Cognitive Dissonance and Attentional Biases Related to Body Dissatisfaction

Not Applicable

Completed

• Conditions: Body-dissatisfaction
• Interventions: Other: The Body Project; Other: Mediapsychoeducation

• Registration Number: NCT03219814
• Lead Sponsor: University of Calgary

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).

Basic Information
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Recruitment & Eligibility
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Study & Design
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Trial Locations

Study Timeline

• Study Start: 2017-05-19
• Study First Submitted: 2017-07-11
• Study First Submitted QC: 2017-07-13
• Study First Posted: 2017-07-18
• Primary Completion: 2018-03-28
• Study Completion: 2018-04-30
• Status Verified: 2020-01
• Last Update Submitted: 2020-01-06
• Last Update Posted: 2020-01-07

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 228

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

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Exclusion Criteria

• male-identified

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Cognitive Dissonance Intervention	The Body Project	Participants in the Cognitive Dissonance condition will complete tasks from Becker et al.'s (2005) 2-session adaptation of the Body Project. In the intervention groups, participants will be asked to consider the costs of pursuing the thin ideal in verbal, written, and behavioural exercises. Participants will be asked to assume the role as a body activist, and will be given several opportunities to vocalize opposition to the social forces that drive the thin ideal throughout the sessions. The first session will involve exercises and discussions about the thin ideal and the costs associated with pursuing it. They will be given a homework assignment to complete at home over the next week. In the following week's session the participants will engage in a role-play exercise, as well as continuing the discussion on the costs of pursuing the thin ideal.
Mediapsychoeducation Intervention	Mediapsychoeducation	Participants in the Mediapsychoeducation condition will complete two sessions of tasks as outlined for Becker et al.'s (2005) media psychoeducation group, which includes no cognitive dissonance tasks. The first session will have the participants discuss the thin ideal and the media's influence on it. They will then watch a 35-minute psychoeducational video on the influence that advertisements have on body image and perpetuating the thin ideal. They will be assigned homework to complete at home during the week between the sessions. The second session will include a discussion surrounding the attainability to the thin ideal, and this discussion will also be expanded to include all forms of media. Participants will then be asked to consider and discuss differences between media images and themselves, as well as whether achieving this "ideal" is realistic, and the costs in trying to achieve this thin ideal. They will then watch a 20-minute video on eating disorders.

Primary Outcome Measures

Name	Time	Method
Change from baseline attentional bias after completing the intervention/control condition, week 2	change in attentional bias from baseline recorded at the end of the assigned intervention/control condition (week 2)	using an EyeLink 1000 eye-tracking system gaze will be tracked for biases to view weight words and images

Secondary Outcome Measures

Name	Time	Method
Change from baseline explicit weight stigma after completing the intervention/control condition, week 2	change in Anti-Fat Attitudes Questionnaire score measured at the end of the assigned intervention/control condition (week 2)	Explicit weight stigma will be assessed using the Anti-Fat Attitudes Questionnaire (Crandall, 1994)
Change from baseline body dissatisfaction after completing the intervention/control condition, week 2	change in BSQ score from baseline measured at the end of the assigned intervention/control condition (week 2)	Level of body dissatisfaction will be measured using the Body Shape Questionnaire (BSQ; Cooper, Taylor, Cooper, \& Fairburn, 1987).
Change from baseline body dissatisfaction at the one-month follow up	change in BSQ score from baseline measured in online follow-up survey administered one month after week 2 of the assigned intervention/control condition	Level of body dissatisfaction will be measured using the Body Shape Questionnaire (BSQ; Cooper, Taylor, Cooper, \& Fairburn, 1987).
Change from baseline body appreciation at the one-month follow up	change in Body Appreciation Scale score measured in online follow-up survey administered one month after week 2 of the assigned intervention/control condition	body appreciation will be assessed using the the Body Appreciation Scale (Tylka \& Wood-Barcalow, 2015).
Change from baseline thin-ideal internalization at the one-month follow up	Change in SATAQ score measured in online follow-up survey administered one month after week 2 of the assigned intervention/control condition	thin-ideal internalization will be assessed using the internalization subscale of the Sociocultural Attitudes Towards Appearance Questionnaire (SATAQ; Schaefer et al., 2015)
Change from baseline body appreciation after completing the intervention/control condition, week 2	change in Body Appreciation Scale score measured at the end of the assigned intervention/control condition (week 2)	body appreciation will be assessed using the the Body Appreciation Scale (Tylka \& Wood-Barcalow, 2015).
Change from baseline thin-ideal internalization after completing the intervention/control condition, week 2	change in SATAQ score measured at the end of the assigned intervention/control condition (week 2)	thin-ideal internalization will be assessed using the internalization subscale of the Sociocultural Attitudes Towards Appearance Questionnaire (SATAQ; Schaefer et al., 2015)
Change from baseline eating pathology after completing the intervention/control condition, week 2	change in EDE-Q score measured at the end of the assigned intervention/control condition (week 2)	eating pathology will be assessed using the Eating Disorder Examination Questionnaire (EDE-Q 6.0; Fairburn \& Beglin, 1994)
Change from baseline weight self-stigma after completing the intervention/control condition, week 2	change in Weight Self-Stigma Questionnaire score measured at the end of the assigned intervention/control condition (week 2)	Weight self-stigma will be assessed using the Weight Self-Stigma Questionnaire (Lillis et al., 2010)
Change from baseline state body dissatisfaction after completing the intervention/control condition, week 2	change in Body Dissatisfaction Visual Analogue Scale score measured at the end of the assigned intervention/control condition (week 2)	State body dissatisfaction will be assessed using a Visual Analogue Scale that asks participants to rate their current level of body satisfaction/dissatisfaction on a scale from 0 (extremely satisfied with your body) to 100 (extremely dissatisfied with your body)
Change from baseline eating pathology at the one-month follow up	change in EDE-Q score measured in online follow-up survey administered one month after week 2 of the assigned intervention/control condition	eating pathology will be assessed using the Eating Disorder Examination Questionnaire (EDE-Q 6.0; Fairburn \& Beglin, 1994)
Change from baseline explicit weight stigma at the one-month follow up	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	Explicit weight stigma will be assessed using the Anti-Fat Attitudes Questionnaire (Crandall, 1994)
Change from baseline weight self-stigma at the one-month follow up	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	Weight self-stigma will be assessed using the Weight Self-Stigma Questionnaire (Lillis et al., 2010)
Change from baseline state body dissatisfaction at the one-month follow up	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	State body dissatisfaction will be assessed using a Visual Analogue Scale that asks participants to rate their current level of body satisfaction/dissatisfaction on a scale from 0 (extremely satisfied with your body) to 100 (extremely dissatisfied with your body)

Trial Locations

Locations (1)

University of Calgary; 🇨🇦 Calgary, Alberta, Canada