A novel ‘practical body image’ therapy for adolescent inpatients with anorexia nervosa: a randomised controlled trial

Abstract Purpose To determine the potential effectiveness of a novel 10-week manualised Practical Body Image therapy (PBI) with mirror exposure (ME), when used as an adjuvant to an intensive treatment package (TAU) in adolescent inpatients with Anorexia Nervosa (AN). To evaluate the effectiveness of ME in an adolescent population. Methods Using a randomised control design, 40 girls aged 11–17 years with AN were assigned to PBI with TAU (n = 20) and TAU alone (n = 20). Both groups completed self-report measures of body image at week 1 and week 10 of the study to measure the potential effectiveness of PBI. The PBI group completed measures at week 7 to evaluate the ME component. Results 31 participants completed the study; 16 TAU, 15 PBI. PBI participants had greater improvement in all outcomes than TAU participants. Medium effect sizes were seen for self-reported weight concern, body image avoidance in terms of clothing and body image anxiety. ME produced effect sizes in self-reported body image avoidance in terms of clothing and grooming that were greater than 0.40, n = 14. Conclusion The findings demonstrate that PBI supports an intensive inpatient treatment package and addresses elements of negative body image. PBI was beneficial for addressing body image dissatisfaction with improvements in weight concerns, body image avoidance and physical appearance trait anxiety following the ME component. The magnitude of the effect sizes is comparable to previous studies. Positive qualitative feedback indicated the intervention was acceptable to users. PBI is a promising new adjuvant treatment for AN. EMB Rating Level I: randomized controlled trial.

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A Short Mindfulness Retreat for Students to Reduce Stress and Promote Self-Compassion: Pilot Randomised Controlled Trial Exploring Both an Indoor and a Natural Outdoor Retreat Setting

Healthcare ◽

10.3390/healthcare9070910 ◽

2021 ◽

Vol 9 (7) ◽

pp. 910

Author(s):

Dorthe Djernis ◽

Mia S. O’Toole ◽

Lone O. Fjorback ◽

Helle Svenningsen ◽

Mimi Y. Mehlsen ◽

...

Keyword(s):

Randomised Controlled Trial ◽

Controlled Trial ◽

Effect Sizes ◽

Medium Effect ◽

Control Group ◽

Post Intervention ◽

Pilot Randomised Controlled Trial ◽

Self Compassion ◽

Randomised Controlled

Here, we developed and examined a new way of disseminating mindfulness in nature to people without meditation experience, based on the finding that mindfulness conducted in natural settings may have added benefits. We evaluated a 5-day residential programme aiming to reduce stress and improve mental health outcomes. We compared an indoor and an outdoor version of the programme to a control group in a pilot randomised controlled trial (RCT). Sixty Danish university students experiencing moderate to high levels of stress were randomised into a residential mindfulness programme indoors (n = 20), in nature (n = 22), or a control group (n = 18). Participants completed the Perceived Stress Scale and the Self-Compassion Scale (primary outcomes) along with additional secondary outcome measures at the start and end of the program and 3 months after. Stress was decreased with small to medium effect sizes post-intervention, although not statistically significant. Self-compassion increased post-intervention, but effect sizes were small and not significant. At follow-up, changes in stress were not significant, however self-compassion increased for both interventions with medium-sized effects. For the intervention groups, medium- to large-sized positive effects on trait mindfulness after a behavioural task were found post-intervention, and small- to medium-sized effects in self-reported mindfulness were seen at follow-up. Connectedness to Nature was the only outcome measure with an incremental effect in nature, exceeding the control with a medium-sized effect at follow-up. All participants in the nature arm completed the intervention, and so did 97% of the participants in all three arms. Overall, the results encourage the conduct of a larger-scale RCT, but only after adjusting some elements of the programme to better fit and take advantage of the potential benefits of the natural environment.

