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Cited by 140Eating Disorders and BehaviorsBody Image and Dysmorphia StudiesNutrition, Health and Food Behavior

Effectiveness of cognitive behavioral therapy supported by virtual reality in the treatment of body image in eating disorders: One year follow-up

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Marco, José H., Perpiñá, Conxa, Botella, Cristina·2013·Psychiatry Research
DOI 10.1016/j.psychres.2013.02.023
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Abstract

Body image disturbance is a significant maintenance and prognosis factor in eating disorders. Hence, existing eating disorder treatments can benefit from direct intervention in patients' body image. No controlled studies have yet compared eating disorder treatments with and without a treatment component centered on body image. This paper includes a controlled study comparing Cognitive Behavioral Treatment (CBT) for eating disorders with and without a component for body image treatment using Virtual Reality techniques. Thirty-four participants diagnosed with eating disorders were evaluated and treated. The clinical improvement was analyzed from statistical and clinical points of view. Results showed that the patients who received the component for body image treatment improved more than the group without this component. Furthermore, improvement was maintained in post-treatment and at one year follow-up. The results reveal the advantage of including a treatment component addressing body image disturbances in the protocol for general treatment of eating disorders. The implications and limitations of these results are discussed below.

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References 72 · Cited by 140

Research works printed but not linked: 37

  1. Botella, C., Villa, H., Garcı ´a-Palacios, A., Ban ˜os, R.M., Perpin ˜a ´, C., Alcan ˜iz, M., 2004. Clinically significant virtual environments for the treatment of panic disorder and agoraphobia. Cyberpsychology & Behavior 7 (5), 527-535.
  2. Butters, J.W., Cash, T.F., 1987. Cognitive-behavioral treatment of women's body- image dissatisfaction. Journal of Consulting and Clinical Psychology 55, 889-897.
  3. Cash, T.F., 1991. Body Image Therapy: a Program for Selfdirected Change. Guilford Press, New York.
  4. Cash, T.F., Grant, J.R., 1996. Cognitive-behavioral treatment of body-image dis- turbances. In: Hersen, M., Hesselt, V.Van (Eds.), Sourcebook of Psychological Treatment Manuals for Adult Disorders. Plenum Press, New York, pp. 567-614.
  5. Cash, T.F., Hrabosky, J.I., 2004. Treatment of body image disturbances. In: Thompson, J.K. (Ed.), Handbook of Eating Disorders and Obesity. Wiley, Hoboken, pp. 515-541.
  6. Fairburn, C.G., 2002. Cognitive-behavioral therapy for bulimia nervosa. In: Fair- burn, C.G., Brownell, K.D. (Eds.), Eating Disorders and Obesity: A Comprehen- sive Handbook, 2nd ed. Guilford Press, New York, pp. 233-237.
  7. Fairburn, C.G., Peveler, R.C., Jones, R., Hope, R.A., Doll, H.A., 1993. Predictors of 12-month outcome in bulimia nervosa and the influence of attitudes to shape and weight. Journal of Consulting and Clinical Psychology 61, 696-698.
  8. Farrell, C., Shafran, R., Lee, M., 2006. Empirically evaluated treatments for body image disturbance: a review. European Eating Disorders Review 14, 289-300.
  9. First, M.B., Gibbon, M., Spitzer, R.L., Williams, J.B.W., Benjamin, L.S., 1997. Structured Clinical Interview for DSM-IV Axis II Personality Disorders, (SCID-II). American Psychiatric Press, Washington.
  10. First, M.B., Spitzer, R.L., Gibbon, M., Williams, J.B.W., 2002. Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Non-patient Edition. Biometrics Research, New York State Psychiatric Institute, New York.
  11. Garner, D.M., 2002. Body image and anorexia nervosa. In: Cash, T.F., Pruzinsky, T. (Eds.), Body Image: A Handbook of Theory, Research, and Clinical Practice. Guilford Press, New York, pp. 295-303.
  12. Garner, D.M., Vitousek, K.M., Pike, K.M., 1997. Cognitive-behavioral therapy for AN. In: Garner, D.M., Garfinkel, P.E. (Eds.), Handbook of Treatment for Eating Disorders. Guilford Press, New York, pp. 94-145.
  13. Gleaves, D.H., Williamson, D.A., Barker, S.E., 1993. Confirmatory factor analysis of a multidimensional model of bulimia nervosa. Journal of Abnormal Psychology 102, 173-176.
  14. Hedges, L.V., Olkin, I., 1985. Statistical Methods for Meta-Analysis. Academic Press, New York.
  15. Henderson, M., Freeman, C., 1987. A self-rating scale for bulimia: the BITE. British Journal of Psychiatry 150, 18-24.
