Feminist identity,body image,and disordered eating

ABSTRACT

Using data from a community-based sample (Project EAT-III), this study (N = 1241; mean age = 25.2) examined the relationship of feminist identity with body image and disordered eating. Feminist-identified women reported significantly higher body satisfaction than non-feminist women and women who did not identify as feminists but held feminist beliefs. However, feminist-identified women did not differ from non-feminist women in disordered eating. Women holding feminist beliefs and non-feminist women did not differ in body satisfaction. Our findings suggest that self-identification as a feminist may promote positive body image in young adult women, but may be insufficient to change behaviors.     

Hypnotic alteration of body image in the eating disordered

A driving force in an eating disorder like anorexia nervosa has been a distorted body image. The psychobiological dynamics of eating disorders have demonstrated significant hypnotic phenomena such as forms of dissociation, hallucination, time distortion and catalepsy, and therefore, pose hypnosis as a good fit for particular parts of treatment. Presented here are four hypnotic approaches designed to inspire the establishment of a reality based body image in the eating disordered individual. Conditional prerequisites for application of these interventions are described and case examples illustrate each approach. A discussion on some of the rationale for formulating these strategies is offered.     

Outcomes of manualized cognitive-behavioral body image therapy with eating disordered women treated in a private clinical practice

Body image change is an important component of the treatment of eating disorders, and cognitive behavioral body image therapy has substantial empirical support as efficacious in the improvement of body image difficulties and disorders. Most evidence comes from randomized, controlled, outcome studies and does not examine effectiveness for persons with clinical eating disorders in the context of “usual care” settings. The present study was conducted in a private practice and assessed 30 women with a range of eating disorder diagnoses. Following manualized group treatment based on Cash's (1997) The Body Image Workbook, clients reported reduced body image dysphoria, greater body and appearance satisfaction on several dimensions, less psychological investment in their appearance, and a better evaluation of their fitness/health. The study's limitations and implications are discussed.     

Moderators of the relationship between body image dissatisfaction and disordered eating

Various affective and personality variables may impact the relationship between body dissatisfaction and disordered eating symptomatology. The current study was a post-hoc analysis examining potential moderators (depression, anxiety, and impulsivity) of this relationship in college women. Four-hundred and seventy-two (472) enrolled college women between the ages of 18 and 55 participated in this study. Moderation analyses indicated that anxiety, depression, and dieting significantly moderated the relationship between body dissatisfaction and disordered eating, whereas impulsivity did not. Findings can be used to generate hypotheses for education and prevention programs on college campuses.     

Comparison of a gratitude-based and cognitive restructuring intervention for body dissatisfaction and dysfunctional eating behavior in college women

Researchers have investigated the efficacy of a gratitude intervention for decreasing body dissatisfaction (BD) in an internet treatment-seeking sample and demonstrated it worked equally well to decrease BD as cognitive restructuring. We extend this research by testing the efficacy of a gratitude intervention on BD, along with common sequelae of BD: dysfunctional eating, negative mood, and depressive symptoms. Females were randomly assigned to Gratitude, Cognitive Restructuring, or Control conditions. Pre- to post-intervention period comparisons found the gratitude intervention to perform better than the other conditions at increasing body esteem, decreasing BD, reducing dysfunctional eating, and reducing depressive symptoms.     

Selective processing of body image words in women at-risk for developing an eating disorder: a preliminary study

We evaluated the utility of the Modified Stroop task as a measure of body image concerns in women at-risk for an eating disorder. Data were collected among 31 participants from an eating disorder prevention program. The Modified Stroop was significantly associated with overeating episodes and an explicit measure of shape concern. The traditional Stroop effect was found while the Modified Stroop effect was non-significant. The results raise questions about the Modified Stroop task's utility in identifying at-risk women. Methodological and clinical implications are discussed.     

Randomized pilot of a self-guided internet coping group for women with early-stage breast cancer

Background: Internet-based methods for provision of psychological support and intervention to cancer survivors hold promise for increasing the public impact of such treatments.Purpose: The goal of this controlled pilot study was to examine the effect and potential mechanisms of action of a self-guided, Internet-based coping-skills training group on quality of life outcomes in women with early-stage breast cancer.Methods: Sixty-two women completed baseline evaluations and were randomized into either a small online coping group or a waiting-list control condition.Results: No main effects for treatment were observed at the 12-week follow up. However, there was a significant interaction between baseline self-reported health status and treatment, such that women with poorer self-perceived health status showed greater improvement in perceived health over time when assigned to the treatment condition. Linguistic analyses revealed that positive changes across quality of life variables were associated with greater expression of negative emotions such as sadness and anxiety, greater cognitive processing, and lower expression of health-related concerns.Conclusions: These results demonstrate the potential efficacy of self-guided Internet coping groups while highlighting the limitations of such groups. These results are part of a larger ongoing study of the Internet as a source of support and information for women with breast cancer, supported by Grant No. DAMD17-00-1-0121 from the Department of the Army Breast Cancer Research Program.     

