Meta-analytic review of dissonance-based eating disorder prevention programs: Intervention, participant, and facilitator features that predict larger effects

Abstract

Many trials have provided support for dissonance-based eating disorder prevention programs. This meta-analytic review characterized the average intervention effects and tested whether various intervention, participant, and facilitator features correlated with larger effects to guide implementation of optimally effective versions of this program. We identified 56 trials that evaluated 68 dissonance-based eating disorder prevention programs (7808 participants). Average intervention effect sizes (d) relative to minimal intervention control conditions and credible alternative interventions (respectively) were 0.57 and 0.31 for thin-ideal internalization, 0.42 and 0.18 for body dissatisfaction, 0.37 and 0.17 for dieting, 0.29 and 0.21 for negative affect, and 0.31 and 0.13 for eating disorder symptoms. As hypothesized, effects were larger for interventions with more dissonance-inducing activities, more group sessions, and larger group sizes, as well as when delivered in-person versus on-line, sessions were recorded, participation was voluntary, body dissatisfaction was required, participants were mid-adolescents or adults (versus older adolescence), there were more ethnic minority participants, groups were led by clinicians versus researchers and at least two facilitators, and when facilitators received more training and supervision. Unexpectedly from a dissonance-induction perspective, effects were larger when participants were compensated. Results offer directions for maximizing the benefits of implementation efforts with dissonance-based eating disorder prevention programs, and may hold lessons for preventing other public health problems with dissonance-based interventions.

Disordered eating,self‐esteem, and depression symptoms in Iranian adolescents and young adults: A network analysis

“…With respect to ED prevention specifically, one prevention program that has demonstrated efficacy is the Body Project (e.g., Le, Barendregt, Hay, & Mihalopoulos, 2017). The Body Project is a dissonance‐based program that directly targets thin‐ideal internalization and greatly decreases risk for ED development among females (Stice, Marti, Shaw, & Rohde, 2019; Stice, Rohde, Shaw, & Gau, 2011). The Body Project has not been evaluated in Iranian people, and only preliminary evidence is available for males (Brown & Keel, 2015).…”

The Impact of a Dissonance-Based Eating Disorders Intervention on Implicit Attitudes to Thinness in Women of Diverse Sexual Orientations

“…The SBIP meets the “gold standard” for eating disorder prevention via body image resilience, with effectiveness appearing to rest on it being interactive, multi-sessional, and dissonance-based instead of being didactic, single session, and psychoeducational (Stice and Shaw, 2004; Stice et al, 2019). As discussed above, however, traditional dissonance interventions have had difficulty in inducing implicit changes in participants.…”

“…Despite well-documented decreases in eating disorder risk, however, the mechanism by which these improvements come about remains opaque. While cognitive dissonance purports to induce genuine change in attitudes, the outcomes tested in the research into eating disorder prevention have almost entirely been explicit, self-report measures which are inherently open to self-report bias (for key reviews see, e.g., Stice and Shaw, 2004; Pennesi and Wade, 2016; Stice et al, 2019). For instance, it may be that participation in body-positive interventions helps participants to ignore their internalized thin ideals without actually changing those internal ideas, or the intervention may lead them to believe that reporting such ideals is socially undesirable, and thus under-report their internal ideals and eating disorder symptomology.…”

Uso da mídia social e sua associação com comportamentos alimentares disfuncionais em estudantes de Nutrição

“…No campo de prevenção dos transtornos alimentares, algumas estratégias já foram desenvolvidas, com destaque para programas de prevenção direcionados para populações seletivas, ou seja, aquelas como maiores riscos de desenvolvimento de transtornos alimentares 37 , como é o caso de estudantes de Nutrição. Programas preventivos com base na dissonância cognitiva têm demonstrado elevada eficácia e eficiência em populações seletivas 11,37 e podem ser implementados no contexto de formação de estudantes de Nutrição como uma estratégia de prevenção de desenvolvimento de transtornos alimentares.…”