Does body satisfaction improve in adolescents with an eating disorder due to an online training based on evaluative conditioning?

Low body body satisfaction and self-esteem are important factors in the
development and maintenance of eating disorders (Stice & Shaw, 2002; Johnson &
Wardle, 2005). In addition, body dissatisfcation appears to be an importnat
predictor of relapse after treatment. Recently, it was found that evaluative
conditioning through a computer training lead to improvement of body
satisfaction and self-esteem. This training was shown to be effective in a
controlled setting in a sample of students without an eating disorder who
followed one training session (Martijn et al., 2010). These positive effects
were replicated among women with a high risk of developing an eating disorder
(Aspen et al., 2015). After the training these women reported less weight and
shape concerns and an increase in self-esteem. One and three months after the
training these positive effects endured. in the present study we want to
investigate whether this training can help to improve body satisfaction in
adolescents with an eating disorder.

The aim of this study is to investigate the effectiveness of a brief computer
intervention to improve body satisfcation and self-esteem in a clinical
population of adolescents with an eating disorder. We will examine whether the
intervention is effective (a) in girls with an eating disorder and (b) as
online intervention. This innovative computertraining is based on conditioning
principles and learns participants to associate their body with positive,
accepting social feedback. The training could form an additional intervention
to treatment as usual.

The study has a single-blind cross-over design. Participants are randomly
divided over an experimental and a control group. Participants in the control
group will receive the experimental intervention after a bogus training. After
the training there are two follow-up measurements to be able to determine the
effects of the training over time.

The interention will be tested in 2 (Condition: experimental, control) x 2
(Time: T1, T2) RM-ANOVA's with body satisfaction and self-esteem as dependent
variables.

In this training participants have to click on pictures of their own body and
pictures of others' bodies. Their own pictures are systematically followed by
portrait pictures of friendly smiling faces. The training exists of 6 sessions
of around 5 minutes and are administered online to adolescents who are
dissatisfied with their bodies. In the bogus training participants will be
shown the same stimuli as in the experimental condition, but these will be
administered in blocks of the same category without any contingency between the
own body and a smiling face.

Participation in the study is not associated with any risks. The only burden to
the participants is a time investment of half an hour to 40 minutes for each
measurement session and the largest part of the assessments can be conducted at
home via the computer. Participation gives direct advantages to the
participant, since pre-clinical studies already showed that this training might
be highly effective in improving body satisfaction. All participants eventually
receive the experimental training and help to gather evidence which is
beneficial for future eating disorder patients.
When the training is indeed effective for this group in improving body image
and self-esteem, the training will be included as a module within the already
existing blended treatment program Smaakk! Smaakk! is part of the blended
treatment program of the national expert network of child- and adolescent
psychiatry (http://netwerk-kjp.nl/e-health), which means that the intervention
will be used in several child- and adolescents treatment centers across the
Netherlands.