Catherine Cook-Cottone

Group Prevention of Eating Disorders with Fifth-Grade Females: Impact on Body Dissatisfaction, Drive for Thinness, and Media Influence

This study investigated the impact of a primary prevention program for eating disorders aimed at fifth-grade females. The curriculum was based on empirically validated risk and protective factors and incorporated interactive discourse, yoga, and relaxation into 10 weekly sessions. Pre- and post-test data from three groups conducted over the course of 13 months were combined for a total of 45 participants. Results indicate completion of the group resulted in a significant decrease on scales measuring body dissatisfaction and drive for thinness, as well as media influence. Implications for practice and future research are discussed. The authors wish to thank Dr. Martin Volker for his invaluable help with the statistical analyses.

Incorporating positive body image into the treatment of eating disorders: A model for attunement and mindful self-care.

This article provides a model for understanding the role positive body image can play in the treatment of eating disorders and methods for guiding patients away from symptoms and toward flourishing. The Attuned Representational Model of Self (Cook-Cottone, 2006) and a conceptual model detailing flourishing in the context of body image and eating behavior (Cook-Cottone et al., 2013) are discussed. The flourishing inherent in positive body image comes hand-in-hand with two critical ways of being: (a) having healthy, embodied awareness of the internal and external aspects of self (i.e., attunement) and (b) engaging in mindful self-care. Attunement and mindful self-care thus are considered as potential targets of actionable therapeutic work in the cultivation of positive body image among those with disordered eating. For context, best-practices in eating disorder treatment are also reviewed. Limitations in current research are detailed and directions for future research are explicated.

Manualized-Group Treatment of Eating Disorders: Attunement in Mind, Body, and Relationship (AMBR)

This article describes a manualized-group treatment of eating disorders, the attunement in mind, body, and relationship (AMBR) program. The cognitive behavioral and dialectic behavioral research as well as the innovative prevention interventions upon which the program is based (e.g., interactive discourse, yoga, and mediation) are introduced. The programs cohesive and integrative nature is explained through a unifying eating disorder theory and unique curricular aspects are explicated. Preliminary data are provided.

Technology and New Directions in Professional Development: Applications of Digital Video, Peer Review, and Self-Reflection.

Pedagogical applications of technology—including digital video, course management systems, online discussion forums, and CD-ROM compilations—for development of professional skills were tested in three distinct professional graduate programs. Role-playing, peer review, and self-reflection instructional methods were technologically enhanced by creating customized interfaces for use in counseling, library science, and teacher education graduate programs. Implications for further iterations of integrating technology and professional development, potential uses in a variety of disciplines, and ways in which the process can be improved are also discussed.

A Review of Family Therapy as an Effective Intervention for Anorexia Nervosa in Adolescents

This review examines family therapy as an effective intervention for Anorexia Nervosa (AN) in adolescents. An electronic and manual literature search was conducted. Studies pertaining to family therapy in the treatment of AN and specifically, the Maudsley Method/Family-Based Treatment were identified. A limited number of randomized control trials exist implicating family therapy. Of the existent studies, methodological limitations pertaining to small, homogeneous sample sizes are evident. Despite the limited number of studies, family therapy appears to illustrate probable efficacy. Additional research and funding are necessary to fully support family therapy in the treatment of AN in adolescents.

Improving Classroom Instruction: Understanding the Developmental Nature of Analyzing Primary Sources.

Abstract Authentic and constructive learning experiences that include analysis of primary source documents are necessary elements of effective social studies teaching (Bailyn, 1994; Leinhardt, Stainton, & Virji, 1994; Wineburg & Wilson, 1991; Young & Leinhardt, 1998). This study examines the abilities of 70 fifth and seventh grade students to complete individual and multiple primary source document analyses based on their current background knowledge. Three researchers coded by grade, level of response (content), and type of processing (analysis of written discourse connectors and organization of written discourse) the completed document analysis tool responses. Rather than relying on others to interpret history for them, findings indicate that engaging students with primary source documents exercises the critical-thinking skills needed to analyze and interpret historical documents. However, this can be a very challenging task for students at this level. After connecting the study’s results to current research, the article concludes with a set of practical suggestions.

