Effectiveness of peer-led eating disorders prevention: A replication trial.

Abstract

The aim of this study was to replicate and extend results of a previous trial that investigated the effectiveness of 2 peer-led eating disorders prevention interventions in reducing eating disorder risk factors in undergraduate women (C. B. Becker, L. M. Smith, & A. C. Ciao, 2006). To extend findings from the previous study by allowing for investigation of differential response, the authors randomly assigned a larger sample of both higher and lower risk sorority members (N ϭ 188; age M ϭ 18.64 years, range ϭ 18 -21; 20% minority) to either a cognitive dissonance (CD) or a media advocacy (MA) intervention under naturalistic conditions. Interventions were delivered by trained sorority peer leaders and consisted of two 2-hr group sessions. Participants completed questionnaires that assessed eating disorder risk factors at pretreatment, posttreatment, 7-week follow-up, and 8-month follow-up. Results indicate that both interventions reduced thin-ideal internalization, body dissatisfaction, dietary restraint, and bulimic pathology at 8 months, although higher and lower risk participants responded somewhat differently. Both CD and MA generally appeared effective for higher risk participants; only CD, however, appeared to benefit lower risk participants. Results further support the viability of using peer leaders in dissonance-based prevention.

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

“…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.…”

Peer-facilitated cognitive dissonance versus healthy weight eating disorders prevention: A randomized comparison

“…CD also has proven effective in mixed risk populations. Becker and colleagues also have demonstrated via a series of studies that CD reduces ED pathology (typically measured via the diagnostic items of the Eating Disorder Examination-Questionnaire) when delivered to collegiate women who had not been selected because of body dissatisfaction (Becker, Smith, & Ciao, 2005;Becker, Smith, & Ciao, 2006;Becker, Bull, Schaumberg, Cauble, & Franco, 2008;Perez, Becker, & Ramirez, in press). This is important because many social systems prefer to deliver programs more universally as opposed to selecting (and possibly stigmatizing) high risk individuals.…”

“…This is important because many social systems prefer to deliver programs more universally as opposed to selecting (and possibly stigmatizing) high risk individuals. Becker and colleagues also demonstrated that undergraduate students could be trained to effectively lead CD to their mixed risk peers (Becker et al, 2006;Becker, Bull, Schaumberg et al, 2008).…”

“…This universal-selective prevention study compares peer-facilitated MHW to peerfacilitated CD when administered to a mixed risk population of college women (see Becker et al, 2005;Becker, Bull, Schaumberg et al, 2008 for evidence showing that sororities consist of members who are both at low and high risk, which is why we refer to this approach as universalselective). Because CD has been shown to produce superior results to waitlist/assessment only controls (e.g., Becker et al, 2005;Stice et al, 2006;, alternative interventions (e.g., Becker et al, 2006) and placebo control (e.g., Stice et al, 2006), we employed a comparative intervention strategy (Kazdin, 2003) and chose to compare peer-facilitated MHW with the ED prevention program that has amassed the greatest amount of empirical support (i.e., CD).…”