Eating Disorder Prevention Program Effectiveness Trial

饮食失调预防计划有效性试验

• 批准号: 7020063
• 负责人: ERIC M STICE
• 金额: $ 33.51万
• 依托单位: OREGON RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-03-01 至 2010-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7020063
• 关键词: adolescence (12-20); attitude; behavior therapy; behavioral /social science research tag; bulimia nervosa; clinical research; clinical trials; eating disorders; female; human subject; human therapy evaluation; interview; longitudinal human study; mental disorder prevention; mental health epidemiology; obesity; pathologic process; patient oriented research; psychopathology; psychotherapy; questionnaires

DESCRIPTION (provided by applicant): Because bulimic pathology is prevalent in adolescent girls, shows a chronic course, results in serious health problems, and is resistant to treatment, it is vital to develop prevention programs for this disorder. We plan to conduct an effectiveness trial of a targeted eating disorder prevention program that produced intervention effects for bulimic pathology, risk factors for bulimic pathology, and risk for future onset of obesity that persisted up to two years and outperformed alternative interventions in controlled efficacy trials conducted by our lab and independent labs. This proposal is the product of a 12-year program of research that identified risk factors for bulimic pathology and conducted efficacy trials of preventive interventions based on this generative research. In this dissonance-based program, an example of translational research, at-risk girls with body image concerns who have internalized the culturally sanctioned thin-ideal voluntarily engage in verbal, written, and behavioral exercises in which they critique this ideal. These counter-attitudinal activities putatively result in decreased internalization of the thin-ideal and consequent reductions in body dissatisfaction, negative affect, dieting, and bulimic pathology. We plan to test whether this targeted program produces intervention effects when delivered by natural providers in real world settings under ecologically valid conditions. We will randomly assign 330 at-risk girls (aged 14- 18) recruited from two entire school districts to the dissonance program or a psycho educational control condition and follow them for two years. School counselors will recruit and screen participants and deliver both interventions in high schools. We will test whether (1) the dissonance program results in greater decreases in bulimic pathology and risk factors for bulimic pathology than the control program, (2) intervention effects are mediated by change in thin-ideal internalization, (3) certain factors moderate program effects (e.g., poor insight regarding the costs of pursuing the thin-ideal), and (4) intervention effects occur for other ecologically meaningful outcomes (e.g., risk for obesity onset and psychosocial functioning). The proposed trial should advance the field because it will be the first effectiveness trial of an eating disorder prevention program and it will be more methodologically rigorous than past trials (e.g. will use random assignment, an attention control condition, blinded diagnostic interviews, multiple-reporter data, and a long-term follow-up).

描述（由申请人提供）：由于暴食症在青春期女孩中普遍存在，呈慢性病程，导致严重的健康问题，并且对治疗有抵抗力，因此制定针对这种疾病的预防计划至关重要。我们计划对一项有针对性的饮食失调预防计划进行有效性试验，该计划对暴食症病理学、暴食症病理学危险因素以及未来持续长达两年的肥胖风险产生干预效果，并且在对照功效试验中优于替代干预措施由我们的实验室和独立实验室进行。该提案是一项为期 12 年的研究计划的产物，该计划确定了贪食症病理学的危险因素，并根据这项生成研究进行了预防干预措施的有效性试验。在这个基于不和谐的项目中，作为转化研究的一个例子，那些对身体形象有顾虑的高危女孩已经内化了文化认可的瘦身理想，她们自愿参与口头、书面和行为练习，批评这种理想。这些反态度活动可能会导致瘦身理想的内在化减少，从而减少身体不满意、负面情绪、节食和贪食症病理。我们计划测试这个有针对性的计划在生态有效条件下由自然提供者在现实世界环境中提供时是否会产生干预效果。我们将从两个整个学区招募的 330 名高危女孩（14-18 岁）随机分配到不和谐项目或心理教育控制条件下，并跟踪她们两年。学校辅导员将招募和筛选参与者，并在高中提供这两项干预措施。我们将测试（1）与对照计划相比，失调计划是否会导致暴食症病理和暴食症危险因素更大程度的减少，（2）干预效果是由瘦理想内化的变化介导的，（3）某些因素会调节计划影响（例如，对追求理想瘦身的成本缺乏了解），以及（4）对其他具有生态意义的结果（例如，肥胖症发病风险和心理社会功能）产生干预效应。拟议的试验应该推进该领域的发展，因为这将是饮食失调预防计划的第一个有效性试验，并且在方法上比过去的试验更加严格（例如，将使用随机分配、注意力控制条件、盲法诊断访谈、多名报告者）数据并进行长期跟踪）。