Relationships among aspects of student alienation and self concept

This study investigated the relationships among previous experiences of student alienation and the various aspects of self concept. A total of 351 undergraduate students were administered the Student Alienation and Trauma Survey-Revised (SATS-R) and the Tennessee Self Concept Scale: Second Edition (TSCS:2). Students were asked to report on their worst experience in school, symptoms they had following this worst experience, and overall feelings about themselves. Results indicated a moderate negative correlation between self concept and student alienation. A stepwise multiple regression analysis indicated that among the subtests of the SATS-R, Hopelessness, and General Maladjustment scores best predicted poor student self concept.

Prevention of Eating Disorders Among Minority Youth: A Matched-Sample Repeated Measures Study

The purpose of this study was to examine ethnic differences in primary prevention programs for eating disorders in young girls. In order to address the dearth of research in this area, this study examined the comparative response to an eating disorder prevention program on fifth-grade minority and White females. Pre- and post-test data were collected from 10 groups participating in the prevention program for a total of 50 girls. Minority participants and White participants were then matched based on Body Mass Index (BMI) and socioeconomic status in order to examine ethnic differences in group effectiveness. Findings indicated that minority and White participants were equally responsive to the prevention program.

Implicit affective associations predict snack choice for those with low, but not high levels of eating disorder symptomatology.

The central purpose of the current study was to examine whether eating disorder symptomatology moderates the extent to which implicitly and explicitly measured affective associations with fruits, or the feelings individuals associate with them, predict food choice. Participants (N = 107) completed both implicit and explicit measures of affective associations with fruits, a self-report of eating disorder symptomatology. In a subsequent snack selection task, they selected either a granola bar or fruit as a measure of their food choice behavior. Logistic regression analyses revealed that eating disorder symptomatology moderated the relation of implicit affective associations on behavior, OR = 0.27, p = .024, 95% CI (0.085, 0.84). A test of the simple effects indicated that implicit affective associations predicted snack choice at or below mean symptomatology levels [OR = 2.073, p = .02, 95% CI (1.12, 3.84)], but not at high levels [OR = 0.56, p = .28, 95% CI (0.18, 1.74)]. The effects of explicit measures on eating behavior were not moderated by eating disorder symptomatology (ps > .05). These findings advance our understanding of both the relation of implicit affective associations on behavior, as well as the ways in which eating disorder symptomatology may impact the decision-making process, thereby perpetuating disorder-related eating behavior. As such, they have implications for both health decision-making theory, as well as for the study and treatment of eating disorders.

Embodied self-regulation and mindful self-care in the prevention of eating disorders

Eating disorders are, in their simplest form, a set of embodied, physical acts that function to negotiate what are perceived as overwhelming internal and external stresses and demands (Cook-Cottone, 2006, 2015a, 2015b). The intentionality, physicality, and ultimate embodiment of eating disorder symptomatology are distinct from symptoms manifest in mood, anxiety, and many other mental illnesses (American Psychiatric Association [APA], 2013). Despite broader etiology, efforts to function are narrowed to a set of physical actions designed to control the size, shape, and/or experience of the body by way of a pathological involvement with food (i.e., bingeing and restriction), pharmaceuticals (i.e., laxatives, diuretics), and exercise (APA, 2013). Since early conceptualizations, it has been understood that those who struggle lack an accurate or valid sense of themselves both in terms of the physical body and a cohesive, functional personal identity (e.g., Chernin, 1985). For clinical patients, the daily experience of the body is distorted, typical development and relationships may be altered, and mortality risk increased (Cook-Cottone, 2015b; Smink, van Hoeken, & Hoek, 2012). In my clinical experience, I have observed that there is an irony present in clinical level eating disorders. I theorize that, in part, the persistence of eating disorders is related to how symptoms allow patients to be deeply connected to their bodies within the context of the challenging inner experiences they try to avoid (e.g., overwhelming feelings, cognitive challenges, and physical sensations) and an ostensibly invalidating and objectifying external world (Beadle, Paradiso, Salerno, & McCormick, 2013; Cook-Cottone, 2006, 2015a; Johnson, Cohen, Kasen, & Brook, 2002). That is, patients are doing two seemingly contrary things. Psychologically, patients are working extremely hard to leave themselves thereby avoiding the authentic experience of their bodies, thoughts, and feelings. Ironically, their eating disorders actively employ them in an intense, unremitting, cognitive, emotional, and most certainly pathological engagement with their bodies. In fact, clinical patients think of almost nothing else, continually distracted by thoughts about and