Bulimia nervosa is one of the most common psychiatric problems faced by female adolescents. Its persistent course can result in serious medical complications, and is associated with co-morbid psychiatric disorders. Although several psycho-educational eating disorder prevention programs have been evaluated in controlled trials, none have reduced bulimic symptoms. The proposed project represents a large-scale randomized trial of a new type of eating disorder prevention program that, in a controlled pilot study (N= 117), resulted in significant reductions in endorsement of the current thin-ideal for women (thin-ideal internalization), body dissatisfaction, dieting, negative affect, and bulimic symptoms). This new program is a dissonance-based intervention, wherein high-risk females who show elevations in thin-ideal internalization voluntarily engage in a series of verbal, written, and behavioral exercises requiring them to critique the thin-ideal during 3 weekly sessions. This intervention is the outgrowth of an 8-year program of generative research on the risk factors for bulimic pathology by this research team. The proposed study will randomly assign 450 high-risk females to the dissonance condition, a psycho-educational placebo control condition, or a measurement-only condition and will follow them for 2 years after program termination.
The aims of this study are to test whether (1) the dissonance intervention results in significantly greater reductions in bulimic symptoms than the placebo and measurement-only control interventions, (2) the program effects on bulimic symptoms are mediated by change in thin-ideal internalization, body dissatisfaction, dieting, and negative affect, and (3) certain factors potentiate (e.g., elevated distress regarding body image and eating disturbances) or mitigate (e.g., poor insight regarding the adverse effects of pursuit of the thin-ideal) program effects. Not only does this intervention appear to be the first to effectively reduce bulimic symptoms, but the proposed study is more methodologically rigorous than past trials because of the use of random assignment, an active placebo control condition, structured psychiatric interviews for assessment purposes, and a long-term follow-up period. Thus, the proposed study should be the definitive test of this new promising eating disorder prevention program and should significantly advance our knowledge regarding the prevention of this pervasive psychiatric problem.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH061957-04
Application #
6697425
Study Section
Special Emphasis Panel (ZRG1-RPHB-2 (01))
Program Officer
Vitiello, Benedetto
Project Start
2001-02-01
Project End
2006-01-31
Budget Start
2004-02-01
Budget End
2005-01-31
Support Year
4
Fiscal Year
2004
Total Cost
$262,500
Indirect Cost
Name
University of Texas Austin
Department
Psychology
Type
Schools of Arts and Sciences
DUNS #
170230239
City
Austin
State
TX
Country
United States
Zip Code
78712
Rohde, Paul; Stice, Eric; Marti, C Nathan (2015) Development and predictive effects of eating disorder risk factors during adolescence: Implications for prevention efforts. Int J Eat Disord 48:187-98
Horney, Audra C; Stice, Eric; Rohde, Paul (2015) An examination of participants who develop an eating disorder despite completing an eating disorder prevention program: implications for improving the yield of prevention efforts. Prev Sci 16:518-26
Müller, Sina; Stice, Eric (2013) Moderators of the intervention effects for a dissonance-based eating disorder prevention program; results from an amalgam of three randomized trials. Behav Res Ther 51:128-33
Stice, Eric; Becker, Carolyn Black; Yokum, Sonja (2013) Eating disorder prevention: current evidence-base and future directions. Int J Eat Disord 46:478-85
Stice, Eric; Marti, C Nathan; Rohde, Paul (2013) Prevalence, incidence, impairment, and course of the proposed DSM-5 eating disorder diagnoses in an 8-year prospective community study of young women. J Abnorm Psychol 122:445-57
Linville, Deanna; Stice, Eric; Gau, Jeff et al. (2011) Predictive effects of mother and peer influences on increases in adolescent eating disorder risk factors and symptoms: a 3-year longitudinal study. Int J Eat Disord 44:745-51
Stice, Eric; Marti, C Nathan; Durant, Shelley (2011) Risk factors for onset of eating disorders: evidence of multiple risk pathways from an 8-year prospective study. Behav Res Ther 49:622-7
Baldwin, Scott A; Bauer, Daniel J; Stice, Eric et al. (2011) Evaluating models for partially clustered designs. Psychol Methods 16:149-65
Shaw, Heather; Stice, Eric; Becker, Carolyn Black (2009) Preventing eating disorders. Child Adolesc Psychiatr Clin N Am 18:199-207
Stice, Eric; Marti, C Nathan; Shaw, Heather et al. (2009) An 8-year longitudinal study of the natural history of threshold, subthreshold, and partial eating disorders from a community sample of adolescents. J Abnorm Psychol 118:587-97

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