Peta Stapleton

Building skills, knowledge and confidence in eating and exercise behavior change: brief motivational interviewing training for healthcare providers.

OBJECTIVE Obesity related health problems affect individuals, families, communities and the broader health care system, however few healthcare providers (e.g., doctors, nurses, social workers, psychologists, counselors) receive formal training in obesity prevention interventions. We examined the effectiveness of training healthcare providers in brief motivational interviewing (brief MI) targeting eating and exercise behavior change. METHODS 163 healthcare providers participated. 128 participants completed a one-day experiential brief MI training workshop followed by electronic peer-support and a further 35 matched controls did not receive the training. RESULTS Participants knowledge of brief MI and confidence in their ability to counsel patients using brief MI significantly improved following training (p<0.05) and remained at 3 and 6-month follow-up (p<0.05). Brief MI skills assessed during the simulated patient interactions indicated a significant improvement across two practical training blocks (p<0.05). CONCLUSION Healthcare providers can learn brief MI skills and knowledge quickly and confidence in their counseling abilities improves and is sustained. PRACTICE IMPLICATIONS Healthcare providers may consider brief MI as an obesity prevention intervention.

Educating Medical Students About Anorexia Nervosa: A Potential Method for Reducing the Volitional Stigma Associated With the Disorder

It is frequently reported that clinicians across a range of professional disciplines experience strong negative reactions toward patients with anorexia nervosa (AN). The present study aimed to develop, evaluate, and compare the effectiveness of two different educational programs, based on an etiological framing model. Participants were medical students (N = 41) from an Australian University, who were randomly assigned to one of three conditions (biogenetic intervention vs. multifactorial intervention vs. control). Outcome attitudinal/stigma data were collected pre- and post-intervention, and at 8 weeks follow-up. Results indicated intervention participations exhibited significantly lower volitional stigma scores compared to the control group, who exhibited no change in attitudes or stigma. Specifically, intervention participants had significantly lower total ED stigma scores, levels of blame, perceptions of AN as a selfish/vain illness, and viewed sufferers as less responsible for their illness at post-intervention. These reductions were maintained at follow-up. Overall, the study provides preliminary evidence that brief targeted interventions can assist in reducing levels of volitional stigma toward AN.

Depression Symptoms Improve after Successful Weight Loss with Emotional Freedom Techniques

Ninety-six overweight or obese adults were randomly allocated to a four-week EFT treatment or waitlist condition. Waitlist participants crossed over to the EFT group upon completion of wait period. Degree of food craving, perceived power of food, restraint capabilities, and psychological symptoms were assessed at pretreatment, posttreatment and at 12-month follow-up for combined EFT groups. Significant improvements in weight, body mass index, food cravings, subjective power of food, craving restraint and psychological coping for EFT participants from pretreatment to 12-month follow-up (P < 0.05) were reported. The current paper isolates the depression symptom levels of participants, as well as levels of eight other psychological conditions. Significant decreases from pre- to posttreatment were found for depression, interpersonal sensitivity, obsessive-compulsivity, paranoid ideation, and somatization (P < 0.05). Significant decreases from pretreatment to 12-month follow-up were found for depression, interpersonal sensitivity, psychoticism, and hostility. The results point to the role depression, and other mental health conditions may play in the successful maintenance of weight loss.

Beliefs about Causes of Obesity: A Comparison of Australian Doctors, Psychologists and Community Members

The current study aimed to investigate differences in beliefs about causes of obesity between Australian doctors, psychologists and a community sample. Forty-one doctors, 66 psychologists and 98 community members completed questionnaires regarding beliefs about causes to obesity, including measures of obesity stigma. The results showed a consistent pattern of beliefs across groups, with all three groups having strong beliefs about behavioural and psychological causes to obesity. Further, results showed that the three groups did not have particularly strong or weak antifat attitudes and although they did not have overly favourable attitudes towards obese people, their attitudes were not highly negative. However, stronger antifat attitudes were found to be predictive of beliefs about behavioural and psychological causes, while weaker antifat attitudes were predictive of beliefs about biological causes of obesity.

Body Image Avoidance, Body Dissatisfaction, and Eating Pathology Is There a Difference Between Male Gym Users and Non–Gym Users?

With research highlighting the increasing prevalence and severity of body image and eating disturbances in males, particularly athletes and regular gymnasium users, the current study examined body image and eating disturbances in a sample of male gym users and non–gym users (N = 180). Based on previous research, it was predicted that male gym users would report greater body image disturbance (e.g., body image avoidance and body dissatisfaction) and eating pathology, compared with non–gym users. Results of the study partially supported hypotheses, revealing body dissatisfaction and eating pathology were significantly increased in male gym users. However, no significant differences were observed in body image avoidance behaviors, though this is likely because of methodological limitations associated with psychometric measures selected. The study provides preliminary evidence that male gym users do experience subclinical eating and body image concerns, with some also experiencing clinically significant symptoms that could be precursors to the later development of an eating disorder. Results of the current study highlight the importance of educating key stakeholders within health and fitness centers, through community-based interventions, to increase awareness regarding male body image and eating disturbances.

