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Originalia

Ist primäre Prävention von Essstörungen langfristig wirksam?

Ergebnisse zur Evaluation eines Trainingsprogramms an Schulen

Published Online:September 01, 2006https://doi.org/10.1026/0943-8149.13.2.79

Abstract

Zusammenfassung. Die Prävention von Essstörungen ist ein Forschungsthema von hoher gesundheitspolitischer Relevanz: Chronifizierte Essstörungen sind mit schwerwiegenden körperlichen Folgen für die Betroffenen verbunden. Außerdem sind subklinische Formen von Essstörungen in immer jüngeren Altersgruppen weit verbreitet. Ziel dieser Studie ist es, die langfristige Effektivität primärer Prävention von Essstörungen zu überprüfen. Dazu ist ein zehnstündiges Trainingsprogramm für Schülerinnen und Schüler entwickelt und über einen Zeitraum von zwei Jahren hinweg evaluiert worden. Das Programm ist unterteilt in ein jeweils fünfstündiges Grundtraining in der 6. Klasse und ein Auffrischungstraining zwei Jahre später (8.Klasse). Inhaltliche Schwerpunkte des Programms sind die kritische Reflexion über das Schönheitsideal in den Medien, Informationen zu gesunder Ernährung und Essstörungen sowie ein Training in Problemlösefähigkeiten und sozialer Kompetenz. Das Programm wurde in einem Prä-Post-Kontrollgruppen-Design mit Follow-up an 204 Schülerinnen und Schülern auf seine Effektivität hin überprüft. Hier zeigte sich im Anschluss an die Programmteilnahme ein signifikanter Zuwachs an ernährungsrelevantem Wissen bei den Programmteilnehmern im Vergleich zur Kontrollgruppe. Im langfristigen Verlauf konnten außerdem signifikante Gruppenunterschiede im Essverhalten sowie im Selbstwertgefühl nachgewiesen werden. Diese Ergebnisse werden im Hinblick auf ihren Beitrag für eine effiziente Vorbeugung von Essstörungen diskutiert.


Is the primary prevention of eating disorders effective in the long run? Results from the evaluation of a training program in schools

Abstract. The prevention of eating disorders is a research area of high health-related relevance. Chronic eating disorders are associated with serious and partly irreversible consequences for physical health. Furthermore, sub-clinical forms are widely spread, even in younger age groups. The objective of the present study is to verify the long-term effectiveness of the primary prevention of eating disorders. A 10-hour-training program for students was developed and evaluated over a two-year period. The program consists of two 5-hourly training sessions, a basic training for 6th grade students and a booster session for 8th grade students. Topics covered include the critical reflection of the beauty ideal in the media, information about healthy eating and eating disorders as well as a training in problem-solving strategies and social skills. The effects of the program were examined in 204 pupils with pre-, post- and follow-up measurements using a control group design. There was a significant increase in knowledge in the experimental group after participation in the training. In the long-term evaluation there have been significant differences between the groups in eating behavior and self-esteem. These results are discussed with regard to their contribution to an efficient prevention of eating disorders.

Literatur

  • Austin, S. B. (2000). Prevention research in eating disorders: theory and new directions. Psychological Medicine , 30 , 1249– 1262 . First citation in articleCrossref, Google Scholar

  • Baranowski, M. J. , Hetherington, M. M. (2001). Testing the efficacy of an eating disorder prevention program. International Journal of Eating Disorders , 30 , 119– 124 . First citation in articleCrossref, Google Scholar

  • Botvin, G. J. , Kantor, L. (2000). Preventing alcohol and tobacco use through life skills training. Alcohol research and health , 4 , 250– 257 . First citation in articleGoogle Scholar

  • Braun, D. L. , Sunday, S. R. , Huang, A. , Halmi, K. A. (1999). More males seek treatment for eating disorders. International Journal of Eating Disorders , 25 , 415– 424 . First citation in articleCrossref, Google Scholar

  • Buddeberg-Fischer, B. (2000). Früherkennung und Prävention von Eßstörungen. Eßverhalten und Körpererleben bei Jugendlichen . Stuttgart: Schattauer . First citation in articleGoogle Scholar

