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Rancaño KM, Lawrence SE. Health Consequences of Familial Negative Weight Talk Across the Spectrum of Gender Diversity. Curr Nutr Rep 2023; 12:581-593. [PMID: 37837600 DOI: 10.1007/s13668-023-00501-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2023] [Indexed: 10/16/2023]
Abstract
PURPOSE OF REVIEW To synthesize differences in familial negative weight talk and health-related correlates across gender identities and to highlight gaps relevant to the unique experiences and health correlates of boys and transgender and gender diverse youth. RECENT FINDINGS Most of the studies included in this review observed no difference by gender in familial negative weight talk health correlates. Gender biases in existing measures, however, may have contributed to underreporting of health correlates in boys. Moreover, transgender and gender diverse youth are severely underrepresented in this research. Future research should consistently examine effect modification across gender identities and include measures that are specific to the weight-based concerns and experiences of boys and transgender and gender diverse youth.
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Affiliation(s)
- Katherine M Rancaño
- Department of Public Health and Community Medicine, Tufts University School of Medicine, 136 Harrison Ave, Boston, MA, 02111, USA.
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52
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Ganson KT, Nguyen L, Ali ARH, Nagata JM, Rodgers RF, Murray SB, Alaggia R. "Eat more protein, build more muscle": A grounded theory study of muscle-building behaviors among Canadian adolescents and young adults. Body Image 2023; 47:101635. [PMID: 37806066 DOI: 10.1016/j.bodyim.2023.101635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 09/11/2023] [Accepted: 09/24/2023] [Indexed: 10/10/2023]
Abstract
Unique risk factors for the development of muscle dissatisfaction and engagement in muscle-building behaviors have been described by theoretical frameworks and supported by empirical research. What remains unknown are the unique processes, including catalysts and facilitators, which underpin engagement in muscle-building behaviors. Therefore, this study used a grounded theory methodology to elucidate the process of engagement in muscle-building behaviors. Thirty-three individual semi-structured interviews with Canadian adolescents and young adults ages 16-30 years were conducted. Transcripts were analyzed using initial and focused coding to identify themes that explained the grounded theory. The core theme underpinning the grounded theory was balancing aesthetic, health, and functional goals in relation to participants' engagement in muscle-building behaviors. Participants described experiences that encompassed several unique phases of muscle-building engagement, including the initiation phase, beginner phase, preservation phase, and intensification phase. Participants also described unique methods of gathering information on muscle-building behaviors, and their own analysis and decision-making processes driving their behaviors. Findings from this study extend prior theory and research by conceptualizing a novel process theory of engagement in muscle-building behaviors among adolescent and young adults, resulting in important implications for research and practice.
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Affiliation(s)
- Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada.
| | - Lynn Nguyen
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Ali Raza Hasan Ali
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Rachel F Rodgers
- Department of Applied Psychology, Northeastern University, Boston, MA, USA; Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, Montpellier, France
| | - Stuart B Murray
- Department of Psychiatry and the Behavioral Sciences, University of Southern California, Los Angeles, CA, USA
| | - Ramona Alaggia
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
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53
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Berengüí R, Castejón MA. Personality Traits and Risk of Eating Disorders in Men: A Cross-Sectional Study. Healthcare (Basel) 2023; 11:2910. [PMID: 37958054 PMCID: PMC10649439 DOI: 10.3390/healthcare11212910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 10/31/2023] [Accepted: 11/03/2023] [Indexed: 11/15/2023] Open
Abstract
Eating disorders (EDs) have been understudied and misunderstood in men. Among the relevant factors in the risk, onset, and maintenance of EDs, personality stands out. Therefore, the aim of the study was to analyze the relationships between personality traits and risk variables for the development of EDs in men. A total of 443 male university students (mean = 22.16 years) who completed the Spanish versions of the Eating Disorder Inventory-3 (EDI-3) and the NEO Five-Factor Inventory (NEO-FFI) participated. Correlation analyses were performed, and in order to determine the predictive role of personality traits on risk scales, a hierarchical multiple regression was performed. The results showed that neuroticism was positively associated with drive for thinness, being its main predictor variable. In bulimia, the main relationships were positively associated with neuroticism and negatively with conscientiousness. As for body dissatisfaction, the main predictor variables were neuroticism and, in a negative sense, extraversion and openness to experience. In conclusion, personality traits are related to the risk of developing EDs in male university students, with neuroticism being the main associated trait.
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Affiliation(s)
- Rosendo Berengüí
- Faculty of Education, Universidad Católica de Murcia (UCAM), 30107 Murcia, Spain
| | - María A. Castejón
- Faculty of Education, Universidad Católica de Murcia (UCAM), 30107 Murcia, Spain
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54
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Chmiel J, Gladka A, Leszek J. The Effect of Transcranial Direct Current Stimulation (tDCS) on Anorexia Nervosa: A Narrative Review. Nutrients 2023; 15:4455. [PMID: 37892530 PMCID: PMC10610104 DOI: 10.3390/nu15204455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 10/17/2023] [Accepted: 10/18/2023] [Indexed: 10/29/2023] Open
Abstract
(1) Introduction: Anorexia nervosa (AN) is a severe, debilitating disease with high incidence and high mortality. The methods of treatment used so far are moderately effective. Evidence from neuroimaging studies helps to design modern methods of therapy. One of them is transcranial direct current stimulation (tDCS), a non-invasive brain neuromodulation technique. (2) Methods: The purpose of this narrative review is to bring together all studies investigating the use of tDCS in the treatment of AN and to evaluate its effect and efficiency. Searches were conducted in the Pubmed/Medline, Research Gate, and Cochrane databases. (3) Results: The literature search resulted in five articles. These studies provide preliminary evidence that tDCS has the potential to alter eating behaviour, body weight, and food intake. Additionally, tDCS reduced symptoms of depression. Throughout all trials, stimulation targeted the left dorsolateral prefrontal cortex (DLPFC). Although the number of studies included is limited, attempts were made to elucidate the potential mechanisms underlying tDCS action in individuals with AN. Recommendations for future tDCS research in AN were issued. (4) Conclusions: The included studies have shown that tDCS stimulation of the left DLPFC has a positive effect on AN clinical symptoms and may improve them, as measured by various assessment measures. It is important to conduct more in-depth research on the potential benefits of using tDCS for treating AN. This should entail well-designed studies incorporating advanced neuroimaging techniques, such as fMRI. The aim is to gain a better understanding of how tDCS works in AN.
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Affiliation(s)
- James Chmiel
- Institute of Neurofeedback and tDCS Poland, 70-393 Szczecin, Poland
| | - Anna Gladka
- Department and Clinic of Psychiatry, Wrocław Medical University, 54-235 Wrocław, Poland
| | - Jerzy Leszek
- Department and Clinic of Psychiatry, Wrocław Medical University, 54-235 Wrocław, Poland
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Murray SB, Diaz-Fong JP, Duval CJ, Balkchyan AA, Nagata JM, Lee DJ, Ganson KT, Toga AW, Siegel SJ, Jann K. Sex differences in regional gray matter density in pre-adolescent binge eating disorder: a voxel-based morphometry study. Psychol Med 2023; 53:6077-6089. [PMID: 36305572 DOI: 10.1017/s0033291722003269] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Binge eating disorder (BED) is a pernicious psychiatric disorder which is linked with broad medical and psychiatric morbidity, and obesity. While BED may be characterized by altered cortical morphometry, no evidence to date examined possible sex-differences in regional gray matter characteristics among those with BED. This is especially important to consider in children, where BED symptoms often emerge coincident with rapid gray matter maturation. METHODS Pre-adolescent, 9-10-year old boys (N = 38) and girls (N = 33) with BED were extracted from the 3.0 baseline (Year 0) release of the Adolescent Brain Cognitive Development Study. We investigated sex differences in gray matter density (GMD) via voxel-based morphometry. Control sex differences were also assessed in age and body mass index and developmentally matched control children (boys N = 36; girls N = 38). Among children with BED, we additionally assessed the association between dorsolateral prefrontal (dlPFC) GMD and parent-reported behavioral approach and inhibition tendencies. RESULTS Girls with BED uniquely demonstrate diffuse clusters of greater GMD (p < 0.05, Threshold Free Cluster Enhancement corrected) in the (i) left dlPFC (p = 0.003), (ii) bilateral dmPFC (p = 0.004), (iii) bilateral primary motor and somatosensory cortex (p = 0.0003) and (iv) bilateral precuneus (p = 0.007). Brain-behavioral associations suggest a unique negative correlation between GMD in the left dlPFC and behavioral approach tendencies among girls with BED. CONCLUSIONS Early-onset BED may be characterized by regional sex differences in terms of its underlying gray matter morphometry.
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Affiliation(s)
- Stuart B Murray
- Department of Psychiatry & Behavioral Sciences, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Joel P Diaz-Fong
- Department of Psychiatry & Behavioral Sciences, Semel Institute for Neuroscience & Human Behavior, University of California, Los Angeles, CA, USA
| | - Christina J Duval
- Department of Psychiatry & Behavioral Sciences, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Ane A Balkchyan
- Department of Psychiatry & Behavioral Sciences, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, CA, USA
| | - Darrin J Lee
- Department of Psychiatry & Behavioral Sciences, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
- Department of Neurological Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA
- USC Neurorestoration Center, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Arthur W Toga
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Steven J Siegel
- Department of Psychiatry & Behavioral Sciences, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Kay Jann
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
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Hirvelä L, Keski-Rahkonen A, Sipilä PN. Associations of broad eating disorder symptoms with later alcohol problems in Finnish adult twins: A nationwide 10-year follow-up. Int J Eat Disord 2023; 56:1854-1865. [PMID: 37353472 DOI: 10.1002/eat.24013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 06/05/2023] [Accepted: 06/06/2023] [Indexed: 06/25/2023]
Abstract
OBJECTIVE Eating disorders are associated with subsequent alcohol problems, but it is not known whether this association also extends to broader eating disorder symptoms not captured by clinical diagnoses. We assessed the longitudinal association of broad eating disorder symptoms with alcohol problems in a nationwide twin sample (FinnTwin16). METHODS Finnish women (N = 1905) and men (N = 1449) self-reported their eating disorder symptoms using the Eating Disorder Inventory-2 Bulimia, Drive for Thinness, and Body Dissatisfaction subscales at the mean age of 24.4 years in 2000-2003. A subsample of participants also completed items on drive for muscularity, height dissatisfaction, and muscle-enhancing supplement use. Alcohol problems were assessed 10 years later at the age of 34.1 in 2010-2012 with the Rutgers Alcohol Problem Index. RESULTS Eating disorder symptoms were associated with later alcohol problems (odds ratio per point increase 1.02-1.18). Bulimia showed stronger associations among men than women (p for interaction .012). Drive for muscularity and height dissatisfaction were also associated with later alcohol problems, but supplement use was not. When accounting for baseline alcohol problems, only Bulimia (among women and men) and Drive for Thinness (among men) were significantly associated with later alcohol problems. Bulimia was also significantly associated with later alcohol problems in within-twin-pair analyses among dizygotic twins, but not among monozygotic twins. DISCUSSION In a longitudinal setting, eating disorder symptoms were associated with later alcohol problems. Bulimic symptoms were a stronger risk factor for men than women. These associations may be attributable to baseline alcohol problems, childhood environment and genetic liability. PUBLIC SIGNIFICANCE This study found that both young adult women and men with broad eating disorder symptoms are at a higher risk of alcohol-related problems than those without such symptoms. Men with bulimic symptoms were at a particularly high risk. These findings emphasize the need for better prevention and treatment of disordered eating, body image concerns and alcohol problems for both young adult women and men.
