Center for Behavioral Intervention Technologies, Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine.
Department of Psychiatry, Washington University School of Medicine.
J Consult Clin Psychol. 2023 May;91(5):280-284. doi: 10.1037/ccp0000786. Epub 2023 Jan 12.
The Student Bodies-Eating Disorders intervention (SB-ED), a digital cognitive behavior therapy-guided self-help intervention for college women with an eating disorder, is effective for reducing eating disorder psychopathology. The purpose of this study was to evaluate moderators and mediators of the SB-ED intervention. To our knowledge, this is the first evaluation of clinical mediators of a digital intervention for women with eating disorders.
This is an exploratory secondary analysis of a cluster randomized trial comparing the SB-ED intervention to referral to usual care among 690 women at 27 United States colleges. Moderators included body mass index (BMI), race, ethnicity, weight/shape concerns, eating disorder impairment, thin ideal internalization, depression, anxiety, and motivation for treatment, assessed at baseline. Thin ideal internalization and depressive symptoms were tested as predictors at postintervention and mediators at 2-year follow-up. Outcome was change in global eating disorder psychopathology.
BMI moderated the effect of the intervention at follow-up (but not posttreatment), with individuals with a lower BMI experiencing more continued improvements in eating disorder psychopathology following the intervention than individuals with a higher BMI. Thin ideal internalization mediated the effect of the intervention at follow-up, and depression partially mediated the effect of the intervention at follow-up.
Results of the mediator analyses suggest that helping college women reduce inflated internalization of the thin ideal and improve depressive symptoms leads to improvements in eating disorder psychopathology. Results also suggest opportunities to optimize the intervention so individuals across the BMI spectrum experience ongoing improvements over time. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
学生群体-饮食失调干预（SB-ED）是一种针对有饮食障碍的大学生的数字认知行为疗法指导的自助干预措施，对于减少饮食障碍病理有效果。本研究的目的是评估 SB-ED 干预的调节因素和中介因素。据我们所知，这是首次对女性饮食障碍数字干预的临床中介因素进行评估。
这是一项对 690 名来自美国 27 所大学的女性进行的群组随机试验的探索性二次分析，比较了 SB-ED 干预与向常规护理转诊。调节因素包括体重指数（BMI）、种族、民族、体重/体型担忧、饮食障碍损伤、瘦理想内化、抑郁、焦虑和治疗动机，这些因素在基线时进行评估。瘦理想内化和抑郁症状在干预后被测试为预测因素，在 2 年随访时被测试为中介因素。结果是整体饮食障碍病理的变化。
BMI 在随访时调节了干预的效果（但不是治疗后），BMI 较低的个体在干预后继续改善饮食障碍病理的程度比 BMI 较高的个体更高。瘦理想内化在随访时中介了干预的效果，抑郁在随访时部分中介了干预的效果。
中介分析的结果表明，帮助大学生减少对瘦理想的过度内化和改善抑郁症状，会导致饮食障碍病理的改善。结果还表明，有机会优化干预措施，使 BMI 范围内的个体随着时间的推移持续改善。
