Reducing Eating Disorder Risk Factors in Sorority Members: A Randomized Trial

Although sororities are often perceived as contributing to eating disordered behavior, limited research has investigated eating disorders in sorority members. The purpose of this study was to investigate the utility of a highly interactive cognitive dissonance prevention program in reducing empirically supported risk factors in sorority members. Members (N=149) were randomized to the highly interactive intervention, a more passive intervention, or wait-list. Results indicated that both interventions reduced dietary restraint, body dissatisfaction, and eating disorder pathology. Only the highly interactive group reduced thin-ideal internalization as compared to waitlist. Exploratory analyses also indicated that interventions were beneficial to both lower- and higher-risk members. Taken together, results suggest that sororities are a viable population to target in the prevention of eating disorders

Peer Facilitated Eating Disorder Prevention: A Randomized Effectiveness Trial of Cognitive Dissonance and Media Advocacy

This study investigated the effectiveness of two interventions in reducing eating disorder risk factors under naturalistic conditions in sororities. Based on previous research, the campus sororities chose to implement a semi-mandatory, two-session eating disorder prevention program to all new sorority members (N=90) during sorority orientation. To facilitate evaluation, sororities agreed to random assignment of new members to either a cognitive dissonance or media advocacy intervention. Undergraduate peer facilitators ran the groups. Although both interventions had an effect, cognitive dissonance generally was superior at eight-month followup. Results further support the utility of cognitive dissonance in reducing eating disorder risk factors, and suggest that non-doctoral level leaders can deliver the program. Results also indicate that a semi-mandatory format does not reduce effectiveness

Effectiveness of a Peer-Delivered Dissonance-Based Program in Reducing Eating Disorder Risk Factors in High School Girls

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 preintervention and postintervention compared with waitlist 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 waitlist 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

Subjective and Objective Binge Eating in Relation to Eating Disorder Symptomatology, Depressive Symptoms, and Self-Esteem among Treatment-Seeking Adolescents with Bulimia Nervosa: Subjective and Objective Binge Eating

This study investigated the importance of the distinction between objective (OBE) and subjective binge eating (SBE) among 80 treatment-seeking adolescents with bulimia nervosa (BN). We explored relationships among OBEs, SBEs, eating disorder (ED) symptomatology, depression, and self-esteem using two approaches. Group comparisons showed that OBE and SBE groups did not differ on ED symptoms or self-esteem; however, the SBE group had significantly greater depression. Examining continuous variables, OBEs (not SBEs) accounted for significant unique variance in global ED pathology, vomiting, and self-esteem. SBEs (not OBEs) accounted for significant unique variance in restraint and depression. Both OBEs and SBEs accounted for significant unique variance in eating concern; neither accounted for unique variance in weight/shape concern, laxative use, diuretic use, or driven exercise. Loss of control, rather than amount of food, may be most important in defining binge eating. Additionally, OBEs may indicate broader ED pathology while SBEs may indicate restrictive/depressive symptomatology

Effectiveness and feasibility of peer-delivered dissonance-based eating disorder prevention in high school girls

Ph.D. University of Hawaii at Manoa 2013.Includes bibliographical references.Objective: Dissonance-based eating disorder prevention programs utilize counterattitudinal exercises to challenge beliefs about the attainability of cultural beauty ideals. Research has demonstrated that dissonance-based prevention is effective in reducing eating disorder risk factors among adolescent and college-aged women. Programs can be delivered using professional providers (e.g., clinical psychologists) as well as endogenous providers (e.g., college-aged peer leaders, high school staff members). The aim of the current research was to investigate the feasibility of using younger peer leaders (i.e., high school girls) to deliver dissonance-based eating disorder prevention. Method: High school peer leaders across two studies (N=20) received 12 hours of training to deliver a manualized program to small groups of their peers. Study 1 (N=23) was a pilot trial to assess the feasibility and acceptability of the intervention. Study 2 (N=50) utilized a quasi-experimental, waitlist-controlled design to assess reductions in five established eating disorder risk factor outcomes: thin-ideal internalization, body dissatisfaction, eating pathology, dietary restraint, and negative affect. Half of participants received the intervention immediately and half participated after a two-week waitlist control period. All participants were assessed three months post-intervention. Results: Adherence to an age-adapted intervention manual was high in both studies. Feedback from participants across studies indicated the intervention was acceptable, enjoyable, and provided new information. Analysis of outcomes in Study 2 revealed significantly greater pre-post reductions in a majority of risk factors for those who received the intervention immediately compared to waitlist controls. Within-subject changes over time revealed significant pre-post reductions in a majority of risk factors that were sustained through 3-month follow-up, except for thin-ideal internalization, which returned to baseline levels. Some discrepancies were found in measures assessing similar outcomes. Discussion: These two studies are the first to examine the feasibility of using high school peer leaders to implement an empirically-supported, dissonance-based eating disorder prevention program. Results provide tentative support for using high school peer leaders to conduct this type of intervention. Limitations of the current research are discussed, and include a small sample size, short-term waitlist comparison, and brief follow-up period. Future research is needed to replicate these findings in larger, randomized trials

