Interpersonal psychotherapy for eating disorders with co-morbid depression: A pilot study

Objective: Patients with eating disorders (ED) often suffer from co-morbid depression, which may complicate the ED treatment. Previous studies have found that ED interventions seem to have limited capacity to reduce depressive symptoms. Several studies of interpersonal psychotherapy (IPT), have found that when patients have been treated for depression, co-morbid symptoms have diminished. As depression and EDs are commonly co-occurring conditions, this pilot study aimed to examine the effect of an IPT treatment for these conditions, with the focus on the depressive symptoms.

Method: In this multi-centre study, 16 patients with EDs and co-occurring major depression received 16 weeks of depression-focused IPT.

Results: Significant improvements with substantial effect sizes were found for both depression (d = 1.48) and ED (d = .93). Symptom reduction in the two syndromes were strongly correlated (r = .625, p = .004). Patients with a restrictive ED did not improve on either depression or ED symptoms.

Conclusion: These findings point to the usefulness of IPT for concurrent depression and ED with a bingeing/purging symptomatology. Working with negative affect and problem-solving related to current interpersonal problems may alleviate general psychological distress among these patients.     

The benefits of self-forgiveness on mental health: Evidence from correlational and experimental research

Previous research on self-forgiveness is mixed. Some argue self-forgiveness may have a salutary influence on mental health problems following an offense, whereas others suggest it may provide an excuse to reoffend. In two studies, we provide correlational and experimental evidence for the salutary effects of self-forgiveness following an offense. In Study 1 (N = 100), self-forgiveness was associated with lower levels of disordered eating behavior. In Study 2 (N = 462), participants recalled a drinking-related transgression, and were randomly assigned to a self-forgiveness or neutral priming condition. Results revealed that participants in the self-forgiveness condition reported significantly more self-forgiving beliefs and fewer feelings of remorse and self-condemnation than participants in the neutral priming condition to the degree that participants believed their drinking was the cause of the offense. These findings highlight the salutary effects of self-forgiveness.     

The impact of smoking cues in antismoking messages among intermittent and light smokers

Objective: Based on the Limited Capacity Model of Motivated Mediated Message Processing, this study explored the effects of smoking cues in antismoking Public Service Announcements (PSAs) on message processing among intermittent/light smokers and nonsmokers.

Method: A 2 (smoking cues: present vs. absent) × 2 (smoking status: smokers vs. nonsmokers) mixed experimental design was conducted. Self-report measures and two physiological measures including skin conductance and heart rate were examined.

Results: Messages with smoking cues generated higher levels of arousal (F = 4.57, p = .04), attention (F = 2.51, p = .04), positive message evaluation (F = 28.70, p < .001) and less intent to smoke (F = 26.60, p < .001). Intermittent and light smokers had much stronger reactions to messages containing tobacco-related visuals, including arousal (F = 4.10, p = .04), perceived ad effectiveness (F = 9.24, p = .03) and intent to smoke (F = 22.98, p < .001).

Implication: The antismoking arguments may have suppressed cue-induced smoking urges, which dampened negative persuasion outcomes. Limitations included the restricted generalisability and the focus on short-term effect. Future research may use a random sample of PSAs with a general population.     

Developing an Acceptance-Based Behavioral Treatment for Binge Eating Disorder: Rationale and Challenges

Binge eating disorder (BED), characterized by recurrent eating episodes in which individuals eat an objectively large amount of food within a short time period accompanied by a sense of loss of control, is the most common eating disorder. While existing treatments, such as cognitive behavioral therapy (CBT), produce remission in a large percentage of individuals with BED, room for improvement in outcomes remains. Two reasons some patients may continue to experience binge eating after a course of treatment are: (a) Difficulty complying with the prescribed behavioral components of CBT due to the discomfort of implementing such strategies; and (b) a lack of focus in current treatments on strategies for coping with high levels of negative affect that often drive binge eating. To optimize treatment outcomes, it is therefore crucial to provide patients with strategies to overcome these issues. A small but growing body of research suggests that acceptance-based treatment approaches may be effective for the treatment of binge eating. The goal of the current paper is to describe the development of an acceptance-based group treatment for BED, discuss the structure of the manual and the rationale and challenges associated with integrating acceptance-based strategies into a CBT protocol, and to discuss clinical strategies for successfully implementing the intervention.     

Ecological momentary assessment of bulimia nervosa: Does dietary restriction predict binge eating?

