Randomized Controlled Pilot Trial of a Novel Dissonance-Based Group Treatment for Eating Disorders

Stice, Eric; Rohde, Paul; Butryn, Meghan L.; Menke, Katharine; Marti, C. Nathan

doi:10.1016/j.brat.2014.12.012

Cited by 36 publications

(48 citation statements)

References 66 publications

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“…A third limitation of this study is the diagnostic heterogeneity of the sample which might have hampered the detection of intervention effects. However, it should be noted that prior studies with similar diagnostic heterogeneity have found significant reductions in negative body image (e.g., Stice, Rohde, Butryn, Menke & Marti, 2015;Hildebrandt, Loeb, Troupe & Delinsky, 2012). Finally, although the standard pictures of the control bodies were adapted to the age category of the participants, it was not feasible to adapt the face stimuli.…”

Section: Discussionmentioning

confidence: 97%

Evaluative conditioning as a body image intervention for adolescents with eating disorders.

Glashouwer¹,

Neimeijer²,

Koning³

et al. 2018

Journal of Consulting and Clinical Psychology

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Objective: The aim was to investigate whether a computer-based evaluative conditioning intervention improves body image in adolescents with an eating disorder. Positive effects were found in earlier studies in healthy female students in a laboratory and a field setting. This study is the first to test evaluative conditioning in a clinical sample under less controlled circumstances. Method: Fifty-one adolescent girls with an eating disorder and a healthy weight were randomly assigned to an experimental condition or a placebo-control condition. The computerized intervention consisted of six online training sessions of 5 minutes, in which participants had to click on pictures of their own and other people's bodies. Their own pictures were systematically followed by portraits of friendly smiling faces. In the control condition, participants were shown the same stimuli, but here, a stimulus was always followed by another stimulus from the same category, so that own body was not paired with smiling faces. Before, directly after, three weeks after and 11 weeks after the intervention, self-report measures of body image and general self-esteem were administered. Automatic selfassociations were also measured with an Implicit Association Test (IAT). Results: In contrast to our hypotheses, we did not find an effect of the intervention on self-report questionnaires measuring body satisfaction, weight and shape concern, and general self-esteem. In addition, the intervention did not show positive effects on implicit associations regarding selfattractiveness. Conclusions: These findings do not support the use of evaluative conditioning in its present form as an intervention for adolescents in clinical practice.

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Section: Discussionmentioning

confidence: 97%

Evaluative conditioning as a body image intervention for adolescents with eating disorders.

Glashouwer¹,

Neimeijer²,

Koning³

et al. 2018

Journal of Consulting and Clinical Psychology

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show abstract

“…To properly interpret the non-significant effects, it is vital to determine whether the supportive mindfulness treatment is effective. We compared the average within-condition pre-post d for BPT and supportive mindfulness treatment in this study, as well as the parallel effect sizes from BPT and usual care in the initial trial (Stice et al, 2015) of this new treatment (Table 6). The average effects reveal four important trends.…”

Section: Discussionmentioning

confidence: 99%

Randomized trial of a dissonance-based group treatment for eating disorders versus a supportive mindfulness group treatment.

Stice¹,

Rohde²,

Shaw³

et al. 2019

Journal of Consulting and Clinical Psychology

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Objective: Evaluate a dissonance-based group eating disorder treatment designed to be a cost-effective front-line transdiagnostic treatment that could be more widely implemented than extant treatments that are more intensive and expensive relative to a supportive mindfulness group treatment typical of that offered at colleges. Method: Young women with eating disorders (N = 84) were randomized to 8-week dissonance-based Body Project Treatment (BPT) or supportive mindfulness treatment, completing diagnostic interviews and questionnaires at pretest, posttest, and 6-month follow-up. Results: Regarding primary outcomes, by 6-month follow-up 77% of BPT participants no longer met diagnosis for an eating disorder versus 60% of supportive mindfulness participants (relative risk ratio = 2.22; 95% CI = 1.01–4.93), though groups did not differ on eating disorder symptom change. Regarding secondary outcomes, BPT versus supportive mindfulness participants showed significantly lower dissonance about affirming the thin ideal at posttest and 6-month follow-up (d = .38 & .32), body dissatisfaction at posttest and 6-month follow-up (d = .62 & .62), negative affect at posttest and 6-month follow-up (d = .49 & .48), and functional impairment (d = .36) at 6-month follow-up; differences in thin-ideal internalization and abstinence from binge eating and compensatory behaviors were not significant. Conclusions: Whereas both treatments appeared effective, BPT produced larger effects and significantly greater remission of eating disorder diagnoses than a credible alternative treatment, which is very rare for trials that have compared active eating disorder treatments. Results suggest it would be useful to refine BPT and conduct target engagement research and efficacy trials.

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“…The most effective and well-studied eating disorder prevention programs, cognitive dissonance programs (Stice et al, 2013), have been shown to reduce thin-ideal internalization and disordered eating in non-clinical and clinical samples of adolescent girls (e.g., Becker, Bull, Schaumberg, Cauble, & Franco, 2008; Becker, Smith, & Ciao, 2006; Coughlin & Kalodner, 2006; Stice et al, 2013; Stice, Rohde, Butryn, Menke, & Marti, 2015; Yamamiya et al, 2005). These prevention programs focus on changing interpretations of beauty ideals by providing psychoeducation on the realities of images presented in the media (e.g., digital editing of body sizes) and asking participants to engage in writing and other activities that actively argue against the thin-ideal.…”

Section: Discussionmentioning

confidence: 99%

Socialization and selection effects in the association between weight conscious peer groups and thin-ideal internalization: A co-twin control study

et al. 2016

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Affiliation with weight conscious peer groups is theorized to increase thin-ideal internalization through socialization processes. However, selection effects could contribute if genetic and/or environmental predispositions lead to affiliation with weight conscious peers. Co-twin control methodology was used to examine socialization and selection effects in 614 female twins (ages 8–15) from the Michigan State University Twin Registry (MSUTR). Thin-ideal internalization and peer group characteristics were assessed via self-report questionnaires. Results suggested the presence of both socialization and selection effects. In terms of socialization, twins who reported increased exposure to weight conscious peers relative to their co-twins had elevated thin-ideal internalization scores, regardless of zygosity. However, associations between weight conscious peers and thin-ideal internationalization within twin pairs were attenuated, suggesting that genetic and shared environmental selection effects also contribute. Findings significantly extend previous work by confirming the presence of socialization processes and highlighting selection processes to be examined in future longitudinal research.

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Randomized Controlled Pilot Trial of a Novel Dissonance-Based Group Treatment for Eating Disorders

Cited by 36 publications

References 66 publications

Evaluative conditioning as a body image intervention for adolescents with eating disorders.

Evaluative conditioning as a body image intervention for adolescents with eating disorders.

Randomized trial of a dissonance-based group treatment for eating disorders versus a supportive mindfulness group treatment.

Socialization and selection effects in the association between weight conscious peer groups and thin-ideal internalization: A co-twin control study

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