Abstract
BackgroundBrief, innovative, mechanistically-driven psychological treatments for body dissatisfaction are needed. We aimed to explore the occurrence of body-related mental images among females reporting a subjective sense of body dissatisfaction (study 1), and to investigate the potential efficacy of a single session of imagery rescripting (ImRS) to reduce body dissatisfaction (Study 2: pilot; Study 3 randomized controlled trial).Methods and ResultsIn study 1 (n = 31), participants reported occurrence of both positive and negative body-related mental imagery. Frequency of body-related mental imagery and negative valence of such images were significantly related to body dissatisfaction. The pilot trial (n = 63) indicated feasibility, whereby ImRS of a distressing body-related mental image significantly reduced the believability, vividness, negative affect and distress of the image within-session and one-week post-session versus an active placebo condition (Expressive writing about body related thoughts and emotions). However, ImRS did not result in significant changes in body dissatisfaction. Study 3 was a randomized controlled trial (n = 113) with 3 conditions—ImRS, Expressive writing, and wait-list control. ImRS resulted in a significant reduction of vividness, controllability and negative affect caused by the image compared to Expressive writing condition, after the intervention. However, there were no significant reductions in body dissatisfaction from baseline to 1-week assessment, nor in post-hoc analyses at the 1-month follow-up. Findings suggest that a single session of imagery rescripting seems to alleviate the negative properties of the image (i.e., has proximal effects as hypothesized in our mechanistic account), but does not bring about a significant change in body dissatisfaction (i.e., transfer downstream to more distal effects).ConclusionsGiven some promising effects of ImRS on negative body-related emotions, but lack of a downstream effect on body dissatisfaction itself, further investigation of the format, dose and focus of ImRS in this context is warranted.
Highlights
Body image dissatisfaction, or body dissatisfaction is a common problem in Western cultures (Fallon et al, 2014)
Our second aim was to study the feasibility and initial effects (Study 2) of a single session of imagery rescripting (ImRS) based on a specific intervention protocol targeting negative body-related mental images compared to a credible placebo condition (Expressive writing about body related thoughts and emotions: Expressive Writing (EW))
Frequency of body-related mental imagery and negative valence of such images were significantly related to body dissatisfaction (Table 1)
Summary
Body dissatisfaction is a common problem in Western cultures (Fallon et al, 2014). We have argued for the need for brief, mechanistically driven, and scalable interventions to improve mental health treatments (Holmes et al, 2018) Such an approach includes new intervention approaches for body dissatisfaction, given its high prevalence, its status as a risk factor for eating disorder, and modest efficiency of current interventions for body dissatisfaction. Participants were instructed to bring to mind the most intrusive and distressing mental body-related image, and to describe the accompanying characteristics of the negative image, as well as triggers and other personal appraisals associated with the image They were guided to find an ‘antidote’ to the previously identified negative emotion and meaning, and to implicitly embody a more reflective and compassionate stance. In the stage the participant was guided to alter some aspects such as the believability of the original negative image in a way that would be impossible in reality (e.g., by making it look funny)
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