Singing Your Negative Body-Related Thoughts

York University

Status: Completed

Conditions: Body Dissatisfaction

Treatments: Behavioral: Cognitive Defusion

Study type: Interventional

Funder types: Other

Identifiers

NCT03646305

2018-111

Details and patient eligibility

About

Study Objectives:

1. Examine whether singing can be used as a cognitive defusion strategy to change one's appraisals of body-related thoughts so they are less threatening to the individual.
2. Explore whether this technique can change the appraisals of one's body (i.e. increasing body satisfaction, increasing body esteem, decreasing the drive towards thinness), as well as increase mood and self-esteem.
3. Compare singing to the defusion strategy of verbal repetition, as well as control conditions, to determine the effectiveness of these techniques.
4. Examine whether defusion techniques would be particularly beneficial for individuals with high thought-shape fusion

Study Hypotheses:

The primary hypothesis was that the cognitive defusion conditions, namely verbal repetition and singing, would foster greater detachment (i.e. defusion) from negative body-related thoughts and change thought appraisals such that these thoughts were less believable and less negative, and the individual was more willing, less likely to avoid, and less uncomfortable when engaging with these thoughts than the control conditions.

Secondary hypotheses propose that these defusion techniques will reduce negative body-related cognitions such as body image distress, drive for thinness, and body dissatisfaction to a greater extent than the control conditions. Moreover, compared to the control condition, these techniques are expected to be superior in reducing negative mood and improving self-esteem. Finally, better outcomes are expected from those in the defusion conditions who practice the technique as instructed (i.e. better homework adherence). Due to the novelty of this intervention, no specific hypotheses have been made regarding whether singing will equal or differ from verbal repetition on the aforementioned outcome measures. Moreover, due to the exploratory nature of applying defusion techniques with individuals with thought-shape fusion, no specific hypotheses have been made around anticipated changes in the perception of the thought, body image satisfaction, mood, self-esteem, and cognitive defusion within this population.

Full description

Eating disorders are characterized by intense mental preoccupation with body shape and weight. Even in the absence of disordered eating, high levels of body dissatisfaction prospectively predict depression and low self-esteem in young women. Common intervention strategies, such as challenging the validity of negative body-related thoughts, often have limited success. Recent research suggests that accepting, rather than challenging, negative body-related thoughts may reduce body image distress by changing the relationship with those thoughts. For example, continually repeating or even singing an unwanted thought has been shown to reduce the believability and discomfort associated with that thought, through a technique known as cognitive defusion. The current study aims to extend the literature on cognitive defusion and test its effectiveness in the treatment of body dissatisfaction. In a randomized controlled trial design, 122 female restrained eaters were randomly assigned to practice either 1) verbally repeating negative body-related thoughts, 2) singing negative body-related thoughts, 3) verbally repeating body-unrelated thoughts (control), or 4) singing body-unrelated thoughts (control). The goal of this study was to determine whether singing one's negative body-related thoughts could lead to greater changes in perception of the thought, body image satisfaction, mood, and self-esteem relative to a control condition when practiced twice daily for one week.

Enrollment: 133 patients

Sex: Female

Ages: 17+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Restrained eaters, as indicated by a score of 15 or greater on the Revised Restraint Scale (Polivy, Herman, & Howard, 1988)
• Identify as female
• Age 17 and older

Exclusion criteria

• Under age 17
• Do not identify as female
• Scores below 15 on the Revised Restraint Scale (Polivy, Herman, & Howard, 1988).

Trial design

Primary purpose: Supportive Care

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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133 participants in 4 patient groups

Verbally repeat body-related thoughts

Experimental group

Description:

A cognitive defusion strategy in which participants repeat a target unwanted thought out loud and as quickly as possible for 60 seconds.

Treatment:

Behavioral: Cognitive Defusion

Sing negative body-related thoughts

Experimental group

Description:

A cognitive defusion strategy in which participants sing a target unwanted thought to the tune of 'twinkle, twinkle' for 60 seconds

Treatment:

Behavioral: Cognitive Defusion

Verbally repeat body-unrelated thoughts

No Intervention group

Description:

A control condition in which participants repeat the phrase "I am talking" out loud and as quickly as possible for 60 seconds.

Sing body-unrelated thoughts

No Intervention group

Description:

A control condition in which participants sing the phrase "I am singing" to the tune of 'twinkle, twinkle' for 60 seconds