Disorders - Eating Disorders
Lewis-Smith, H., Garbett, K. M., Chaudhry, A., Dhillon, M., Shroff,
H., White, P., Diedrichs, P. C.
Body dissatisfaction is highly prevalent among adolescents in low- and middle- income countries, including in India. However,
evidence-based interventions are lacking. This study evaluated the efficacy of a school-based mixed-gender body image intervention among adolescents
in India. A randomized controlled trial was conducted among 568 (43 % girls) Year 7 students (aged 11-14; 94 % aged 12-13) in six schools in Delhi.
Each school was randomly allocated to receive five 45-minute intervention sessions delivered by trained psychologists or a wait-list control
condition. The primary outcome of body image and related secondary outcomes were assessed at pre-intervention, post-intervention, and 3-month
follow-up. Intention-to-treat linear mixed models analyses showed improvements in body image relative to the control group at post-intervention and
3-month follow-up. Significant improvements were identified at post-intervention for internalization, life disengagement, disordered eating, self-
esteem, and negative affect, with effects maintained in nearly all outcomes (girls only - internalization, boys only - life disengagement) at 3-month
follow-up. This study presents the first mixed-gender school-based body image intervention in India, which was efficacious in improving urban
adolescents' body image, disordered eating, and related outcomes. Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights
reserved.
Body image, 44 : 148-
156
- Year: 2023
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Kadriu, F., Claes, L., Witteman,
C., Woelk, M., Krans, J.
Background and objectives: This study compared the effect of imagery rescripting focusing on self-compassion, imagery
rescripting focusing on mastery, and a positive memory control condition on (1) emotional responses towards the memory (one day after), (2) changes
in the believability of negative core beliefs, and dysfunctional eating behaviors (one week after) in individual at risk for developing an eating
disorder. Method(s): Female participants (N = 69) were allocated to one of three conditions: ImRs focusing on self-compassion (N = 24), ImRs focusing
on self-mastery (N = 23), and positive memory control condition (N = 22). Participants in the ImRs conditions received a 20-min self-guided ImRs
intervention, whereas participants in the control condition received a 20-min self-guided task focusing on an unrelated positive memory. Result(s):
The experimental manipulation successfully induced the use of self-compassion and mastery strategies in the respective imagery rescripting condition.
However, our data show that a single 20-min session of self-guided imagery rescripting focusing on compassion and/or mastery has no effect on the
emotional response towards the aversive memory or in the change of core beliefs and eating behaviors at follow up. Limitation(s): We discuss
potential reasons for the null findings, including the use of a single imagery rescripting session, the sample size and the measurement of
manipulation checks. Conclusion(s): Future studies are needed to rule out methodological explanations for the null results. These findings may be of
value for the development of future experimental lab paradigms which aim to evaluate the causal effects and working mechanisms of imagery
rescripting. Copyright © 2022 The Authors
Journal of Behavior Therapy and Experimental Psychiatry, 78 (no
pagination) :
- Year: 2023
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Forbes, J., Paxton, S., Yager, Z.
Following calls for the independent replication of universal body
image programs under diverse conditions, this research aimed to investigate whether the universal co-educational prevention program developed for
audiences in the United Kingdom (Dove Confident Me, DCM), was an acceptable and effective intervention when delivered by teachers to adolescent girls
attending a single-sex Australian school. Comprising two studies, Study 1, evaluated DCM among Grade 8 students (N = 198) at a single-sex private
school, and compared the results with students (N = 208) s from a matched comparison group. No improvements were observed on outcome measures between
the comparison and intervention girls over the three time points. Study 2 involved minor modifications to the aesthetics and content of the program,
as well as the logistics of delivery. Delivered by teachers to Grade 8 students (N = 242 intervention and N = 354 comparison), there were significant
improvements in acceptability of the modified DCM program, yet no interaction effects observed on outcome measures. While the program did no harm, it
is possible that there are adjustments to the methods utilized and content of programs that are trialed in efforts to prevent body image concerns and
eating disorders in the school setting. Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.
Body image, 46 : 152-
167
- Year: 2023
- Problem: Eating Disorders
(any)
- Type: Controlled clinical trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Egbert, A. H., Gorrell, S., Smith, K.
E., Goldschmidt, A.
B., Hughes, E. K., Sawyer, S. M., Yeo, M., Lock, J., Le-Grange, D.
