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Bottera AR, Dougherty EN, Todorov S, Wildes JE. Fear of negative evaluation and intolerance of uncertainty: Assessing potential internalizing correlates of eating disorder-related clinical impairment and differences across diagnostic presentations. Eat Behav 2024; 53:101869. [PMID: 38479247 PMCID: PMC11144087 DOI: 10.1016/j.eatbeh.2024.101869] [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: 09/22/2023] [Revised: 03/01/2024] [Accepted: 03/04/2024] [Indexed: 06/03/2024]
Abstract
The Hierarchical Taxonomy of Internalizing Dimensions for Eating Disorders model positions eating disorder (ED) symptoms on an internalizing dimension alongside anxiety and mood symptoms. Symptom dimensions falling under the internalizing subfactors of distress (e.g., social anxiety) and fear/avoidance (e.g., panic, compulsions, checking) may differentially guide treatment. We examined relations between fear of negative evaluation and intolerance of uncertainty (core features of social anxiety and obsessive-compulsive disorder, respectively) and ED-related impairment and potential diagnostic differences. We hypothesized that: (a) fear of negative evaluation and intolerance of uncertainty would be related to ED-related impairment, (b) the relation between fear of negative evaluation and impairment would be strongest among individuals with "binge-eating syndromes" (i.e., bulimia nervosa [BN], binge-eating disorder [BED]), and (c) the relation between intolerance of uncertainty and impairment would be strongest among individuals with "weight-phobic syndromes" (i.e., anorexia nervosa [AN], BN, atypical AN). Participants (N = 236) included children/adolescents and adults evaluated for outpatient ED treatment. Participants completed questionnaires and semi-structured diagnostic interviews. Greater fear of negative evaluation and greater intolerance of uncertainty were related to greater clinical impairment, and the strength of these relations depended on ED diagnosis. Fear of negative evaluation was related to impairment among individuals with AN and atypical AN, and intolerance of uncertainty was related to impairment for individuals with AN, BN, and atypical AN. We identified fear of negative evaluation and intolerance of uncertainty as correlates of clinical impairment, highlighting the potential utility of developing treatments to target these internalizing constructs, especially for individuals with weight-phobic syndromes.
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Affiliation(s)
- Angeline R Bottera
- Department of Psychology, University of Kansas, United States of America
| | - Elizabeth N Dougherty
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, United States of America
| | - Sophia Todorov
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, United States of America
| | - Jennifer E Wildes
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, United States of America.
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2
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Portingale J, Kenny J, Fuller-Tyszkiewicz M, Krug I. Effects of videoconferencing use on momentary changes in disordered eating urges, body dissatisfaction, and mood. EUROPEAN EATING DISORDERS REVIEW 2024; 32:201-214. [PMID: 37805970 DOI: 10.1002/erv.3036] [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: 03/02/2023] [Revised: 09/11/2023] [Accepted: 09/27/2023] [Indexed: 10/10/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic led to a global surge in videoconferencing use for work/study-related reasons. Although these platforms heighten exposure to one's image, the implications of videoconferencing use on body image and eating concerns remain scantly examined. This study sought to investigate, in an Australian sample, whether videoconferencing for work/study-related reasons predicted increases in body dissatisfaction (BD), urge to engage in disordered eating (DE; restrictive eating, exercise, overeating/purging), and negative mood at the state level. Participants (N = 482, 78.8% women, Mage = 20.5 years [SD = 5.3]) completed baseline demographic measures, accompanied by an ecological momentary assessment (EMA) of videoconferencing for work/study-related reasons, BD, DE urges, and negative mood six times a day for 7 days via a smartphone application. Most participants (n = 429; 89.0%) reported state-based videoconferencing use during the EMA phase. Consistent with expectations, state-based videoconferencing use was associated with an increase in state-level urges to engage in exercise. However, contrary to predictions, state-based videoconferencing use was linked to a decrease in state-level BD at the next assessment point and failed to predict negative mood and urges to engage in restrictive eating or overeating/purging at the state level. Given the simplified measure of videoconferencing use, the current research is considered preliminary and future replication and extension, using more nuanced measures, is warranted.
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Affiliation(s)
- Jade Portingale
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jesy Kenny
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Matthew Fuller-Tyszkiewicz
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- Centre for Social and Early Emotional Development, Deakin University, Burwood, Victoria, Australia
| | - Isabel Krug
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
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3
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Pompili S, Bianchi D, Di Tata D, Cannoni E, Di Norcia A, Lonigro A, Longobardi E, Laghi F. Social Anxiety and Drunkorexia Behaviors among Adolescents and Young Adults: The Moderating Role of Resilience. Subst Use Misuse 2024; 59:825-831. [PMID: 38263611 DOI: 10.1080/10826084.2024.2305790] [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: 01/25/2024]
Abstract
Background: Existing evidence showed that social anxiety represents a significant factor in eating disorders. However, to our knowledge, no prior study has examined the association between social anxiety and drunkorexia behaviors. Objectives: The present study aimed at exploring the relationship between social anxiety and drunkorexia behaviors, and investigating resilience as a moderator of this relationship. Participants were 333 adolescents and young adults aged 15-24 years (Mage=18.26, SDage= 1.55; 66% females) who completed an online survey. Results: The results indicated that drunkorexia behaviors were positively correlated to three dimensions of social anxiety; however, only fear of negative evaluation had a significant predictive effect. In addition, resilience only moderated the relationship between fear of negative evaluation and drunkorexia behaviors, such that youths reporting high fear of negative evaluation and low resilience showed greater drunkorexia behaviors, whereas youths reporting high resilience showed no correlation between fear of negative evaluation and drunkorexia behaviors. Conclusions: The findings highlight the importance of drunkorexia interventions and preventive measures aimed at strengthening youths' resilience and ability to effectively manage stress and social anxiety (i.e., fear of negative evaluation).
