The role of ethnicity and parental bonding in the eating and weight concerns of Asian-American and Caucasian college women

The mother-daughter Shared Agency in Weight Management Scale (SAWMS): development, validation, and implications for body dissatisfaction

BACKGROUND

Much research suggests that mothers play an important role in shaping daughters' body image, yet less is known about how mother-daughter relationship dynamics in weight management affect daughters' body dissatisfaction. The current paper described the development and validation of the mother-daughter Shared Agency in Weight Management Scale (SAWMS) and examined its associations with daughter's body dissatisfaction.

METHODS

In Study 1 (N = 676 college students), we explored the factor structure of the mother-daughter SAWMS and identified three processes (control, autonomy support, and collaboration) whereby mothers work with daughters in weight management. In Study 2 (N = 439 college students), we finalized the factor structure of the scale by conducting two CFAs and assessing the test-retest reliability of each subscale. In Study 3 (same sample as Study 2), we examined the psychometric properties of the subscales and their associations with daughters' body dissatisfaction.

RESULTS

Combining results from EFA and IRT, we identified three mother-daughter dynamics in weight management-maternal control, maternal autonomy support, and maternal collaboration. However, based on various empirical results indicating poor psychometric properties of the maternal collaboration subscale, we removed it from the mother-daughter SAWMS and only evaluated the psychometric properties of the remaining two subscales (i.e., control and autonomy support). They explained a significant amount of variance in daughters' body dissatisfaction over and above the effect of maternal pressure to be thin. Maternal control was a significant and positive predictor of daughters' body dissatisfaction; maternal autonomy support was a significant and negative predictor.

CONCLUSIONS

Results suggested that maternal control in weight management was associated with daughters' increased body dissatisfaction, whereas maternal autonomy support in weight management was associated with daughters' lower body dissatisfaction. These specific ways in which mother work with daughters in weight management provide nuances in understanding young women's body dissatisfaction. Our SAWMS offers new ways to examine body image among young women through the mother-daughter relationship dynamics in weight management.

Asian students in the anglosphere - unravelling the unique familial pressures contributing to eating pathology: a systematic review

BACKGROUND

There is no clear consensus on the specific familial pressures affecting Asian students in the Anglosphere, despite the validation of the Tripartite Influence model of eating disturbances in this group. However, traditional familial risk factors for disordered eating can be elevated for immigrant Asians with collectivistic-oriented familial dynamics, necessitating an examination of the culture-specific risk profile for eating pathology in student-aged Asians. This systematic review aims to consolidate and critically examine the literature on the most widely studied familial pressures related to disordered eating in Asian students in the Anglosphere.

METHODS

A systematic search was conducted in five databases for peer-reviewed articles measuring familial pressures and eating pathology in Asian students > 10 years old from an Anglosphere country. Following PRISMA guidelines, papers were screened by title, abstract and full text based on the eligibility criteria. Eligible studies were qualitatively analysed and synthesised narratively to assess the relationship between familial pressures and eating pathology.

RESULTS

In total, 14 papers were eligible for inclusion in the review. Eight topics related to familial stressors were identified (1) intergenerational conflict; (2) lack of familial cohesion; (3) parental overprotection; (4) low parental care; (5) familial achievement orientation; (6) parental expectations; (7) parental criticism; and (8) direct parental influence. In multiple studies, intergenerational conflict, maternal overprotection, and familial achievement orientation were significantly elevated and associated with disordered eating in US and UK Asian students, compared to white students. The studies examining parental criticism and familial cohesion had more heterogeneous findings.

CONCLUSION

The findings demonstrate the perception of Asian parenting styles as overprotective and incompatible with individualist-oriented Western values could increase eating pathology in adolescent and university students living in Anglosphere countries. The synthesised findings of the literature also indicate disordered eating acts as a compensatory mechanism for the ongoing psychological distress generated from intergenerational conflict and familial achievement orientation. Conversely, traditional eating disorder literature on familial cohesion and low parental care may not be applicable to young Asians. Future research should focus on how social appearance anxiety and psychological factors can mediate the link between disordered eating and familial stressors in Asian students.

