Internet-based interpretation bias modification for body dissatisfaction: A three-armed randomized controlled trial
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A1 Alkuperäisartikkeli tieteellisessä aikakauslehdessä
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Authors
Dietel, Fanny Alexandra
Zache, Carina
Burkner, Paul-Christian
Schulte, Johanna
Moebius, Martin
Bischof, Annika
Wilhelm, Sabine
Buhlmann, Ulrike
Date
2020-06-01
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en
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15
972-986
972-986
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INTERNATIONAL JOURNAL OF EATING DISORDERS, Volume 53, issue 6
Abstract
Objective Appearance-related interpretation bias is postulated to play a role in the maintenance of body dissatisfaction (BD), a risk factor for body dysmorphic disorder (BDD), and eating disorders (ED). Cognitive bias modification for interpretation (CBM-I) has been shown to reduce maladaptive interpretation bias and symptoms in various emotional disorders. This study investigated the acceptability and efficacy of an easily disseminable, web-based CBM-I program for BD. Methods Individuals with high BD (N = 318) were randomized to a multi-session CBM-I (Sentence Word Association Paradigm [SWAP] with feedback) vs. control (SWAP without feedback) versus waitlist condition. Interpretation bias, BD and associated symptoms were assessed at baseline and post-intervention. Symptoms were monitored up to 1-week and 4-week follow-up. We further investigated transference effects to stress reactivity, as predicted by cognitive-behavioral models, at post-intervention. Results Appearance-related CBM-I led to a differential pre-post increase in adaptive interpretation patterns, particularly for appearance-related and social situations (d = 0.65-1.18). Both CBM-I and control training reduced BD, BDD symptom severity, and depression. However, CBM-I (vs. control and waitlist) improved appearance-related quality of life (d = 0.51), self-esteem (d = 0.52), and maladaptive appearance-related beliefs (d = 0.47). State stress reactivity was overall reduced in the CBM-I condition (vs. waitlist). Intervention effects largely held stable up to follow-ups. Treatment satisfaction was comparable to other CBM-I studies, with low rates of adverse reactions. Discussion These findings support assumptions of cognitive-behavioral models for BD, BDD, and ED, and suggest that web-based CBM-I is an efficacious and acceptable intervention option.Description
Keywords
body dissatisfaction, body dysmorphic disorder, cognitive bias modification, eating disorders, internet treatment, interpretation bias, COGNITIVE-BEHAVIORAL THERAPY, DYSMORPHIC DISORDER, EATING-DISORDERS, SOCIAL ANXIETY, MULTILEVEL MODELS, ADOLESCENT GIRLS, SELF-ESTEEM, PREVALENCE, VALIDATION, INVENTORY
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Citation
Dietel, F A, Zache, C, Burkner, P-C, Schulte, J, Moebius, M, Bischof, A, Wilhelm, S & Buhlmann, U 2020, ' Internet-based interpretation bias modification for body dissatisfaction : A three-armed randomized controlled trial ', International Journal of Eating Disorders, vol. 53, no. 6, pp. 972-986 . https://doi.org/10.1002/eat.23280