Educating Medical Students About Anorexia Nervosa: A Potential Method for Reducing the Volitional Stigma Associated With the Disorder

Abstract

It is frequently reported that clinicians across a range of professional disciplines experience strong negative reactions toward patients with anorexia nervosa (AN). The present study aimed to develop, evaluate, and compare the effectiveness of two different educational programs, based on an etiological framing model. Participants were medical students (N = 41) from an Australian University, who were randomly assigned to one of three conditions (biogenetic intervention vs. multifactorial intervention vs. control). Outcome attitudinal/stigma data were collected pre- and post-intervention, and at 8 weeks follow-up. Results indicated intervention participations exhibited significantly lower volitional stigma scores compared to the control group, who exhibited no change in attitudes or stigma. Specifically, intervention participants had significantly lower total ED stigma scores, levels of blame, perceptions of AN as a selfish/vain illness, and viewed sufferers as less responsible for their illness at post-intervention. These reductions were maintained at follow-up. Overall, the study provides preliminary evidence that brief targeted interventions can assist in reducing levels of volitional stigma toward AN.

Interventions to reduce the stigma of eating disorders: A systematic review and meta‐analysis

“…Findings are grouped by type of stigma outcome (attitudinal, affective and behavioral outcomes). Two studies—Wingfield et al () and Bannatyne and Stapleton () compared different etiological explanations with a control (no explanation or no intervention). Four—Bannatyne and Abel (), Borenstein (), and Crisafulli, Von Holle, et al () and Crisafulli, Thompson‐Brenner, et al () compared etiological explanations with each other.…”

“…Six studies examining etiological explanations of ED included attitudinal outcomes of stigma (Bannatyne & Abel, ; Bannatyne & Stapleton, ; Borenstein, ; Crisafulli, Von Holle, et al, ; Crisafulli, Thompson‐Brenner, et al, ; Wingfield et al, ), for example, attitudes toward people with ED such as personal responsibility and blame. All but one (Crisafulli, et al, ) included more than one attitudinal measure of stigma.…”

“…All but one (Crisafulli, et al, ) included more than one attitudinal measure of stigma. All studies included biological explanations (Bannatyne & Abel, ; Bannatyne & Stapleton, ; Borenstein, ; Crisafulli, Thompson‐Brenner, et al, ; Crisafulli, Von Holle, et al, ; Wingfield et al, ), four included sociocultural explanations (Bannatyne & Abel, ; Crisafulli, Von Holle, et al, ; Crisafulli, et al, ; Wingfield et al, ), three included multifactorial explanations (Bannatyne & Abel, ; Bannatyne & Stapleton, ; Crisafulli, et al, ), and two included environmental explanations (Bannatyne & Abel, ; Borenstein, ). All but one study, by Wingfield et al () specifically examined AN as the target diagnosis (i.e., the person in the vignette was identified as someone with AN).…”

“…Within the etiological explanations technique, in relation to EDs, there are two common explanations used. The first is explaining that EDs are primarily caused by biological factors (Bannatyne & Abel, ; Bannatyne & Stapleton, ; Borenstein, ; Crisafulli, Thompson‐Brenner, Franko, Eddy, & Herzog, ; Crisafulli, Von Holle, et al, ; Wingfield, Kelly, Serdar, Shivy, & Mazzeo, ). This is because illnesses perceived as being biological in origin are associated with less personal responsibility for illness (Crisafulli, Von Holle, et al, ; Weiner, ).…”

“…By explaining that an ED is caused by factors beyond the individual's control, beliefs about personal responsibility may be reduced. The second common approach within the etiological explanations technique is to explain that EDs are the result of sociocultural and environmental factors such as trauma, pressure from media, and thin‐ideal internalization (Crisafulli, Von Holle, et al, ; Bannatyne & Abel, ; Bannatyne & Stapleton, ; Borenstein, ; Crisafulli, Thompson‐Brenner, Franko, Eddy, & Herzog, ; Wingfield et al, ). However, there may be the belief in the community that individuals ought to be able to manage these pressures, and therefore these explanations may be associated with study participants attributing more personal responsibility for EDs (Crisafulli, Von Holle, et al, ).…”