Dissonance and healthy weight eating disorder prevention programs: long-term effects from a randomized efficacy trial.
Adolescent girls with body dissatisfaction (N = 481, SD = 1.4) were randomized to a dissonance-based thin-ideal internalization reduction program, healthy weight control program, expressive writing control condition, or assessment-only control condition. Dissonance participants showed significantly greater decreases in thin-ideal internalization, body dissatisfaction, negative affect, eating disorder symptoms, and psychosocial impairment and lower risk for eating pathology onset through 2- to 3-year follow-up than did assessment-only controls. Dissonance participants showed greater decreases in thin-ideal internalization, body dissatisfaction, and psychosocial impairment than did expressive writing controls. Healthy weight participants showed greater decreases in thin-ideal internalization, body dissatisfaction, negative affect, eating disorder symptoms, and psychosocial impairment; less increases in weight; and lower risk for eating pathology and obesity onset through 2- to 3-year follow-up than did assessment-only controls. Healthy weight participants showed greater decreases in thin-ideal internalization and weight than did expressive writing controls. Dissonance participants showed a 60% reduction in risk for eating pathology onset, and healthy weight participants showed a 61% reduction in risk for eating pathology onset and a 55% reduction in risk for obesity onset relative to assessment-only controls through 3-year follow-up, implying that the effects are clinically important and enduring.
Stice
Eric
E
Department of Psychology, University of Texas at Austin, TX, USA. estice@ori.org
Marti
C Nathan
CN
Spoor
Sonja
S
Presnell
Katherine
K
Shaw
Heather
H
D000293:Adolescent; D000856:Anorexia Nervosa / Q000517:prevention & control* / Q000523:psychology; D001828:Body Image; D001835:Body Weight; D052018:Bulimia Nervosa / Q000517:prevention & control* / Q000523:psychology; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003073:Cognitive Dissonance; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007389:Internal-External Control; D009765:Obesity / Q000517:prevention & control / Q000523:psychology; D011615:Psychotherapy, Group / Q000379:methods*; D013851:Thinness / Q000523:psychology; D016896:Treatment Outcome; D014956:Writing