Reducing a negative body image: A (masked) counterconditioning approach

The prevalence of a negative body image is high, which is problematic because it is associated with a range of (mental) health problems. Current stand-alone treatments may only lead to small improvements in body image (Alleva et al., 2015), thus more effective treatments are needed. Evaluative counterconditioning procedures in which own body-pictures are coupled with positive social feedback seem to be a valuable addition to currently available treatments. Such procedures were effective in reducing body dissatisfaction in small-scale studies (Aspen et al., 2015; Martijn et al., 2010). To examine if implementation in a clinical setting is worthwhile, five studies were conducted to test the effectiveness of the original counterconditioning procedure (Martijn et al., 2010) and four new counterconditioning procedures which were designed to further strengthen counterconditioning effects. One of the studies showed that women evaluated their body pictures more positively after the (original) counterconditioning procedure compared to women in a control condition but in none of the studies did women report more body satisfaction after counterconditioning. The ineffectiveness of the counterconditioning procedures may have been due to the intense negative feelings that women with a negative body image experience when they see pictures of their body. In one study we found that higher levels of body dissatisfaction were associated with higher levels of self-reported disgust in response to seeing their own body. Taken together, the findings of the studies in this dissertation do not support the implementation of the tested counterconditioning procedures in a clinical setting to treat body dissatisfaction.