Two-three-year stability and interrelations of bulimotypic indicators and depressive and anxious symptoms in middle-aged women

Role of self-esteem in the association between mindset of socioeconomic status and well-being: A cross-lagged panel analysis

People who believe that their socioeconomic status (SES) can be changed-with growth mindset or incremental implicit theory of SES-tend to have better psychological well-being. Nevertheless, it remains unclear on why growth mindset of SES benefits well-being. The present research aims to answer this question by investigating the longitudinal associations between mindset of SES and well-being (i.e. depression and anxiety) and a potential mechanism (i.e. self-esteem). We recruited 600 adults in Guangzhou, China, as participants in this study. Participants completed a list of questionnaires containing measures of mindset of SES, self-esteem, depression, and anxiety at three time points over the course of 18 months. The cross-lagged panel model showed that individuals holding a growth mindset of SES reported significantly lower depression and anxiety 1 year later, but the effect was not sustained later. More importantly, self-esteem accounted for the associations of mindset of SES with both depression and anxiety, such that individuals with growth mindset of SES had higher self-esteem, and in turn, demonstrated lower depression and anxiety over 18 months. These findings deepen the understanding of the salutary effects of implicit theories of SES on psychological well-being. Implications for future research and mindset-related interventions are discussed.

Longitudinal relations of self-criticism with disordered eating behaviors and nonsuicidal self-injury

OBJECTIVE

Self-criticism has been proposed as a transdiagnostic predictor of disordered eating and nonsuicidal self-injury (NSSI). First, this study explored cross-sectional associations of multiple disordered eating behaviors, NSSI, and self-criticism. Second, it tested longitudinal relations of self-criticism with disordered eating and NSSI, adjusting for baseline levels of both behaviors.

METHODS

In Sub-study 1, undergraduates (N = 251, 79.5% female, M_age = 19.1 years) completed self-report measures of disordered eating, NSSI, and self-criticism at baseline and after 8 weeks. In Sub-study 2, community-based young adults with histories of disordered eating, NSSI, or both (N = 517, 88.8% female, M_age = 24.7 years) completed measures of disordered eating, NSSI, and self-criticism at baseline and after 4 weeks. All measures were completed online.

RESULTS

In Sub-study 1, both disordered eating and NSSI showed significant cross-sectional associations with self-criticism, and self-criticism was significantly related to binge eating, fasting, and NSSI at follow-up. In Sub-study 2, both behaviors again showed significant cross-sectional associations with self-criticism. Self-criticism showed significant longitudinal relations with fasting, purging, and excessive exercise. Longitudinal relations of self-criticism with NSSI varied across disordered eating behaviors.

DISCUSSION

NSSI showed cross-sectional associations with a range of disordered eating behaviors. Self-criticism reflects a common correlate of both disordered eating and NSSI. Evidence supported transdiagnostic longitudinal impact of self-criticism across multiple forms of disordered eating but provided more limited support for impacts on NSSI.

Longitudinal Bi-directional Effects of Disordered Eating, Depression and Anxiety

OBJECTIVE

The present study aims to explore the potentially longitudinal bi-directional effects of disordered eating (DE) symptoms with depression and anxiety.

METHOD

Participants were 189 (49.5% male) adolescents from Melbourne, Australia. DE, depressive and anxiety symptoms were assessed at approximately 15, 16.5 and 18.5 years of age.

RESULTS

Analysis of longitudinal bi-directional effects assessed via cross-lagged models indicated that DE symptoms of eating and shape/weight concerns were risk factors for anxiety. Results also showed that depression was a risk factor for eating concerns.

CONCLUSION

Our findings provide preliminary evidence that preventative measures designed to target concerns about eating and shape/weight might be most efficacious in reducing the transmission of effects between symptoms of DE, depression and anxiety. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

A systematic review and meta-analysis on the longitudinal relationship between eating pathology and depression

OBJECTIVE

Undertake a meta-analysis to provide a quantitative synthesis of longitudinal studies that assessed the direction of effects between eating pathology and depression. A second aim was to use meta-regression to account for heterogeneity in terms of study-level effect modifiers.