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Affiliation(s)
- Sara Pompili
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
| | - Dora Bianchi
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
| | - Daniele Di Tata
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
| | - Eleonora Cannoni
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
| | - Anna Di Norcia
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
| | - Antonia Lonigro
- Department of Education Science, University of Rome Tre, Rome, Italy
| | - Emiddia Longobardi
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Fiorenzo Laghi
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
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4
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Lacroix E, Smith AJ, Husain IA, Orth U, von Ranson KM. Normative body image development: A longitudinal meta-analysis of mean-level change. Body Image 2023; 45:238-264. [PMID: 36965235 DOI: 10.1016/j.bodyim.2023.03.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 02/20/2023] [Accepted: 03/08/2023] [Indexed: 03/27/2023]
Abstract
This meta-analysis synthesized longitudinal data on mean-level change in body image, focusing on the constructs of body satisfaction and dissatisfaction, body esteem, perceived attractiveness, valuation, self-objectification, and body shame. We searched five databases and accessed unpublished data to identify studies that assessed body image at two or more time points over six months or longer. Analyses were based on data from 142 samples representing a total of 128,254 participants. The age associated with the midpoint of measurement intervals ranged from 6 to 54 years. Multilevel metaregression models examined standardized yearly mean change, and the potential moderators of body image construct, gender, birth cohort, attrition rate, age, and time lag. Boys and men showed fluctuations in overall body image with net-improvements between ages 10 and 24. Girls and women showed worsening body image between ages 10 and 16, but improvements between ages 16 and 24. Change was greatest between ages 10 and 14, and stabilized around age 24. We found no effect of construct, birth cohort, or attrition rate. Results suggest a need to revise understandings of normative body image development: sensitive periods may occur somewhat earlier than previously believed, and body image may show mean-level improvements during certain age ranges.
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Affiliation(s)
- Emilie Lacroix
- Department of Psychology, University of New Brunswick, 38 Dineen Dr., Fredericton, NB E3B 5A3, Canada.
| | - Alyssa J Smith
- Department of Psychology, University of Calgary, 2500 University Dr. NW, Calgary, AB T2N 1N4, Canada
| | - Incé A Husain
- Department of Psychology, University of New Brunswick, 38 Dineen Dr., Fredericton, NB E3B 5A3, Canada
| | - Ulrich Orth
- Department of Psychology, University of Bern, Fabrikstrasse 8, 3012 Bern, Switzerland
| | - Kristin M von Ranson
- Department of Psychology, University of Calgary, 2500 University Dr. NW, Calgary, AB T2N 1N4, Canada
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5
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Dahill LM, Hay P, Morrison NMV, Touyz S, Mitchison D, Bussey K, Mannan H. Associations between Parents' Body Weight/Shape Comments and Disordered Eating Amongst Adolescents over Time-A Longitudinal Study. Nutrients 2023; 15:1419. [PMID: 36986150 PMCID: PMC10059676 DOI: 10.3390/nu15061419] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/10/2023] [Accepted: 03/13/2023] [Indexed: 03/17/2023] Open
Abstract
Parents are key influencers of adolescents' attitudes on weight, shape, and eating, and make more positive than negative comments, with negative comments most impactful. This study examined prospective unique associations of parental positive and negative comments in a community sample of adolescents with paediatric psychosocial quality of life (PED-QoL), Eating Disorder Weight/Shape Cognitions (EDEQ-WS), BMI percentile, and Psychological Distress (K10) scales. Data were from 2056 adolescents from the EveryBODY study cohort. Multiple regressions were conducted for the impacts of parental positive and negative comments on four dependent variables at one year after controlling for their stage of adolescence (early, middle, late). Multiple imputation and bootstrapping were used for handling missing data and violations of normality. Results indicated that positive maternal comments on eating were associated with increased EDCs and better quality of life at one year. Paternal positive weight shape comments were associated with a decrease in psychological distress, but positive eating comments saw a decrease in quality of life. Findings highlight the nuances of parental comments and how these are perceived and interpreted, and could alert health care workers and family practitioners who have weight, shape, and eating conversations to be aware of the potential influence of their communication.
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Affiliation(s)
- Lucy M. Dahill
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW 2051, Australia; (P.H.); (N.M.V.M.); (D.M.); (H.M.)
| | - Phillipa Hay
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW 2051, Australia; (P.H.); (N.M.V.M.); (D.M.); (H.M.)
