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Susan J Paxton

Publications and source records attributed to Susan J Paxton.

At least 19 recordsLinked to original sources
PubMed2026

Post-trial 12-month follow-up of TRACE (targeted research on addictive and compulsive eating) randomised controlled trial participants: A brief report.

Few treatment interventions for addictive eating have evaluated long-term effectiveness. This post-trial follow-up study evaluates secondary changes in addictive eating symptoms and quality of life at 12-months in a sample of individuals who participated in the TRACE (Targeted Research for Addictive and Compulsive Eating) RCT. Thirty-three adults out of possible 144 (82% female), median age 53 years, randomised to either the active intervention (five telehealth sessions delivered over 3-months), passive intervention (self-guided workbook) or control group completed an online post-trial survey. Pre- and immediate post-intervention (3-months) outcomes were compared to 12-months post-trial outcomes. Positive effects reported in the short term showed a rebound effect at post-trial follow-up in ∼50% of participants. The findings suggest that longer term support is needed to maintain changes in addictive eating behaviours and improve quality of life. Future research is needed to identify optimal intervention durations and support options for sustained change. Australian New Zealand Clinical Trials Registry (ACTRN12621001079831).

Humans↗
PubMed2006

Does body satisfaction matter? Five-year longitudinal associations between body satisfaction and health behaviors in adolescent females and males.

PURPOSE: This study addresses the question, "Does body satisfaction matter?" by examining longitudinal associations between body satisfaction and weight-related health-promoting and health-compromising behaviors five years later among adolescents. METHODS: Project EAT-II followed an ethnically and socioeconomically diverse sample of 2516 adolescents from 1999 (Time 1) to 2004 (Time 2). Associations between body satisfaction at Time 1 and health behaviors at Time 2 were examined, adjusting for sociodemographic characteristics and Time 1 health behaviors, with and without adjustment for body mass index (BMI). RESULTS: In females, lower body satisfaction predicted higher levels of dieting, unhealthy and very unhealthy weight control behaviors and binge eating, and lower levels of physical activity and fruit and vegetable intake. After adjusting for BMI, associations between body satisfaction and dieting, very unhealthy weight control behaviors, and physical activity remained statistically significant. In males, lower body satisfaction predicted higher levels of dieting, healthy, unhealthy, and very unhealthy weight control behaviors, binge eating, and smoking, and lower levels of physical activity. After adjusting for BMI, associations between body satisfaction and dieting, unhealthy weight control behavior, and binge eating remained statistically significant. CONCLUSIONS: The study findings indicate that, in general, lower body satisfaction does not serve as a motivator for engaging in healthy weight management behaviors, but rather predicts the use of behaviors that may place adolescents at risk for weight gain and poorer overall health. Interventions with adolescents should strive to enhance body satisfaction and avoid messages likely to lead to decreases in body satisfaction.

Adolescent↗
PubMed2006

Five-year change in body satisfaction among adolescents.

OBJECTIVE: The present study uses longitudinal data to examine changes in body satisfaction among male and female adolescents from baseline to 5 years. METHODS: A diverse sample of 2,516 adolescents completed surveys in 1999 and 2004, reporting satisfaction with 10 body parts or attributes, height/weight, and other characteristics. Multivariable general linear modeling was used to estimate change in body satisfaction from Time 1 to Time 2, by age group, race, and change in body mass index (BMI) category. RESULTS: Body satisfaction decreased over 5 years (mean satisfaction change=-0.79) in all groups except older adolescent females. Scores decreased significantly more among younger adolescents than older adolescents, among some racial/ethnic groups of males, and among those whose BMI increased. However, among males, change in body satisfaction depended on BMI category at baseline. CONCLUSIONS: Different types of prevention programs addressing body image may be needed for males and females at different developmental stages and may need to address changes in BMI.

Adolescent↗
PubMed2006

Prospective predictors of body dissatisfaction in adolescent girls and boys: a five-year longitudinal study.

This study investigated prospective risk factors for increases in body dissatisfaction in adolescent girls and boys in the Eating Among Teens Project. At the time of first assessment (Time 1), participants were a cohort of early adolescent girls (N=440) and boys (N=366) and a cohort of middle adolescent girls (N=946) and boys (N=764). Participants were followed up 5 years later (Time 2). Potential prospective risk factors examined included body mass index, socioeconomic status, ethnicity, parent dieting environment, peer environment, and psychological factors. Predictors of Time 2 body dissatisfaction were Time 1 body dissatisfaction, body mass index, socioeconomic status, being African American, friend dieting and teasing, self-esteem, and depression. However, the profile of predictors differed across the samples.

Adolescent↗
PubMed2006

Vigorous exercise and birth outcomes in a sample of recreational exercisers: a prospective study across pregnancy.

