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Forbes J, Paxton S, Yager Z. Raising Confident Girls: A pragmatic school-based trial of a body image and parenting program for mothers of adolescent girls. Body Image 2024; 50:101718. [PMID: 38815453 DOI: 10.1016/j.bodyim.2024.101718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 04/08/2024] [Accepted: 04/22/2024] [Indexed: 06/01/2024]
Abstract
This study evaluated Raising Confident Girls (RCG), delivered to mothers of Year 8 students (mean age 12.8-years) who were receiving the classroom-based Dove Confident Me (DCM) program. RCG is an interactive, multi-session intervention designed to improve body image in mothers in order to enhance their capacity to parent and role model this to their daughters. A pragmatic non-randomised controlled trial involved delivery of the program to mothers (n = 69) over three, 2-hour seminars in evenings, compared with a comparison group (n = 51). The study took place at an independent all-girls secondary school in Australia. Multilevel mixed modelling analyses compared pre- and post-test scores on standardized scales. Mothers who participated in the program had significantly higher scores on primary outcome variables of body esteem and body appreciation compared to the comparison group at post-test. Further, participation significantly improved mother's knowledge, confidence, and skills for parenting, and improved role modeling of positive body image. Mothers were well engaged, with low attrition rates, and rated the program highly. The RCG program was effective and engaging for mothers, offering deeper insight into improving parental engagement in body image interventions delivered within the school context.
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Affiliation(s)
- Jody Forbes
- School Psychologist, Brisbane Girls Grammar School, Australia
| | | | - Zali Yager
- Institute for Health and Sport, Victoria University, Australia; The Embrace Collective, Australia.
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Babbott KM, Consedine NS, Roberts M. Your Body Is Your Home: The feasibility of an intuitive eating intervention for early adolescents. Int J Eat Disord 2024; 57:727-739. [PMID: 38379127 DOI: 10.1002/eat.24163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 01/25/2024] [Accepted: 01/25/2024] [Indexed: 02/22/2024]
Abstract
OBJECTIVE Intuitive eating (IE) is an emerging health promotion framework which has shown promise in the prevention and early intervention of disordered eating (DE) behavior in adults. This study sought to extend this work by assessing the feasibility and preliminary efficacy of a 5-week IE intervention, "Your Body is Your Home," delivered in school classrooms for early adolescents aged 11-13. METHODS The present study utilized a quasi-experimental design. Eligibility criteria were defined a priori and published in a registered protocol. Four classrooms (n = 128 student participants) were recruited into two streams, and self-report questionnaires were administered at pre-test, post-test, and 4-week follow-up. The questionnaires included the Intuitive Eating Scale for Early Adolescents (IES-2-EA), the Body Appreciation Scale (BAS-2), and the WHO Wellbeing Index (WHO-5). Linear mixed models were used to conduct preliminary efficacy testing. RESULTS The results indicate that a brief classroom-based IE intervention is feasible and acceptable for both students and teaching staff; retention, fidelity, and attendance targets were achieved. Students and teachers rated all five sessions of the intervention as a highly feasible method of health promotion. Further, preliminary efficacy data suggest IE interventions aimed at early adolescents may be a feasible way of improving certain aspects of IE (p < .001) in male and female participants, and body appreciation (p < .001) in male participants. DISCUSSION The study provides preliminary support for the implementation and evaluation of an IE intervention as part of school-based health promotion and offers preliminary effect size estimates for a larger-scale randomized trial. PUBLIC SIGNIFICANCE Existing evidence suggests that IE may be a useful framework through which relationships with food and the body can be improved. The present study seeks to extend this work by adapting the framework for early adolescents (among whom the framework is not well understood) and examining feasibility, acceptability, and preliminary changes to several health and well-being metrics following a 5-week school-based intervention.
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Affiliation(s)
- Katie M Babbott
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Nathan S Consedine
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Marion Roberts
- General Practice & Primary Healthcare, University of Auckland, Auckland, New Zealand
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Pérez-Vázquez J, González-Roz A, Amigo-Vázquez I. Effectiveness of an e-Health Quasi-Randomized Controlled Universal Prevention Program for Eating Disorders in Spanish Adolescents. JOURNAL OF PREVENTION (2022) 2024; 45:87-105. [PMID: 37906405 PMCID: PMC10844343 DOI: 10.1007/s10935-023-00751-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/06/2023] [Indexed: 11/02/2023]
Abstract
Eating disorders (EDs) and sub-threshold conditions are prevalent in the adolescent population. Unfortunately, most preventive interventions have been targeted at emerging adults and the effectiveness of online prevention programs has yet to be determined in adolescents. This study sought to examine the short-term effectiveness of a universal e-Health psychoeducational prevention program for EDs compared to a control (non-intervention) group in Spanish adolescents. Using a quasi-randomized trial design, a total of 161 [% girls: 45.96; Mage(SD) = 12.43 (0.43)] adolescents from 5 participating schools were allocated to two intervention arms: (1) psychoeducational intervention (n = 79) and (2) wait-list control (n = 82). The intervention was delivered over 3 months through 3 modules that were accessible 24/7 and 3 school sessions guided by the students´ tutors focusing on nutrition, promoting a healthy lifestyle, mitigating body concerns, and social pressures. Participants completed an online assessment battery including the Eating Attitudes Test (EAT-26) and measures of self-esteem, family disruption, compliance with the Mediterranean diet, and lifestyle. Correlational analysis showed small to moderate relationships between self-esteem and family function (rho = 0.413, p = 0.001), BMI (body mass index) and the EAT-26 dieting subscale (rho = 0.417, p = 0.001), physical activity and the bulimia subscale (rho = - 0.237, p = 0.003), and self-esteem and the dieting subscale (rho = - 0.223, p = 0.004). At the post-intervention assessment, the intervention group showed a statistically significant reduction in ED risk (EAT-26) (d = - 0.323, p = 0.040) and the oral control subscale (d = 0.327, p = 0.038). The e-health intervention including tutor-led digital components was effective for reducing ED risk in children. Results must be interpreted with caution due to the low statistical power and the limited sample size. Large scale randomized controlled trials with longer follow-ups will be needed to bolster the evidence.
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Affiliation(s)
- Jorge Pérez-Vázquez
- Department of Psychology, Faculty of Psychology, Plaza Feijoo S/N, 33003, Oviedo, Asturias, Spain.
| | - Alba González-Roz
- Department of Psychology, Faculty of Psychology, Plaza Feijoo S/N, 33003, Oviedo, Asturias, Spain
| | - Isaac Amigo-Vázquez
- Department of Psychology, Faculty of Psychology, Plaza Feijoo S/N, 33003, Oviedo, Asturias, Spain
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Forbes J, Paxton S, Yager Z. Independent pragmatic replication of the Dove Confident Me body image program in an Australian Girls Independent Secondary School. Body Image 2023; 46:152-167. [PMID: 37327594 DOI: 10.1016/j.bodyim.2023.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 05/30/2023] [Accepted: 06/01/2023] [Indexed: 06/18/2023]
Abstract
Following calls for the independent replication of universal body image programs under diverse conditions, this research aimed to investigate whether the universal co-educational prevention program developed for audiences in the United Kingdom (Dove Confident Me, DCM), was an acceptable and effective intervention when delivered by teachers to adolescent girls attending a single-sex Australian school. Comprising two studies, Study 1, evaluated DCM among Grade 8 students (N = 198) at a single-sex private school, and compared the results with students (N = 208) s from a matched comparison group. No improvements were observed on outcome measures between the comparison and intervention girls over the three time points. Study 2 involved minor modifications to the aesthetics and content of the program, as well as the logistics of delivery. Delivered by teachers to Grade 8 students (N = 242 intervention and N = 354 comparison), there were significant improvements in acceptability of the modified DCM program, yet no interaction effects observed on outcome measures. While the program did no harm, it is possible that there are adjustments to the methods utilized and content of programs that are trialed in efforts to prevent body image concerns and eating disorders in the school setting.
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Affiliation(s)
- Jody Forbes
- School Psychologist, Brisbane Girls Grammar School, Australia
| | | | - Zali Yager
- Institute for Health and Sport, Victoria University, Executive Director, The Embrace Collective, Australia.
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Raffoul A, Turner SL, Salvia MG, Austin SB. Population-level policy recommendations for the prevention of disordered weight control behaviors: A scoping review. Int J Eat Disord 2023; 56:1463-1479. [PMID: 37096990 DOI: 10.1002/eat.23970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 04/10/2023] [Accepted: 04/11/2023] [Indexed: 04/26/2023]
Abstract
OBJECTIVE The aim of this scoping review was to identify recommendations and gaps in knowledge surrounding the prevention of disordered weight control behaviors (DWCBs) through policy. METHOD A search was conducted in several databases to identify English language articles that described an active policy, recommendation, guideline, or educational curriculum that could be implemented by governments or regulatory bodies to prevent DWCBs or related constructs (e.g., weight stigma, body dissatisfaction). Two researchers independently screened articles with oversight from a third researcher. Data were extracted from the final sample (n = 65) and analyzed qualitatively across all articles and within the domains of education, public policy, public health, industry regulation, and media. RESULTS Only a single empirical evaluation of an implemented policy to reduce DWCBs was identified. Over one-third of articles proposed recommendations relating to industry regulation and media (n = 24, 36.9%), followed by education (n = 21, 32.3%), public policy (n = 19, 29.2%), and public health (n = 10, 15.4%). Recommendations included school-based changes to curricula, staff training, and anti-bullying policies; legislation to ban weight discrimination; policies informed by strategic science; collaboration with researchers from other fields; de-emphasizing weight in health communications; diversifying body sizes and limiting modified images in media; and restricting the sale of weight-loss supplements. DISCUSSION The findings of this review highlight gaps in empirically evaluated policies to reduce DWCBs but also promising policy recommendations across several domains. Although some policy recommendations were supported by empirical evidence, others were primarily based on experts' knowledge, highlighting the need for greater research on population-level DWCBs prevention through policy. PUBLIC SIGNIFICANCE Our scoping review of the evidence on policies for the prevention of disordered weight control behaviors identified several recommendations across the domains of education, public policy, public health, and industry regulation and media. Although few empirical investigations of implemented policies have been conducted, expert recommendations for policies to prevent disordered weight control behaviors among populations are plentiful and warrant future consideration by researchers and policymakers alike.
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Affiliation(s)
- Amanda Raffoul
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| | - Samantha L Turner
- Tan Chingfen Graduate School of Nursing, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Meg G Salvia
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - S Bryn Austin
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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Norton L, Parkinson J, MacGuinness M, Harris N, Hart L. Examining the feasibility of a brief parent intervention designed to promote positive food communication with infants. Pilot Feasibility Stud 2023; 9:93. [PMID: 37270631 DOI: 10.1186/s40814-023-01328-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 05/26/2023] [Indexed: 06/05/2023] Open
Abstract
BACKGROUND Few prevention interventions exist focusing on supporting parents to use positive food communication at mealtimes, for the prevention of disordered eating. "Mealtime chatter matters (MCM)" is a brief intervention designed for parents of infants. The intervention was designed in collaboration with child health nurses (CHNs) to be embedded into usual care. The overall aim of this study was to test the feasibility of the intervention through examining the acceptability of the MCM content and resources and the potential impact of the intervention on parents. METHODS This pilot study utilised a mixed methods approach and took place within a regional child health service in Queensland, Australia (October 2021 to June 2022). Participants were parents of infants attending child health education groups and CHNs. The intervention consisted of a brief education session (including accompanying resources), facilitated by a Paediatric Dietitian. The acceptability of MCM content and resources was assessed by both parents and CHNs via self-reported questionnaires and the potential impact on parents assessed via pre-/post-self-reported questionnaires. RESULTS Forty-six parents of infants (aged < 8 months) and six CHNs who hosted the intervention and observed the program's delivery participated in the study. MCM content and resources were highly acceptable to parents and CHNs, as both qualitative and quantitative data concurred. How the program may have potentially impacted parenting practices was unclear from the survey results and further investigation is required to better understand these. Tangible lessons and opportunities to further test this intervention were clear from current results. CONCLUSION Overall, MCM was acceptable to both parents and CHNs, with the content and resources both being highly valued. Parents reported the content to be informative and engaging and CHNs were keen to have such an intervention available in the future. However, further modification and testing is required of MCM. This feasibility study is an essential first step in supporting parents and CHNs to access an evidence-based intervention with the aim of preventing disordered eating. TRIAL REGISTRATION Griffith University Human Research Ethics Committee (2021/577) and Gold Coast Hospital and Health Service Human Research Ethics Committee (QGC/76618).