A mindful eating group as an adjunct to individual treatment for eating disorders: a pilot study

The objective of this study was to investigate potential benefits of a Mindful Eating Group as an adjunct to long-term treatment for a variety of eating disorders. Individuals (N = 33) attending treatment at an outpatient treatment facility participated in the 10-week intervention designed to enhance awareness around hunger and satiety cues. Disordered eating symptoms were assessed pre- and post-intervention using the EAT-26. Significant reductions were found on all subscales of the EAT-26 with large effect sizes. No significant differences were identified between eating disorder diagnoses. Results suggest potential benefits of an adjunct mindfulness group intervention when treating a variety of eating disorders. Limitations are discussed.     

Depression and anxiety symptoms in women at high risk for breast cancer: pilot study of a group intervention.

OBJECTIVE: The psycho-oncology literature to date contains only one outcome study based on a group model for high-risk relatives of breast cancer patients. The authors set out to study the effects of group intervention in high-risk relatives of breast cancer patients. METHOD: Thirty-three high-risk relatives of breast cancer patients participated in a six-session, 12-hour group intervention model that consisted of educational and psychosocial components. RESULTS: There was a significant reduction of depression symptoms as reported on the Center for Epidemiologic Studies Depression Scale. Similarly, there was a significant reduction of anxiety symptoms as reported on the State-Trait Anxiety Inventory state scale. CONCLUSIONS: In this pilot study, the investigators found the group intervention model effective at reducing symptoms of depression and reactive (not chronic) anxiety.     

Postpartum depression in women receiving public assistance: pilot study of an interpersonal-therapy-oriented group intervention

OBJECTIVE: This study investigated whether a preventive intervention based on the principles of interpersonal psychotherapy administered to pregnant women would reduce the risk of postpartum major depression. METHOD: Thirty-seven pregnant women receiving public assistance who had at least one risk factor for postpartum depression were randomly assigned to a four-session group intervention or to a treatment-as-usual condition. Thirty-five of the women completed the study. Structured diagnostic interviews were administered to assess for postpartum major depression. RESULTS: Within 3 months after they gave birth, six (33%) of the 18 women in the treatment-as-usual condition had developed postpartum major depression, compared with none of the 17 women in the intervention condition. CONCLUSIONS: A four-session interpersonal-therapy-oriented group intervention was successful in preventing the occurrence of major depression during a postpartum period of 3 months in a group of financially disadvantaged women.     

BRIDGE (building the relationship between body image and disordered eating graph and explanation): a tool for parents and professionals

BRIDGE (Building the Relationship Between Body Image and Disordered Eating Graph and Explanation) is a tool for mental health professionals, parents, teachers, and the general public. BRIDGE offers the potential for a new level of understanding between body image and disordered eating behaviors. This tool provides a framework that describes the connection between the attitudes we hold about our bodies and the corresponding behaviors we may practice. This practical tool takes fundamental concepts established in the eating disorder literature and presents them in a basic and easily understood manner. This paper invites further testing of this educational tool for parents, teachers, and professionals in a number of contexts including prevention and treatment programs.     

An elementary school project for developing healthy body image and reducing risk factors for unhealthy and disordered eating

Abstract

When we conceptualized this journal a few years ago, everyone recognized a need for a practical, feminist, multidisciplinary forum. However, some noted academics were skeptical about finding enough to say about prevention. Fortunately, they were wrong, greatly due to the vitality of Niva Piran, editor of our Prevention Series. Over the last three years, Eating Disorders: The Journal of Treatment and Prevention has emerged as the leading publication in this area, and Volume 4 will conclude with a special issue highlighting the latest approaches to and results of eating disorders prevention.     

A parent-only group intervention for children with anxiety disorders: pilot study

OBJECTIVE: Working to optimize treatment outcome and use resources efficiently, investigators conducted the first test of an existing parent-only group cognitive-behavioral therapy protocol to treat 24 children 7 to 16 years old with primary anxiety disorder diagnoses. METHOD: Over the course of 7 months, the authors evaluated a manual-based therapy protocol that teaches parents skills to work with their children as lay therapists in the context of their ongoing interactions and daily life. This was an uncontrolled pilot study, examining within-subject outcomes via measures from multiple informants, aimed at generating estimates of effect size. RESULTS: Children demonstrated significant improvement on parent- and clinician-rated measures of anxiety. Twenty-five percent of primary anxiety diagnoses fully remitted, and the average number of anxiety diagnoses dropped from 3.4 to 1.5. The intervention had a large effect on anxiety disorder severity and impairment, parental attitudes, targeted anxious behavior problems, and clinician-rated impairment. Children with anxiety-disordered parents reported more improvement than children whose parents were not anxious. The intervention was acceptable to families. CONCLUSIONS: The results of this pilot study suggest that parents acting as lay cognitive-behavioral therapists for their anxious children may be effectively and acceptably trained in a group format.     

