Eating disorders (ED) constitute a serious public health issue affecting predominantly women and appearing typically in adolescence or early adulthood. EDs are extremely difficult to treat, as these disorders are ego-syntonic, and many patients do not seek treatment. It is vital to focus on the development of successful early-intervention programs for individuals presenting at risk and are on a trajectory towards developing EDs. This study is a randomized controlled trial evaluating an innovative digital gamified Acceptance and Commitment early-intervention program (AcceptME) for young females showing signs and symptoms of an ED and at high risk for an ED. Participants (n = 92; Mage = 15.30 years, SD = 2.15) received either AcceptME (n = 62) or a waitlist control (n = 30). Analyses indicated that the AcceptME program effectively reduced weight and shape concerns with large effects when compared to waitlist controls. Most participants scored below the at-risk cut-off (WCS score < 52) in the AcceptME at end-of-intervention (57.1%) compared to controls (7.1%), with odds of falling into the at-risk group being 14.5 times higher for participants in the control group. At follow-up, 72% of completers reported scores below the at-risk cut-off in the AcceptME group. The intervention also resulted in a decrease in ED symptomatology and increased body image flexibility. Overall, results suggest that the AcceptME program holds promise for early-intervention of young women at risk for developing an ED.

The present study aimed to examine the psychometric properties and factorial structure of the Greek version of the Body Image-Acceptance and Action Questionnaire (BI-AAQ). The BI-AAQ assesses cognitive flexibility and acceptance relative to body image. Two samples: an all female middle and high school sample (N = 85; Age M = 17.97, SD = 2.74) and a college student sample (N = 240; Age M = 21.50; SD = 2.98) in Cyprus completed a set of self-reported eating-related questionnaires. Reliability analysis showed that the Greek BI-AAQ has high internal consistency and good item-total correlations. Principal Component Analysis (Sample 1) and Confirmatory Factor Analysis (Sample 2) supported a one-factor solution, as in the case of the original BI-AAQ. Hierarchical multiple regression predicting eating disorder behaviors (as assessed by the EDE-Q) from Weight Concerns (WCS) and BI-AAQ scores after controlling for BMI, produced a significant model, which accounted for 67% of variance. The BI-AAQ remained a significant predictor of eating disorder behaviors after controlling for BMI and weight concerns scores. The Greek version of the BI-AAQ questionnaire is thus a robust and reliable instrument. It adds to previous knowledge and research on the role of psychological flexibility and acceptance of body image in eating disorder behaviours and psychological difficulties.

The present study aimed to explore the prevalence rates of eating disorders among Greek-Cypriot adolescents and young adults and examine the role of the following variables in relation to eating disorder risk: gender, age, dieting, exercise and present-ideal weight discrepancy. One thousand and eighty-one middle, high school and university students responded to self-reported measures assessing eating disorders, weight-related concerns and behaviors. Prevalence estimates were 26% for high eating disorder risk and 14.98% for subthreshold eating disorders symptoms while 12% of participants met criteria of an eating disorder diagnosis. Multivariate logistic regression confirmed well-established predictors for eating disorder risk including present to ideal weight discrepancy which had a differential effect on risk in adolescents (i.e., 6-10 kg) and young adults (11+kg). This is the first study to provide prevalence rates of the entire eating pathology spectrum among Greek-Cypriot youth. Results are discussed in terms of their implications in the development of age-specific screening tools and prevention programs.

No abstract

Background: Digital prevention programs for a variety of psychological conditions, including eating disorders (EDs) are increasing. Yet, none to date have leveraged gamification and vicarious learning components grounded in empirically-supported therapeutic approaches to engage young people at risk for developing EDs in behavior change. The current paper describes the development and preliminary acceptability and feasibility testing of AcceptME, a novel self-directed, gamified digital ED selective prevention program based on Acceptance and Commitment Therapy (ACT). AcceptME helps women and girls identified at risk for an ED relate differently to their thoughts and feelings, such that these experiences do not have undue influence over their behavior and actions can instead be guided by personal values. Methods: Users learned skills of psychological flexibility by helping a third-person avatar (a main character in a storyline) navigate situations that elicit distressing thoughts/feelings, and via interactive exercises, practiced applying these skills to their own experiences. Young women and girls in the Republic of Cyprus with high weight concern scores (N=58, Mage=15.27, SD=2.25) completed six 30-minute digital sessions and reported on session and intervention acceptability.Results: Attrition was 35.42%. The majority of participants were either “Very” (40%) or “Mostly” (57%) Satisfied with the program. Fifty-two percent reported that the program “Helped a lot,” and 48% said it “Helped a bit.” Conclusion: Digital technology and gamification have advantages for engagement and delivery. The current study suggests a promising direction for early ED interventions to reach at risk youth and preliminary data to guide development.