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Brief non-dieting intervention increases intuitive eating and reduces dieting intention, body image dissatisfaction, and anti-fat attitudes: A randomized controlled trial

Appetite ◽

10.1016/j.appet.2019.104556 ◽

2020 ◽

Vol 148 ◽

pp. 104556 ◽

Cited By ~ 3

Author(s):

Rebecca E. Wilson ◽

Rachel D. Marshall ◽

Jessica M. Murakami ◽

Janet D. Latner

Keyword(s):

Body Image ◽

Randomized Controlled Trial ◽

Controlled Trial ◽

Body Image Dissatisfaction ◽

Intuitive Eating ◽

Randomized Controlled

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Suicidal Tendencies and Body Image and Experience in Anorexia nervosa and Suicidal Female Adolescent Inpatients

Psychotherapy and Psychosomatics ◽

10.1159/000067183 ◽

2002 ◽

Vol 72 (1) ◽

pp. 16-25 ◽

Cited By ~ 19

Author(s):

Daniel Stein ◽

Israel Orbach ◽

Mirit Shani-Sela ◽

Dov Har-Even ◽

Amit Yaruslasky ◽

...

Keyword(s):

Body Image ◽

Anorexia Nervosa ◽

Female Adolescent ◽

Adolescent Inpatients

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Body image avoidance: An under-explored yet important factor in the relationship between body image dissatisfaction and disordered eating

Journal of Contextual Behavioral Science ◽

10.1016/j.jcbs.2014.01.002 ◽

2014 ◽

Vol 3 (3) ◽

pp. 203-211 ◽

Cited By ~ 30

Author(s):

C. Alix Timko ◽

Adrienne S. Juarascio ◽

Lindsay M. Martin ◽

Ashley Faherty ◽

Cynthia Kalodner

Keyword(s):

Body Image ◽

Disordered Eating ◽

Body Image Dissatisfaction ◽

The Relationship ◽

Body Image Avoidance

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Körperbezogenes Vermeidungsverhalten: Validierung des deutschsprachigen Body Image Avoidance Questionnaire (BIAQ) an Jugendlichen mit Anorexia und Bulimia Nervosa sowie einer gesunden Kontrollgruppe

PPmP - Psychotherapie · Psychosomatik · Medizinische Psychologie ◽

10.1055/s-0043-116848 ◽

2017 ◽

Vol 68 (03/04) ◽

pp. 126-136 ◽

Cited By ~ 3

Author(s):

Beate Steinfeld ◽

Manuel Waldorf ◽

Anika Bauer ◽

Thomas Huber ◽

Karsten Braks ◽

...

Keyword(s):

Body Image ◽

Anorexia Nervosa ◽

Bulimia Nervosa ◽

Konfirmatorische Faktorenanalyse ◽

Deutschsprachige Version ◽

Body Image Avoidance

ZusammenfassungKörperbezogenes Vermeidungsverhalten wird als behaviorale Manifestation einer Körperbildstörung konzeptualisiert und beschreibt Anstrengungen, der Auseinandersetzung mit dem eigenen Körper aus dem Wege zu gehen. Während Studien Hinweise darauf liefern, dass körperbezogenes Vermeidungsverhalten im Erwachsenenalter zur Entstehung und Aufrechterhaltung von Essstörungen beiträgt, existieren bisher keine entsprechenden Befunde für das Jugendalter. Der Body Image Avoidance Questionnaire (BIAQ) ist der international am weitesten verbreitete Fragebogen zur Messung des körperbezogenen Vermeidungsverhaltens. Da seine deutschsprachige Version bisher nur an einer Stichprobe aus Erwachsenen validiert wurde, ist das Ziel der vorliegenden Studie, den Fragebogen an Jugendlichen mit Essstörungen teststatistisch zu überprüfen. Insgesamt N=127 weibliche Jugendliche, davon n=57 mit einer Anorexia Nervosa und n=24 mit einer Bulimia Nervosa (BN) sowie n=46 gesunde weibliche Jugendliche beantworteten den BIAQ und verschiedene Instrumente zur Erfassung der Körperbild- und Essstörungssymptomatik. Die für die englischsprachige Originalversion angenommene Faktorenstruktur von dem Faktor höherer Ordnung „Körperbezogenes Vermeidungsverhalten“ und den 4 Subfaktoren „Kleidung“, „Soziale Aktivitäten“, „Gezügeltes Essverhalten“ sowie „Pflegen und Wiegen“ konnte durch eine konfirmatorische Faktorenanalyse bestätigt werden. Mit Ausnahme der Skala „Pflegen und Wiegen“ weisen alle Skalen eine überwiegend akzeptable interne Konsistenz, Test-Retest-Reliabilität, differenzielle Validität sowie Konstruktvalidität auf. Aufgrund ihrer befriedigenden psychometrischen Kennwerte ist der Einsatz der BIAQ-Skalen „Kleidung“, „Soziale Aktivitäten“ und „Gezügeltes Essverhalten“ auch für das Jugendalter in Forschung und Praxis zu empfehlen.

