eating pathology in gay men.
(PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract).
Behaviour Research & Therapy, 74 : 1-
10
- Year: 2015
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive dissonance
therapy