Psychology Commons^™

Psychometric Properties Of The Contextual Body Image Questionnaire For Athletes: A Replication And Extension Study In Female Collegiate Athletes, Tiffany Stewart, Lisa S. Kilpela, Nicole Wesley, K. Baule, Carolyn Becker

Psychology Faculty Research

Background

Although the link between body dissatisfaction and eating disorder (ED) pathology is well-established in general female samples, less is known about contextual body image (CBI) among female athletes. CBI refers to female athletes’ body image concerns in two contexts: sport and daily life. The Contextual Body Image Questionnaire for Athletes (CBIQA) measures four dimensions of body image (Appearance, Thin-Fat Self-Evaluation, Thin-Fat Others’ Evaluation, and Muscularity) in both contexts. In a sample of female collegiate athletes, this study sought to A) investigate the psychometric properties of the CBIQA, B) examine the cross-sectional relation of CBI with ED pathology and negative …

Food Insecurity And Eating Disorders: A Review Of Emerging Evidence, V. M. Hazzard, K. A. Loth, L. Hooper, Carolyn Black Becker

Psychology Faculty Research

Purpose of Review: This review summarizes emerging evidence for the relationship between food insecurity and eating disorder (ED) pathology, outlines priorities for future research in this area, and comments on considerations for clinical and public health practice.

Recent Findings: Among adults, food insecurity is cross-sectionally associated with higher levels of overall ED pathology, binge eating, compensatory behaviors, binge-eating disorder, and bulimia nervosa. Evidence for similar relationships among adolescents has been less robust; however, compared to studies of adults, there have been substantially fewer studies conducted in adolescents to date.

Summary: Emerging evidence consistently indicates that food insecurity …

Eating Disorder Pathology Among Individuals Living With Food Insecurity: A Replication Study, Carolyn Becker, Keesha M. Middlemass, Francesca Gomez, Andrea Martinez-Abrego

Psychology Faculty Research

Eating disorders (EDs) are stereotypically associated with thin, White, affluent women and girls. One result of the ED stereotype has been a relative dearth of ED research with marginalized communities. The aim of the present study was to replicate recent findings showing an association between severity of food insecurity (FI) and increased ED pathology. Participants included 891 clients at an urban food bank. Results replicated previous research with participants in the most severe FI group reporting significantly higher levels of ED pathology, dietary restraint, anxiety, and depression. Findings provide further evidence that the thin, White, affluent, female ED stereotype offers …

The Athletes' Relationships With Training Scale (Art): A Self-Report Measure Of Unhealthy Training Behaviors Associated With Eating Disorders, D. A. N. Chapa, K. E. Hagan, K. T. Forbush, V. L. Perko, D. A. Sorokina, A. Y. Alasmar, Carolyn Black Becker, R. T. Sherman, R. A. Thompson, J, G. Farrell, T. M. Stewart

Psychology Faculty Research

Objective: Several studies indicate that eating-disorder (ED) psychopathology is elevated in athletes compared to non-athletes. The assessment of excessive exercise among athletes is a challenge because, compared to non-athletes, athletes are required to train at higher intensities and for longer periods of time. However, individuals participating in competitive sports are still susceptible to unhealthy physical-activity patterns. Most ED assessments were developed and normed in non-athlete samples and, therefore, do not capture the nuances of athletes' training experiences. The purpose of the current study was to develop and validate a clinically useful, self-report measure of unhealthy training behaviors and beliefs in …

From Efficacy To Global Impact: Lessons Learned About What Not To Do In Translating Our Research To Reach, Carolyn Becker

Psychology Faculty Research

Although members of the Association for Behavioral and Cognitive Therapies have made significant strides towards the collective goals outlined in our mission statement, we routinely acknowledge that our ability to develop empirically supported treatments exceeds our success in improving dissemination and implementation of said interventions. Further, as noted by Kazdin and Blase (2011), even if we succeeded in having every clinician world-wide administer our best treatments with excellent competency, we still would be unsuccessful in markedly impacting the worldwide burden of mental illness because most treatments require intensive labor by expensive providers. To this end, Kazdin and Blase and others …

The Female Athlete Body (Fab) Study: Rationale, Design, And Baseline Characteristics, Tiffany M. Stewart, Tarryn Pollard, Tom Hildebrandt, Robbie Beyl, Nicole Wesley, Lisa S. Kilpela, Carolyn Becker

Psychology Faculty Research

Background: Eating Disorders (EDs) are serious psychiatric illnesses marked by psychiatric comorbidity, medical complications, and functional impairment. Research indicates that female athletes are often at greater risk for developing ED pathology versus non-athlete females. The Female Athlete Body (FAB) study is a three-site, randomized controlled trial (RCT) designed to assess the efficacy of a behavioral ED prevention program for female collegiate athletes when implemented by community providers. This paper describes the design, intervention, and participant baseline characteristics. Future papers will discuss outcomes.