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Affiliation(s)
- Leon Hirvelä
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | | | - Pyry N Sipilä
- Department of Public Health, University of Helsinki, Helsinki, Finland
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Gorrell S, Vendlinski SS, Thompson AS, Downey AE, Kramer R, Hail L, Clifton S, Forsberg S, Reilly EE, Saunders E, Buckelew SM, Le Grange D. Modification of an inpatient medical management protocol for pediatric Avoidant/Restrictive Food Intake Disorder: improving the standard of care. J Eat Disord 2023; 11:165. [PMID: 37737186 PMCID: PMC10514937 DOI: 10.1186/s40337-023-00895-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 09/16/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND No guidelines currently exist that represent a standardization of care for Avoidant/Restrictive Food Intake Disorder (ARFID) on an inpatient service. Unique features of this diagnosis (e.g., sensory sensitivity contributing to involuntary emesis) suggest that established protocols that were developed for anorexia nervosa might be less effective for adolescents with ARFID. To inform improved inpatient medical stabilization and care for these patients, we first provide an overview of clinical characteristics for patients with ARFID who presented to a pediatric hospital for inpatient eating disorder care. We use these descriptives to outline the rationale for, and executions of, modifications to an inpatient protocol designed to flexibly meet the needs of this clinical population. METHODS Chart review with descriptive statistics were conducted for patients who had received an ARFID diagnosis from March 2019 to March 2023 (N = 32, aged 9-23). We then present a case series (n = 3) of adolescents who either transitioned to a novel adjusted protocol from an original standard of care on the inpatient service, or who received only the standard protocol. RESULTS The sample was aged M(SD) = 15.6 (3.3) years, 53% male, and a majority (69%) presented with the ARFID presentation specific to fear of negative consequences. On average, patients had deviated from their growth curve for just over two years and presented with mean 76% of their estimated body weight. Of those requiring nasogastric tube insertion during admission (n = 8, 25%), average duration of tube placement was 15 days. From within this sample, case series data suggest that the adjusted protocol will continue to have a positive impact on care trajectory among adolescents admitted for ARFID including improved weight gain, reduction of emesis, and improved food intake. CONCLUSIONS Findings demonstrate the likely need to tailor established medical inpatient protocols for those with ARFID given different symptom presentation and maintenance factors compared to patients with anorexia nervosa. Further research is warranted to explore the longer-term impact of protocol changes and to inform standardization of care for this high priority clinical population across care sites.
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Affiliation(s)
- Sasha Gorrell
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, 675 18th St., San Francisco, CA, 94143, USA.
| | - Siena S Vendlinski
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Arianna S Thompson
- School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Amanda E Downey
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, 675 18th St., San Francisco, CA, 94143, USA
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Rachel Kramer
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, 675 18th St., San Francisco, CA, 94143, USA
| | - Lisa Hail
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, 675 18th St., San Francisco, CA, 94143, USA
| | - Sharon Clifton
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Sarah Forsberg
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, 675 18th St., San Francisco, CA, 94143, USA
| | - Erin E Reilly
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, 675 18th St., San Francisco, CA, 94143, USA
| | - Elizabeth Saunders
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Sara M Buckelew
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Daniel Le Grange
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, 675 18th St., San Francisco, CA, 94143, USA
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, IL, USA
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58
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Ganson KT, Hallward L, Rodgers RF, Testa A, Jackson DB, Nagata JM. Associations between violent victimization and symptoms of muscle dysmorphia: Findings from the Canadian Study of Adolescent Health Behaviors. Body Image 2023; 46:294-299. [PMID: 37392677 DOI: 10.1016/j.bodyim.2023.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 06/16/2023] [Accepted: 06/17/2023] [Indexed: 07/03/2023]
Abstract
This study aimed to determine the associations between violent victimization and symptoms of muscle dysmorphia (MD) among a sample of Canadian adolescents and young adults. Data from 2538 adolescents and young adults (16-30 years) from the Canadian Study of Adolescent Health Behaviors were analyzed. Violent victimization assessed included experiences of rape, sexual assault, emotional abuse, and physical abuse occurring in the past 12 months. A violent victimization sum score was also created. Symptoms of MD were assessed using the Muscle Dysmorphic Disorder Inventory (MDDI). Linear regression analyses were conducted, stratified by gender, to determine the associations between violent victimization and MDDI total score and subscale scores. Among women and men, experiencing sexual assault, physical abuse, and emotional abuse in the past 12 months were significantly associated with a higher MDDI total score. Additionally, as the number of forms of violent victimization experienced increased, the likelihood of a higher MDDI total score also increased, with the strongest association among women and men who reported experiencing three or more victimizations. Findings expand the limited prior research suggesting associations between violent victimization and MD by assessing these associations via multiple forms of victimization and amongst a sample of Canadian adolescents and young adults.
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Affiliation(s)
- Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada.
| | - Laura Hallward
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada; School of Kinesiology, Western University, London, Ontario, Canada
| | - Rachel F Rodgers
- Department of Applied Psychology, Northeastern University, Boston, MA, USA; Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, Montpellier, France
| | - Alexander Testa
- Department of Management, Policy and Community Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Dylan B Jackson
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
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Santana DD, Mitchison D, Mannan H, Griffiths S, Appolinario JC, da Veiga GV, Touyz S, Hay P. Twenty-year associations between disordered eating behaviors and sociodemographic features in a multiple cross-sectional sample. Psychol Med 2023; 53:5012-5021. [PMID: 35833367 DOI: 10.1017/s0033291722001994] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Disordered eating behaviors (DEB) impact on health and wellbeing worldwide. This study aimed to examine sociodemographic trends in the prevalence of DEB over 20 years in the Australian general population. METHODS Data were derived from five sequential cross-sectional surveys (1998, 2008, 2009, 2016 and 2017) with population-representative samples of adults and adolescents residing in South Australia (N = 15 075). DEBs investigated were objective binge eating (OBE), strict dieting/fasting, and purging. Sociodemographic data included gender, age, educational level, work and marital status, and residence. RESULTS OBE prevalence increased significantly. Strict dieting/fasting also increased from 1998 to 2008/9 but remained stable between 2008/9 and 2016/7. Purging prevalence did not change significantly over time. All survey years were associated with a significantly higher odds of OBE, and strict diet/fasting compared to 1998. Lower age, a higher Accessibility Remoteness Index of Australia (ARIA) score, higher body mass index (BMI), higher educational attainment, and not being in a married or de facto relationship were independently associated with greater adjusted odds for endorsing OBE. Younger age, female gender, and higher BMI were also independently associated with greater adjusted odds for endorsing strict dieting/fasting. CONCLUSIONS The increased prevalence of DEBs in various strata of Australian society has both public health and clinical implications. The results refute the stereotype that eating disorders (EDs) predominantly affect young women. They build impetus for future research on EDs among men and older individuals, with a view to developing tailored public health and clinical interventions for these populations.
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Affiliation(s)
- Danilo Dias Santana
- Josué de Castro Institute of Nutrition, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- School of Medicine, Translational Health Research Institute, Western Sydney University, New South Wales, Australia
| | - Deborah Mitchison
- Department of Psychology, Centre for Emotional Health, Macquarie University, New South Wales, Australia
- Camden and Campbelltown Hospitals, SWSLHD, New South Wales, Australia
| | - Haider Mannan
- School of Medicine, Translational Health Research Institute, Western Sydney University, New South Wales, Australia
| | - Scott Griffiths
- Melbourne School of Psychological Sciences, University of Melbourne, Victoria, Australia
| | - Jose Carlos Appolinario
- Group of Obesity and Eating Disorders, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Gloria Valeria da Veiga
- Josué de Castro Institute of Nutrition, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Stephen Touyz
- School of Psychology, University of Sydney, New South Wales, Australia
| | - Phillipa Hay
- School of Medicine, Translational Health Research Institute, Western Sydney University, New South Wales, Australia
- Camden and Campbelltown Hospitals, SWSLHD, New South Wales, Australia
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60
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Barbierik L, Bacikova-Sleskova M, Petrovova V. The Role of Social Appearance Comparison in Body Dissatisfaction of Adolescent Boys and Girls. EUROPES JOURNAL OF PSYCHOLOGY 2023; 19:244-258. [PMID: 37731755 PMCID: PMC10508200 DOI: 10.5964/ejop.6443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 01/09/2023] [Indexed: 09/22/2023]
Abstract
The main aim of the present study is to investigate the indirect effect of the association between thin-ideal internalisation (1), muscular-ideal internalization (2) and body dissatisfaction (BD) through the general social appearance comparison separately among boys and girls. 154 adolescents (mean age 18.2 years, SD = 0.73; 56.5% girls) provided information on the explored variables. Two hierarchical regression models were carried out for boys and girls separately. The general appearance comparison works as an important explanatory mechanism in the relationship between thin-ideal internalization and BD among girls as well as between muscular-ideal internalization and BD among both boys and girls. The more individuals internalize the societal ideals of appearance, the more they compare their physical appearance to others and thus the greater BD they perceive. The current results contribute to previous research findings by indicating the social appearance comparison as a risk factor which enhances BD among both boys and girls in late adolescence. The findings may facilitate identifying individuals who are vulnerable to body dissatisfaction earlier, before more serious eating problems occur.
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Affiliation(s)
- Lucia Barbierik
- Department of Educational Psychology and Health Psychology, Pavol Jozef Šafárik University in Košice, Košice, Slovak Republic
| | - Maria Bacikova-Sleskova
- Department of Educational Psychology and Health Psychology, Pavol Jozef Šafárik University in Košice, Košice, Slovak Republic
| | - Veronika Petrovova
- Department of Educational Psychology and Health Psychology, Pavol Jozef Šafárik University in Košice, Košice, Slovak Republic
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Fields EL. Achieving Health Equity for Sexual and Gender-Diverse Youth. Pediatr Clin North Am 2023; 70:813-835. [PMID: 37422316 DOI: 10.1016/j.pcl.2023.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/10/2023]
Abstract
Compared to their heterosexual and cisgender peers, sexual and gender diverse (SGD) youth, especially those from minoritized racial/ethnic groups, experience significant disparities in health, health care, and social conditions that can threaten their health and well-being. This article describes the disparities impacting SGD youth, their differential exposure to the stigma and discrimination that foster these disparities, and the protective factors that can mitigate or disrupt the impact of these exposures. On the final point, the article specifically focuses on pediatric providers and inclusive, affirming, medical homes as critical protective factors for SGD youth and their families.
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Affiliation(s)
- Errol L Fields
- Division of Adolescent/Young Adult Medicine, Department of Pediatrics Johns Hopkins School of Medicine, 200 North Wolfe Street, Room 2015, Baltimore, MD 21287, USA.
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62
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Mol T, Thompson JK, Fuller-Tyszkiewicz M. A meta-analytic review of impact of measurement choice on RCTs to reduce appearance internalization. Int J Eat Disord 2023; 56:1480-1501. [PMID: 37237436 DOI: 10.1002/eat.23990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 05/02/2023] [Accepted: 05/02/2023] [Indexed: 05/28/2023]
Abstract
OBJECTIVE Prior reviews have shown that interventions targeting internalization of appearance standards are generally efficacious, though there is considerable heterogeneity in estimates across studies. This updated review of the literature evaluates whether efficacy estimates from RCTs systematically vary as a function of three related outcome measures (internalization, awareness, and perceived pressure regarding appearance standards). METHODS Seven electronic databases were systematically searched from inception to February 8, 2023. The Cochrane Risk of Bias tool assessed each study's risk of bias. Studies included were randomized-controlled trials evaluating body image/eating disorder prevention or intervention programs targeting internalization as a focal point of treatment. Effect sizes were meta-analyzed and meta-regression analyses were conducted investigating the impact of outcome measure choice on study effect size at post-intervention and follow-up. RESULTS Thirty-seven studies (N = 4809 participants) were included. The meta-analytic findings as expected found interventions efficacious at reducing internalization post-intervention (d = -0.47, 95% CI [-0.60 to -0.34], k = 44), and at follow-up (d = -0.28, 95% CI [-0.39 to -0.17], k = 43), but also highly heterogenous (I2 = 52-67%). Operationalization of internalization moderated results at follow-up but not post-intervention timepoints, with awareness measures (compared with internalization measures) producing weaker effect sizes. Exploratory analyses found bigger effects when internalization was compared with all other measurement categories combined, suggesting possible issues with statistical power in main analyses. DISCUSSION Mixed present findings suggest need for further evaluation of measurement effects on efficacy, and possible caution in choice of outcome measure for internalization-based interventions. PUBLIC SIGNIFICANCE STATEMENT This review provides some preliminary evidence that choice of survey measures used in randomized controlled trials can impact our judgments about whether a trial reduces the extent to which participants endorse unrealistic appearance standards. Accuracy in measurement of this efficacy of trials is crucial, given the role that internalized appearance standards play in onset and maintenance of eating disorders.
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Affiliation(s)
- Tess Mol
- School of Psychology, Deakin University, Geelong, Victoria, Australia
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Layman Ba HM, Keirns Ms NG, Hawkins PhD MAW. Internalization of body image as a potential mediator of the relationship between body acceptance by others and intuitive eating. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:1797-1803. [PMID: 34292849 DOI: 10.1080/07448481.2021.1947832] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 03/22/2021] [Accepted: 06/20/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To investigate the role of internalization of body image ideals as a potential mediator between perceived body acceptance and intuitive eating among college students. PARTICIPANTS/METHOD 168 undergraduates completed the Body Acceptance By Others Scale (BAOS), Sociocultural Attitudes Toward Appearance Questionnaire-3 (SATAQ-3; Internalization-Total and -General, -Athletic subscales), and Intuitive Eating Scale (IES). RESULTS Internalization-Total mediated the relationship between BAOS and IES (b=.19, p<.001). Internalization-General was a significant mediator of the BAOS-IES relationship (b=.14, p=.006), while Internalization-Athletic was not (p=.993). Post-hoc analyses stratified by gender followed similar patterns, aside from a negative but nonsignificant relationship between Internalization-Athletic and IES in men (b=-.16, p=.650). CONCLUSIONS These data suggest that internalization of general (i.e., thin) body image ideals may be more destructive to body satisfaction and adaptive eating styles in college students than athletic-ideal internalization. More research is needed to examine the role of athletic-ideal internalization on body image and eating behaviors.
