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Objective: During the past decades, cosmetic surgery has become increasingly popular. People with certain psychopathology disorders, for example, body dysmorphic disorder (BDD), are dissatisfied with their physical appearance, and a significant number try to receive cosmetic medical treatment for their complaints. It seems relatively easy for them to receive this type of surgery, despite the fact that it has no or even adverse effects on the symptoms. The present study aimed to investigate the psychological condition and especially the presence of psychopathological symptoms such as BDD in cosmetic surgery patients. Methods: Questionnaires about body image dissatisfaction, symptoms of BDD and psychopathology in general and satisfaction about surgery were sent to patients who had been treated in a large cosmetic surgery clinic. Results: Of the patients who replied, 86% were pleased with the outcome of the cosmetic procedure. Further, 21-59% of these former patients scored higher on questionnaires of body image dissatisfaction and psychopathological symptoms than a norm group from the general population. When differentiating the group on the basis of BDD symptomatology, it appeared that the high BDD symptomatic group displayed significantly worse outcome on all measurements. That is, high BDD symptomatic patients were more dissatisfied about the result of surgery, exhibited higher levels of psychopathology, and had lower self-esteem than the low symptomatic BDD patients. Conclusion: These findings clearly suggest that the evaluation of the psychological condition and motivation of the candidate patient might be a valuable addition to the standard procedure in cosmetic medical treatment settings.

Body dysmorphic disorder is a severe disturbance in which the person is preoccupied with an imagined defect in appearance. It is unclear what causes and what maintains BDD, although it is assumed that patients are characterized by an increased self-focused attention. Since patients spend a lot of time examining their 'defect' in reflecting surfaces, it might well be that mirror gazing itself is an important maintaining factor for BDD, as it may lead to a loss of sense of proportions. If so, normal individuals' body evaluations are expected to decrease likewise after mirror exposure. In the present study, 50 female students watched both their own face in the mirror and a photograph of a neutral female face for 3.5 min. Before and after gazing, they rated the attractiveness of the faces. Results indicate that mirror exposure did not lead to decreased attractiveness in normal participants. However, when participants were divided into high and low satisfaction about appearance, highly satisfied individuals' evaluations of their own face improved, whereas low satisfied individuals' evaluations tended to decrease. For the other face, only the low satisfied individuals showed increased attractiveness scores at post-test. The results are explained by selective visual attention and are in line with recent findings in eating disordered women.

Background and Objectives: Though there is some evidence that body exposure increases body satisfaction, it is still unclear why exposure works and how attention should be guided during exposure. This pilot study manipulates the focus of attention during body exposure. Methods: Female participants high in body dissatisfaction were randomly assigned to an exposure intervention that exclusively focused on self-defined attractive (n = 11) or self-defined unattractive (n = 11) body parts. Both interventions consisted of five exposure sessions and homework. Outcome and process of change were studied. Results: Both types of exposure were equally effective and led to significant improvements in body satisfaction, body checking, body concerns, body avoidance and mood at post-test. Improvements for body satisfaction and mood were maintained at follow-up while body shape concerns and body checking still improved between post-test and follow-up. Body avoidance improvements were maintained for the positive exposure while the negative exposure tended to further decrease long-term body avoidance at follow-up.. The 'positive' exposure induced positive feelings during all exposure sessions while the 'negative' exposure initially induced a worsening of feelings but feelings started to improve after some sessions. The most unattractive body part was rated increasingly attractive in both conditions though this increase was significantly larger in the negative compared to the positive exposure condition. Limitations: The sample size was small and non-clinical. Conclusions: Both types of exposure might be effective and clinically useful. Negative exposure is emotionally hard but might be significantly more effective in increasing the perceived attractiveness of loathed body parts and in decreasing avoidance behavior. (c) 2015 Elsevier Ltd. All rights reserved.

The present study investigated whether a single-session of food cue exposure for overweight women would decrease 'if CS then US' expectancies, cue reactivity and eating in the absence of hunger (EAH). EAH was measured in a behavioural paradigm that enabled to also investigate whether the cue exposure effects were specific for exposed foods or would generalise to food items that were not present during exposure. Overweight women were randomly assigned to either the cue exposure intervention or a control intervention that focused on body image. In line with the hypotheses, results showed that cue exposure induced a significant decrease in 'if CS then US' expectancies, in contrast to the control intervention. It was also found that, compared to the control intervention, desires to eat initially increased during cue exposure while gradual extinction was observed towards the end of the intervention. No extinction of increased salivation responses was found. Regarding EAH, the intake of the exposed food item was significantly less in the exposure condition than in the control condition, whereas total caloric food intake was not different between conditions, indicating that cue exposure was effective in reducing intake but did not generalise to the intake of other food items. (C) 2015 Elsevier Ltd. All rights reserved.

Background and Objectives: Though there is some evidence that body exposure increases body satisfaction, it is still unclear why exposure works and how attention should be guided during exposure. This pilot study manipulates the focus of attention during body exposure. Methods: Female participants high in body dissatisfaction were randomly assigned to an exposure intervention that exclusively focused on self-defined attractive (n = 11) or self-defined unattractive (n = 11) body parts. Both interventions consisted of five exposure sessions and homework. Outcome and process of change were studied. Results: Both types of exposure were equally effective and led to significant improvements in body satisfaction, body checking, body concerns, body avoidance and mood at post-test. Improvements for body satisfaction and mood were maintained at follow-up while body shape concerns and body checking still improved between post-test and follow-up. Body avoidance improvements were maintained for the positive exposure while the negative exposure tended to further decrease long-term body avoidance at follow-up.. The 'positive' exposure induced positive feelings during all exposure sessions while the 'negative' exposure initially induced a worsening of feelings but feelings started to improve after some sessions. The most unattractive body part was rated increasingly attractive in both conditions though this increase was significantly larger in the negative compared to the positive exposure condition. Limitations: The sample size was small and non-clinical. Conclusions: Both types of exposure might be effective and clinically useful. Negative exposure is emotionally hard but might be significantly more effective in increasing the perceived attractiveness of loathed body parts and in decreasing avoidance behavior. (c) 2015 Elsevier Ltd. All rights reserved.