OBJECTIVE: This study examined the question of whether vigorous exercise undertaken by recreational exercisers across pregnancy, defined in two ways, were associated with reduced infant birthweight and gestational age at birth. METHODS: A prospective approach was implemented. A total of 148 pregnant women participated. Average intensity duration and frequency of vigorous exercise reported were examined and compared with two existing definitions of vigorous exercise. Participants completed questionnaires (including retrospective reports on 3 months prepregnancy) and an exercise diary at 16-23 weeks pregnancy, 24-31 weeks pregnancy and 32-38 weeks pregnancy, and at 7 to 14 days post-partum a birth outcomes questionnaire was completed. RESULTS: There were no significant differences between exercise groups for birthweight and gestational age at birth. CONCLUSIONS: There was no evidence that the intensity duration and frequency of vigorous exercise were associated with significant reductions in mean birth outcomes for the infants of women who participated in the study. Replication in a large, more diverse sample is recommended.

Adult↗
PubMed2006

Body dissatisfaction prospectively predicts depressive mood and low self-esteem in adolescent girls and boys.

This research examined whether body dissatisfaction prospectively predicted depressive mood and low self-esteem in adolescent girls and boys 5 years later. Participants were early-adolescent girls (n = 440, Time 1 M age = 12.7 years) and boys (n = 366, Time 1 M age = 12.8 years) and midadolescent girls (n = 946, Time 1 M age = 15.8 years) and boys (n = 764, Time 1 M age = 15.9 years). After controlling for Time 1 of the relevant dependent variable, ethnicity, socioeconomic status, and body mass index, Time 1 body dissatisfaction was a unique predictor of Time 2 depressive mood and low self-esteem in early-adolescent girls (depressive mood: F = 4.80, p < .05; self-esteem: F = 9.64, p < .01) and midadolescent boys (depressive mood: F = 12.27, p < .001; self-esteem: F = 9.38, p < .01) but not in early-adolescent boys or midadolescent girls. These findings are consistent with the hypothesis that body dissatisfaction is a risk factor for depressive mood and low self-esteem in both girls and boys but in different phases of adolescence.

Adolescent↗
PubMed2005

How do adolescent girls evaluate body dissatisfaction prevention messages?

PURPOSE: This research examined responses of adolescent girls to messages typically used in eating disorder and body image prevention programs and 2 new messages promoting a positive body image and persuading against body comparison with the media and peers. METHODS: Girls in the 7th, 8th, and 10th grades completed a questionnaire assessing comparison tendency, internalization of the thin body ideal, body image concerns, psychological functioning, and risk factors for eating disorders. Two weeks later, participants viewed on videotape 9 persuasive messages and 1 nonpersuasive control message and rated them on relevance, believability, emotional response to body, intention to compare, and intention to diet. RESULTS: Two message themes frequently used in prevention programs (1. media images are not real, and 2. the ideal body changes through history and between cultures) and 1 new message (don't fall into the comparison trap) were rated most strongly. Relevance ratings consistently were associated positively with body comparison, internalization of the thin ideal, body dissatisfaction, and dieting measures. CONCLUSIONS: Body dissatisfaction prevention messages vary in their persuasiveness and this research identifies messages that potentially are of particular value for inclusion in intervention programs.

Adolescent↗
PubMed2005

Guided self-help for bulimia nervosa in primary care: a randomized controlled trial.

BACKGROUND: To increase access to cognitive behavioural therapy for bulimia nervosa new delivery modes are being examined. Guided Self-Help (GSH) in primary care is potentially valuable in this respect. This research aimed to compare outcomes following GSH delivered by general practitioners (GPs) in the normal course of their practice to a delayed treatment control (DTC) condition, and to examine the maintenance of treatment gains at 3 and 6 months following completion of GSH. METHOD: Participants were 109 women with full syndrome or sub-threshold bulimia nervosa, randomly allocated to GSH ( n = 54) and DTC ( n = 55). The GSH group received direction and support from a GP over a 17-week period while working through the manual in Bulimia Nervosa and Binge-Eating: A Guide to Recovery by P. J. Cooper (1995). GSH and DTC groups were assessed pre-treatment and 1 week following the 17-week intervention or waiting interval. The GSH group was reassessed at 3- and 6-month follow-up. RESULTS: Intention-to-treat analyses at end of treatment revealed significant improvements in bulimic and psychological symptoms in GSH compared with DTC, reduction in mean frequency of binge-eating episodes by 60% in GSH and 6% in DTC, and remission from all binge-eating and compensatory behaviours in 28% of the GSH and 11% of the DTC sample. Treatment gains were maintained at 3- and 6-month follow-up. CONCLUSION: Outcomes in GSH compare favourably with those of specialist-delivered psychological treatments. These findings are considered in light of the nature of the therapy offered and the primary care context.

