ABSTRACT
There is overwhelming evidence that sociocultural factors create and maintain the beliefs, emotions, and behaviors that make up the continuum of eating problems and eating disorders (see chapter 5). In other words, risk factors such as the female gender role, negative body image, the idealization of slenderness, unwarranted and uncontrollable fear of fat, and rigid dieting are learned to a significant degree. As discussed in chapter 4, what an individual learns is affected by a variety of ecological influences that operate at different levels of organization (e.g., family, neighborhood, school, culture). The processes by which people learn involve direct rewards and punishments, observation of what actual people do and feel, and interpretation of information gleaned from what other people say, as well as from mass media, books, and so forth. Therefore, some researchers in the field of eating problems have drawn on either cognitive social learning theory (now called social cognitive theory or SCT; Bandura, 1986) or cognitive-behavioral theory (CBT) to develop prevention programs for children and adolescents. In fact, most of the research on universal, selective, and targeted prevention of eating problems and eating disorders have been guided by one or both of these models (Levine & Piran, 2001, 2004; Piran, 1995). There is a long tradition of research in which SCT has been applied with moderate success to prevention of cardiovascular disease, substance abuse, and teenage pregnancy (Baranowski, Perry, & Parcel, 2002; Botvin, 2000). The substance abuse research is considered in de-
tail in chapter 10. Use of CBT methods for prevention is a logical outgrowth of the effectiveness of cognitive-behavioral therapy in the treatment of depression and various psychological problems, including negative body image and disordered eating (Cash, 1996; Fairburn, 1997; Wilson, Fairburn, & Agras, 1997). This chapter introduces the essential components of the SCT and CBT models for prevention.
