Thesis
Feasibility, acceptability, and preliminary target engagement of a healthy physical activity promotion intervention for bulimia nervosa: development and evaluation via case series design
Master of Science (M.S.), Drexel University
May 2020
DOI:
https://doi.org/10.17918/00001032
Abstract
Bulimia nervosa (BN) is characterized by a pattern of binge eating and compensatory behaviors as well as an overemphasis on body weight and shape in self-evaluation. Although cognitive behavioral therapy (CBT) is efficacious, recent reviews suggest that only 30% of patients reach abstinence at post-treatment. One potential reason for these poor outcomes is that CBT fails to adequately reduce elevated global negative affect (NA), affect reactivity, and overvaluation of shape and weight which have been shown to be correlated with poorer treatment outcomes in BN. Therefore, novel treatment components that focus on improving affect lability, global NA, and body satisfaction are needed in order to enhance outcomes. Promoting physical activity (PA) is a promising avenue through which to reduce global negative affect, affect lability, and improve body image in healthy individuals, other clinical populations (e.g. individuals with depression or anxiety) and individuals with eating disorders. While prescribing PA for individuals with BN has been controversial, this approach may have many benefits, including promoting healthy lifetime exercise habits that reduce likelihood of relapse through the improvement of emotion regulation skills and weight regulation. Given the promise of PA for targeting key maintenance factors of BN, we developed a 12-session healthy PA promotion intervention for BN and tested initial feasibility, acceptability, and target engagement through in an iterative case series (n=3). The treatment covered cognitive-behavioral skills designed to identify, practice and achieve behavioral goals while asking patients to engage in up to 150 minutes of moderate-to-vigorous PA per week, which was be pre-planned during each session with the client's therapist. The healthy PA promotion intervention was both feasible and acceptable. In the current study, the healthy PA promotion intervention resulted in a clinically significant decrease in BN symptom frequency in each participant. Further, participants showed clinically significant decreases in affect lability, negative affect, and overvaluation of shape and weight. The increases in weekly PA observed are equivalent with other studies, which demonstrates that healthy PA interventions can have beneficial effects on BN symptoms, affect, and overvaluation of shape and weight. A healthy PA intervention may be a good fit for increasing engagement with the difficult work of changing eating behavior when participants are reticent to do so for fear of weight gain. However, due to the small sample size, conclusions must be treated with caution. Future research should investigate alternative approaches for promoting healthy PA and include a larger sample in order to further test initial efficacy of this treatment approach.
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Details
- Title
- Feasibility, acceptability, and preliminary target engagement of a healthy physical activity promotion intervention for bulimia nervosa
- Creators
- Elizabeth W. Lampe
- Contributors
- Stephanie M. Manasse (Advisor)Evan M. Forman (Advisor)
- Awarding Institution
- Drexel University
- Degree Awarded
- Master of Science (M.S.)
- Publisher
- Drexel University; Philadelphia, Pennsylvania
- Number of pages
- 50 pages
- Resource Type
- Thesis
- Language
- English
- Academic Unit
- Psychological and Brain Sciences (Psychology); College of Arts and Sciences; Drexel University
- Other Identifier
- 991014695542004721