Date post: | 24-Dec-2015 |
Category: |
Documents |
Upload: | sibyl-mitchell |
View: | 213 times |
Download: | 2 times |
Freshmen 3033 (22%) 21%
Sophomores 2636 (19%) 23%
Juniors 1919 (14%) 20%
Seniors 3551 (26%) 20%
Graduate 2560 (19%) 10%
The most potent risk factor for developing an eating disorder is being a woman1.
For all eating disorders combined, the median age of onset was between ages 18 and 212.
5x more prevalent among13 -19 y.o. than other age groups.
3x increase in incidence of AN in females ages 20 to 303,4.
0.9% life-time prevalence of AN among women1.
AN interferes with educational, vocational, and independent functioning5.
AN increases mortality rate and rates of persistent psychological problems5.
Prevalence 1% for adult women and 1-3% among adolescent and young
adult women3,1
Greatest incidence of BN between the ages 16 - 206
3% incidence in the general adult population3
35-50% of adolescent females seeking ED symptom treatment3
Women ages 15-17 with EDNOS, 2-3x more likely to experience depression, anxiety, and substance abuse as young adults7
Subclinical eating disturbances predict onset of obesity, depression, substance abuse, among other health problems8
Prevalence 2-3%• 77% of those are women3,1
At 12 year follow-up:• 1/3 of individuals with BN or BED diagnoses
continued to meet ED criteria• 3.6% were classified as obese (BMI scores ≥
30)1
UND Reference Group
N/A 97.1% 94.8%
Experienced, w/o Affect
2.4% 4.0%
Lower Exam Grade 0.2% 0.6%
Lower Course Grade 0.2% 0.4%
Incomplete/drop 0.1% 0.1%
Thesis Disruption 0.0% 0.2%
Total: 2.9% 5.3%
58-80% of college-aged women have negative body image 9,10
Body dissatisfaction increases during and after transition from high school to college 10
ESTs:• Long-term outcomes for bulimia similar to
no treatment: ~50% at 5 years12
Prevention Programs:• Meta-analysis: 23% effectively reduced ED
symptoms immediately and at follow-up13
• 5% produced effects that lasted 1+ year(s)
13
“I am concerned about my eating habits and my body image.”
190 (30%) reported concern about eating
45 (24%) had subclinical disorder
Outreach programs (2007)
Date Self-assessments (SA)Week before
SAWeek of
SA Week after
Love your body week
1/29 – 2/2
2 4 7
Eating Disorders Awareness Week
2/26 – 3/2
7 7 7
Among UCC clients
2005 – 2006
2006 – 2007
2007 – 2008
2008 – 2009
2009 – 2010
% eating disorders diagnoses
3% 2% 1% 2% 1%
Clients reporting eating concern
Followed through on EDI-RF assessment
Met Criteria for eating- disorderedbehaviors
190 (23%) 129 (16%) 45 (5%)
Developed by Eric Stice• “Programs that Work”
Small & large-scale effectiveness trials
Independently evaluated• Decreased eating disorder rates • Decreased depression rates• Improved body satisfaction• Lowered levels of obesity at follow-up
Introductory Psychology or other Psychology Courses• Offer Extra Credit• Screeners• Online Extra Credit System (SONA Systems)
6 Semesters, 649 female students
65.8% felt moderately to extremely fat
61.3% moderate to extreme fear of fatness
56.8% self-judgments based on weight moderate to severe
54.4% self-judgments based on shape moderate to severe
2.8% laxatives ≥ 1/mo 5.3% self-induce vomiting ≥ 1/mo 5.9% took diet pills ≥1/mo 12.6% fasted for 24hr+ at a time ≥1/mo
• 3.3% ≥1/wk 15.3% take “dietary supplement” ≥1/mo
• 9.5% ≥1/wk 55.5% skipped meals ≥1/mo
• 37.3% ≥1/wk
Four, one-hour meetings, once a week Groups of 8 to 15 members, all female
students, ages 18-25 Two female facilitators Round-table seating with whiteboard Handouts provided Discussion-based content, homework
between sessions (debrief and review)
What you say and argue for/against in front of peers makes you
Disequilibrium or discomfort leads to change
Agree to attendance Agree to confidentiality Agree to participation
• All say “yes” Normalization of body image concern Course introduction/overview
Magazine pictures – collect attributes of “perfect woman”• Traits in opposition• Is it really possible to attain this?
Thin Tan Perfect skin Large breasts Long, wavy hair Outgoing Adventurous/Free
Spirit
www.victoriassecret.com
Were there other times in history when perfect woman different?
Where did the thin ideal come from?
How promoted to us?
How do such messages make you feel?
What happens if you achieve the ideal?• Really?
Differentiate healthy ideal from thin ideal
Costs of pursuing the thin ideal• Effect on health, relationships, society? • Who does benefit?