The present study investigated whether a single-session of food cue exposure for overweight women would decrease 'if CS then US' expectancies, cue reactivity and eating in the absence of hunger (EAH). EAH was measured in a behavioural paradigm that enabled to also investigate whether the cue exposure effects were specific for exposed foods or would generalise to food items that were not present during exposure. Overweight women were randomly assigned to either the cue exposure intervention or a control intervention that focused on body image. In line with the hypotheses, results showed that cue exposure induced a significant decrease in 'if CS then US' expectancies, in contrast to the control intervention. It was also found that, compared to the control intervention, desires to eat initially increased during cue exposure while gradual extinction was observed towards the end of the intervention. No extinction of increased salivation responses was found. Regarding EAH, the intake of the exposed food item was significantly less in the exposure condition than in the control condition, whereas total caloric food intake was not different between conditions, indicating that cue exposure was effective in reducing intake but did not generalise to the intake of other food items. (C) 2015 Elsevier Ltd. All rights reserved.

Cosmetic surgery has become increasingly popular in the past 15 years, and even seems to be common practice. The overall picture communicates that people profit from these interventions. Generally, people wish to alter their appearance when they are dissatisfied about their body image and when appearance determines their self-esteem to a great extent. Body image disturbances, such as body dysmorphic disorder (bdd), are situated within the extreme dissatisfaction range. Bdd is a serious disorder which is characterised by a preoccupation with an imaginary defect in appearance or an excessive concern about a slight physical abnormality. Patients can be effectively treated with cognitive behavioural therapy or a serotonin reuptake inhibitor, but most of them are convinced that cosmetic surgery is the only answer. Surgery outcome is often disappointing, however. This article aims to summarise the literature about cosmetic surgery and bdd and argues that cosmetic surgery patients should be screened psychologically to detect whether they have bdd. Results of a pilot study are presented to underpin this claim. (netherlands journal of psychology, 62, 34-41.).

Patients with fear of blushing as the predominant complaint (N = 31) were randomly assigned to (1) exposure in vivo (EXP), or (2) task concentration training (TCT), in order to test the effect of redirecting attention above exposure only. In addition, it was investigated whether treatment reduced actual blush behavior; therefore, physiological parameters of blushing were measured during two behavioral tests. Half of the patients served as waiting-list controls first. Assessments were held before and after treatment, at 6-weeks, and at 1-year follow-up. Both treatments appeared to be effective in reducing fear of blushing and realizing cognitive change, Yet, at posttest, TCT tended to produce better results with respect to fear of blushing. At 6-weeks follow-up, TCT produced significantly more cognitive change. At 1-year follow-up, patients further improved, while differential effects had disappeared, The reduction in fear of blushing was not paralleled by a reduction in actual blush behavior during the behavioral assessments. Thus, it seems that fear of blushing reflects a fearful preoccupation, irrespective of actual facial coloration.

The purpose of the present study was to determine the effect of metacognitive therapy (MCT) on symptoms of body dysmorphic disorder (BDD) and on symptoms of thought-fusion, by means of a wait-list controlled clinical trial. Participants were referred from dermatology and cosmetic surgery clinics in the city of Isfahan, Iran, and 20 patients were selected on the basis of DSM-IV-TR diagnostic criteria for BOO. They were randomly assigned to either the experimental or the wait-list control group. The Yale-Brown Obsessive Compulsive Scale Modified for Body Dysmorphic Disorder (BDD-YBOCS) and the Thought-Fusion Inventory (TFI) were used as the outcome measures. The experimental group received 8 weekly metacognitive intervention sessions. The control group was in the waiting-list until the end of the follow-up. Measures were taken at pre-test, post-test (after 2 months) and follow-up (after 6-months), The results of analysis of variance showed that MCT significantly reduced the symptoms of BDD and of thought-fusion, compared to the wait-list. Effects on both outcome measures were maintained at 6-months follow-up.

Objective: During the past decades, cosmetic surgery has become increasingly popular. People with certain psychopathology disorders, for example, body dysmorphic disorder (BDD), are dissatisfied with their physical appearance, and a significant number try to receive cosmetic medical treatment for their complaints. It seems relatively easy for them to receive this type of surgery, despite the fact that it has no or even adverse effects on the symptoms. The present study aimed to investigate the psychological condition and especially the presence of psychopathological symptoms such as BDD in cosmetic surgery patients. Methods: Questionnaires about body image dissatisfaction, symptoms of BDD and psychopathology in general and satisfaction about surgery were sent to patients who had been treated in a large cosmetic surgery clinic. Results: Of the patients who replied, 86% were pleased with the outcome of the cosmetic procedure. Further, 21-59% of these former patients scored higher on questionnaires of body image dissatisfaction and psychopathological symptoms than a norm group from the general population. When differentiating the group on the basis of BDD symptomatology, it appeared that the high BDD symptomatic group displayed significantly worse outcome on all measurements. That is, high BDD symptomatic patients were more dissatisfied about the result of surgery, exhibited higher levels of psychopathology, and had lower self-esteem than the low symptomatic BDD patients. Conclusion: These findings clearly suggest that the evaluation of the psychological condition and motivation of the candidate patient might be a valuable addition to the standard procedure in cosmetic medical treatment settings.