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Affiliation(s)
- Lyza Norton
- Griffith University, 1 Parklands Drive, Southport, QLD, 4222, Australia.
| | - Joy Parkinson
- Griffith University, 170 Kessels Road, Nathan, QLD, 4111, Australia
- Australian eHealth Research Centre, CSIRO, Level 7, 296 Herston Road, Herston, QLD, 4029, Australia
| | - Margaret MacGuinness
- Gold Coast Hospital and Health Service, 1 Hospital Blvd, Southport, QLD, 4215, Australia
| | - Neil Harris
- Griffith University, 1 Parklands Drive, Southport, QLD, 4222, Australia
| | - Laura Hart
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Carlton, VIC, 3010, Australia
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Breton É, Côté SM, Dubois L, Vitaro F, Boivin M, Tremblay RE, Booij L. Childhood Overeating and Disordered Eating From Early Adolescence to Young Adulthood: A Longitudinal Study on the Mediating Role of BMI, Victimization and Desire for Thinness. J Youth Adolesc 2023:10.1007/s10964-023-01796-5. [PMID: 37270466 DOI: 10.1007/s10964-023-01796-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 05/21/2023] [Indexed: 06/05/2023]
Abstract
Eating disorders have early origins, and there could be a continuum between childhood eating behaviors, such as overeating, and long-term disordered eating, but this remains to be shown. BMI, desire for thinness and peer victimization could influence this continuum, but their interactions are unknown. To fill this gap, the study used data from the Quebec Longitudinal Study of Child Development (N = 1511; 52% girls), in which 30.9% of youth presented a trajectory associated with high disordered eating from 12 to 20 years. The results support an indirect association between overeating at age 5 and disordered eating trajectories, with different mediation processes observed between boys and girls. The findings underscore the importance of promoting healthy body images and eating behaviors among youths.
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Affiliation(s)
- Édith Breton
- Sainte-Justine Hospital Research Centre, Montreal, Canada
- Department of Psychiatry and Addictology, University of Montreal, Montreal, Canada
| | - Sylvana M Côté
- Sainte-Justine Hospital Research Centre, Montreal, Canada
- School of Public Health, University of Montreal, Montreal, Canada
| | - Lise Dubois
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Frank Vitaro
- Sainte-Justine Hospital Research Centre, Montreal, Canada
- School of Psychoeducation, University of Montreal, Montreal, Canada
| | - Michel Boivin
- Department of Psychology, University Laval, Quebec, Canada
| | - Richard E Tremblay
- Sainte-Justine Hospital Research Centre, Montreal, Canada
- Department of Psychology and Pediatrics, University of Montreal, Montreal, Canada
| | - Linda Booij
- Sainte-Justine Hospital Research Centre, Montreal, Canada.
- Department of Psychiatry and Addictology, University of Montreal, Montreal, Canada.
- Department of Psychology, Concordia University, Montreal, Canada.
- Department of Psychiatry, McGill University, Montreal, Canada.
- Research centre, Douglas Mental Health University Institute, Montreal, Canada.
- Eating Disorders Continuum, Douglas Mental Health University Institute, Montreal, Canada.
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Prevention and early intervention in eating disorders: findings from a rapid review. J Eat Disord 2023; 11:38. [PMID: 36899428 PMCID: PMC9999654 DOI: 10.1186/s40337-023-00758-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 02/19/2023] [Indexed: 03/12/2023] Open
Abstract
BACKGROUND Eating disorders (EDs) are complex psychological disorders, with low rates of detection and early intervention. They can lead to significant mental and physical health complications, especially if intervention is delayed. Given high rates of morbidity and mortality, low treatment uptake, and significant rates of relapse, it is important to examine prevention, early intervention, and early recognition initiatives. The aim of this review is to identify and evaluate literature on preventative and early intervention programs in EDs. METHODS This paper is one of a series of Rapid Reviews, designed to inform the Australian National Eating Disorders Research and Translation Strategy 2021-2031, funded, and released by the Australian Government. To provide a current and rigorous review, peer-reviewed articles between 2009 and 2021 published in English were searched across three databases: ScienceDirect, PubMed and Ovid/Medline. Priority was given to high-level evidence including meta-analyses, systematic reviews, Randomised Control Trials, and large population studies. Findings from selected studies pertaining to prevention and early intervention in EDs were evaluated and are presented in this review. RESULTS In total, 130 studies were identified in the current review, 72% relating to prevention and 28% to early intervention. Most programs were theory-driven and targeted one or more ED risk factors such as thin-ideal internalisation and/or body dissatisfaction. There is reasonable evidence to support prevention programs reducing risk factors, particularly as part of school or university-based programs, with established feasibility and relatively high acceptance among students. There is increasing evidence around the use of technology (to increase dissemination potential) and for use of mindfulness approaches (targeting emotional resilience). Few longitudinal studies assessing incident cases following participation in a prevention program exist. CONCLUSIONS Although several prevention and early intervention programs have been shown to significantly reduce risk factors, promote symptom recognition, and encourage help-seeking behaviour, most of these studies have been conducted in older adolescent and university aged students, past the age of peak ED onset. One of the most targeted risk factors, body dissatisfaction, is found in girls as young as 6 years old, indicating a need for further research implementing prevention initiatives at younger ages. Follow-up research is limited; thus, the long-term efficacy and effectiveness of studied programs is unknown. Greater attention should be paid to the implementation of prevention and early intervention programs in identified high-risk cohorts or diverse groups, where a more targeted approach may be necessary.
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Colombo GE, Pirotta S, Sabag A. Diet and Exercise in the Management of Polycystic Ovary Syndrome: Practical Considerations for Person-Centered Care. Semin Reprod Med 2023; 41:26-36. [PMID: 38040023 DOI: 10.1055/s-0043-1777116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2023]
Abstract
Polycystic ovary syndrome (PCOS) is a complex multisystem condition associated with life-long reproductive, metabolic, and psychological symptoms. Individuals with PCOS are at an increased risk of cardiovascular disease and type 2 diabetes, with approximately 70% of all PCOS cases presenting with insulin resistance. Lifestyle interventions have historically been recommended as first-line therapies for the management of PCOS-related cardiometabolic disorders. The term "lifestyle management" incorporates a multifaceted approach to dietary, exercise, and behavioral strategies, aiming to promote a healthy lifestyle. This approach has been commonly employed in practice, in particular through exercise and dietary modulation, due to its effect on cardiometabolic outcomes as well as its tolerability. Furthermore, there is evidence to suggest that combining dietary change with exercise may yield the greatest improvements in clinical outcomes. However, such practices require careful consideration and coordination, as there are instances where certain exercise and/or dietary prescriptions may compromise the effectiveness of the respective interventions. Thus, this review aims to provide practical guidance on diet and exercise planning in the routine care of PCOS. Such recommendations include emphasizing realistic and achievable goals, as well as minimizing barriers to lifestyle changes in order to increase the long-term sustainability of this treatment strategy.
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Affiliation(s)
- Giorgia E Colombo
- Department of Obstetrics and Gynecology, Ospedale Regionale di Lugano, Lugano, Switzerland
| | - Stephanie Pirotta
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Angelo Sabag
- Discipline of Exercise and Sport Science, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
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Dunker KLL, Carvalho PHBD, Amaral ACS. Eating disorders prevention programs in Latin American countries: A systematic review. Int J Eat Disord 2023; 56:691-707. [PMID: 36789735 DOI: 10.1002/eat.23916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 01/26/2023] [Accepted: 01/31/2023] [Indexed: 02/16/2023]
Abstract
OBJECTIVE This systematic review evaluates and summarizes existing eating disorder (ED) prevention programs in Latin American countries. METHODS A systematic literature search was conducted using the Cochrane Controlled Trial Register, PubMed, and Virtual Health Library databases up to and including July 31, 2022. All ED prevention studies published in English, Spanish or Portuguese were eligible, regardless of the study design, sample characteristics, and type of prevention programs. The Cochrane Collaboration Risk of Bias criteria were used to evaluate the quality of the included studies. RESULTS Twenty-two studies were included. Most were pilot studies that were nonrandomized, had a high risk of bias, were from Mexico and Brazil, and employed selective interventions. Dissonance-based programs and social cognitive theory were the commonly used approaches in interventions, and most of them were tested in adolescent girls and women. Short follow-ups were used, varying from 1 to 6 months. Many found significant decreases after the intervention and/or at follow-up in ED/disordered eating risk behaviors/symptoms, negative affect, body-ideal internalization, and body image disturbances. CONCLUSIONS This review highlights promising efforts to prevent EDs among Latin American countries. Some barriers in conducting research include funding restrictions, laws that do not allow remuneration or compensation for participants, and high costs of training. Nonetheless, the outcomes of the programs developed and evaluated so far are positive enough to merit further work on ED prevention. Efforts for future researchers should recruit samples with diverse characteristics, use robust designs and data analysis techniques, and expand the accessibility of prevention programs. PUBLIC SIGNIFICANCE STATEMENT The development of effective eating disorder (ED) prevention programs that can be broadly implemented is a public health priority. Nevertheless, there is limited evidence regarding the characteristics of ED prevention programs and their efficacy among Latin American countries. In the present study, we reviewed existing ED prevention programs adopted in Latin America, described their characteristics and outcomes, noted the limitations of available programs, and discussed the implications of these findings for efforts to prevent the development of EDs in Latin America. The outcomes of the programs developed and evaluated so far are positive enough to merit the development and rigorous evaluation of future programs and their broad dissemination in Latin American countries. PROSPERO registration number CRD42021275245.