Parental bonds and body dissatisfaction in a clinical sample: The mediating roles of attachment anxiety and media internalization

We evaluated an attachment theory model in which mother and father care were hypothesized to be indirectly related to body dissatisfaction mediated by attachment anxiety and media internalization. Participants were 232 women diagnosed with an eating disorder who completed a retrospective measure of parental bonds, and measures of attachment anxiety, media internalization, and body image. Mother care was negatively associated with body dissatisfaction, suggesting that recollection of mothers as less caring was directly related to poorer body image. Lower father care, was indirectly associated with greater body dissatisfaction mediated by higher attachment anxiety and higher media internalization. That is, women with an eating disorder who recollected fathers as less caring had higher attachment anxiety, which was related to greater internalizing of media-related thin ideals, that in turn was associated with poorer body image. Mothers and fathers may impact body dissatisfaction by differing mechanisms in clinical samples.

Differential impact of upward and downward comparisons on diverse women's disordered eating behaviors and body image

OBJECTIVE

Etiological models of disordered eating are limited in their consideration of racial/ethnic differences in risk factors. Appearance comparisons are consistent predictors of disordered eating outcomes, but research predominantly examines these associations among White women and overlooks the potential differential impact of upward (comparing to someone perceived as better off) versus downward comparisons (comparing to someone perceived as worse off). This study investigated race/ethnicity as a moderator of the associations between upward and downward appearance comparisons and disordered eating outcomes and body satisfaction of young adult women.

METHOD

Measures of upward and downward appearance comparisons, body satisfaction, and disordered eating were administered to 1,014 young adult women. A multiple group (by race/ethnicity) path analysis was estimated using maximum likelihood estimation for each disordered eating and body satisfaction outcome, controlling for age and BMI.

RESULTS

Upward comparisons were associated with higher levels of disordered eating behaviors and lower body satisfaction for women of all racial/ethnic groups. Downward appearance comparisons emerged as detrimental for Hispanic/Latina women, but were protective for Asian and White women.

DISCUSSION

Findings challenge the belief that appearance comparisons impact all women similarly and that downward comparisons are universally protective, a position often promulgated by clinical treatment approaches. © 2015 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:519-523).

Implicit out-group preference is associated with eating disorders symptoms amongst Emirati females

Studies exploring the relationship between acculturation and eating disorders symptoms have proven equivocal. Socially desirable responding associated with the use of explicit measures may account for these mixed findings. This study explores the relationship between in-group identity, acculturation and eating disorders symptoms using both implicit and explicit assessments. Emirati female college students (N=94) completed an affective priming task (APT) designed to implicitly assess Emirati in-group evaluations. Participants also completed explicit measures, including the Westernization Survey and the Multicomponent In-group Identification Scale. Eating disorders symptoms were assessed using the Eating Attitudes Test. Only implicit in-group evaluations were correlated with eating disorders symptoms. Specifically, increases in in-group preference were associated with lower levels of eating disorders symptomatology. Furthermore, participants with an actual out-group preference had significantly higher levels of eating disorders symptomatology compared with those demonstrating an in-group preference. These findings support the acculturative stress hypothesis, and suggest that the relationship between eating disorders and acculturation may be better understood with reference to implicit rather than explicit in-group evaluations.

The impact of spirituality on eating disorder symptomatology in ethnically diverse Canadian women

BACKGROUND

There is currently a gap in our knowledge of how eating disorder symptomatology is impacted by spirituality and religiosity. To date, studies examining the role of ethnicity in women's self-reported levels of eating disorder symptomatology have neglected the roles of spirituality and religiosity.

AIMS

This study addresses this gap in the literature by investigating ethnicity, spirituality, religiosity, body shame, body mass index (BMI) and age in relation to eating disorder symptomatology in women.

METHODS

A representative non-clinical sample of ethnically diverse Canadian women (N = 591) was surveyed.

RESULTS

Younger women, particularly those with higher body shame, BMI and lower spirituality, reported more eating disorder symptomatology. Hispanic and Asian women had higher body shame and lower BMI compared to white women. Spirituality was more strongly related to eating disorder symptomatology than religiosity.

