Disorders - Eating Disorders
Lopez-Guimera, G., Sanchez-Carracedo, D., Fauquet, J., Portell, M., Raich, R. M.
This study
assessed the impact of a school-based program aimed at preventing disordered eating. The program was based on the media-literacy approach and has
interactive format. The program was assessed under strong methodological conditions. Seven schools with 263 Spanish adolescent girls in the area of
Barcelona, were randomly assigned to either the complete prevention program condition, the partial program condition or the non-treatment control
condition, and assessed at pre, post and 6-month follow-up. The program was effective in generating positive changes at follow-up. The effects sizes
(ESd = 0.29 to ESd = 0.38) were greater, on average, than that obtained up to now in selective-universal programs, and similar or greater than that
achieved by targeted prevention programs. The results indicate a greater and relevant effect size of the intervention in those participants who
completed the inter-session interactive activities (ESd = 0.29 to ESd = 0.45) although the differences were not significant. These results suggest
the importance of monitoring adherence to the activities in all programs defined as \"interactive\". The implications and limitations of this study
are discussed. (copyright) 2011 by The Spanish Journal of Psychology.
Spanish Journal of Psychology, 14(1) : 293-303
- Year: 2011
- Problem: Eating Disorders
(any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Midgley, N., Kennedy, E.
For many years psychoanalytic and psychodynamic
therapies have been considered to lack a credible evidence-base and have consistently failed to appear in lists of 'empirically supported
treatments'. This study systematically reviews the research evaluating the efficacy and effectiveness of psychodynamic psychotherapy for children
and young people. The researchers identified 34 separate studies that met criteria for inclusion, including nine randomised controlled trials. While
many of the studies reported are limited by sample size and lack of control groups, the review indicates that there is increasing evidence to suggest
the effectiveness of psychoanalytic psychotherapy for children and adolescents. The article aims to provide as complete a picture as possible of the
existing evidence base, thereby enabling more refined questions to be asked regarding the nature of the current evidence and gaps requiring further
exploration. (copyright) 2011 Copyright Taylor and Francis Group, LLC.
Journal of Child
Psychotherapy, 37(3) : 232-260
- Year: 2011
- Problem: Anxiety Disorders (any), Depressive Disorders, Eating Disorders
(any)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Psychodynamic/Psychoanalysis
Luethcke, C. A., McDaniel, L., Becker, C. B.
This study compares different versions of mirror exposure (ME), a body image
intervention with research support. ME protocols were adapted to maximize control and comparability, and scripted for delivery by research
assistants. Female undergraduates (N=168) were randomly assigned to receive mindfulness-based (MB; n=58), nonjudgmental (NJ; n=55), or cognitive
dissonance-based (CD, n=55) ME. Participants completed the Body Image Avoidance Questionnaire (BIAQ), Body Checking Questionnaire (BCQ), Satisfaction
with Body Parts Scale (SBPS), Beck Depression Inventory-II (BDI-II), and Eating Disorders Examination Questionnaire (EDE-Q) at pre-treatment, post-
treatment, and 1-month follow-up. Mixed models ANOVAs revealed a significant main effect of time on all measures, and no significant time by
condition interaction for any measures except the SBPS. Post-hoc analysis revealed that only CD ME significantly improved SBPS outcome. Results
suggest that all versions of ME reduce eating disorder risk factors, but only CD ME improves body satisfaction. (copyright) 2011 Elsevier Ltd.
Body
Image, 8(3) : 251-258
- Year: 2011
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions, Mindfulness based
therapy, Cognitive dissonance
therapy
McMillan, W., Stice, E., Rohde, P.
Objective: As cognitive dissonance is theorized to contribute to the effects of dissonance-based eating disorder prevention
programs, we evaluated a high-dissonance version of this program against a low-dissonance version and a wait-list control condition to provide an
experimental test of the mechanism of intervention effects. Method: Female college students (N = 124, mean age = 20.9 years, SD = 3.9) with body
image concerns were randomized to the 3 conditions. The high-dissonance program was designed to maximize dissonance induction, and the low-dissonance
program was designed to minimize it; the substantive content of the 2 programs was matched. Results: Relative to controls, those in the high-
dissonance condition showed significantly greater reductions in thin-ideal internalization, body dissatisfaction, dieting, and eating disorder
symptoms by posttest, and those in the low-dissonance condition showed significantly greater reductions in the first 3 outcomes by posttest, with
most of these effects persisting to 3-month follow-up. High-dissonance participants showed significantly greater reductions in eating disorder
symptoms than low-dissonance participants did by posttest, but this effect was nonsignificant by 3-month follow-up. Conclusions: Results suggest that
dissonance induction contributes to intervention effects but imply that the intervention content, nonspecific factors, and demand characteristics
play a much more potent role in producing effects. (copyright) 2011 American Psychological Association.