The purpose of the present study was to determine the effect of metacognitive therapy (MCT) on symptoms of body dysmorphic disorder (BDD) and on symptoms of thought-fusion, by means of a wait-list controlled clinical trial. Participants were referred from dermatology and cosmetic surgery clinics in the city of Isfahan, Iran, and 20 patients were selected on the basis of DSM-IV-TR diagnostic criteria for BOO. They were randomly assigned to either the experimental or the wait-list control group. The Yale-Brown Obsessive Compulsive Scale Modified for Body Dysmorphic Disorder (BDD-YBOCS) and the Thought-Fusion Inventory (TFI) were used as the outcome measures. The experimental group received 8 weekly metacognitive intervention sessions. The control group was in the waiting-list until the end of the follow-up. Measures were taken at pre-test, post-test (after 2 months) and follow-up (after 6-months), The results of analysis of variance showed that MCT significantly reduced the symptoms of BDD and of thought-fusion, compared to the wait-list. Effects on both outcome measures were maintained at 6-months follow-up.

Objective: In general, treatment of childhood obesity focuses on treating the obese children. The results of child-directed treatments are disappointing in the long run. In the current study, it is tested whether a treatment aimed solely at obese children's parents results in positive effects on the children's weight status. In addition, potential predictors of treatment success are identified. Methods: The parents of 98 overweight or obese children (aged 7-13 years) were randomly assigned to either the cognitive-behavioural group treatment (eight sessions) or the waiting-list control group. Results: With respect to child body mass index (BMI) percentile, the parents' treatment was successful in reducing overweight from pretreatment to posttreatment: BMI percentile decreased significantly by 2.4% in the treatment group, whereas there was no change in the waiting-list control group. There was no significant relapse at follow-up (3 months). Child BMI percentile did not decrease in the waiting-list control group. In addition, significant main effects of time were found for both groups with respect to eating psychopathology (decrease), self-esteem (increase) and negative thoughts (decrease). Finally, parental BMI decreased significantly only in the treatment group. Four predictors were identified with respect to treatment success, namely, lower socioeconomic status, younger age of the child, higher parental attendance and lower BMI percentile of the child before treatment. Conclusions: The parents' treatment had significant effects on child and parent BMI. Long-term endurance of these positive effects needs to be studied. Striking are the positive effects of time in the waiting-list control group for some psychological outcome measures. Obviously, waiting for treatment already affects psychological processes (but not behaviour) in the children. International Journal of Obesity (2011) 35, 501-509; doi: 10.1038/ijo.2011.16; published online 1 March 2011

In de dsm-iv (apa, 2000) worden drie verschillende eetstoornissen beschreven: bulimia nervosa, anorexia nervosa en eetstoornissen niet anderszins omschreven (eetstoornissen nao, waaronder ook de eetbuistoornis valt). Obesitas is geen eetstoornis volgens de dsm-iv en ook in de dsm-v – die in 2013 wordt verwacht – zal obesitas niet als eetstoornis opgenomen worden. Desondanks beschouwen wij obesitas als een gedragsprobleem dat in de ggz behandeld zou moeten worden (jansen e.a., 2009). Wie blijvend gewicht wil verliezen en daar weinig succes mee boekt, heeft veel baat bij de cognitieve technieken die in dit hoofdstuk beschreven worden. De hier beschreven cognitieve technieken kunnen dus bij elk eet- of gewichtsprobleem worden toegepast.

Objective: In general, treatment of childhood obesity focuses on treating the obese children. The results of child-directed treatments are disappointing in the long run. In the current study, it is tested whether a treatment aimed solely at obese children's parents results in positive effects on the children's weight status. In addition, potential predictors of treatment success are identified. Methods: The parents of 98 overweight or obese children (aged 7-13 years) were randomly assigned to either the cognitive-behavioural group treatment (eight sessions) or the waiting-list control group. Results: With respect to child body mass index (BMI) percentile, the parents' treatment was successful in reducing overweight from pretreatment to posttreatment: BMI percentile decreased significantly by 2.4% in the treatment group, whereas there was no change in the waiting-list control group. There was no significant relapse at follow-up (3 months). Child BMI percentile did not decrease in the waiting-list control group. In addition, significant main effects of time were found for both groups with respect to eating psychopathology (decrease), self-esteem (increase) and negative thoughts (decrease). Finally, parental BMI decreased significantly only in the treatment group. Four predictors were identified with respect to treatment success, namely, lower socioeconomic status, younger age of the child, higher parental attendance and lower BMI percentile of the child before treatment. Conclusions: The parents' treatment had significant effects on child and parent BMI. Long-term endurance of these positive effects needs to be studied. Striking are the positive effects of time in the waiting-list control group for some psychological outcome measures. Obviously, waiting for treatment already affects psychological processes (but not behaviour) in the children. International Journal of Obesity (2011) 35, 501-509; doi: 10.1038/ijo.2011.16; published online 1 March 2011

The prevalence of overweight is increasing dramatically in children. A protective factor against the development of overweight is a sufficient intake of fruit and vegetables. However, the consumption of fruit and vegetables in children is far from ideal these days. Therefore, it is important to examine how the intake of fruit and vegetables can be promoted. In this study, the effects of two fruit promoting techniques were evaluated in 4-7-year-old children: presenting fruit in a more visually appealing manner versus restricting the intake of fruit. Two presentations of fruit (regular and visually appealing) were offered to the participants. In a first taste session participants were either allowed to eat from both fruit presentations (no-prohibition group) or prohibited from eating one of the two presentations (regular fruit prohibited group/visually appealing fruit prohibited group). In a second taste session all participants were allowed to eat from both fruit presentations. The results indicated that visual appeal had a strong effect on consumption of the fruit. With respect to restriction, no effects were found. Parents, schools, supermarkets and food producers should take advantage of these results, and offer children fruit and vegetables that are presented in a visually appealing manner.

