1. Kaitlyn Patterson & Wendy Wolfe
Cognitive and Gratitude-Based Interventions for Reducing Body Dissatisfaction
Kaitlyn Patterson & Wendy Wolfe
Materials and Procedure
Our study was conducted in two phases. In the first phase, participants completed the following measures in Survey Monkey: Locus of Control Scale (LCS), Body Shape Questionnaire (BSQ), Self-Focused Attention Scale (SFAS), a health behavior survey, Eating Attitudes Test (EAT), Positive and Negative Affect Scale (PANAS), Body Esteem Scale (B-ES), Center for Epidemiologic Studies Depression Scale (CES-D), Body Appreciation Scale (BAS), Gratitude Questionnaire (GQ-6), Binge Eating Scale (BES), Perfectionism Inventory (PI), Mental Health History Survey, and a Demographic Survey. The BSQ and the B-ES (weight concern subscale) were used to establish a high body dissatisfaction (high BD) group and a low body dissatisfaction (low BD) group, based on participant scores above or below 1 SD of the established mean score for the measure.
Eligible participants were invited to complete a second (intervention) phase of the study. Participants were randomly assigned to the Grat (high BD N= 10, low BD N= 7), CR (high BD N= 3, low BD N=14), or control (high BD N= 10, low BD N=7) conditions and were ed the appropriate intervention workbook. All participants received basic educational information about body image. Grat participants received a workbook with instructions to create a gratitude list (a list enumerating the things for which they felt grateful) on a daily basis for 14 days. CR participants received a workbook with automatic thought records (ATR’s) and instructions for completing the ATR’s on a daily basis for 14 days. CR participants were encouraged to complete the ATR’s in reference to negative thoughts about the body, or in reference to general negative thoughts if negative body–related thoughts had not occurred that day. After reviewing their workbooks, but prior to beginning the intervention, participants rated how effective they anticipated the intervention would be (expectancy). During the intervention phase, participants in the Grat and CR conditions were sent a daily to assess perceived difficulty and time spent on the previous day’s worksheet. Participants turned in their workbook pages at the end of each week. At the end of the 14 days, participants completed the following measures in Survey Monkey: BSQ, BAS, B-ES, EAT, BES, CES-D, and PANAS, and were debriefed.
Introduction
Follow-up analyses were conducted using Tukey’s post hoc tests. Pre- and post-intervention results are graphed below depicting the differences between the intervention conditions.
Gratitude interventions have been used effectively in the treatment of depression, PTSD, and for improving psychological wellness (Nelson, 2009). Recently, researchers have investigated the efficacy of gratitude interventions for decreasing body dissatisfaction among a sample of self-selected male and female adults from the United Kingdom (Geraghty, Wood, & Hyland, 2010). Results demonstrated that the gratitude intervention (Grat) worked equally well to decrease body dissatisfaction as a cognitive restructuring intervention (CR) and that both performed significantly better than no intervention. Moreover, fewer participants dropped out of the Grat condition, indicating that such an intervention may be associated with greater adherence than the more established CR interventions used for improving body satisfaction. We have extended this investigation by comparing Grat, CR, and control conditions on both body dissatisfaction and eating behaviors in a college female population. Through this investigation, we hope to replicate the findings of Geraghty et al. (2010) in a non-self-selection sample. We are also including measures of eating behaviors to determine if change in body dissatisfaction is associated with change in eating behaviors. Finally, we are comparing the efficacy of the interventions in participants with low versus high levels of body dissatisfaction.
Figure 2. Tukey's post-hoc test indicated a significant difference between CR and Control groups. Higher scores indicate greater body satisfaction.
Figure 1. Tukey's post-hoc test indicated a significant difference between CR and Control groups. Higher scores indicate greater body dissatisfaction.
Figure 3. Tukey's post-hoc test indicated a significant difference between CR and Grat groups. Higher scores indicate an increase in positive affect.
Conclusion
Hypotheses
Our preliminary results illustrate a significant difference in how CR interventions and Grat interventions affect change on the BSQ, BAS, and PANAS (positive) measures in a non-clinical population. The Grat intervention had a beneficial effect on the BAS and BSQ, whereas the CR intervention showed a detrimental effect on the BSQ, BAS, and PANAS (positive). However, it should be noted that the Grat performed similarly to the Control intervention in impacting body dissatisfaction, and the unexpected effect of the CR intervention may be due to the small number of high BD participants randomly assigned to that particular condition. It is possible that the CR intervention may have idiosyncratic effects in a non-clinical (low BD) population. However, data collection is ongoing and a larger sample size is need to confirm these preliminary findings, as well as to adequately test the efficacy of the Grat intervention.
Participants in the Grat and CR conditions will experience a more significant decrease in body dissatisfaction than those in the control condition.
The above finding will be greatest among participants high in body dissatisfaction.
Participants in the Grat and CR conditions will experience a greater decrease in dysfunctional eating behaviors, as compared to those in the control condition.
Results
Researchers performed a multivariate analysis of covariance (MANCOVA) with expectancy as the covariate. Independent variables were intervention condition and high/low BD; dependent variables were change in the BSQ, BAS, B-ES, BES, EAT, CES-D, and PANAS. No main effect was found for BD group, nor an interaction between BD group and intervention condition on the dependent variables. However, there was a significant main effect of intervention condition on change in the BSQ [F(2, 44)= 3.66, p<.05], the BAS [F(2, 44) = 3.24, p < .05], and the PANAS positive [F(2, 44)= 3.33, p<.05]. Intervention condition was not associated with a change in eating behavior.
Method
Key References
Participants
Participants were 52 female undergraduate students, who received course credit for their participation (61.5% Caucasian, M age= 23.5).
Geraghty, A.W., Wood, A. M., Hyland, M.E. (2010). Attrition from self-directed interventions: investigating the
relationship between psychological predictors, intervention content and dropout from a body dissatisfaction intervention. Social Science and Medicine, 71,
Nelson, C. (2009). Appreciating gratitude: can gratitude be used as a psychological intervention to improve individual well-being. Counseling Psychology Reviews, 24(3&4),
For further information, contact: Wendy Wolfe, Poster presented at the annual meeting of the Southeastern Psychological Association, Nashville, TN (March, 2014)