School-based eating disorder prevention: A pilot effectiveness trial of teacher-delivered Media Smart

Author version made available in accordance with Publisher copyright policy.AIM: This pilot study tested teacher-delivered Media Smart, a school-based eating disorder prevention program that has achieved significant benefits when delivered by health professionals. METHOD: Two Grade 7 classes (N = 51; M age = 12.43 years) participated, with one randomly allocated to Media Smart (n = 27; 67% girls) and the other to a control condition of usual lessons (n = 24; 37% girls). Program feasibility was assessed by teacher self-report, whereas student self-report of shape and weight concern (primary outcome variable) and seven additional risk factors were measured at baseline, post-program and 6-month follow up. RESULTS: Teacher ratings of program feasibility revealed that 25 of the 29 (86.2%) program activities were taught with 96% of activities rated as either highly (19 activities) or moderately (5 activities) valuable for students. Mixed model analyses were conducted using a 2 (group: Media Smart, control) × 2 (time: post-program, 6-month follow up) × 2 (gender: girls, boys) design, with baseline scores as a covariate. A not-significant trend for group favouring Media Smart was observed for shape and weight concern (Cohen's d effect size [d] = 0.32), whereas significant effects were found for feelings of ineffectiveness (d = 0.52) and weight-related peer teasing (d = 0.68). CONCLUSIONS: The program was feasible for teacher delivery and showed some promising results, supporting a more substantial randomized-controlled effectiveness trial

An investigation of temperament endophenotype candidates for early emergence of the core cognitive component of eating disorders

This study was designed to investigate potential temperament endophenotypes for clinically significant importance of shape and weight. Seven temperament risk factors for eating disorders and the Eating Disorder Examination were assessed in 699 female twins aged 12–15 years. Each variable was evaluated against the following endophenotype criteria : associated with illness in the general population ; found in non-affected family members at a higher rate than in the general population ; and, heritable. All seven variables were significantly associated with clinically significant importance of shape and weight, while thin-ideal internalization, ineffectiveness, body dissatisfaction and sensitivity to punishment were found at significantly elevated levels in non-affected twins, when controlling for sister’s temperament score. These four variables had genetic correlations with importance of shape and weight, ranging from 0.48 to 0.95. Future research should evaluate the stability of the identified endophenotypes and their utility for predicting significant growth in importance of shape and weight, and also whether different endophenotypes emerge when the importance of weight and shape reaches its peak in adolescents, around 15 to 16 years of age

Depression as a moderator of benefit from Media Smart: a school-based eating disorder prevention program

© 2013. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/Objective: To investigate if baseline depression moderated response to Media Smart, an 8-lesson school-based program previously found to achieve a long-term risk reduction effect in young adolescents. Method: 540 Grade 8 students (M age = 13.62 years, SD = .37) from 4 schools participated with 11 classes receiving the Media Smart program (126 girls; 107 boys) and 13 comparison classes receiving their normal lessons (147 girls; 160 boys). Shape and weight concern, media internalization, body dissatisfaction, dieting, ineffectiveness, and perceived pressure were the outcome variables. Results: Moderation was indicated by significant interaction effects for group (Media Smart; Control) X moderator (high depression; low depression) X time (post-program; 6-month follow-up; 2.5-year follow-up), with baseline entered as a covariate. Such effects were found for shape and weight concern, media internalization, body dissatisfaction, ineffectiveness and perceived pressure. Post-hoc testing found high depression Media Smart participants scored significantly lower than their control counterparts at post-program on shape and weight concern, media internalization and dieting, whereas low depression Media Smart participants scored significantly lower on shape and weight concern at 2.5-year follow-up. Discussion: Media Smart achieved a reduction in eating disorder risk factors for high-depression participants and a reduced rate of growth in risk factor scores for low-depression participants

Examination of the Sociocultural Attitudes Towards Appearance Questionnaire-3 in a mixed-gender young-adolescent sample

