Social anxiety versus educational interventions for disordered eating behaviors and attitudes in socially anxious college women at high-risk for developing an eating disorder
The etiology of eating disorders is generally considered to be a complex interplay of factors beyond a simple preoccupation with food and body size. Although the link between eating disorders and mood disorders has been well-established in the literature, research has begun to implicate anxiety as a potential precursor to the development of eating disorders. Specifically, features of social anxiety may play a significant role in the development and maintenance of eating disorders. Given that eating disorders are associated with significant health risks, including death, preventing the onset or development of eating disorders may have a substantial impact on health costs to the individual and society. Existing eating disorder prevention programs, however, only address food preoccupation and body image disturbance. Despite evidence suggesting that social anxiety may play a role in both the development of eating disorders and relapse following treatment, to date no prevention efforts have included a social anxiety intervention component. Accordingly, the purpose of this study was to determine if an intervention for social anxiety would reduce negative eating behaviors and attitudes in women who are considered at risk for developing an eating disorder. It was expected that the social anxiety intervention would be as effective as an educational eating disorder prevention group in reducing negative eating behaviors and attitudes. Both major intervention groups were expected to lead to significant reductions in negative eating behaviors and attitudes compared to a no intervention control group. Sixty-two women were recruited from undergraduate psychology classes and an on-campus sorority and were screened using measures assessing eating behavior and social anxiety. Participants were randomly assigned to one of three groups: (a) a social anxiety intervention group, (b) an educational eating disorder prevention intervention group, or (c) a no intervention control group. All participants completed a battery of measures at three times during the study: (a) pre-intervention, (b) post-intervention, and (c) two-week follow-up. The measures assessed eating attitudes, eating behavior, social anxiety, trait anxiety, and depression. The data were analyzed via a series of 3 x 3 (Group by Time) mixed design ANOVAs. Results suggested that the use of a social anxiety intervention did not lead to significant reductions in negative eating behaviors or attitudes. The use of the educational eating disorders prevention group led to significant reductions in negative eating behaviors, but not eating attitudes. Neither of the major intervention groups affected social anxiety. Implications of these findings are addressed, as well as directions for future research related to eating disorder prevention programs.