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Preocupação e insatisfação com o corpo, checagem e evitação corporal em pessoas com transtornos alimentares

Paidéia (Ribeirão Preto) ◽

10.1590/s0103-863x2012000300009 ◽

2012 ◽

Vol 22 (53) ◽

pp. 375-381 ◽

Cited By ~ 4

Author(s):

Angela Nogueira Neves Betanho Campana ◽

Maria da Consolação Gomes Cunha Fernandes Tavares ◽

Celso Garcia Júnior

Keyword(s):

Body Image ◽

Anorexia Nervosa ◽

Bulimia Nervosa ◽

Body Shape ◽

Body Checking ◽

Body Image Avoidance

Este estudo teve por objetivo avaliar aspectos da imagem corporal em uma amostra de pessoas com anorexia nervosa, bulimia nervosa e transtorno alimentar não-especificado. A amostra foi composta por 14 voluntárias atendidas pelo Ambulatório de Transtornos Alimentares da Universidade Estadual de Campinas. O Software de Avaliação Perceptiva foi utilizado para avaliar a insatisfação com o corpo. A preocupação com o corpo, checagem e evitação corporal foram avaliadas pelo Body Shape Questionnaire, Body Checking Questionnaire e Body Image Avoidance Questionnaire, respectivamente. A análise descritiva e as correlações entre as medidas mostraram elevados níveis de insatisfação, checagem, evitação e preocupação com o corpo, com associações significantes. Estes achados evidenciaram a importância dos parâmetros investigados na dinâmica dos transtornos alimentares. Conhecer esses componentes da imagem corporal favorece a ampliação das possibilidades de melhor compreender como se organiza a representação mental do corpo dessas pacientes e planejar mais cuidadosamente as intervenções no decurso do tratamento.

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Psychological interventions for adolescent psychosis: A pilot controlled trial in routine care

European Psychiatry ◽

10.1016/j.eurpsy.2013.05.008 ◽

2013 ◽

Vol 28 (7) ◽

pp. 423-426 ◽

Cited By ~ 13

Author(s):

S. Browning ◽

R. Corrigall ◽

P. Garety ◽

R. Emsley ◽

S. Jolley

Keyword(s):

Controlled Trial ◽

Behavioural Therapy ◽

Routine Care ◽

Additional Treatment ◽

Self Report ◽

Effect Sizes ◽

Psychotic Symptoms ◽

Adolescent Population ◽

Psychological Therapies ◽

Adolescent Inpatients

AbstractPurposeEvidence for the recommendation to deliver Cognitive Behavioural Therapy (CBT) and Family Interventions (FI) to under-18s with psychosis derives from adult research, and no previous study has focused exclusively on an adolescent population. We evaluated adaptations of these therapies for adolescent inpatients with psychosis (CBTpA and FIpA), delivered as an adjunct to inpatient standard care (SC).Subjects and methodsThirty adolescent inpatients with psychotic symptoms on admission were sequentially allocated to receive CBTpA + SC (n = 10); FIpA + SC (n = 10) or SC alone (n = 10). Psychotic symptoms and functioning were measured at admission and discharge.ResultsGroup comparisons did not reach conventional significance, but effect sizes in this pilot study showed a promising impact of CBTpA compared to SC alone, in reducing symptoms (ES: d = 0.6), with smaller effect sizes for functioning (d = 0.2) and for FIpA (symptoms, d = 0.1 and functioning, d = 0.4). There was no advantage of either additional treatment in reducing length of stay, but self-report satisfaction ratings were higher for both psychological therapies.Discussion and conclusionsThe study is the first to focus on an exclusively adolescent population, using appropriately adapted therapy protocols. Findings suggest that the interventions are feasible, acceptable and helpful for adolescents with psychosis. Larger randomised controlled trials are now needed.

