1. Wendy L. Wolfe, Kaitlyn Patterson, & Hannah Towhey
Comparison of a Gratitude-Based and a Cognitive Restructuring Intervention for Body Dissatisfaction and Eating Behavior in College Women
Wendy L. Wolfe, Kaitlyn Patterson, & Hannah Towhey
body image. Grat participants received a workbook with instructions to create a gratitude list (a list enumerating the things for which they felt grateful) on a daily basis for 14 days. CR participants received a workbook with automatic thought records (ATR’s) and instructions for completing the ATR’s on a daily basis for 14 days. CR participants were encouraged to complete the ATR’s in reference to negative thoughts about the body, or in reference to general negative thoughts if negative body–related thoughts had not occurred that day. After reviewing their workbooks, but prior to beginning the intervention, participants rated how effective they anticipated the intervention would be (expectancy). During the intervention phase, participants in the Grat and CR conditions were sent a daily to assess perceived difficulty and time spent on the previous day’s worksheet. Participants turned in their workbook pages at the end of each week. At the end of the 14 days, participants completed the following measures in Survey Monkey: BSQ, BAS, B-ES, EAT, BES, CES-D, and PANAS, and were debriefed.
Introduction
Gratitude interventions have been used effectively in the treatment of depression, PTSD, and for improving psychological wellness (Nelson, 2009). Recently, researchers have investigated the efficacy of gratitude interventions for decreasing body dissatisfaction among a sample of self-selected male and female adults from the United Kingdom (Geraghty, Wood, & Hyland, 2010). Results demonstrated that the gratitude intervention (Grat) worked equally well to decrease body dissatisfaction as a cognitive restructuring intervention (CR) and that both performed significantly better than no intervention. Moreover, fewer participants dropped out of the Grat condition, indicating that such an intervention may be associated with greater adherence than the more established CR interventions used for improving body satisfaction. We have extended this investigation by comparing Grat, CR, and control conditions on both body dissatisfaction and eating behaviors in a college female population. Through this investigation, we hope to replicate the findings of Geraghty et al. (2010) in a non-self-selection sample.
Figure 1. Body dissatisfaction as measured by the BSQ between the pre-intervention and the post-intervention.
Figure 2. Body satisfaction as measured by the B-ES (Weight Concern Scale) between the pre-intervention and the post-intervention.
Results
Results indicated no pre-intervention differences across conditions on any dependent variable and no differences between the Grat and CR conditions on expectancy, difficulty, or time spent on the intervention. Responses to body dissatisfaction, eating, and mood measures after the two-week intervention period were compared to participants’ earlier responses. Researchers performed repeated-measures general linear model analyses and found that the Grat intervention performed better than the other conditions at decreasing levels of body dissatisfaction on the B-ES, weight concern subscale [F(2, 104)=8.54, p<.01] and the BSQ [F(2, 105)=5.05, p<.01]. Moreover, the Grat intervention performed better on the EAT [F(2,105)= 4.4, p<.05]. The Grat intervention also performed better at decreasing negative mood on the PANAS [F(2, 105)=5.02, p<.01] and the CES-D [F(2, 104)=6.45, p<.01]. Additionally, the Grat intervention increased positive mood on the PANAS [F(2, 105)=3.56, p<.05]. Significantly more Grat participants (80%) than CR participants (67%) completed the two week intervention (p<.05). To compare the efficacy of the interventions in a sub-clinical sample, data from participants with a high degree of body dissatisfaction (1 standard deviation above the published mean of the BSQ and the B-ES) were analyzed separately (N = 47). The gratitude intervention performed better than the other conditions at decreasing body dissatisfaction on the weight concern scale of the B-ES [F(2,44)=6.42, p<.01] and the results from the other body dissatisfaction measures, while not statistically significant, trended in the same direction.
Method
Participants
Participants were 107 female undergraduate students, who received course credit for their participation (61.5% Caucasian, M age= 20.44).
Materials and Procedures
Our study was conducted in two phases. In the first phase, participants completed the following measures in Survey Monkey: Body Shape Questionnaire (BSQ), Eating Attitudes Test (EAT), Positive and Negative Affect Scale (PANAS), Body Esteem Scale (B-ES), Center for Epidemiologic Studies Depression Scale (CES-D), Body Appreciation Scale (BAS), and the Binge Eating Scale (BES). Other distractor measures and measures of potential mediators were interspersed with the above measures.
All participants who completed the first survey were invited to complete a second (intervention) phase of the study. Participants were randomly assigned to the Grat (N=35), CR (N=28), or control (N=45) conditions and were ed the appropriate intervention workbook. All participants received basic educational information about
Figure 3. Change in eating disorder symptoms as measured by the EAT between the pre-intervention and the post-intervention.
Figure 4. Change in depressive symptoms as measured by the CES-D between the pre-intervention and the post-intervention.
Conclusion
Our results illustrate a significant difference in how CR interventions and Grat interventions affect change on the BSQ, B-ES, EAT, PANAS, and CES-D measures in a non-clinical population. Not only did the gratitude intervention perform better on these measures, but the cognitive restructuring intervention tended to have the opposite effect. Our results suggest that in a nonclinical population, gratitude interventions should be considered to decrease body dissatisfaction, dysfunctional eating behaviors, depression, and negative mood.
Key References
Geraghty, A.W., Wood, A. M., Hyland, M.E. (2010). Attrition from self-directed interventions: investigating the
relationship between psychological predictors, intervention content and dropout from a body dissatisfaction intervention. Social Science and Medicine, 71,
Nelson, C. (2009). Appreciating gratitude: can gratitude be used as a psychological intervention to improve individual well-being. Counseling Psychology Reviews, 24(3&4),
For further information, contact: Wendy Wolfe, Poster presented at the 49th Annual Convention of ABCT (November, 2015)