- South West Sydney Local Health District, Camden and Campbelltown Hospitals, Campbelltown, NSW 2560, Australia
| | - Natalie M. V. Morrison
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW 2051, Australia; (P.H.); (N.M.V.M.); (D.M.); (H.M.)
| | - Stephen Touyz
- School of Psychology and Inside Out Institute, University of Sydney, Sydney, NSW 2006, Australia;
- Sydney Local Health District, Camperdown, NSW 2050, Australia
| | - Deborah Mitchison
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW 2051, Australia; (P.H.); (N.M.V.M.); (D.M.); (H.M.)
- Centre for Emotional Health, Macquarie University, North Ryde, NSW 2109, Australia;
| | - Kay Bussey
- Centre for Emotional Health, Macquarie University, North Ryde, NSW 2109, Australia;
| | - Haider Mannan
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW 2051, Australia; (P.H.); (N.M.V.M.); (D.M.); (H.M.)
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6
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Clague CA, Prnjak K, Mitchison D. "I don't want them to judge me": Separating out the role of fear of negative evaluation, neuroticism, and low self-esteem in eating disorders. Eat Behav 2023; 49:101708. [PMID: 36868004 DOI: 10.1016/j.eatbeh.2023.101708] [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: 08/20/2022] [Revised: 02/13/2023] [Accepted: 02/13/2023] [Indexed: 02/17/2023]
Abstract
Fear of negative evaluation (FNE) is a transdiagnostic risk factor that has an important role in eating disorder (ED) onset and maintenance, as well as other psychopathologies. However, no research has explored whether FNE has associations with probable ED status when accounting for related vulnerabilities, and whether this relationship changes across gender and weight status. The current study sought out to explore how FNE explains probable ED status above and beyond heightened neuroticism and low self-esteem, with gender and BMI serving as potential moderators of this relationship. Participants were 910 university students (85 % females) aged 18-26 years (Mage = 19.90; SDage = 2.06) living in Australia, who completed measures of psychological distress, personality, self-esteem, FNE, and ED status. Logistic regression analysis showed that FNE was associated with probable ED status. This relationship was stronger among individuals with underweight and healthy-weight, whilst an interaction with gender was not significant. These findings shed light on the unique role FNE has in probable ED status across gender, which appears to be more pronounced in those with a lower BMI. Therefore, FNE should be considered as a potential target in ED screening and early intervention alongside other important transdiagnostic risk factors.
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Affiliation(s)
- Caitlin A Clague
- School of Psychology, Western Sydney University, Sydney, Australia.
| | - Katarina Prnjak
- School of Medicine, Translational Health Research Institute, Western Sydney University, Sydney, Australia
| | - Deborah Mitchison
- School of Medicine, Translational Health Research Institute, Western Sydney University, Sydney, Australia
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7
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van der Cruijsen R, Blankenstein NE, Spaans JP, Peters S, Crone EA. Longitudinal self-concept development in adolescence. Soc Cogn Affect Neurosci 2023; 18:6987492. [PMID: 36639935 PMCID: PMC10036877 DOI: 10.1093/scan/nsac062] [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: 03/02/2022] [Revised: 12/06/2022] [Accepted: 01/13/2023] [Indexed: 01/15/2023] Open
Abstract
This longitudinal behavioral neuroimaging study tested two hypotheses concerning self-concept development in adolescence: domain-specific self-concept and similarity between own (direct) and perceived peers' (reflected) opinions of the self. Participants (N = 189; 10-24 years) evaluated their traits in academic, physical appearance and prosocial domains from direct and reflected perspectives in an functional magnetic resonance imaging session across three time points (TP1: n = 160; TP2: n = 151; TP3: n = 144). Behaviorally, we observed a mid-adolescent dip in self-concept positivity, which was strongest for the academic domain, showing domain differentiation in mid-adolescence. Self-evaluations were associated with activity in, e.g. medial prefrontal cortex (mPFC) and temporal-parietal junction (TPJ). mPFC showed an adolescent-emerging peak in activation, pronounced more for direct than reflected self-evaluations. TPJ activation was generally stronger for reflected self-evaluations, and activation linearly increased with age for both reflected and direct self-evaluations. Longitudinal prediction analyses showed that positivity of self-evaluations predicted increases in self-concept clarity and less fear of negative evaluation 1 and 2 years later, highlighting the developmental benefits of acquiring a positive self-concept. Together, we show that adolescent self-development is characterized by dissociable neural patterns underlying self-evaluations in different domains, and from reflected and direct perspectives, confirming adolescence as a formative phase for developing a coherent and positive self-concept.