  • Buddeberg-Fischer, B. , Reed, V. (2001). Prevention of disturbed eating behavior: An intervention program in swiss high school classes. Eating Disorders: The Journal of Treatment and Prevention , 9 , 109– 124 . First citation in articleCrossref, Google Scholar

  • Calam, R. , Waller, G. (1998). Are eating and psychosocial characteristics in early teenage years useful predictors of eating characteristics in early adulthood? A 7-year longitudinal study. International Journal of Eating Disorders , 24 , 351– 362 . First citation in articleCrossref, Google Scholar

  • Carter, J. C. , Stewart, D. A. , Dunn, V. J. , Fairburn, C. G. (1997). Primary prevention of eating disorders: Might it do more harm than good?. International Journal of Eating Disorders , 22 , 167– 172 . First citation in articleCrossref, Google Scholar

  • Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Erlbaum . First citation in articleGoogle Scholar

  • Crago, M. , Shisslak, C. M. , Ruble, A. (2001). Protective factors in the development of eating disorders. In R. H. Striegel-Moore & L. Smolak (Eds.), Eating disorders. Innovative directions in research and practice (pp. 75-89). Washington, DC: APA . First citation in articleCrossref, Google Scholar

  • Dallal, G. E. (1998). Intention-to-treat analysis. The Little Handbook of Statistical Practice, 19 Absätze . Verfügbar unter: www.tufts.edu/~gdallal/LHSP.HTM [02. 09. 2004] . First citation in articleGoogle Scholar

  • Dannigkeit, N. , Köster, G. (2000). Prävention von Essstörungen - Ein Trainingsprogramm . Unveröffentlichte Diplomarbeit, Philipps-Universität Marburg . First citation in articleGoogle Scholar

  • Dannigkeit, N. , Köster, G. , Tuschen-Caffier, B. (2002). Prävention von Essstörungen - Ein Trainingsprogramm für Schulen. In B. Röhrle (Hrsg), Prävention und Gesundheitsförderung (Bd. 2.; S. 151-171). Tübingen: dgvt-Verlag . First citation in articleGoogle Scholar

  • Fishbein, M. , Ajzen, I. (1974). Attitudes towards objects as predictors of single and multiple behavioral criteria. Psychological Review , 81 , 59– 74 . First citation in articleCrossref, Google Scholar

  • Franko, D. L. , Orosan-Weine, P. (1998). The prevention of eating disorders: Empirical, methodological, and conceptual considerations. Clinical Psychology Practice , 5 , 459– 477 . First citation in articleCrossref, Google Scholar

  • Franzen, S. (1994). Familiale Transmission von Gezügeltem Eßverhalten . Unveröffentlichte Dissertation, Philipps-Universität Marburg . First citation in articleGoogle Scholar

  • Franzen, S. , Florin, I. (1997). Der Dutch Eating Behavior Questionnaire für Kinder (DEBQ-K). Ein Fragebogen zur Erfassung gezügelten Eßverhaltens. Kindheit und Entwicklung , 6 , 116– 122 . First citation in articleGoogle Scholar

  • Friedman, S. S. (1998). Girls in the 90s: A gender-based model for eating disorders prevention. Patient Education and Counseling , 33 , 217– 224 . First citation in articleCrossref, Google Scholar

  • Grave, R. D. , De Luca, L. , Campello, G. (2001). Middle school primary prevention program for eating disorders: A controlled study with a twelve-month follow-up. Eating Disorders: The Journal of Treatment and Prevention , 9 , 327– 337 . First citation in articleCrossref, Google Scholar

  • Grunert, S. (1989). Ein Inventar zur Erfassung von Selbstaussagen zum Ernährungsverhalten. Diagnostica , 35 , 167– 179 . First citation in articleGoogle Scholar

  • Haberman, S. , Luffey, D. (1998). Weighting in college students‘ diet and excercise behaviors. Journal of American College Health , 46 , 189– 191 . First citation in articleCrossref, Google Scholar