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Affiliation(s)
- Harley M Layman Ba
- Department of Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Natalie G Keirns Ms
- Department of Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
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Carrino EA, Flatt RE, Pawar PS, Sanzari CM, Tregarthen JP, Argue S, Thornton LM, Bulik CM, Watson HJ. Sociodemographic and clinical characteristics of treated and untreated adults with bulimia nervosa or binge-eating disorder recruited for a large-scale research study. J Eat Disord 2023; 11:126. [PMID: 37525298 PMCID: PMC10391988 DOI: 10.1186/s40337-023-00846-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 07/17/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Eating disorders affect millions of people worldwide, but most never receive treatment. The majority of clinical research on eating disorders has focused on individuals recruited from treatment settings, which may not represent the broader population of people with eating disorders. This study aimed to identify potential differences in the characteristics of individuals with eating disorders based on whether they self-reported accessing treatment or not, in order to contribute to a better understanding of their diverse needs and experiences. METHODS The study population included 762 community-recruited individuals (85% female, M ± SD age = 30 ± 7 years) with bulimia nervosa or binge-eating disorder (BN/BED) enrolled in the Binge Eating Genetics Initiative (BEGIN) United States study arm. Participants completed self-report surveys on demographics, treatment history, past and current eating disorder symptoms, weight history, and their current mental health and gastrointestinal symptoms. Untreated participants (n = 291, 38%) were compared with treated participants (n = 471, 62%) who self-reported accessing BN/BED treatment at some point in their lives. RESULTS Untreated participants disproportionately self-identified as male and as a racial or ethnic minority compared with treated participants. Treated participants reported a more severe illness history, specifically, an earlier age at onset, more longstanding and frequent eating disorder symptoms over their lifetime, and greater body dissatisfaction and comorbid mental health symptoms (i.e., depression, anxiety, ADHD) at the time of the study. A history of anorexia nervosa was positively associated with treatment engagement. Individuals self-reporting a history of inpatient or residential treatment exhibited the most severe illness history, those with outpatient treatment had a less severe illness history, and untreated individuals had the mildest illness history. CONCLUSIONS Historically overlooked and marginalized populations self-reported lower treatment access rates, while those who accessed treatment reported more severe eating disorder and comorbid mental health symptoms, which may have motivated them to seek treatment. Clinic-based recruitment samples may not represent individuals with milder symptoms or racial and ethnic diversity, and males. Community-based recruitment is crucial for improving the ability to apply research findings to broader populations and reducing disparities in medical research. Trial Registration ClinicalTrials.gov NCT04162574 ( https://clinicaltrials.gov/ct2/show/NCT04162574 ).
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Affiliation(s)
- Emily A. Carrino
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - Rachael E. Flatt
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - Pratiksha S. Pawar
- Department of Biotechnology, Dr D. Y. Patil Biotechnology and Bioinformatics Institute, Dr. D. Y. Patil Vidyapeeth, Pune, India
| | - Christina M. Sanzari
- Department of Psychology, State University of New York at Albany, Albany, NY USA
| | | | | | - Laura M. Thornton
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - Cynthia M. Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels Väg 12A, 171 65 Solna, Stockholm Sweden
| | - Hunna J. Watson
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
- Discipline of Psychology, School of Population Health, Curtin University, Perth, Australia
- Division of Paediatrics, School of Medicine, The University of Western Australia, Perth, Australia
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Ćorić MK, Graovac M, Pravdić N, Raguž AB, Kaštelan A. Predictive factors of disordered eating among adolescents in Bosnia and Herzegovina. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:258. [PMID: 37727435 PMCID: PMC10506781 DOI: 10.4103/jehp.jehp_1560_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 02/14/2023] [Indexed: 09/21/2023]
Abstract
BACKGROUND Due to excessive concerns and focus on weight control and body shape, adolescents often resort to inappropriate behaviours and attitudes towards eating, resulting in physical and psychological issues. This study aimed to assess possible relationships and predictor variables between disordered eating and age, BMI, body appreciation, self-esteem, quality of family interactions, psychosocial health and childhood trauma experience in adolescents of both sexes in the city of Mostar (Bosnia and Herzegovina). MATERIALS AND METHODS A cross-sectional study was carried out on a suitable sample of 724 high-school students aged 14-19 years. The following tools have been used: socio-demographic questionnaire, The Eating Attitudes Test (EAT-26), Body Mass Index (BMI), Body Appreciation Scale (BAS), Rosenberg's Self-Esteem Scale, Quality of Family Interaction Scale (KOBI), and Paediatric Quality of Life Inventory, version 4.0 (PedsQLTM) and Childhood trauma Questionnaire (CTQ). Collected data were analyzed in SPSS v. 20.0 software using Pearson's correlation coefficient and multiple regression analysis. RESULTS Body appreciation is the most significant predictor for developing disordered eating across the entire sample of adolescents (β = -0.325, P < 0.05) and individually for male adolescents (β = -0.199, P = 0.010) and female adolescents (β = -0.379, P < 0.001). In addition to this variable, BMI has proved to be a statistically significant predictor in explaining the eating behaviours of female adolescents (β = 0.185, P < 0.001), while this happens to be self-esteem for male adolescents (β = -0.211, P < 0.022). CONCLUSION The most significant risk factors for developing disordered eating in adolescents are body appreciation, BMI and self-esteem. Results of this research can contribute to enhancement of intervention programmes which promote a positive body image and aim to prevent disordered eating in adolescents of both sexes.
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Affiliation(s)
- Martina Krešić Ćorić
- Psychiatry Clinic, School of Medicine, University of Mostar, Mostar, Bosnia and Herzegovina
| | - Mirjana Graovac
- Department of Psychiatry and Psychological Medicine, School of Medicine, University of Rijeka, Rijeka, Croatia
| | - Nikolina Pravdić
- Department of Neurology, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina
| | - Ana Boban Raguž
- Pediatric Clinic, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina
| | - Ana Kaštelan
- Department of Psychiatry and Psychological Medicine, School of Medicine, University of Rijeka, Rijeka, Croatia
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Rodríguez-Testal JF, Trinidad-Montero JM, Rosales Becerra Á, Faija C, Senín-Calderón C. Psychometric properties of the Pride in Eating Pathology Scale in a Spanish population. J Eat Disord 2023; 11:124. [PMID: 37507784 PMCID: PMC10386289 DOI: 10.1186/s40337-023-00847-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND In its relation to eating disorders, pride is one of the self-conscious emotions least analyzed, and requires valid and reliable instruments for its measurement. This study aimed to examine the factor structure and the psychometric properties of the Pride in Eating Pathology Scale (PEP-S), in the Spanish general population, as well as between-sex differences in PEP-S scores. METHODS Of the 1483 participants aged 18 to 34 (M = 21.99; SD = 3.09), 954 were women (65.2%) and the majority were university students (78.8%). Psychometric properties of the scale were tested in a cross-sectional design using cross-validation, i.e., exploratory and confirmatory factor analysis, and estimation of invariance (sex). RESULTS The four-factor structure found was similar to the original scale with invariance across sex and internal consistency (ordinal alpha .99) and stability (.85). Evidence of convergent validity and differences between sexes were found. Specifically, women scored higher on all the factors, including the healthier sense of pride. CONCLUSIONS The PEP-S scale is an instrument with evidence of validity and reliability in the Spanish population. Although it still has to be tested in a clinical population, it constitutes a promising instrument for the evaluation of the self-conscious emotion, pride.
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Affiliation(s)
| | | | - Ángela Rosales Becerra
- Personality, Evaluation and Psychological Treatment Department, University of Seville, Seville, Spain
| | - Cintia Faija
- Department of Primary Care & Mental Health, University of Liverpool, Liverpool, UK
| | - Cristina Senín-Calderón
- Department of Psychology, University of Cádiz, Avda. República Árabe Saharaui S/N. Puerto Real, Cádiz, Spain.
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Traut P, Halbeisen G, Braks K, Huber TJ, Paslakis G. Sociodemographic and clinical features of men and women with eating disorders: a diagnosis-matched, retrospective comparison among inpatients. Front Psychiatry 2023; 14:1192693. [PMID: 37484681 PMCID: PMC10359980 DOI: 10.3389/fpsyt.2023.1192693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 06/22/2023] [Indexed: 07/25/2023] Open
Abstract
Introduction Eating disorders (EDs) are among the most severe mental disorders in women and men, often associated with high symptom burden and significant limitations in daily functioning, frequent comorbidities, chronic course of illness, and even high mortality rates. At the same time, differences between men and women with EDs remain poorly explored. Methods In this study, we compared 104 men to 104 diagnosis-matched women with EDs regarding sociodemographic and clinical features. Using latent class mixture modelling, we identified four distinct patient subgroups based on their sociodemographic features. Results Men with EDs had significantly higher odds than women to belong to a "single-childfree-working" class. Moreover, while there were few overall differences in ED-related symptoms and general psychopathology between men and women, single-childfree-working men with EDs presented with higher general psychopathology symptoms than men in the other classes. Discussion We discuss how considering sex and gender along with further sociodemographic differences in EDs may help to improve ED diagnosis and treatment.
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Affiliation(s)
- Philipp Traut
- University Clinic for Psychosomatic Medicine and Psychotherapy, Medical Faculty, Campus East-Westphalia, Ruhr-University Bochum, Luebbecke, Germany
| | - Georg Halbeisen
- University Clinic for Psychosomatic Medicine and Psychotherapy, Medical Faculty, Campus East-Westphalia, Ruhr-University Bochum, Luebbecke, Germany
| | - Karsten Braks
- Centre for Eating Disorders, Klinik am Korso, Bad Oeynhausen, Germany
| | - Thomas J. Huber
- Centre for Eating Disorders, Klinik am Korso, Bad Oeynhausen, Germany
| | - Georgios Paslakis
- University Clinic for Psychosomatic Medicine and Psychotherapy, Medical Faculty, Campus East-Westphalia, Ruhr-University Bochum, Luebbecke, Germany
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Burke NL, Hazzard VM, Schaefer LM, Simone M, O’Flynn JL, Rodgers RF. Socioeconomic status and eating disorder prevalence: at the intersections of gender identity, sexual orientation, and race/ethnicity. Psychol Med 2023; 53:4255-4265. [PMID: 35574702 PMCID: PMC9666565 DOI: 10.1017/s0033291722001015] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Longstanding biases have fostered the erroneous notion that only those of higher socioeconomic status (SES) experience eating disorders (EDs); however, EDs present across all SES strata. Considering the dearth of ED research among those of lower SES, this study examined (1) the overall association between SES and ED prevalence, and (2) ED prevalence in the context of four relevant social identities (i.e. SES, gender identity, sexual orientation, and race/ethnicity) from an intersectional perspective, as unique combinations of multiple social identities may differentially influence risk. METHODS A sample of 120 891 undergraduate/graduate students from the Healthy Minds Study self-reported family SES with a single-item question, gender identity, sexual orientation, and race/ethnicity, and were screened for ED risk. RESULTS Participants of lower SES had 1.27 (95% CI 1.25-1.30) times greater prevalence of a positive ED screen than those of higher SES. Substantial heterogeneity was observed across the four social identities beyond the association with SES. For example, positive ED screens were particularly common among lower SES, Latinx, sexual minority cisgender men and women, with 52% of bisexual men and 52% of lesbian women of Latinx ethnicity and lower SES screening positive. CONCLUSIONS Although positive ED screens were more common among undergraduate/graduate students of lower SES, the particularly high ED risk reported by certain groups of lower SES with multiple minority identities reinforces the importance of investigating multi-layered constructs of identity when identifying groups at disproportionate risk.