CONCLUSIONS

This is the first study identifying interactive relationships between ethnicity, spirituality, body shame, BMI and age on eating disorder symptomatology in women. Particularly significant is that higher spirituality was related to a lower level of eating disorder symptomatology. These findings have important implications for treatment and women's physical and psychological health and wellness.

Deviating from the norm: body mass index (BMI) differences and psychosocial adjustment among early adolescent girls

OBJECTIVE

To examine whether deviation from one's ethnic group norm on body mass index (BMI) was related to psychosocial maladjustment among early adolescent girls, and whether specific ethnic groups were more vulnerable to maladjustment.

METHODS

Hierarchical regression analyses were conducted on self- and peer-report measures from an ethnically diverse sample of sixth-grade girls (N = 2,636).

RESULTS

African Americans and Latinas had a higher mean BMI than Asians and Whites. As deviation from their ethnic group BMI norm increased, girls reported greater social anxiety, depression, peer victimization, and lower self-worth, and had lower peer-reported social status. Associations were specific to girls deviating toward obesity status. Ethnic differences revealed that Asian girls deviating toward obesity status were particularly vulnerable to internalizing symptoms.

CONCLUSIONS

Emotional maladjustment may be more severe among overweight/obese girls whose ethnic group BMI norm is furthest away from overweight/obesity status. Implications for obesity work with ethnically diverse adolescents were discussed.

Individual and familial correlates of body satisfaction in male and female college students

OBJECTIVE

This study investigates the relative contributions of global self-esteem, body mass index (BMI), dieting behaviors, and perceived parental control and care on body satisfaction among a nonclinical sample of college students.

PARTICIPANTS AND METHODS

Participants (49 males and 299 females) reported weight and height (to calculate BMI) and completed the EAT 26 test. Perceived parental care and control, global self-esteem, and body satisfaction were measured and examined in relation to BMI and dieting behavior.

RESULTS

High BMIs were associated with lower body satisfaction for both genders; dieting behavior, self-esteem, and perceived parental care and control demonstrated a unique gender-specific association among variables in prediction of body satisfaction and dieting behavior for each gender.

CONCLUSIONS

Body satisfaction as a part of global self-esteem is constructed differently by males and females. Various aspects of parenting (care and control) are associated with self-esteem and body satisfaction for each gender, influencing dieting behavior.

Informing family approaches to eating disorder prevention: perspectives of those who have been there

OBJECTIVE

The study explored how aspects of the family environment may relate to the onset of eating disorders.

METHOD

Semi-structured interviews were conducted with 27 individuals currently receiving treatment for eating disorders. Data were analyzed using principles of content analysis.

RESULTS

Eight themes emerged regarding recommendations for families to prevent the onset of eating disorders: (1) Enhance parental support; (2) Decrease weight and body talk; (3) Provide a supportive home food environment; (4) Model healthy eating habits and physical activity patterns; (5) Help your children build self-esteem beyond looks and physical appearance; (6) Encourage appropriate expression of feelings and use of coping mechanisms; (7) Increase your understanding of eating disorder signs and symptoms; and (8) Gain support in dealing appropriately with your own struggles.

DISCUSSION

Our results can be utilized to generate new theoretical insights as to how parents can raise children with healthy weight-related attitudes and behaviors.

A comparison of ethnic groups in the treatment of bulimia nervosa

This exploratory study investigated whether White and ethnic minority bulimic participants differ on key features of eating psychopathology and treatment outcome. Data from a randomized controlled multi-site study comparing the efficacy of either cognitive-behavioral therapy (CBT) or interpersonal therapy (IPT) for 219 women with bulimia nervosa were analyzed. A significant baseline ethnic difference for body mass index (BMI) (p<.001) was found as well as an ethnicity by center interaction for a prior history of depression (p<.05). In addition, there was a significant ethnic difference for the Weight Concerns subscale of the Eating Disorder Examination (EDE). However, once BMI was controlled, this difference did not retain significance. At post-treatment, while all ethnic groups responded with higher abstinence rates to CBT than IPT, an ethnicity by treatment effect was found for the reduction of objective binge eating episodes. Black participants, compared to other groups, showed greater reductions in binge eating episodes when treated with IPT than CBT. Other findings related to secondary outcome measures, though limited by small sample size, are discussed as providing directions for future research.

