Dissonance prevention program decreases thin-ideal internalization, body dissatisfaction, dieting, negative affect, and bulimic symptoms: A preliminary experiment

Abstract

Objective Because psychoeducational primary prevention programs for eating disorders have met with little success, this preliminary experiment tested a dissonance‐based targeted preventive intervention. Method Female undergraduates (N = 30) with elevated body image concerns were assigned to a three‐session intervention, wherein they voluntarily argued against the thin ideal, or a delayed‐intervention control condition. Participants completed a baseline, termination, and a 1‐month follow‐up survey. Results The intervention resulted in a subsequent decrease in thin‐ideal internalization, body dissatisfaction, dieting, negative affect, and bulimic symptomatology, with most changes remaining at the 1‐month follow‐up. Discussion These preliminary results suggest that this dissonance‐based targeted prevention intervention reduces bulimic pathology and known risk factors for eating disturbances, and provide experimental support for the claim that thin‐ideal internalization contributes to body dissatisfaction, dieting, negative affect, and bulimic symptoms. © 2000 by John Wiley & Sons, Inc. Int J Eat Disord 27: 206–217, 2000.

Associations Between Fear of Negative Evaluation and Eating Pathology During Intervention and 12-Month Follow-up

“…First, we found no significant main effect over time in either direction, nor did we find improvement in negative affect over the course of intervention and follow-up. This finding is inconsistent with studies demonstrating positive associations between FNE and negative affect (e.g., Weeks & Howell, 2012; Utschig et al, 2010) and reductions in negative affect across dissonance-based ED prevention programs (Becker, McDaniel, Bull, Powell, & McIntyre, 2012; Stice et al, 2001; 2000; 2006; 2008; 2002). A floor effect for negative affect may have accounted for these discrepant findings.…”

“…A floor effect for negative affect may have accounted for these discrepant findings. Scores on the PANAS-X typically range from about 2.10 to 2.22 ( SD = 0.69 to 0.98) in trials of dissonance prevention programs (e.g., McMillan, Stice, & Rohde, 2011; Stice, Mazotti, Weibel, & Agras, 2000; Stice, Presnell, Gau, & Shaw, 2007; Stice et al, 2008), whereas the mean score at baseline for the current sample was 1.52 ( SD = 0.57). The relatively low level of negative affect experienced by the participants at baseline may have left little room for improvement across the intervention, and the restricted range may have precluded significant associations with other variables.…”

“…Eating Disorders Diagnostic Scale (EDDS; Stice et al, 2000) scores indicated that 14 (17.3%) participants were experiencing clinically significant eating pathology at baseline. Two (2.5%) participants met full diagnostic criteria for bulimia nervosa and four (4.9%) met criteria for binge eating disorder.…”

“…The primary aim of the study was to examine outcome differences between a two-session version and a four-session version of the dissonance intervention, both of which effectively reduce ED risk factors (Becker et al, 2008; 2006; 2005; Stice et al, 2001; 2006; 2000; 2008 Stice et al, 2002). This study was guided by evidence that distributing prevention content across a greater number of sessions facilitates learning, consolidation, skills practice, and behavior change (Bouton, 2000, 2002) and by important clinical considerations such as increasing retention and enhancing group cohesion, which may be achieved by consolidating intervention content which reduces logistical scheduling difficulties.…”

“…Some of the most efficacious prevention programs have been informed by the dual-pathway model of bulimic pathology, which posits five risk factors for the development of bulimia nervosa: social pressure to be thin, thin ideal internalization, body dissatisfaction, dieting, and negative affect (Stice, 2001; Stice & Agras, 1998). Dissonance-based programs primarily target internalization of the thin ideal and have demonstrated both efficacy and effectiveness (Becker, Bull, Schaumberg, Cauble, & Franco, 2008; Becker, Smith & Ciao, 2006; Stice, Chase, Stormer, & Appel, 2001; Stice, Mazotti, Weibel, & Agras, 2000; Stice, Shaw, Burton, & Wade, 2006; Stice, Marti, Spoor, Presnell, & Shaw, 2008; Stice, Trost, & Chase, 2003). However, there is room for improvement.…”