title: Testing the efficacy of pure versus guided mirror exposure in women with bulimia nervosa: A combination of neuroendocrine and psychological indices.
abstract: OBJECTIVE
  Body exposure improves body image problems in women with eating disorders. However it has almost always been combined with other interventions. Thus, the efficacy of body exposure alone (i.e., pure exposure) remains largely unclear. We aimed to compare the efficacy of two body exposure techniques through psychological and neuroendocrine indices recorded within and between successive sessions.
  
  
  METHODS
  Twenty-nine women with high body dissatisfaction and diagnosis of bulimia nervosa were randomly assigned to one of two treatment groups: Pure Exposure (n = 14) or Guided Exposure (n = 15). Participants received 6 exposure sessions. After each session, changes in thoughts (positive/negative) and body satisfaction were assessed. Also, we assessed the body discomfort experienced by participants within and between sessions. Finally, the changes in salivary cortisol levels within and between the initial and final treatment sessions were measured.
  
  
  RESULTS
  Both groups showed a reduction in negative thoughts and a progressive increase in positive thoughts throughout the treatment. However, the increase in body satisfaction and the reduction in subjective discomfort within the sessions were greater in the pure exposure group. The cortisol levels during the initial and final treatment sessions decreased in both groups.
  
  
  CONCLUSIONS
  Methodological limitations are reported.
  
  
  CONCLUSIONS
  These results suggest that pure and guided exposures are effective interventions for improving thoughts and neuroendocrine responses, although pure exposure increased more body satisfaction feelings in bulimic women. Subjective discomfort also showed different patterns of change within and along sessions for each treatment. Reasons for these results are discussed.
authors: Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, Campus la Cartuja s/n, 18071, University of Granada, Granada, Spain. Electronic address: sdiaz_1@ugr.es.
authors: Sandra
authors: S
authors: Díaz-Ferrer
authors: Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, Campus la Cartuja s/n, 18071, University of Granada, Granada, Spain. Electronic address: srruiz@ugr.es.
authors: Sonia
authors: S
authors: Rodríguez-Ruiz
authors: Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, Campus la Cartuja s/n, 18071, University of Granada, Granada, Spain. Electronic address: bortega@ugr.es.
authors: Blanca
authors: B
authors: Ortega-Roldán
authors: Department of Psychology, Faculty of Humanities and Educational Sciences, Campus las Lagunillas, s/n 2307, University of Jaén, Jaén, Spain. Electronic address: smoreno@ujaen.es.
authors: Silvia
authors: S
authors: Moreno-Domínguez
authors: Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, Campus la Cartuja s/n, 18071, University of Granada, Granada, Spain. Electronic address: mcfersan@ugr.es.
authors: M Carmen
authors: MC
authors: Fernández-Santaella
mesh_terms: D000328:Adult; D001828:Body Image / Q000523:psychology*; D052018:Bulimia Nervosa / Q000378:metabolism / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D007171:Implosive Therapy / Q000379:methods*; D017063:Outcome Assessment, Health Care; D055815:Young Adult
chemical_list: D006854:Hydrocortisone
keywords: Body discomfort; Body dissatisfaction; Bulimia nervosa; Mirror exposure; Salivary cortisol