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Affiliation(s)
- Renske van der Cruijsen
- Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Burgemeester Oudlaan 50, Rotterdam 3062 PA, The Netherlands
| | - Neeltje E Blankenstein
- Department of Developmental Psychology, Leiden University, Wassenaarseweg 52, Leiden 2333 AK, The Netherlands
- Leiden Institute for Brain and Cognition, Wassenaarseweg 52, Leiden 2333 AK, The Netherlands
| | - Jochem P Spaans
- Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Burgemeester Oudlaan 50, Rotterdam 3062 PA, The Netherlands
| | - Sabine Peters
- Department of Developmental Psychology, Leiden University, Wassenaarseweg 52, Leiden 2333 AK, The Netherlands
- Leiden Institute for Brain and Cognition, Wassenaarseweg 52, Leiden 2333 AK, The Netherlands
| | - Eveline A Crone
- Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Burgemeester Oudlaan 50, Rotterdam 3062 PA, The Netherlands
- Department of Developmental Psychology, Leiden University, Wassenaarseweg 52, Leiden 2333 AK, The Netherlands
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8
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Jabali O, Saeedi M, Rabayaa M, Othman N. Zoom dysmorphia in e-teaching: shifting the value from attributes to appearance. EDUCATION AND INFORMATION TECHNOLOGIES 2022; 28:6781-6799. [PMID: 36465426 PMCID: PMC9684764 DOI: 10.1007/s10639-022-11470-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 10/17/2022] [Accepted: 11/14/2022] [Indexed: 05/25/2023]
Abstract
The current study is motivated by Tory Higgins's self-discrepancy theory and the objectification theory. It aimed to investigate university staff members' perspectives towards zoom dysmorphia while involved in e-teaching during the Covid-19 Pandemic in terms of its popularity, causes, and instructors' experiences with the healing or eliminating mechanisms. Put simply, the researchers meant to identify the impact of the pandemic on body image and the long-term repercussions of e-teaching on instructors' quality. A descriptive online questionnaire was compiled to explore the way (630) university staff members having academic and academic/administrative positions evaluate, perceive, and handle zoom dysmorphia while teaching online. The study results showed several associations between the variables studied. Gender was significant because females proved to have more features of dysmorphia; faculty members who serve in scientific faculties also proved to expect more features of dysmorphia as they tended not to turn on their cameras. The study results also showed that sufferers of zoom dysmorphia warranted that their appearances occasionally made them feel insecure and occupationally unstable. Therefore, they tried different healing mechanisms to eliminate or, at least, reduce its traits. The study concluded that the prevalence of zoom dysmorphia may result in shifting the value from good, effective attributes (e.g., professionalism, adaptability, collaboration, empathy, and patience) of instructors to merely outside physical appearances. The researchers recommend that educators should elicit the presence of zoom dysmorphia at an early stage. They should prepare courses to improve instructors' self-confidence, and provide them with proper technical experience.
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Affiliation(s)
- Oqab Jabali
- Language Center, Faculty of Humanities, An-Najah National University, Nablus, Palestine
| | - Munther Saeedi
- Language Center, Faculty of Humanities, An-Najah National University, Nablus, Palestine
| | - Maha Rabayaa
- Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Nihad Othman
- Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
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9
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Sahlan RN, Keshishian AC, Christian C, Levinson CA. Eating disorder and social anxiety symptoms in Iranian preadolescents: a network analysis. Eat Weight Disord 2022; 27:1855-1867. [PMID: 34787832 DOI: 10.1007/s40519-021-01329-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 10/28/2021] [Indexed: 12/21/2022] Open
Abstract
PURPOSE Network studies of eating disorder (ED) symptoms have identified central and bridge symptoms in Western samples, yet few network models of ED symptoms have been tested in non-Western samples, especially among preadolescents. The current study tested a network model of ED symptoms in Iranian preadolescents (ages 9 to 13), as well as a model of co-occurring social anxiety disorder (SAD) and ED symptoms. METHOD Preadolescent boys (n = 405) and girls (n = 325) completed the Children Eating Attitudes Test-20 and Social Anxiety Scale for Children. We estimated two network models (ED and ED/SAD networks) and identified central and bridge symptoms, as well as tested if these models differed by sex. RESULTS We found that discomfort eating sweets were the most central symptoms in ED networks. Concern over being judged was central in networks including both ED and SAD symptoms. Additionally, concern over being judged was the strongest bridge symptoms. Networks did not differ by sex. CONCLUSION Future research is needed to test if interventions focused on bridge symptoms (i.e., concern over being judged) as primary intervention points target comorbid ED-SAD pathology in preadolescents at risk for ED and SAD. LEVEL OF EVIDENCE Level III; Evidence obtained from well-designed observational study, including case-control design for relevant aspects of the study.
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Affiliation(s)
- Reza N Sahlan
- Department of Clinical Psychology, Iran University of Medical Sciences, Tehran, Iran
| | - Ani C Keshishian
- Department of Psychological and Brain Sciences, University of Louisville, Life Sciences Building, Louisville, KY, 40292, USA
| | - Caroline Christian
- Department of Psychological and Brain Sciences, University of Louisville, Life Sciences Building, Louisville, KY, 40292, USA
| | - Cheri A Levinson
- Department of Psychological and Brain Sciences, University of Louisville, Life Sciences Building, Louisville, KY, 40292, USA.