Objective: Family-based treatment (FBT) is a well-established intervention for adolescent anorexia nervosa
(AN). Although FBT is efficacious in promoting weight gain and improvements in psychological symptoms, for some adolescents, cognitive/attitudinal
recovery lags behind weight gain. This study conducted an exploratory post hoc analysis of outcomes of adolescents who achieved weight gain by the
end of FBT but continued to experience elevated psychological symptoms post-treatment. Method(s): Data were drawn from two randomised controlled
trials (RCTs) testing two forms of FBT (conjoint/whole family and parent-focussed). Descriptive statistics and generalised estimating equations were
used to examine differences in treatment outcomes between non-cognitive responders (NCRs) (those who regained weight but continued to experience
psychological symptoms) and full responders (FRs) (those who achieved both weight and cognitive restoration by the end of treatment) (n = 80; 83.7%
female, Agemean [SD] = 14.66 [1.73]). Result(s): By 12 months post-treatment, there were no differences in weight between NCRs and FRs.
However, NCRs had a slower trajectory of weight gain than FRs and continued to have elevated levels of psychological symptoms throughout the follow-
up period. Conclusion(s): A subset of adolescents appear to continue to experience clinically significant levels of eating pathology up to 12 months
after FBT even when weight restoration is achieved. Copyright © 2023 Eating Disorders Association and John Wiley & Sons Ltd.
European Eating Disorders Review, 31(3) : 425-
432
- Year: 2023
- Problem: Eating Disorders
(any), Anorexia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Datta, Nandini, Matheson, Brittany E., Citron, Kyra, Van-Wye, Eliza Margaret, Lock, James D.
Eating disorders (EDs) are life-threatening psychiatric illnesses that occur in adolescents. Unfortunately, limited randomized
controlled trials exist to address EDs in this vulnerable population. The current review updates a prior Journal of Clinical Child and Adolescent
Psychology review from 2015. The recommendations in this review build upon those that were previously published. This update was completed through a
systematic search of three major scientific databases (PsychInfo, Pubmed, and Cochrane) from 2015 to 2022 (inclusively) from three databases,
employing relevant medial subject headings. Additionally, expert colleagues were asked for additional literature to include. Thirty-one new studies
were added to this review. Psychosocial treatments included family therapies, individual therapy, cognitive-behavioral therapy, interpersonal
psychotherapy, cognitive training, dialectical behavioral therapy, and more recently, virtual or telehealth-based practices and guided self-help
modalities for carers of youth with EDs. Using the Journal of Clinical Child and Adolescent Psychology's methodological review criteria, this update
found behavioral family-based treatment modalities (FBT) for both adolescent anorexia nervosa and bulimia nervosa met well-established treatment
criteria. To date, there were no well-established treatments found for child and adolescent avoidant-restrictive food intake disorder, or binge
eating disorder. Internet facilitated cognitive-behavioral therapy and family-based therapy were found to be possibly efficacious for binge eating
disorder. Family-based treatment was found to be possibly efficacious for avoidant restrictive food intake disorder, with other clinical trials for
cognitive treatment modalities under way. Ongoing research examining treatments for eating disorders in children and adolescents broadly is needed.
(PsycInfo Database Record (c) 2023 APA, all rights reserved)
Journal of Clinical Child and Adolescent
Psychology, 52(2) : 159-170
- Year: 2023
- Problem: Eating Disorders
(any)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any)
D'Adamo, L., Ghaderi, A., Rohde, P., Gau, J. M., Shaw, H., Stice, E.
BACKGROUND: This study tested whether the dissonance-based Body Project eating disorder prevention program
reduced onset of subthreshold/threshold anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and purging disorder (PD) over
long-term follow-up. METHOD(S): Data were combined from three prevention trials that targeted young women at high-risk for eating disorders (N =
1092; M age = 19.3). Participants were randomized to Body Project groups led by peer educators or expressive writing/educational controls and
completed masked diagnostic interviews over 2- to 4-year follow-ups. Logistic regressions tested whether onset of each eating disorder over follow-up
differed between Body Project and control participants. RESULT(S): Peer-led Body Project groups produced a 46% reduction in onset of
subthreshold/threshold BN and a 62% reduction in onset of PD relative to controls over follow-up. Rates of onset of subthreshold/threshold AN and BED
did not significantly differ between peer-led Body Project participants and control participants. CONCLUSION(S): Results support the dissemination of
the peer-led Body Project for reducing future onset of BN and PD. This study and recent research suggest that thin-ideal internalization, the risk
factor for eating disorders targeted in the Body Project, may be more relevant for predicting onset of BN and PD compared to AN and BED. Findings
support the development of a version of the Body Project aimed to reduce risk factors that have predicted future onset of all four types of eating
disorders (e.g. overvaluation of weight/shape, fear of weight gain), which may more effectively prevent all eating disorder types.
Psychological medicine, : 1-
8
- Year: 2023
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Other Psychological Interventions, Other service delivery and improvement
interventions
Ciao, A. C., Duvall, A., Pascual, S., Lawley, K. A.