A comparative study of body image of Australian and Pakistani young females

This research compares Australian and Pakistani females on body image attitudes. The sample consisted of Caucasian-Australian and Pakistani first year university students, ranging in age from 17 to 22. The Pakistani sample was subdivided into two groups: Urdu-medium and English-medium, representing the middle and upper social classes, respectively. The results revealed that, although all the groups identified a similar body shape as the 'ideal', the Australian females expressed significantly higher levels of body dissatisfaction on all measures of body image than did the Pakistani females. Within the Pakistani sample, females from the English-medium institutions expressed greater weight concern than did the Urdu-medium females. The findings are discussed in terms of the possible role of cultural values in shaping the body image attitudes of young females.

Acculturation and eating disorders in Asian and Caucasian Australian university students

This study aimed to compare the attitudes and psychopathology of eating disorders of Asian and Caucasian university students using a survey method. The study also investigated the relationship between acculturation, attitudes and psychopathology of eating disorders in sub-groups of Asian girls. There were 130 Asian and 110 Caucasian adolescent girls, aged 18-24 who were screened using the Eating Attitudes Test (EAT-26), the Eating Disorders Inventory (EDI-2) and an Acculturation Index. The Asian group did not have higher mean EAT score than the Caucasian group, but had higher mean score in some sub-scales of the EDI-2. Eating disordered attitudes and psychopathology was not significantly different in the low compared to the high accultured Asian girls. This study suggests that Asian and Caucasian university students in Western Australia are equally susceptible to eating disorders, and that the level of acculturation does not modify the susceptibility of Asian students for eating disorders.

Asian American college women's body image: A pilot study

The purpose of this study was to examine the effects of values acculturation and the influence of media on Asian American college women's overall body image. A sample of 59 Asian American women from two large universities completed self-report surveys, which included questions regarding values acculturation, media internalization, and overall body satisfaction. Results showed that Asian American women who identified more strongly with traditional Asian values reported higher levels of body image dissatisfaction. Further, Asian American women who reported higher internalization of media portrayals of beauty ideals reported higher body image dissatisfaction. Research and clinical recommendations are made to enhance psychologists' understanding of Asian American women's body image and acculturation.

Ethnicity and body dissatisfaction among women in the United States: A meta-analysis

The prevailing view in popular culture and the psychological literature is that White women have greater body dissatisfaction than women of color. In this meta-analysis, 6 main effect sizes were obtained for differences among Asian American, Black, Hispanic, and White women with a sample of 98 studies, yielding 222 effect sizes. The average d for the White-Black comparison was 0.29, indicating that White women are more dissatisfied, but the difference is small. All other comparisons were smaller, and many were close to zero. The findings directly challenge the belief that there are large differences in dissatisfaction between White and all non-White women and suggest that body dissatisfaction may not be the golden girl problem promoted in the literature. Implications for theory and treatment are discussed.

Eating disorders in Asian populations: a critique of current approaches to the study of culture, ethnicity, and eating disorders

There is increasing evidence that eating disorders are present among ethnically diverse populations, and researchers have suggested that investigations in this area may inform the field's understanding of how sociocultural factors are related to the development of eating disorders. Although it is generally accepted that sociocultural factors are key in eating disorder etiology, knowledge on how best to study these influences in diverse groups is still limited. In this article, the authors review how the research literature has explored relationships among culture, ethnicity, and eating disorders in Asian populations and critically examine strategies that have been used to investigate these issues across 1 ethnic/racial group. The methodological challenges encountered in these approaches are identified and considered in the provision of recommendations for future endeavors to improve the field's understanding of how culture is related to eating disorders.

The development of eating pathology in Chinese-Australian women: acculturation versus culture clash

OBJECTIVE

Recent research suggests there has been an increase in the incidence of eating pathology among Asian women residing in the West. Two alternate explanations for the development of this eating pathology have been proposed; acculturation versus culture clash. The current study was designed to further examine the influence of acculturation versus culture clash on the development of eating pathology in Chinese-Australian women.