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Affiliation(s)
- Karin Louise Lenz Dunker
- AMBULIM, Eating Disorders Program, Institute of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Pedro Henrique Berbert de Carvalho
- AMBULIM, Eating Disorders Program, Institute of Psychiatry, University of São Paulo, São Paulo, Brazil.,NICTA, Body Image and Eating Disorder Research Group, Federal University of Juiz de Fora, Governador Valadares, Brazil
| | - Ana Carolina Soares Amaral
- Federal Institute of Education, Science and Technology of Southeast of Minas Gerais, Barbacena, Minas Gerais, Brazil
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The Needs of School Professionals for Eating Disorder Prevention in Australian Schools: A Mixed-Methods Survey. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121979. [PMID: 36553421 PMCID: PMC9776611 DOI: 10.3390/children9121979] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/06/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022]
Abstract
(1) Background: School professionals such as teachers and counsellors are uniquely positioned to facilitate discussion around disordered eating and body image; however, little is known about the needs of school professionals with respect to eating disorder prevention. This study aimed to explore the needs and perceptions of Australian school professionals regarding eating disorder prevention. (2) Methods: School professionals were recruited to a mixed-methods online cross-sectional survey. The survey assessed demographics and perceived needs and attitudes to eating disorder prevention. (3) Results: Most participants (92%) were willing to participate in eating disorder prevention; however, only 61% reported good knowledge and 41% reported feeling confident in implementing eating disorder prevention. Those who had received training in eating disorders (24%) reported higher confidence (p = 0.02) and knowledge (p = 0.04). Only 66% of respondents reported that all teachers should be involved in eating disorder prevention while barriers including workload, knowledge, and resources were commonly highlighted. Fewer respondents working in primary school settings reported the need for prevention approaches (p = 0.046). (4) Conclusions: Despite a willingness to be involved in the prevention of eating disorders, there are inconsistencies in attitudes regarding the role of school professionals in eating disorder prevention. The findings of this study reinforce that understanding professional roles, school settings, and personal attitudes is critical in the development of more efficacious school professional training and prevention interventions.
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McGowan A, Barry MR, Sonneville KR, Leung CW. Greater social adversity is associated with more disordered eating attitudes and behaviors among children from Southeast Michigan. Int J Eat Disord 2022; 55:1670-1677. [PMID: 35833678 PMCID: PMC10084038 DOI: 10.1002/eat.23775] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 06/25/2022] [Accepted: 06/27/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The objective of this study is to examine the association between indicators of social adversity, including socioeconomic status and race/ethnicity, and children's disordered eating behaviors and attitudes. METHODS Children ages 8-10 years old (n = 183) were recruited from Michigan. Data were collected through in-home surveys. The Children's Eating Attitudes Test (ChEAT-24) measured disordered eating attitudes and behaviors in the sample. Cumulative social adversity was considered the sum of four binary variables: caregiver race/ethnicity, caregiver education, household income, and child-reported food security status. Linear mixed models examined the association between social adversity indicators and ChEAT-24 scores. RESULTS Children of primary caregivers of color had significantly higher ChEAT-24 scores than children of white caregivers (p = .03). Children who reported food insecurity had significantly higher ChEAT-24 scores compared to children who reported food security (p = .01). Compared to children with the lowest social adversity score, children with the highest score had a 4.8-unit higher ChEAT-24 score (95% CI .3-9.4), after adjusting for covariates. A significant trend was observed for greater social adversity and higher ChEAT-24 score (p-trend = .02). CONCLUSION A linear association was observed between greater social adversity and more disordered eating behaviors and attitudes among children in this sample. These findings emphasize the need for eating disorder research in children from racial/ethnic minorities and socioeconomically disadvantaged populations to support future prevention efforts. PUBLIC SIGNIFICANCE Greater exposure to social adversity was associated with more disordered eating behaviors among preadolescent children. Given that eating disorders are understudied in lower-income and minority racial/ethnic populations, this study highlights the need for additional research to better support prevention and treatment efforts among children from socioeconomically diverse backgrounds.
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Affiliation(s)
- Andrea McGowan
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Mikayla R Barry
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Kendrin R Sonneville
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Cindy W Leung
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
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13
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İnce B, Yücel B. Reducing eating disorders risk in Turkish female university students using cognitive behavioural theory: A randomized controlled feasibility trial. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03909-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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14
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Urban B, Knutson D, Klooster D, Soper J. Social and contextual influences on eating pathology in transgender and nonbinary adults. Eat Disord 2022; 31:301-319. [PMID: 36325725 DOI: 10.1080/10640266.2022.2135715] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Eating pathology (EP) is reported at alarmingly high rates among transgender and nonbinary (TNB) people. The present study investigates key associations between experiences that are common in TNB populations and EP. TNB individuals located within the United States (N = 212) who self-identified as currently experiencing disordered eating or an eating disorder were recruited from social media outlets and completed an online survey that included measures of EP, discrimination-based trauma symptoms, internalized transphobia, and gender dysphoria. The average age of participants was just over 27 years old (SD = 6.22) and the majority of participants (68.9%) were nonbinary. Data were analyzed using IBM SPSS version 28 and PROCESS 4.0. Discrimination trauma [β = .27, t(211) = 3.90, p < .001] and internalized transphobia [β = .21, t(211) = 3.03, p = .003] were significant predictors of EP in a multiple regression model. Additionally, internalized transphobia partially mediated the association between discrimination trauma and EP. Findings reinforce the need for trauma-informed and multiculturally competent provision of services for TNB populations presenting with eating concerns. Results also highlight the complex role that previously unexplored variables play in the etiology of EP for TNB populations. Implications and clinical recommendations are discussed.
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Affiliation(s)
- Bek Urban
- School of Community Health Sciences, Counseling & Counseling Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Douglas Knutson
- School of Community Health Sciences, Counseling & Counseling Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Dannie Klooster
- School of Community Health Sciences, Counseling & Counseling Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Jules Soper
- School of Community Health Sciences, Counseling & Counseling Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
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15
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Zomback L, Barré LK. Randomized control trial of a single-session intervention targeting sociocultural pressures of body image in college sorority women. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022:1-5. [PMID: 36170556 DOI: 10.1080/07448481.2022.2124379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 07/12/2022] [Accepted: 09/05/2022] [Indexed: 06/16/2023]
Abstract
Objective: To assess the effectiveness of a peer-led single-session intervention targeting the sociocultural pressures of body image. Participants: New members of 13 sororities at one university. Methods: Participants were randomized by sorority into the intervention (n = 207) or wait list control (n = 264). Online surveys were administered at baseline and one month to assess social determinants of body image, body image dissatisfaction (BID), and body appreciation. Multiple logistic and linear regression analyses compared changes over time between groups. Results: We observed significant improvements in overall sociocultural pressures of body image (p = .001) and the subscales of Norms (p < .001) and Perceived Norms (p = .009) of eating and exercise behaviors. Change in BID and body appreciation did not differ between groups. Conclusion: A one-hour peer-led community-level intervention can lead to positive changes in sociocultural pressures in new initiates to a sorority.
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Affiliation(s)
- Lori Zomback
- Department of Nutritional Sciences, Cornell University, Ithaca, New York, USA
- College of Medicine, SUNY Downstate Medical Center, Brooklyn, New York, USA
| | - Laura K Barré
- Department of Nutritional Sciences, Cornell University, Ithaca, New York, USA
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16
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Borgelt S, Burmeister JM. Disordered eating in collegiate English equestrian athletes in aesthetic and nonaesthetic disciplines. Eat Behav 2022; 46:101661. [PMID: 35988298 DOI: 10.1016/j.eatbeh.2022.101661] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 07/24/2022] [Accepted: 08/04/2022] [Indexed: 12/24/2022]
Abstract
Little is known about the rates of disordered eating behaviors in the athletes who compete in the disciplines that comprise collegiate English Equestrian sports. Importantly, in some subdisciplines, riders' scores depend upon judges' assessment of their appearance while riding, rather than upon solely objective measures such as time to complete a course. The purpose of the present research was to 1) assess the current rate of disordered eating behaviors in college equestrian athletes, 2) test whether certain disciplines of English riding (i.e., those that focus on aesthetics or non-aesthetics) at the collegiate level have higher rates of disordered eating behaviors, and 3) test whether these athletes face different pressures for appearance and weight if they specialize in aesthetic riding disciplines. English equestrian student athletes from across the United States (N = 330; 97 % female) and from the following disciplines were surveyed: equitation (aesthetic), dressage (aesthetic), hunters (aesthetic), jumpers (non-aesthetic), and eventing (non-aesthetic). The results suggest a high prevalence of disordered eating in the sport (35 % met cut off for disordered eating using the EAT-26). Findings suggest similar rates of disordered eating behaviors between the aesthetic and non-aesthetic disciplines. Findings also indicate that student athletes in aesthetic disciplines were much more likely to say that they were weighed by coaches and pressured to lose weight. Thus, the current study lends empirical support to the notion that coaches can be a source of pressure for these athletes. Issues of addressing disordered eating in coaching and future research are discussed.
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Affiliation(s)
- Sarah Borgelt
- The University of Findlay, College of Arts, Humanities, and Social Sciences, Department of Behavioral Sciences, 1000 N. Main St., Findlay, OH 45840, United States of America.
| | - Jacob M Burmeister
- The University of Findlay, College of Arts, Humanities, and Social Sciences, Department of Behavioral Sciences, 1000 N. Main St., Findlay, OH 45840, United States of America.
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17
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Kotarski BA, Rodgers J. Eating disorder risk identification through embedded electronic medical record prompting. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:1536-1542. [PMID: 33300837 DOI: 10.1080/07448481.2020.1810051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 02/14/2020] [Accepted: 02/18/2020] [Indexed: 06/12/2023]
Abstract
Objective: To evaluate whether the use of electronic medical record (EMR) to prompt universal eating disorder screening with a short questionnaire improved risk detection in a college gynecology clinic. Design: Data obtained via a convenience sample of patients accessing a university health clinic. Clinicians were prompted with the SCOFF tool, a 5-item questionnaire for eating disorder risk with sensitivity of 87.5% and specificity of 95%. Participants: 111 Female-identified patients, ages 18-37. Methods: Clinicians assessed eating disorder symptoms via EMR prompting. Comparison of risk identification from the previous year, in which patients were not universally screened, was conducted via EMR review. Results: Findings showed improved risk identification compared with previous year's symptom-only identification (p = .0047). Conclusion: The SCOFF tool, combined with EMR prompting, can improve eating disorder risk detection.
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Affiliation(s)
- Beth Ann Kotarski
- Carnegie Mellon University, University Health Services, Pittsburgh, Pennsylvania, USA
- Graduate Nursing, Edinboro University of Pennsylvania, Edinboro, Pennsylvania, USA
| | - Jill Rodgers
- Graduate Nursing, Edinboro University of Pennsylvania, Edinboro, Pennsylvania, USA
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18
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Breton É, Dufour R, Côté SM, Dubois L, Vitaro F, Boivin M, Tremblay RE, Booij L. Developmental trajectories of eating disorder symptoms: A longitudinal study from early adolescence to young adulthood. J Eat Disord 2022; 10:84. [PMID: 35725645 PMCID: PMC9210773 DOI: 10.1186/s40337-022-00603-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 06/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adolescence is a critical period for the development of eating disorders, but data is lacking on the heterogeneity of their evolution during that time-period. Group-based trajectories can be used to understand how eating disorders emerge and evolve over time. The aim of this study was to identify groups of individuals with distinct levels of eating disorder symptoms between 12 and 20 years and the onset of different types of symptoms. We also studied sex differences in the evolution and course of eating disorder symptoms from early adolescence to adulthood. METHODS Using archival data from the QLSCD cohort, trajectories of eating disorder symptomatology were estimated from ages 12 to 20 years using semiparametric models. These trajectories included overall eating disorder symptomatology as measured by the SCOFF (Sick, Control, One Stone, Fat, Food), sex, and symptom-specific trajectories. RESULTS Two groups of adolescents following distinct trajectories of eating disorder symptoms were identified. The first trajectory group included 30.9% of youth with sharply rising levels between 12 and 15 years, followed by high levels of symptoms between 15 and 20 years. The second trajectory group included 69.1% of youth with low and stable levels of symptoms between 12 and 20 years. Sex-specific models indicated that the proportion of girls in the high trajectory group was 1.3 times higher than the proportion of boys (42.8% girls vs. 32.3% boys). Trajectories of SCOFF items were similar for loss-of-control eating, feeling overweight, and attributing importance to food. The weight loss item had a different developmental pattern, increasing between 12 and 15 years and then decreasing between 17 and 20 years. CONCLUSIONS The largest increase in eating disorder symptoms in adolescence is between the ages of 12 and 15 . Yet, most prevention programs start after 15 years of age. Our findings suggest that, unlike common practices, eating disorder prevention programs should aim to start before puberty.