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Affiliation(s)
- Natasha L. Burke
- Department of Psychology, Fordham University, 441 East Fordham Road, Dealy Hall, Bronx, NY 10458, USA
| | - Vivienne M. Hazzard
- Department of Psychiatry and Behavioral Science, University of Minnesota Medical School, Minneapolis, MN, USA, 55454
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA, 55454
| | - Lauren M. Schaefer
- Sanford Center for Bio-behavioral Research, 120 Eighth Street South, Fargo, ND 58103, USA
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, 1919 Elm Street N, Fargo, ND, 58102, USA
| | - Melissa Simone
- Department of Psychiatry and Behavioral Science, University of Minnesota Medical School, Minneapolis, MN, USA, 55454
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA, 55454
| | - Jennifer L. O’Flynn
- Department of Applied Psychology, Northeastern University, 360 Huntington Avenue, Boston, MA 02115, USA
- Cambridge Health Alliance, Department of Psychiatry, Cambridge, MA, 02139, USA
| | - Rachel F. Rodgers
- Department of Applied Psychology, Northeastern University, 360 Huntington Avenue, Boston, MA 02115, USA
- Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHRU Montpellier, France
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Riva A, Purpura G, Di Guardo S, Falbo M, Pigni M, Nacinovich R. Psychological features in male and female adolescents with eating disorders: is it the same condition? Eat Weight Disord 2023; 28:56. [PMID: 37378688 DOI: 10.1007/s40519-023-01583-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 06/15/2023] [Indexed: 06/29/2023] Open
Abstract
PURPOSE Eating disorders (EDs) are psychiatric disorders with a typical prevalence in adolescence. EDs have long been wrongly considered female gender-bound disorders, resulting in a systematic underrepresentation of males in EDs research. The main goal of the present study is exploring the clinical and psychological characteristics of adolescent males with EDs in comparison with females. METHODS In this observational and retrospective study, 14 males and 28 females hospitalized for eating disorders during the adolescent age (from 12 to 17.11 years) were recruited. Main clinical data (age, BMI, duration of illness), behavioural characteristic of the disorder (over-exercising, self-harm, purging-behaviours) and psychological symptoms (Eating Disorders Inventory-3rd edition-EDI-3, Symptom Checklist-90-Revised-SCL-90, Children's Global Assessment Scale-C-GAS) were collected and examined for significant correlations with severity of body mass index (BMI). RESULTS Adolescent males show a peculiar and more severe psychopathological profiles partially influenced by BMI and characterized by purging-behaviours, over-exercising, obsessive-compulsive behaviour, anxiety, and psychoticism. CONCLUSION This study suggests a gender-specific profile of adolescent males with EDs, which may be considered in diagnosis and treatment. LEVEL III Evidence obtained from retrospective well-designed case-control study.
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Affiliation(s)
- Anna Riva
- School of Medicine and Surgery, University of Milano Bicocca, 20900, Monza, Italy
- Child and Adolescent Health Department, Fondazione IRCCS San Gerardo dei Tintori, 20900, Monza, Italy
| | - Giulia Purpura
- School of Medicine and Surgery, University of Milano Bicocca, 20900, Monza, Italy.
| | - Simona Di Guardo
- Child and Adolescent Health Department, Fondazione IRCCS San Gerardo dei Tintori, 20900, Monza, Italy
| | - Mariella Falbo
- Child and Adolescent Health Department, Fondazione IRCCS San Gerardo dei Tintori, 20900, Monza, Italy
| | - Maria Pigni
- School of Medicine and Surgery, University of Milano Bicocca, 20900, Monza, Italy
- Child and Adolescent Health Department, Fondazione IRCCS San Gerardo dei Tintori, 20900, Monza, Italy
| | - Renata Nacinovich
- School of Medicine and Surgery, University of Milano Bicocca, 20900, Monza, Italy
- Child and Adolescent Health Department, Fondazione IRCCS San Gerardo dei Tintori, 20900, Monza, Italy
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Knight R, Preston C. Exploring the effects of gender and sexual orientation on disordered eating: an EFA to CFA study of the Eating Disorder Examination Questionnaire. J Eat Disord 2023; 11:100. [PMID: 37349796 DOI: 10.1186/s40337-023-00821-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 06/10/2023] [Indexed: 06/24/2023] Open
Abstract
Several problems limit our understanding of the ways that gender and sexual orientation influence disordered eating. These include the reliance on measures that have been developed and validated in samples of cisgender heterosexual women, and the lack of confirmed measurement invariance that allows us to meaningfully compare these experiences between groups. This study was an EFA to CFA exploration of the Eating Disorder Examination Questionnaire in a group of heterosexual, bisexual, gay, and lesbian men and women. In total 1638 participants were recruited via adverts in traditional and social media to complete an online survey. A 14-item, three-factor model of the EDE-Q was confirmed as best fitting the data and measurement invariance between groups was ascertained. Sexual orientation influenced disordered eating and muscularity-related thoughts and behaviours in men but not women. Heterosexual men reported more muscularity-related concerns and behaviours, whereas gay men showed more thinness-related concerns and behaviours. Bisexual participants showed a different pattern, highlighting the importance of treating this group individually and not collating all non-heterosexual participants together. Small but significant effects of sexual orientation and gender have an impact on the kinds of disordered eating thoughts and behaviours one might experience, and could influence prevention and treatment. Clinicians may be able to provide more effective and tailored interventions by taking into account gender and sexual orientation in sensitive ways.
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Affiliation(s)
- Ruth Knight
- Department of Psychology, York St John University, Lord Mayors Walk, York, Y031 7EX, UK.
- University of York, York, UK.
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Schloesser L, Lotter LD, Offermann J, Borucki K, Biemann R, Seitz J, Konrad K, Herpertz-Dahlmann B. Sex-dependent clinical presentation, body image, and endocrine status in long-term remitted anorexia nervosa. EUROPEAN EATING DISORDERS REVIEW 2023. [PMID: 37319038 DOI: 10.1002/erv.2997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 05/26/2023] [Accepted: 06/01/2023] [Indexed: 06/17/2023]
Abstract
OBJECTIVE Although anorexia nervosa (AN) in males has recently gained attention, knowledge of its psychological and physiological outcomes is still scarce. We explore sex-specific characteristics of long-term remitted AN with respect to residual eating disorder (ED) psychopathology, body image, and endocrinology. METHOD We recruited 33 patients with AN in remission for at least 18 months (24 women, 9 men) and 36 matched healthy controls (HCs). Eating disorder psychopathology and body image ideals were assessed via clinical interviews, questionnaires, and an interactive 3D body morphing tool. Plasma levels of leptin, free triiodothyronine, cortisol, and sex hormones were quantified. Univariate models controlled for age and weight were used to test for the effects of diagnosis and sex. RESULTS Both patient groups showed residual ED psychopathology but normal weight and hormone levels relative to HCs. Male remitted patients demonstrated significantly stronger muscularity-focused body image ideals, evident in interviews, self-reports, and behavioural data, than both female patients and HCs. CONCLUSIONS Sex-specific body image characteristics in patients with remitted AN point towards the need to adjust test instruments and diagnostic criteria to male-specific psychopathology. In the future, sufficiently powered studies should evaluate the risk of men with AN developing muscle dysmorphia in the long term.
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Affiliation(s)
- Louisa Schloesser
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH Aachen, Aachen, Germany
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH Aachen, Aachen, Germany
| | - Leon D Lotter
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH Aachen, Aachen, Germany
- Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Jülich Research Centre, Jülich, Germany
- Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Max Planck School of Cognition, Leipzig, Germany
| | - Jan Offermann
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH Aachen, Aachen, Germany
| | - Katrin Borucki
- Institute for Clinical Chemistry and Pathobiochemistry, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Ronald Biemann
- Institute for Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, Leipzig, Germany
| | - Jochen Seitz
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH Aachen, Aachen, Germany
| | - Kerstin Konrad
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH Aachen, Aachen, Germany
- JARA-Brain Institute II, Molecular Neuroscience and Neuroimaging, Jülich Research Centre, Jülich, Germany
| | - Beate Herpertz-Dahlmann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH Aachen, Aachen, Germany
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Kirby AS, Jenks R, Walsh F, Duncan M. Attentional Biases Towards Body-Related Stimuli in Healthy Males: A Systematic Review. Psychol Rep 2023:332941231177243. [PMID: 37211416 DOI: 10.1177/00332941231177243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Recent literature has discussed the role of attentional biases towards body-related stimuli. Specific foci have been on those with high levels of body image concerns and female samples. Unfortunately, there has been limited focus on male samples within existing literature. The aim of the current study was to provide a critical synthesis of the findings of existing studies exploring attentional biases in adult males towards body-related stimuli. Critical synthesis of the findings of 20 studies explored four key methodologies: eye-tracking, dot-probe, visual search, and other methodologies (e.g. ARDPEI task). The current review provides evidence of specific attentional biases towards body-related stimuli in adult males experiencing body image concerns. Similar patterns of attentional biases are also demonstrated in males with body image pathologies. However, there appears to be distinct patterns of attentional biases for male and female participants. It is recommended that future research considers these findings and utilises measures developed specifically for male samples. Furthermore, additional variables require further attention, i.e. reasons for engaging in social comparison and/or engaging in physical activity.
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Affiliation(s)
- Alexandra S Kirby
- Centre for Sport, Exercise and Life Sciences, Coventry University, Coventry, UK
- Department of Arts, Humanities and Human Sciences, Newman University, Bartley Green, UK
| | - Rebecca Jenks
- School of Psychological, Social and Behavioural Sciences, Coventry University, Coventry, UK
| | - Francesca Walsh
- School of Psychological, Social and Behavioural Sciences, Coventry University, Coventry, UK
| | - Michael Duncan
- Centre for Sport, Exercise and Life Sciences, Coventry University, Coventry, UK
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Carrino E, Flatt R, Pawar P, Sanzari C, Tregarthen J, Argue S, Thornton L, Bulik C, Watson H. Sociodemographic and Clinical Characteristics of Treated and Untreated Adults with Bulimia Nervosa and/or Binge-eating Disorder Recruited for a Large-Scale Research Study. RESEARCH SQUARE 2023:rs.3.rs-2899349. [PMID: 37214840 PMCID: PMC10197743 DOI: 10.21203/rs.3.rs-2899349/v1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Background: Eating disorders affect millions of people worldwide, but most never receive treatment. The majority of clinical research on eating disorders has focused on individuals recruited from treatment settings, which may not represent the broader population of people with eating disorders. This study compared the characteristics of individuals with eating disorders based on whether they self-reported accessing treatment or not, to identify potential differences and contribute to a better understanding of the diverse needs and experiences of individuals with eating disorders. Methods: The study population included 762 community-recruited individuals (85% female, M ± SD age = 30 ± 7 y) with bulimia nervosa and/or binge eating disorder (BN/BED) enrolled in the Binge-Eating Genetics Initiative (BEGIN) United States study arm. Participants completed self-report surveys on demographics, treatment history, past and current eating disorder symptoms, weight history, and current mental health and gastrointestinal comorbidity. Untreated participants ( n = 291, 38%) were compared with treated participants ( n = 471, 62%) who self-reported accessing BN/BED treatment at some point in their lives. Results: Untreated participants disproportionately self-identified as male and as a racial or ethnic minority compared with treated participants. Treated participants reported a more severe illness history, specifically, an earlier age at onset, more longstanding and frequent ED symptoms over their lifetime, and higher body dissatisfaction and comorbid mental health symptoms (i.e., depression, anxiety, ADHD) at the time of the study. Those who reported a history of inpatient or residential treatment displayed the most severe illness history, whereas those who reported outpatient treatment had a less severe illness history, and untreated individuals had the mildest illness history. Conclusions: Individuals from historically overlooked or marginalized populations were less likely to access treatment. Those who accessed treatment had more severe ED and comorbid symptoms, which may have motivated them to seek treatment. Clinic-based recruitment samples may not accurately represent all individuals with EDs, particularly those with milder symptoms and those with gender or racial/ethnic diversity. The results of this study indicate that community-based recruitment is crucial for improving the ability to apply research findings to broader populations and to reduce disparities in medical research. Trial Registration : ClinicalTrials.gov NCT04162574 (https://clinicaltrials.gov/ct2/show/NCT04162574).
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74
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Lim M, Kou R, Esposito G, Jawed A, Dimitriou D, Mangar SA. Exploring the Relationship between Disordered Sleep and Mood in Male Anorexia Nervosa: An Actigraphy Study. Nutrients 2023; 15:2176. [PMID: 37432391 DOI: 10.3390/nu15092176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 04/25/2023] [Accepted: 04/28/2023] [Indexed: 07/12/2023] Open
Abstract
Eating disorders (EDs), including anorexia nervosa (AN), are severe psychological disorders that affect individuals' eating behaviours and body perception. Previous research has shown that people with EDs often report poorer sleep. Some literature has suggested that it is mood dysregulation that mediates the link between EDs and sleep. However, the majority of previous studies only focused on females, while male ED patients have been overlooked. Therefore, the present study aimed to investigate the relationships between EDs, mood, and sleep among male ED patients. Using a mixture of actigraphy recordings and self-reported questionnaires, the current study analysed a total 33 adult male participants diagnosed with AN. The participants first wore an actigraphy device for seven continuous days, following which their ED severity and mood were assessed by the Eating Disorder Examination Questionnaire (EDE-Q) and Depression Anxiety Stress Scale (DASS), respectively. The descriptive actigraphy results suggested that, similar to females, males with AN also showed disturbed sleep, including insomnia, sleep fragmentation, low sleep efficiency, and increased napping sessions. However, when ED severity was correlated against actigraphy data and mood, no significant relationships were found between them. Thus, it was suggested that future studies may investigate discrete ED symptoms instead of global ED severity interacting with sleep and mood. Overall, this study represents an initial step in the investigation of EDs and sleep and mood dysregulation among an under-represented sample.
