Cognitive Dissonance and Attentional Biases Related to Body Dissatisfaction

University of Calgary

Status: Completed

Conditions: Body-dissatisfaction

Treatments: Other: The Body Project; Other: Mediapsychoeducation

Study type: Interventional

Funder types: Other

Identifiers

NCT03219814

REB14-1451

Details and patient eligibility

About

The purpose of this study is to assess a cognitive dissonance-based eating disorder prevention intervention program on its ability to reduce attentional biases in body-dissatisfied women.

Full description

Eating disorders are some of the most prevalent psychiatric disorders affecting women in Westernized cultures, and are associated with a range of medical complications; in severe cases, eating disorders can lead to death. Unfortunately, a large proportion of individuals with eating disorders do not receive treatment, and of those who do receive treatment, only approximately 40-50% of clients are symptom-free at the end of treatment. In addition to limited efficacy, existing treatments can be time-consuming and costly. From both public health and humanitarian perspectives it is best to prevent eating disorders prior to their emergence.

This study will use a randomized, controlled design to investigate the effects of a cognitive dissonance-based intervention on attentional biases for weight words in body-dissatisfied women. Cognitive dissonance is thought to occur when there is a discrepancy between one's beliefs or attitudes, and behaviour. The experience of dissonance is thought to create discomfort, and resultantly individuals change their beliefs to be in line with their behaviours. Thus, the core tenet of cognitive dissonance-based interventions is the concept of engaging participants in counter-attitudinal behaviours (e.g., speaking out against the thin ideal) to enact change through cognitive dissonance. This cognitive dissonance-based intervention (The Body Project) targets body dissatisfaction, thin-ideal internalization, and eating disorder symptoms.

Almost all research on the Body Project has assessed its efficacy via self-report, however, this study will use an eye-tracker to measure the gaze. Attentional biases are less susceptible to self-reporting biases than traditional pencil-and-paper questionnaires and so are a more reliable measure of cognitive processing The participants in this study will be placed into one of three different conditions: cognitive dissonance (CD), media psychoeducation (MP), or waitlist control (WL), and a similar number of women will be allocated to the body-satisfied (BS) condition. Both the CD and MP intervention groups will consist of two approximately 2-hour sessions scheduled one week apart, as well as a 30-minute online follow-up questionnaire 1 month after the second intervention/assessment session. Individuals allocated to WL will begin to receive the intervention approximately 5 weeks after the CD and MP groups (after their 1 month follow-up survey). The BS group will consist of two approximately 35- to 40-minute assessment-only sessions scheduled one week apart.

All groups of participants will full out several self-report questionnaire as well as participate in a brief eye-tracking assessment both before and after their allocated intervention group (the BS condition and waitlist control will only complete the questionnaires and eye tracking assessment). Participants will sign up for a group time slot, and the group time slots will be randomly assigned to be given either the CD, and MP, or the WL condition.

Participants will be recruited through the University of Calgary Department of Psychology Research Participation System (RPS) as well as campus community participants recruited through campus advertisements. Potential participants will be pre-screened for the presence of body dissatisfaction (or body satisfaction for the BS assessment only group).

Enrollment: 228 patients

Sex: All

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• body-dissatisfied for three conditions (cognitive dissonance, media psychoeducation, waitlist control)
• body-satisfied for one condition (body-satisfied assessment only condition)
• female-identified for all conditions

Exclusion criteria

• male-identified

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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228 participants in 4 patient groups

Cognitive Dissonance Intervention

Experimental group

Description:

Participants in the Cognitive Dissonance condition will complete tasks from Becker et al.'s (2005) 2-session adaptation of the Body Project. In the intervention groups, participants will be asked to consider the costs of pursuing the thin ideal in verbal, written, and behavioural exercises. Participants will be asked to assume the role as a body activist, and will be given several opportunities to vocalize opposition to the social forces that drive the thin ideal throughout the sessions. The first session will involve exercises and discussions about the thin ideal and the costs associated with pursuing it. They will be given a homework assignment to complete at home over the next week. In the following week's session the participants will engage in a role-play exercise, as well as continuing the discussion on the costs of pursuing the thin ideal.

Treatment:

Other: The Body Project

Mediapsychoeducation Intervention

Active Comparator group

Description:

Participants in the Mediapsychoeducation condition will complete two sessions of tasks as outlined for Becker et al.'s (2005) media psychoeducation group, which includes no cognitive dissonance tasks. The first session will have the participants discuss the thin ideal and the media's influence on it. They will then watch a 35-minute psychoeducational video on the influence that advertisements have on body image and perpetuating the thin ideal. They will be assigned homework to complete at home during the week between the sessions. The second session will include a discussion surrounding the attainability to the thin ideal, and this discussion will also be expanded to include all forms of media. Participants will then be asked to consider and discuss differences between media images and themselves, as well as whether achieving this "ideal" is realistic, and the costs in trying to achieve this thin ideal. They will then watch a 20-minute video on eating disorders.

Treatment:

Other: Mediapsychoeducation

Waitlist Control

No Intervention group

Description:

The participants in the Waitlist condition will be given the Cognitive Dissonance intervention between 5 and 6 weeks after their second assessment-only session (the cognitive dissonance intervention will be offered and scheduled 1 week after their 1-month online follow-up questionnaire).

Body-Satisfied Assessment Only Condition

No Intervention group

Description:

Body-satisfied women will be recruited to engage in the assessment portion of the study only (i.e. they will be given NO intervention but are serving as a control in terms of eye-tracking assessment). Body-satisfied women will be assessed to compare their attention to weight words with body-dissatisfied women's attention to weight words. This comparison will be done with an aim of replicating the findings of Tobin (2015), to ensure that for this particular sample, body-dissatisfied women exhibit stronger attentional biases for weight words than body-satisfied women. Attention to weight words in body-satisfied women will be assessed at two time points, one week apart, to ensure there are no spurious changes in attention in body satisfied women.