Disorders - Eating Disorders
Rutherford, L., Couturier, J.
Objective: Psychotherapeutic interventions for child and adolescent eating disorders have
recently received increasing attention in the research literature. This article attempts to summarize these studies. Method: The current literature
was reviewed using the PubMed and Embase databases under the search terms eating disorders, child, adolescent, and psychotherapy. Here we will
present a practical overview of the current evidence for psychotherapeutic interventions in this clinical population. Results: There have been some
very promising findings with regards to specific types of therapy for anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (BED).
Conclusions: The best evidence available suggests that family-therapy models are most effective for treating adolescents with AN, and that CBT models
are most effective for adolescent BN, although family-based treatment may also be effective for adolescents with BN. Too few studies have been done
on BED in adolescents to draw any conclusions; however CBT, IPT and DBT are all theoretically promising.
Canadian Child &
Adolescent Psychiatry Review, 16(4) : 153-157
- Year: 2007
- Problem: Eating Disorders
(any)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any)
Russell-Mayhew, S., Arthur, N., Ewashen, C.
This
study examines the effectiveness of a wellness-based prevention program on elementary and junior high students' body image, personal attitudes, and
eating behaviors. Group differences in measures of student attitudes and eating behaviors are examined to determine the effect of targeting different
participant combinations (students, parents, and teachers) in 10 groups. For elementary schools, student participants consisted of control (no
intervention) (n = 36), student only (n = 81), student/parent (n = 124), student/parent/teacher (n = 103), and parent/teacher (n = 149). For junior
high schools, student participants consisted of control (n = 143), student only (n=215), student/parent (n=65), student/parent/teacher (n = 14), and
parent/teacher (n = 177). Overall, complete data was available for 1,095 students, 114 parents and 92 teachers. Results indicate that self-concept
and eating attitudes and behaviors were positively affected by participation in the program. For example, in elementary schools posttest scores on
the behavior subscale of the self-concept measure are significantly higher for the student/parent/teacher group than for the control group. Results
indicate that a one-time wellness-based eating disorder prevention program with students, which have in the past shown to be minimally effective, may
be more effective in changing attitudes and behaviors when teachers and parents are involved.
Eating Disorders., 15(2) : 159-
181
- Year: 2007
- Problem: Eating Disorders
(any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Stice, Eric, Shaw, Heather, Marti, C. Nathan
This meta-analytic review found that 51% of eating disorder prevention
programs reduced eating disorder risk factors and 29% reduced current or future eating pathology. Larger effects occurred for programs that were
selected (versus universal), interactive (versus didactic), multisession (versus single session), solely offered to females (versus both sexes),
offered to participants over 15 years of age (versus younger ones), and delivered by professional interventionists (versus endogenous providers).
Programs with body acceptance and dissonance-induction content and without psychoeducational content and programs evaluated in trials using validated
measures and a shorter follow-up period also produced larger effects. Results identify promising programs and delineate sample, format, and design
features associated with larger effects, which may inform the design of more effective prevention programs in the future. [References: 97]
Annual Review
of Clinical Psychology, 3 : 207-31
- Year: 2007
- Problem: Eating Disorders
(any)
- Type: Systematic reviews
-
Stage: Universal prevention, At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any)
Taylor, C. Barr, Bryson, Susan, Luce, Kristine H., Cunning, Darby, Doyle, Angela Celio, Abascal, Liana B., Rockwell, Roxanne, Dev, Pavarti, Winzelberg, Andrew J., Wilfley, Denise E.
CONTEXT: Eating disorders, an important health problem among college-age
women, may be preventable, given that modifiable risk factors for eating disorders have been identified and interventions have been evaluated to
reduce these risk factors. OBJECTIVE: To determine if an Internet-based psychosocial intervention can prevent the onset of eating disorders (EDs) in
young women at risk for developing EDs. SETTING: San Diego and the San Francisco Bay Area in California. PARTICIPANTS: College-age women with high
weight and shape concerns were recruited via campus e-mails, posters, and mass media. Six hundred thirty-seven eligible participants were identified,
of whom 157 were excluded, for a total sample of 480. Recruitment occurred between November 13, 2000, and October 10, 2003.Intervention A randomized
controlled trial of an 8-week, Internet-based cognitive-behavioral intervention (Student Bodies) that included a moderated online discussion group.
