Weight Stigma among Doctoral Clinical Psychology Students: Examining Change and Testing Underlying Mechanisms. - Project Summary/Abstract Weight stigma is a modifiable risk factor that negatively impacts the health and well-being of higher-weight people and those with lower BMI who simply perceive themselves as heavy. Weight stigma leads to poorer health outcomes due to stress processes, lower quality healthcare provision, and healthcare avoidance by patients to avoid stigma. Psychologists play a large role in behavioral health programs, as well as care for eating disorders, body dysmorphia, and other conditions that make it essential that they are able to effectively communicate with higher-weight people in a non-stigmatizing way. Weight stigma is a major risk factor for psychological disorders and weight stigma is prevalent among mental healthcare providers. Evidence from studies in medical education suggest that training in healthcare disciplines may reinforce and increase weight stigma. It is necessary to provide training to future clinical psychologists in patient - centered communication strategies about body image, weight, weight-inclusive care, and to eliminate common weight-related biases and stereotypes that will affect care quality. Although clinical psychologists play an important role in healthcare, it is not known how weight stigma changes during training, if doctoral training perpetuates weight stigma over time, and if theoretically- and empirically-supported mechanisms underlying the development of weight stigma apply in clinical psychology settings. The long-term goal of the proposed research is to examine changes in weight stigma among psychology trainees during four years of doctoral clinical training. The aims of this study are to 1) establish whether weight stigma changes as a function of time in doctoral clinical psychology training and 2) identify mechanisms underlying the development of weight stigma during doctoral clinical training. Given that weight stigma is rarely addressed in clinical psychology training programs, it is hypothesized that weight stigma will intensify during time in clinical training. In addition, it is hypothesized that weight controllability beliefs, quality of intergroup contact with higher-weight people, and perceived social acceptability of weight stigma will mediate the effect of time in clinical training on weight stigma. This study will use a prospective cohort longitudinal design and online survey methodology collecting four waves of data across four years of training from students enrolled in APA-accredited doctoral clinical psychology programs. Longitudinal mediation methods will be used to examine how processes unfold over time and the temporal order of events. The proposed research will yield novel insights to inform more effective weight stigma reduction interventions and the development of training competencies to address weight stigma and provide weight- inclusive healthcare training. This project will provide the foundation from which to comprehensively address a long-standing call to increase preparedness of future mental health professionals and improve the quality of care for people of all sizes.