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AN-VR-BE. A Randomized Controlled Trial for Reducing Fear of Gaining Weight and Other Eating Disorder Symptoms in Anorexia Nervosa through Virtual Reality-Based Body Exposure

Journal of Clinical Medicine ◽

10.3390/jcm10040682 ◽

2021 ◽

Vol 10 (4) ◽

pp. 682

Author(s):

Bruno Porras-Garcia ◽

Marta Ferrer-Garcia ◽

Eduardo Serrano-Troncoso ◽

Marta Carulla-Roig ◽

Pau Soto-Usera ◽

...

Keyword(s):

Body Image ◽

Virtual Reality ◽

Anorexia Nervosa ◽

Exposure Therapy ◽

Controlled Trial ◽

Control Group ◽

Significant Group ◽

Treatment As Usual ◽

Experimental Group

In vivo body exposure therapy is considered an effective and suitable intervention to help patients with anorexia nervosa (AN) reduce their body image disturbances (BIDs). However, these interventions have notable limitations and cannot effectively reproduce certain fears usually found in AN, such as the fear of gaining weight (FGW). The latest developments in virtual reality (VR) technology and embodiment-based procedures could overcome these limitations and allow AN patients to confront their FGW and BIDs. This study aimed to provide further evidence of the efficacy of an enhanced (by means of embodiment) VR-based body exposure therapy for the treatment of AN. Thirty-five AN patients (16 in the experimental group, 19 in the control group) participated in the study. FGW, BIDs, and other body-related and ED measures were assessed before and after the intervention and three months later. The experimental group received treatment as usual (TAU) and five additional sessions of VR-based body exposure therapy, while the control group received only TAU. After the intervention, ED symptoms were clearly reduced in both groups, with most of the changes being more noticeable in the experimental group. Specifically, after the intervention and at follow-up, significant group differences were found in the FGW and BIDs, with the experimental group showing significantly lower values than the control group. The current study provides new insights and encouraging findings in the field of exposure-based therapies in AN. VR technology might improve research and clinical practice in AN by providing new tools to help patients confront their core fears (i.e., food- or weight-related cues) and improve their emotional, cognitive, and behavioral responses to their body image.

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Comparing Effectiveness of HRV-Biofeedback and Mindfulness for Workplace Stress Reduction: A Randomized Controlled Trial

Applied Psychophysiology and Biofeedback ◽

10.1007/s10484-020-09477-w ◽

2020 ◽

Vol 45 (4) ◽

pp. 307-322

Author(s):

Amelie Edith Brinkmann ◽

Sophia Antonia Press ◽

Eduard Helmert ◽

Martin Hautzinger ◽

Inna Khazan ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Stress Reduction ◽

Small Sample Size ◽

Controlled Trial ◽

Small Sample ◽

Workplace Stress ◽

Effect Sizes ◽

Medium Effect ◽

Control Group ◽

Randomized Controlled

Abstract Psychophysiological disorders due to work-related stress continue to be highly costly for health systems and approaches for cost-effective and easily accessible interventions are much needed. Both heart rate variability-biofeedback (HRV-Bfb) and mindfulness-based interventions (MBI) have been empirically shown to reduce stress. This study compares these two interventions in the work context to a wait-list-control-group (WLC). In this three-armed randomized controlled trial (RCT), 69 healthy adults employed in the same organization were randomized to participate in HRV-Bfb, MBI or the WLC. Participants were assessed for psychophysiological parameters of stress (stress perception, coping, HRV parameters and cortisol) and stress related symptoms (depressive symptoms, psychological wellbeing, mindfulness and self-compassion). Participants trained using either HRV-Bfb or MBI for 6 weeks on a daily basis. Outcomes were assessed at baseline, after the intervention and at follow-up 12 weeks later. Results did not show any statistically significant differences between HRV-Bfb and MBI groups, and neither of the intervention groups (IGs) differed from the WLC. Findings suggest an overall reduction in stress for all groups, including the WLC, with mostly small to medium effect sizes. However, it is important to note that participants with higher baseline stress levels might benefit more from mindfulness and biofeedback-based stress reduction interventions. The results have to be interpreted with caution due to the relatively small sample size. MBI might have a slightly stronger effect on stress reduction in comparison to HRV-Bfb, as suggested by the effect sizes. This study highlights issues and challenges of the implementation of such interventions in corporate health management.

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