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Affiliation(s)
- Édith Breton
- Sainte-Justine Hospital Research Centre, Montreal, Canada.,Department of Psychiatry and Addictology, University of Montreal, Montreal, Canada
| | - Rachel Dufour
- Sainte-Justine Hospital Research Centre, Montreal, Canada.,Department of Psychology, Concordia University, 7141 Sherbrooke Street West, Montreal, QC, H4B 1R6, Canada
| | - Sylvana M Côté
- Sainte-Justine Hospital Research Centre, Montreal, Canada.,School of Public Health, University of Montreal, Montreal, Canada
| | - Lise Dubois
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Frank Vitaro
- Sainte-Justine Hospital Research Centre, Montreal, Canada.,School of Psychoeducation, University of Montreal, Montreal, Canada
| | - Michel Boivin
- Department of Psychology, University Laval, Quebec, Canada
| | - Richard E Tremblay
- Sainte-Justine Hospital Research Centre, Montreal, Canada.,Department of Psychology and Pediatrics, University of Montreal, Montreal, Canada
| | - Linda Booij
- Sainte-Justine Hospital Research Centre, Montreal, Canada. .,Department of Psychiatry and Addictology, University of Montreal, Montreal, Canada. .,Department of Psychology, Concordia University, 7141 Sherbrooke Street West, Montreal, QC, H4B 1R6, Canada. .,Department of Psychiatry, McGill University, Montreal, Canada.
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19
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Skubisz C, Seeney AN, Pacanowski CR. Testing Theory-Based Expressive Writing Interventions to Reduce Disordered Eating Behaviors and Cognitions. Am J Lifestyle Med 2022. [DOI: 10.1177/15598276221082604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Disordered eating includes both behaviors and cognitions and can cause many of the same negative health outcomes as clinically diagnosed eating disorders (e.g., growth retardation, nutritional deficiencies, and psychosocial disturbances). Compared to the general population, disordered eating is more common in college-age women. An experiment was conducted to test 8 expressive writing interventions in the context of disordered eating. Interventions were drawn from theory-based prevention programs, which included cognitive behavioral therapy, peer and media risk reduction, and cognitive dissonance theory. Dependent variables included emotions (e.g., sadness and hope), evaluation of the expressive writing interventions (e.g., engagement, clarity, ease, and interest), and re-evaluation of disordered eating behaviors and cognitions. Results show that 62.90% of participants had observed disordered eating in their peers. Sadness, with an action tendency related to increased inward evaluation, was the most typical emotional response upon completion of the expressive writing tasks. Interventions that were based on the principles of cognitive behavioral therapy led to the most positive outcomes including engagement and re-evaluation of current disordered eating behaviors and cognitions. Overall, it was concluded that expressive writing interventions are effective in eliciting emotions and causing a re-evaluation of harmful behaviors and cognitions in the context of disordered eating.
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Affiliation(s)
- Christine Skubisz
- Behavioral Health and Nutrition, University of Delaware, Newark, DE, USA
| | - Angelina N Seeney
- Behavioral Health and Nutrition, University of Delaware, Newark, DE, USA
| | - Carly R Pacanowski
- Behavioral Health and Nutrition, University of Delaware, Newark, DE, USA
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20
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Patel C, Walasek L, Karasouli E, Meyer C. Content and Validity of Claims Made about Food Parenting Practices in United Kingdom Online News Articles. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095053. [PMID: 35564446 PMCID: PMC9105157 DOI: 10.3390/ijerph19095053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/11/2022] [Accepted: 04/11/2022] [Indexed: 02/04/2023]
Abstract
The objective of this study was to qualitatively summarise the content of online news articles pertaining to food parenting practices and determine whether this content is substantiated by the scientific literature. News article data were identified and collected from United Kingdom online news published during 2010–2017 period using the News on the Web corpus. A coding framework was used to categorise the content of news articles to identify information related to food parenting practices. Then, claims made about food parenting practices were extracted from relevant news articles. Each claim was evaluated to determine the extent to which any claims were supported by the available scientific research evidence. The study identified ten claims across thirty-two relevant online news articles. Claims made across the news articles reported on the following food parenting practices: food restrictions, food-based threats and bribes, pressure to eat, use of food to control negative emotions, food availability, food preparation, and meal and snack routines. Eight out of the ten claims identified did not refer to scientific research evidence. News articles frequently lacked detail and information to explain to readers why and how the use of certain food parenting practices could have a lasting impact on children’s health outcomes. Considering the influence that news media has on parents, the reporting of food parenting practices in news articles should aim to provide a balanced view of the published scientific evidence and recognise the difficulties and barriers that prevent the use of helpful and healthy food parenting practices. The study results in this paper could be used to aid and structure of the dissemination of food parenting practice research findings in the media, inform public health education to influence perceptions of unhelpful food parenting practices, and promote parental use of responsive food parenting practices.
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Affiliation(s)
- Chloe Patel
- Warwick Manufacturting Group, Behaviour and Wellbeing Science, University of Warwick, Coventry CV4 7AL, UK;
- Correspondence:
| | - Lukasz Walasek
- Department of Psychology, University of Warwick, Coventry CV4 7AL, UK;
| | - Eleni Karasouli
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK;
| | - Caroline Meyer
- Warwick Manufacturting Group, Behaviour and Wellbeing Science, University of Warwick, Coventry CV4 7AL, UK;
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21
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Wyssen A, Munsch S. [Physical Activity in the Prevention and Treatment of Eating Disorders]. PRAXIS 2022; 111:327-332. [PMID: 35473329 DOI: 10.1024/1661-8157/a003840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Physical Activity in the Prevention and Treatment of Eating Disorders Abstract. On the one hand, excessive or insufficient physical activity is a phenomenological feature and an important etiological factor in eating disorders. On the other hand, healthy and adaptive physical activity has the potential to support the effectiveness of preventive and therapeutic interventions for eating disorders. Research findings confirm the usefulness of interventions focusing on physical activity as an add-on to psychotherapy. Professionally planned and accompanied interventions of this kind are not counterproductive or dangerous but can have a positive effect on the treatment outcome. The current state of research allows a preliminary formulation of guidelines to embed physical activity interventions into evidence-based treatment approaches. The focus of such interventions lies on the reduction of unhealthy, excessive physical activity and the promotion of flexible physical activity.
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Affiliation(s)
- Andrea Wyssen
- Universitätsklinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Universität Bern, Bern, Schweiz
| | - Simone Munsch
- Klinische Psychologie und Psychotherapie, Departement für Psychologie, Universität Fribourg, Fribourg, Schweiz
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22
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Stewart C, Goddard E, Cakir Z, Hall R, Allen G. Can more people be "Happy Being Me"? Testing the delivery of a universal body satisfaction program by clinicians and school staff. Eat Disord 2022; 30:182-209. [PMID: 33131458 DOI: 10.1080/10640266.2020.1771165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The research presented here evaluates the delivery of Happy Being Me (HBM; Dunstan, Paxton & McLean, 2017) with boys and girls in their first year of secondary school in the UK (Year 7 and after comparisons aged 11-12). HBM is a manualised universal prevention programme which aims to improve body dissatisfaction and associated risk factors. Risk factors studied here were internalization of the thin ideal, physical appearance comparisons, appearance conversations. Secondary outcomes measured were self-esteem and eating disorder symptomsStudy 1 tested the effectiveness of HBM (n = 172) compared to a control group (n = 197) who received curriculum as usual. HBM resulted in significantly improved body satisfaction post-intervention which was maintained at follow up. There were no significant changes in risk factors.Study 2 compared clinician (n = 172) and teacher (n = 174) delivery. Students who received clinician-led, but not teacher-led, HBM had improved body satisfaction and this was maintained at follow up. Internalization of the thin ideal and self-esteem, improved in both clinician and teacher-led groups with small to medium sized effects. HBM can be delivered by clinicians independent of programme developers in a heterogeneous sample with positive effects on body satisfaction. Issues arising for wider delivery are discussed.
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Affiliation(s)
- Catherine Stewart
- Maudsley Centre for Child and Adolescent Eating Disorders, South London and Maudsley NHS Foundation Trust, London, UK
| | - Elizabeth Goddard
- Maudsley Centre for Child and Adolescent Eating Disorders, South London and Maudsley NHS Foundation Trust, London, UK
| | - Ziba Cakir
- Maudsley Centre for Child and Adolescent Eating Disorders, South London and Maudsley NHS Foundation Trust, London, UK
| | - Richard Hall
- Maudsley Centre for Child and Adolescent Eating Disorders, South London and Maudsley NHS Foundation Trust, London, UK.,Department of Clinical, Educational, and Health Psychology, University College London, London, UK
| | - Gill Allen
- Maudsley Centre for Child and Adolescent Eating Disorders, South London and Maudsley NHS Foundation Trust, London, UK.,Bromley Y, Community Well-being Service for Children and Families, Bromley, UK
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23
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Balciuniene V, Jankauskiene R, Baceviciene M. Effect of an education and mindfulness-based physical activity intervention for the promotion of positive body image in Lithuanian female students. Eat Weight Disord 2022; 27:563-577. [PMID: 33877646 PMCID: PMC8056191 DOI: 10.1007/s40519-021-01195-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 04/10/2021] [Indexed: 01/04/2023] Open
Abstract
PURPOSE The aim of this study was to test the effectiveness of an 8-week classroom education and mindfulness-based physical activity intervention for the promotion of positive body image in female students. METHODS A quasi-experimental study was carried out with 110 Lithuanian female students (mean age 21.5 ± 3.5, range 19-35 years). Thirty students voluntarily participated in the intervention programme and 80 students volunteered in the assessment-only control group. The intervention comprised five cognitive behavioural therapy classroom education sessions and mindfulness-based exercise (one exercise workout per week). The intervention group was evaluated with a pre-test and post-test and the control group completed measures at parallel times. RESULTS Compared with the control group participants, the intervention group participants reported greater improvements in positive body image and a reduction in body dissatisfaction and drive for thinness and internalisation of stereotyped beauty ideals, with medium to large effects. There were significant time × group interactions for pre-test to post-test changes in internalisation of beauty ideals, body area satisfaction, body dissatisfaction and body appreciation. In all cases, the interaction reflected greater pre-test to post-test changes in the intervention group compared with the control group, whose scores remained stable. A decrease in appearance orientation, overweight preoccupation, disordered eating and physical activity was observed in the control group, but the effect sizes were low. CONCLUSION The preliminary findings of this study support the efficacy of cognitive behavioural therapy methods and mindfulness-based exercise intervention aimed to promote positive body image in student-aged women. Future studies should test the efficacy of the introduced programme in larger randomised samples of young women. LEVEL IV Evidence obtained from multiple time series with or without an intervention.
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Affiliation(s)
- Vaiva Balciuniene
- Department of Physical and Social Education, Lithuanian Sports University, Sporto 6, 44221, Kaunas, Lithuania
| | - Rasa Jankauskiene
- Institute of Sport Science and Innovations, Lithuanian Sports University, Sporto 6, 44221, Kaunas, Lithuania
| | - Migle Baceviciene
- Department of Physical and Social Education, Lithuanian Sports University, Sporto 6, 44221, Kaunas, Lithuania.
