The Attuned Representation Model for the Primary Prevention of Eating Disorders: An Overview for School Psychologists.

The Attuned Representation Model of eating-disorder etiology and symptom maintenance is a comprehensive model that can effectively guide prevention and treatment efforts by addressing individual, cultural, and interactive issues. The model integrates the risk factors related to the onset of eating-disordered behaviors (i.e., biological, psychological, and social) as well as addresses ongoing systemic discordance that plays a significant role in the risk, etiology, and maintenance of eating disorders. To clarify the structure of the model, it is explicated in terms of its fit with the current state of empirical etiological research. After the model is detailed, it is described within the context of the role of the school psychologist in the prevention of eating disorders. Finally, implications for future research are briefly described. © 2006 Wiley Periodicals, Inc. Eating disorders continue to pose significant risk as a psychological and medical disruption of normal childhood and adolescent development (Hoek & van Hoeken, 2003; Keel & Herzog, 2004). Although researchers and practitioners have identified many critical causal factors for integration into prevention and treatment protocols (e.g.,Austin, 2000; Myers,Wonderlich, Norton, &C rosby, 2004), cultural trends seem to be increasingly undesirable. Children and adolescents are regularly inundated with confusing and discordant messages emphasizing body shape and size. To illustrate, news media provide ongoing updates on the medical establishment’s battle against childhood obesity. Gym teachers publicly weigh children to warn of high body mass index. Parents and teachers discuss their own diets and obligatory exercise all designed to change body size and shape. Simultaneously, health class teachers and media literacy campaigns deplore waiflike presentations of women. Counselors and talk-show hosts describe extreme thinness as an illness (i.e., anorexia nervosa). All this is accompanied by a chronic barrage of media messages and sales enticements endorsing heavy and unhealthy food consumption (Bauer, Yang, & Austin, 2004) alongside the idealization of the exceptionally thin ideal for women and an unattainable muscular stature for men (Littleton & Ollendick, 2003). Disturbingly, missing from the central focus and ongoing popular dialogue is the presence of essential developmental issues such as nutrition, self-care, communication, assertiveness, and emotional regulation. It is a systemic approach to this ongoing cultural discordance, the role of individual skills and vulnerabilities, and the interface of these variables that has not been well addressed in etiological and treatment models. Understanding at this level is critical to successful prevention and treatment practices. The Attuned Representation Model is a comprehensive model that can effectively guide prevention and treatment efforts by addressing cultural, individual, and interface issues.The model integrates the risk factors related to the onset of eating-disordered behaviors (i.e., biological, psychological, and social) as well as addresses ongoing systemic discordance that plays a significant role in the risk, etiology, and maintenance of eating disorders.