Journal of Consulting &
Clinical Psychology, 79(1) : 129-134
- Year: 2011
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive dissonance
therapy
Storch, Maja, Keller, Ferdinand, Weber, Julia, Spindler, Anja, Milos, Gabriella
This study examined the effects of a psychoeducational training program
in affect regulation for patients with eating disorders. Nineteen female patients completed measures of affect regulation (ACS-90), alexithymia
(TAS-26), and eating behavior (EDE-Q). Data were assessed at baseline and at 3 and 12 months posttreatment. Dependent on date of entering hospital,
the patients were allocated consecutively to the control group (n =11), which received inpatient treatment as usual, or to the treatment group (n =
8), which received training in addition to usual inpatient treatment. At follow-up, the training was associated with statistically significant
improvement in the skill of down-regulating negative affect and with a tendency towards less dietary restraint. Regarding alexithymia no clear
results were found. Despite the small sample size, results showed that in addition to the general improvement due to the treatment usually provided
in the clinical setting, the training program resulted in specific benefits for the patients with regard to their affect regulation skills.
American Journal of Psychotherapy, 65(1) : 81-93
- Year: 2011
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Psychoeducation
Siemer, C. P., Fogel, J., VanVoorhees, B. W.
The authors conducted a
review of the literature with regard to child and adolescent mental health intervention, from which they identified 20 unique publications and 12
separate interventions. These interventions encompassed depression, anxiety, substance abuse, eating disorders, and mental health promotion. Studies
were heterogeneous, with a wide range of study designs and comparison groups creating some challenges in interpretation. However, modest evidence was
found that Internet interventions showed benefits compared with controls and preintervention symptom levels. Interventions had been developed for a
range of settings, but tended to recruit middle-class participants of European ethnicity. Internet interventions showed a range of approaches toward
engaging children and incorporating parents and peers into the learning process. (copyright) 2011 Elsevier Inc.
Child & Adolescent
Psychiatric Clinics of North America, 20(1) : 135-153
- Year: 2011
- Problem: Anxiety Disorders (any), Depressive Disorders, Eating Disorders
(any)
- Type: Systematic reviews
-
Stage: Universal prevention, At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Technology, interventions delivered using technology (e.g. online, SMS)
Becker, Carolyn Black, Wilson, Chantale, Williams, Allison, Kelly,
Mackenzie, McDaniel, Leda, Elmquist, Joanna
Research supports the efficacy
of both cognitive dissonance (CD) and healthy weight (HW) eating disorders prevention, and indicates that CD can be delivered by peer-facilitators,
which facilitates dissemination. This study investigated if peer-facilitators can deliver HW when it is modified for their use and extended follow-up
of peer-facilitated CD as compared to previous trials. Based on pilot data, we modified HW (MHW) to facilitate peer delivery, elaborate benefits of
the healthy-ideal, and place greater emphasis on consuming nutrient dense foods. Female sorority members (N=106) were randomized to either two 2-h
sessions of CD or MHW. Participants completed assessment pre- and post-intervention, and at 8-week, 8-month, and 14-month follow-up. Consistent with
hypotheses, CD decreased negative affect, thin-ideal internalization, and bulimic pathology to a greater degree post-intervention. Both CD and MHW
reduced negative affect, internalization, body dissatisfaction, dietary restraint, and bulimic pathology at 14 months.; Copyright © 2010 Elsevier
Ltd. All rights reserved.
Body Image, 7(4) : 280-288
- Year: 2010
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: Universal prevention, At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Psychological Interventions
(any), Cognitive dissonance
therapy, Dietary advice, dietary change
Fairburn, Christopher G., Cooper,
Zafra, Doll, Helen A., O'Connor, Marianne E., Bohn, Kristin, Hawker, Deborah M., Wales, Jackie A., Palmer, Robert L.
Objective: The aim of this
study was to compare two cognitive-behavioral treatments for outpatients with eating disorders, one focusing solely on eating disorder features and
the other a more complex treatment that also addresses mood intolerance, clinical perfectionism, low self-esteem, or interpersonal difficulties.
Method: A total of 154 patients who had a DSM-IV eating disorder but were not markedly underweight (body mass index over 17.5), were enrolled in a
two-site randomized controlled trial involving 20 weeks of treatment and a 60-week closed period of follow-up. The control condition was an 8-week
waiting list period preceding treatment. Outcomes were measured by independent assessors who were blind to treatment condition. Results: Patients in
the waiting list control condition exhibited little change in symptom severity, whereas those in the two treatment conditions exhibited substantial
and equivalent change, which was well maintained during follow-up. At the 60-week follow-up assessment, 51.3% of the sample had a level of eating
disorder features less than one standard deviation above the community mean. Treatment outcome did not depend on eating disorder diagnosis. Patients
with marked mood intolerance, clinical perfectionism, low self-esteem, or interpersonal difficulties appeared to respond better to the more complex
treatment, with the reverse pattern evident among the remaining patients. Conclusions: These two transdiagnostic treatments appear to be suitable for
the majority of outpatients with an eating disorder. The simpler treatment may best be viewed as the default version, with the more complex treatment
reserved for patients with marked additional psychopathology of the type targeted by the treatment. (PsycINFO Database Record (c) 2010 APA, all
rights reserved) (journal abstract)
American Journal of Psychiatry, 166(3) : 311-319
- Year: 2009
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Stice, Eric, Rohde, Paul, Gau, Jeff, Shaw, Heather
Efficacy trials indicate that an eating disorder prevention program
involving dissonance-inducing activities that decrease thin-ideal internalization reduces risk for current and future eating pathology, yet it is
unclear whether this program produces effects under real-world conditions. The present effectiveness trial tested whether this program produced
effects when school staff recruit participants and deliver the intervention. Adolescent girls with body image concerns (N = 306; M age = 15.7, SD =
1.1) randomized to the dissonance intervention showed significantly greater decreases in thin-ideal internalization, body dissatisfaction, dieting
attempts, and eating disorder symptoms from pretest to posttest than did those assigned to a psychoeducational brochure control condition, with the
effects for body dissatisfaction, dieting, and eating disorder symptoms persisting through 1-year follow-up. Effects were slightly smaller than those
observed in a prior efficacy trial, suggesting that this program is effective under real-world conditions, but that facilitator selection, training,
and supervision could be improved.; (c) 2009 APA, all rights reserved.