METHOD

A systematic review was conducted on 42 studies that assessed the longitudinal relationship between eating pathology and depression. Of these 42 studies, multilevel random-effects meta-analyses were conducted on 30 eligible studies.

RESULTS

Meta-analysis results showed that eating pathology was a risk factor for depression (rm  = 0.13) and that depression was a risk factor for eating pathology (rm  = 0.16). Meta-regression analyses showed that these effects were significantly stronger for studies that operationalized eating pathology as an eating disorder diagnosis versus eating pathology symptoms, and for studies that operationalized the respective outcome measure as a categorical variable (e.g., a diagnosis of a disorder or where symptoms were "present"/"absent") versus a continuous measure. Results also showed that in relation to eating pathology type, the effect of an eating disorder diagnosis and bulimic symptoms on depression was significantly stronger for younger participants.

DISCUSSION

Eating pathology and depression are concurrent risk factors for each other, suggesting that future research would benefit from identifying factors that are etiological to the development of both constructs.

RESUMEN OBJETIVO

Llevar a cabo un meta-análisis para proporcionar una síntesis cuantitativa de los estudios longitudinales que evaluaron la dirección de los efectos entre la alimentación patológica y la depresión. Un segundo objetivo fue utilizar la meta-regresión para dar cuenta de la heterogeneidad en términos de modificadores del efecto a nivel de estudio. MÉTODO: Una revisión sistemática se llevó a cabo en 42 estudios que evaluaron la relación longitudinal entre la alimentación patológica y la depresión. De estos 42 estudios, se realizaron meta-análisis de multinivel de efectos aleatorios en 30 estudios elegibles.

RESULTADOS

Los resultados del meta-análisis mostraron que la alimentación patológica era un factor de riesgo para depresión (rm=0.13) y que la depresión era un factor de riesgo para la alimentación patológica (rm=0.16). Los análisis de meta-regresión mostraron que estos efectos eran significativamente más fuertes para estudios que operacionalizaban la alimentación patológica como un diagnóstico de trastorno de la conducta alimentaria versus síntomas de alimentación patológica, y para los estudios que operacionalizaban la medida respectiva de resultado como una variable categórica (e.g., un diagnóstico de trastorno o cuando los síntomas estaban "presentes"/"ausentes") versus una medida continua. Los resultados mostraron que en relación al tipo de alimentación patológica, el efecto de un diagnóstico de trastorno de la conducta alimentaria y síntomas bulímicos en la depresión era significativamente más fuerte para participantes más jóvenes. DISCUSIÓN: La alimentación patológica y la depresión son factores de riesgo concurrentes uno para el otro, lo que sugiere que la investigación futura se beneficiaría de identificar factores que son etiológicos al desarrollo de ambos constructos. © 2015 Wiley Periodicals, Inc. (Int J Eat Disord 2016;49:439-454).

Reciprocal associations between depressive symptoms and disordered eating among adolescent girls and boys: a multiwave, prospective study

Symptoms of depression and eating disorders increase during adolescence, particularly among girls, and they tend to co-occur. Despite this evidence, there is meager research on whether depression increases the risk of future eating pathology, or vice versa, and we do not know whether these processes are different for adolescent girls and boys. Accordingly, this study explored the prospective reciprocal associations between depressive symptoms and disordered eating at different time points from preadolescence to mid-adolescence and tested the moderator effect of gender on these associations. A community-based sample of Spanish youth (N = 942, 49 % female) was assessed at ages of approximately 10-11 (T1), 12-13 (T2), 14-15 (T3), and 16-17 (T4) years. The bidirectional relationships between depressive symptoms and disordered eating were estimated in an autoregressive cross-lagged model with latent variables. A unidirectional, age-specific association between depressive symptoms at T1 and disordered eating at T2 was found. No other significant cross-lagged effect emerged, but the stability of the constructs was considerable. Gender did not moderate any of the links examined. Regardless of gender, the transition from childhood to adolescence appears to be a key period when depressive symptoms foster the development of disordered eating. These findings suggest that early prevention and treatment of depression targeting both girls and boys may result in lower levels of depressive symptoms and disordered eating in adolescence.