  • Hammer, L. D. , Kraemer, H. C. , Wilson, D. M. , Ritter, P. L. , Dornbusch, S. M. (1991). Standarized percentile curves of body mass index for children and adolescents. American Journal of Diseases in Children , 145 , 259– 263 . First citation in articleGoogle Scholar

  • Heatherton, T. F. , Polivy, J. (1991). Development and validation of a scale for measuring state self-esteem. Journal of Personality and Social Psychology , 60 , 895– 910 . First citation in articleCrossref, Google Scholar

  • Hebebrand, J. (1999). Adipositas. In H. Remschmidt (Hrsg.), Kinder- und Jugendpsychiatrie. Eine praktische Einführung (S. 252-258). Stuttgart: Thieme . First citation in articleGoogle Scholar

  • Hohler, R. R. (1997). Selbstwertschwankungen bei Bulimia Nervosa . Marburg: Tectum . First citation in articleGoogle Scholar

  • Huon, G. F. , Roncolato, W. G. , Ritchie, J. E. , Braganza, C. (1997). Prevention of dieting-induced disorders: Findings and implications of a pilot study. Eating Disorders: The Journal of Treatment and Prevention , 5 , 280– 291 . First citation in articleCrossref, Google Scholar

  • Jacobi, C. , Zwaan, M. de , Hayward, C. , Kraemer, H. C. , Agras, W. S. (2004). Coming to terms with risk factors for eating disorders: Application of risk terminology and suggestions for a general taxonomy. Psychological Bulletin , 130 , 19– 65 . First citation in articleCrossref, Google Scholar

  • Kater, K. J. , Rohwer, J. , Levine, M. P. (2000). An elementary school project for developing healthy body image and reducing risk factors for unhealthy and disordered eating. Eating Disorders: The Journal of Treatment and Prevention , 8 , 3– 16 . First citation in articleCrossref, Google Scholar

  • Killen, J. D. , Hayward, C. , Litt, I. , Hammer, L. D. , Wilson, D. M. , Miner, B. M. , Taylor, C. B. , Varady, M. A. , Shisslak, C. (1992). Is puberty a risk factor for eating disorders?. American Journal of Diseases in Children , 146 , 323– 325 . First citation in articleGoogle Scholar

  • Köster, G. , Dannigkeit, N. , Tuschen-Caffier, B. (2001). Prävention von Essstörungen - Wirksamkeit eines Trainingsprogramms an Schulen. Zeitschrift für Gesundheitspsychologie , 9 , 147– 157 . First citation in articleLink, Google Scholar

  • Laessle, R. G. , Wurmser, H. , Pirke, K. M. (2000). Essstörungen. In J. Margraf (Hrsg.), Lehrbuch der Verhaltenstherapie (Bd. 2; S. 223-246). Berlin: Springer . First citation in articleCrossref, Google Scholar

  • Larisch, H. , Lohaus, A. (1992). Gesundheitsförderung im Kindes- und Jugendalter: Ansatzpunkte zu einer pädagogisch-psychologischen Intervention. Psychologie in Erziehung und Unterricht , 39 , 196– 203 . First citation in articleGoogle Scholar

  • Leppin, A. , Hurrelmann, K. (2000). Prävention von Rauchen durch Lebenskompetenzförderung: Welche Rolle spielt die schulische Lernumwelt?. In A. Leppin, K. Hurrelmann & H. Petermann (Hrsg.), Jugendliche und Alltagsdrogen. Konsum und Perspektiven der Prävention (S. 218-240). Neuwied, Berlin: Luchterhand . First citation in articleGoogle Scholar

  • Leon, G. R. , Keel, P. K. , Klump, K. L. , Fulkerson, J. A. (1997). Prevention Research. The future of risk factor research in understanding the etiology of eating disorders. Psychopharmacology Bulletin , 33 , 405– 411 . First citation in articleGoogle Scholar

  • Levine, M. P. , Smolak, L. , Moodey, A. F. , Shuman, M. D. , Hessen, L. D. (1994). Normative developmental challenges and dieting and eating disturbances in middle school girls. International Journal of Eating Disorders , 15 , 11– 20 . First citation in articleCrossref, Google Scholar