Eating Disorder Patient Experiences of Volitional Stigma Within the Healthcare System and Views on Biogenetic Framing: A Qualitative Perspective: Eating disorders, stigma, and health care

Objective Research has consistently indicated that fear of stigma is a pertinent factor when understanding the poor prevalence of treatment seeking among individuals with mental illness, particularly eating disorders (EDs). The purpose of this study was to investigate the treatment experiences of ED sufferers within an Australian context, in addition to exploring patient views on framing EDs as biogenetic conditions, given the increased understanding and presentation of EDs as biologically based conditions. Methods Semi‐structured online data collection was conducted with 35 Australian women with a history of an ED (54.3% in treatment, 45.7% in “recovery” or “recovered”). The data were evaluated using a three‐phased coding system, allowing findings to emerge from significant themes inherent within the raw data (thematic analysis). Results Treatment was perceived as traumatic, punitive, blaming, lacking in understanding/education, and overemphasised the physical dimensions of the illness. The experience of volitional stigma in the healthcare system was frequent and expected, and for many sufferers had adverse effects. Biogenetic framing was perceived to be more likely to reduce (rather than exacerbate) stigma, particularly perceptions of volition and personal responsibility. Although reductions in blame and responsibility were welcomed, there was concern that biogenetic explanations could negatively impact recovery by endorsing genetic fatalism and encouraging self‐fulfilling prophecies via genetic essentialism. Conclusions Overall, findings highlight that attention to volitional stigma within the health system is required (particularly education) and that aetiological framing (with caution and sensitivity) is perceived to be a feasible stigma reduction method by ED sufferers.

Consensus on the assessment of disordered eating in pregnancy: an international Delphi study

This study aimed to assess and develop consensus on the assessment of disordered eating in pregnancy. A three-round modified Delphi approach was used. Participants were international clinicians and researchers (N = 26) with extensive knowledge on and/or clinical experience with eating disorders, particularly in relation to pregnancy and/or women’s health. Clear consensus among the panel, defined as 75% agreement, was reached regarding the assessment of disordered eating in pregnancy, in addition to potential assessment methods. Antenatal assessment of disordered eating was perceived to be crucial and ideally occur in a routine manner. Despite agreement that various assessment methods would be relevant in assessing disordered eating in pregnancy, psychometrically sound brief screening instruments were perceived to be most feasible for practitioners and women accessing antenatal care; however, these instruments must be pregnancy-specific and delivered in an authentic and caring manner to be beneficial.

Self-esteem and body image in females: The mediating role of self-compassion and appearance contingent self-worth.

Body dissatisfaction is a major source of suffering among women of all ages. One factor that has the potential to mitigate body dissatisfaction, as well as promote a positive body image and psychological wellbeing, is self-compassion. This study explored sources of positive and negative body image by investigating the relationship between self-esteem, self-compassion, and appearance contingent self-worth in conceptualizing body image avoidance behaviors. The multiple mediation model assessed the responses of 222 female participants from the general community. Self-compassion and appearance contingent self-worth were both found to partially mediate the relationships between self-esteem and body image avoidance behaviors. The findings are discussed in light of clinical interventions and directions for future research in the body image field.

Effectiveness of a School-Based Emotional Freedom Techniques Intervention for Promoting Student Wellbeing

In academic settings, fear of failure and associated emotional difficulties are common and often result in maladaptive behaviours, which often lead to failure or lowered scholastic achievement. Higher levels of self-esteem and resilience have been shown to protect against fear of failure and emotional difficulties, and predict improved academic outcomes in students. However, few studies have investigated the efficacy of group intervention methods aimed at improving self-esteem and resilience. This non-randomised universal intervention represents the first Australian study of the efficacy of a group Emotional Freedom Techniques (EFT) treatment program within high schools, aimed at increasing student self-esteem and resilience, and decreasing fear of failure and emotional difficulties. The EFT intervention groups (N = 204) were drawn from two different school cohorts. Results showed a significant improvement in fear of failure, whereby fears were significantly lower from pre-intervention to 12-month follow-up. Findings also indicated a significant main effect of time for emotional and behavioural difficulties, however post hoc tests indicated no statistically significant changes between the time points measured. No significant changes were observed in measures of self-esteem or resilience. The results suggested that EFT might be an effective group intervention for some students decreasing their fear of failure; however, further research is required.

Eating disorder patient experiences of volitional stigma within the healthcare system and views on biogenetic framing: A qualitative perspective

Objective Research has consistently indicated that fear of stigma is a pertinent factor when understanding the poor prevalence of treatment seeking among individuals with mental illness, particularly eating disorders (EDs). The purpose of this study was to investigate the treatment experiences of ED sufferers within an Australian context, in addition to exploring patient views on framing EDs as biogenetic conditions, given the increased understanding and presentation of EDs as biologically based conditions. Methods Semi‐structured online data collection was conducted with 35 Australian women with a history of an ED (54.3% in treatment, 45.7% in “recovery” or “recovered”). The data were evaluated using a three‐phased coding system, allowing findings to emerge from significant themes inherent within the raw data (thematic analysis). Results Treatment was perceived as traumatic, punitive, blaming, lacking in understanding/education, and overemphasised the physical dimensions of the illness. The experience of volitional stigma in the healthcare system was frequent and expected, and for many sufferers had adverse effects. Biogenetic framing was perceived to be more likely to reduce (rather than exacerbate) stigma, particularly perceptions of volition and personal responsibility. Although reductions in blame and responsibility were welcomed, there was concern that biogenetic explanations could negatively impact recovery by endorsing genetic fatalism and encouraging self‐fulfilling prophecies via genetic essentialism. Conclusions Overall, findings highlight that attention to volitional stigma within the health system is required (particularly education) and that aetiological framing (with caution and sensitivity) is perceived to be a feasible stigma reduction method by ED sufferers.