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24
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Stewart TM, Martin CK, Williamson DA. The Complicated Relationship between Dieting, Dietary Restraint, Caloric Restriction, and Eating Disorders: Is a Shift in Public Health Messaging Warranted? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:491. [PMID: 35010751 PMCID: PMC8745028 DOI: 10.3390/ijerph19010491] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/09/2021] [Accepted: 12/21/2021] [Indexed: 02/01/2023]
Abstract
The origins of theories specifying dietary restraint as a cause of eating disorders can be traced to the 1970s. This paper will present an overview of the origins of dietary restraint theories and a brief historical review of evidence will be summarized. Recent research will be presented, including the results from the CALERIE Phase 1 study, as well as CALERIE Phase 2, which were NIH-sponsored randomized controlled trials. CALERIE 2 provided a test of the effect of two years of caloric restriction (CR) on the development of eating disorder syndromes and symptoms in comparison to a control group that did not alter eating behavior or body weight. The intervention was effective for inducing a chronic (two-year) reduction in total energy expenditure and increased dietary restraint but did not increase symptoms of eating disorders. The results of this recent investigation and other studies have not provided experimental support for conventional dietary restraint theories of eating disorders. These findings are discussed in terms of potential revisions of dietary restraint theory, as well as the implications for a paradigm shift in public health messaging related to dieting.
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Affiliation(s)
- Tiffany M. Stewart
- Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA; (C.K.M.); (D.A.W.)
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25
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Physical exercise and sports in eating disorders. NUTR HOSP 2022; 39:33-40. [DOI: 10.20960/nh.04176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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26
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New approaches to the prevention of eating disorders. NUTR HOSP 2022; 39:138-149. [DOI: 10.20960/nh.04189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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27
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Prevention of eating disorders in secondary education centers. NUTR HOSP 2022; 39:86-92. [DOI: 10.20960/nh.04183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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28
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Hudson TA, Amaral ACS, Stice E, Gau J, Ferreira MEC. Dissonance-based eating disorder prevention among Brazilian young women: A randomized efficacy trial of the Body Project. Body Image 2021; 38:1-9. [PMID: 33780888 DOI: 10.1016/j.bodyim.2021.03.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 03/10/2021] [Accepted: 03/13/2021] [Indexed: 11/25/2022]
Abstract
A randomized controlled trial was conducted to assess the efficacy of the Body Project eating disorder prevention program in reducing eating disorder risk factors and symptoms in young Brazilian women. A total of 141 female university students aged 18-30 years old were randomly assigned to one of two conditions: assessment-only condition (n = 78) and Body Project condition (n = 63). Participants completed scales assessing body dissatisfaction, sociocultural influence, disordered eating attitudes and behaviors, eating disorders symptoms, body appreciation, depressive mood and negative affect at baseline, posttest, and at 1- and 6-month follow-ups. Body Project participants showed significantly greater reductions in body dissatisfaction, sociocultural influence, disordered eating, eating disorder symptoms, depressive symptoms, and negative affect, and greater increases in body appreciation (d = .35-.48) compared to assessment-only participants. Most of the effects persisted through 6-month follow-up (d = .35-.74). Results provide evidence that the Body Project is an effective intervention to reduce eating disorder risk factors and eating disorder symptoms among Brazilian young women, and that this intervention is naturally culturally adaptive.
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Affiliation(s)
- Tassiana Aparecida Hudson
- Department of Physical Education, Federal University of Juiz de Fora, s/n José Lourenço Kelmer Street, University Campus, Juiz de Fora, 36036-900, Brazil.
| | - Ana Carolina Soares Amaral
- Federal Institute of Education, Science and Technology of Southeast of Minas Gerais, 204 Monsenhor José Augusto Street, Barbacena, Minas Gerais, 36205-018, Brazil.
| | - Eric Stice
- Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, Stanford, CA 94305, United States.
| | - Jeff Gau
- Oregon Research Institute, 1776 Millrace Dr, Eugene, OR 97403, United States.
| | - Maria Elisa Caputo Ferreira
- Department of Physical Education, Federal University of Juiz de Fora, s/n José Lourenço Kelmer Street, University Campus, Juiz de Fora, 36036-900, Brazil.
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29
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Day AS, Yao CK, Costello SP, Andrews JM, Bryant RV. Food avoidance, restrictive eating behaviour and association with quality of life in adults with inflammatory bowel disease: A systematic scoping review. Appetite 2021; 167:105650. [PMID: 34391842 DOI: 10.1016/j.appet.2021.105650] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 05/17/2021] [Accepted: 08/11/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Dietary misconceptions and behaviours may worsen outcomes of inflammatory bowel disease (IBD). This scoping review aims to examine the dietary beliefs and behaviours of individuals with IBD and identify evidence of food avoidance, dietary restriction or disordered eating and any association with quality of life (QoL). METHODOLOGY A systematic search of CINAL, EMBASE, MEDLINE was conducted. Primary, peer-reviewed studies in English examining dietary beliefs and dietary behaviours or diet and quality of life in adults with inflammatory bowel disease were included. Key dietary terminology was pre-defined. RESULTS Twenty-nine studies met inclusion criteria. A range of quantitative self-reported questionnaires (16/29), qualitative interviews (1/29) and mixed methods (7/29) were used to measure dietary beliefs and dietary behaviours. A high prevalence of food avoidance (28-89%) and restrictive dietary behaviours (41-93%) were identified. Factors associated with these behaviours included a diagnosis of CD, perceived active disease, female sex, dietary misinformation, and fears of adverse bowel symptoms. Diet and QoL remains largely unexplored in IBD beyond two recent studies demonstrating impairment of food-related quality of life in IBD. CONCLUSION A high prevalence of self-reported food avoidance and restrictive dietary behaviour exists in people with IBD. The psychosocial impact of IBD-related dietary behaviour is poorly understood. Validated tools with predefined diet terminology and objective markers of disease activity are required to measure dietary behaviour in future prospective studies, using food-related quality of life as an outcome measure.
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Affiliation(s)
- Alice S Day
- Inflammatory Bowel Disease Services, The Department of Gastroenterology and Hepatology, The Queen Elizabeth Hospital, 28 Woodville Road, Woodville South, 5011, South Australia, Australia; School of Medicine, Faculty of Health Sciences, University of Adelaide, Frome Road, Adelaide, 5000, South Australia, Australia.
| | - Chu K Yao
- Translational Nutritional Sciences, Department of Gastroenterology, Monash University & Alfred Hospital, 99 Commercial Road, Melbourne, 3000, Victoria, Australia.
| | - Samuel P Costello
- Inflammatory Bowel Disease Services, The Department of Gastroenterology and Hepatology, The Queen Elizabeth Hospital, 28 Woodville Road, Woodville South, 5011, South Australia, Australia; School of Medicine, Faculty of Health Sciences, University of Adelaide, Frome Road, Adelaide, 5000, South Australia, Australia.
| | - Jane M Andrews
- School of Medicine, Faculty of Health Sciences, University of Adelaide, Frome Road, Adelaide, 5000, South Australia, Australia; Inflammatory Bowel Disease Service, Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, Adelaide, 5000, South Australia, Australia.
| | - Robert V Bryant
- Inflammatory Bowel Disease Services, The Department of Gastroenterology and Hepatology, The Queen Elizabeth Hospital, 28 Woodville Road, Woodville South, 5011, South Australia, Australia; School of Medicine, Faculty of Health Sciences, University of Adelaide, Frome Road, Adelaide, 5000, South Australia, Australia.
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An exploration of the tripartite influence model of body image in Lithuanian sample of young adults: does body weight make a difference? Eat Weight Disord 2021; 26:1781-1791. [PMID: 32894452 DOI: 10.1007/s40519-020-00996-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 08/25/2020] [Indexed: 10/23/2022] Open
Abstract
PURPOSE The present study aimed to test the sociocultural Tripartite Influence Model (TIM) that helps to explain the associations between the sociocultural pressures to achieve stereotyped body ideals and disordered eating in young Lithuanian women and men of different body mass. METHODS A mixed-gender sample of students (n = 1850, 58.8% female, the mean age of men was 20.4 (SD = 3.1) years, of women 22.4 (SD = 5.8) years) filled in series of questionnaires including the social attitudes towards appearance, body image, disordered eating and drive for muscularity. Mediation analyses were performed to estimate the size of total, direct, and indirect effects of variables in the models. RESULTS For women of different body weight, the TIM model was fully replicated. For men of normal weight, internalization of the muscular/athletic ideal, drive for muscularity and greater investment towards appearance mediated the relationships between peers' pressures and disordered eating. For overweight men, internalization of the thin and muscular/athletic ideals, poorer body image mediated associations between pressure from the peers and disordered eating. However, the internalization of the muscular/athletic ideal and the greater appearance evaluation mediated the associations between sociocultural pressures and disordered eating for overweight and obese men. CONCLUSION The TIM was replicated in women of different body weight. However, internalization of the thin/low fat ideal was not relevant for men of normal body weight and internalization of the muscular ideal had different outcomes for men of different body mass index. The implications of the results for practice are discussed. LEVEL OF EVIDENCE V, Cross-sectional descriptive study.
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Riehl ME, Scarlata K. Understanding Disordered Eating Risks in Patients with Gastrointestinal Conditions. J Acad Nutr Diet 2021; 122:491-499. [PMID: 33893063 DOI: 10.1016/j.jand.2021.03.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 02/27/2021] [Accepted: 03/04/2021] [Indexed: 12/18/2022]
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Leins J, Waldorf M, Suchan B, Diers M, Herpertz S, Paslakis G, Steins-Loeber S. Exposure to the thin beauty ideal: Are there subliminal priming effects? Int J Eat Disord 2021; 54:506-515. [PMID: 33432706 DOI: 10.1002/eat.23461] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 12/18/2020] [Accepted: 12/19/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Previous research suggested that exposure to the thin beauty ideal propagated by the media is associated with body dissatisfaction and the development of disordered eating. Given recent suggestions regarding the role of automatic processes, we aimed to enhance our understanding of automatic, unconscious responses to body pictures and the association with the internalization of the thin ideal and the severity of eating disorder symptoms. METHOD An affective priming task with body pictures of different weight as primes and a normal-weight body picture as target, which had to be evaluated with regard to attractiveness and desirability, was administered to healthy women with either subliminal prime presentation (Experiment 1) or conscious presentation (Experiment 2). RESULTS Subliminal presentation did not affect the evaluation of the normal-weight target, although strength of evaluative shifts was significantly associated with internalization of the thin ideal. In contrast, the conscious presentation of the ultra-thin prime decreased and of the obese prime increased desirability and attractiveness ratings of the target. DISCUSSION Prevention strategies focusing on the critical evaluation of the thin ideal are important. Future studies are warranted to enhance our understanding of automatic, unconscious processes in women experiencing eating disorders.