METHOD

Eighty-one Chinese-Australian women completed a questionnaire investigating their level of eating pathology, perceived sociocultural influences to lose weight, parental overprotection and care, self-perceptions of physical appearance, sociability and global self-worth, and the strength of their ethnic identity.

RESULTS

It was found that, overall, low levels of satisfaction with physical appearance, high levels of parental overprotection, and high levels of perceived pressure from best female friends to lose weight predicted greater eating pathology in both acculturated and traditional women. However, acculturated women who perceived higher levels of pressure from their fathers and best male friends to lose weight and traditional women who experienced higher levels of parental care reported the greatest eating pathology.

DISCUSSION

The findings suggest that there are both similarities and differences between the risk factors that correlate with eating pathology between acculturated and traditional women.

Parental bonding: a key factor for mental health of college women

The purpose of this study was to investigate the relationship of parental bonding to the mental health of college women aged 18 to 24 years. A cross-sectional study of a volunteer sample of 246 college women was conducted. Data on depressive symptoms, negative thinking, self-esteem, and parental bonding were collected via self-report. Maternal care was the strongest predictor of all four mental health indices. Paternal overprotection predicted scores of three of the four mental health measures. Women with optimal maternal and paternal bonding profiles (high care/low overprotection) had fewer depressive symptoms, less negative thinking, and higher self-esteem than women with other bonding profiles. The findings have implications for prevention, screening, and intervention to enhance the mental health of college women.

Culture and the development of eating disorders: a tripartite model

Eating disorders are often conceptualized as"culture-bound problems;"however, the processes by which culture contributes to eating disorders have yet to be elucidated by researchers. This manuscript moves beyond research's current emphasis on evaluating the prevalence rates of eating disorders among ethnic groups, and presents a tripartite model to aid in understanding how cultural processes influence eating disorders. Cultural influences on the development of eating behaviors, body image ideals, and conceptions of health and illness are discussed. It is hoped that the ideas presented will be used to direct efforts to further develop models of the relations between culture and eating disorders and will be considered in the development of programs seeking to aid in the prevention and treatment of maladaptive eating patterns.

Physical health vulnerability in adult children from divorced and intact families

OBJECTIVES

The current study evaluated family process variables associated with markers of physical health vulnerability.

METHODS

Retrospective reports of parental caring, conflict, and divorce-specific factors were examined in reference to hostility, somatic symptoms, and illness reports in young adults from divorced (n=253) and intact (n=552) families.

RESULTS

Contrary to expectations, participants from divorced and intact families were equivalent on all health-related measures. Within the intact group, parental conflict and low parental caring were associated with hostility, somatic symptoms, and illness reports. Within the divorce group, negative feelings about the divorce were associated with higher hostility, somatic complaints, and illness reports.

CONCLUSIONS

Results suggest that parental divorce in itself does not increase long-term vulnerability to physical illness; rather it is the negativity of the experience that is associated with vulnerability. Although overall health markers did not differ, the family process variables associated with physical health risk differed for individuals from divorced versus intact families.

Some features of mothers of patients with eating disorders

The aim of this study was to compare some of the characteristics of 50 mothers of patients with an eating disorder (ED) with those of a control group of 30 mothers of non-consulting adolescents. In comparison with the control group, the patients' mothers had higher scores for the bulimic factor of the Eating Attitudes Test-26, more frequent binge eating episodes, more eating disorder symptoms, more depression episodes, a higher incidence of bottle-fed daughters, provoked abortions and poor mother-daughter relationships with their own mothers. We recommend one-to-one diagnostic interviews with patients' mothers at the beginning of consultations.

Causes of eating disorders

Anorexia nervosa and bulimia nervosa have emerged as the predominant eating disorders. We review the recent research evidence pertaining to the development of these disorders, including sociocultural factors (e.g., media and peer influences), family factors (e.g., enmeshment and criticism), negative affect, low self-esteem, and body dissatisfaction. Also reviewed are cognitive and biological aspects of eating disorders. Some contributory factors appear to be necessary for the appearance of eating disorders, but none is sufficient. Eating disorders may represent a way of coping with problems of identity and personal control.

