title: Randomized controlled pilot trial of a novel dissonance-based group treatment for eating disorders.
abstract: The authors conducted a pilot trial of a new dissonance-based group eating disorder treatment designed to be a cost-effective front-line transdiagnostic treatment that could be more widely disseminated than extant individual or family treatments that are more expensive and difficult to deliver. Young women with a DSM-5 eating disorder (N = 72) were randomized to an 8-week dissonance-based Counter Attitudinal Therapy group treatment or a usual care control condition, completing diagnostic interviews and questionnaires at pre, post, and 2-month follow-up. Intent-to-treat analyses revealed that intervention participants showed greater reductions in outcomes than usual care controls in a multivariate multilevel model (χ(2)[6] = 34.1, p < .001), producing large effects for thin-ideal internalization (d = .79), body dissatisfaction (d = 1.14), and blinded interview-assessed eating disorder symptoms (d = .95), and medium effects for dissonance regarding perpetuating the thin ideal (d = .65) and negative affect (d = .55). Midway through this pilot we refined engagement procedures, which was associated with increased effect sizes (e.g., the d for eating disorder symptoms increased from .51 to 2.30). This new group treatment produced large reductions in eating disorder symptoms, which is encouraging because it requires about 1/20th the therapist time necessary for extant individual and family treatments, and has the potential to provide a cost-effective and efficacious approach to reaching the majority of individuals with eating disorders who do not presently received treatment.
authors.affiliation: Oregon Research Institute, USA. Electronic address: estice@ori.org.
authors.forename: Eric
authors.initials: E
authors.lastname: Stice
authors.affiliation: Oregon Research Institute, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Rohde
authors.affiliation: Drexel University, USA.
authors.forename: Meghan
authors.initials: M
authors.lastname: Butryn
authors.affiliation: University of Texas at Austin, USA.
authors.forename: Katharine S
authors.initials: KS
authors.lastname: Menke
authors.affiliation: University of Texas at Austin, USA.
authors.forename: C Nathan
authors.initials: CN
authors.lastname: Marti
mesh_terms: D000293:Adolescent; D000328:Adult; D001290:Attitude; D001828:Body Image / Q000523:psychology*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003073:Cognitive Dissonance; D001068:Feeding and Eating Disorders / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D010865:Pilot Projects; D011615:Psychotherapy, Group / Q000379:methods*; D012649:Self Concept; D016896:Treatment Outcome; D055815:Young Adult
keywords: Dissonance; Eating disorder; Efficacy trial; Group; Treatment