A Preliminary Trial of a Prototype Internet Dissonance-Based Eating Disorder Prevention Program for Young Women With Body Image Concerns

Oregon Research Institute.
Journal of Consulting and Clinical Psychology (Impact Factor: 4.85). 04/2012; 80(5):907-16. DOI: 10.1037/a0028016
Source: PubMed


Objective: A group dissonance-based eating disorder prevention program, in which young women critique the thin ideal, reduces eating disorder risk factors and symptoms, but it can be difficult to identify school clinicians with the time and expertise to deliver the intervention. Thus, we developed a prototype Internet version of this program and evaluated it in a preliminary trial. Method: Female college students with body dissatisfaction (N = 107; M age = 21.6 years, SD = 6.6) were randomized to the Internet intervention, group intervention, educational video condition, or educational brochure condition. Results: Internet and group participants showed greater pre-post reductions in eating disorder risk factors and symptoms than video controls (M ds = 0.47 and 0.54, respectively) and brochure controls (M ds = 0.75 and 0.72, respectively), with many effects reaching significance. Effects did not differ significantly for Internet versus group participants (M ds = -0.13) or for video versus brochure controls (M d = 0.25). Effect sizes for the Internet intervention were similar to those previously observed for group versions of this intervention. Conclusions: Results suggest that this prototype Internet intervention is as efficacious as the group intervention, implying that there would be merit in completing this intervention and evaluating it in a fully powered trial. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

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Available from: Paul Rohde, Sep 30, 2014
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    • "It seems unlikely that differential clinical experience of facilitators explains the fact that the Body Project tends to produce larger effects than other eating disorder prevention programs, because numerous trials of other eating disorder prevention programs have often had graduate students or experienced clinicians deliver the interventions. Thus, while the acute effects from this trial suggested that the eBody Project produced effects that were similar in magnitude to the Body Project effects (Stice et al., 2012), results from the present report indicate that the group Body Project generally produces more clinically meaningful intervention effects that show greater persistence over time if delivered by experienced clinicians, but that the eBody Project produces effects that are similar to those observed by clinicians with less expertise. One potential explanation for why the effects for key outcomes such as thin-ideal internalization were weaker for the eBody Project versus the Body Project is that participants may feel greater public accountability when they critique the thin ideal in a group of peers, versus online, potentially because they continue to see these peers outside of the group setting or have the potential to do so, whereas they are more anonymous when they critique the thin ideal on the Internet. "
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    ABSTRACT: Objective: A group-based eating disorder prevention program wherein young women explore the costs of pursuing the thin ideal reduces eating disorder risk factors and symptoms. However, it can be challenging to identify school clinicians to effectively deliver the intervention. The present study compares the effects of a new Internet-based version of this prevention program, which could facilitate dissemination, to the group-based program and to educational video and educational brochure control conditions at 1- and 2-year follow-up. Method: Female college students with body dissatisfaction (n = 107; M age = 21.6, SD = 6.6) were randomized to these 4 conditions. Results: Internet participants showed reductions in eating disorder risk factors and symptoms relative to the 2 control conditions at 1- and 2-year follow-up (M -d = .34 and .17, respectively), but the effects were smaller than parallel comparisons for the group participants (M -d = .48 and .43, respectively). Yet the Internet intervention produced large weight gain prevention effects relative to the 2 control conditions at 1- and 2-year follow-up (M -d = .80 and .73, respectively), which were larger than the parallel effects for the group intervention (M -d = .19 and .47, respectively). Conclusions: Although the effects for the Internet versus group intervention were similar at posttest, results suggest that the effects faded more quickly for the Internet intervention. However, the Internet intervention produced large weight gain prevention effects, implying that it might be useful for simultaneously preventing eating disordered behavior and unhealthy weight gain.
    Health Psychology 07/2014; 33(12). DOI:10.1037/hea0000090 · 3.59 Impact Factor
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    • "Consistent with the other applications of cognitive dissonance, it appears to be superior to the neutral or mindfulness approach and is associated with longer duration of positive effects.[70] It has also been delivered via the internet, with reported positive effects comparable to those seen with a face-to-face group intervention.[71] This, along with other internet-based interventions that report positive findings,[72] is encouraging and reflects a potential route by which eating disorder prevention can be disseminated in countries where mainstream prevention efforts are currently limited but where rapid modernization permits easy access to online material. "
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    ABSTRACT: Eating disorders are common, life-threatening conditions in Western countries, but until relatively recently they were regarded as uncommon in non-Western cultures. However, the prevalence of eating disorders in many of the more affluent non-Western countries is rising rapidly as community members, particularly young women, internalize the 'thin ideal' that has been widely promoted by the international media. This review discusses the factors involved in the development of eating disorders in non-Western settings with a particular emphasis on the influences of urbanization, modernization, Westernization, and the resulting changes in women's roles. The cognitive dissonance programs developed in Western countries that have proven successful in countering the negative effects of the thin idea are described and their potential application to East Asia and other non-Western countries are discussed.
    Shanghai Archives of Psychiatry 12/2013; 25(6):332-40. DOI:10.3969/j.issn.1002-0829.2013.06.002
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    • "Attractiveness and physical appearance issues arising in potential romantic relationships might be pertinent foci for older adolescents based on effects of reported pressure from current or desired dating partners. Finally, adaptations of internet-based programs (e.g., Bruning-Brown et al. 2004; Stice et al. 2012a) may be especially useful in China where training of and access to qualified practitioners are significant barriers to accessing treatment (Gao et al. 2010; Lee and Lee 2000). Despite its implications, the main limitations of the study must be noted. "
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    ABSTRACT: Even though reliable eating disorder risk factors have been identified among adolescent girls, little is known about predictors of increased vulnerability within specific phases of adolescence or among adolescent boys, particularly in highly populated non-Western contexts. In this study, early and middle adolescent boys (n = 1,271) and girls (n = 1,415) from Chongqing, China completed validated measures of eating disorder pathology and putative risk factors at baseline and 2 years follow-up. Multivariate models for boys of each age group indicated increases in disordered eating at follow-up were predicted by higher initial body mass index, negative affect and body dissatisfaction levels as well as attendant increases in perceived appearance pressure from mass media, body dissatisfaction, negative affect between assessments. High baseline levels of reported appearance pressure from parents and dating partners contributed, respectively, to prediction models of younger and older boys. More distinct constellations of significant predictors emerged in multivariate models of early versus middle adolescent girls. Together, findings indicated body dissatisfaction and negative affect were fairly robust risk factors for exacerbations in disturbances across samples while risk factors such as perceived pressure from desired/prospective dating partners were salient only during particular phases of adolescence.
    Journal of Abnormal Child Psychology 11/2013; 42(5). DOI:10.1007/s10802-013-9823-z · 3.09 Impact Factor
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