Prevention of eating disorders: current evidence-base for dissonance-based programmes and future directions

Dakanalis, Antonios; Clerici, Massimo; Stice, Eric

doi:10.1007/s40519-019-00719-3

Cited by 23 publications

(29 citation statements)

References 81 publications

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“…Cognitive dissonance is currently one of the most effective approaches (Le et al, 2017), in which participants engage in counter‐attitudinal verbal, behavioral and written exercises to challenge internalized sociocultural appearance ideals over a period of 2–6 hr of modular interactive sessions (Stice, Shaw, Becker, & Rohde, 2008). Guided by cognitive dissonance theory (Festinger, 1957) and the dual pathway model of bulimia nervosa pathology (Stice, 2001), dissonance‐based interventions primarily target appearance‐ideal internalization and have demonstrated efficacy in reducing multiple risk factors and onset of eating disorders in adolescent girls and young women up to 3 years later (Dakanalis, Clerici, & Stice, 2019; Stice, Marti, Shaw, & Rohde, 2019). More recently, mindfulness‐based eating disorder prevention has received preliminary support (Beccia, Dunlap, Hanes, Courneene, & Zwickey, 2018).…”

Section: Introductionmentioning

confidence: 99%

Examining the efficacy of video‐based microinterventions for improving risk and protective factors for disordered eating among young adult women

Atkinson

Diedrichs

2021

Intl J Eating Disorders

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Objective Brief self‐guided activities designed for focused and immediate benefits, termed microinterventions, have the potential to aid reach and engagement in mental health interventions; however further validation is needed. This study evaluated effects of two microinterventions for responding to appearance‐ideal media on risk and protective factors for disordered eating. Method Undergraduate women (N = 202, Mage = 19.90, SD = 2.75) were allocated quasi‐randomly to one of three 15‐min video‐based microinterventions (mindfulness, cognitive dissonance, educational control) in the lab and assessed on state outcomes at baseline and immediate posttest. One week later, trait factors were assessed and participants underwent an appearance‐ideal media exposure task. Results Both mindfulness and dissonance groups reported significant immediate benefits to state appearance‐ideal internalization, perceived sociocultural pressures and related distress, and mood, compared to educational control (Glass's Δ effect sizes = .40–.94), but not state weight or appearance satisfaction. At 1‐week follow‐up, mindfulness and dissonance groups demonstrated improved trait appearance‐ideal internalization (Δ = .40 and .42), weight and shape concerns (Δ = .27 [ns] and .44), and body appreciation (Δ = .39 and .46) compared to the educational control. There were no effects on trait perceived pressures, negative affect, or body image psychological flexibility, and no differential changes in state outcomes from premedia to postmedia exposure. Discussion Microinterventions using mindfulness and dissonance techniques show promise for improving some risk and potential protective factors for disordered eating in the immediate and short‐term. Further research is required to substantiate their place within the spectrum of eating disorder prevention, early intervention and treatment techniques.

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Section: Introductionmentioning

confidence: 99%

Examining the efficacy of video‐based microinterventions for improving risk and protective factors for disordered eating among young adult women

Atkinson

Diedrichs

2021

Intl J Eating Disorders

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“…The findings from studies have revealed significant, small to moderate effects on eating disorder symptoms and risk factors [3]. Successful programmes are carried out in groups and involve dissonance-based intervention, cognitive behaviour therapy, media literacy education, self-esteem enhancement strategies and stress management skills [3,[5][6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Effect of an education and mindfulness-based physical activity intervention for the promotion of positive body image in Lithuanian female students

2021

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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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“…Finally, research has suggested evaluating optimal methods for disseminating ED prevention programs, including DB interventions (Dakanalis, Clerici, & Stice, 2019; Stice et al, 2019). Although efficacious ED prevention programs exist, few studies have explored how to implement them more broadly (Stice et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Dissonance‐based eating disorder prevention delivered in‐person after an online training: A randomized controlled trial for Brazilian men with body dissatisfaction

Almeida

Brown

Campos

et al. 2020

Intl J Eating Disorders

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Objective Few prevention programs have been developed and empirically evaluated to address eating disorder (ED) and muscle dysmorphia (MD) symptoms in men. Furthermore, new strategies for the broad implementation of available programs are needed. We investigated the acceptability and efficacy of a dissonance‐based (DB) intervention for Brazilian undergraduate men with body dissatisfaction to target risk and protective factors for ED and MD symptoms (the Body Project: More Than Muscles) after an online training for facilitators. Method Participants were randomized to a two‐session DB‐intervention (n = 89) or assessment‐only control (AOC) (n = 91), and completed validated measures assessing ED and MD risk and protective factors pre‐intervention, post‐intervention, and at 4‐ and 24‐week follow‐up post‐intervention. Results Acceptability ratings were highly favorable. Regarding efficacy, the DB condition demonstrated significantly greater decreases in ED and MD risk factors compared to AOC from pre‐intervention to 4‐week (p‐values <.05, between‐condition Cohen's d = 0.35–1.10) and 24‐week follow‐up (p‐values <.05, between‐condition Cohen's d = 0.33–0.78). Results at post‐intervention were not significant, with the exception that body appreciation showed significantly greater improvements in the DB condition (post‐intervention: p < .01, between‐condition Cohen's d = 0.40; 4‐week: p < .001, between‐condition Cohen's d = 0.80; and 24‐week follow‐up: p < .001, between‐condition Cohen's d = 0.58). Discussion Results support the acceptability and efficacy of a DB‐intervention delivered in‐person after an online training for facilitators up to 24‐week follow‐up in Brazilian men.

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Prevention of eating disorders: current evidence-base for dissonance-based programmes and future directions

Cited by 23 publications

References 81 publications

Examining the efficacy of video‐based microinterventions for improving risk and protective factors for disordered eating among young adult women

Examining the efficacy of video‐based microinterventions for improving risk and protective factors for disordered eating among young adult women

Effect of an education and mindfulness-based physical activity intervention for the promotion of positive body image in Lithuanian female students

Dissonance‐based eating disorder prevention delivered in‐person after an online training: A randomized controlled trial for Brazilian men with body dissatisfaction

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