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Affiliation(s)
- Mengyu Lim
- Psychology Program, School of Social Sciences, Nanyang Technological University, 48 Nanyang Avenue, Singapore 639818, Singapore
| | - Ruoxin Kou
- Sleep Education and Research Laboratory, UCL Institute of Education, London WC1H 0AA, UK
| | - Gianluca Esposito
- Affiliative Behaviour and Physiology Lab, Department of Psychology and Cognitive Science, University of Trento, 84 Corso Bettini, 38068 Rovereto, Italy
| | - Aisha Jawed
- Sleep Education and Research Laboratory, UCL Institute of Education, London WC1H 0AA, UK
| | - Dagmara Dimitriou
- Sleep Education and Research Laboratory, UCL Institute of Education, London WC1H 0AA, UK
| | - Stephen A Mangar
- Department of Clinical Oncology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London W6 8RF, UK
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75
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Groves V, Ridley BJ, Cornelissen PL, Maalin N, Mohamed S, Kramer RSS, McCarty K, Tovée MJ, Cornelissen KK. Men's perception of current and ideal body composition and the influence of media internalization on body judgements. Front Psychol 2023; 14:1116686. [PMID: 37205060 PMCID: PMC10185840 DOI: 10.3389/fpsyg.2023.1116686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 03/31/2023] [Indexed: 05/21/2023] Open
Abstract
Introduction To determine men's body ideals and the factors that influence these choices, this study used a matrix of computer generated (CG) male bodies (based on an analysis of 3D scanned real bodies) which independently varied in fat and muscle content. Methods Two hundred and fifty-eight male participants completed a range of psychometric measures to index body concerns and body ideal internalization and then chose the CG body that best reflected their own current body, as well as the body that reflected their personal ideal. A subset of participants was then retested to check that these judgements were stable over time. Results While judgements of the ideal body seem to be influenced by a shared appearance ideal, the degree to which this ideal was internalized showed significant variability between participants. The effect of this internalization was reflected in the difference between the estimated current body and the ideal. Discussion Higher internalization led to a preference for higher muscle and lower fat content. This preference was most marked for fat content, although reducing adiposity also made the underlying musculature more salient. Additionally, the ideal body composition was modulated by the composition the participant believed his current body had (i.e., it seemed that a participant's ideal body was anchored by what they believed to be their current body and what change was possible from this starting point).
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Affiliation(s)
- Vicki Groves
- Department of Psychology, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Bethany J. Ridley
- Department of Psychology, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Piers L. Cornelissen
- Department of Psychology, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Nadia Maalin
- Department of Psychology, Birmingham City University, Birmingham, United Kingdom
| | - Sophie Mohamed
- Aberdeen Royal Infirmary, NHS Grampian, Aberdeen, United Kingdom
| | | | - Kristofor McCarty
- Department of Psychology, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Martin J. Tovée
- Department of Psychology, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Katri K. Cornelissen
- Department of Psychology, Northumbria University, Newcastle upon Tyne, United Kingdom
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76
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He J, Barnhart WR, Zhang Y, Han J, Wang Z, Cui S, Nagata JM. Muscularity teasing and its relations with muscularity bias internalization, muscularity-oriented body dissatisfaction, and muscularity-oriented disordered eating in Chinese adult men. Body Image 2023; 45:382-390. [PMID: 37104997 DOI: 10.1016/j.bodyim.2023.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 03/31/2023] [Accepted: 04/13/2023] [Indexed: 04/29/2023]
Abstract
Despite increasing research on weight teasing and other forms of appearance teasing, muscularity teasing, which occurs when an individual is victimized due to low muscularity, has not yet received research attention. Given the solid evidence of positive relations between weight teasing and thinness-oriented body dissatisfaction and disordered eating, we aimed to tap into muscularity teasing and examine its relations with muscularity-oriented body dissatisfaction and muscularity-oriented disordered eating (e.g., rigid dietary rules for enhancing muscularity). A sample of 500 Chinese men, aged 18 - 62 years, were recruited online, and they competed questionnaires assessing muscularity teasing, muscularity bias internalization, muscularity-oriented body dissatisfaction, and muscularity-oriented disordered eating. Correlation analyses showed that muscularity teasing was significantly related to muscularity bias internalization (r = 0.55, p < .001), muscularity-oriented body dissatisfaction (r = 0.50, p < .001), and muscularity-oriented disordered eating (r = 0.38, p < .001). Structural equation modelling indicated that muscularity bias internalization and muscularity-oriented body dissatisfaction, as concurrent mediators, fully mediated the relationships between muscularity teasing and muscularity-oriented disordered eating. Findings extend existing knowledge in appearance teasing research to encompass muscularity teasing in order to better understand the etiology of muscularity-oriented body dissatisfaction and muscularity-oriented disordered eating.
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Affiliation(s)
- Jinbo He
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, China.
| | - Wesley R Barnhart
- Department of Psychology, Bowling Green State University, Bowling Green, OH, USA
| | - Yuchen Zhang
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, China
| | - Jiayi Han
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, China
| | - Ziyue Wang
- School of Humanities and Social Sciences, Beijing Forestry University, Beijing, China
| | - Shuqi Cui
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, China
| | - Jason M Nagata
- Division of Adolescent & Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
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77
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Grunewald W, Gagliano E, Brown TA, Smith AR. Conformity to masculine norms, interoceptive dysfunction, and changes in muscle dysmorphia symptoms. Body Image 2023; 45:343-354. [PMID: 37037062 DOI: 10.1016/j.bodyim.2023.03.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 03/15/2023] [Accepted: 03/27/2023] [Indexed: 04/12/2023]
Abstract
Muscle dysmorphia (MD) is a psychiatric illness characterized by preoccupation and compulsive behaviors to increase muscle size/definition. Despite its severity, few risk factors/mechanisms for MD have been identified. Conformity to masculine norms may be a MD risk factor. Furthermore, interoceptive dysfunction may facilitate MD. symptoms, as well as underlie relationships between conformity to masculine norms and MD symptoms. However, research has yet to test the mediating role of interoceptive dysfunction for said relationships. The current study tested if interoceptive dysfunction underlies relationships between conformity to masculine norms and MD symptoms among 269 US men who completed three surveys separated by one month that contained measures of focal constructs. Our sample was majority White, heterosexual, and non-Hispanic. A three-wave autoregressive mediation model was tested in which conformity to masculine norms predicted interoceptive dysfunction, which then predicted MD symptoms. Results indicated that conformity to specific masculine norms predicted both interoceptive dysfunction and MD symptoms over time. Furthermore, our hypothesized mediation pathways were not discovered. Conformity to masculine norms appears to be a risk factor for MD symptoms and interoceptive dysfunction. If clinicians can reduce rigid adherence to masculine stereotypes, this may increase connection with one's body and reduce subsequent MD symptoms.
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Affiliation(s)
- William Grunewald
- Auburn University, Department of Psychological Sciences, 226 Thach Hall Auburn University, Auburn, AL 36849, United States.
| | - Elena Gagliano
- Auburn University, Department of Psychological Sciences, 226 Thach Hall Auburn University, Auburn, AL 36849, United States
| | - Tiffany A Brown
- Auburn University, Department of Psychological Sciences, 226 Thach Hall Auburn University, Auburn, AL 36849, United States
| | - April R Smith
- Auburn University, Department of Psychological Sciences, 226 Thach Hall Auburn University, Auburn, AL 36849, United States
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78
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Murray SB, Alba C, Duval CJ, Nagata JM, Ganson KT, Jann K. Sex differences in functional connectivity from reward-based regions in pre-adolescent binge eating disorder. Psychiatry Res 2023; 324:115186. [PMID: 37084569 DOI: 10.1016/j.psychres.2023.115186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 03/28/2023] [Accepted: 03/31/2023] [Indexed: 04/23/2023]
Affiliation(s)
- Stuart B Murray
- Department of Psychiatry & Behavioral Sciences, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA.
| | - Celina Alba
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Christina J Duval
- Department of Psychiatry & Behavioral Sciences, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Kay Jann
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
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79
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Gewirtz-Meydan A, Spivak-Lavi Z. The association between problematic pornography use and eating disorder symptoms among heterosexual and sexual minority men. Body Image 2023; 45:284-295. [PMID: 37011472 DOI: 10.1016/j.bodyim.2023.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 03/10/2023] [Accepted: 03/14/2023] [Indexed: 04/05/2023]
Abstract
In this study, we investigated the link between problematic pornography use and eating disorder symptoms in men, with body comparison and body image as mediators, and perceived realism and anxiety and depression as moderators. We also analyzed the model for both heterosexual and sexual minority men to detect any differences. The current study included 705 Israeli men, 479 of whom identified as heterosexual and 226 as sexual minority. The majority of the sample (90.6%) identified as Jewish with a mean age of 32.5. Results showed that problematic pornography use was linked to more upward body comparison, which in turn was related to negative body image, and ultimately, increased severity of eating disorder symptoms. Anxiety and depression moderated the association between male body image and eating disorder symptoms. However, perceived realism did not moderate the link between problematic pornography use and upward body comparison. Whereas there were significant differences in the mean rank values between heterosexual and sexual minority men in all measures, the processes linking these measures were virtually the same. To reduce the risk of developing or worsening eating disorder symptoms, clinicians working with male clients should assess for problematic pornography use and body image concerns during therapy.
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Affiliation(s)
- Ateret Gewirtz-Meydan
- School of Social Work, Faculty of Social Welfare and Health Sciences University of Haifa, Israel. agewirtz-@univ.haifa.ac.il
| | - Zohar Spivak-Lavi
- Faculty of Social Work, Max Stern Yezreel Valley College, Emek Yezreel, Israel.
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80
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Lu J, Zhang H, Cao W, Jiang S, Fang H, Yu D, Yang L. Study on the Zinc Nutritional Status and Risk Factors of Chinese 6–18-Year-Old Children. Nutrients 2023; 15:nu15071685. [PMID: 37049525 PMCID: PMC10096995 DOI: 10.3390/nu15071685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 03/21/2023] [Accepted: 03/28/2023] [Indexed: 04/03/2023] Open
Abstract
Zinc is an essential micronutrient that is involved in several metabolic processes, especially children’s growth and development. Although many previous studies have evaluated the zinc nutritional status of children, there are very few reports on children aged 6–18 years old. Furthermore, there are few reports on children’s zinc nutrition status based on the Chinese population. According to WHO data, the prevalence of zinc deficiency in Asian countries is rather high and has resulted in high child mortality. In this study, we aimed to comprehensively assess zinc nutritional status and the prevalence of zinc deficiency among children aged 6–18 years in China based on nationally representative cross-sectional data. Subgroup comparisons were made under possible influencing factors. The potential risk factors of zinc deficiency were also discussed. A total of 64,850 children, equally male and female, were recruited from 150 monitoring sites in 31 provinces through stratified random sampling from China National Nutrition and Health Survey of Children and Lactating Mothers (CNNHS 2016–2017). Median and interquartile intervals were used to represent the overall zinc concentration levels and different subgroups. A Chi-square test was used to compare serum zinc levels and the prevalence of zinc deficiency in children under different group variables. In order to study the influencing factors of zinc deficiency, multiple logistic regression was utilized. It was found that the median concentration of serum Zn was 88.39 μg/dL and the prevalence of Zn deficiency was 9.62%. The possible influence factors for Zn deficiency were sex, anemia, nutritional status, city type and income. By conducting a subgroup analysis of the factors, it was found that males; those with anemia, stunting and low income; and children living in rural areas have a higher risk of Zn deficiency. This study offers a comprehensive analysis of Zn nutritional status among Chinese children, which provides reliable data for policy formulation to improve the zinc nutrition status of children.
