Eating Disorder Prevention Programs: A Meta-Analytic Review Eric Stice and Heather Shaw Presented by Lisa Hoekzema Radford University

Purpose Better prevention programs need to be developed because: –Eating pathology is one of the most prevalent psychiatric problems for women and girls –Less than a third of individuals with eating disorders receive treatment –Treatment produces symptom remission in only 40% to 60% of patients

Issues to Consider Will programs that are targeted at a high-risk group prove more successful than universal programs? Are intervention effects stronger for female only groups verses male or mixed gender groups? Do programs targeted at participants who are in the developmental period in which the pathology typically begins show better results?

Issues to Consider Are interactive programs more effective than didactic programs? Will stronger effects be seen in multiple session interventions relative to single session? Do programs that focus on established risk factors rather than non-established factors have a larger effect?

Dependent Measures Knowledge Body Mass Thin-ideal internalization Body dissatisfaction Dieting Negative affect Eating pathology

Literature Review Computer search ( ) –PsychINFO –MEDLINE –Dissertation Abstracts International –Cumulative index to nursing and Allied Health Literature Key word: Eating disorder, eating pathology, anorexia, anorexic, bulimia, bulimic, binge eating, prevention, preventive, intervention

Literature Review Table of contents from related journals –International Journal of Eating Disorders, Journal of Consulting and Clinical Psychology… Reference sections of all identified articles, chapters and books Researcher’s unpublished work Found Studies that met criteria –60 separate effect sizes

Inclusion/Exclusion Rules Included both trials that tested for intervention effects on eating pathology and those that focused on intervention effects on risk factors that have been established as predictors of eating pathology Must have random assignment to group and control group Must know if experimental group effects were significantly different from the control group effects Must include a minimum of 10 trials

Potential Moderators Target audience Method of presentation Age of participants Gender composition of group Number of sessions Program content Validity of scales used

Results: Knowledge Average Effect Size at termination:.30* Χ 2 (15, N= 16)= * Moderators: none Average Effect Size at Follow-Up:.29* Χ 2 (12, N= 13)= 97.76* Moderators: none

Results: Body Mass Average Effect Size at termination:.12* Χ 2 (10, N= 11)= 25.95* Average Effect Size at Follow-Up:.05 Χ 2 (10, N= 11)= 18.26, ns Follow-UP Group risk format 2.15* age gender number of sessions content valid measures?

Results: Thin-Ideal Internalized Average Effect Size at termination:.30* Χ 2 (15, N= 16)= * Average Effect Size at Follow-Up:.15 Χ 2 (16, N= 17)= 25.88, ns Follow-UP Group risk 2.93* format age 2.16* gender 2.04* number of sessions content-2.20* valid measures?2.50*

Results: Body Dissatisfaction Average Effect Size at termination:.13* Χ 2 (45, N= 46)= 85.02* Average Effect Size at Follow-Up:.12* Χ 2 (36, N= 37)= 76.11* Follow-UP Group risk 4.71* 6.72* format 1.97* age 2.03* 3.81* gender 2.52* number of sessions2.15* content3.52* valid measures? 2.69*

Results: Dieting Average effect size at termination=.11* Χ 2 (32, N= 33)= 59.76* Average effect size at follow-up=.11* Χ 2 (31, N= 32)= 66.58* Follow-UP Group risk 2.88* 6.40* format 2.54* 2.69* age 3.77* gender number of sessions3.27* content valid measures?

Results: Negative Affect Average effect size at termination=.14* Χ 2 (33, N= 32)= 77.41* Average effect size at follow-up=.09* Χ 2 (22, N= 23)= 27.04, ns Follow-UP Group risk 6.20* format 2.28* age 2.90* gender number of sessions content-3.40* valid measures?

Results: Eating Pathology Average effect size at termination=.12* Χ 2 (38, N= 39)= 83.11* Average effect size at follow-up=.12* Χ 2 (27, N= 28)= 42.81* Follow-UP Group risk 5.34* 4.80* format 3.93* 1.99* age 2.55* 2.93* gender number of sessions2.48* content-2.60*-2.04* valid measures?

Conclusions/Recommendations There may be multiple approaches that prevent eating pathology Better outcomes for: –High-risk participants –Interactive programs –Participants who were 15+ years old –Female only programs –Multiple sessions –Studies that used validated measures If the best intervention was used, 60,157 cases of pathology could be prevented