The present study examined whether mindfulness-based strategies can effectively reduce food cravings in an overweight and obese adult population. Individuals participating in a dietary group treatment for overweight received an additional 7-week manual based training that aimed to promote regulation of cravings by means of acceptance. The control group did not receive this additional training program. The results showed that participants in the experimental group reported significantly lower cravings for food after the intervention compared to the control group. The findings are discussed in terms of possible mechanisms like prevention of goal frustration, disengagement of obsessive thinking and reduction of automatic relations between urge and reaction.

The prevalence of overweight is increasing dramatically in children. A protective factor against the development of overweight is a sufficient intake of fruit and vegetables. However, the consumption of fruit and vegetables in children is far from ideal these days. Therefore, it is important to examine how the intake of fruit and vegetables can be promoted. In this study, the effects of two fruit promoting techniques were evaluated in 4-7-year-old children: presenting fruit in a more visually appealing manner versus restricting the intake of fruit. Two presentations of fruit (regular and visually appealing) were offered to the participants. In a first taste session participants were either allowed to eat from both fruit presentations (no-prohibition group) or prohibited from eating one of the two presentations (regular fruit prohibited group/visually appealing fruit prohibited group). In a second taste session all participants were allowed to eat from both fruit presentations. The results indicated that visual appeal had a strong effect on consumption of the fruit. With respect to restriction, no effects were found. Parents, schools, supermarkets and food producers should take advantage of these results, and offer children fruit and vegetables that are presented in a visually appealing manner.

The present study examined whether mindfulness-based strategies can effectively reduce food cravings in an overweight and obese adult population. Individuals participating in a dietary group treatment for overweight received an additional 7-week manual based training that aimed to promote regulation of cravings by means of acceptance. The control group did not receive this additional training program. The results showed that participants in the experimental group reported significantly lower cravings for food after the intervention compared to the control group. The findings are discussed in terms of possible mechanisms like prevention of goal frustration, disengagement of obsessive thinking and reduction of automatic relations between urge and reaction.

Objective: The treatment of obesity is universally disappointing; although usually some weight loss is reported directly after treatment, eventual relapse to, or even above, former body weight is common. In this study it is tested whether the addition of cognitive therapy to a standard dietetic treatment for obesity might prevent relapse. It is argued that the addition of cognitive therapy might not only be effective in reducing weight and related concerns, depressed mood, and low self-esteem, but also has an enduring effect that lasts beyond the end of treatment. Methods: Non-eating-disordered overweight and obese participants in a community health center (N=204) were randomly assigned to a group dietetic treatment+cognitive therapy or a group dietetic treatment+physical exercise. Results: Both treatments were quite successful and led to significant decreases in BMI, specific eating psychopathology (binge eating, weight-, shape-, and eating concerns) and general psychopathology (depression, low sell-esteem). In the long run, however, the cognitive dietetic treatment was significantly better than the exercise dietetic treatment; participants in the cognitive dietetic treatment maintained all their weight loss, whereas participants in the physical exercise dietetic treatment regained part (25%) of their lost weight. Conclusion: Cognitive therapy had enduring effects that lasted beyond the end of treatment. This potential prophylactic effect of cognitive therapy is promising; it might be a new strategy to combat the global epidemic of obesity.

Obese people prefer and over consume high-fat foods. At the same time they often attempt to lose weight. In two studies we investigated relations between palatable high-fat food words and disinhibition related concepts (study 1) and palatable high-fat food words and restraint related concepts (study 2) within the semantic priming paradigm. In study 1, 24 overweight/obese and 19 healthy weight women participated. There was no association between palatable high-fat food words and disinhibition. In study 2, 27 obese and 29 healthy weight women participated. The presentation of palatable high-fat food words facilitated the accessibility of restraint related concepts as hypothesized, but independent of weight status. Clearly, early associations with palatable high-fat food words are restraint related in both healthy weight and obese people. (PsycINFO Database Record (c) 2009 APA, all rights reserved) (journal abstract)

Body dysmorphic disorder is a severe disturbance in which the person is preoccupied with an imagined defect in appearance. It is unclear what causes and what maintains BDD, although it is assumed that patients are characterized by an increased self-focused attention. Since patients spend a lot of time examining their 'defect' in reflecting surfaces, it might well be that mirror gazing itself is an important maintaining factor for BDD, as it may lead to a loss of sense of proportions. If so, normal individuals' body evaluations are expected to decrease likewise after mirror exposure. In the present study, 50 female students watched both their own face in the mirror and a photograph of a neutral female face for 3.5 min. Before and after gazing, they rated the attractiveness of the faces. Results indicate that mirror exposure did not lead to decreased attractiveness in normal participants. However, when participants were divided into high and low satisfaction about appearance, highly satisfied individuals' evaluations of their own face improved, whereas low satisfied individuals' evaluations tended to decrease. For the other face, only the low satisfied individuals showed increased attractiveness scores at post-test. The results are explained by selective visual attention and are in line with recent findings in eating disordered women.

Objective: The treatment of obesity is universally disappointing; although usually some weight loss is reported directly after treatment, eventual relapse to, or even above, former body weight is common. In this study it is tested whether the addition of cognitive therapy to a standard dietetic treatment for obesity might prevent relapse. It is argued that the addition of cognitive therapy might not only be effective in reducing weight and related concerns, depressed mood, and low self-esteem, but also has an enduring effect that lasts beyond the end of treatment. Methods: Non-eating-disordered overweight and obese participants in a community health center (N=204) were randomly assigned to a group dietetic treatment+cognitive therapy or a group dietetic treatment+physical exercise. Results: Both treatments were quite successful and led to significant decreases in BMI, specific eating psychopathology (binge eating, weight-, shape-, and eating concerns) and general psychopathology (depression, low sell-esteem). In the long run, however, the cognitive dietetic treatment was significantly better than the exercise dietetic treatment; participants in the cognitive dietetic treatment maintained all their weight loss, whereas participants in the physical exercise dietetic treatment regained part (25%) of their lost weight. Conclusion: Cognitive therapy had enduring effects that lasted beyond the end of treatment. This potential prophylactic effect of cognitive therapy is promising; it might be a new strategy to combat the global epidemic of obesity.

Obese people prefer and over consume high-fat foods. At the same time they often attempt to lose weight. In two studies we investigated relations between palatable high-fat food words and disinhibition related concepts (study 1) and palatable high-fat food words and restraint related concepts (study 2) within the semantic priming paradigm. In study 1, 24 overweight/obese and 19 healthy weight women participated. There was no association between palatable high-fat food words and disinhibition. In study 2, 27 obese and 29 healthy weight women participated. The presentation of palatable high-fat food words facilitated the accessibility of restraint related concepts as hypothesized, but independent of weight status. Clearly, early associations with palatable high-fat food words are restraint related in both healthy weight and obese people. (PsycINFO Database Record (c) 2009 APA, all rights reserved) (journal abstract)

overweight is increasing rapidly in children, compelling researchers to seek for determinants of adverse food intake. In a previous experiment it was found that manipulating the restriction of attractive snacks increased the desirability and intake of these snacks. in the present study, we tested whether this paradoxical restricting effect is also seen in relatively less attractive but healthy food, i.e. fruit. Will fruit become More desirable through restriction, and will children eat more forbidden fruit than non-forbidden fruit? Two groups of young children were forbidden to eat fruits and sweets, respectively, whereas a control group was invited to eat everything. Desire for sweets remained high in the sweets-prohibition condition, whereas it decreased in the fruit-prohibition and no-prohibition conditions. No group differences were found regarding the desire for fruit, With respect to intake, children in both the fruit- and the sweets-prohibition condition consumed more of the formerly forbidden food during a taste session as compared to the no-prohibition condition. In addition, total food intake was higher in the two prohibition conditions than in the no-prohibition condition. These data indicate that the adverse effects of restriction apply to both attractive unhealthy and relatively less attractive but healthy food.

Objectives: In the present study the hypothesis was tested that a regular dietary treatment for obesity that is primarily directed at decreasing weight will also decrease concerns about shape, weight and eating, will reduce binge eating and will improve mood and self-esteem. Moreover we investigated whether a group treatment and an individual treatment were equally effective. Method: Fifty-four obese participants followed either a group treatment (n=31) or an individual treatment (n=23) provided by dieticians. Results: The data showed that overall, BMI weight concerns and depressive symptoms de decreased and self-esteem increased. The percentage of bingers decreased marginally significantly. For dietary restraint eating concerns and shape concerns group treatment led to grate changes than individual treatment. Conclusions: Although the dietary treatment was not aimed at changing psychological characteristics patients significantly improved on measures of eating related and general psychopathology. (PsycINFO Database Record (c) 2010 APA, all rights reserved) (journal abstract)

overweight is increasing rapidly in children, compelling researchers to seek for determinants of adverse food intake. In a previous experiment it was found that manipulating the restriction of attractive snacks increased the desirability and intake of these snacks. in the present study, we tested whether this paradoxical restricting effect is also seen in relatively less attractive but healthy food, i.e. fruit. Will fruit become More desirable through restriction, and will children eat more forbidden fruit than non-forbidden fruit? Two groups of young children were forbidden to eat fruits and sweets, respectively, whereas a control group was invited to eat everything. Desire for sweets remained high in the sweets-prohibition condition, whereas it decreased in the fruit-prohibition and no-prohibition conditions. No group differences were found regarding the desire for fruit, With respect to intake, children in both the fruit- and the sweets-prohibition condition consumed more of the formerly forbidden food during a taste session as compared to the no-prohibition condition. In addition, total food intake was higher in the two prohibition conditions than in the no-prohibition condition. These data indicate that the adverse effects of restriction apply to both attractive unhealthy and relatively less attractive but healthy food.

Objectives: In the present study the hypothesis was tested that a regular dietary treatment for obesity that is primarily directed at decreasing weight will also decrease concerns about shape, weight and eating, will reduce binge eating and will improve mood and self-esteem. Moreover we investigated whether a group treatment and an individual treatment were equally effective. Method: Fifty-four obese participants followed either a group treatment (n=31) or an individual treatment (n=23) provided by dieticians. Results: The data showed that overall, BMI weight concerns and depressive symptoms de decreased and self-esteem increased. The percentage of bingers decreased marginally significantly. For dietary restraint eating concerns and shape concerns group treatment led to grate changes than individual treatment. Conclusions: Although the dietary treatment was not aimed at changing psychological characteristics patients significantly improved on measures of eating related and general psychopathology. (PsycINFO Database Record (c) 2010 APA, all rights reserved) (journal abstract)

It has been suggested that drug cue-elicited urges and psychophysiological reactions are the results of Pavlovian conditioning processes and that it should be possible to extinguish these responses with cue exposure with response prevention. It has already been shown that subjective cue-elicited urges can be extinguished, but it is unclear whether this is also true for cue-elicited psychophysiological arousal. This was tested in the present study in a heterogeneous sample of drug and alcohol dependent patients. It was found that cue-elicited urges can indeed be extinguished. However, such a clear pattern of extinguished cue reactivity was not found for the psychophysiological measures. Furthermore, the extinction of drug urges was not specific for cue exposure treatment. It is concluded that cue-elicited psychophysiological arousal does not underlie subjective cue reactivity and may not reflect Pavlovian conditioned drug responding.

Treatment for obesity is still running short, particularly on the long term. However, some people do take advantage of treatments and are able to retain their weight loss. What makes the difference between those who can keep their weight loss and those who cannot? One possible predictor of relapse in obesity treatment is impulsivity. Overall, obese people are found to be more impulsive than lean people, especially obese binge eaters. Intuitively, it would make sense that the most impulsive people are less able to keep control over eating behaviour. Therefore, impulsivity could serve as an obstacle for treatment. In the present study impulsivity was measured with a behavioural task (the stop signal task) in 26 obese children. Overweight of the children was measured before and after treatment and at 6 and 12 months follow ups. The results show that impulsivity was related to overweight at all moments: The most impulsive children were the most overweight ones; even after 12 months. Moreover, impulsivity predicted therapy success: the most impulsive children lost less weight. Impulsivity appears to contribute to the difference between succeeding or failing in attempts to lose weight.

The current study compared two measurements assessing eating disorder psychopathology in overweight children and adolescents: an interview and a self-report questionnaire. An adjusted version of the child eating disorder examination questionnaire (chede-q) was compared with the child eating disorder examination interview (chede), which is considered the gold standard. Thirty-eight overweight children and adolescents (aged 8-14) participated in the study. Regarding objective bulimic episodes, the current study found that using smaller chunks of information decreased the discrepancy between interview and questionnaire. The chances are that the gap between chede-q and chede can be reduced if more attention is paid to children’s abilities concerning the understanding of complex concepts. (netherlands journal of psychology, 63, 102-106).

Obese children are often liable to weight-related teasing, and in earlier studies this childhood teasing has been found to predict body dissatisfaction. Cognitive theory postulates that negative experiences are the source of interpretation biases, implicating that weight-related teasing might make obese children vulnerable to shape- and weight-related interpretation biases. In the present study, it was tested whether young overweight children show interpretation biases related to body weight/shape and self-esteem. A Situation Interpretation Test (SIT) was used to find out whether overweight children (n = 20) interpret neutral and negative ambiguous situations more often in terms of their concerns about body weight/shape and self-esteem than healthy controls (n = 16). The data show that 8- to 12-year-old overweight children indeed show interpretation biases, that is, they were more likely to endorse negative appearance and self-esteem-related interpretations of a neutral or negative event than normal-weight children. Also, the perceived threat value of these events was higher in the overweight group. Interpretation biases like this might increase and maintain body dissatisfaction and psychological distress. It is therefore argued that the vulnerability to the development of an interpretation bias emphasises the need to use cognitive strategies that tackle these biases in the treatment of overweight children.

Overweight is becoming more prevalent in children. Parents' behaviours play an important role in children's eating behaviour and weight status. In addition to modelling and providing meals, parents also have an influence by using control techniques. One frequently used technique is restriction of intake. In this study, it was tested whether a prohibition of food in the first phase would lead to an increase in desire for the target food and overeating in the second phase. Sure enough, desire increased significantly in the prohibition group, whereas it remained constant in the no-prohibition group. Though no significant differences between groups were found in the absolute consumption of the target food, the proportion of consumed target food (target food intake/total food intake) was significantly higher in the prohibition group. Finally, children whose parents imposed either very little or a lot of restriction at home consumed more kilocalories during the whole experiment, as opposed to children who were exposed to a moderate level of restriction at home. These data indicate that restriction can have adverse effects on children's food preference and caloric intake.

It has been suggested that drug cue-elicited urges and psychophysiological reactions are the results of Pavlovian conditioning processes and that it should be possible to extinguish these responses with cue exposure with response prevention. It has already been shown that subjective cue-elicited urges can be extinguished, but it is unclear whether this is also true for cue-elicited psychophysiological arousal. This was tested in the present study in a heterogeneous sample of drug and alcohol dependent patients. It was found that cue-elicited urges can indeed be extinguished. However, such a clear pattern of extinguished cue reactivity was not found for the psychophysiological measures. Furthermore, the extinction of drug urges was not specific for cue exposure treatment. It is concluded that cue-elicited psychophysiological arousal does not underlie subjective cue reactivity and may not reflect Pavlovian conditioned drug responding.

Treatment for obesity is still running short, particularly on the long term. However, some people do take advantage of treatments and are able to retain their weight loss. What makes the difference between those who can keep their weight loss and those who cannot? One possible predictor of relapse in obesity treatment is impulsivity. Overall, obese people are found to be more impulsive than lean people, especially obese binge eaters. Intuitively, it would make sense that the most impulsive people are less able to keep control over eating behaviour. Therefore, impulsivity could serve as an obstacle for treatment. In the present study impulsivity was measured with a behavioural task (the stop signal task) in 26 obese children. Overweight of the children was measured before and after treatment and at 6 and 12 months follow ups. The results show that impulsivity was related to overweight at all moments: The most impulsive children were the most overweight ones; even after 12 months. Moreover, impulsivity predicted therapy success: the most impulsive children lost less weight. Impulsivity appears to contribute to the difference between succeeding or failing in attempts to lose weight.

The current study compared two measurements assessing eating disorder psychopathology in overweight children and adolescents: an interview and a self-report questionnaire. An adjusted version of the child eating disorder examination questionnaire (chede-q) was compared with the child eating disorder examination interview (chede), which is considered the gold standard. Thirty-eight overweight children and adolescents (aged 8-14) participated in the study. Regarding objective bulimic episodes, the current study found that using smaller chunks of information decreased the discrepancy between interview and questionnaire. The chances are that the gap between chede-q and chede can be reduced if more attention is paid to children’s abilities concerning the understanding of complex concepts. (netherlands journal of psychology, 63, 102-106).

Obese children are often liable to weight-related teasing, and in earlier studies this childhood teasing has been found to predict body dissatisfaction. Cognitive theory postulates that negative experiences are the source of interpretation biases, implicating that weight-related teasing might make obese children vulnerable to shape- and weight-related interpretation biases. In the present study, it was tested whether young overweight children show interpretation biases related to body weight/shape and self-esteem. A Situation Interpretation Test (SIT) was used to find out whether overweight children (n = 20) interpret neutral and negative ambiguous situations more often in terms of their concerns about body weight/shape and self-esteem than healthy controls (n = 16). The data show that 8- to 12-year-old overweight children indeed show interpretation biases, that is, they were more likely to endorse negative appearance and self-esteem-related interpretations of a neutral or negative event than normal-weight children. Also, the perceived threat value of these events was higher in the overweight group. Interpretation biases like this might increase and maintain body dissatisfaction and psychological distress. It is therefore argued that the vulnerability to the development of an interpretation bias emphasises the need to use cognitive strategies that tackle these biases in the treatment of overweight children.

Overweight is becoming more prevalent in children. Parents' behaviours play an important role in children's eating behaviour and weight status. In addition to modelling and providing meals, parents also have an influence by using control techniques. One frequently used technique is restriction of intake. In this study, it was tested whether a prohibition of food in the first phase would lead to an increase in desire for the target food and overeating in the second phase. Sure enough, desire increased significantly in the prohibition group, whereas it remained constant in the no-prohibition group. Though no significant differences between groups were found in the absolute consumption of the target food, the proportion of consumed target food (target food intake/total food intake) was significantly higher in the prohibition group. Finally, children whose parents imposed either very little or a lot of restriction at home consumed more kilocalories during the whole experiment, as opposed to children who were exposed to a moderate level of restriction at home. These data indicate that restriction can have adverse effects on children's food preference and caloric intake.

Self-esteem is an important construct that is related to academic achievement, social functioning and psychopathology in children and adolescents. Therefore, it is not surprising that many interventions have tried to change levels of self-esteem in this population. In this article a theoretical overview of self-esteem in children and adolescents is presented, in which recent research on different aspects of self-esteem will be discussed. Subsequently, research on treatment and primary prevention programs to change self-esteem in children and adolescents is reviewed. It is argued that self-esteem interventions will be more effective when they are theory- and evidence-based and tailored to the specific needs of different target groups. Finally, a roadmap for the development of theory- and evidence-based interventions is presented and some recommendations for future self-esteem interventions are provided., This is a postprint of the article published in Netherlands Journal of Psychology

Objective: Comorbid depression has been found to increase morbidity in a variety of disorders. This study aimed to investigate whether the presence of depressive symptoms in overweight and obese people is related to increased specific eating psychopathology and decreased self-esteem. Methods: Overweight/obese people seeking dietary treatment were grouped according to their scores on the Beck Depression Inventory (BDI), resulting in a mildly to moderately depressed group (BDI >= 10; n = 66; the symptomatic group) and a non-depressed group (BDI <10; n = 83). Eating psychopathology was measured by the Eating Disorder Examination-Questionnaire (EDE-Q); self-esteem was measured by the Rosenberg Self-Esteem Scale. Results: Symptomatic people had more shape, weight and eating concerns (P-values <0.001); scored higher on restraint (P <0.01); had lower self-esteem (P <0.001); and had a higher BMI (P <0.05) than non-depressed people. Furthermore, the percentage of bingers was higher in the symptomatic group (P <0.01). Conclusion: Symptomatic participants suffered more than non-depressed participants, and not only from their depression. Practice implications: For dieticians treating overweight and obese people, the BDI is a useful instrument for identifying the subgroup with depressive symptoms-the group that is at risk for (eating) psychopathology.

Self-esteem is an important construct that is related to academic achievement, social functioning and psychopathology in children and adolescents. Therefore, it is not surprising that many interventions have tried to change levels of self-esteem in this population. In this article a theoretical overview of self-esteem in children and adolescents is presented, in which recent research on different aspects of self-esteem will be discussed. Subsequently, research on treatment and primary prevention programs to change self-esteem in children and adolescents is reviewed. It is argued that self-esteem interventions will be more effective when they are theory- and evidence-based and tailored to the specific needs of different target groups. Finally, a roadmap for the development of theory- and evidence-based interventions is presented and some recommendations for future self-esteem interventions are provided. (netherlands journal of psychology 2006, 62, 26-33.).

Objective: Comorbid depression has been found to increase morbidity in a variety of disorders. This study aimed to investigate whether the presence of depressive symptoms in overweight and obese people is related to increased specific eating psychopathology and decreased self-esteem. Methods: Overweight/obese people seeking dietary treatment were grouped according to their scores on the Beck Depression Inventory (BDI), resulting in a mildly to moderately depressed group (BDI >= 10; n = 66; the symptomatic group) and a non-depressed group (BDI <10; n = 83). Eating psychopathology was measured by the Eating Disorder Examination-Questionnaire (EDE-Q); self-esteem was measured by the Rosenberg Self-Esteem Scale. Results: Symptomatic people had more shape, weight and eating concerns (P-values <0.001); scored higher on restraint (P <0.01); had lower self-esteem (P <0.001); and had a higher BMI (P <0.05) than non-depressed people. Furthermore, the percentage of bingers was higher in the symptomatic group (P <0.01). Conclusion: Symptomatic participants suffered more than non-depressed participants, and not only from their depression. Practice implications: For dieticians treating overweight and obese people, the BDI is a useful instrument for identifying the subgroup with depressive symptoms-the group that is at risk for (eating) psychopathology.