OBJECTIVE: A novel peer facilitation model was used to deliver a
two session, dissonance-based, inclusive body image intervention that critically examines how internalized size-based oppression intersects with
race, class, gender, sexuality, and ability.\rMETHOD: The EVERYbody Project was open to all college students and delivered by \"expert\" peer
facilitators with body image and diversity experience and advanced facilitation skills. Recruitment was halted due to COVID-19; 90 students in the
Northwest US (M age = 19.83 years, SD = 2.38; 80% female-identified, 13% male-identified, 7% gender expansive) were randomized to receive the
EVERYbody Project or a video-based, low-dissonance comparison intervention.\rRESULTS: Around half of students (56%) held one or more specific
socially marginalized identity (26% with a racial or ethnic identity other than white and non-Hispanic, 39% with a sexual identity other than
straight, 7% with a gender identity other than cisgender). The EVERYbody Project produced greater reductions in three outcomes associated with poor
body image (internalized appearance norms, body dissatisfaction, and negative affect) compared to the video intervention through 3-month follow-up
(ps < .003) with medium between group effects. Both conditions experienced small reductions in eating disorder psychopathology over time.
\rDISCUSSION: Expert peer facilitation may be a viable delivery model for inclusive, diversity-focused dissonance-based body image programs.\rPUBLIC
SIGNIFICANCE: This study explored a novel facilitation approach for a diversity-focused body image program for college students. A brief (4 h)
dissonance-based program was open to all college students and delivered by \"expert\" diverse peer leaders who were screened for facilitation
readiness. Body image and related outcomes were improved through 3-month follow-up relative to a comparison condition, suggesting that expert peer
facilitation may be a viable option for delivering universal, inclusive body image programming.
International Journal of Eating
Disorders, 56(2) : 372-383
- Year: 2023
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Cognitive dissonance
therapy
Butler, R. M., Heimberg, R. G.
Exposure therapy has been investigated as a treatment for eating disorders, but prior research has largely
neglected core fears underlying the disorder such as rejection, abandonment, disgust, and loss of control. We tested the feasibility and
acceptability of using imaginal exposure to target disordered eating related fears by randomizing participants (N=47) with disordered eating to:
imaginal exposure (IE), imaginal exposure preceded by a brief food exposure (IE+Food), or an assessment control. Participants attended two in-person
visits and completed pretreatment, posttreatment, and one-month follow-up questionnaires. IE was rated more acceptable than IE+Food. Retention was
high across conditions. Habituation occurred for subjective distress and believability of feared outcomes, suggesting that imaginal exposure
effectively activates core fears. Distress tolerance and confidence in ability to change improved. Disordered eating symptoms, fears, preoccupations,
and rituals decreased in all conditions, indicating that IE was not specifically responsible for improvement.
Behavior modification, 47(1) : 46-70
- Year: 2023
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Exposure therapy, Exposure
and response prevention, Other Psychological Interventions
Barone, J., Oliveri, M., Bonaventura, R. E., Mangano, G. R.
Aim: This study aimed to explore the effect of intermittent theta
burst stimulation (iTBS) of the right and left dorsolateral prefrontal cortex (DLPFC) in people with self-reported dysregulated eating behaviors but
without a diagnosis of eating disorders (EDs). Methods: Participants were randomly divided into two equivalent groups according to the side (right or
left) of the hemisphere to be stimulated and they were tested before and after a single iTBS session. Outcome measurements were scores on self-report
questionnaires assessing psychological dimensions related to eating behaviors (EDI-3), anxiety (STAI-Y), and tonic electrodermal activity. Results:
The iTBS interfered with both psychological and neurophysiological measures. Significant variations of physiological arousal after iTBS of both the
right and left DLPFC were witnessed by increased mean amplitude of non-specific skin conductance responses. With regard to the psychological
measures, the iTBS on the left DLPFC significantly reduced the scores of the EDI-3 subscales drive for thinness and body dissatisfaction.
Interestingly, these two scales are two of the three EDI-3 clinic scales (drive for thinness, body dissatisfaction, and bulimia) used as specific
markers to assess the onset and/or maintenance of eating disorders. Conclusion: Our results show that the left DLPFC iTBS has an impact on the
psychological dimensions that are risk factors for the onset of eating disorders, suggesting that an altered hemispheric asymmetry similar to that
encountered in clinical populations is present in normal subjects even in the absence of clinical symptoms.
Frontiers in Human Neuroscience, 17 : ArtID 1108869
- Year: 2023
- Problem: Eating Disorders
(any), Bulimia Nervosa
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Biological Interventions
(any), Transcranial magnetic stimulation
(TMS)
Balzan, R. P., Gilder, M., Thompson, M., Wade, T. D.
