Intervention Programs Reduce Cardiac Risk in Eating Disorders
Disonance-based prevention programs can reduce both the symptoms of eating disorders and the associated cardiac risks.
A dissonance-based prevention program can reduce the symptoms of eating disorders as well as reduce cardiac risk in women with eating disorder symptoms, according to a study published in Health Psychology.
In this study, researchers from Cornell College in Mount Vernon, Iowa, working together with researchers from the University of Iowa in Iowa City, enlisted 47 women with subclinical and clinical eating disorder symptoms from 2 Midwestern cities and 5 surrounding suburban and rural communities. Although previous research primarily focused on cardiac risks in the treatment realm, this study also sought to understand cardiac risk in subclinical populations at the prevention level.
"Dissonance programs have been implemented widely in the prevention realm and shown to be highly effective," Melinda Green, PhD, from the Department of Psychology at Cornell College Body Dissatisfaction and Eating Disorder Research Laboratory, said in an interview with Psychiatry Advisor. "Now that the authors working in this area are expanding into the realm of treatment research, I believe the efficacy of the paradigm will be demonstrated in that realm."
The researchers randomly assigned the participants to an assessment-only control program or a dissonance-based condition at baseline, postintervention, and 2-month follow-up; the latter group completed a version of The Body Project, a selective eating disorder prevention program for young women with body dissatisfaction. This group-based intervention provides a forum for young women who have internalized the thin-ideal to critique it in verbal, written, and behavioral exercises, including four 60-minute group sessions led by a trained facilitator and individual homework assignments.
"The trials explicitly address 2 significant risk factors for eating disorders; namely, self-objectification and maladaptive social comparison," Dr Green said. "Research suggests these attributes play an important role in the onset and maintenance of disordered eating. Addressing them directly in treatment and prevention paradigms may increase program efficacy."
At each assessment period, the researchers assessed QT interval length, mean R wave amplitude, vagal tone, and sympathetic tone. The researchers' prediction was confirmed: eating disorder symptoms were significantly lower and body mass index and mean R wave amplitude were significantly higher among participants in the dissonance condition at postintervention compared with baseline, and sympathetic tone was slightly higher (P < .10). R wave amplitude, sympathetic tone, and body mass index were all significantly higher in the dissonance condition at 2-month follow-up; in the control group, however, sympathetic tone decreased at follow-up, suggesting increased cardiac risk in that group over time, and confirming that dissonance-based prevention programs improve cardiac outcomes in affected women.
"We are thrilled that we were able to demonstrate significant improvements in eating disorder symptoms and cardiac risk factors in the participants involved in our research, Dr Green stated. "Cardiac causes represent one of the leading causes of death in this patient group, so this finding is significant."
Green MA, Willis M, Fernandez-Kong K, et al. Dissonance-based eating disorder program reduces cardiac risk: A preliminary trial [published online November 3, 2016]. Health Psychol. doi: 10.1037/hea0000438