A Randomized Comparative Trial of Self-Affirmation and Psychoeducation Interventions for Improving Body Image in Young Women

Abstract

Body image concerns are a widespread experience, particularly for young women, and are associated with a number of undesirable consequences, including eating disorders. Self affirmation theory provides a framework for understanding poor body image as well as a potential means for improving the problematic cognitions and emotions associated with such concerns. The present randomized comparative trial was designed to investigate the utility of a self-affirmation intervention for improving body image concerns. Lakehead University women with a desire to improve their body image were randomly assigned to a self-affirmation intervention (SA; n = 190) where they engaged in self-affirmation exercises designed to teach them to affirm nonappearance domains of self-worth. The efficacy of SA was compared to a psychoeducational video intervention (PE; n = 189) that addressed body image and associated concerns. Results indicated that both interventions were successful at reducing concerns with weight and shape, eating-related concerns, investment in appearance contingent self-worth, and impairment associated with these concerns at the end of the 28-day intervention period and at 3- month follow-up. However, PE was superior at addressing eating-related concerns and impairment in functioning. Moderation analyses were unsuccessful at predicting intervention outcome based on participant baseline levels of self-esteem, positive and negative affect, ruminative thinking, and coping flexibility. Exploratory analyses determined that 14% of the variance in postintervention and 3-month follow-up weight and shape concerns was attributed to initial ratings of confidence in the interventions and the number of exercises participants completed. Results are discussed in terms of their relevance to the self-affirmation and broader psychotherapy literature, strengths and limitations, as well as implications for future research.