Abstract (eng)
Theoretical Background: Negative body-image plays an important role in the development and maintenance of eating disorders. Therefore, it should be specifically addressed in treatment. Moreover, assessment of negative body-image should also be implemented in routine outcome evaluations of treatment. Cognitive-emotional aspects of the body-image may be accessed in confrontational situations where patients are presented with displays of their own body, using either a mirror or video.
Objective: The aim of this study was to evaluate an in‐patient treatment program for patients with eating disorders of a psychosomatic clinic in Lower Austria. Treatment included a module that focused specifically on patients' negative body‐image (body-image therapy). In particular, this study examined the therapeutical changes in patients' body‐image following therapy.
Methods: Participants were 121 female patients (47 diagnosed with bulimia nervosa, 74 with anorexia nervosa) who were hospitalised for about 10 weeks. For outcome assessment the Symptom‐Check‐List 90‐R, the Beck Depression Inventory, the Eating‐Disorder‐Inventory‐2, the FKKS (Frankfurter Körperkonzeptskalen), and the FBeK (Fragebogen zur Beschreibung des eigenen Körpers) were used, with the FKKS and FBeK serving as two different measures of various aspects of body-image. The course of body-image therapy was examined longitudinally in a subsample of 25 patients, 15 of which also participated in video confrontations at the beginning and at the end of treatment.
Results: Treatment resulted in significant and mostly large improvements among patients of both diagnostic groups. Bulimic patients had a slightly better outcome than anorectic patients. Negative body‐related cognitions and emotions emerged less frequently in the second video confrontation, while positive evaluations and emotions emerged more often. Behavioral avoidance of patients' own bodily displays lessened and gave way to increased interest. The longitudinal evaluation of the body-image therapy revealed strongly individualized therapy courses and also highlighted the confrontational character of body‐image therapy itself.