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10
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Exploring associations between positive and negative valanced parental comments about adolescents' bodies and eating and eating problems: a community study. J Eat Disord 2022; 10:43. [PMID: 35331338 PMCID: PMC8953043 DOI: 10.1186/s40337-022-00561-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 02/27/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adolescence is a time of rapid emotional and physical development when foundational self-concepts (including beliefs about one's weight and shape) are established. Parents are key influencers of adolescent beliefs and behaviours. This study aimed to investigate associations between perceived positive and negative parental comments on weight/shape and eating, with sons' and daughters' psychological distress and eating disorder cognitions (EDCs). METHODS A representative mixed-sex sample of 2204 Australian adolescents (12-19 years) from the EveryBODY Study completed an online survey exploring eating behaviours, psychological wellbeing and experiences of parental comments regarding weight, shape and eating behaviours. RESULTS Correlation analyses revealed that adolescents' reports of perceived positive parental comments on shape/weight were significantly associated with lower psychological distress and EDCs only for daughters. All perceived negative parental comments on shape/weight or eating were associated with greater psychological distress and EDCs for both sons and daughters. In the final model of the regression analysis, only perceived parental negative shape/weight and maternal negative eating comments, adolescent stage and biological sex were significantly associated with EDCs. When known contributors such as BMI percentile and psychological distress were included in the regression model, adolescent stage and perceived negative paternal comments were no longer significantly associated with EDCs. CONCLUSIONS Overall, results show perceived negative comments were associated with poorer adolescent mental health, both their specific EDCs and general distress. Findings highlight the importance of raising awareness of potential negative impacts within family systems of comments around weight/shape and eating in these key formative years. Trial Registration The study was approved by the Macquarie University Human Research Ethics Committee (HREC 5201600312) and the New South Wales Department of Education.
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11
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Barbeau K, Carbonneau N, Pelletier L. Family members and peers' negative and positive body talk: How they relate to adolescent girls' body talk and eating disorder attitudes. Body Image 2022; 40:213-224. [PMID: 35026685 DOI: 10.1016/j.bodyim.2021.12.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 12/14/2021] [Accepted: 12/17/2021] [Indexed: 11/25/2022]
Abstract
Research examining the interpersonal correlates of body talk has primarily focused on the negative consequences of perceiving fat talk on women's own body talk and eating behaviours; however, little is known about the correlates and effects of positive body talk. This study examined the associations between perceived family and peer negative and positive body talk and adolescent girls' body talk and eating disorder attitudes, and the mediating role of adolescents' fear of negative evaluation and self-compassion in these relationships. Influences of family members and peers were compared to examine the uniformity of these interpersonal processes. Adolescent girls (N = 331, M age = 15.7, SD = 1.0) completed a survey. Path analysis models suggested that in the peer and family models, perceived negative body talk was associated with more self-related negative talk through fear of negative evaluation and lower self-compassion, whereas perceived positive body talk was associated with more self-related positive talk through self-compassion. Additionally, adolescents' fear of negative evaluation and self-related negative talk were mediators between perceived negative body talk and eating disorder attitudes. Results suggest that negative and positive body talk are cultivated interpersonally by increasing evaluative concerns and decreasing self-compassion.
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Affiliation(s)
| | - Noémie Carbonneau
- Department of Psychology, Université du Québec à Trois-Rivières, Canada
| | - Luc Pelletier
- Department of Psychology, University of Ottawa, Canada
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12
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Perthes K, Kirschbaum-Lesch I, Legenbauer T, Holtmann M, Hammerle F, Kolar DR. Emotion regulation in adolescents with anorexia and bulimia nervosa: Differential use of adaptive and maladaptive strategies compared to healthy adolescents. Int J Eat Disord 2021; 54:2206-2212. [PMID: 34542185 DOI: 10.1002/eat.23608] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 09/08/2021] [Accepted: 09/09/2021] [Indexed: 01/29/2023]
Abstract
OBJECTIVE Adolescents with anorexia (AN) and bulimia nervosa (BN) often struggle with emotion regulation (ER). These difficulties have predominantly been assessed across emotions, without considering adaptive and maladaptive ER separately. We compared adolescents with AN or BN to healthy adolescents (HCs) regarding the adaptive and maladaptive ER of three emotions. METHOD A treatment-seeking sample of 197 adolescents (atypical/full-threshold AN: N = 118, atypical/full-threshold BN: N = 32; HC: N = 47) reported emotion-specific ER with the FEEL-KJ questionnaire. Mixed models were calculated for adaptive and maladaptive ER to assess differences between emotions (anxiety, anger, and sadness) and groups (AN, BN, and HC). RESULTS Main effects of emotion (p < .001) and group (p < .001) were found, but no interaction effects were found (p > .05). Post hoc tests showed lower maladaptive and higher adaptive ER for anxiety than anger or sadness (p < .001). AN and BN reported lower adaptive (p < .001) and higher maladaptive ER than HCs (p < .001). BN showed the highest levels of maladaptive ER (p = .009). DISCUSSION The differences between AN and BN in adaptive and maladaptive ER should be considered. Furthermore, investigating differences in ER of other emotions in eating disorders might be promising.
