The goal of this clinical trial is to investigate the efficacy of an online group prevention program developed for women at risk for eating disorders with randomized controlled trial. The main questions it aims to answer are: * Does the ACT intervention lead to a significant difference in disordered eating behaviors among individuals at risk for eating disorders? * Does the ACT intervention lead to a significant difference in body dissatisfaction among individuals at risk for eating disorders? * Does the ACT intervention lead to a significant difference in obsessive-compulsive and borderline personality beliefs among individuals at risk for eating disorders? * Does body image flexibility significantly affect the impact of the ACT intervention on disordered eating behaviors? * Do self-as-context, cognitive defusion, and present-moment awareness significantly affect the impact of the ACT intervention on disordered eating behaviors? Participant will: Join the online 4-session ACT-based group program Fill the measures at pre-test, post-test and follow-up assessment.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
28
This intervention protocol was developed specifically for women who have body dissatisfaction and disordered eating behaviors. Based on the psychological flexibility model (hexaflex), it is designed to improve people's body image flexibility using Acceptance and Commitment Therapy techniques. Interventions related to the dimensions of the hexaflex were made during each session. The first session covers values and goal setting. The second session includes creative hopelessness, acceptance, and self-compassion. The third session covers defusion and mindfulness. The last session focuses on self-as-context exercises and the combined use of skills for committed action.
Ibn Haldun University Psychotherapy Application and Research Center (IPAM)
Istanbul, Basaksehir, Turkey (Türkiye)
Disordered eating, assesed by the Turkish form of the Eating disorder examination questionnaire (EDE-Q)
Disordered eating is a risk factor for eating disorders. In a prevalence study conducted in Türkiye, individuals with EDE-Q scores of 3.03 and above were defined as a high-risk group (Deveci, 2020). In this study, EDE-Q scores were assessed for inclusion criteria during enrollment. Additionally, changes in EDE-Q scores are assessed at post-test and follow-up to assess treatment effect.
Time frame: Baseline (pretest), week 4(posttest), 3-month follow-up
Body dissatisfaction, assesed by the Turkish form of Body shape Questionnaire (BSQ)
A total score of the questionnaire can be in the range of 34 to 204 where total score lower than 110 represents no concern, a total score between 110 and 137 represents mild concern, a total score between 138 and 166 represents moderate concern, and a total score higher than 167 represent severe concern. In this study, EDE-Q scores were assessed for inclusion criteria during enrollment; participans scores of 110 and above are included. Additionally, changes in EDE-Q scores are assessed at post-test and follow-up.
Time frame: Baseline (pretest), week 4(posttest), 3-month follow-up
Body image flexibility, assesed by the Turkish form of the Body Image Acceptance and Action Questionnaire (BI-AAQ)
Body image flexibility (BIF) is a construct derived from the psychological flexibility model. BIF is defined as the capacity to experience perceptions, sensations, feelings, thoughts, and beliefs related to one's body without avoidance while acting in alignment with personal values. The BI-AAQ consists of 12 items; higher scores indicate lower BIF and increased body image inflexibility. In this study, this scale would be used to assess how one's relation with body image-related internal experiences changes after the prevention program.
Time frame: Baseline (pretest), week 4(posttest), 3-month follow-up
Psychological flexibility, assesed by Acceptance and Action Questionnaire (AAQ-II)
The AAQ-II is designed to assess psychological flexibility defined as the capacity to be in contact with the present moment, fully aware of one's thoughts, emotions, and sensations. Higher scores indicate decreased psychological flexibility and increased experiential avoidance. In this study, the scale was used to assess changes in the general psychological flexibility.
Time frame: Baseline (pretest), week 4(posttest), 3-month follow-up
Present moment awareness, assesed by the Turkish form of the Freiburg Mindfulness Inventory (FMI)
Present moment awareness is one of the dimensions of the psychological flexibility model. It is defined as the ability to fully engage with the present moment. Higher scores indicate better present moment awareness. In future studies, it is desired to examine which dimension of the psychological flexibility model has an effect on the treatment outcome. In this study, FMI was used to test its suitability in measuring change in this intervention.
Time frame: Baseline (pretest), week 4(posttest), 3-month follow-up
Contextual Self, assesed by the Turkish form of the Self-As-Context Scale (SACS)
Contextual Self is one of the dimensions of the psychological flexibility model. It is defined as one's ability to view himself with a broader perspective. Higher scores indicate improved contextual self. In future studies, it is desired to examine which dimension of the psychological flexibility model has an effect on the treatment outcome. In this study, SACS was used to test its suitability in measuring change in this intervention.
Time frame: Baseline (pretest), week 4(posttest), 3-month follow-up
Defusion, assesed by the Turkish form of the Cognitive Fusion Scale (CFS)
Defusion is one of the dimensions of the psychological flexibility model. It is defined as one's ability to separate himself from his thoughts. Higher scores indicate fusion, which is the opposite of defusion. In future studies, it is desired to examine which dimension of the psychological flexibility model has an effect on the treatment outcome. In this study, SACS was used to test its suitability in measuring change in this intervention.
Time frame: Baseline (pretest), week 4(posttest), 3-month follow-up
Personality beliefs, assesed by the Turkish form of the Personality Beliefs Questionnaire- Short Form (PBQ-SF)
Obsessive-compulsive personality disorder and borderline personality disorder are the most common personality disorders in eating disorders. PBQ is designed to assess dysfunctional personality beliefs, and higher scores on a subscale indicate stronger dysfunctional beliefs related to the corresponding personality. In future studies, it is desired to examine how the personality beliefs are affected by the prevention program. In this study, PBQ-SF was used to test its suitability in measuring change in personality beliefs by this intervention.
Time frame: Baseline (pretest), week 4(posttest), 3-month follow-up
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