  • Levine, M. , Piran, N. (1999). Approaches to health promotion in the prevention of eating disorders . Unpublished manuscript, Kenyon College, Gambier, OH . First citation in articleGoogle Scholar

  • Levine, M. P. , Smolak, L. (2001). Primary prevention of body image disturbances and disordered eating in childhood and early adolescence. In J. K. Thompson & L. Smolak (Eds.), Body Image, Eating Disorders and Obesity in Youth (pp. 237-261). Washington, DC: APA . First citation in articleCrossref, Google Scholar

  • Lienert, G. A. , Raatz, U. (1998). Testaufbau und Testanalyse . Weinheim: PVU . First citation in articleGoogle Scholar

  • Mann, T. , Nolen-Hoeksema, S. , Huang, K. , Burgard, D. , Wright, A. , Hanson, K. (1997). Are two interventions worse than none? Joint primary and secondary prevention of eating disorders in college females. Health Psychology , 16 , 215– 225 . First citation in articleCrossref, Google Scholar

  • Mittag, W. , Jerusalem, M. (1999). Gesundheitsförderung bei Kindern und Jugendlichen. In B. Röhrle & G. Sommer (Hrsg.), Prävention und Gesundheitsförderung. Fortschritte der Gemeindepsychologie und Gesundheitsförderung (Band 4; S. 161-179). Tübingen: dgvt-Verlag & Münster: Verlag für Psychotherapie . First citation in articleGoogle Scholar

  • Moreno, A. B. , Thelen, M. H. (1995). Eating behavior in junior high school females. Adolescence , 30 , 171– 174 . First citation in articleGoogle Scholar

  • Muir, S. L. , Wertheim, E. H. , Paxton, S. J. (1999). Adolescent girls‘ first diets: Triggers and the role of multiple dimensions of self-concept. Eating Disorders: The Journal of Treatment and Prevention , 7 , 259– 270 . First citation in articleCrossref, Google Scholar

  • Mussell, M. P. , Binford, R. B. (2000). Eating Disorders: Summary of Risk Factors, Prevention Programming and Prevention Research. The Counseling Psychologist , 28 , 764– 796 . First citation in articleCrossref, Google Scholar

  • Neumark-Sztainer, D. , Butler, R. , Palti, H. (1995). Eating disturbances among adolescent girls: evaluation of a school-based primary prevention program. Journal of Nutrition Education , 27 , 24– 31 . First citation in articleCrossref, Google Scholar

  • O’Dea, J. , Abraham, S. (2000). Improving the body image, eating attitudes and behaviors of young male and female adolescents: A new educational approach that focuses on self-esteem. International Journal of Eating Disorders , 28 , 43– 57 . First citation in articleCrossref, Google Scholar

  • Oerter, R. , Dreher, E. (1995). Jugendalter. In R. Oerter & L. Montada (Hrsg.), Entwicklungspsychologie (S. 310-396). Weinheim: PVU . First citation in articleGoogle Scholar

  • Paxton, S. J. , Wertheim, E. H. , Gibbons, K. , Szmukler, G. I. , Hillier, L. , Petrovich, J. L. (1991). Body image satisfaction, dieting beliefs, and weight loss behaviors in adolescent girls and boys. Journal of Youth and Adolescence , 20 , 361– 379 . First citation in articleCrossref, Google Scholar

  • Phelps, L. , Johnston, L. S. , Augustyniak, K. (1999). Prevention of eating disorders: Identification of predictor variables. Eating Disorders: The Journal of Treatment and Prevention , 7 , 99– 108 . First citation in articleCrossref, Google Scholar

  • Piran, N. (1995). Prevention: Can early lessons lead to a delineation of an alternative model? A critical look at prevention with school children. Eating Disorders: The Journal of Treatment and Prevention , 3 , 28– 36 . First citation in articleCrossref, Google Scholar

  • Prochaska, J. O. , DiClemente, C. C. , Norcross, J. C. (1992). In search of how people change: Applications to addictive behaviors. American Psychologist , 47 , 1102– 1114 . First citation in articleCrossref, Google Scholar