Are you one of those people?• Given the costs, does it make sense to
pursue it?
Challenging “Fat Talk”• “she really let herself go,” “your so thin
how do you do it?”• How can you stop this talk? • Can talk impact how you think about your
body?
Future pressure to be thin• Anticipate how to deal with pressure
Role play obsession with thin ideal:• “I just saw an ad for a new diet pill. I’m
going to order it so I can finally be as thin as I want”
• “She doesn’t have the body to be wearing that outfit.”
• Give counter-statements• Debrief
“I am thinking of going on a diet, want to join me?”
“Swimsuit season is just around the corner, and so I think I will start skipping breakfasts to take off some extra weight.”
Write letter to an adolescent girl struggling with body image• Costs
Self-Affirmation • Write down 10 positive qualities• Was it difficult to come up with things?
Why?• Midwest modesty
Verbal Challenge• Real-life thin ideal statements • Actual vs. ideal response?
10 things to resist the thin ideal • Example: Do not buy fashion magazines• Take one from list and do it
Was it difficult? Barriers? Could this make a difference?
Behavioral Challenge• Do something not done currently due to
body image concerns• Why do this?• Debrief:
Was it as bad as you thought it would be? Did others react? What learned?
Redo: Letter to an adolescent girl• Additional costs?
Redo: Self-Affirmation exercise• Positive Body Talk:
With a friend/family member, talk about your positives Keep a journal of the things your body allows you to do Make a pact with another to avoid negative body talk No complaints about your body – replace them with
positive statements Next time you get a compliment, accept it.
What has the class done for you• Others struggling with same problems• Feel more comfortable with self• Change in how talk about own and others’
bodies
Change from active control in manual
Same four-week group set up
Same size and facilitation
Addresses healthy activity levels and stress management at each meeting.
Addresses special topics each week.
Healthy Lifestyle – focusing mostly in this course on emotional and physical dimensions
Weekly Physical Activity Principles
Weekly Stress Management Principles
Goals set are individually tailored, monitored by facilitators, re-evaluated
Eating Healthy
Equipment/Exercise training at Wellness Center
Access to dietician and physical training staff
Progressive Muscle Relaxation
No group contact
Chosen by• Random selection• No availability • Late sign-up• Did not attend assigned groups
Given option to participate in later semesters in active groups
Demographics Multidimensional Body-Self Relations
Questionnaire (MBSRQ) Positive and Negative Affect Scale (PANAS) Weight Control Survey Ideal Body Stereotype Scale (IBSS) Body Image Quality of Life Inventory (BIQLI) Sociocultural Attitudes Toward Appearance
Questionnaire (SATAQ) Depression Anxiety Stress Scales (DASS) Self-Esteem Scale (SES) Eating Screen
Multivariate Repeated Measures Analysis• Significant interaction of pre/post * group
Appearance Evaluation Health Orientation Body Area Satisfaction Perceived Weight Class Overweight Preoccupation Ideal Body Stereotype Scale Sociocultural Attitudes Toward Attractiveness Quest. Positive Affect Depression Self-Esteem
Multiple Analyses – Bonferroni Correction (p<.002)
At Post-Test: • MBSRQ (Body Image)
BASS Weight Preoccupation
• IBSS (internalization)• SATAQ (body image/internalization)• PANAS – Positive Affect• Self-Esteem
Extra Credit Offerings for classes such as Intro to Psych
Larger groups, break into smaller groups
Sign-up at Love Your Body Week
Sorority – condensed two-meeting group
1: Treasure, Claudino, & Zucker, 2010
2: Hudson et al., 20073: Adams & Sutker,
20044: Pawluck & Gorey,
19985: Pope, Hudson,
Yurgelun-Todd, & Hudson, 1984
6: Keski-Rahkonen et al., 2009
7: Patton, et al. (2008) 8: Stice, Marti, Spoor,
Presnell, & Shaw, 2008
9: Twamley & Davis, 1999
10: Vohs, Heatherton, & Marcia, 2001
11: Seidel, Presnell, & Rosenfield, 2009
12: Fairburn, Cooper, Doll, Norman, & O'Connor, 2000
13. Stice, Shaw, & Marti, 2007
Body Image Quality of Life Inventory (BIQLI) – Cash, T.F. & Flemming, E.C. (2002)
Depression Anxiety Stress Scales (DASS) – Lovibond & Lovibond (1995)
Eating Screen – Stice, E., Fisher, M., Martinez, E. (2004)
Ideal Body Stereo Type Scale (IBSS) – Stice, E.
Multidimensional Body-Self Relations Questionnaire (MBSRQ) – Cash,T.F.
Self-Esteem Scale (SES) - Rosenberg
Sociocultural Attitudes Toward Appearance Questionnaire (SATAQ) – Thompson et al. (2004)
Weight Control Survey – Journal of American College Health