Moderators of the intervention effects for a dissonance-based eating disorder prevention program; results from an amalgam of three randomized trials

Abstract

Objective: To investigate factors hypothesized to moderate the effects of a dissonance-based eating disorder prevention program, including initial elevations in thin-ideal internalization, body dissatisfaction, eating disorders symptoms, and older participant age.

Method: Adolescent female high school and college students with body image concerns (N=977; M age=18.6) were randomized to a dissonance-based thin-ideal internalization reduction program or an assessment-only control condition in three prevention trials.

Results: The intervention produced (a) significantly stronger reductions in thin-ideal internalization for participants with initial elevations in thin-ideal internalization and a threshold/subthreshold DSM-5 eating disorder at baseline, (b) significantly greater reductions in eating disorder symptoms for participants with versus without a DSM-5 eating disorder at baseline, and (c) significantly stronger reductions in body dissatisfaction for late adolescence/young adulthood versus mid-adolescent participants. Baseline body dissatisfaction did not moderate the intervention effects.

Conclusion: Overall, intervention effects tended to be amplified for individuals with initial elevations in risk factors and a DSM-5 eating disorder at baseline. Results suggest that this prevention program is effective for a broad range of individuals, but is somewhat more beneficial for the subgroups identified in the moderation analyses.

Figure 1a

Change in thin-ideal internalization for participants with high and low thin-ideal internalization

Figure 1b

Change in eating disorder symptoms for people with high and low thin-ideal internalization at pretest

Figure 2

Change in eating disorder symptoms for participants with and without cating disorder at pretest

Figure 3

Change in body dissatisfaction for participants with age above and below the median