Adult↗
PubMed2004

Effect of social desirability on adolescent girls' responses to an eating disorders prevention program.

OBJECTIVE: The current study examined whether a social desirability response bias is a source of measurement error in prevention research. METHOD: Six hundred and seventy-seven female students in Grade 7 (n = 345) and Grade 8 (n = 332) were divided into either an intervention condition, in which participants watched a videotape promoting body acceptance and discouraging dieting and then discussed issues related to the video, or a control condition. Questionnaires were completed at baseline, postintervention, and at 1-month follow-up. RESULTS: Social desirability scores were correlated at a low but significant level with baseline body dissatisfaction, drive for thinness, bulimic tendencies, intention to diet, and size discrepancy for intervention participants. Social desirability did not correlate significantly with change over time in the outcome measures. DISCUSSION: The findings suggested that changes in girls' self-reports related to a prevention program were relatively free of social desirability response bias.

Adolescent↗
PubMed2003

General practitioners' perspectives regarding competence and confidentiality in an adolescent with suspected anorexia nervosa: legal and ethical considerations.

In Victoria, Australia, the legal position regarding young people's competence to make medical treatment decisions has not been clarified in legislation, and a number of often vague common law decisions must be relied on for guidance. This situation produces a degree of uncertainty about appropriate professional practice, while also potentially impeding young people's rights claims in health care settings. With this in mind, the present research explored general practitioners' competence and confidentiality decisions regarding a 17-year-old female who presented with symptoms of an eating disorder. Questionnaires were sent to a random sample of 500 Victorian general practitioners, of whom 190 responded. After reading a case vignette, general practitioners indicated whether they would find the hypothetical patient competent and if they would maintain her confidentiality. Seventy-three per cent of respondents found the patient competent and most would have maintained confidentiality, at least initially. However, subsequent analysis of the rationales supplied for these decisions revealed a wide diversity in general practitioners' understandings and implementations of extant legal authority. This research highlights the need for general practitioners to be exposed to up-to-date and clinically relevant explanations of contemporary legal positions.

Adolescent↗
PubMed2002

Development of body image, eating disturbance, and general psychological functioning in adolescent females: a replication using covariance structure modeling in an Australian sample.

OBJECTIVE: The current study is a follow up to a covariance structure modeling (CSM) investigation of predictors of body image, eating dysfunction, and general psychological functioning in U.S. adolescent females. METHOD: Four hundred and seventy Australian girls (13-17 years old) completed measures of teasing history, body dissatisfaction, global psychological functioning, dietary restraint, and bulimic behaviors. They were also measured in order to compute body mass index (BMI). CSM techniques were used to analyze the relationships between these latent variables. Two a priori models were tested, one was selected, and post-hoc model-fitting was undertaken. RESULTS: The final model indicated that BMI directly influenced teasing, which directly influenced body dissatisfaction. Body dissatisfaction influenced both global psychological functioning and restriction, whereas restriction had a direct influence on bulimia. Global psychological functioning also had a direct influence on bulimia. DISCUSSION: The results support previous research indicating that teasing and body dissatisfaction are risk factors for the development of eating disturbances.

Adolescent↗
PubMed2002

Evaluations of dieting prevention messages by adolescent girls.

BACKGROUND: Dieting prevention interventions have been relatively unsuccessful and may be more effective if they concentrate on messages known to be relatively high on persuasive properties. We aimed to identify anti-dieting messages rated most strongly on persuasive dimensions and participant characteristics that predicted message evaluations in adolescent girls. METHODS: Grade 7 and 8 girls completed questionnaires assessing risk factors for, and early symptoms of, eating disorders. Two weeks later, participants viewed on video seven messages (each 2-3 minutes long) frequently used to dissuade against dieting in prevention interventions and one control message. After viewing each message, participants rated it on a scale assessing the persuasive dimensions of Relevance, Believability, Emotional Response, and Intention to Diet. RESULTS AND CONCLUSIONS: A quarter to a third of participants felt less likely to go on a diet after viewing the messages. "Skipping meals makes you feel starved so you overeat and feel bad" and "Don't be fooled by the fad diets promoted in the media" were rated most strongly. Higher dieting, body dissatisfaction, and negative affect were generally associated with lower persuasive ratings, suggesting the importance of intervention prior to the establishment of dieting behaviors after which there is more message resistance. Age was also a predictor of Believability for some messages, supporting the importance of ensuring the age appropriateness of messages.

Adolescent↗
PubMed2002

Predictors of vulnerability to reduced body image satisfaction and psychological wellbeing in response to exposure to idealized female media images in adolescent girls.