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Affiliation(s)
- Judith Leins
- Department of Psychiatry, Ubbo-Emmius Hospital Norden, Norden, Germany.,Department of Clinical Psychology and Psychotherapy, University of Bamberg, Bamberg, Germany
| | - Manuel Waldorf
- Department of Clinical Psychology and Psychotherapy, Osnabrück University, Osnabrück, Germany
| | - Boris Suchan
- Clinical Neuropsychology, Ruhr University Bochum, Bochum, Germany
| | - Martin Diers
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital Bochum, Ruhr University Bochum, Bochum, Germany
| | - Stephan Herpertz
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital Bochum, Ruhr University Bochum, Bochum, Germany
| | - Georgios Paslakis
- Department of Psychosomatic Medicine and Psychotherapy, Ruhr University Bochum, Lübbecke, Germany
| | - Sabine Steins-Loeber
- Department of Clinical Psychology and Psychotherapy, University of Bamberg, Bamberg, Germany
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Behrens SC, Meneguzzo P, Favaro A, Teufel M, Skoda EM, Lindner M, Walder L, Quiros Ramirez A, Zipfel S, Mohler B, Black M, Giel KE. Weight bias and linguistic body representation in anorexia nervosa: Findings from the BodyTalk project. EUROPEAN EATING DISORDERS REVIEW 2020; 29:204-215. [PMID: 33252835 DOI: 10.1002/erv.2812] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/17/2020] [Accepted: 11/01/2020] [Indexed: 11/12/2022]
Abstract
OBJECTIVE This study provides a comprehensive assessment of own body representation and linguistic representation of bodies in general in women with typical and atypical anorexia nervosa (AN). METHODS In a series of desktop experiments, participants rated a set of adjectives according to their match with a series of computer generated bodies varying in body mass index, and generated prototypic body shapes for the same set of adjectives. We analysed how body mass index of the bodies was associated with positive or negative valence of the adjectives in the different groups. Further, body image and own body perception were assessed. RESULTS In a German-Italian sample comprising 39 women with AN, 20 women with atypical AN and 40 age matched control participants, we observed effects indicative of weight stigmatization, but no significant differences between the groups. Generally, positive adjectives were associated with lean bodies, whereas negative adjectives were associated with obese bodies. DISCUSSION Our observations suggest that patients with both typical and atypical AN affectively and visually represent body descriptions not differently from healthy women. We conclude that overvaluation of low body weight and fear of weight gain cannot be explained by generally distorted perception or cognition, but require individual consideration.
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Affiliation(s)
- Simone Claire Behrens
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany.,Max Planck Institute for Intelligent Systems, Tübingen, Germany
| | - Paolo Meneguzzo
- Department of Neuroscience, University of Padova, Padova, Italy
| | - Angela Favaro
- Department of Neuroscience, University of Padova, Padova, Italy.,Padova Neuroscience Center, University of Padova, Padova, Italy
| | - Martin Teufel
- Clinic for Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, LVR University-Hospital Essen, Essen, Germany
| | - Eva-Maria Skoda
- Clinic for Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, LVR University-Hospital Essen, Essen, Germany
| | - Marion Lindner
- Clinic for Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, LVR University-Hospital Essen, Essen, Germany
| | - Lukas Walder
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany
| | - Alejandra Quiros Ramirez
- Max Planck Institute for Intelligent Systems, Tübingen, Germany.,Psychology Department, University of Konstanz, Konstanz, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany
| | - Betty Mohler
- Max Planck Institute for Intelligent Systems, Tübingen, Germany
| | - Michael Black
- Max Planck Institute for Intelligent Systems, Tübingen, Germany
| | - Katrin E Giel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany
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Jankauskiene R, Baceviciene M, Trinkuniene L. Examining Body Appreciation and Disordered Eating in Adolescents of Different Sports Practice: Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17114044. [PMID: 32517115 PMCID: PMC7312658 DOI: 10.3390/ijerph17114044] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 06/03/2020] [Accepted: 06/04/2020] [Indexed: 12/24/2022]
Abstract
This cross-sectional study aimed to examine the associations between body appreciation, body functionality and disordered eating in a large adolescent sample of different levels and types of sports practice. Method: The sample consisted of 1412 adolescents (59.8% were girls). The ages ranged from 15 to 18 years old, with a mean age of 16.9 (SD = 0.5) for girls and 17.0 (SD = 0.4) for boys. Participants completed an anonymous questionnaire assessing the nature of sports participation, body appreciation, body functionality, self-esteem, body dissatisfaction, internalisation of sociocultural beauty ideals and disordered eating. A two-way ANOVA was employed to test the differences in body image concerns, body appreciation, perceived physical fitness and disordered eating behaviours in gender groups and groups of different sport types and levels. Multiple linear regression analyses were performed to predict disordered eating behaviours of different study variables. Results: Participants of leisure and competitive sports reported greater body appreciation, self-esteem and lower body dissatisfaction compared to non-participants. No differences in body appreciation and disordered eating were observed in adolescents involved in weight-sensitive and less weight-sensitive sports. Body appreciation and body functionality were associated with lower disordered eating in adolescent girls not participating in sports, leisure exercisers and participants of competitive sport as well as in boys participating in competitive sports, controlling for body mass index. Adolescent boys demonstrated greater body appreciation compared to girls. Conclusions: The results of this study support the knowledge of the protective role of positive body image preventing dysfunctional eating in adolescent girls of various sports practice and in competitive sports involved boys. Disordered eating prevention and clinical treatment programs for adolescents of different physical activity might benefit from including education about body appreciation and functionality.
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Affiliation(s)
- Rasa Jankauskiene
- Institute of Sport Science and Innovations, Lithuanian Sports University, 4221 Kaunas, Lithuania;
| | - Migle Baceviciene
- Department of Physical and Social Education, Lithuanian Sports University, 44221 Kaunas, Lithuania;
- Correspondence: ; Tel.: +370-37-302638
| | - Laima Trinkuniene
- Department of Physical and Social Education, Lithuanian Sports University, 44221 Kaunas, Lithuania;
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Hirsch KE, Blomquist KK. Community-Based Prevention Programs for Disordered Eating and Obesity: Updates and Current Limitations. Curr Obes Rep 2020; 9:81-97. [PMID: 32445131 DOI: 10.1007/s13679-020-00373-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE OF REVIEW To review the status of community-based disordered eating and obesity prevention programs from 2014 to 2019. RECENT FINDINGS In the last 5 years, prevention programs have found success in intervening with children and parental figures in wellness centers, physical activity centers, childcare centers, workplaces, online, and over-the-phone through directly reducing disordered eating and obesity or by targeting risk factors of disordered eating and obesity. Community-based prevention programs for disordered eating and programs targeting both disordered eating and obesity were scarce, highlighting the critical need for the development of these programs. Qualities of the most effective programs were those in which parents and children were educated on physical activity and nutrition via multiple group-based sessions. Limitations of current prevention programs include few programs targeting high-risk populations, a dearth of trained community members serving as facilitators, inconsistent reporting of adherence rates, and few direct measurements of disordered eating and obesity, as well as few long-term follow-ups, precluding the evaluation of sustained effectiveness.
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Affiliation(s)
- Katherine E Hirsch
- Department of Kinesiology, University of Windsor, 401 Sunset Avenue, Windsor, Ontario, N9B 3P4, Canada
| | - Kerstin K Blomquist
- Department of Psychology, Furman University, 3300 Poinsett Highway, Greenville, SC, 29613, USA.
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Baceviciene M, Jankauskiene R. Associations between Body Appreciation and Disordered Eating in a Large Sample of Adolescents. Nutrients 2020; 12:nu12030752. [PMID: 32178334 PMCID: PMC7146197 DOI: 10.3390/nu12030752] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 03/06/2020] [Accepted: 03/10/2020] [Indexed: 12/25/2022] Open
Abstract
Body appreciation is one of the main facets of a positive body image. The present study aimed to examine the psychometric properties of the Lithuanian version of the Body Appreciation Scale-2 (BAS-2-LT) and test the associations between body appreciation and disordered eating in a large sample of adolescents of both genders. Method: The sample consisted of 1412 adolescents (40.2% were boys). The ages ranged from 15 to 18 years (92.4% were 17), with a mean age of 16.9 (SD = 0.5) for girls and 17.0 (SD = 0.4) for boys. Participants completed the BAS-2-LT alongside the measures of body dissatisfaction, disordered eating, body mass index, self-esteem, body functionality, and participation in sports. Linear regressions were used to test the associations between study variables and disordered eating. Results: BAS-2-LT replicated the original one-dimensional structure in girls and boys. Invariance across genders was established. The instrument showed good internal consistency and temporal stability. Body appreciation was negatively correlated with higher levels of body mass index, body dissatisfaction, and disordered eating. Positive associations were observed between body appreciation, self-esteem, body functionality, and sports participation. Higher levels of body appreciation decreased the risk of disordered eating behaviors in both genders. Conclusions: The results of the present study support the psychometric properties of BAS-2-LT. Body appreciation is associated with lower disordered eating in adolescent girls and boys. These findings present empirical support for the development of interventions programs that promote positive body images and aim to prevent disordered eating in adolescent boys and girls.
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Affiliation(s)
- Migle Baceviciene
- Department of Physical and Social Education, Lithuanian Sports University, Sporto 6, 44221 Kaunas, Lithuania
- Correspondence: ; Tel.: +370-37-302638
| | - Rasa Jankauskiene
- Institute of Sport Science and Innovations, Lithuanian Sports University, Sporto 6, 44221 Kaunas, Lithuania;
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Baceviciene M, Balciuniene V, Jankauskiene R. Validation of the Lithuanian version of the Eating Disorder Examination Questionnaire 6.0 in a student sample. Brain Behav 2020; 10:e01555. [PMID: 31991064 PMCID: PMC7066329 DOI: 10.1002/brb3.1555] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 01/06/2020] [Accepted: 01/13/2020] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND AND OBJECTIVES The Eating Disorder Examination Questionnaire 6.0 (EDE-Q 6.0) is one of the most broadly used self-report tools that assesses attitudes and behaviors associated with eating disorders (EDs). The aim of the present study was to examine the reliability, validity, and factor structure of the Lithuanian version of the EDE-Q 6.0 (LT-EDE-Q 6.0) in a nonclinical student sample. MATERIALS AND METHODS A sample of 382 students (mean age 24.0 ± 6.4) participated in the study. The students completed a self-report questionnaire measuring the risk of EDs (LT-EDE-Q 6.0), body image (LT-MBSRQ-AS), quality of life (LT-WHOQOL-BREF), and self-esteem (RSES). Cronbach's alpha assessed the internal consistency of the EDE-Q 6.0. Pearson's correlations were used for the analyses of the construct and concurrent validity with the subscales of LT-MBSRQ-AS, LT-WHOQOL-BREF, and RSES. Intraclass correlation coefficients (ICC) were calculated for assessing test-retest reliability. RESULTS The mean score of the LT-EDE-Q 6.0 in the mixed sample was 1.5 ± 1.02. For women and men, the general mean scores were higher than in the majority of the samples of Western Europe but lower than in the United States. Acceptable internal consistency for the four subscales (0.75-0.88) and the LT-EDE-Q 6.0 general score (0.94) was obtained. Test-retest reliability was good to excellent for all subscales (0.66-0.91) and for the items that assessed essential behavioral features of EDs (0.84-0.90, except item 14 ICC = 0.4). The LT-EDE-Q 6.0 scores had adequate concurrent validity. However, the original 4-factor structure or other proposed models of EDE-Q were not obtained by CFA. CONCLUSIONS The results of the current study support the applicability, validity, and reliability of the LT-EDE-Q 6.0 in a nonclinical Lithuanian student sample. However, we recommend assessing the general scale score without the application of the subscales. The Lithuanian version of this instrument should be further investigated with clinical samples to identify clinically diagnosed cases.