OBJECTIVE: This pilot study investigated the feasibility
and preliminary efficacy of the metacognitive training for eating disorders (MCT-ED) program in adolescents with anorexia nervosa (AN). We report
attrition and subjective evaluation as well as changes to cognitive flexibility, perfectionism and eating disorder pathology relative to waitlist
controls.\rMETHOD: Female (n = 35, aged 13-17 years) outpatients with a diagnosis of AN (n = 20) or atypical AN (n = 15) completed baseline measures
of cognitive flexibility, perfectionism, and eating disorder pathology (May 2020-May 2022). Participants were randomly allocated to either
treatment-as-usual (TAU) plus MCT-ED or TAU waitlist condition. All participants completed post-intervention and 3-month follow-up questionnaires.
\rRESULTS: The MCT-ED condition had a treatment attrition rate <15%. Participants provided positive evaluation of the program. There were large
between groups differences favoring MCT-ED at post-intervention and 3-month follow-up for concern over mistakes perfectionism (respective ds = -1.25,
95% CI [-2.06, -.45]; -.83, 95% CI [-1.60, .06]) with a significant group difference post-intervention but not 3-month follow-up.\rDISCUSSION:
Findings provide tentative support for the feasibility of MCT-ED as an adjunct intervention for young people with AN, however replication is needed
with a larger sample size to further explore its efficacy.\rPUBLIC SIGNIFICANCE: Metacognitive training for eating disorders (MCT-ED) is a feasible
adjunct intervention for adolescents with anorexia nervosa. The intervention, which targets thinking styles and is delivered online by a therapist,
received positive feedback, had high treatment retention, and led to reductions in perfectionism by the end of treatment compared to wait-list
controls. Although these gains were not sustained long-term, the program is suitable adjunct intervention for young people with eating disorders.
International Journal of
Eating Disorders, 09 : 09
- Year: 2023
- Problem: Eating Disorders
(any), Anorexia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive remediation
therapy
AlShebali, M., Becker, C., Kellett, S., AlHadi, A., Waller, G.
The aims of this study were to determine the
effectiveness of an adapted version of the Body Project for young Saudi women, and to determine the impact of compliance (i.e. adherence to homework
and attendance) on outcomes. A randomized controlled trial was used, allocating Saudi undergraduate females (N = 92; mean age = 20.48 years; SD =
2.28) to either a culturally-adapted version of the Body Project or a health education control condition. Participants completed self-report measures
of eating pathology, body image, depression and social anxiety before and following the interventions and at three-month follow-up. Interaction terms
showed that, relative to the control group, the intervention group had significantly reduced levels of eating concerns, body dissatisfaction and
depression, but social anxiety did not change significantly in either group. Levels of session attendance and homework completion did not influence
outcomes. Thus, the Body Project was effective for Saudi women in reducing eating pathology, body image dissatisfaction, and depression, though not
social anxiety. This outcome indicates the value of the Body Project as a prevention tool when adapted to non-Western cultures. Copyright © 2023 The
Author(s). Published by Elsevier Ltd.. All rights reserved.
Body image, 45 : 307-317
- Year: 2023
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: Universal prevention, At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive dissonance
therapy
Xin, R., Fitzpatrick, O. M., Ho-Lam-Lai, P., Weisz, J.
R., Price, M. A.
Asian American (AsA) youth comprise a large and fast-growing
proportion of the U. S. population. AsA youth have comparable and sometimes higher rates of mental health concerns compared to White youth, but are
significantly less likely to access mental health services. Cognitive-behavioral therapy (CBT) was originally designed by and for White and Western
populations, but might provide clinical benefits for AsA youth because several CBT characteristics overlap with some AsA values (e.g., directive
therapeutic style; family involvement). Despite this promise, there has yet to be a synthesis of evidence on the effectiveness of CBT, either
culturally-adapted or non-adapted, for AsA youth. A systematic narrative review identified randomized controlled trials (RCTs) of CBT conducted with
AsA youth. Electronic databases used included PsycINFO, Web of Science, PubMed, and ProQuest. Our search yielded 2,059 articles, of which, 8 RCTs
(386 participants) met inclusion criteria. Studies were heterogeneous across targeted problems (e.g., phobia, depression) and age (M = 8.4-22.1
years). Findings suggest that both culturally-adapted and non-adapted CBT (3 and 5 RCTs, respectively) were effective in reducing a range of
emotional and behavioral problems for AsA youth. The dearth of studies with AsA youth underscores the need for enhancing the cultural responsiveness
of clinical research and practice, as well as harnessing community-engaged methods to improve the accessibility and uptake of evidence-based mental
health services for AsA youth. Copyright © 2022 Society of Clinical Child & Adolescent Psychology.
Evidence-Based Practice in Child and Adolescent Mental Health, 7(2) : 198-
212
- Year: 2022
- Problem: Specific
Phobia, Depressive Disorders, Eating Disorders
(any), Substance Use Disorders (any)
- Type: Systematic reviews
-
Stage: Universal prevention, Disorder established (diagnosed disorder), At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)