Anti-fat prejudice reduction: a review of published studies

To access publisher full text version of this article. Please click on the hyperlink in Additional Links fieldPrejudice against those who are perceived as 'fat' or obese (anti-fat prejudice) is rife, increasing, and associated with negative outcomes for those targeted for such treatment. The present review sought to identify and describe published research on interventions to reduce anti-fat prejudice. A systematic search of relevant databases (e.g. PsychInfo, PubMed, Scopus) found 16 published studies that had sought to reduce anti-fat prejudice. Most notable was the lack of research on interventions for reducing anti-fat prejudice. Methodological problems that limit the interpretability of results were identified in the majority of studies found. Interventions employing more rigorous experimental designs provided at best mixed evidence for effectiveness. Although several studies reported changes in beliefs and knowledge about the causes of obesity, reductions in anti-fat prejudice did not typically accompany these changes. Anti-fat prejudice interventions adopting social norm- and social consensus-based approaches appear encouraging but are scarce. The lack of prejudice reduction following most interventions suggests that psychological mechanisms other than, or additional to, those being manipulated may underpin anti-fat prejudice. New directions for researching anti-fat prejudice are suggested. Given the strength of antipathy displayed toward those who are perceived as 'fat' or obese, research in this area is urgently required

Family functioning in two treatments for adolescent anorexia nervosa.

ObjectiveFamily functioning impairment is widely reported in the eating disorders literature, yet few studies have examined the role of family functioning in treatment for adolescent anorexia nervosa (AN). This study examined family functioning in two treatments for adolescent AN from multiple family members' perspectives.MethodParticipants were 121 adolescents with AN ages 12-18 from a randomized-controlled trial comparing family-based treatment (FBT) to individual adolescent-focused therapy (AFT). Multiple clinical characteristics were assessed at baseline. Family functioning from the perspective of the adolescent and both parents was assessed at baseline and after 1 year of treatment. Full remission from AN was defined as achieving both weight restoration and normalized eating disorder psychopathology.ResultsIn general, families dealing with AN reported some baseline impairment in family functioning, but average ratings were only slightly elevated compared to published impaired functioning cutoffs. Adolescents' perspectives on family functioning were the most impaired and were generally associated with poorer psychosocial functioning and greater clinical severity. Regardless of initial level of family functioning, improvements in several family functioning domains were uniquely related to full remission at the end of treatment in both FBT and AFT. However, FBT had a more positive impact on several specific aspects of family functioning compared to AFT.DiscussionFamilies seeking treatment for adolescent AN report some difficulties in family functioning, with adolescents reporting the greatest impairment. Although FBT may be effective in improving some specific aspects of family dynamics, remission from AN was associated with improved family dynamics, regardless of treatment type

Is weight gain really a catalyst for broader recovery?: The impact of weight gain on psychological symptoms in the treatment of adolescent anorexia nervosa.

The main aims of this study were to describe change in psychological outcomes for adolescents with anorexia nervosa across two treatments, and to explore predictors of change, including baseline demographic and clinical characteristics, as well as weight gain over time. Participants were 121 adolescents with anorexia nervosa from a two-site (Chicago and Stanford) randomized controlled trial who received either family-based treatment or individual adolescent supportive psychotherapy. Psychological symptoms (i.e., eating disorder psychopathology, depressive symptoms, and self-esteem) were assessed at baseline, end of treatment, 6-month, and 12-month follow-up. Conditional multilevel growth models were used to test for predictors of slope for each outcome. Most psychological symptoms improved significantly from baseline to 12 month follow-up, regardless of treatment type. Depressive symptoms and dietary restraint were most improved, weight and shape concerns were least improved, and self-esteem was not at all improved. Weight gain emerged as a significant predictor of improved eating disorder pathology, with earlier weight gain having a greater impact on symptom improvement than later weight gain. Adolescents who presented with more severe, complex, and enduring clinical presentations (i.e., longer duration of illness, greater eating disorder pathology, binge-eating/purging subtype) also appeared to benefit more psychologically from treatment