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Affiliation(s)
- Karin Perthes
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medicine of the Johannes Gutenberg-University, Mainz, Germany
| | - Inken Kirschbaum-Lesch
- LWL University Hospital Hamm for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatic, Ruhr University Bochum, Hamm, Germany
| | - Tanja Legenbauer
- LWL University Hospital Hamm for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatic, Ruhr University Bochum, Hamm, Germany
| | - Martin Holtmann
- LWL University Hospital Hamm for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatic, Ruhr University Bochum, Hamm, Germany
| | - Florian Hammerle
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medicine of the Johannes Gutenberg-University, Mainz, Germany
| | - David R Kolar
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medicine of the Johannes Gutenberg-University, Mainz, Germany.,Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
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13
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Trompeter N, Bussey K, Forbes MK, Mond J, Hay P, Basten C, Goldstein M, Thornton C, Heruc G, Byrne S, Griffiths S, Lonergan A, Touyz S, Mitchison D. Differences between Australian adolescents with eating disorder symptoms who are in treatment or not in treatment for an eating disorder. Early Interv Psychiatry 2021; 15:882-888. [PMID: 32881352 DOI: 10.1111/eip.13027] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 06/23/2020] [Accepted: 08/02/2020] [Indexed: 01/17/2023]
Abstract
BACKGROUND Mental health problems frequently occur during adolescence, however, few adolescents seek treatment for these problems, especially for eating disorders. The current study aimed to quantify how adolescents in a clinical sample (ie, those receiving treatment for an eating disorder), differ in terms of psychological factors (eating disorder symptoms and psychological distress), compared to adolescents with eating pathology in a community sample (ie, those not receiving treatment). METHOD Data were used from a community sample of adolescents with eating disorder pathology who have not sought treatment (n = 1011) and a clinical sample of adolescents presenting at eating disorder services for treatment (n = 153). Participants reported demographics and completed questionnaires assessing weight/shape concerns, disordered eating and psychological distress. RESULTS Adolescents with a lower BMI, more frequent purging and higher weight/shape concerns were more common in the clinical sample, while those engaging in more frequent driven exercise were less common in the clinical sample. The samples did not differ in severity of psychological distress. CONCLUSIONS The findings highlight the need for increasing mental health literacy about the role of BMI and driven exercise in eating disorder symptom presentation to increase early detection of these disorders among adolescents.
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Affiliation(s)
- Nora Trompeter
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Kay Bussey
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Miriam K Forbes
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Jonathan Mond
- Centre for Rural Health, University of Tasmania, Launceston, Australia.,School of Medicine, Western Sydney University, Sydney, Australia
| | - Phillipa Hay
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia.,Camden and Campbelltown Hospital, SWSLHD, Campbelltown, Australia
| | - Christopher Basten
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Mandy Goldstein
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia.,Mandy Goldstein Psychology, Private Practice, Sydney, Australia
| | - Christopher Thornton
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia.,The Redleaf Practice, Private Practice, Sydney, Australia
| | - Gabriella Heruc
- School of Medicine, Western Sydney University, Sydney, Australia.,Appetite for Change, Private Practice, Sydney, Australia
| | - Susan Byrne
- School of Psychological Sciences, University of Western Australia, Perth, Australia.,The Swan Centre, Private Practice, Perth, Australia
| | - Scott Griffiths
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Alexandra Lonergan
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Stephen Touyz
- School of Psychology and Inside Out Institute, University of Sydney, Sydney, Australia
| | - Deborah Mitchison
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia.,Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
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14
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Diet quality among Indigenous and non-Indigenous children and youth in Canada in 2004 and 2015: a repeated cross-sectional design. Public Health Nutr 2021; 25:123-132. [PMID: 34108071 PMCID: PMC8825962 DOI: 10.1017/s1368980021002561] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The objectives were to describe changes in diet quality between off-reserve Indigenous and non-Indigenous children and youth from 2004 to 2015 and examine the association between food security and diet quality. DESIGN We utilised a repeated cross-sectional design using both the 2004 and 2015 nutrition-focused Canadian Community Health Surveys, including 24-h dietary recall. Diet quality was estimated according to the Healthy Eating Index (HEI). SETTING The surveys were conducted off-reserve in Canada's ten provinces. PARTICIPANTS Our analysis included children and youth 2-17 years old (n 18 189). Indigenous and non-Indigenous participants were matched, and using a general linear model, we tested time period and (non-)Indigenous identifiers, including their interaction effect, as predictors of HEI. RESULTS Both Indigenous and non-Indigenous children and youth had significantly higher HEI scores in 2015 as compared to 2004. There was not a significant (non-)Indigenous and time period interaction effect, indicating the improvements in diet quality in 2015 were similar between both Indigenous and non-Indigenous populations. Improvements in diet quality are largely attributed to reductions in percentage energy from 'other' foods, though a disparity between Indigenous and non-Indigenous children and youth persisted in 2015. Overall, food security was lower among the Indigenous population and positively, and independently, associated with diet quality overall, though this relationship differed between boys and girls. CONCLUSIONS School policies may have contributed to similar improvements in diet quality among Indigenous and non-Indigenous populations. However, an in-depth sex and gender-based analysis of the relationship between food security and diet quality is required.