Author version made available in accordance with publisher copyright policy.Thin-ideal (or media) internalization is an important eating disorder risk factor that has become a central target of many prevention programs. However, evidence for its valid assessment in young, mixed-gender, adolescent samples is limited, and the current study is the first published to explore the psychometric properties of the 30-item Sociocultural Attitudes Towards Appearance Questionnaire-3 (SATAQ-3: Thompson, van den Berg, Roehrig, Guarda, & Heinberg, 2004) in a non-adult community sample. Two samples of Grade 8 students (M age = 13.68 years, SD = .39), totalling 680 girls (N =332) and boys (N =348) completed the SATAQ-3 and other measures, whereas a smaller sample (N = 123) of Grade 10 females (M age = 15.01 years, SD = .41) served as a comparison group for supplementary analyses. Principal component analyses (PCA) with data from Sample One (N=201) revealed four factors with eigenvalues >1.0, similar to the original authors structure but where some cross-loading occurred between the Pressures and Internalization – General scales. Confirmatory factor analyses (CFA) were conducted with data from Sample Two (N=479) on the factor solution found in the PCA. The model did not fit well, leading to further revisions based on removal of cross-loading items and CFA modification indices, resulting in a 19-item, 4 factor solution with acceptable fit. Examinations of validity and reliability were generally acceptable. The overall findings suggest an abbreviated version of the SATAQ-3 might be more appropriate than the original version with young-adolescent, mixed gender audiences. Further examinations of the psychometric properties of the SATAQ-3 with this demographic are indicated

A longitudinal investigation of the impact of disordered eating on young women's quality of life

"This article may not exactly replicate the authoritative document published in the APA journal. It is not the copy of record." Author manuscript made available here in accordance with Publisher copyright policy.OBJECTIVE: The extent to which subclinical levels of disordered eating affect quality of life (QOL) was assessed. METHOD: Four waves of self-report data from Survey 2 (S2) to 5 (S5) of a national longitudinal survey of young Australian women (N = 9,688) were used to assess the impact of any level of disordered eating at S2 on QOL over the following 9 years, and to evaluate any moderating effects of social support and of depression. RESULTS: At baseline, 23% of the women exhibited some level of disordered eating, and they scored significantly lower on both the physical and the mental component scores of the SF-36 at every survey; differences in mental health were still clinically meaningful at S5. Social support and depressive symptoms each acted as a moderator of the mental component scores. Women with both disordered eating and low social support, or disordered eating and depression, had the worst initial scores; although they improved the most over time, they still had the lowest scores at S5. Higher social support at baseline resulted in women with disordered eating being largely indistinguishable from women without disordered eating who had low social support. Lower levels of depression resulted in women with disordered eating having a significantly better QOL than women with high levels of depression, regardless of eating status. CONCLUSIONS: This is the first study to examine the long-term impact of subclinical levels of disordered eating on QOL, and it suggests that even apparently minor levels of symptomatology are associated with significant and far-reaching deficits in well-being

Life Smart: A Pilot Study of a School-Based Program to Reduce the Risk of Both Eating Disorders and Obesity in Young Adolescent Girls and Boys.

Author version made available following 36 month embargo from date of publication (22 May 2013) in accordance with publisher copyright policy.Objective: To develop and pilot Life Smart, an 8-lesson program aimed at reducing risk factors for both eating disorders and obesity. Methods: Grade 7 girls and boys (N=115) from one independent school were randomly allocated to the Life Smart (2 classes; N = 51) or control (3 usual classes; N=64) conditions. Risk factors were measured at baseline and post-program (5-weeks later). Results: Life Smart was rated as moderately enjoyable and valuable by participants. ANCOVAs with baseline as a covariate revealed a significant main effect for group favouring Life Smart for shape and weight concern (Effect Size [ES] = .54), with post-hoc testing finding girls particularly benefited on this variable (ES = .78). Conclusions: Feedback was generally favourable, with some suggestions for even more interactive content. The program showed more promise with girls. Informed by these findings, the program underwent revisions and is now being evaluated in a randomized controlled trial

Interactive programme to enhance protective factors for eating disorders in girls with type 1 diabetes

"This is the peer reviewed version of the following article: [Wilksch, S. M., Starkey, K., Gannoni, A., Kelly, T. and Wade, T. D. (2013), Interactive programme to enhance protective factors for eating disorders in girls with type 1 diabetes. Early Intervention in Psychiatry, 7: 315–321], which has been published in final form at [http://dx.doi.org/10.1111/eip.12012]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving. http://olabout.wiley.com/WileyCDA/Section/id-820227.html#terms"AIMS: This study evaluated the effectiveness of a pilot programme in enhancing protective factors for eating disorders in young girls with type 1 diabetes (T1D). METHODS: Twenty girls with T1D (M age = 11.06 years) attended two 4-h group sessions. A 4-week baseline control period was compared against changes at post-programme and at 1-month follow-up on measures of eating disorder risk factors and indicators of glycaemic control. RESULTS: At post-intervention, significant improvements were found for self-efficacy related to diabetes management, self-esteem, body-esteem,thin-ideal internalization and perfectionism. These gains were maintained at 1-month follow-up. Participants were also rated by their parents as assuming more responsibility for specific diabetes-related tasks at follow-up. CONCLUSIONS: A brief interactive programme can favourably impact protective factors for disordered eating. The development of effective disordered eating prevention strategies for girls with T1D is an urgent priority and the current study is a first step in this direction