Body-image attitudes and psychosocial functioning in Euro-American and Asian-American college women

Euro-American (n = 94) and Asian-American (n = 72) college women were compared on multiple dimensions of body image, including global body satisfaction, preoccupation with appearance, satisfaction with individual body parts or features, and weight concern, and psychosocial functioning, including self-esteem, public self-consciousness, social anxiety, and public body consciousness. Both groups reported similar scores on these variables and showed similar patterns of correlations between body-image and psychosocial variables. Despite similar global body satisfaction, there were group differences in satisfaction with individual body parts or features, with Asian-American women reporting lower satisfaction with six parts or features and higher satisfaction with one feature. Stepwise multiple regression analyses predicting global body satisfaction from individual body parts or features suggested that both the specific body parts or features most salient to global body satisfaction and the relative influence of these parts or features varied as a function of ethnicity. Implications of these findings for research and practice are discussed.

The positive influence of maternal identification on body image, eating attitudes, and self-esteem of Hispanic and Anglo girls

OBJECTIVE

The role of maternal identification in the development of girls' body image, eating attitudes, and self-esteem was examined.

METHOD

Hispanic and Anglo girls (n = 410) ages 8-13 were surveyed using the Body Esteem Scale (BES), the Children's Eating Attitudes Test, the Piers-Harris Children's Self-Concept Scale, and the Child Figure Drawing task. From this sample, normal-weight girls with high or low scores on the BES were selected for the main study. Ninety-two mother-daughter pairs participated in this second phase in which mothers completed similar questionnaires and girls performed a Q-sort task measuring maternal identification.

RESULTS

Maternal identification was positively correlated with girls' self-esteem and negatively correlated with eating problems and body dissatisfaction. Also, mothers with high self-esteem tended to have daughters with high self-esteem. The mothers of girls with low BES scores found a significantly greater discrepancy than the mothers of girls with high BES scores when contrasting their daughters' current shape with either the ideal figure for their daughter or the figure they believed boys would find attractive.

DISCUSSION

Girls who aspired to be like their mothers in terms of personality traits felt better about themselves and their bodies compared with girls with low maternal identification.

Ethnic differences in eating disorder symptoms among college students: the confounding role of body mass index

Eating disorders are among the most common psychopathologies on college campuses. Research on ethnic differences in eating disorder symptoms and prevalence has resulted in conflicting conclusions. Some studies find that particular ethnic groups have a higher prevalence of a symptom; others find that members of that ethnic group have a lower prevalence of the same symptom. The authors explored the role of body mass index (BMI), one potential confound. They used a reliable measure of eating disorder symptoms to assess differences between Hispanic, Asian, and non-Hispanic White college women from two separate samples. After controlling for BMI, ethnic differences in eating disorder symptoms of concern about weight and shape disappeared, but differences in restrained eating remained. Inconsistent findings in the ethnic-difference literature on eating disorders may result from systematic group differences in BMI. Implications for college health programs, counseling, and case finding are discussed.

Cross-Cultural Research on Anorexia Nervosa: Assumptions Regarding the Role of Body Weight

OBJECTIVE

To critically examine two assumptions guiding cross-cultural research on the weight concerns of anorexia nervosa: (1) that weight concerns are specific to contemporary, Western manifestations of the disorder and (2) that the dissemination of Western values regarding thinness is primarily responsible for the development of anorexia nervosa in non-Western contexts.

METHOD

A review of theoretical and empirical literature on cross-cultural aspects of anorexia nervosa and the medical records of 14 Asian patients treated for eating disorders in Sydney, Australia.

RESULTS AND DISCUSSION

Regarding the first assumption: It is argued that weight concerns when defined as weight loss that is positively valued (rather than a fat phobia) is a defining characteristic of anorexia nervosa and is not limited to contemporary, Western cases of the disorder. Regarding the second assumption: It is argued that the occurrence of anorexia nervosa in non-Western contexts cannot be solely attributed to the acceptance of Western thinness ideals because values and practices intrinsic to non-Western cultures are also likely to be etiologically relevant.