Sociocultural and developmental influences on body dissatisfaction and disordered eating attitudes and behaviors of Asian women

This study is an examination of the influence of sociocultural and developmental factors on body dissatisfaction and disordered eating attitudes and behaviors in two Asian populations: 298 Taiwanese-American (TA) women undergoing acculturating changes and 347 Taiwanese (T) women undergoing modernizing changes. Contrary to the initial hypothesis, body dissatisfaction rates and disordered eating attitudes and behaviors were found to be significantly higher in the T group. Subjects in the T group had higher Taiwanese ethnic identity scores but also lower perceptions of maternal control. Body dissatisfaction was found to be a moderating variable between ethnic identity and disordered eating attitudes and behaviors for the TA group only. The "girl next door" hypothesis, based on the social comparison theory, was set forth to help explain why this result was found only in the TA group. In the T group, ethnic identity and body dissatisfaction were independently associated with disordered eating. Results failed to support a link between parental control and the development of an eating disorder, and implications from a cross-cultural perspective are addressed.     

Dance movement therapy for obese women with emotional eating: A controlled pilot study

This study explored the effectiveness of dance movement therapy (DMT) in obese women with emotional eating who were trying to lose weight. 158 women were recruited from a commercial weight loss programme: 92 with BMI ≥ 28 were identified as emotional eaters and divided into: an exercise control (n = 32) and non-exercisers (n = 60). The non-exercises were partially randomised to non exercise control (n = 30) and treatment group (n = 30). Using a pre- and post-intervention design, 24 of the DMT treatment group, 28 of the exercise control and 27 of the non-exercise control completed all measures on a battery of tests for psychological distress, body image distress, self-esteem and emotional eating. Findings were analysed for statistical significance.     

Dieting frequency among college females: association with disordered eating, body image, and related psychological problems

OBJECTIVE: To examine associations between dieting frequency and eating disorder behaviors, body satisfaction, and related factors. METHOD: Females (N=345) whose average age and body mass index (BMI) were 20.58 and 21.79, respectively, were grouped into three categories of lifetime dieting frequency (never, 1-5 times, or 6 or more times) and matched on current BMI across categories. RESULT: Positive associations were found between dieting frequency and eating disorder symptoms and related problems such as body dissatisfaction, current body size perception, depression, exercise preoccupation, and feelings of ineffectiveness and insecurity. Dieting frequency was inversely associated with self-esteem, ideal body size, emotional regulation, and impulse control. DISCUSSION: Independent of current BMI, frequency of dieting behaviors is strongly associated with negative emotions and problematic behaviors. As this study is correlational in nature, future longitudinal studies should ascertain the sequence of onset of these experiences.     

Early intervention in eating disorders: a parent group approach

Aim: Early intervention in eating disorders (EDs) has been a neglected area. Peak onset is in adolescence, suggesting that early intervention should include parents. We synthesize findings from five key theoretical domains, and present pilot data from a phase‐specific early intervention for new onset EDs in young people. Methods: From literature searches, we reviewed current knowledge on risk factors for EDs; ED prevention in young people; the evidence base for treatment for young people with EDs; early intervention in other mental health fields; and parenting interventions. Based on these findings, we devised and piloted a parent group intervention. Results: Presenting features are typically parental concern about changes in eating behaviour and/or weight loss. There is a delay between symptom onset and help seeking, by which time the illness is well established. Early intervention should therefore target parents and be delivered at secondary rather than primary care. Effective treatments favour family‐focused interventions with parental responsibility for symptom management. We hypothesized that a parents' group might be effective for addressing the specific emotional experience of parents in the early stages and their relative lack of knowledge and understanding. Pilot data show significant improvements in knowledge, skills, confidence, understanding and their child's adherence to meal plans as a result of a 6‐week parent group intervention. Conclusion: A parent group intervention addressing themes identified from risk factor, prevention and treatment research is a potentially promising approach to early intervention for EDs. The impact of the intervention on patient outcome needs evaluation.     

Assessment methods for eating disorders and body image disorders

The growing interest in the treatment and research of eating disorders has stimulated the development of assessment methods, and there are now many questionnaires for evaluating behavioral and attitudinal characteristics of eating pathology. The present article sets out to review the assessment tools that are widely used in clinical practice and research. In particular, it covers self-report measures with summaries of their psychometric properties. It also presents diagnostic questionnaires based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, diagnostic criteria. The instruments described include screening questionnaires, measurement tools for specific eating disorder symptoms, measurement of quality of life in eating disorders, and some tools for the measurement of body image disorder, a common feature of eating disorders. There is also a discussion of distorting factors that decrease the authenticity of assessment tools. These problems arise from the definition of some constructs and from the phenomena of denial and concealment, which are frequent among eating-disordered individuals. The frequent co-occurrence of other psychopathological features (e.g., multiimpulsive symptoms) shows that other psychological phenomena should also be evaluated in line with the assessment of eating disorders.