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81
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Sahlan RN, Saunders JF, Fitzsimmons-Craft EE. Validation of a Farsi version of the Eating Pathology Symptoms Inventory (F-EPSI) among Iranian adolescents. Eat Weight Disord 2023; 28:33. [PMID: 36971859 PMCID: PMC10042940 DOI: 10.1007/s40519-023-01561-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 03/11/2023] [Indexed: 03/29/2023] Open
Abstract
PURPOSE Limited research has validated eating pathology assessments in Iranian adolescent boys and girls. In particular, the measures that have been validated do not capture both boys' and girls' eating behaviors in adolescence. The purpose of the current study was to validate a Farsi version of the Eating Pathology Symptoms Inventory (F-EPSI) for use in Iranian adolescents. METHODS Participants (N = 913; 85.3% girls) were adolescents who completed a battery of questionnaires including the F-EPSI. In addition, F-EPSI data for Iranian adolescents were compared with those of previously published data of adult Iranian college students. RESULTS Confirmatory Factor Analysis (CFA) indicated that the F-EPSI had an acceptable fit to the data and supported the eight-factor model. The scale was invariant by gender, weight status, eating disorder, and age groups. Boys reported higher scores than girls on the Excessive Exercise, Muscle Building, Body Dissatisfaction, and Binge Eating subscales. Adolescents with higher weight and eating disorder symptoms endorsed higher scores on the F-EPSI subscales. Older adolescents and adults reported higher scores than younger adolescents and adolescents, respectively. Adolescents had higher scores than adults on Restricting and Excessive Exercise subscales. The F-EPSI demonstrated good convergent validity through correlations with other eating pathology symptoms. The F-EPSI subscales were associated with depression and body mass index (zBMI) in expected directions that indicate criterion validity of the scale. CONCLUSIONS Findings suggest that the F-EPSI is a reliable and valid measure in Iranian non-clinical adolescents. The F-EPSI will enable researchers to examine a broad array of eating pathology symptoms in adolescents for whom Farsi is their official language. LEVEL OF EVIDENCE Level V; Cross-sectional descriptive study.
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Affiliation(s)
- Reza N Sahlan
- Department of Clinical Psychology, Iran University of Medical Sciences, Tehran, Iran
| | | | - Ellen E Fitzsimmons-Craft
- Department of Psychiatry, Washington University School of Medicine, Washington University in St. Louis, Mailstop 8134-29-2100, 660 South Euclid Avenue, St. Louis, MO, 63110, USA.
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82
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Lin Y, Lu C, Huang Z, Barnhart WR, Cui T, He J. Exploring the links between celebrity worship, body dissatisfaction, and disordered eating among young adult celebrity worshippers in China. Body Image 2023; 45:210-218. [PMID: 36963336 DOI: 10.1016/j.bodyim.2023.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 03/07/2023] [Accepted: 03/08/2023] [Indexed: 03/26/2023]
Abstract
Considerable evidence exists on the associations of celebrity worship with body dissatisfaction and disordered eating. However, relevant findings are confined to Western contexts and thinness-oriented body dissatisfaction and disordered eating. Consequently, the relationships of celebrity worship with muscularity-oriented body dissatisfaction and disordered eating are largely underexplored, especially in non-Western countries. Thus, the present study aimed to examine the relationships of celebrity worship with body dissatisfaction and disordered eating in China. A total of 593 young adult celebrity worshippers in China were recruited online. Correlation and mediation analyses were conducted. In contrast to previous findings, celebrity worship was not associated with thinness-oriented body dissatisfaction. However, significant associations were identified between celebrity worship and muscularity-oriented body dissatisfaction for men (r = 0.32, p < .001) and women (r = 0.26, p < .001), thinness-oriented disordered eating for men (r = 0.31, p < .001) and women (r = 0.37, p < .001), and muscularity-oriented disordered eating for men (r = 0.58, p < .001). Body image inflexibility mediated the associations between celebrity worship and disordered eating in men and women. Findings indicate that celebrity worship correlates positively with body dissatisfaction and disordered eating in Chinese young adults.
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Affiliation(s)
- Yitong Lin
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, China
| | - Chen Lu
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, China
| | - Zizhen Huang
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, China
| | - Wesley R Barnhart
- Department of Psychology, Bowling Green State University, Bowling Green, OH, USA
| | - Tianxiang Cui
- Department of Psychology, University of Macau, Macau, China
| | - Jinbo He
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, China.
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83
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Laskowski NM, Halbeisen G, Braks K, Huber TJ, Paslakis G. Factor structure of the Eating Disorder Examination-Questionnaire (EDE-Q) in adult men with eating disorders. J Eat Disord 2023; 11:34. [PMID: 36879335 PMCID: PMC9987121 DOI: 10.1186/s40337-023-00757-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 02/17/2023] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND Previous investigations on the Eating Disorder Examination-Questionnaire (EDE-Q) factor structures in men have been restricted to non-clinical settings, limiting conclusions about the factorial validity in men with eating disorders (ED). This study aimed to examine the factor structure of the German EDE-Q in a clinical group of adult men with diagnosed ED. METHODS ED symptoms were assessed using the validated German version of the EDE-Q. Exploratory factor analysis (EFA) using principal-axis factoring based on polychoric correlations was conducted for the full sample (N = 188) using Varimax-Rotation with Kaiser-Normalization. RESULTS Horn's parallel analysis suggested a five-factor solution with an explained variance of 68%. The EFA factors were labeled "Restraint" (items 1, 3-6), "Body Dissatisfaction" (items 25-28), "Weight Concern" (items 10-12, 20), "Preoccupation" (items 7 and 8), and "Importance" (items 22 and 23). Items 2, 9, 19, 21, and 24 were excluded due to low communalities. CONCLUSIONS Factors associated with body concerns and body dissatisfaction in adult men with ED are not fully represented in the EDE-Q. This could be due to differences in body ideals in men, e.g., the underestimation of the role of concerns about musculature. Consequently, it may be useful to apply the 17-item five-factor structure of the EDE-Q presented here to adult men with diagnosed ED.
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Affiliation(s)
- Nora M Laskowski
- University Clinic for Psychosomatic Medicine and Psychotherapy, Medical Faculty, Campus East-Westphalia, Ruhr-University Bochum, Virchowstr. 65, 32312, Luebbecke, Germany.
| | - Georg Halbeisen
- University Clinic for Psychosomatic Medicine and Psychotherapy, Medical Faculty, Campus East-Westphalia, Ruhr-University Bochum, Virchowstr. 65, 32312, Luebbecke, Germany
| | - Karsten Braks
- Centre for Eating Disorders, Klinik am Korso, 32545, Bad Oeynhausen, Germany
| | - Thomas J Huber
- Centre for Eating Disorders, Klinik am Korso, 32545, Bad Oeynhausen, Germany
| | - Georgios Paslakis
- University Clinic for Psychosomatic Medicine and Psychotherapy, Medical Faculty, Campus East-Westphalia, Ruhr-University Bochum, Virchowstr. 65, 32312, Luebbecke, Germany
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84
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Anastasiades E, Argyrides M. Exploring the role of positive body image in healthy orthorexia and orthorexia nervosa: A gender comparison. Appetite 2023; 185:106523. [PMID: 36871603 DOI: 10.1016/j.appet.2023.106523] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 02/28/2023] [Accepted: 03/02/2023] [Indexed: 03/07/2023]
Abstract
Current scholarship on orthorexia nervosa remains undecided about the role of body image in this novel eating disorder. This study aimed to explore the role of positive body image in differentiating between healthy orthorexia and orthorexia nervosa and assess how this might differ for men and women. A total of 814 participants (67.1% women; age M = 40.30, SD = 14.50) completed the Teruel Orthorexia scale, as well as measures of embodiment, intuitive eating, body appreciation and functionality appreciation. A cluster analysis revealed four distinct profiles characterized by high healthy orthorexia and low orthorexia nervosa; low healthy orthorexia and low orthorexia nervosa; low healthy orthorexia and high orthorexia nervosa; and high healthy orthorexia and high orthorexia nervosa. A MANOVA identified significant differences for positive body image between these four clusters, as well as that there were no significant differences between men and women for healthy orthorexia and orthorexia nervosa, despite men scoring significantly higher than women on all measures of positive body image. Cluster × gender interaction effects were found for intuitive eating, functionality appreciation, body appreciation and experience of embodiment. These findings indicate that the role of positive body image in healthy orthorexia and orthorexia nervosa may differ for men and women, making these relationships worthy of further exploration.
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85
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Wilkop M, Wade TD, Keegan E, Cohen-Woods S. Impairments among DSM-5 eating disorders: A systematic review and multilevel meta-analysis. Clin Psychol Rev 2023; 101:102267. [PMID: 36963207 DOI: 10.1016/j.cpr.2023.102267] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 01/16/2023] [Accepted: 02/28/2023] [Indexed: 03/06/2023]
Abstract
Previous research revealed that people who did not meet full DSM-IV criteria for anorexia nervosa (AN), bulimia nervosa (BN), or binge-eating disorder (BED) but met criteria for eating disorder not otherwise specified (EDNOS) display high levels of psychiatric and physical morbidity commensurate with full criteria eating disorders. The DSM-5 introduced significant changes to eating disorder diagnostic criteria, so the present study aimed to determine whether the revised diagnostic criteria better distinguish between full criteria eating disorders, and other specified feeding or eating disorder (OSFED) and unspecified feeding or eating disorder (UFED). We present a series of meta-analyses comparing eating pathology, general psychopathology, and physical health impairments among those with AN, BN, and BED, compared to those with OSFED or UFED (n = 69 eligible studies). Results showed significantly more eating pathology in OSFED compared to AN, no difference in general psychopathology, and greater physical health impairments in AN. BN had greater eating pathology and general psychopathology than OSFED, but OSFED showed more physical health impairments. No differences were found between BN and purging disorder or low-frequency BN, or between BED and OSFED. Findings highlight the clinical severity of OSFED and suggest the DSM-5 criteria may not appropriately account for these presentations.
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Affiliation(s)
- Madeleine Wilkop
- Discipline of Psychology, College of Education, Psychology, and Social Work, Flinders University, Adelaide, South Australia, Australia; Blackbird Initiative, Flinders University Institute for Mental Health and Wellbeing, Flinders University, Adelaide, South Australia, Australia
| | - Tracey D Wade
- Discipline of Psychology, College of Education, Psychology, and Social Work, Flinders University, Adelaide, South Australia, Australia; Blackbird Initiative, Flinders University Institute for Mental Health and Wellbeing, Flinders University, Adelaide, South Australia, Australia
| | - Ella Keegan
- Discipline of Psychology, College of Education, Psychology, and Social Work, Flinders University, Adelaide, South Australia, Australia; Blackbird Initiative, Flinders University Institute for Mental Health and Wellbeing, Flinders University, Adelaide, South Australia, Australia
| | - Sarah Cohen-Woods
- Discipline of Psychology, College of Education, Psychology, and Social Work, Flinders University, Adelaide, South Australia, Australia; Blackbird Initiative, Flinders University Institute for Mental Health and Wellbeing, Flinders University, Adelaide, South Australia, Australia; Flinders Centre for Innovation in Cancer, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.
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86
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Hallward L, Nagata JM, Rodgers RF, Ganson KT. Examination of eating disorder psychopathology across sexual and gender identities among a Canadian sample. Int J Eat Disord 2023; 56:604-615. [PMID: 36493406 DOI: 10.1002/eat.23872] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 11/29/2022] [Accepted: 11/29/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Eating disorders (EDs) disproportionately affect sexual and gender minorities, with majority of research conducted among samples in the United States. The purpose of this study was to examine ED psychopathology among adolescents and young adults in Canada with diverse gender and sexual identities. METHOD Data were collected from 2,714 Canadians, aged 16-30 years old, via an online survey at the end of 2021 during the COVID-19 pandemic. Participants responded to sociodemographic questions (including history of EDs) and reported on eating attitudes and behaviors. Descriptive statistics and multiple modified Poisson and linear regressions were conducted. RESULTS Over half the sample was heterosexual, 35% were sexual minority cisgender men and women, and 6.5% were transgender and gender non-conforming (TGNC) people. The sample overall reported elevated ED psychopathology based on their eating attitudes and behaviors. TGNC participants reported the most severe ED psychopathology. Generally, sexual minority cisgender women and cisgender men had elevated ED psychopathology compared to their heterosexual counterparts. Regression analyses revealed all gender and sexual minorities reported greater ED psychopathology compared to heterosexual cisgender men. DISCUSSION The Canadian sample reported elevated ED psychopathology compared to previous studies among various populations. Additional investigations are now needed to observe how ED psychopathology continues to change after the onset of the pandemic. Further research is needed among cisgender men, TGNC people, and sexual minorities to understand the unique stressors they face that lead to high ED psychopathology, and develop appropriate prevention and treatment tools. PUBLIC SIGNIFICANCE EDs affect people of all gender and sexual identities. People who identify as a gender and/or sexual minority often experience problematic eating attitudes and behaviors, particularly transgender and gender non-conforming people of all sexual identities. More research attention is needed among these populations, especially due to a paucity of research among Canadians, to develop effective diagnostic tools, prevention efforts, and treatment programs specific to gender and sexual identities.