  • Rathner, G. , Waldherr, K. (1997). Eating Disorder Inventory-2: Eine deutschsprachige Validierung mit Normen für weibliche und männliche Jugendliche. Zeitschrift für Klinische Psychologie, Psychiatrie und Psychotherapie , 45 , 157– 182 . First citation in articleGoogle Scholar

  • Santonastaso, P. , Zanetti, T. , Ferrara, S. , Olivotto, M. C. , Magnavita, N. , Favaro, A. (1999). A preventive intervention program in adolescent schoolgirls: A longitudinal study. Psychotherapy and Psychosomatics , 68 , 46– 50 . First citation in articleCrossref, Google Scholar

  • Schwartz, D. J. , Phares, V. , Tantleff-Dunn, S. , Thompson, J. K. (1999). Body image, psychological functioning, and parental feedback regarding physical appearance. International Journal of Eating Disorders , 25 , 339– 343 . First citation in articleCrossref, Google Scholar

  • Silverstein, B. , Perlick, D. (1995). The cost of competence: Why inequality causes depression, eating disorders, and illness in women . New York: Oxford University Press . First citation in articleGoogle Scholar

  • Smolak, L. , Levine, M. P. (2001). A two-year follow-up of a primary prevention program for negative body image and unhealthy weight regulation. Eating Disorders: The Journal of Treatment and Prevention , 9 , 313– 325 . First citation in articleCrossref, Google Scholar

  • Stewart, D. A. , Carter, J. C. , Drinkwater, J. , Hainsworth, J. , Fairburn, C. G. (2001). Modification of eating attitudes and behavior in adolescent girls: A controlled study. International Journal of Eating Disorders , 29 , 107– 118 . First citation in articleCrossref, Google Scholar

  • Stice, E. (2001). Risk factors for eating pathology: Recent advances and future directions. In R. H. Striegel-Moore & L. Smolak (Eds.), Eating disorders. Innovative directions in research and practice (pp. 51-73). Washington, DC: APA . First citation in articleGoogle Scholar

  • Streiner, D. , Geddes, J. (2001). Intention to treat analysis in clinical trials when there are missing data. Evidence-Based Mental Health , 4 , 70– 71 . First citation in articleCrossref, Google Scholar

  • Striegel-Moore, R. H. , Cachelin, F. M. (2001). Etiology of eating disorders in women. The Counseling Psychologist , 29 , 635– 661 . First citation in articleCrossref, Google Scholar

  • Strien, T. van , Frijters, J. E. R. , Bergers, G. P. A. , Defares, P. B. (1986). The Dutch Eating Behavior Questionnaire (DEBQ) for assessment of restrained, emotional and external eating behavior. International Journal of Eating Disorders , 5 , 295– 315 . First citation in articleCrossref, Google Scholar

  • Suckfüll, T. , Stillger, B. (1999). Starke Kinder brauchen starke Eltern - familienbezogene Suchtprävention - Konzepte und Praxisbeispiele. In Bundeszentrale für gesundheitliche Aufklärung (Hrsg.), Forschung und Praxis der Gesundheitsförderung, 7. Köln: BzgA . First citation in articleGoogle Scholar

  • Wade, T. D. , Davidson, S. , O’Dea, J. A. (2003). A preliminary controlled evaluation of a school-based media literacy program and self-esteem program for reducing eating disorder risk factors. International Journal of Eating Disorders , 33 , 371– 383 . First citation in articleCrossref, Google Scholar

  • Walden, K. (1998). Welche Rolle spielen “Selbstsicherheit“ und “Beeinflußbarkeit“ bei der Nikotinprävention für Mädchen und Jungen? Untersuchung der Notwendigkeit geschlechtsbezogener Prävention im Rahmen eines schulischen Lebenskompetenzprogrammes . Marburg: Dissertation am Fachbereich Psychologie der Philipps-Universität Marburg . First citation in articleGoogle Scholar

  • World Health Organization (1994). The development and dissemination of life skills education: An overview . Genf, World Health Organization . First citation in articleGoogle Scholar

  • Zerbe, K. J. (1992). Eating disorders in the 1990s: Clinical challenges and treatment implications. Bulletin Menninger Clinic , 56 , 167– 187 . First citation in articleGoogle Scholar