Mindfulness-based prevention for eating disorders: A school-based cluster randomized controlled study
Mindfulness-based prevention for eating disorders: A school-based cluster randomized controlled study
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DOI：
10.1002/eat.22416
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发表时间：
2015-11-01
影响因子：
5.5
通讯作者：
Wade, Tracey D.
中科院分区：
文献类型：
--
作者：
Atkinson, Melissa J.;Wade, Tracey D.
成功地预防饮食失调是一个重要的目标，因为它对健康和福祉具有破坏性的长期影响，治疗结果适中，在高危人群中寻求治疗的比例较低。基于正念的方法在饮食失调的治疗中得到了早期的支持，但还没有被评估为一种预防策略。本研究旨在评估一种新的以正念为基础的干预方法的可行性、可接受性和有效性，以降低青春期女性饮食失调的风险，在最佳(受训的促进者)和任务转移(非专家的促进者)两种条件下。方法以学校为基础的整群随机对照试验，将19个班级(N=347)的青春期女孩分配到基于正念的干预、基于不和谐的干预或照常控制的班级。对接受专家促进的156个班级的子集分别进行分析，作为最佳条件下交付的替代。结果任务转移促进对结果没有显著的干预效应。在最佳促进条件下，通过6个月的随访，接受正念训练的学生在体重和形状关注、饮食限制、瘦-理想内化、进食障碍症状和心理社会障碍方面与对照组相比显著减少。接受不和谐的学生显示出社会文化压力的显著减少。两种干预措施之间的差异无统计学意义。学生和教职员工都报告了适度的干预可接受性。讨论结果显示，正念在预防饮食失调中的应用前景光明；然而，需要进一步的工作来提高影响和可接受性，并使较不专业的提供者提供的结果能够取得成功。(C)2015 Wiley期刊公司(INJ Eat Disord 2015；48：1024-1037)。
ObjectiveSuccessful prevention of eating disorders represents an important goal due to damaging long-term impacts on health and well-being, modest treatment outcomes, and low treatment seeking among individuals at risk. Mindfulness-based approaches have received early support in the treatment of eating disorders, but have not been evaluated as a prevention strategy. This study aimed to assess the feasibility, acceptability, and efficacy of a novel mindfulness-based intervention for reducing the risk of eating disorders among adolescent females, under both optimal (trained facilitator) and task-shifted (non-expert facilitator) conditions.MethodA school-based cluster randomized controlled trial was conducted in which 19 classes of adolescent girls (N=347) were allocated to a three-session mindfulness-based intervention, dissonance-based intervention, or classes as usual control. A subset of classes (N = 156) receiving expert facilitation were analyzed separately as a proxy for delivery under optimal conditions.ResultsTask-shifted facilitation showed no significant intervention effects across outcomes. Under optimal facilitation, students receiving mindfulness demonstrated significant reductions in weight and shape concern, dietary restraint, thin-ideal internalization, eating disorder symptoms, and psychosocial impairment relative to control by 6-month follow-up. Students receiving dissonance showed significant reductions in socio-cultural pressures. There were no statistically significant differences between the two interventions. Moderate intervention acceptability was reported by both students and teaching staff.DiscussionFindings show promise for the application of mindfulness in the prevention of eating disorders; however, further work is required to increase both impact and acceptability, and to enable successful outcomes when delivered by less expert providers. (c) 2015 Wiley Periodicals, Inc. (Int J Eat Disord 2015; 48:1024-1037).