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Affiliation(s)
- Laura Hallward
- School of Kinesiology, Western University, London, Ontario, Canada
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, California, USA
| | - Rachel F Rodgers
- Department of Applied Psychology, Northeastern University, Boston, Massachusetts, USA.,Department of Psychiatric Emergency and Acute Care, Lapeyronie Hospital, Montpellier, France
| | - Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
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87
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Why do queer men experience negative body image? A narrative review and testable stigma model. Body Image 2023; 45:94-104. [PMID: 36867966 DOI: 10.1016/j.bodyim.2023.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 02/11/2023] [Accepted: 02/13/2023] [Indexed: 03/05/2023]
Abstract
Queer men (i.e., men who are not heterosexual; sexual minority men) are disproportionately affected by negative body image - they experience greater body dissatisfaction are more likely to develop eating disorders than heterosexual men. While existing literature has examined individual-level predictors of negative body image for queer men, less is known about why queer men as a group are disproportionately affected by negative body image. By synthesising existing theoretical frameworks, research, policy, and media reporting, this narrative review moves towards an understanding of systemic-level negative body image for queer men. Through the lens of hegemonic masculinity, we explain how systemic experiences of stigma work to inform unattainable appearance standards for queer men, and how these standards then contribute to pervasive negative body image concerns among this community. Next, we describe how systemic stigma works to exacerbate negative health outcomes for queer men with body image concerns. Finally, we present a synthesized model of the processes outlined in this review, articulate testable predictions for future studies, and describe practical implications that could be widely employed to improve body image for queer men. Our review is the first to propose a comprehensive explanation of systemic negative body image for queer men.
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88
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Ganson KT, Nagata JM, Jones CP, Testa A, Jackson DB, Hammond D. Screen time, social media use, and weight-change behaviors: Results from an international sample of adolescents. Prev Med 2023; 168:107450. [PMID: 36791972 PMCID: PMC10952354 DOI: 10.1016/j.ypmed.2023.107450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 12/13/2022] [Accepted: 02/10/2023] [Indexed: 02/16/2023]
Abstract
This study aimed to investigate whether screen time and social media use are associated with weight-change behaviors among an international sample of adolescents. Cross-sectional data from the 2020 International Food Policy Study Youth Survey (ages 10-17; Australia, Canada, Chile, Mexico, United Kingdom, United States; N = 12,031) were analyzed. Self-reported hours of use of five forms of screen time (e.g., social media use), and total screen time per weekday were assessed. Use of six contemporary social media platforms (e.g., Facebook, Instagram) were also assessed. Weight-change behaviors included current attempts to gain weight, lose weight, stay the same weight, and not do anything to change weight, as well as dieting to lose weight in the past 12 months. Greater total screen time per weekday was associated with attempts to gain weight and lose weight, and dieting to lose weight. Specific social media platform use was associated with weight-change behaviors. For example, use of Twitter was most strongly associated with attempts to gain weight, lose weight, and dieting to lose weight. Findings underscore the international pervasiveness of screen time and social media use correlating with weight-change behaviors among adolescents. Global efforts are needed to ensure the appropriate use of screens and social media among adolescents.
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Affiliation(s)
- Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada.
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Catrin P Jones
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Alexander Testa
- Department of Management, Policy and Community Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Dylan B Jackson
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - David Hammond
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
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89
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Yager Z, Doley JR, McLean SA, Griffiths S. Goodform: A cluster randomised controlled trial of a school-based program to prevent body dissatisfaction and muscle building supplement use among adolescent boys. Body Image 2023; 44:24-35. [PMID: 36434957 DOI: 10.1016/j.bodyim.2022.11.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 10/31/2022] [Accepted: 11/05/2022] [Indexed: 11/27/2022]
Abstract
Although body dissatisfaction is common among adolescent boys, few intervention programs specifically developed for boys have been shown to be effective for reducing body dissatisfaction. Our study aim was to evaluate Goodform, a 4-session, teacher delivered intervention program specifically developed for boys to reduce body dissatisfaction and muscle building supplement use. The Goodform program was based on cognitive dissonance, social learning theory, and a social norms approach, and drew from two existing body image intervention programs that have shown promise among males: The Body Project- More than Muscles, and the Athletes Training and Learning to Avoid Steroids Program (ATLAS). A sample of 488 boys in grades 9 and 10 (Mage = 14.81, SDage = 0.51) at nine secondary schools in Australia were randomly assigned to Goodform (n = 244) or control (n = 244) at the school level. Self-reported body image, supplement use, anabolic androgenic steroid (AAS) use, and attitudes around using AAS and muscle building supplements were measured at baseline, post-intervention, and eight-week follow-up. Analyses with multi-level, mixed-effect regression models revealed no changes over time attributable to the intervention. Our results have implications for researchers in the body image and eating disorder prevention fields. Lessons learned in this study can inform future school-based efforts for reducing muscle building supplement use.
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Affiliation(s)
- Zali Yager
- Institute for Health and Sport, Victoria University, Footscray Park, Australia; Body Confident Collective, Australia.
| | - Jo R Doley
- Institute for Health and Sport, Victoria University, Footscray Park, Australia
| | - Siân A McLean
- The Bouverie Centre and Department of Psychology, Counselling, and Therapy, La Trobe University, Melbourne, Australia
| | - Scott Griffiths
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Australia
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90
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Muscle dysmorphia symptomatology among a national sample of Canadian adolescents and young adults. Body Image 2023; 44:178-186. [PMID: 36642014 DOI: 10.1016/j.bodyim.2023.01.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 12/13/2022] [Accepted: 01/03/2023] [Indexed: 01/15/2023]
Abstract
The aim of this study was to describe muscle dysmorphia (MD) symptomatology among a large, diverse, and national sample of adolescents and young adults in Canada. Data from the Canadian Study of Adolescent Health Behaviors (N = 2256) were analyzed. MD symptomatology was assessed using the Muscle Dysmorphic Disorder Inventory (MDDI). Men (mean [M] = 33.9, standard deviation [SD] = 8.6) reported significantly greater overall MD symptomatology compared to women (M = 30.1, SD = 7.3) and transgender/gender non-conforming (TGNC; M = 31.5, SD = 7.6) participants. Similarly, the prevalence of clinical MD risk was also highest among men (25.7 %). In regression analyses, participants who identified as South Asian (B 1.97, 95 % confidence interval [CI] 0.41, 3.52) or Middle Eastern (B 2.92, 95 % CI 0.50,5.35), compared to White participants, or identified as gay or lesbian (B 2.65, 95 % CI 1.19, 4.10), compared to heterosexual participants, had greater MD symptomatology. Findings are the first to describe the MD symptomatology among Canadian adolescents and young adults. Health care and public health professionals should be aware of the overall high occurrence of MD symptomatology in this sample, and future research is needed to continue to describe MD among Canadian young people.
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91
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Navas-León S, Morales Márquez L, Sánchez-Martín M, Crucianelli L, Bianchi-Berthouze N, Borda-Mas M, Tajadura-Jiménez A. Exploring multisensory integration of non-naturalistic sounds on body perception in young females with eating disorders symptomatology: a study protocol. J Eat Disord 2023; 11:28. [PMID: 36849992 PMCID: PMC9969697 DOI: 10.1186/s40337-023-00749-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 02/06/2023] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND Bodily illusions can be used to investigate the experience of being in a body by manipulating the underlying processes of multisensory integration. Research suggests that people with eating disorders (EDs) may have impairments in visual, interoceptive, proprioceptive, and tactile bodily perception. Furthermore, people with EDs also show abnormalities in integrating multisensory visuo-tactile and visual-auditory signals related to the body, which may contribute to the development of body image disturbances. Visuo-auditory integration abnormalities have been observed also in people with subthreshold ED symptomatology. However, it remains unclear whether these impairments are specific to bodily signals or if they extend to any auditory signals. METHODS We will recruit 50 participants (aged 18-24; females assigned at birth) with ED symptomatology (subthreshold group) and 50 control participants. The Eating Disorder Examination Questionnaire will be administered to screen for ED symptomatology and divide the sample into two groups accordingly (control and subthreshold group using a clinical cut-off score of 2.8). The strength of both illusions will be measured implicitly with estimations of body part position and size, and explicitly with self-report questionnaires. As a secondary aim, regression analysis will be run to test the predictive role of susceptibility for both illusions on interoceptive body awareness (measured by the Multidimensional Assessment of Interoceptive Awareness Scale) and sensory-processing sensitivity (measured by the Highly Sensitive Person Scale). DISCUSSION Our study may contribute to our understanding of the mechanisms underlying body image disturbances. The results may pave the way for novel clinical interventions targeting early symptoms prior to the development of the disorder in young females.
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Affiliation(s)
- Sergio Navas-León
- Department of Psychology, Universidad Loyola Andalucía, Dos Hermanas, Spain
| | | | | | | | | | | | - Ana Tajadura-Jiménez
- UCL Interaction Centre, University College London, London, UK. .,i_mBODY lab, DEI Interactive Systems Group, Department of Computer Science and Engineering, Universidad Carlos III de Madrid, Madrid, Spain.
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92
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Breton É, Juster RP, Booij L. Gender and sex in eating disorders: A narrative review of the current state of knowledge, research gaps, and recommendations. Brain Behav 2023; 13:e2871. [PMID: 36840375 PMCID: PMC10097055 DOI: 10.1002/brb3.2871] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 11/10/2022] [Accepted: 12/08/2022] [Indexed: 02/26/2023] Open
Abstract
INTRODUCTION Eating disorders (EDs) have long been considered conditions exclusively affecting women, and studies in the ED field regularly exclude men. Research efforts are needed to better understand the role of gender and sex in EDs. This review describes the role of gender and sex in the development of EDs from a biopsychosocial perspective. METHODS The primary hypothesis of this narrative review is that gender and sex interact to influence ED risk. The literature review was conducted using the PubMed database. RESULTS This review first presents the general characteristics and prevalence of EDs according to gender and sex. Next, neurodevelopmental processes, neurobiology, gender roles, body image, and the minority stress model are addressed. Lastly, research perspectives to better include gender and sex in the field of EDs are discussed (e.g., representation of gender and sex diversities, development of appropriate assessment tools, and increasing awareness). CONCLUSION Although substantial knowledge gaps remain, there is a growing recognition of the importance of integrating gender and sex in ED research that holds promise for further development in the field.
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Affiliation(s)
- Édith Breton
- CHU Sainte-Justine Research Centre, Montreal, Canada.,Department of Psychiatry and Addictology, University of Montreal, Montreal, Canada
| | - Robert-Paul Juster
- Department of Psychiatry and Addictology, University of Montreal, Montreal, Canada.,Research Centre of the Montreal Mental Health University Institute, Montreal, Canada
| | - Linda Booij
- CHU Sainte-Justine Research Centre, Montreal, Canada.,Department of Psychiatry and Addictology, University of Montreal, Montreal, Canada.,Department of Psychology, Concordia University, Montreal, Canada.,Department of Psychiatry, McGill University, Montreal, Canada
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93
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Parker MN, Lavender JM, Schvey NA, Tanofsky-Kraff M. Practical Considerations for Using the Eating Disorder Examination Interview with Adolescents. Adolesc Health Med Ther 2023; 14:63-85. [PMID: 36860931 PMCID: PMC9969870 DOI: 10.2147/ahmt.s220102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 02/14/2023] [Indexed: 02/24/2023] Open
Abstract
Approximately 35 years after its initial publication, the Eating Disorder Examination (EDE) remains one of the most widely used semi-structured interviews for assessing eating disorder diagnoses and symptomatology. Although the interview provides certain advantages over other common measurement approaches (ie, questionnaires), there are particular considerations regarding the EDE that warrant attention, including in its use with adolescents. The aims of this paper are therefore to: 1) provide a brief overview of the interview itself, as well as a description of its origin and underlying conceptual framework; 2) describe relevant factors for administering the interview with adolescents; 3) review potential limitations regarding use of the EDE with adolescents; 4) address considerations for using the EDE with pertinent subpopulations of adolescents who may experience distinct eating disorder symptoms and/or risk factors; and 5) discuss the integration of self-report questionnaires with the EDE. Advantages of using the EDE include the ability for interviewers to clarify complex concepts and mitigate inattentive responding, enhanced orientation to the interview timeframe to improve recall, increased diagnostic accuracy compared to questionnaires, and accounting for potentially salient external factors (eg, food/eating rules imposed by a parent/guardian). Limitations include more extensive training requirements, greater assessment burden, variable psychometric performance across subgroups, lack of items evaluating muscularity-oriented symptoms and avoidant/restrictive food intake disorder diagnostic criteria, and lack of explicit consideration for salient risk factors other than weight and shape concerns (eg, food insecurity).