Methods: Female collegiate athletes (N = 481) aged 17–21 were randomized by site, team, and sport type to …

Food Insecurity And Eating Disorder Pathology, Carolyn Becker, Keesha M. Middlemass, Brigitte Taylor, Clara Johnson, Francesca Gomez

Psychology Faculty Research

Objective: The primary aim of this study was to investigate eating disorder (ED) pathology in those living with food insecurity. A secondary aim was to investigate whether any-reason dietary restraint, weight self-stigma, and worry increased as level of food insecurity increased.

Method: Participants (N = 503) seeking food from food pantries completed questionnaires assessing level of food insecurity, demographics, ED pathology, dietary restraint, weight self-stigma, and worry.

Results: Consistent with hypotheses, participants with the highest level of food insecurity (i.e., adults who reported having hungry children in their household) also endorsed significantly higher levels of binge eating, overall ED …

The Three-Legged Stool Of Evidence-Based Practice In Eating Disorder Treatment: Research, Clinical, And Patient Perspectives, C. B. Peterson, Carolyn Becker, J. Treasure, R. Shafran, R. Bryant-Waugh

Psychology Faculty Research

Background

Evidence-based practice in eating disorders incorporates three essential components: research evidence, clinical expertise, and patient values, preferences, and characteristics. Conceptualized as a ‘three-legged stool’ by Sackett et al. in 1996 (BMJ), all of these components of evidence-based practice are considered essential for providing optimal care in the treatment of eating disorders. However, the extent to which these individual aspects of evidence-based practice are valued among clinicians and researchers is variable, with each of these stool ‘legs’ being neglected at times. As a result, empirical support and patient preferences for treatment are not consistently considered in the selection and implementation …

Our Critics Might Have Valid Concerns: Reducing Our Propensity To Conflate, Carolyn Becker

Psychology Faculty Research

As noted by Austin elsewhere in this issue, the field of eating disorders (ED) prevention has made remarkable scientific strides in the past two decades (see Austin, 2016). Over this same period, the field also has seen improved political standing within the greater ED community. For instance, prevention researchers present more regularly at key ED conferences, increasingly via invitation “up on the big stage” in plenaries and keynote addresses. Prevention researchers and advocates also appear to have grown in number and hold more positions in a variety of ranks throughout key ED organizations. Finally, a number of prominent ED researchers …

Effectiveness Of A Peer-Delivered Dissonance-Based Program In Reducing Eating Disorder Risk Factors In High School Girls, Anna C. Ciao, J. D. Latner, K. E. Brown, D. S. Ebneter, Carolyn Becker

Psychology Faculty Research

Objective

This pilot study investigated the feasibility, acceptability, and effectiveness of a peer-led dissonance-based eating disorders (ED) prevention/risk factor reduction program with high school girls.

Method

Ninth grade girls (n  = 50) received the peer-led program within the school curriculum. A quasi-experimental design was used to assess changes in ED risk factors preintervention and postintervention compared with waitlist control. Participants were followed through 3-month follow-up.

Results

Peer-leader adherence to an intervention manual tailored for this age group was high. The intervention was rated as highly acceptable, with a large proportion of participants reporting that they enjoyed the program and …

Reducing Eating Disorder Risk Factors: A Controlled Investigation Of A Blended Task-Shifting/Train-The-Trainer Approach To Dissemination And Implementation, Lisa S. Kilpela, Kaitlin Hill, Mackenzie Kelly, Joanna Elmquist, Paige Ottoson, Thomas Hildebrandt, Carolyn Becker