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Affiliation(s)
- Migle Baceviciene
- Department of Physical and Social EducationLithuanian Sports UniversityKaunasLithuania
| | - Vaiva Balciuniene
- Department of Physical and Social EducationLithuanian Sports UniversityKaunasLithuania
| | - Rasa Jankauskiene
- Institute of Sport Science and InnovationLithuanian Sports UniversityKaunasLithuania
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Baceviciene M, Jankauskiene R, Balciuniene V. Validation of the Lithuanian Version of the Sociocultural Attitudes towards Appearance Questionnaire-4 (SATAQ-4) in a Student Sample. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E932. [PMID: 32028616 PMCID: PMC7036838 DOI: 10.3390/ijerph17030932] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 01/17/2020] [Accepted: 02/01/2020] [Indexed: 01/07/2023]
Abstract
The Sociocultural Attitudes Towards Appearance Questionnaire-4 (SATAQ-4) is one of the most broadly used self-report tools that assess the general role of sociocultural influences on body image and appearance-related internalization. The present study aimed to examine the reliability, validity, and factor structure of the Lithuanian version of the SATAQ-4 (LT-SATAQ-4), as a screening self-report instrument for assessing the role of sociocultural influences on body image. A mixed-gender sample (N = 1850) of undergraduate students (88.7%) and graduate students (11.3%) from different state universities and colleges participated in this study (average age 21.6 ±5.0). The students completed a self-report online questionnaire. Intraclass correlation coefficients (ICCs) were calculated for assessing test-retest reliability. The construct validity of the Lithuanian Sociocultural Attitudes Towards Appearance Questionnaire-4 (LT-SATAQ-4) was studied performing exploratory factor analysis (EFA), and then confirmatory factor analysis (CFA). The mean scores for the LT-SATAQ-4 subscales ranged from 1.6 ± 0.9 (Pressure subscale: Peers) to 2.7 ± 1.2 (Internalization subscale: Thin/Low Body Fat). Test-retest reliability was good to excellent for the general and subscale scores (0.85-1.00) except for the Pressure subscale: Peers (0.60). The original 5-factor structure was confirmed by EFA and CFA. Good to excellent internal consistency for each subscale (attempted 0.9 and more) and for the LT-SATAQ-4 global scale (0.91) was obtained. The LT-SATAQ-4 scores had adequate concurrent validity with the measures of the body image, disordered eating, self-esteem, and body mass index. The results support the psychometric properties of the LT-SATAQ-4 and its' use in Lithuanian student samples. The Lithuanian SATAQ-4 is a useful measure to examine the pressures to internalize appearance ideals in Lithuanian-speaking samples of young individuals.
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Affiliation(s)
- Migle Baceviciene
- Department of Physical and Social Education, Lithuanian Sports University, Sporto 6, 44221 Kaunas, Lithuania;
| | - Rasa Jankauskiene
- Institute of Sport Science and Innovations, Lithuanian Sports University, Sporto 6, 44221 Kaunas, Lithuania;
| | - Vaiva Balciuniene
- Department of Physical and Social Education, Lithuanian Sports University, Sporto 6, 44221 Kaunas, Lithuania;
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O’Connor SM, Culbert KM, Mayhall LA, Burt SA, Klump KL. Differences in genetic and environmental influences on body weight and shape concerns across pubertal development in females. J Psychiatr Res 2020; 121:39-46. [PMID: 31759219 PMCID: PMC7099836 DOI: 10.1016/j.jpsychires.2019.11.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 10/12/2019] [Accepted: 11/07/2019] [Indexed: 02/08/2023]
Abstract
The heritability of disordered eating increases during puberty; however, prior studies have largely examined a composite score of disordered eating, rather than specific symptoms. Body weight and shape concerns cut across all eating disorder diagnoses and are some of the strongest prospective risk factors for the development of eating disorders. Yet, little is known about potential developmental increases or decreases in genetic and environmental influences for these key symptoms. This study examined differences in genetic and environmental effects on a range of body weight and shape concerns during puberty and compared results to findings for overall levels of disordered eating symptoms. Participants were 926 same-sex female twins (ages 8-16) from the Michigan State University Twin Registry. Well-validated questionnaires were used to examine pubertal maturation, overall levels of disordered eating, and a range of cognitive body weight/shape constructs: body dissatisfaction, weight/shape concerns, and weight preoccupation. Findings for overall levels of disordered eating were very similar to those obtained in previous work, with significantly increased genetic effects in girls at more advanced pubertal development. Importantly, these same pubertal increases in genetic influences were observed for body dissatisfaction and weight/shape concerns. However, no pubertal moderation of genetic effects was observed for weight preoccupation; instead, pubertal moderation of nonshared and shared environmental effects was observed. Our findings point to differences in the extent to which genetic and environmental factors contribute to various cognitive body weight and shape symptoms during puberty.
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Affiliation(s)
- Shannon M. O’Connor
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - Kristen M. Culbert
- Department of Family Medicine and Public Health, Wayne State University School of Medicine, Detroit, MI, USA
| | - Laura A. Mayhall
- Department of Communicative Sciences and Disorders, Michigan State University, East Lansing, MI, USA
| | - S. Alexandra Burt
- Department of Psychology, Michigan State University, East Lansing, MI, USA
| | - Kelly L. Klump
- Department of Psychology, Michigan State University, East Lansing, MI, USA
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Chen A, Couturier J. Triggers for Children and Adolescents with Anorexia Nervosa: A Retrospective Chart Review. JOURNAL OF THE CANADIAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY = JOURNAL DE L'ACADEMIE CANADIENNE DE PSYCHIATRIE DE L'ENFANT ET DE L'ADOLESCENT 2019; 28:134-140. [PMID: 31798651 PMCID: PMC6863573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 09/13/2019] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Anorexia nervosa may arise from a wide range of influences, often involving an interplay of biological, psychological, and sociocultural factors. The present study examines the nature of triggers for children and adolescents with anorexia nervosa at the time of diagnosis. METHOD A qualitative retrospective chart review of 50 patients diagnosed with anorexia nervosa-restrictive subtype was conducted, revealing both specific and non-specific themes for triggers of anorexia nervosa. RESULTS Specific themes revealed triggers pertaining to internalization of the thin ideal, healthy eating education, sports performance motivations, and weight-related teasing. Non-specific factors included general preoccupations about weight, shape, and healthiness. CONCLUSIONS Examining adolescent perceptions of healthy messages from key players, including teachers, family, and peers, can better inform researchers and policy makers of the impact of health-focused messages on child and adolescent populations.
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Affiliation(s)
| | - Jennifer Couturier
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario
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Dakanalis A, Clerici M, Stice E. Prevention of eating disorders: current evidence-base for dissonance-based programmes and future directions. Eat Weight Disord 2019; 24:597-603. [PMID: 31147968 DOI: 10.1007/s40519-019-00719-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 05/21/2019] [Indexed: 12/11/2022] Open
Affiliation(s)
- Antonios Dakanalis
- Department of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, 20900, Monza, Italy.
| | - Massimo Clerici
- Department of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, 20900, Monza, Italy
| | - Eric Stice
- Oregon Research Institute, 1776 Millrace Drive, Eugene, OR, 97403, USA
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Buerger A, Ernst V, Wolter V, Huss M, Kaess M, Hammerle F. Treating eating disorders in the real world - MaiStep: A skill-based universal prevention for schools. Prev Med 2019; 123:324-332. [PMID: 31004619 DOI: 10.1016/j.ypmed.2019.04.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Revised: 04/08/2019] [Accepted: 04/14/2019] [Indexed: 01/09/2023]
Abstract
Eating disorders are difficult to treat and often associated with morbidity and mortality. Universal prevention approaches are increasingly focusing on enhancing skills, but few eating disorder programs are available for under-15-year-olds. This study aimed to develop and examine a school-based universal prevention program ('MaiStep') for adolescent boys and girls. A three-arm randomized controlled trial with baseline, post-intervention and 12-month follow-up was conducted with 1654 adolescents (M = 13.35, SD 0.76). 'MaiStep' was delivered by psychologists in the first intervention group (IG1) and teachers in the second intervention group (IG2), and compared to an active control group (ACG). Primary outcomes were eating disorder-related risk factors measured with scales of the Eating Disorder Inventory-2 (e.g. 'drive for thinness', 'interoceptive awareness'), cognitions and affect related to the body (Body Shape Questionnaire, BSQ-8), and behaviors (Body Image Avoidance Questionnaire, BIAQ). The total sample (N1) was divided into a healthy subsample (N2) and a sample fulfilling DSM-5 criteria for a subthreshold eating disorder (N3) measured with the self-report Structured Inventory for Anorexic and Bulimic Syndromes (SIAB-S). Significant improvements in 'interoceptive awareness' (EDI-2) and lower BIAQ scores emerged in N1 at post-intervention and at 12-month follow-up (F(4; 3038) = 3.068, p = .016, ηpart2 = 0.004 and F(4; 2900) = 2.993, p = .018, ηpart2 = 0.004) and in N2 at post-intervention and at 12-month follow-up (F(4; 2812) = 3.147, p = .014, ηpart2 = 0.004 and F(4; 2684) = 3.674, p = .005, ηpart2 = 0.005). The healthy subsample N2 additionally showed significantly lower scores on 'drive for thinness' (EDI-2) and on the BSQ-8c at post-intervention (F(2; 1446) = 3.091, p = .046, ηpart2 = 0.004 and F(2; 1453) = 3.505, p = .030, ηpart2 = 0.005) but not at 12-month follow-up. No significant results emerged for N3. The positive findings of improved 'interoceptive awareness' (EDI-2) and reduced body image avoidance (BIAQ) indicate that broad disseminated universal prevention under the age of 15 is possible. Trial registration MaiStep is registered at the German Clinical Trials Register (DRKS00005050).
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Affiliation(s)
- Arne Buerger
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wuerzburg, Margarete-Hoeppel-Platz 1, 97080 Wuerzburg, Germany.
| | - Verena Ernst
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Vanessa Wolter
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Michael Huss
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Stoeckli, Bolligenstrasse 141c, 3000 Bern 60, Switzerland; Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Blumenstraße 8, 69115 Heidelberg, Germany
| | - Florian Hammerle
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
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Abstract
Body dissatisfaction is a risk factor for development of eating disorders and represents a core psychopathologic feature of eating disorders. Prevention and treatment interventions address established risk and maintaining factors for body dissatisfaction: appearance pressures, internalization of appearance ideals, upward appearance comparison, avoidance and checking, and body disparagement. It is essential to address body dissatisfaction within eating disorders treatment to improve outcomes and reduce risk of relapse. Future directions in research and treatment aim to reach populations increasingly recognized as in need, including children, men, and individuals at higher weights, with the ultimate goal of reducing the significant distress associated with body dissatisfaction.
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Leme ACB, Philippi ST, Thompson D, Nicklas T, Baranowski T. "Healthy Habits, Healthy Girls-Brazil": an obesity prevention program with added focus on eating disorders. Eat Weight Disord 2019; 24:107-119. [PMID: 29730727 DOI: 10.1007/s40519-018-0510-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 04/24/2018] [Indexed: 12/21/2022] Open
Abstract
PURPOSE To evaluate the immediate post-intervention and 6-month post-intervention effects of a Brazilian school-based randomized controlled trial for girls targeting shared risk factors for obesity and disordered eating. METHODS Total of 253 girls, mean of 15.6 (0.05) years from 1st to 3rd grades of high school participated in this 6-month school-based cluster randomized controlled trial. "Healthy Habits, Healthy Girls-Brazil (H3G-Brazil)", originally developed in Australia, emphasized 10 key nutrition and physical activity (PA) messages delivered over 6 months. Disordered eating prevention procedures, i.e., prevention of weight-teasing, body satisfaction, and unhealthy weight control behavior, were added to the intervention. Body dissatisfaction, unhealthy weight control behaviors and social cognitive-related diet, and physical activity variables were assessed at baseline, immediate post-intervention, and 6-month post-intervention. Intervention effects were determined by one-way analysis of covariance or logistic regression, after checking for the clustering effects of school. The control group did not receive intervention prior to follow-up assessment. A conservative significance level was set at p < 0.01. RESULTS Beneficial effects were detected for PA social support (F = 6.005, p = 0.01), and healthy eating strategies (F = 6.08, p = 0.01) immediate post-intervention; and healthy eating social support (F = 14.731, p = 0.00) and healthy eating strategies (F = 5.812, p = 0.01) at 6-month post-intervention. Intervention group was more likely to report unhealthy weight control behaviors (OR = 1.92, 95% CI 1.15-3.21, p = 0.01) at 6-month post-intervention. No other significant immediate or 6-month post effects were detected. CONCLUSION H3G-Brazil demonstrated positive 6-month effects on some social cognitive variables but an adverse effect on unhealthy weight control behaviors. Thus, this study was not able to achieve synergy by combining obesity and disordered eating prevention procedures in an intervention among low-income girls in Brazil. TRIAL REGISTRATION Level I: cluster randomized controlled trial.