  16. Kendall, P.C., Marrs-Garcia, A., Nath, S.R., Sheldrick, R.C., 1999. Normative compar- isons for the evaluation of clinical significance. Journal of Consulting and Clinical Psychology 53, 43-48.
  17. Linehan, M.M., 1993. Cognitive-Behavioral Treatment of Borderline Personality Disorder. Guilford Press, New York.
  18. Lobbestael, J., Leurgans, M., Arntz, A., 2011. Inter-rater reliability of the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID I) and Axis II Disorders (SCID II). Clinical Psychology & Psychotherapy 18 (1), 75-79.
  19. Lundgren, D.J., Danoff-Burg, S., Anderson, D.A., 2004. Cogntitve-behavioral therapy for bulimia nervosa: an empirical analysis of clinical significance. International Journal of Eating Disorders 35, 262-274.
  20. Mahon, J., 2000. Dropping out from psychological treatment for eating disorders: what are the Issues? European Eating Disorders Review 8, 198-216.
  21. North, M., North, S., 1996. Virtual reality psychotherapy. The Journal of Medicine and Virtual Reality 1, 28-32.
  22. North, M., North, S., Coble, J., 1997. Virtual Reality Therapy. I.P.I. Press, Ann Arbor, Michigan.
  23. North, M., North, S., Coble, J.R., 1998. Virtual reality therapy: an effective treatment for phobias. In: Riva, G., Widerhold, B.K., Molinari, E. (Eds.), Virtual Environments in Clinical Psychology and Neuroscience. IOS Press, Amsterdam.
  24. Perpin ˜a ´, C., Botella, C., Ban ˜os, R.M., 2003. Virtual reality in eating disorders. European Eating Disorders Review 11, 261-278.
  25. Perpin ˜a, C., Gallego, M.J., Botella, C., 2006. Psychometric properties of the Situational Inventory of Body-Image Dysphoria-Short form in a Spanish sample. Body Image: An International Journal of Research 3, 301-306.
  26. Probst, M., Vandereycken, W., Van Coppenolle, H., Vanderlinden, J., 1995. The body attitude test for patients with an eating disorder: psychometric characteristics of a new questionnaire. Eating Disorders: The Journal of Treatment and Prevention 3, 133-145.
  27. Riva, G., Bacchetta, M., Baruffi, M., Molinari, E., 2002. Virtual-reality-based multi- dimensional therapy for the treatment of body image disturbances in binge eating disorders: a preliminary controlled study. IEEE Transactions on Infor- mation Technology in Biomedicine 6, 224-234.
  28. Rizzo, A.A., Wiederhold, M.D., Buckwalter, J.G., 1998. Basic issues in the use of virtual environments for mental health applications. In: Riva, G., Widerhold, B.K., Molinari, E. (Eds.), Virtual Environments in Clinical Psychology and Neuroscience. IOS Press, Amsterdam, pp. 21-42.
  29. Rosen, J.C., 1996. Body image assessment and treatment in controlled studies of eating disorders. International Journal of Eating Disorders 20, 331-343.
  30. Schwartz, M.D., Brownell, K.D., 2004. Obesity and body image. Body Image: An International Journal of Research 1, 43-56.
  31. Shisslak, C.M., Crago, M., 2001. Risk and protective factors in the development of eating disorders. In: Thompson, J.K., Smolak, L. (Eds.), Body Image, Eating Disorders, and Obesity in Youth: Assessment, Prevention, and Treatment. American Psychological Association, Washington, pp. 103-125.
  32. Stice, E., 2002. Body image and bulimia nervosa. In: Cash, T.F., Pruzinsky, T. (Eds.), Body Image: A Handbook of theory, Research, and Clinical Practice. Guilford Press, New York, pp. 304-311.
  33. Stice, E., Shaw, H.E., 2002. Role of body dissatisfaction in the onset and maintenance of eating pathology: a synthesis of research findings. Journal of Psychosomatic Research 53, 985-993.
  34. Thompson, J.K., 1992. Body image: extent of disturbance, associated features, theoretical models, assessment methodologies, intervention strategies, and a proposal for a new DSM-IV category-Body Image Disorder. In: Hersen, M., Esisler, R.M., Miller, P.M. (Eds.), Progress in Behavior Modification. Sycamore Press, Sycamore IL, pp. 3-54.
  35. Thompson, J.K., Heimberg, L.J., Clarke, A.J., 1996. Treatment of body image disturbances in eating disorders. In: Thompson, J.K. (Ed.), Body Image, Eating Disorders, and Obesity. American Psychological Association, Washington, pp. 303-320.
  36. Vitousek, K.B., 2002. Cognitive-behavioral therapy for anorexia nervosa. In: Fair- burn, C.G., Brownell, K.D. (Eds.), Eating Disorders and Obesity: a Comprehen- sive Handbook, 2nd ed. Guilford Press, New York, pp. 233-237.
  37. Wilson, T.G., Fairburn, C.G., Agras, W.S., 1997. Cognitive-behavioral therapy for bulimia nervosa. In: Garner, D.M., Garfinkel, P.E. (Eds.), Handbook of Treat- ment for Eating Disorders. Guilford Press, New York, pp. 67-93.