Media Smart-Targeted: Diagnostic outcomes from a two-country pragmatic online eating disorder risk reduction trial for young adults

This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving'. Copyright 2018 Wiley Periodicals, Inc. This author accepted manuscript is made available following 6 month embargo from date of publication (January 2018) in accordance with the publisher’s copyright policyBackground: Diagnostic outcomes in eating disorder (ED) risk reduction trials are important but rarely reported. Methods: An online pragmatic randomized-controlled trial was conducted with young-adult women in Australia and New Zealand seeking to improve their body image. Media Smart-Targeted (MS-T) was a 9-module program released weekly while control participants received tips for positive body image. Eating Disorder Examination–Questionnaire (EDE-Q) scores from baseline and 12-month follow-up were used to investigate two outcomes: ED onset in those who were asymptomatic at baseline (prevention effects); and, ED remission in those who met diagnosis at baseline (treatment effects). Results: MS-T participants were 66% less likely than controls to develop an ED by 12-month follow-up (non-significant). MS-T participants who met ED criteria at baseline were 75% less likely than controls to still meet diagnostic criteria at follow-up. This effect was significant and remained so for both those who did and who did not access external face-to-face ED treatment during the trial. Conclusions: Whilst further investigations are necessary, MS-T has fully automated procedures, low implementation costs, the potential to be delivered at-scale to assist those assist those where face-to-face services are limited or not available (e.g., remote areas)

Prevention Across the Spectrum: a randomized controlled trial of three programs to reduce risk factors for both eating disorders and obesity

Author version made available in accordance with publisher copyright policy.Background: A randomized-controlled trial (RCT) of 3 school-based programs and a no intervention control group was conducted to evaluate their efficacy in reducing eating disorder and obesity risk factors. Methods: N = 1,316 Grade 7 and 8 girls and boys (M age = 13.21 years) across three Australian states were randomly allocated to: Media Smart; Life Smart; Helping, Encouraging, Listening and Protecting Peers Initiative (HELPP) or control (usual school class). Risk factors were measured at baseline, post-program (5-weeks later), and 6- and 12-month follow-up. Results: Media Smart girls had half the rate of onset of clinically significant concerns about shape and weight than control girls at 12-month follow-up. Media Smart and HELPP girls reported significantly lower weight and shape concern than Life Smart girls at 12-month follow-up. Media Smart and control girls scored significantly lower than HELPP girls on eating concerns and perceived pressure at 6-month follow-up. Media Smart and HELPP boys experienced significant benefit on media internalization compared to control boys and these were sustained at 12-month follow-up in Media Smart boys. A group x time effect found Media Smart participants reported more physical activity than control and HELPP participants at 6-month follow-up, while a main effect for group found Media Smart participants reported less screen time than controls. Conclusions: Media Smart was the only program to show benefit on both disordered eating and obesity risk factors. Whilst further investigations are indicated, this study suggests that this program is a promising approach to reducing risk factors for both problems

How perfectionism and ineffectiveness influence growth of eating disorder risk in young adolescent girls

© 2015. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/. Author version available following 24 month embargo from date of publication (Feb 3 2015) in accordance with publisher copyright policy.Objective: While perfectionism is widely considered to influence risk for eating disorders, results of longitudinal studies are mixed. The goal of the current study was to investigate a more complex model of how baseline perfectionism (both high personal standards and self-critical evaluative concerns) might influence change in risk status for eating disorders in young adolescent girls, through its influence on ineffectiveness. Method: The study was conducted with 926 girls (mean age of 13 years), and involved three waves of data (baseline, 6- and 12-month follow-up). Latent growth curve modeling, incorporating the average rate at which risk changed over time, the intercept (initial status) of ineffectiveness, and baseline perfectionism, was used to explore longitudinal mediation. Results: Personal standards was not supported as contributing to risk but results indicated that the higher mean scores on ineffectiveness over the three waves mediated the relationship between higher baseline self-critical evaluative concerns and both measures of eating disorder risk. The relationship between concern over mistakes and change in risk was small and negative. Discussion: These results suggest the usefulness of interventions related to self-criticism and ineffectiveness for decreasing risk for developing an eating disorder in young adolescent girls