Psychology Faculty Research

Recent advances in psychological intervention research have led to an increase in evidence-based interventions (EBIs), yet there remains a lag in dissemination and implementation of EBIs. Task-shifting and the train-the-trainer (TTT) model offer two potential strategies for enhancing reach of EBIs. The Body Project, an EBI found to prevent onset of eating disorders, served as the vehicle for this dissemination/implementation study. The primary aim of this study was to determine if training of peer-leaders for the Body Project could be task-shifted to undergraduate students using a hybrid task-shifting/TTT model. Our secondary aim was to determine if subgroups of participants evidenced …

Reducing Eating Disorder Risk Factors: A Controlled Investigation Of A Blended Task-Shifting/Train-The-Trainer Approach To Dissemination And Implementation, Lisa S. Kilpela, Kaitlin Hill, Mackenzie Kelly, Joanna Elmquist, Paige Ottoson, D. Keith, Thomas Hildebrandt, Carolyn Becker

Psychology Faculty Research

Recent advances in psychological intervention research have led to an increase in evidence-based interventions (EBIs), yet there remains a lag in dissemination and implementation of EBIs. Task-shifting and the train-the-trainer (TTT) model offer two potential strategies for enhancing reach of EBIs. The Body Project, an EBI found to prevent onset of eating disorders, served as the vehicle for this dissemination/implementation study. The primary aim of this study was to determine if training of peer-leaders for the Body Project could be task-shifted to undergraduate students using a hybrid task-shifting/TTT model. Our secondary aim was to determine if subgroups of participants evidenced …

Changing The Course Of Comorbid Eating Disorders And Depression: What Is The Role Of Public Health Interventions In Targeting Shared Risk Factors?, Carolyn Becker, Maribel Plasencia, Lisa S. Kilpela, Morgan Briggs, Tiffany Stewart

Psychology Faculty Research

Public health has a productive history of improving global health due to its focus on reaching large populations using effective and scalable interventions. Yet, the marriage between evidence-based science and the implementation of community/public health interventions within mental illness remains underdeveloped. Research suggests that major depression is the most commonly cited comorbidity for eating disorders (EDs). Thus, identification of public health strategies that jointly impact depression and EDs, including shared risk factors, has the potential to significantly impact mental health suffering. The primary aim of this paper is to examine and discuss such public health approaches as well as explore …

Eating Disorder Prevention: Current Evidence-Base And Future Directions, Eric Stice, Carolyn Becker, S. Yokum

Psychology Faculty Research

Objective

This narrative review sought to (a) characterize prevention programs that have produced reliable, reproducible, and clinically meaningful effects in efficacy trials, (b) discuss effectiveness trials that have tested whether prevention programs produce intervention effects under ecologically valid real-world conditions, (c) discuss dissemination efforts and research on dissemination, and (d) offer suggestions regarding directions for future research in this field.

Conclusion

A literature revealed that 6 prevention programs have produced significant reductions in eating disorder symptoms through at least 6-month follow-up and that 2 have significantly reduced future eating disorder onset. Effectiveness trials indicate that 2 prevention programs have produced …

Reducing Self-Objectification: Are Dissonance-Based Methods A Possible Approach?, Carolyn Becker, Kaitlin Hill, Rebecca Greif, H. Han, Tiffany Stewart

Psychology Faculty Research

Background: Previous research has documented that self-objectification is associated with numerous negative outcomes including body shame, eating disorder (ED) pathology, and negative affect. This exploratory open study investigated whether or not an evidence-based body image improvement program that targets thin-ideal internalization in university women also reduces self-objectification. A second aim of the study was to determine if previous findings showing that body shame mediated the relationship between self-objectification and eating disorder pathology at a single time point (consistent with self-objectification theory) but did not mediate longitudinally (inconsistent with self-objectification theory) would be replicated in a new sample under novel conditions. …

I’M Not Just Fat, I’M Old: Has The Study Of Body Image Talk Overlooked “Old Talk?”, Carolyn Becker, Phillippa C. Diedrichs, G. Jankowski, Chelsey Werchan

Psychology Faculty Research

Background: Research indicates that body dissatisfaction is correlated with and often predictive of both physical and mental health problems. “Fat talk,” a well-studied form of body image talk in adolescents and university-aged women, has been implicated as contributing to body dissatisfaction and mediating the relationship between body dissatisfaction and other mental health problems. Limited research, however, has investigated fat talk across the female lifespan. Further, consistent with most body image research, fat talk research solely focuses on the thin dimension of idealized female attractiveness, even though other dimensions may contribute to body dissatisfaction in women.