Predictors of change in body satisfaction, depressed mood, anxiety and anger, were examined following exposure to idealized female advertising images in Grades 7 and 10 girls. Stable body dissatisfaction, physical appearance comparison tendency, internalization of thin ideal, self-esteem, depression, identity confusion and body mass index (BMI) were assessed. One week later, participants viewed magazine images, before and after which they completed assessments of state body satisfaction, state depression, state anxiety and state anger. Participants were randomly allocated to view either images of idealized females (experimental condition) or fashion accessories (control condition). For both grades, there was a significant decrease in state body satisfaction and a significant increase in state depression attributable to viewing the female images. In Grade 7 girls in the experimental condition, decrease in state body satisfaction was predicted by stable body dissatisfaction and BMI, while significant predictors of decreases in the measures of negative affect included internalization of the thin-ideal and appearance comparison. In Grade 10 girls, reduction in state body satisfaction and increase in state depression was predicted by internalization of the thin-ideal, appearance comparison and stable body dissatisfaction. These findings indicate the importance of individual differences in short-term reaction to viewing idealized media images.

Adolescent↗
PubMed2002

A controlled evaluation of an eating disorders primary prevention videotape using the Elaboration Likelihood Model of Persuasion.

OBJECTIVE: The aim was to extend findings related to a previously reported eating disorders prevention program by comparing treatment and control groups, adding a follow-up, and examining whether receiver characteristics, personal relevance and need for cognition (NFC), could predict attitude change in early adolescent girls. METHOD: Grade 7 girls were either shown a brief prevention videotape on dieting and body image (n = 104) or given no intervention (n = 114). All girls completed pre-, post- and 1-month follow-up questionnaires. RESULTS: The intervention group resulted in significantly more positive changes in attitude and knowledge at post-intervention, but only in knowledge at follow-up. There was no strong evidence that pre-intervention characteristics of recipients predicted responses to the videotape intervention when changes were compared to the control group. CONCLUSION: This prevention videotape appeared to have positive immediate effects, but additional intervention (e.g., booster sessions) may be required for longer-term change.

Adolescent↗
PubMed2002

Development of the Children's Body Image Scale.

OBJECTIVE: The aim of this study was to develop a gender-appropriate pictorial scale to measure body image in young children based on a measurable index of adiposity. METHOD: Pictorial scales for boys and girls containing seven body pictures representing standard percentile curves for body mass index (BMI) for healthy children were developed. The Children's Body Image Scale (CBIS) was administered to 312 children aged between 7 and 12 years. RESULTS: Accuracy of body size perception, indicated by the correlation between actual and perceived BMI category figure, developed with age, girls acquiring accuracy earlier than boys. Whereas girls developed a good accuracy (r =.60, p <.001, 10-12 years), in boys, the correlation, though significant, was not strong (r =.35, p <.01, 10-12 years). There was a consistent bias towards underestimation of body size using this technique. There was a high frequency of body size dissatisfaction across all the age ranges, 48% girls and 36% boys wished to have a smaller body figure than their own, and only 10% of girls and 20% boys wished to have a larger body figure. Construct validity was assessed in a subset of 153 children in which additional measures of restrained eating (DEBQ-R) and body esteem were available. From the age of 8 years, the CBIS provides a good measure of body dissatisfaction. CONCLUSIONS: The CBIS provides a good measure of body size perception in girls and an adequate measure in boys aged 8 years and older. It also provides a good measure of body size dissatisfaction in children. Internalization of a thin body ideal takes place at a young age, many children desiring a BMI below the average norm.

Body Constitution↗
PubMedDate not supplied

Comparison of internet and face-to-face delivery of a group body image and disordered eating intervention for women: a pilot study.

Increased access to therapy for body dissatisfaction and disordered eating is required. This pilot study compared a group intervention delivered face-to-face or synchronously over the Internet. Women with body dissatisfaction and disordered eating were randomly assigned to a face-to-face (N = 19) or Internet (N = 21) group. Body dissatisfaction, disordered eating, and psychological variables were assessed at baseline, post-intervention, and two months follow-up. Significant improvements on all outcome variables were observed and maintained at follow-up in both groups. There were no significant differences between delivery modes. This program shows promise, and the Internet mode of delivery has potential to overcome geographical distance.

Adolescent↗
PubMedDate not supplied

Prevention of body dissatisfaction and disordered eating: What next?

Eating disorder prevention is a young field that has made significant strides in the past two decades. It is timely to take a look back at what we have learned during this period in order to begin to address the question, "What next?" This paper considers several key issues based upon a review of the literature and the authors' perspectives. Topics discussed include: (1) environmental approaches; (2) global mental health versus eating disorder specific interventions; (3) participatory approaches; (4) the integration of obesity and eating disorder prevention; (5) boys; (6) program evaluation; and (7) whether we know enough to move ahead.

Adolescent↗