Online imagery rescripting among young women at risk of developing an eating disorder: A randomized controlled trial

Abstract

Objective: This study compared the effectiveness of two approaches to imagery rescripting (body versus general) among young women with an elevated risk of developing an eating disorder. Method: University students (N = 130 females) were randomly assigned to one of the four conditions: body or general imagery rescripting, psychoeducation, control. After initial brief laboratory training delivered online, participants in the imagery rescripting conditions were asked to practice imagery rescripting for 5 min each day for a week. Primary (global eating psychopathology, eating disorder behaviors, and body image acceptance) and secondary outcomes (self-compassion, fear of self-compassion, and dysfunctional attitudes) were measured at baseline and one-week follow up. Results: Completer analyses showed both imagery rescripting conditions and psychoeducation had significant impact on global eating psychopathology and body acceptance (d = 0.60-0.78). Psychoeducation did not impact secondary variables, whereas body imagery rescripting improved self-compassion and fear of self-compassion (d = 0.61-0.80) and general imagery rescripting improved dysfunctional attitudes (d = 0.82) compared to control. Intent to treat analyses had similar but slightly less robust results. Discussion: While three active groups had significant impact on the primary variables, imagery rescripting approaches had impact on other variables that maintain disordered eating. Future research should investigate the impact of combining psychoeducation and imagery rescripting in terms of impact on disordered eating.

The impact of COVID‐19 on body‐dissatisfied female university students

“…Specifically, participants first completed baseline measures after which they received a body‐specific negative mood induction (details can be found in Zhou, Pennesi, & Wade, 2020). Then participants either get randomly allocated to an active intervention (e.g., imagery rescripting, psychoeducation, or the combination of the two) or control.…”

Imagery Rescripting of Autobiographical Memories Versus Intrusive Images in Individuals with Disordered Eating

“…That is, the effects may have been different or stronger, if participants had used adaptive strategies more frequently. As previous studies typically have not reported the used strategies qualitatively, the use of non-adaptive ImRs scripts may also have been a problem in earlier studies (e.g., Pennesi & Wade, 2018;Zhou et al, 2020). Indeed, a recent study in social anxiety explored the strategies that patients used during a single ImRs session and, strikingly, 43% of the participants chose at least one avoidant strategy even though in this study the ImRs was therapist guided (Romano et al, 2020).…”

“…These studies indicate that ImRs has potential as a brief, easily accessible intervention for at-risk populations. However, effect sizes for the change in core beliefs were small (g = 0.2; Cooper et al, 2007), and medium for disordered eating (d = 0.59-0.64; Pennesi & Wade, 2018;Zhou et al, 2020). Furthermore, a recent randomized control trial in patients with anorexia nervosa showed that receiving one ImRs session before the treatment compared to treatment only actually slowed down symptom reduction (Zhou & Wade, 2021).…”

“…In two pilot studies in bulimia nervosa, an ImRs session targeting traumatic memories decreased negative core beliefs (Cooper et al, 2007), although its effect did not significantly differ from cognitive restructuring (Dugué et al, 2018). Two studies in women with ED symptoms reported that a 5-min self-guided ImRs task delivered online for 1 week was associated with reduced disordered eating compared to a no-task control condition (Pennesi & Wade, 2018;Zhou et al, 2020). These studies indicate that ImRs has potential as a brief, easily accessible intervention for at-risk populations.…”

Open science practices for eating disorders research

“…Increasingly, funders not only require but also monitor grant recipients' compliance with trial registration and sanction those who fail to comply (e.g., The Wellcome Trust, 2021). Consequently, preregistration of prevention or treatment trials is common and is required for publication in the three major eating disorder journals: the IJED (e.g., König et al, 2018;Sadeh-Sharvit et al, 2018;Zhou, Pennesi, & Wade, 2020), the European Eating Disorders Review, and the Journal of Eating Disorders.…”