Authors
Marco, J. H., Perpiñá, C., & Botella, C.
Affiliations
  • Valencia Catholic University Saint Vincent Martyr (ES)
  • Universitat de València (ES)
  • Universitat Jaume I (ES)
ORCID
Venue
Psychiatry Research
Publisher
Elsevier BV
Published
2013-10
Volume
209
Issue
3
Pages
619-625
ISSN
0165-1781 (ISSN-L)
DOI
10.1016/j.psychres.2013.02.023
OpenAlex
W2093215456
Cited by
140
References
72
Citations by year
2026: 2 · 2025: 9 · 2024: 15 · 2023: 7 · 2022: 19 · 2021: 7 · 2020: 11 · 2019: 16 · 2018: 14 · 2017: 13 · 2016: 10 · 2015: 11 · 2014: 4 · 2013: 2
FWCI
9.99
Type
journal article
Language
en
Open access
Locations
  • Psychiatry Research (publishedVersion)
  • PubMed (publishedVersion)
  • Repositori UJI (Universitat Jaume I) (submittedVersion)
  • LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, public-domain)
  • RIUCV (Universidad Católica de Valencia San Vicente Martír) (submittedVersion)
Funders
Instituto de Salud Carlos III
Topics
  • Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
  • Social Sciences › Psychology › Clinical Psychology › Body Image and Dysmorphia Studies
  • Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
Keywords
eating disorders, body image disturbance, cognitive behavioral therapy, virtual reality, treatment effectiveness, long-term follow-up
MeSH terms
Adolescent, Adult, Feeding and Eating Disorders, Attitude to Health, Body Image, Female, Follow-Up Studies, Humans, Cognitive Behavioral Therapy, Treatment Outcome, Young Adult, Virtual Reality Exposure Therapy

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