Tuesday, Jan 29, 2013
PSYC*3690 Community Mental Health Lecture #7
Analysis Questions for the Reading by Stice et al (2007)
- comparing 2 interventions for eating disorders
- looking to see what the mediators were - trying to determine
how these interventions work
- what are the “active ingredients?”
- e.g. take a pill, see a wonderful outcome, mediators is how does
it achieve that outcome, what mechanism is used
1. What are the predictors/RISK FACTORS for eating disorders among adolescent girls?
- body image concerns/dissatisfaction
- having internalized the thin ideal
- negative affect
2. Does the statistic that 10% of adolescent girls have an eating disorder refer to the incidence
or the prevalence of eating disorders among this age and gender group?
3. What are the intervention strategies used in the dissonance-based program?
- voluntarily engage in verbal, written and behavioural exercises in which they critiqued the thin
- conducted in sessions and between sessions they had homework too
- had to publicly argue against the thin ideal (essays)
4. What are the intervention strategies in the healthy weight management program?
- encouraged to make healthy and lasting changes to their diet and physical activity level as a
way of balancing their energy needs with energy intake and thereby achieving a healthier
weight and satisfaction
- with support, each participant initiated an individual lifestyle change plan to reduce intake of
fat and sugar and increase physical activity
- personal lifestyle plan
- motivation interview
5. What are three outcomes that both of the above programs have achieved in previous indepen-
dent trials of each program?
- dissonance: body dissatisfaction, negative affect and bulimic symptoms
- healthy weight: produces reductions in body dissatisfaction, dieting, negative affect, and bulim-
ic symptoms 6. When the first 4-group trial was conducted (top, left of p. 21), which intervention group did
the best and which group was second best?
- dissonance participants did the best, healthy weight management was the second best
7. What was the “active” control condition used in both the first and the current 4-group trials,
and why was it important to include that condition?
- in the active control condition, participants wrote about emotionally significant topics
- expressive writing - other research shows that people benefit from writing about their traumas
- why did they have this? to isolate the effects of demand characteristics and expectancy effects
from nonspecific factors e.g. social support from the group members
- worried that it wasn’t really the specific dissonance and healthy eating, it was just giving a
group special attention which results in a placebo effect - self-fulfilling prophecy
- the writing group believes that it will help their disorder just like the other groups and are also
getting the same amount of attention
8. What does the following sentence mean: “Mediation analyses provide a test of the mecha-
nisms that putatively underlie intervention effects”?
- studying the reasons that the interventions are effecting (what changes in the individual causes
- let’s find out how and why those interventions produce those outcomes
- find the mechanisms
9. What were the hypothesized mediators of each of the two types of intervention?
- dissonance: reductions in thin-ideal internalization
- healthy eating: improvements in healthy eating and physical activity
10. Was this a universal, selective or indicated prevention program?
- selective -WRONG
- was actually INDICATED - for inclusion the students have to endorse body image concerns
during a telephone screen
- each girl was individually screened and found to be at risk
- *Indicated means everybody has been individually screened for the risk factor, not the disorder
11. Was this a primary, secondary, or tertiary prevention program?
- secondary - WRONG
- those who were confirmed cases according to the DSM of anorexia, bulimia or binge-eating
disorder were given a treatment referral and excluded
- secondary is when you intervene early in an established disorder, all of the girls with estab-
lished disorder were not included
- this is PRIMARY
12. How many times were data collected from the study participants and when?
- 4 times, once per week for 4 weeks
13. Did the study designers do anything to ensure that the program which was actually delivered
to the participants was implemented correctly? - this is an issue called Program Fidelity
- these intervention programs do specify what they should do
- these interventions won’t even be considered unless they are made into a manual that specifies
exactly what interventions you do, what training is necessary, how much you’re doing of each
- all much be specialized so it can be replicated
- one of the biggest problems in psychology is the non-replicability of studies
- there’s pressure to get significant results, how that happens is sometimes voodoo
- the vast majority of these programs have been designed and implemented by researchers
- they are able to do this because they got a big grant, they use this to hire graduate and under-
graduate students and design this program as an absolute rolls royce of a program
- everybody is excited when there is a significant result and it is published and cited
- somebody in health services reads this and thinks wow we need to do this, the problem is they
don’t have the money to replicate the program exactly like it was done in the experiment
- a rolls royce program become a hyundai
- these articles are about efficacy studies/interventions - programs done under ideal situations
- efficacy studies don’t get disseminated in a way that matches their beautiful resourced condi-