Participants were studied for up to 3 years. MAIN OUTCOME MEASURES: The main outcome measure was time to onset of a subclinical or clinical ED.
Secondary measures included change in scores on the Weight Concerns Scale, Global Eating Disorder Examination Questionnaire, and Eating Disorder
Inventory drive for thinness and bulimia subscales and depressed mood. Moderators of outcome were examined. RESULTS: There was a significant
reduction in Weight Concerns Scale scores in the Student Bodies intervention group compared with the control group at postintervention (P < .001), 1
year (P < .001), and 2 years (P < .001). The slope for reducing Weight Concerns Scale score was significantly greater in the treatment compared with
the control group (P = .02). Over the course of follow-up, 43 participants developed subclinical or clinical EDs. While there was no overall
significant difference in onset of EDs between the intervention and control groups, the intervention significantly reduced the onset of EDs in 2
subgroups identified through moderator analyses: (1) participants with an elevated body mass index (BMI) (> or =25, calculated as weight in kilograms
divided by height in meters squared) at baseline and (2) at 1 site, participants with baseline compensatory behaviors (eg, self-induced vomiting,
laxative use, diuretic use, diet pill use, driven exercise). No intervention participant with an elevated baseline BMI developed an ED, while the
rates of onset of ED in the comparable BMI control group (based on survival analysis) were 4.7% at 1 year and 11.9% at 2 years. In the subgroup with
a BMI of 25 or higher, the cumulative survival incidence was significantly lower at 2 years for the intervention compared with the control group (95%
confidence interval, 0% for intervention group; 2.7% to 21.1% for control group). For the San Francisco Bay Area site sample with baseline
compensatory behaviors, 4% of participants in the intervention group developed EDs at 1 year and 14.4%, by 2 years. Rates for the comparable control
group were 16% and 30.4%, respectively. CONCLUSIONS: Among college-age women with high weight and shape concerns, an 8-week, Internet-based
cognitive-behavioral intervention can significantly reduce weight and shape concerns for up to 2 years and decrease risk for the onset of EDs, at
least in some high-risk groups. To our knowledge, this is the first study to show that EDs can be prevented in high-risk groups.
Archives of General Psychiatry, 63(8) : 881-
8
- Year: 2006
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Self-help, Technology, interventions delivered using technology (e.g. online, SMS)
Stice, Eric, Shaw, Heather, Burton, Emily, Wade, Emily
In this trial, adolescent girls with body dissatisfaction (N = 481, M age = 17 years) were
randomized to an eating disorder prevention program involving dissonance-inducing activities that reduce thin-ideal internalization, a prevention
program promoting healthy weight management, an expressive writing control condition, or an assessment-only control condition. Dissonance
participants showed significantly greater reductions in eating disorder risk factors and bulimic symptoms than healthy weight, expressive writing,
and assessment-only participants, and healthy weight participants showed significantly greater reductions in risk factors and symptoms than
expressive writing and assessment-only participants from pretest to posttest. Although these effects faded over 6-month and 12-month follow-ups,
dissonance and healthy weight participants showed significantly lower binge eating and obesity onset and reduced service utilization through 12-month
follow-up, suggesting that both interventions have public health potential. Copyright 2006 APA
Journal of Consulting & Clinical Psychology, 74(2) : 263-
75
- Year: 2006
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Psychological Interventions
(any), Psychoeducation, Other Psychological Interventions, Cognitive dissonance
therapy, Creative expression: music, dance, drama, art
Roehrig, Megan, Thompson, J. Kevin, Brannick, Michael, van den
Berg, Patricia
OBJECTIVE: A dissonance-based program aimed at reducing thin-ideal internalization has been found to significantly decrease
levels of bulimic symptoms in young adult and adolescent females. Because this program is multifaceted, containing psychoeducation,
counterattitudinal advocacy, and behavioral exposure components, the current study sought to investigate the mechanisms involved in symptom
reduction. METHOD: The current study compared the original treatment program with a dismantled version of the full package, which consisted solely of
the specific dissonance component (i.e., the counterattitudinal advocacy procedure). Seventy-eight women were randomly assigned to either the full
treatment condition or the counterattitudinal advocacy condition. RESULTS: Findings suggest that both interventions significantly reduced established
risk factors for eating pathology as well as bulimic symptoms at termination and at 1-month follow-up. CONCLUSION: Both treatments appear to be
equally effective at reducing eating pathology in at-risk college women. Limitations of the study are discussed, and directions for future research
are offered. 2005 by Wiley Periodicals, Inc.
International Journal of Eating Disorders, 39(1) : 1-
10
- Year: 2006
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive dissonance
therapy
Low, Kathryn
Graff, Charanasomboon, Swita, Lesser, Jill, Reinhalter, Katie, Martin, Rachel, Jones, Hannah, Winzelberg, Andy, Abascal, Liana, Taylor, C. Barr
Computer-based delivery of health-related psychoeducational programming is increasingly popular. In the present study, 72 non-
symptomatic undergraduate women were randomized to an Internet-based prevention program for eating disorders with or without accompanying discussion
groups, or a control group. Sixty-one of the women (84%) completed the Student Bodies program, and were assessed at short and eight-nine month
follow-up. Participation in the program resulted in better outcomes across all groups compared to controls, and women in the unmoderated discussion
group appeared to have the most reduction in risk. Benefits of the program continued at follow-up. Decrease in risk also was associated with time
spent using the Internet-based program. The present study suggests that the use of Student Bodies may reduce risk of eating and body image concerns
over the long term, and that moderation of discussion groups may not be essential for successful outcomes. Further research on larger samples will
help determine the degree to which discussion groups or the Student Bodies program alone are effective.
Brunner-Mazel Eating Disorders Monograph Series, 14(1) : 17-
30
- Year: 2006
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Self-help, Technology, interventions delivered using technology (e.g. online, SMS)
Stice, E., Orjada,
K., Tristan, J.
Objective: We conducted a controlled trial of a psychoeducational eating disturbance intervention to replicate the positive findings
observed in the preliminary evaluation of this intervention and to determine whether the effects persist for a longer follow-up period. Method:
College women who took the psychoeducational class and a matched control sample of students (N = 95) completed pretest, posttest, and 6-month
follow-up surveys. Results: Intervention participants showed significantly greater reductions in thin-ideal internalization, body dissatisfaction,
dieting, and eating disorder symptoms, as well as significantly less weight gain, relative to matched controls over the study period. Intervention
effects tended to be larger at 6-month follow-up than at posttest. Conclusion: These findings suggest that the intervention effects for eating
disorder risk factors and eating disorder symptoms, as well as the weight gain prevention effects, are reproducible and persist over time. This
intervention has both mental health and public health significance. copyright 2006 by Wiley Periodicals, Inc.
International Journal of Eating Disorders., 39(3) : 233-
239
- Year: 2006
- Problem: Eating Disorders
(any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Psychoeducation
Wilksch, Simon M., Tiggemann, Marika, Wade, Tracey D.