Relationship between depressive mood and eating disorders in a non-clinical young female sample: a one-year longitudinal analysis of cross-lagged and simultaneous effects

Although it is generally agreed that eating disorders (EDs) and depressive mood (DM) are related, the main ambiguity arises from difficulties in determining their cause-effect relationships. The aim of this study was to examine the longitudinal reciprocal causation between EDs and DM among female students. Several models (cross-lagged effects and simultaneous effects) were tested in order to disentangle the prospective relationships between DM (measured by the Beck Depression Inventory-Short Form) and EDs (measured by the Eating Attitudes Test-26) using structural equation modeling with latent variables on one-year longitudinal data. A total of 567 female students were interviewed at the beginning of the first university year (T1); 373 of them were re-interviewed 6 months later (T2), and 359 were re-interviewed after a further 6 months (T3). The results support (1) the prospective reciprocal effects model and (2) the simultaneous reciprocal effects model. The implications of the findings in terms of theoretical improvements and effective treatments are discussed.

Restrained eating and self-esteem in premenopausal and postmenopausal women

BACKGROUND

There has been limited research about disordered eating in middle-aged women, and to date, few data exist about restrained eating behavior in postmenopausal women. Therefore, the aim of this study was to examine eating behavior with a specific focus on menopause as an associated factor in restrained eating. Beyond this, we were interested in how postmenopausal status and self-esteem would interact to determine eating patterns in women in middle age.

METHODS

We conducted an online survey in women aged between 40 and 66. Eating behavior was assessed with the Eating Disorder Examination-Questionnaire (EDE-Q) in premenopausal (N = 318) and postmenopausal women (N = 250). All participants rated their self-esteem using the Rosenberg Self-Esteem Scale (RSE) and reported their weight, height, waist circumference, and hip circumference.

RESULTS

15.7% of all participants showed clinically meaningful scores on restrained eating. Postmenopausal women showed significantly higher scores on the EDE-Q subscale of restrained eating as compared to premenopausal women, but when controlling for body mass index, however, this finding was no longer significant. Further exploratory analyses suggest that particularly low or high self-esteem levels are associated with restrained eating. Self-esteem might serve as a mediator between menopausal status and restrained eating, however results of these additional analyses were inconsistent.

CONCLUSIONS

Restrained eating may appear in middle-aged women. Particularly in postmenopausal women, restrained eating might be associated with lower and higher self-esteem.

Disordered Eating and Psychological Distress among Adults

The majority of our knowledge about eating disorders derives from adolescent and young adult samples; knowledge regarding disordered eating in middle and later adulthood is limited. We examined the associations among known predictors of eating disorders for younger adults in an age-diverse sample and within the context of psychological distress. Using data from 567 adults (ages 18 to 88 years), we tested a path model in which age, gender, eating-related cognitions, and satisfaction with appearance predicted eating disorders which, in turn, predicted psychological distress. The model fit the data well (χ2 (DF= 11, N = 567) = 30.58, p < .001; GFI = .987, NFI = .963; RMSEA = .056), explaining 20.1% of the variance in psychological distress.

Media Exposure, Body Dissatisfaction, and Disordered Eating in Middle-aged Women

The primary aim of our study was to examine the influence of media exposure on body dissatisfaction and disordered eating in middle-aged women. A sample of 101 women, aged between 35 and 55 years, completed questionnaire measures of media exposure, thin-ideal internalization, social comparison, appearance investment, aging anxiety, body dissatisfaction, and disordered eating. Television, but not magazine exposure, was positively related to body dissatisfaction and disordered eating. In contrast, both television and magazine exposure were positive correlates of all four proposed media-processing variables (internalization, social comparison, appearance investment, and aging anxiety), which were themselves positive correlates of both body dissatisfaction and disordered eating. Structural equation modelling revealed that the influence of media exposure was fully mediated by the proposed media processes. The analyses also indicated that our proposed sociocultural model of disordered eating provided a reasonably good fit to the data, suggesting that sociocultural theory can be extended to women of middle-age. An important practical implication of this finding is that strategies aimed at challenging and minimizing these media processes may reduce some of the negative impact of media exposure in middle-aged women.