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15
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Effects of Nutrition, and Physical Activity Habits and Perceptions on Body Mass Index (BMI) in Children Aged 12-15 Years: A Cross-Sectional Study Comparing Boys and Girls. CHILDREN-BASEL 2021; 8:children8040277. [PMID: 33916861 PMCID: PMC8066370 DOI: 10.3390/children8040277] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 03/22/2021] [Accepted: 03/25/2021] [Indexed: 11/16/2022]
Abstract
Background: The aim of the present study was to examine the effects of socioeconomic status, nutrition and physical activity lifestyle habits and perceptions on Body Mass Index (BMI) in children aged 12-15 years in Greece. Furthermore, to compare the difference between the two sexes. Methods: This is a cross-sectional study conducted on a representative secondary school cohort that included 5144 subjects, aged 12 to 15 years. Students and their parents filled in validated questionnaires evaluating socioeconomic status, nutrition and physical activity. International Obesity Task Force cut offs were used to classify the children. Factor analysis of mixed data and partial proportional ordered logistic models were used to analyze ΒMΙ distributions. All analyses were stratified by gender. Results: Boys were 2.9 (95%CI: 2.592-3.328) times more likely to be overweight/obese than girls. Partial proportional ordinal models indicate significant associations between nutritional and physical habits and perceptions variables but also significant gender differences in socio-demographic, nutritional risk factors as well as physical activity habits and perceptions. Conclusions: A clear understanding of the factors that contribute to the sex differences in nutrition and physical activity habits and perceptions may guide intervention efforts.
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16
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Prevalence of Parental Comments on Weight/Shape/Eating amongst Sons and Daughters in an Adolescent Sample. Nutrients 2021; 13:nu13010158. [PMID: 33418994 PMCID: PMC7825281 DOI: 10.3390/nu13010158] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 12/22/2020] [Accepted: 01/04/2021] [Indexed: 02/06/2023] Open
Abstract
Reports suggest that 12–76% of adolescents have experienced parental comments regarding their weight/shape and/or eating behaviours. Parents may engage in conversations about weight/shape and eating out of concern, even without any ill intent; however, the associations of these comments with subsequent problematic psychosocial and eating behaviours are evidenced. Therefore, an in-depth understanding of the content and prevalence of such comments is needed. To date, adolescent-reported prevalence estimates have not included differentiation between mother or father and sons or daughters, nor have they considered eating-focussed comments. This study considered the prevalence of positive and negative parental commentary regarding weight/shape and eating with a focus on parental origin. A total of 2287 Australian male and female adolescents participated via a self-report survey. Adolescents reported frequent positive comments on weight/shape and on eating, most commonly maternal positive comments on weight/shape (78%; 95% CI 77–80). Daughters reported significantly more maternal comments on weight/shape (positive and negative) as well as more negative eating comments from mothers than did sons. Sons reported significantly more negative weight/shape comments from fathers than did daughters. Some negative comments increased significantly with age. These findings support a notable prevalence of reported parental weight/shape and eating comments directed at their offspring, particularly from mothers.
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17
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Levinson CA, Williams BM. Eating disorder fear networks: Identification of central eating disorder fears. Int J Eat Disord 2020; 53:1960-1973. [PMID: 32918319 DOI: 10.1002/eat.23382] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 08/28/2020] [Accepted: 08/28/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Eating-related fear and anxiety are hallmark symptoms of eating disorders (EDs). However, it is still unclear which fears are most important (e.g., food, weight gain), which has practical implications, given treatments for eating-related fear necessitate modifications based on the specific fear driving ED pathology. For example, exposure treatments should be optimized based on specific fears that maintain pathology. The current study (N = 1,622 combined clinical ED and undergraduate sample) begins to answer questions on the precise nature of ED fears and how they operate with other ED symptoms. METHOD We used network analysis to create two models of ED fears and symptoms. The first model consisted of ED fears only (e.g., fears of food, fears of weight gain) to identify which fear is most central. The second model consisted of ED fears and ED symptoms to detect how ED fears operate with ED symptoms. RESULTS We found fear of disliking how one's body feels due to weight gain, disliking eating in social situations, feeling tense around food, fear of judgment due to weight gain, and food anxiety were the most central ED fears. We also identified several bridge symptoms between ED fears and symptoms. Finally, we found that the most central ED fears predicted excessive exercise at two-month follow-up. DISCUSSION These data support the idea that consequences (i.e., judgment) associated with fears of weight gain and interoceptive fears are the most central ED fears. These data have implications for the future development of precision interventions targeted to address ED-related fear.
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Affiliation(s)
- Cheri A Levinson
- Department of Psychological & Brain Sciences, University of Louisville, Louisville, Kentucky, USA
| | - Brenna M Williams
- Department of Psychological & Brain Sciences, University of Louisville, Louisville, Kentucky, USA
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18
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Cooper M, Eddy KT, Thomas JJ, Franko DL, Carron-Arthur B, Keshishian AC, Griffiths KM. Muscle dysmorphia: A systematic and meta-analytic review of the literature to assess diagnostic validity. Int J Eat Disord 2020; 53:1583-1604. [PMID: 32737999 DOI: 10.1002/eat.23349] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 06/26/2020] [Accepted: 06/29/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Although muscle dysmorphia (MD) is a new addition to DSM-5 as a specifier of body dysmorphic disorder (BDD), previous studies have treated MD as a stand-alone diagnosis. We aimed to assess the validity of MD as a stand-alone diagnosis via systematic and meta-analytic review of MD literature using both Robins and Guze criteria and additional criteria from Kendler. METHOD We performed a systematic search of ProQuest, PsycInfo, and PubMed databases for the period of January 1993 to October 2019 resulting in 40 papers to examine Robins and Guze's criteria (clinical picture) as well as those added by Kendler (antecedent validators; concurrent validators; predictive validators). RESULTS We identified two distinct symptomatic presentations of MD using cluster analysis, a behavioral type and cognitive/behavioral type. For examining the concurrent validators, quantitative meta-analyses differentiated MD populations from controls; however, results were inconclusive in delineating MD from existing disorders. For assessing antecedent and predictive validators, the symptomatic profiles, treatment response, and familial links for MD were similar to those for BDD and for eating disorders. DISCUSSION We found preliminary support for MD as a clinically valid presentation, but insufficient evidence to determine whether it is best categorized as a specifier of BDD or unique psychiatric condition.
