Stice Eric, Rohde Paul, Butryn Meghan L, Shaw Heather, Marti C Nathan
Oregon Research Institute, 1776 Millrace Drive, Eugene, OR, 97403, USA.
Oregon Research Institute, 1776 Millrace Drive, Eugene, OR, 97403, USA.
Behav Res Ther. 2015 Aug;71:20-6. doi: 10.1016/j.brat.2015.05.012. Epub 2015 May 28.
An efficacy trial found that a dissonance-based prevention program reduced risk factors, eating disorder symptoms, and future eating disorder onset, but smaller effects emerged when high school clinicians recruited students and delivered the program under real-world conditions in an effectiveness trial. The current report describes results at 2- and 3-year follow-up from an effectiveness trial that tested whether a new enhanced dissonance version of this program produced larger effects when college clinicians recruit students and deliver the intervention using improved train and supervision procedures.
Young women from eight universities (N = 408, M age = 21.6, SD = 5.64) were randomized to the prevention program or an educational brochure control condition.
Dissonance participants showed greater decreases in risk factors, eating disorder symptoms, and psychosocial impairment by 3-year follow-up than controls, but not healthcare utilization, BMI, or eating disorder onset.
This novel multisite effectiveness trial found that the enhanced dissonance intervention and improved training and supervision procedures produced an average effect size at 3-year follow-up that was 290% and 160% larger than effects observed in the high school effectiveness trial and efficacy trial respectively. Yet, the lack of eating disorder onset effects may imply that factors beyond pursuit of the thin ideal now contribute to eating disorder onset.
一项疗效试验发现,基于认知失调的预防计划可降低风险因素、饮食失调症状以及未来饮食失调的发生率,但在一项实效性试验中,当高中临床医生招募学生并在现实条件下实施该计划时,效果则较小。本报告描述了一项实效性试验在2年和3年随访时的结果,该试验测试了该计划的一个新的强化认知失调版本在大学临床医生招募学生并使用改进的培训和监督程序实施干预时是否会产生更大的效果。
来自八所大学的年轻女性(N = 408,年龄中位数 = 21.6,标准差 = 5.64)被随机分为预防计划组或教育宣传册对照组。
到3年随访时,认知失调组参与者在风险因素、饮食失调症状和心理社会损害方面的下降幅度比对照组更大,但在医疗保健利用率、体重指数或饮食失调发生率方面没有差异。
这项新的多地点实效性试验发现,强化认知失调干预以及改进的培训和监督程序在3年随访时产生的平均效应量分别比高中实效性试验和疗效试验中观察到的效应量高出290%和160%。然而,饮食失调发生率方面缺乏效果可能意味着,除了追求瘦身理想之外的因素现在也对饮食失调的发生起作用。