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Meta-analytic review of dissonance-based eating disorder prevention programs: Intervention, participant, and facilitator features that predict larger effects
Open accessAbstract
Many trials have provided support for dissonance-based eating disorder prevention programs. This meta-analytic review characterized the average intervention effects and tested whether various intervention, participant, and facilitator features correlated with larger effects to guide implementation of optimally effective versions of this program. We identified 56 trials that evaluated 68 dissonance-based eating disorder prevention programs (7808 participants). Average intervention effect sizes (d) relative to minimal intervention control conditions and credible alternative interventions (respectively) were 0.57 and 0.31 for thin-ideal internalization, 0.42 and 0.18 for body dissatisfaction, 0.37 and 0.17 for dieting, 0.29 and 0.21 for negative affect, and 0.31 and 0.13 for eating disorder symptoms. As hypothesized, effects were larger for interventions with more dissonance-inducing activities, more group sessions, and larger group sizes, as well as when delivered in-person versus on-line, sessions were recorded, participation was voluntary, body dissatisfaction was required, participants were mid-adolescents or adults (versus older adolescence), there were more ethnic minority participants, groups were led by clinicians versus researchers and at least two facilitators, and when facilitators received more training and supervision. Unexpectedly from a dissonance-induction perspective, effects were larger when participants were compensated. Results offer directions for maximizing the benefits of implementation efforts with dissonance-based eating disorder prevention programs, and may hold lessons for preventing other public health problems with dissonance-based interventions.
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“Although programs focusing only on body image internalization are not as effective as those also including media literacy,321 more benefit has been found with dissonance-based prevention programs.322”
From Digital Ecosystems, Children, and Adolescents: Technical Report (2026) · cites this paper as [322]
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A randomized trial of online single-session interventions for adolescent depression during COVID-19
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Metadata
- Authors
- Stice, E., Marti, C. N., Shaw, H., & Rohde, P.
- Affiliations
- Oregon Research Institute (US)
- Corresponding author
- Stice, Eric
- Venue
- Clinical Psychology Review
- Publisher
- Elsevier BV
- Published
- 2019-06
- Volume
- 70
- Pages
- 91-107
- ISSN
- 0272-7358 (ISSN-L)
- PMC
- PMC6536334
- OpenAlex
- W2938078844
- Cited by
- 171
- References
- 114
- Citations by year
- 2026: 21 · 2025: 18 · 2024: 31 · 2023: 32 · 2022: 26 · 2021: 25 · 2020: 14 · 2019: 3
- FWCI
- 2.69
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Clinical Psychology Review (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Social Sciences › Psychology › Clinical Psychology › Body Image and Dysmorphia Studies
- Keywords
- dissonance-based intervention, eating disorder prevention, cognitive dissonance, thin-ideal internalization, body dissatisfaction, dieting, negative affect, eating disorder symptoms, intervention features, facilitator training, participant characteristics, participant compensation, adolescents
- MeSH terms
- Feeding and Eating Disorders, Cognitive Dissonance, Humans, Outcome and Process Assessment, Health Care
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