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Affiliation(s)
- Megan N Parker
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Jason M Lavender
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
- Military Cardiovascular Outcomes Research (MiCOR) Program, Bethesda, MD, USA
- The Metis Foundation, San Antonio, TX, USA
| | - Natasha A Schvey
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Marian Tanofsky-Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
- Military Cardiovascular Outcomes Research (MiCOR) Program, Bethesda, MD, USA
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94
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Epidemiology of eating disorders: population, prevalence, disease burden and quality of life informing public policy in Australia-a rapid review. J Eat Disord 2023; 11:23. [PMID: 36793104 PMCID: PMC9933292 DOI: 10.1186/s40337-023-00738-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 01/22/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND Understanding of the epidemiology and health burden of eating disorders has progressed significantly in the last 2 decades. It was considered one of seven key areas to inform the Australian Government commissioned National Eating Disorder Research and Translation Strategy 2021-2031, as emerging research had highlighted a rise in eating disorder prevalence and worsening burden-of-illness. The aim of this review was to better understand the global epidemiology and impact of eating disorders to inform policy decision-making. METHODS Using a systematic Rapid Review methodology, ScienceDirect, PubMed and Medline (Ovid) were searched for peer-reviewed studies published between 2009 and 2021. Clear inclusion criteria were developed in consultation with experts in the field. Purposive sampling of literature was conducted, which predominately focused on higher-level evidence (meta-analyses, systematic reviews, and large epidemiological studies), synthesised, and narratively analysed. RESULTS 135 studies were deemed eligible for inclusion in this review (N = 1324). Prevalence estimates varied. Global Lifetime prevalence of any eating disorder ranged from 0.74 to 2.2% in males, and 2.58-8.4% in females. Australian 3-month point-prevalence of broadly defined disorders was around 16% in females. Eating disorders appeared more prevalent in young people and adolescents, particularly females (in Australia: eating disorders ~ 22.2%; disordered eating ~ 25.7%). Limited evidence was found on sex, sexuality and gender diverse (LGBTQI +) individuals, particularly males, who had a six-fold increase in prevalence compared to the general male population, with increased illness impact. Similarly, limited evidence on First Australian's (Aboriginal and Torres Strait Islander) suggests prevalence rates similar to non-Indigenous Australians. No prevalence studies were identified specifically assessing culturally and linguistically diverse populations. Global disease burden of any eating disorder was 43.4 age-standardised disability-adjusted-life-years per 100,000; increasing by 9.4% between 2007 and 2017. Australian's total economic cost was estimated at $84 billion from years-of-life lost due to disability and death, and annual lost earnings ~ $1.646 billion." CONCLUSIONS There is no doubt that eating disorder prevalence and impact are on the rise, particularly in at-risk and understudied populations. Much of the evidence came from female-only samples, and Western, high-income countries which more readily have access to specialised services. Future research should examine more representative samples. There is an urgent need for more refined epidemiological methods to better understand these complex illnesses over time, to guide health policy and development-of-care.
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95
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Field SL, Fox JRE, Jones CRG, Williams MO. "Work WITH us": a Delphi study about improving eating disorder treatment for autistic women with anorexia nervosa. J Eat Disord 2023; 11:17. [PMID: 36759874 PMCID: PMC9909870 DOI: 10.1186/s40337-023-00740-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 01/26/2023] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND There is an increased prevalence of anorexia nervosa (AN) in autistic women and this group has poorer treatment outcomes compared to non-autistic women with AN. However, there is little research into improving eating disorder treatment for autistic women. This study investigated how best to support autistic women with AN within eating disorder services. METHOD A three-stage Delphi study was conducted with 49 participants with relevant expertise as a researcher, clinician, or expert by experience. RESULTS A total of 70 statements were generated, with 56 reaching consensus after the final round. Statements reaching consensus made recommendations for adaptations to treatment, staff training, and service organisation. CONCLUSIONS The results highlight the need to distinguish between autism- and AN-related difficulties, accommodate autistic traits such as sensory sensitivities and communication differences, and ensure the autistic voice is present in both the development and delivery of care. Future research should investigate the impact of these adaptations on outcomes. The applicability of these recommendations to autistic people with other eating disorders and of other genders needs to be investigated further.
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Affiliation(s)
- Sarah L Field
- South Wales Doctoral Programme in Clinical Psychology, Cardiff University, 11Th Floor, Tower Building, 70 Park Place, Cardiff, CF10 3AT, UK
| | - John R E Fox
- South Wales Doctoral Programme in Clinical Psychology, Cardiff University, 11Th Floor, Tower Building, 70 Park Place, Cardiff, CF10 3AT, UK.,Doctorate in Clinical Psychology, University of Liverpool, Liverpool, L69 7ZA, UK
| | - Catherine R G Jones
- Wales Autism Research Centre, School of Psychology, Cardiff University, Cardiff, CF10 3AT, UK
| | - Marc O Williams
- South Wales Doctoral Programme in Clinical Psychology, Cardiff University, 11Th Floor, Tower Building, 70 Park Place, Cardiff, CF10 3AT, UK.
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96
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Linardon J, Greenwood CJ, Macdonald JA, Spry EA, Wertheim EH, Le Grange D, Letcher P, Olsson CA. Eating and Body Image Disturbances in Adolescence and Substance Use Throughout Young Adulthood: Findings from the Australian Temperament Project. Int J Ment Health Addict 2023. [DOI: 10.1007/s11469-023-01023-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Abstract
Abstract We investigated whether eating and body image disturbances in mid-adolescence were associated with substance use in young adulthood. Participants (n = 1566) completed the drive for thinness, bulimic behavior, and body dissatisfaction subscales from the Eating Disorder Inventory during adolescence (15–16 years), and reported frequencies of substance use (tobacco, cannabis, binge drinking, other illicit substances) across young adulthood (19–20, 23–24, and 27–28 years). Adolescent body dissatisfaction was associated with a 10% increase in the rate of binge drinking and tobacco smoking, with effects being of similar magnitude in men and women, and across young adulthood. The association between bulimic behavior and tobacco smoking was strongest in the earlier years of young adulthood (19–20 years). Relationships between cannabis use, bulimic behavior, and body dissatisfaction were evident in men only. Findings highlight important targets for prevention programs, as well as focused monitoring efforts to identify individuals at risk of later substance use.
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97
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Harris EA, Griffiths S. The differential effects of state and trait masculinity and femininity on body satisfaction among sexual minority men. Body Image 2023; 45:34-45. [PMID: 36764237 DOI: 10.1016/j.bodyim.2023.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 01/22/2023] [Accepted: 01/23/2023] [Indexed: 02/11/2023]
Abstract
Masculine men are more likely to idealise being tall, muscular, and lean. Feminine men, on the other hand, are more likely to idealise leanness. At the trait level, masculinity and femininity have been linked with an unhealthy striving for these idealised traits and body dissatisfaction. However, it is unclear how feeling masculine or feminine in the moment might be associated with body satisfaction. Is feeling masculine and/or feminine associated with a boost in body satisfaction? In the first large-scale experience sampling study of masculinity and femininity (nobservations=25,133; Nparticipants=530), we find that state masculinity and femininity, but not trait, are associated with increased body satisfaction among sexual minority men. We also find a gender congruence effect whereby the positive associations between state masculinity/femininity on body satisfaction are more pronounced when these feelings align with trait levels of masculinity/femininity. Exploratory analyses revealed a moderating effect of eating disorder history. The associations between masculinity and femininity on body satisfaction were amplified for people who had been diagnosed with an eating disorder. This study presents the first evidence that the links between masculinity and femininity and body satisfaction can be delineated based on whether they are measured as traits or states.
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Affiliation(s)
- Emily A Harris
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC 3010, Australia.
| | - Scott Griffiths
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC 3010, Australia
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98
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Ganson KT, Hallward L, Cunningham ML, Murray SB, Nagata JM. Anabolic-Androgenic Steroid Use: Patterns of Use among a National Sample of Canadian Adolescents and Young Adults. PERFORMANCE ENHANCEMENT & HEALTH 2023; 11:100241. [PMID: 37841070 PMCID: PMC10571510 DOI: 10.1016/j.peh.2022.100241] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
Background Androgenic-anabolic steroid (AAS) use is relatively common among international recreational and community samples and is associated with several deleterious side effects and health consequences that have not been studied recently among a large Canadian sample. Therefore, the purpose of this study was to assess and describe characteristics of AAS users compared to non-AAS users among a national sample of Canadian adolescents and young adults. Methods Data from 2,774 adolescents and young adults from the Canadian Study of Adolescent Health Behaviors were analyzed. Participants were recruited via social media advertisements and completed the survey online. Survey items measured sociodemographics, AAS use, AAS side effects, motives for AAS use, AAS administration, body satisfaction, other illicit substance use, mental health, and violence involvement. Results Among the overall sample, 1.6% of participants reported lifetime AAS use, with the majority of users being White, heterosexual males. Most users strived to gain weight, with main motives for AAS use including increased muscularity and strength, and improved appearance. Most AAS users were satisfied with their body compared to non-users. Approximately one in five users had AAS dependence and experienced multiple adverse side effects. Few differences between users and non-users in self-reported mental health were found. Conclusion Findings indicate that AAS use among a community sample of Canadian adolescents and young adults is an important health issue, particularly given the relatively high occurrence of AAS dependence and adverse side effects reported by users. Findings support the need for education and intervention efforts from healthcare professionals. Further investigations among Canadian AAS users may provide more insight regarding the unique supports these individuals require.
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Affiliation(s)
- Kyle T. Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Laura Hallward
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
- School of Kinesiology, Western University, London, Ontario, Canada
| | | | - Stuart B. Murray
- Department of Psychiatry and the Behavioral Sciences, University of Southern California, Los Angeles, CA, USA
| | - Jason M. Nagata
- Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
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99
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Sahlan RN, Sala M. Eating disorder psychopathology and resilience in Iranian college students: A network analysis. J Clin Psychol 2023; 79:497-513. [PMID: 35975401 DOI: 10.1002/jclp.23428] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 06/13/2022] [Accepted: 07/26/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Eating disorder (ED) psychopathology is common among Iranian college students. Resilience (i.e., the ability to bounce back and adapt in the face of adverse and stressful conditions) has been found to be a protective factor against ED psychopathology in the West. However, no research to date has examined resilience as a protective factor against ED psychopathology in Iran. The current study used network analysis to examine an ED and resilience network in an Iranian sample. METHOD Participants were Iranian college students (N = 478) who completed the Farsi-Eating Disorder Examination-Questionnaire and Farsi-Brief Resilience Scale. We estimated a network of ED symptoms and resilience processes and identified central and bridge symptoms. RESULTS Central ED and resilience nodes were discomfort in seeing one's own body, feeling guilty about eating due to shape/weight, and thinking about shape and weight making it difficult to concentrate. Having a hard time making it through stressful events bridged with binge eating and fear of losing control over eating. CONCLUSION Processes related to managing stress and binge eating appear to maintain the association between ED symptoms and resilience processes.
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Affiliation(s)
- Reza N Sahlan
- Department of Clinical Psychology, Iran University of Medical Sciences, Tehran, Iran
| | - Margaret Sala
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York, USA
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100
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Talbot D, Mahlberg J, Cunningham ML, Pinkus RT, Szabo M. The Somatomorphic Matrix-Female: More evidence for the validity of bidimensional figural rating scales for women. J Clin Psychol 2023; 79:477-496. [PMID: 36000930 DOI: 10.1002/jclp.23420] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 05/16/2022] [Accepted: 07/10/2022] [Indexed: 01/19/2023]
Abstract
Our study aimed to develop and provide a preliminary psychometric validation of the Somatomorphic Matrix-Female (SM-F), a new bidimensional female figural rating scale which can be used to gauge actual and desired levels of both body fat and muscularity in a consolidated measure, as well as providing an index of actual-desired body discrepancy based on these measures. Across two studies undergraduate women (n Study 1 = 481; n Study 2 = 391) completed the Eating Disorder Examination-Questionnaire, the Body Shape Questionnaire-34, and the Depression Anxiety Stress Scales-21 (Study 1) and the Drive for Thinness Scale and the Drive for Muscularity Scale (Study 2), as well as the SM-F. Overall, the SM-F demonstrated sound content, concurrent, and convergent validity for actual and desired body fat, actual and desired muscularity, and their respective discrepancy scores.
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Affiliation(s)
- Daniel Talbot
- Department of Psychiatry, Westmead Hospital, Sydney, New South Wales, Australia.,Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.,School of Arts and Sciences, The University of Notre Dame, Sydney, New South Wales, Australia
| | - Justin Mahlberg
- School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia.,The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Sydney, New South Wales, Australia
| | | | - Rebecca T Pinkus
- School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
| | - Marianna Szabo
- School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
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