Factors associated with body dissatisfaction and disordered eating in women in midlife

OBJECTIVE

In this study, we examined developmentally appropriate factors that may be associated with body dissatisfaction and disordered eating in women in midlife.

METHOD

Participants were a community sample of 200 women aged 35-65. Outcome measures were the weight concern, shape concern, eating concern, and restraint subscales of the Eating Disorder Examination-Questionnaire (EDE-Q). Independent variables were importance of appearance, importance of function, cognitive reappraisal (of aging changes to appearance), and body-related self-care.

RESULTS

Importance of appearance, self-care, and body mass index (BMI) accounted for variance in regression modeling for all EDE-Q variables. In addition, cognitive reappraisal was related to shape concern and restraint, and importance of function and age were also associated with restraint. Participants identified as probable eating disorder cases had significantly higher BMI, importance of appearance and function, and significantly lower cognitive reappraisal and self-care scores than participants identified as noncases.

DISCUSSION

This study provides support for the role of developmentally relevant factors in body dissatisfaction and disordered eating in midlife women.

Depression and eating pathology: prospective reciprocal relations in adolescents

The association between disordered eating and depression has been established, but less is known about the temporal relations between these two disturbances. Accordingly, the current study examined the reciprocal relations between depressive and bulimic symptoms over an 8-year period, with longitudinal data from a community sample of 496 female adolescents. Depressive symptoms predicted future increases in bulimic symptoms, and bulimic symptoms likewise predicted increases in depressive symptoms, controlling for earlier levels of symptoms for each outcome. These results provide evidence consistent with the hypothesis that the two disorders contribute reciprocally to each other, and indicate that successful prevention or treatment of one disorder may yield effects for the other. However, the relatively small predictive effect sizes imply that some third variable may contribute to both conditions (e.g., temperamental negative affectivity).

Comparison of middle-age and young women inpatients with eating disorders

The aim of the study was to compare clinical presentations of eating disorders (ED) in midlife vs. younger inpatients. The sample consisted of 604 inpatients, 302 admitted to treatment at the age of 40 or older, and 302 admitted between ages 18-25, a more common ED age. Results suggested several unique features of midlife vs. younger ED inpatients: significantly more diagnoses of anorexia nervosa, both subtypes, and fewer diagnoses of bulimia nervosa; greater ED severity but fewer body image issues and less body image distortion; greater emotional and behavioral overcontrol and symptom denial; more bipolar and major depressive disorders, suicidality, and sexual abuse histories; a trend toward greater misuse of calming/sedating substances; and fewer maturation issues. The corresponding needs among midlife ED patients for specialized assessment and treatment interventions are considered.

The co-morbidity of eating disorders and anxiety disorders: a review

OBJECTIVE

To critically review the literature examining the co-morbidity between eating disorders and anxiety disorders.

METHOD

A review of the literature on the co-morbidity between anorexia nervosa, bulimia nervosa and eating disorders not otherwise specified and the anxiety disorders of OCD, PTSD, social anxiety, GAD, panic and agoraphobia.

RESULTS

Of the empirical studies undertaken, it is clear that anxiety disorders are significantly more frequent in subjects with eating disorders than the general community. Researchers have shown that often anxiety disorders pre-date eating disorders, leading to a suggestion that early onset anxiety may predispose individuals to developing an eating disorder. To date however, the research presents strikingly inconsistent findings, thus complicating our understanding of eating disorder and anxiety co-morbidity. Furthermore, despite indications that eating disorder prevalence amongst individuals presenting for anxiety treatment may be high, there is a distinct lack of research in this area.

DISCUSSION

This review critically examines the available research to date on the co-morbidity of eating disorders and anxiety disorders. Some of the methodological limitations of previous research are presented, in order to highlight the issues which warrant further scientific investigation in this area.