Clinical trial NCT03219814: Cognitive Dissonance and Attentional Biases Related to Body Dissatisfaction
Official title: Does a Cognitive Dissonance-Based Eating Disorder Prevention Intervention Reduce Attentional Biases in Body-Dissatisfied Women?
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Body-dissatisfaction
Keywords: body-image
attention
cognitive dissonance
eating disorder prevention
Lead sponsor: University of Calgary
Sponsor class: OTHER
First posted: 2017-07-18
Enrollment: 228
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: PREVENTION

Brief summary: The purpose of this study is to assess a cognitive dissonance-based eating disorder prevention intervention program on its ability to reduce attentional biases in body-dissatisfied women.

Detailed description: Eating disorders are some of the most prevalent psychiatric disorders affecting women in Westernized cultures, and are associated with a range of medical complications; in severe cases, eating disorders can lead to death. Unfortunately, a large proportion of individuals with eating disorders do not receive treatment, and of those who do receive treatment, only approximately 40-50% of clients are symptom-free at the end of treatment. In addition to limited efficacy, existing treatments can be time-consuming and costly. From both public health and humanitarian perspectives it is best to prevent eating disorders prior to their emergence.

This study will use a randomized, controlled design to investigate the effects of a cognitive dissonance-based intervention on attentional biases for weight words in body-dissatisfied women. Cognitive dissonance is thought to occur when there is a discrepancy between one's beliefs or attitudes, and behaviour. The experience of dissonance is thought to create discomfort, and resultantly individuals change their beliefs to be in line with their behaviours. Thus, the core tenet of cognitive dissonance-based interventions is the concept of engaging participants in counter-attitudinal behaviours (e.g., speaking out against the thin ideal) to enact change through cognitive dissonance. This cognitive dissonance-based intervention (The Body Project) targets body dissatisfaction, thin-ideal internalization, and eating disorder symptoms.

Almost all research on the Body Project has assessed its efficacy via self-report, however, this study will use an eye-tracker to measure the gaze. Attentional biases are less susceptible to self-reporting biases than traditional pencil-and-paper questionnaires and so are a more reliable measure of cognitive processing The participants in this study will be placed into one of three different conditions: cognitive dissonance (CD), media psychoeducation (MP), or waitlist control (WL), and a similar number of women will be allocated to the body-satisfied (BS) condition. Both the CD and MP intervention groups will consist of two approximately 2-hour sessions scheduled one week apart, as well as a 30-minute online follow-up questionnaire 1 month after the second intervention/assessment session. Individuals allocated to WL will begin to receive the intervention approximately 5 weeks after the CD and MP groups (after their 1 month follow-up survey). The BS group will consist of two approximately 35- to 40-minute assessment-only sessions scheduled one week apart.

All groups of participants will full out several self-report questionnaire as well as participate in a brief eye-tracking assessment both before and after their allocated intervention group (the BS condition and waitlist control will only complete the questionnaires and eye tracking assessment). Participants will sign up for a group time slot, and the group time slots will be randomly assigned to be given either the CD, and MP, or the WL condition.

Participants will be recruited through the University of Calgary Department of Psychology Research Participation System (RPS) as well as campus community participants recruited through campus advertisements. Potential participants will be pre-screened for the presence of body dissatisfaction (or body satisfaction for the BS assessment only group).

Eligibility criteria: Inclusion Criteria:

* body-dissatisfied for three conditions (cognitive dissonance, media psychoeducation, waitlist control)
* body-satisfied for one condition (body-satisfied assessment only condition)
* female-identified for all conditions

Exclusion Criteria:

* male-identified

Primary outcomes:
measure: Change from baseline attentional bias after completing the intervention/control condition, week 2
timeFrame: change in attentional bias from baseline recorded at the end of the assigned intervention/control condition (week 2)
Secondary outcomes:
measure: Change from baseline body dissatisfaction after completing the intervention/control condition, week 2
timeFrame: change in BSQ score from baseline measured at the end of the assigned intervention/control condition (week 2)
measure: Change from baseline body dissatisfaction at the one-month follow up
timeFrame: change in BSQ score from baseline measured in online follow-up survey administered one month after week 2 of the assigned intervention/control condition
measure: Change from baseline body appreciation after completing the intervention/control condition, week 2
timeFrame: change in Body Appreciation Scale score measured at the end of the assigned intervention/control condition (week 2)
measure: Change from baseline body appreciation at the one-month follow up
timeFrame: change in Body Appreciation Scale score measured in online follow-up survey administered one month after week 2 of the assigned intervention/control condition
measure: Change from baseline thin-ideal internalization after completing the intervention/control condition, week 2
timeFrame: change in SATAQ score measured at the end of the assigned intervention/control condition (week 2)
measure: Change from baseline thin-ideal internalization at the one-month follow up
timeFrame: Change in SATAQ score measured in online follow-up survey administered one month after week 2 of the assigned intervention/control condition
measure: Change from baseline eating pathology after completing the intervention/control condition, week 2
timeFrame: change in EDE-Q score measured at the end of the assigned intervention/control condition (week 2)
measure: Change from baseline eating pathology at the one-month follow up
timeFrame: change in EDE-Q score measured in online follow-up survey administered one month after week 2 of the assigned intervention/control condition
measure: Change from baseline explicit weight stigma after completing the intervention/control condition, week 2
timeFrame: change in Anti-Fat Attitudes Questionnaire score measured at the end of the assigned intervention/control condition (week 2)
measure: Change from baseline explicit weight stigma at the one-month follow up
timeFrame: Change in Anti-Fat Attitudes Questionnaire score measured in online follow-up survey administered one month after week 2 of the assigned intervention/control condition
measure: Change from baseline weight self-stigma after completing the intervention/control condition, week 2
timeFrame: change in Weight Self-Stigma Questionnaire score measured at the end of the assigned intervention/control condition (week 2)
measure: Change from baseline weight self-stigma at the one-month follow up
timeFrame: change in Weight Self-Stigma Questionnaire score measured in online follow-up survey administered one month after week 2 of the assigned intervention/control condition
measure: Change from baseline state body dissatisfaction after completing the intervention/control condition, week 2
timeFrame: change in Body Dissatisfaction Visual Analogue Scale score measured at the end of the assigned intervention/control condition (week 2)
measure: Change from baseline state body dissatisfaction at the one-month follow up
timeFrame: change in Body Dissatisfaction Visual Analogue Scale score measured in online follow-up survey administered one month after week 2 of the assigned intervention/control condition
Other outcomes:
Locations:
city: Calgary
country: Canada
facility: University of Calgary
state: Alberta
Study officials:
affiliation: University of Calgary
name: Kristin von Ranson, PhD
role: PRINCIPAL_INVESTIGATOR
References:
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citation: Stice, E., Rohde, P., & Shaw, H. (2013). The Body Project: A dissonance-based eating disorder prevention intervention (Updated ed.). Facilitator guide.
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citation: Tobin LN, Sears CR, von Ranson KM. Two eating disorder preventive interventions reduce attentional biases in body-dissatisfied university women: A cluster randomized controlled trial. J Consult Clin Psychol. 2022 Dec;90(12):911-924. doi: 10.1037/ccp0000768. Epub 2022 Nov 17.