Journal of Consulting & Clinical
Psychology, 77(5) : 825-834
- Year: 2009
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Psychoeducation, Cognitive dissonance
therapy
Wilksch, Simon M., Wade, Tracey D.
Objective: Method: Results: Conclusion: Recent eating disorder prevention efforts have targeted high-risk
females in late adolescence (>15 years). Methodologically rigorous evaluations of prevention programs directed to younger, mixed-sex, universal
audiences are largely absent. The primary objective was to evaluate a theoretically informed media literacy program delivered to a mixed-sex,
universal, young adolescent audience.Five hundred forty Grade 8 students (mean age 13.62 years, SD 0.37 years) from 4 schools participated with a
total of 11 classes receiving the 8-lesson media literacy program (126 girls and 107 boys) and 13 comparison classes receiving their normal school
lessons (147 girls and 160 boys). Shape and weight concern (primary outcome variable) and seven additional eating disorder risk factors (e.g.,
dieting, media internalization) were measured with validated questionnaires at baseline, postprogram, and 6- and 30-month follow-up.Linear mixed
model analyses were conducted using a 2 (group: media literacy program, control) x 3 (time: postprogram, 6-month follow-up, 30-month follow-up) x 2
(sex: girls, boys) mixed within-between design, with baseline entered as a covariate. Main effects for group, favoring the media literacy program,
were found for shape and weight concern (effect size [ES] = 0.29), dieting (ES = 0.26), body dissatisfaction (ES = 0.20), ineffectiveness (ES =
0.23), and depression (ES = 0.26).Media literacy can be an effective intervention for reducing shape and weight concern and other eating disorder
risk factors long-term in a universal mixed-sex, young adolescent population. More evaluations of methodologically sound prevention programs are
required with this demographic.
Journal of the American Academy of Child & Adolescent Psychiatry, 48(6) : 652-
661
- Year: 2009
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Yager, Zali, O'Dea,
Jennifer A.
Body dissatisfaction, dieting, eating
disorders and exercise disorders are prevalent among male and female university students worldwide. Male students are also increasingly adopting
health-damaging, body-image-related behaviors such as excessive weight lifting, body building and steroid abuse. Given the severity and difficulty of
treating eating disorders, prevention of these problems is a recognized public health goal. Health promotion and health education programs have been
conducted in the university setting since the mid 1980s, but few have achieved significant improvements in target health attitudes and behaviors. In
this paper, 27 large, randomized and controlled health promotion and health education programs to improve body dissatisfaction, dieting and
disordered eating and exercise behaviors of male and female college students are reviewed. In general, health education programs to improve body
image and prevent eating disorders in the university setting have been limited by small sample sizes and the exclusion of male students. The majority
of studies were conducted among either female undergraduate psychology students or women that were recruited using on-campus advertising. The latter
reduces the ability to generalize results to the whole university population, or the general community. In addition, there has been a paucity of
longitudinal studies that are methodologically sound, as only 82% (22/27) of interventions included in the review used random assignment of groups,
and only 52% (n = 14) included follow-up testing. Information-based, cognitive behavioral and psycho-educational approaches have been the least
effective at improving body image and eating problems among university students. Successful elements for future initiatives are identified as taking
a media literacy- and dissonance-based educational approach, incorporating health education activities that build self-esteem, and using computers
and the internet as a delivery medium. A newly designed program for Australian university students is described. [References: 79]
Health Promotion International, 23(2) : 173-89
- Year: 2008
- Problem: Eating Disorders
(any)
- Type: Systematic reviews
-
Stage: Universal prevention, At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any)
Ridolfi, D. R., Vander Wal, J. S.
The purpose of this
study was to assess the effectiveness of a body image dissatisfaction prevention session that provided information on body image and media literacy
to college women. Participants were 81 undergraduates who were randomly assigned to attend either a body image intervention or a control
intervention. Participants completed measures at pre- and post-intervention and at 4-week follow-up. The body image group improved significantly more
than the control group on body shape concerns, but not on the other outcome variables. Efficacious interventions capable of reaching large numbers of
women are necessary to help dispel the \"normative discontent\" prevalent today.
Eating Disorders., 16(5) : 428-
443
- Year: 2008
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions