An intervention mapping adaptation framework to develop a self-help intervention for athletes with eating disorder symptoms.

OBJECTIVE: This research forum describes the use of the intervention mapping for adaptation (IMA) framework to develop and evaluate a novel intervention for athletes with mild eating disorder (ED) symptoms. METHODS: The six IMA steps were followed. In step 1 (needs assessment), we conducted a systematic review of athlete ED interventions and held interviews/focus groups with athletes and sports professionals to inform intervention format and delivery. In step 2 (intervention search), needs assessment information guided the search for an evidence-based intervention suitable for adaptation to athletes. In steps 3 and 4 (intervention development), the identified intervention was adapted and feedback sought from athletes and sport professionals. In steps 5 and 6 (implementation and evaluation), a feasibility study was conducted with athletes (n = 35; females: n = 27; Mage = 27.1). RESULTS: The review highlighted poor evidence for the acceptability and relative efficacy of existing interventions, which were all delivered face-to-face in groups. Interview/focus group data suggested a need for more accessible intervention formats (e.g., self-help). One non-athlete self-help intervention was determined suitable for adaptation to athletes, and adaptations were made. Initial feedback suggested the adapted intervention was relevant within sport settings. The feasibility study revealed that the intervention (MOPED-A: Motivational and Psycho-Educational Self-Help Programme for Athletes with Mild Eating Disorder Symptoms) can be feasibly implemented, is acceptable to athletes and shows potential for reducing ED symptoms. DISCUSSION: IMA is a useful framework for developing participant-centered and evidence-based interventions. The findings and approach taken provide a framework for other researchers and clinicians in developing similar interventions in the ED domain. PUBLIC SIGNIFICANCE: The novel self-help intervention described in this article was developed using intervention mapping and provides promise as a tool for reducing eating disorder symptoms in athletes. We describe how adopting and systematically following a health intervention development approach, such as intervention mapping, can ensure that eating disorder interventions are participant-centered, contextually relevant, and evidence-based, which in turn could help to maximize their reach and effectiveness.

Evaluating a motivational and psycho-educational self-help intervention for athletes with mild eating disorder symptoms: A mixed methods feasibility study.

OBJECTIVE: The primary aim was to assess the feasibility of undertaking a study evaluating the novel Motivational and Psycho-Educational Self-Help Programme for Athletes with Mild Eating Disorder Symptoms (MOPED-A). A mixed-methods approach was adopted to explore the feasibility of recruiting and retaining participants, and to evaluate the acceptability of measures, procedures and the intervention. A secondary aim was to explore the potential efficacy of MOPED-A in reducing athletes' eating disorder symptoms. METHOD: Thirty-five athletes were recruited. Participation involved completing MOPED-A over a 6-week period and completing self-report measures at baseline (T1), post-intervention (T2) and 4-week follow-up (T3). A subsample (n = 15) completed an interview at T2. RESULTS: Retention was good throughout the study (n = 28; 80%). Quantitative and qualitative feedback suggested the format, delivery, content and dosage of MOPED-A were acceptable. Athletes valued that the intervention was tailored to them, and this facilitated both participation and completion. Over a third of participants reported disclosing their eating difficulties and deciding to seek further support. Large reductions in eating disorder symptoms were detected at T2 and sustained at T3. CONCLUSIONS: The MOPED-A intervention can be feasibly implemented, is acceptable to participants, and demonstrates potential for reducing symptoms in athletes. A larger, controlled trial is warranted.

Me, myself, and my muscles: associations between narcissism and muscle dysmorphia.

The conceptualisation and measurement of the associations between narcissism and muscle dysmorphia (MD) are poorly understood in the literature. It is recognised that narcissism features two broad dimensions: vulnerable and grandiose. Studying both narcissism dimensions is important given their differences in etiology and health-related outcomes. Therefore, the aim of this study was to investigate the associations between MD, vulnerable and grandiose narcissism. A total of 336 participants (48% male; Mage = 26.4 years) completed measures of MD and narcissism. Hierarchical regression analysis revealed that vulnerable narcissism was significantly, positively associated with MD, whilst grandiose narcissism was not. Practitioners should be aware that vulnerable narcissism may be a potential risk factor of MD.

Nature and efficacy of interventions addressing eating psychopathology in athletes: A systematic review of randomised and nonrandomised trials.

OBJECTIVE: This systematic review aimed to evaluate the nature of interventions addressing eating psychopathology in athletes, identify the characteristics of successful interventions, and review the efficacy of interventions at reducing or preventing eating psychopathology. METHOD: SPORTDiscus, MEDLINE, and PsycINFO were searched to identify studies addressing eating psychopathology in athletes, which included an outcome measure of disordered eating. RESULTS: Seventeen studies (11 randomised controlled trials, six nonrandomised trials) reporting data on 13 interventions were included. The methodological quality was observed to be generally low. All interventions (11 implemented in North America) were delivered face to face in groups with variable duration and intensity. Thirteen studies reported significant reductions in athletes' eating psychopathology following the intervention, with seven reporting sustained effects (small to moderate). Successful interventions were characterised by higher intervention dosage, higher retention, and incorporated a focus on self-esteem and self-efficacy. CONCLUSION: The complex nature of interventions, combined with a lack of evaluation data and poor methodological quality, limits the scaling and refinement of many interventions. Future research should explore other modes of delivery, collect evaluation data, and adhere to clearer study reporting. Doing this will consequently improve the development and delivery of effective eating psychopathology interventions offered to athletes more widely.