Reducing body dissatisfaction in adolescent girls: development and evaluation of a school-based cognitive-behavioural intervention

Di Stefano, T 2013, Reducing body dissatisfaction in adolescent girls: development and evaluation of a school-based cognitive-behavioural intervention, Doctor of Philosophy (PhD), Health Sciences, RMIT University.


Document type: Thesis
Collection: Theses

Title Reducing body dissatisfaction in adolescent girls: development and evaluation of a school-based cognitive-behavioural intervention
Author(s) Di Stefano, T
Year 2013
Abstract The major objectives of this research were to (a) test hypothesised mediational pathways for the onset and consequences of body dissatisfaction proposed in the major theoretical formulations for this disturbance; and (b) develop and evaluate a new empirically informed school-based body dissatisfaction intervention for adolescent girls. The program featured hallmarks of clinical body image cognitive-behavioural therapy treatment plans, including identification of sociocultural influences on body image; cognitive restructuring to modify dysfunctional and overvalued appearance-related beliefs; exposure therapy to reduce body image avoidance; relapse prevention strategies; and homework assignments.

Two hundred and two adolescent females (mean age = 15.65 years, SD = 1.04 years) were recruited from a public high school and randomly assigned by class to the intervention or assessment-only control condition. Tests of hypothesised three-variable mediational pathways for the onset and consequences of body dissatisfaction provided strong cross-sectional support for the mediational relations articulated in the original dual pathway model of bulimic pathology (Stice, Nemeroff, & Shaw, 1996), but little evidence was found for those proposed in the tripartite influence model of body image and eating disturbance (Thompson, Heinberg, Altabe, & Tantleff-Dunn, 1999). Participants in the intervention condition showed significantly greater decreases in body dissatisfaction, body image emotional distress, self-reported dieting, thin-ideal internalisation, appearance social comparison, and perceived sociocultural pressure to be thin, and significantly greater increases in self-esteem, at posttest and 4-month follow-up relative to assessment-only controls. Effect sizes remained moderate to large through 4-month follow-up, and benchmarking comparisons with normative data suggested that intervention effects were clinically meaningful. A qualitative investigation was also embedded within the cluster randomised controlled trial to explore participants’ experience and perceptions of the new program. Results suggested that participants not only were able to understand, internalise, and meaningfully apply the core tenants of the intervention, but they also enjoyed the experience and would endorse its dissemination to their peers. Independent replication of results is needed from methodologically rigorous experimental studies which include an alternative intervention condition to rule out demand characteristics or expectancy effects, and a longer follow-up period to better determine the persistence of intervention effects.
Degree Doctor of Philosophy (PhD)
Institution RMIT University
School, Department or Centre Health Sciences
Keyword(s) prevention
body dissatisfaction
eating disorders
cognitive-behavioural therapy
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Created: Mon, 16 Dec 2013, 09:23:10 EST by Brett Fenton
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