OBJECTIVE: The primary objective of the current study was to examine the efficacy of single media literacy lessons in reducing media
internalization in young adolescents. METHOD: Eleven classes of 237 students (100 girls and 137 boys; mean age = 13.79 years, SD = .42) randomly
received 1 of 6 lessons. Eating disorder risk factors were assessed at baseline, and the Sociocultural Attitudes Towards Appearance Questionnaire-3
(SATAQ-3) was used to assess media internalization postintervention. RESULTS: At postintervention, boys had significantly lower SATAQ-3 scores on 4
of the 5 subscales (effect sizes = .42-.71), whereas girls had significantly lower scores on 1 subscale (effect size = .54). Higher baseline levels
of dietary restraint, magazines bought/read, and perceived sociocultural pressure predicted smaller reductions in boys' scores, whereas depression
predicted smaller reductions in girls' scores. CONCLUSION: The current study provides support that boys be included in eating disorder prevention
programs and that media literacy may represent a promising prevention approach.
International Journal of Eating Disorders, 39(5) : 385-
93
- Year: 2006
- Problem: Eating Disorders
(any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Pokrajac-Bulian, A., Zivcic-Becirevic, I., Calugi, S., Dalle Grave, R.
The main purpose of this pilot study was to evaluate the efficacy of a schoolbased program of eating
disorder prevention on a sample of young adolescents in Croatia. The program was designed to reduce dietary restraint and preoccupation with shape
and weight. One hundred and thirty-nine students (69 boys and 70 girls; mean age 12.8 years) were evaluated; 75 participated in the program
(experimental group) and 64 formed the control group. Outcome measures included eating disorder attitudes, dieting behavior, selfesteem, and
knowledge of the topics covered by the program. Outcome measures were evaluated one week before the intervention, one week afterwards, and during a
follow-up of 6 months. The program significantly reduced eating disorder attitudes and dieting behavior, and improved knowledge in the female
experimental group. A significant and positive effect on eating disorders attitude and knowledge, but not on dietary habits, was noticed in the male
experimental group. No significant effects were observed in the control group. The findings of this prevention program give encouraging results and
should be evaluated in further studies on larger samples.
Eating & Weight Disorders, 11(4) : 171-8
- Year: 2006
- Problem: Eating Disorders
(any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Psychoeducation, Other Psychological Interventions
Gollings, E., Paxton, S. J.
Increased access to therapy for body dissatisfaction and disordered
eating is required. This pilot study compared a group intervention delivered face-to-face or synchronously over the Internet. Women with body
dissatisfaction and disordered eating were randomly assigned to a face-to-face (N = 19) or Internet (N = 21) group. Body dissatisfaction, disordered
eating, and psychological variables were assessed at baseline, post-intervention, and two months follow-up. Significant improvements on all outcome
variables were observed and maintained at follow-up in both groups. There were no significant differences between delivery modes. This program shows
promise, and the Internet mode of delivery has potential to overcome geographical distance. Copyright copyright 2005 Taylor & Francis.
Eating
Disorders., 14(1) : 1-15
- Year: 2006
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Technology, comparing delivery mode (e.g. online vs. face-to-face)
Frayne, A., Wade, T. D.
Written emotional expression using
Permebaker's paradigm has been shown to produce significant improvements in health and psychological functioning in student groups and some clinical
groups. This paradigm has not been examined with respect to disordered eating or its associated psychopathology. The current study examined 98 female
university students (mean age = 22.75 years, SD = 8.31) who were randomly assigned to either an emotional expression writing condition relating to
past trauma, or a control writing condition that focused on future planning. The students repeated the writing task on three occasions in 1 week. All
measures were completed at baseline and 10-week follow-up; measures of distress were additionally completed after each occasion of writing. A
significant two-way interaction was found for ineffectiveness and disordered eating showing both variables to decrease in the planning compared to
the emotional expression condition over time. A significant three-way interaction for externalised self-perception showed different levels of denial
coping affected the helpfulness of both writing paradigms. Investigation of a variety of forms of structured therapeutic writing is advocated with
clinical eating disorder populations. Copyright copyright 2006 John Wiley & Sons, Ltd and Eating Disorders Association.
European Eating Disorders Review., 14(5) : 329-
340
- Year: 2006
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Creative expression: music, dance, drama, art