The purpose of this study was to examine the relationship between caloric restriction (CR) and binge eating (BE) using ecological momentary assessment (EMA). Participants included 133 women with bulimia nervosa (BN) who completed an EMA protocol for 2 weeks. Logistic regression analyses tested whether CR increased the probability of BE episodes. The results revealed that the odds of BE increased on the day that restriction occurred as well as on the following day. In addition, both restriction and BE on one day predicted the likelihood of BE the subsequent day, but restriction for two days prior to the episode failed to add additional information for predicting BE. These findings support the cognitive behavioral therapy (CBT) model of BN, suggesting that self-reported dietary restriction is predictive of subsequent BE episodes, and that reducing dietary restriction in treatment may lead to improvements in bulimic symptoms.     

Randomised controlled trial of a guided self-help treatment on the Internet for binge eating disorder

Binge eating disorder (BED) is a common and under-treated condition with major health implications. Cognitive behavioural therapy (CBT) self-help manuals have proved to be efficient in BED treatment. Increasing evidence also support the use of new technology to improve treatment access and dissemination. This is the first randomised controlled study to evaluate the efficacy of an Internet guided self-help treatment programme, based on CBT, for adults with threshold and subthreshold BED. Seventy-four women were randomised into two groups. The first group received the six-month online programme with a six-month follow-up. The second group was placed in a six-month waiting list before participating in the six-month intervention. Guidance consisted of a regular e-mail contact with a coach during the whole intervention. Binge eating behaviour, drive for thinness, body dissatisfaction and interoceptive awareness significantly improved after the Internet self-help treatment intervention. The number of objective binge episodes, overall eating disorder symptoms score and perceived hunger also decreased. Improvements were maintained at six-month follow-up. Dropouts exhibited more shape concern and a higher drive for thinness. Overall, a transfer of CBT-based self-help techniques to the Internet was well accepted by patients, and showed positive results for eating disorders psychopathology.     

Through the eyes of dieters: Biased size perception of food following tempting food primes

Why do some dieters succeed in controlling their diet while others do not? This research focused on a perceptual process—size perception of food objects—that may moderate the success of dieters in self-control dilemmas. We assessed successful and unsuccessful dieters' size perception of palatable food (Study 1) and diet-food (Study 2) after pre-exposing them to tempting food primes. Dieters perceived palatable food as bigger when primed with tempting food (vs. control prime), regardless of self-regulatory success in dieting (Study 1). Palatable food thus looms larger for both unsuccessful and successful dieters when in a “hot” state. In contrast, the perceived size of diet-food was increased by a tempting food prime only for successful dieters, but decreased for unsuccessful dieters (Study 2). These results are interpreted in terms of differences in the mental accessibility of competing goals (eating enjoyment vs. dieting) in successful vs. unsuccessful dieters. Indeed, when the dieting goal was made accessible for all dieters by a diet prime, even unsuccessful dieters perceived diet-food as bigger (Study 2). This research provides insight into a perceptual process that may be detrimental or beneficial in resolving self-control conflicts in the domain of eating and dieting behavior—and probably other domains of self-control as well.     

音乐节奏和共餐人数对就餐时间的影响

本实验采用现场实验研究的方法,对不同音乐节奏和共餐人数条件下大学生就餐时间的差异进行了分析。结果表明:(1)总的来说,音乐节奏对就餐时间的主效应是显著的,快节奏音乐下的就餐时间少于慢节奏下的就餐时间;(2)单人组被试就餐时间显著快于多人组被试共餐时间;(3)音乐节奏和共餐人数对就餐时间存在交互作用;(4)在单人就餐时音乐节奏对就餐时间的效应是显著的,而多人共餐则没有这种效应或效应不显著。     

The impact of advertisements featuring ultra‐thin or average‐size models on women with a history of eating disorders

Previous research demonstrates that exposure to ultra‐thin media models leads to increased body image concerns amongst women (Groesz, Levine, & Murnen, 2002 ). There is emerging evidence that attractive, average‐size models do not have this negative effect and can be effective in advertising (e.g. Halliwell & Dittmar, 2004 ). The present study investigates these factors amongst women with a history of eating disorders. Participants either viewed advertisements featuring ultra‐thin, average‐size or control images. Immediately after exposure, they reported their body‐focused anxiety and rated the effectiveness of the advertisements. Whereas exposure to ultra‐thin models did not lead to increased body‐focused anxiety, exposure to average‐size models produced a relief effect, whereby women reported lower levels of body‐focused anxiety. Advertisements featuring ultra‐thin and average‐size models were equally effective. The results suggest that average‐size, attractive models could be used effectively in advertising, which may help to relieve body image concerns amongst these women. Copyright © 2005 John Wiley & Sons, Ltd.