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Affiliation(s)
- Marita Cooper
- Centre for Mental Health Research, Research School of Population Health, Australian National University, Canberra, Australia
| | - Kamryn T Eddy
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Jennifer J Thomas
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Debra L Franko
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts, USA.,Northeastern University, Boston, Massachusetts, USA
| | - Bradley Carron-Arthur
- Centre for Mental Health Research, Research School of Population Health, Australian National University, Canberra, Australia
| | - Ani C Keshishian
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky, USA
| | - Kathleen M Griffiths
- Research School of Psychology, Australian National University, Canberra, Australia
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19
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Bourne L, Bryant-Waugh R, Cook J, Mandy W. Avoidant/restrictive food intake disorder: A systematic scoping review of the current literature. Psychiatry Res 2020; 288:112961. [PMID: 32283448 DOI: 10.1016/j.psychres.2020.112961] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 03/24/2020] [Accepted: 03/27/2020] [Indexed: 01/16/2023]
Abstract
Avoidant/restrictive food intake disorder (ARFID) was recently introduced to psychiatric nosology to describe a group of patients who have avoidant or restrictive eating behaviours that are not motivated by a body image disturbance or a desire to be thinner. This scoping review aimed to systematically assess the extent and nature of the ARFID literature, to identify gaps in current understanding, and to make recommendations for further study. Following an extensive database search, 291 unique references were identified. When matched against pre-determined eligibility criteria, 78 full-text publications from 14 countries were found to report primary, empirical data relating to ARFID. This literature was synthesised and categorised into five subject areas according to the central area of focus: diagnosis and assessment, clinical characteristics, treatment interventions, clinical outcomes, and prevalence. The current evidence base supports ARFID as a distinct clinical entity, but there is a limited understanding in all areas. Several possible avenues for further study are indicated, with an emphasis placed on first parsing this disorder's heterogeneous presentation. A better understanding of the varied mechanisms which drive food avoidance and/or restriction will inform the development of targeted treatment interventions, refine screening tools and impact clinical outcomes.
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Affiliation(s)
- Laura Bourne
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.
| | - Rachel Bryant-Waugh
- Maudsley Centre for Child and Adolescent Eating Disorders, South London and Maudsley NHS Foundation Trust, London, UK
| | - Julia Cook
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - William Mandy
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
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20
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Lonergan AR, Bussey K, Fardouly J, Griffiths S, Murray SB, Hay P, Mond J, Trompeter N, Mitchison D. Protect me from my selfie: Examining the association between photo-based social media behaviors and self-reported eating disorders in adolescence. Int J Eat Disord 2020; 53:485-496. [PMID: 32259344 DOI: 10.1002/eat.23256] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 02/18/2020] [Accepted: 02/21/2020] [Indexed: 01/27/2023]
Abstract
OBJECTIVE This study examined whether social media behaviors were associated with higher odds of meeting criteria for an eating disorder and whether gender moderated these relationships. METHOD Australian adolescents (N = 4,209; 53.15% girls) completed the self-report photo investment and manipulation scales. Additional self-report items assessed avoidance of posting selfies and investment in others' selfies. Eating disorders were identified by the Eating Disorder Examination Questionnaire and other self-report measures aligned with diagnostic and statistical manual for mental disorders-5 criteria. RESULTS A multinomial logistic regression examining the effect of avoidance of posting selfies, photo investment, photo manipulation, and investment in others' selfies on the likelihood of meeting criteria for an eating disorder, compared to no disorder, was significant (χ2 [42] = 1,128.93, p < .001). Greater avoidance was associated with higher odds of meeting criteria for all disorders except clinical/subclinical binge-eating disorder and purging disorder. Increased photo investment was related to greater odds of meeting criteria for all disorders. A similar relationship emerged for photo manipulation, with the exception of clinical/subclinical binge-eating disorder, and unspecified feeding and eating disorder. Investment in others' selfies was associated with higher odds of meeting criteria for all disorders except clinical/subclinical anorexia nervosa and purging disorder. There was a significant interaction between gender and avoidance (χ2 [1] = 5.23, p = .025, OR = 1.74), whereby boys were more likely to meet criteria for clinical/subclinical anorexia nervosa in the context of greater avoidance of posting selfies. DISCUSSION Appearance-related social media behaviors may be indicative of eating disorder risk. Implications for clinicians and advancements for social media screening tools are discussed.
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Affiliation(s)
- Alexandra R Lonergan
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Kay Bussey
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Jasmine Fardouly
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Scott Griffiths
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Stuart B Murray
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA
| | - Phillipa Hay
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
| | - Jonathan Mond
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia.,Centre for Rural Health, University of Tasmania, Launceston, Australia
| | - Nora Trompeter
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Deborah Mitchison
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia.,Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
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