Article

Dissonance and healthy weight eating disorder prevention programs: Long-term effects from a randomized efficacy trial

Department of Psychology, University of Texas at Austin, TX, USA.
Journal of Consulting and Clinical Psychology (Impact Factor: 4.85). 05/2008; 76(2):329-40. DOI: 10.1037/0022-006X.76.2.329
Source: PubMed

ABSTRACT Adolescent girls with body dissatisfaction (N = 481, SD = 1.4) were randomized to a dissonance-based thin-ideal internalization reduction program, healthy weight control program, expressive writing control condition, or assessment-only control condition. Dissonance participants showed significantly greater decreases in thin-ideal internalization, body dissatisfaction, negative affect, eating disorder symptoms, and psychosocial impairment and lower risk for eating pathology onset through 2- to 3-year follow-up than did assessment-only controls. Dissonance participants showed greater decreases in thin-ideal internalization, body dissatisfaction, and psychosocial impairment than did expressive writing controls. Healthy weight participants showed greater decreases in thin-ideal internalization, body dissatisfaction, negative affect, eating disorder symptoms, and psychosocial impairment; less increases in weight; and lower risk for eating pathology and obesity onset through 2- to 3-year follow-up than did assessment-only controls. Healthy weight participants showed greater decreases in thin-ideal internalization and weight than did expressive writing controls. Dissonance participants showed a 60% reduction in risk for eating pathology onset, and healthy weight participants showed a 61% reduction in risk for eating pathology onset and a 55% reduction in risk for obesity onset relative to assessment-only controls through 3-year follow-up, implying that the effects are clinically important and enduring.

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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. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
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