Cosmetic surgery has become increasingly popular in the past 15 years, and even seems to be common practice. The overall picture communicates that people profit from these interventions. Generally, people wish to alter their appearance when they are dissatisfied about their body image and when appearance determines their self-esteem to a great extent. Body image disturbances, such as body dysmorphic disorder (bdd), are situated within the extreme dissatisfaction range. Bdd is a serious disorder which is characterised by a preoccupation with an imaginary defect in appearance or an excessive concern about a slight physical abnormality. Patients can be effectively treated with cognitive behavioural therapy or a serotonin reuptake inhibitor, but most of them are convinced that cosmetic surgery is the only answer. Surgery outcome is often disappointing, however. This article aims to summarise the literature about cosmetic surgery and bdd and argues that cosmetic surgery patients should be screened psychologically to detect whether they have bdd. Results of a pilot study are presented to underpin this claim. (netherlands journal of psychology, 62, 34-41.).

Self-esteem is an important construct that is related to academic achievement, social functioning and psychopathology in children and adolescents. Therefore, it is not surprising that many interventions have tried to change levels of self-esteem in this population. In this article a theoretical overview of self-esteem in children and adolescents is presented, in which recent research on different aspects of self-esteem will be discussed. Subsequently, research on treatment and primary prevention programs to change self-esteem in children and adolescents is reviewed. It is argued that self-esteem interventions will be more effective when they are theory- and evidence-based and tailored to the specific needs of different target groups. Finally, a roadmap for the development of theory- and evidence-based interventions is presented and some recommendations for future self-esteem interventions are provided. (netherlands journal of psychology 2006, 62, 26-33.).

Body image disturbance is characteristic of eating disorders, and current treatments use body exposure to reduce bad body feelings. There is however little known about the cognitive effects of body exposure. In the present study, eye movement registration (electroculography) as a direct index of selective visual attention was used while eating symptomatic and normal control participants were exposed to digitalized pictures of their own body and control bodies. The data showed a decreased focus on their own 'beautiful' body parts in the high symptomatic participants, whereas inspection of their own 'ugly' body parts was given priority. In the normal control group a self-serving cognitive bias was found: they focused more on their own 'beautiful' body parts and less on their own 'ugly' body parts. When viewing other bodies the pattern was reversed: high symptom participants allocated their attention to the beautiful parts of other bodies, whereas normal controls concentrated on the ugly parts of the other bodies. From the present findings the hypothesis follows that a change in the processing of information might be needed for body exposure to be successful.

Body image disturbance is characteristic of eating disorders, and current treatments use body exposure to reduce bad body feelings. There is however little known about the cognitive effects of body exposure. In the present study, eye movement registration (electroculography) as a direct index of selective visual attention was used while eating symptomatic and normal control participants were exposed to digitalized pictures of their own body and control bodies. The data showed a decreased focus on their own 'beautiful' body parts in the high symptomatic participants, whereas inspection of their own 'ugly' body parts was given priority. In the normal control group a self-serving cognitive bias was found: they focused more on their own 'beautiful' body parts and less on their own 'ugly' body parts. When viewing other bodies the pattern was reversed: high symptom participants allocated their attention to the beautiful parts of other bodies, whereas normal controls concentrated on the ugly parts of the other bodies. From the present findings the hypothesis follows that a change in the processing of information might be needed for body exposure to be successful.

Overweight is becoming more common in children, but we know nearly nothing about the eating behavior of overweight children. Learning theory predicts that overeating follows from learned associations between the smell and taste of palatable food on the one hand and intake on the other hand. It was tested whether overweight children overeat after confrontation to these cues. They indeed failed to regulate food intake after both the exposure to the intense smell of tasty food (without eating it) and after eating a small preload of appetizing food, whereas normal-weight children decreased their intake after both cues. Overweight children are thus more vulnerable to triggers of overeating. Their overeating was not related to psychological factors like mood, body esteem, and a restrained eating style, but it was related to cue-elicited salivation flow. Apart from supporting the cue reactivity model of overeating, the data point to an interesting satiety phenomenon in normal eaters after prolonged and intense smelling palatable food without eating it.

Overweight is becoming more common in children, but we know nearly nothing about the eating behavior of overweight children. Learning theory predicts that overeating follows from learned associations between the smell and taste of palatable food on the one hand and intake on the other hand. It was tested whether overweight children overeat after confrontation to these cues. They indeed failed to regulate food intake after both the exposure to the intense smell of tasty food (without eating it) and after eating a small preload of appetizing food, whereas normal-weight children decreased their intake after both cues. Overweight children are thus more vulnerable to triggers of overeating. Their overeating was not related to psychological factors like mood, body esteem, and a restrained eating style, but it was related to cue-elicited salivation flow. Apart from supporting the cue reactivity model of overeating, the data point to an interesting satiety phenomenon in normal eaters after prolonged and intense smelling palatable food without eating it.

Patients with fear of blushing as the predominant complaint (N = 31) were randomly assigned to (1) exposure in vivo (EXP), or (2) task concentration training (TCT), in order to test the effect of redirecting attention above exposure only. In addition, it was investigated whether treatment reduced actual blush behavior; therefore, physiological parameters of blushing were measured during two behavioral tests. Half of the patients served as waiting-list controls first. Assessments were held before and after treatment, at 6-weeks, and at 1-year follow-up. Both treatments appeared to be effective in reducing fear of blushing and realizing cognitive change, Yet, at posttest, TCT tended to produce better results with respect to fear of blushing. At 6-weeks follow-up, TCT produced significantly more cognitive change. At 1-year follow-up, patients further improved, while differential effects had disappeared, The reduction in fear of blushing was not paralleled by a reduction in actual blush behavior during the behavioral assessments. Thus, it seems that fear of blushing reflects a fearful preoccupation, irrespective of actual facial coloration.