Author: Melissa Jayne Atkinson
Atkinson, Melissa Jayne, 2014 Examination of a Mindfulness-based Prevention Program for Eating Disorders and Related Risk Factors, Flinders University, School of Psychology
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Prevention of eating disorders represents an important goal due to damaging long-term impacts on health and well-being, modest treatment outcomes, and low treatment seeking among individuals at risk. The present research therefore investigated a novel prevention approach based on mindfulness, with the aim of progressing knowledge regarding successful strategies for reducing risk of disordered eating. This research first sought to investigate individual engagement in metacognitive acceptance, a core concept within mindfulness practice. Female undergraduate students underwent a body dissatisfaction induction procedure, received training in metacognitive acceptance or no training (control), and were assessed on engagement. Non-engagement in acceptance was associated with negative affect, emotion regulation difficulties and avoidant coping. Acceptance training significantly reduced weight and appearance dissatisfaction and negative affect relative to control, with effects moderated by mindfulness, emotion regulation difficulty and avoidant coping. These findings provided support for the short-term efficacy of metacognitive acceptance, and identified the need to cater for those with emotion related difficulty when delivering acceptance-based interventions. The next objective was to conduct a controlled comparison of a mindfulness-based versus a dissonance-based program with respect to reducing risk of disordered eating in young females. This was conducted initially with a sample of young adult women experiencing body concerns, and due to limitations conferred by a small sample, was also conducted as a class-based intervention with senior female high school students. Regarding the young adults, mindfulness participants demonstrated short-term improvements in weight and shape concern, dietary restraint, thin-ideal internalisation, eating disorder symptoms and related impairment relative to control. In contrast, dissonance participants did not show significant improvements over control on any outcomes. Within the high school sample, results favoured dissonance with respect to reductions in weight concerns and negative affect; however, the pattern of results was generally weaker across the range of risk factors. In a subsample of students receiving instruction from a facilitator with a higher level of expertise in mindfulness training, positive effects for the mindfulness intervention on key risk factors emerged over follow-up. These findings support the efficacy of mindfulness-based prevention, with stronger effects seen in the older age group. Due to low recruitment, a further study investigated voluntary participation in selective eating disorder prevention programs and evaluated a motivational approach to increasing participation. Female undergraduate students were randomised to a motivational or control condition, presented with a flyer for a prevention trial and assessed regarding participation. Interest and likelihood of participation was low overall. Lack of time was the most commonly endorsed reason, with participants high on weight concerns more likely to cite the group format of the intervention as a deterrent. Belief in the helpfulness of body image programs and personal ineffectiveness were significant predictors of interest in participation. The motivational approach was not effective in increasing participation. Consequently, future eating disorder prevention efforts relying on voluntary participation may benefit from emphasising specific benefits during promotion and ensuring delivery in a time-flexible format that avoids stigmatisation. Collectively, these findings provide support for further research regarding the application of mindfulness in a prevention context. Questions that need to be addressed include best practice regarding the optimum population, delivery format and dissemination strategies of various prevention approaches to ensure maximum impact on the prevention of eating disorders.
Keywords: eating disorders,prevention,mindfulness,acceptance,cognitive dissonance
Subject: Psychology thesis
Thesis type: Doctor of Philosophy
School: School of Psychology
Supervisor: Professor Tracey Wade