Latest News & Research: 25 June 2019

This week: Online therapy reshapes body image issues • Substitution is best to curb poor food choices • Friend circles predict health

Online therapy reshapes body image issues

Overcoming personal obsession with body image can be treated effectively through online therapy according to a new study by Flinders University researchers.

Cognitive Behavioural Therapy for Perfectionism (CBT-P) reduces not only the primary issues of perfectionism, but also secondary outcomes such as depression and body image disturbance – and a new study has found that internet delivery of this program is comparable to face-to-face therapy sessions.

The study focuses on ways of addressing Dysmorphic Concern, which is characterised by a person’s overconcern with appearance-based imperfections and compulsions (such as mirror checking and reassurance-seeking) and which impairs their functioning. Such appearance-based preoccupations occur in 30-46% of young adults.

The study’s lead author Shevaugn Johnson, from Flinders University’s College of Education, Psychology and Social Work, says proof of effective online treatment for Dysmorphic Concern provides a safe environment for people who are already anxious about their appearance and therefore may be unwilling to seek therapy assistance.

‘Perfectionism in our study group centred around perceived appearance-based flaws, and therefore targeting perfectionism can help reduce their unrealistic standards of beauty’ said Johnson; ‘This research is important because online dissemination of treatment will increase the likelihood of more people being treated for dysmorphic concern, which is a risk factor for the development of body dysmorphic disorder.’

The study evaluated the use of Internet-delivered Cognitive Behavioural Therapy for Perfectionism (ICBT-P), with 31 participants (28 being women), aged between 18 and 39, having high levels of dysmorphic concern, to examine the impact on perfectionism, dysmorphic concern, body image disturbance, negative affect, and selective attention towards appearance-based stimuli. Within this study group, 35% of participants experienced depression, and 42% experienced anxiety.

Through this process, body image disturbance, depression, anxiety and stress were targeted. And the results found that aside from anxiety, there were significant reductions across all variables of interest at immediate and one-month post-treatment follow-up. Further, it was found that the treatment effects endured and became larger over time.

While replication in clinical populations is needed, it is hoped that randomised controlled trials will be used to compare the efficacy of ICBT-P against traditional Cognitive Behavioural Therapy for body dysmorphic disorder (BDD) in participants diagnosed with BDD.

Flinders’ Professor Tracey Wade said: ‘This is the first study to use a perfectionism intervention to treat dysmorphic concerns and it is encouraging to see that internet therapy can produce such strong and enduring results. Internet therapies are easy to access and can be used widely across a number of settings, and they offer great promise for future treatment of dysmorphic concerns.’

The results of this study support the use of ICBT-P as an efficacious treatment worthy of further examination in populations who experience high levels of dysmorphic concern.

Source: Flinders University

Substitution is best to curb poor food choices

In a new study, Flinders University researchers have found that promoting substitution can help to turn around children’s excessive consumption of nutrient-poor foods and beverages – resulting in nutritional benefits that are even better than reducing intake of these discretionary food and drink choices.

Almost one in four Australian children is overweight or has obesity by the time they start school, often leading to a lifelong trajectory of obesity, poor health and reduced achievement.

Flinders University researchers studied the impact on the energy and nutrient intakes of more than 2000 Australian 2- to 18-year-olds through simulations of three dietary strategies. They found that substitution (replacing discretionary choices for healthy foods) and moderation (reduction of discretionary choices) achieved the greatest differences in energy, added sugars, and sodium intake, although substitution had a smaller impact on protein, fibre and micronutrients readings compared with the moderation strategy.

A third strategy – reformulation, which is finding discretionary foods with reduced saturated fats, added sugars and sodium – is the least effective means of changing excessive intakes, but the researchers said it still has a role to play in changing children’s diet choices and, with further food science adaptations, the potential for significant benefits.

The study’s dietary interventions involved a 50% reduction of intake (moderating), replacing 50% of discretionary choices with core foods (substituting), or choosing food and drink products with reduced target nutrients (reformulating).

‘Each of three dietary strategies have a role in improving diet quality, with varied effects on energy, saturated fat, added sugars and sodium’ says report co-author Associate Professor Rebecca Golley, Flinders University’s nationally recognised expert in child obesity and nutrition promotion.

‘The message is to replace discretionary choices with foods such as vegetables, whole grains and dairy. This will achieve similar benefits to moderation but will have the additional benefits of improving diet quality and micronutrient intake. Dietary approaches to reduce discretionary choices (moderation) or replace them with core choices (substitution) show promise in achieving meaningful reductions in energy intake for obesity prevention in Australian children.’

Source: Source: Flinders University

Your friend circle predicts health

Wearable fitness trackers have made it all too easy for us to make assumptions about our health. We may look to our heart rate to determine whether we really felt the stress of that presentation at work this morning, or think ourselves healthier based on the number of steps we’ve taken by the end of the day.

But to get a better reading on your overall health and wellness, you’d be better off looking at the strength and structure of your circle of friends, according to a new study in the Public Library of Science journal, PLOS One.

While previous studies have shown how beliefs, opinions and attitudes spread throughout our social networks, researchers at the University of Notre Dame were interested in what the structure of social networks says about the state of health, happiness and stress.

‘We were interested in the topology of the social network — what does my position within my social network predict about my health and wellbeing?’ said Nitesh Chawla, a lead author of the study; ‘What we found was the social network structure provides a significant improvement in predictability of wellness states of an individual over just using the data derived from wearables, like the number of steps or heart rate.’

For the study, participants wore Fitbits to capture health behaviour data, such as steps, sleep, heart rate and activity level, and completed surveys and self-assessments about their feelings of stress, happiness and positivity. Chawla and his team then analysed and modelled the data, using machine learning, alongside an individual’s social network characteristics including degree, centrality, clustering coefficient and number of triangles. These characteristics are indicative of properties like connectivity, social balance, reciprocity and closeness within the social network. The study showed a strong correlation between social network structures, heart rate, number of steps and level of activity.

Social network structure provided significant improvement in predicting one’s health and wellbeing compared to just looking at health behaviour data from the Fitbit alone. For example, when social network structure is combined with the data derived from wearables, the machine learning model achieved a 65% improvement in predicting happiness, 54% improvement in predicting one’s self-assessed health prediction, 55% improvement in predicting positive attitude, and 38% improvement in predicting success.

‘This study asserts that without social network information, we only have an incomplete view of an individual’s wellness state, and to be fully predictive or to be able to derive interventions, it is critical to be aware of the social network structural features as well’ Chawla said.

Source: University of Notre Dame