A Brief, Peer Co-Led, Group-Based Eating Disorder Prevention Program for Sexual Minority Young Adult Men

项目摘要/摘要 进食障碍对治疗具有抵抗力，并与严重的发病率和死亡率有关。因此， 非常需要有效和高效的饮食失调预防计划。已经有了一个 公众和临床医生长期以来的信念是，进食障碍几乎是一种 女性问题。然而，现有的文献发现，男性也会经历饮食失调，构成 高达40%的人患有诊断性/亚阈值进食病理。在男性中，性少数群体(即， 同性恋者、双性恋者和非异性恋者)是一个显著的亚群，有很大的风险 出现进食障碍。事实上，与男性相比，性少数男性不仅风险更高 异性恋男性，但与异性恋女性相比，风险也更高。终生流行率 少数民族男性进食障碍的诊断率为8.8%，亚临床诊断率为15.6%。 这与异性恋女性形成对比，在异性恋女性中，临床和亚临床诊断的流行率为 分别为4.8%和8.0%。这些发现表明，性少数群体男性很可能是 弱势群体在饮食病理方面的风险。到目前为止，关于饮食失调的研究还很少。 性少数男性的预防方案。我们只知道之前的一个预防计划 以性少数族裔男性为目标。这个项目，骄傲身体项目，由我们的研究开发和测试 团队，是一个两节课，同伴共同领导，小组，认知不和谐为基础的饮食失调预防计划， 基于与女性共同开发的现有饮食失调预防计划。在我们的初步随机调查中 对照试验(RCT)，我们发现对进食病理和相关的进食障碍有显著和巨大的影响 风险因素，与等待名单对照条件相比，在治疗后和治疗后4周。 此外，初步的中介分析表明，外貌理想和身体的内化 在治疗条件和饮食之间的关系中，不满意是有显著差异的原因 病理学。这些结果代表了证明可接受性、可行性和 一项针对性少数男性的简短、同伴主导的进食障碍预防计划的初步效果。尽管 这些初步的发现，需要未来的研究来进一步测试这一有希望的干预措施。具体地说，它不是 与一段时间相比，是否知道骄傲身体项目会在临床和统计上产生显著影响 注意匹配控制条件。此外，目前还不清楚干预效果是否会持续到 干预后4周。考虑到这些局限性，我们建议进行一项随机对照试验 评估骄傲身体项目达到时间和注意力匹配的主动控制状态，并跟踪 参与者为期24个月。此外，我们计划评估潜在的调解人(身体不满和 内化外貌理想)对进食障碍症状的治疗效果。

Project Summary/Abstract Eating disorders are resistant to treatment and associated with significant morbidity and mortality. Thus, efficacious and efficient eating disorder prevention programs are greatly needed. There has been a longstanding belief among the general public, and clinicians, that eating disorders are nearly an exclusively female problem. However, extant literature has found that males also experience eating disorders, constituting up to 40% of individuals with diagnostic/sub-threshold eating pathology. Among males, sexual minorities (i.e., gay, bisexual, and non-heterosexual identified individuals) are a salient subgroup that is at substantial risk for developing eating disorders. Indeed, sexual minority males are not only at elevated risk compared to heterosexual males, but are also at elevated risk compared to heterosexual females. The lifetime prevalence for any eating disorder diagnosis among sexual minority males is 8.8%, and subclinical diagnosis is 15.6%. This is in contrast to heterosexual females, in which the prevalence for clinical and subclinical diagnoses are at 4.8% and 8.0%, respectively. These findings indicate that sexual minority males may well be one of the most vulnerable groups in regard to eating pathology risk. To date, there is a paucity of research on eating disorder prevention programs among sexual minority males. We are only aware of one previous prevention program targeting sexual minority males. This program, the PRIDE Body Project, developed and tested by our research team, is a two-session, peer co-led, group, cognitive dissonance-based eating disorder prevention program, based on existing eating disorder prevention programs developed with females. In our preliminary randomized controlled trial (RCT), we found significant and large effects on eating pathology and relevant eating disorder risk factors, compared to a waitlist control condition, at post-treatment and 4-weeks post-treatment. Additionally, preliminary mediation analyses revealed that internalization of the appearance ideal and body dissatisfaction accounted for significant variance in the relationship between treatment condition and eating pathology. These results represent an important first step in demonstrating the acceptability, feasibility, and preliminary efficacy of a brief, peer-led eating disorder prevention program for sexual minority males. Despite these initial findings, future research is needed to further test this promising intervention. Specifically, it is not known if the PRIDE Body Project will exert a clinically and statistically significant effect in comparison to a time and attention matched control condition. Additionally, it is unknown if the intervention effects will persist beyond 4-weeks post intervention. With these limitations in mind, we propose to conduct a randomized controlled trial assessing the PRIDE Body Project to a time and attention-matched active control condition, and follow participants for 24 months. Additionally, we plan to assess potential mediators (body dissatisfaction and internalization of the appearance ideal) of the treatment effect on eating disorder symptoms.