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Affiliation(s)
- Ana Carolina Barco Leme
- Children's Nutrition Research Center, Baylor College of Medicine, Houston, USA. .,Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil.
| | | | - Debbe Thompson
- Children's Nutrition Research Center, Baylor College of Medicine, Houston, USA
| | - Theresa Nicklas
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Tom Baranowski
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
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Breithaupt L, Eickman L, Byrne CE, Fischer S. REbeL peer education: A model of a voluntary, after-school program for eating disorder prevention. Eat Behav 2019; 32:111-116. [PMID: 27825587 DOI: 10.1016/j.eatbeh.2016.10.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Dissonance-based eating disorder prevention leads to decreases in risk factors for these disorders. Although controlled trials have demonstrated that targeted, manualized programs reduce eating disorder risk, concerns regarding implementation and dissemination remain. A primary concern is the difficulty in adapting programs for a high school setting for populations at highest risk: adolescents. This paper describes the REbeL Peer Education model and assesses the initial pilot trials of the intervention. The program is novel in that it utilizes a voluntary, self-selection model that is sustainable in a high school setting, and focuses on empowerment and effective cognitive dissonance based prevention activities. High school peer-educators self-selected into the semi-manualized dissonance based intervention. Group activities were peer led, designed to critique the thin ideal, and designed to empower macro (school and larger community wide) changes in the pilot trial (N=47) assess the effectiveness and feasibility of the intervention. Results of the initial pilot study revealed preliminary support for the feasibility of the program, increases in feelings of empowerment, and decreases in eating disorder cognitions and behaviors with moderate to large effect sizes. Feedback from participants indicated that the intervention was enjoyable, educational, and empowering. This study is the first to adapt dissonance-based prevention models to a semi-manualized, peer-led, prevention program integrated into high school settings.
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Affiliation(s)
- Lauren Breithaupt
- George Mason University, Department of Psychology, 4400 University Drive, 3F5, Fairfax, VA 22030, United States; REbeL, Inc. 12980 Metcalf, Suite 325, Overland Park, KS 66213, United States.
| | - Laura Eickman
- REbeL, Inc. 12980 Metcalf, Suite 325, Overland Park, KS 66213, United States
| | - Catherine E Byrne
- George Mason University, Department of Psychology, 4400 University Drive, 3F5, Fairfax, VA 22030, United States
| | - Sarah Fischer
- George Mason University, Department of Psychology, 4400 University Drive, 3F5, Fairfax, VA 22030, United States
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Hughes EK, Mundy LK, Romaniuk H, Sawyer SM, Wake M, Williams J, Olds T, Allen NB, Patton GC. Body Image Dissatisfaction and the Adrenarchal Transition. J Adolesc Health 2018; 63:621-627. [PMID: 30120063 DOI: 10.1016/j.jadohealth.2018.05.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 05/04/2018] [Accepted: 05/04/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Puberty marks a transition in risk for body image disturbance and disordered eating. Yet few studies have examined these symptoms across puberty and none have examined links with adrenarche, the earliest phase in the pubertal hormonal cascade. METHOD Levels of adrenal androgens (dehydroepiandrosterone, dehydroepiandrosterone sulphate, and testosterone) were measured in a population-based study of 8- to 9-year-old children (516 males and 621 females). Body dissatisfaction was measured using the Kids' Eating Disorder Scale Silhouettes. Covariates included body mass index, age, and socioeconomic status. RESULTS There were significant associations between adrenal androgen levels and greater body dissatisfaction in both males and females. Specifically, females with more advanced levels of dehydroepiandrosterone and testosterone relative to peers, and males with more advanced levels of testosterone relative to peers, reported greater body dissatisfaction. However, after adjusting for covariates, hormones levels were no longer associated with body dissatisfaction, and only higher body mass index had a clear association with body dissatisfaction. CONCLUSIONS The adrenarchal transition brings a heightened risk for body dissatisfaction. Whether this arises from the neuroendocrine effects of adrenal androgens or as a reaction to the greater body mass that accompanies adrenarche requires further exploration.
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Affiliation(s)
- Elizabeth K Hughes
- The University of Melbourne, Parkville, Victoria, Australia; Murdoch Children's Research Institute, Parkville, Victoria, Australia; Royal Children's Hospital, Parkville, Victoria, Australia.
| | - Lisa K Mundy
- The University of Melbourne, Parkville, Victoria, Australia; Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Helena Romaniuk
- The University of Melbourne, Parkville, Victoria, Australia; Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Susan M Sawyer
- The University of Melbourne, Parkville, Victoria, Australia; Murdoch Children's Research Institute, Parkville, Victoria, Australia; Royal Children's Hospital, Parkville, Victoria, Australia
| | - Melissa Wake
- The University of Melbourne, Parkville, Victoria, Australia; Murdoch Children's Research Institute, Parkville, Victoria, Australia; Deakin University, Burwood, Victoria, Australia
| | - Joanne Williams
- University of Auckland, Auckland, New Zealand; Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Timothy Olds
- Murdoch Children's Research Institute, Parkville, Victoria, Australia; University of South Australia, South Australia, Australia
| | - Nicholas B Allen
- The University of Melbourne, Parkville, Victoria, Australia; University of Oregon, Eugene, Oregon
| | - George C Patton
- The University of Melbourne, Parkville, Victoria, Australia; Murdoch Children's Research Institute, Parkville, Victoria, Australia; Royal Children's Hospital, Parkville, Victoria, Australia
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Yu Z, Indelicato NA, Fuglestad P, Tan M, Bane L, Stice C. Sex differences in disordered eating and food addiction among college students. Appetite 2018; 129:12-18. [DOI: 10.1016/j.appet.2018.06.028] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 06/18/2018] [Accepted: 06/19/2018] [Indexed: 01/22/2023]
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Pedersen L, Hicks RE, Rosenrauch S. Sociocultural pressure as a mediator of eating disorder symptoms in a non-clinical Australian sample. COGENT PSYCHOLOGY 2018. [DOI: 10.1080/23311908.2018.1523347] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Affiliation(s)
- Linda Pedersen
- School of Psychology, Bond University, Robina, Queensland 4229, Australia
| | - Richard E. Hicks
- School of Psychology, Bond University, Robina, Queensland 4229, Australia
| | - Sharon Rosenrauch
- School of Psychology, Bond University, Robina, Queensland 4229, Australia
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49
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Agam-Bitton R, Abu Ahmad W, Golan M. Girls-only vs. mixed-gender groups in the delivery of a universal wellness programme among adolescents: A cluster-randomized controlled trial. PLoS One 2018; 13:e0198872. [PMID: 29912918 PMCID: PMC6005464 DOI: 10.1371/journal.pone.0198872] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 04/22/2018] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Investigation of the optimal setting for body image prevention programmes is important to maximize the outcomes of such programmes. OBJECTIVES We examined the preferred setting for a school-based wellness programme called "In Favour of Myself". METHODS A total of 259 girls (mean 13.82±0.64 years) were divided into a girls-only intervention group, a mixed-gender intervention and a waiting list control group. The participants completed self-report questionnaires at baseline, post-intervention (2 months) and at follow-up (3 months) examining changes in self-esteem, media literacy, body image and risk factors for eating disorders. The intervention group participants also completed a satisfaction questionnaire. RESULTS Both intervention groups demonstrated statistically significant improvements in identifying advertising strategies (p<0.01) compared with the controls, with the girls-only arm (p<0.001) showing better results. Compared with the girls-only arm and the control group, the mixed-gender group demonstrated statistically significantly greater improvements in the internalization of pressure for thinness (p<0.004), the body-esteem appearance subscale (p<0.025) and body-esteem body-weight subscale (p<0.012) as well as reductions in their perceived current body silhouettes and in the gap between their current and ideal body image (p<0.003). Body dissatisfaction was increased following the programme, although not in a statistically significant manner, with the worst negative effect observed in the girls-only arm. All other differences among the study arms did not show statistically significant differences. Mediation models revealed that body-esteem was directly mediated by group, with statistically significant mediation only in the mixed group. Current body image was mediated indirectly by group through media literacy (i.e., recognizing advertisement strategies and internalization of pressure for thinness), with statistical significance only in the mixed-gender arm compared with the girls-only arm. Higher programme satisfaction was reported in the mixed-gender group (91%) vs. the girls-only groups (79%). CONCLUSIONS These outcomes provide preliminary evidence indicating the superiority of a mixed-gender setting compared with a girls-only setting for delivering prevention programmes to 13- to 14-year-old adolescents to enhance their media literacy, positive self-esteem and body image. TRIAL REGISTRATION NCT02653586.
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Affiliation(s)
- Reut Agam-Bitton
- Department of Nutritional Sciences, Tel Hai College, Upper Galilee, Israel
| | - Wiessam Abu Ahmad
- Department of Nutritional Sciences, Tel Hai College, Upper Galilee, Israel
- Hebrew University-Hadassah Braun School of Public Health and Community Medicine, Jerusalem, Israel
| | - Moria Golan
- Department of Nutritional Sciences, Tel Hai College, Upper Galilee, Israel
- Shahaf, Community Services for the Management of Weight-Related Problems, Tel Aviv, Israel
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50
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Mahoney B. Aging Anxieties and Disturbed Eating in Female Students: It's not all About Aging Appearance Concern. EUROPES JOURNAL OF PSYCHOLOGY 2018; 14:7-27. [PMID: 29899795 PMCID: PMC5973514 DOI: 10.5964/ejop.v14i1.1390] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 08/14/2017] [Indexed: 11/28/2022]
Abstract
Fear and anxiety about aging have increased amongst female university students and these personal aging concerns are associated with disturbed eating, also prevalent in this group. Evidence suggests concern about aging appearance could account for the link between aging anxiety and problem eating in young women due to their belief in the thin – youth ideal. However, whether appearance concern is the strongest aging anxiety predictor of global and specific disturbed eating behaviors is unclear. The study examines this in a sample of female students at a Midlands university in the United Kingdom (N = 200, 18 – 39 years) who completed the Anxiety about Aging Scale and the Eating Disorders Inventory-3. The findings show general and a model of four aging anxieties predicted significantly greater global disturbed eating with medium and large effects sizes respectively. However, greater anxiety about the psychological challenges and interpersonal losses associated with aging best predicted global and specific disturbed eating behaviors and aging appearance concern was a weaker predictor. Implications for interventions targeting female students eating behavior are considered.
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Affiliation(s)
- Béré Mahoney
- Department of Psychology, University of Worcester, Worcester, United Kingdom
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