Method: The current study investigated …

Can We Reduce Eating Disorder Risk Factors In Female College Athletes? A Randomized Exploratory Investigation Of Two Peer-Led Interventions, Carolyn Becker, Leda Mcdaniel, Stephanie Bull, Marc Powell, Kevin Mcintyre

Psychology Faculty Research

Female athletes are at least as at risk as other women for eating disorders (EDs) and at risk for the female athlete triad (i.e., inadequate energy availability, menstrual disorders, and osteoporosis). This study investigated whether two evidence-based programs appear promising for future study if modified to address the unique needs of female athletes. Athletes were randomly assigned to athlete-modified dissonance prevention or healthy weight intervention (AM-HWI). ED risk factors were assessed pre/post-treatment, and 6-week and 1-year follow-up. Results (analyzed sample, N = 157) indicated that both interventions reduced thin-ideal internalization, dietary restraint, bulimic pathology, shape and weight concern, and negative …

Peer-Facilitated Cognitive Dissonance Versus Healthy Weight Eating Disorders Prevention: A Randomized Comparison, Carolyn Becker, Chantale Wilson, Allison Williams, Mackenzie Kelly, Leda Mcdaniel, Joanna Elmquist

Psychology Faculty Research

Research supports the efficacy of both cognitive dissonance (CD) and healthy weight (HW) eating disorders prevention, and indicates that CD can be delivered by peer-facilitators, which facilitates dissemination. This study investigated if peer-facilitators can deliver HW when it is modified for their use and extended follow-up of peer-facilitated CD as compared to previous trials. Based on pilot data, we modified HW (MHW) to facilitate peer delivery, elaborate benefits of the healthy-ideal, and place greater emphasis on consuming nutrient dense foods. Female sorority members (N=106) were randomized to either two 2-hour sessions of CD or MHW. Participants completed assessment …

Use Of Empirically Supported Interventions For Psychopathology: Can The Participatory Approach Move Us Beyond The Research-To-Practice Gap?, Carolyn Becker, E. Stice, H. Shaw, S. Woda

Psychology Faculty Research

Dissemination, or distribution, of empirically-supported interventions (ESIs) for psychopathology remains a significant challenge. This paper reviews the principles of community-partnership research (CPR) and explores why CPR might improve distribution of psychological ESIs. Benefits of CPR include building trust, pooling resources and knowledge, and better serving a community by directly involving its members in the design and implementation of research. In addition, after establishing a community’s trust using CPR, researchers are likely to be better positioned to partner with communities in the further distribution of ESIs via community networks. This paper reviews the case of dissonance-based eating disorder prevention interventions to …

Dissonance-Based Interventions For The Prevention Of Eating Disorders: Using Persuasion Principles To Promote Health, Eric Stice, H. Shaw, Carolyn Becker, P. Rohde

Psychology Faculty Research

The limited efficacy of prior eating disorder (ED) prevention programs led to the development of dissonance-based interventions (DBI) that utilize dissonance-based persuasion principles from social psychology. Although DBIs have been used to change other attitudes and behaviors, only recently have they been applied to ED prevention. This article reviews the theoretical rationale and empirical support for this type of prevention program. Relative to assessment-only controls, DBIs have produced greater reductions in ED risk factors, ED symptoms, future risk for onset of threshold or subthreshold EDs, future risk for obesity onset, and mental health utilization, with some effects persisting through 3-year …

Peer Facilitated Eating Disorder Prevention: A Randomized Effectiveness Trial Of Cognitive Dissonance And Media Advocacy, Carolyn Becker, Lisa M. Smith, Anna C. Ciao

Psychology Faculty Research

This study investigated the effectiveness of two interventions in reducing eating disorder risk factors under naturalistic conditions in sororities. Based on previous research, the campus sororities chose to implement a semi-mandatory, two-session eating disorder prevention program to all new sorority members (N=90) during sorority orientation. To facilitate evaluation, sororities agreed to random assignment of new members to either a cognitive dissonance or media advocacy intervention. Undergraduate peer facilitators ran the groups. Although both interventions had an effect, cognitive dissonance generally was superior at eight-month followup. Results further support the utility of cognitive dissonance in reducing eating disorder risk factors, and …