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Wall PL, Fassnacht DB, Fabry E, O'Shea AE, Houlihan C, Mulgrew K, Ali K. Understanding stigma in the context of help-seeking for eating disorders. J Eat Disord 2024; 12:126. [PMID: 39223635 PMCID: PMC11367835 DOI: 10.1186/s40337-024-01086-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Accepted: 08/13/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND Stigma is a complex construct and its association with help-seeking among those experiencing eating disorders is not well understood. Rates of help-seeking are low for those with eating disorder symptoms and, therefore, determining the role of stigma and shame in this relationship is needed to help inform effective awareness campaigns aimed at improving prognostic outcomes. The current study examined the associations between perceived stigma, self-stigma, shame, and help-seeking behaviour in a community sample of individuals with elevated eating disorder symptoms. METHODS Participants completed an online survey that included measures of stigma and shame as perceived barriers to help-seeking for individuals with eating disorders. Those with elevated eating disorder symptoms and high clinical impairment were included in the study (N = 333). RESULTS Using binary logistic regression models controlling for age and gender, results showed that perceived stigma, self-stigma, and shame predicted 64% of help-seeking behaviour (p = .005). The only significant unique predictor of formal help-seeking was "Being concerned that other people believe eating disorders are not real illnesses". No other stigma or shame items were found to significantly predict help-seeking. CONCLUSIONS The present findings suggest that while stigma plays an important role in help-seeking, it might not be the primary reason preventing individuals with eating disorders from accessing care. The field is encouraged to investigate these factors to promote help-seeking effectively.
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Affiliation(s)
- Prudence L Wall
- School of Health, University of the Sunshine Coast, Sippy Downs, Australia
| | - Daniel B Fassnacht
- School of Health, University of the Sunshine Coast, Sippy Downs, Australia
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia
| | - Esme Fabry
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia
| | - Anne E O'Shea
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia
| | - Catherine Houlihan
- School of Health, University of the Sunshine Coast, Sippy Downs, Australia
| | - Kate Mulgrew
- School of Health, University of the Sunshine Coast, Sippy Downs, Australia
| | - Kathina Ali
- School of Health, University of the Sunshine Coast, Sippy Downs, Australia.
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia.
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2
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Sharma AK, Jain K, Mulchandani K, Sorte SR, Rathod SB, Vij V, Gumashta J. Navigating the challenges: exploring the association between COVID-19 lockdowns and eating behavior in university students: a systematic review and investigation of factors impacting ed levels. Horm Mol Biol Clin Investig 2024; 0:hmbci-2023-0049. [PMID: 39138656 DOI: 10.1515/hmbci-2023-0049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 07/09/2024] [Indexed: 08/15/2024]
Abstract
INTRODUCTION The COVID-19 pandemic has significantly impacted the mental and physical well-being of individuals globally, with university students being particularly susceptible to mental health issues. Factors such as the transition to adulthood, economic hardships, and academic responsibilities, compounded by pandemic-related disruptions like lockdowns and remote learning, have elevated stress levels and altered daily routines. The pandemic has given rise to post-traumatic stress symptoms in certain individuals, including university students which may contribute to the emergence of emotional eating or adopting unhealthy eating patterns as a coping mechanism, leading to excessive consumption or unhealthy dietary choices. This review aims to investigate the influence of COVID-19 restrictions on eating disorders among university students and identifying the contributing factors. CONTENT Out of 59 identified articles, 10 met the inclusion criteria, involving 23,542 participants (70.2 % women, 29.35 % men, 0.42 % gender fluid/undisclosed). The lockdown led to increased prevalence and severity of eating disorders among university students, particularly in women. SUMMARY The review highlights a notable increase in eating disorders among university students during the COVID-19 pandemic. Mental health issues, reduced physical activity, and economic stress were significant contributors to this trend, with women being disproportionately affected. OUTLOOK To mitigate the impact of future pandemics or similar disruptions, universities should implement early screening, provide mental health counseling, virtual support groups, nutritional guidance, and opportunities for physical activity. Encouraging students to seek professional help is crucial for managing mental health and eating habits in such scenarios.
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Affiliation(s)
| | | | | | - Smita R Sorte
- Department of Physiology, AIIMS, Nagpur, Maharashtra, India
| | | | - Vinu Vij
- Department of Physiology, AIIMS, Nagpur, Maharashtra, India
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3
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Zhou Y, Pellizzer M, Keegan E, Wade TD. Factor Structure and Psychometric Properties of the ED-15 in People With an Eating Disorder. Int J Eat Disord 2024. [PMID: 39132900 DOI: 10.1002/eat.24271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Revised: 07/14/2024] [Accepted: 07/15/2024] [Indexed: 08/13/2024]
Abstract
OBJECTIVE This study examines the factorial structure and psychometric properties of the Eating Disorder-15 questionnaire (ED-15) in a large clinical sample, as well as the instrument's sensitivity to early clinical change in therapy and ability to measure remission. METHOD Participants with eating disorders (N = 278) referred to the Flinders University Services for Eating Disorders in South Australia completed the ED-15 as well as other measures of eating disorder symptoms and co-occurring psychopathology, including depression, anxiety, and stress. RESULTS Confirmatory factor analysis (CFA) revealed a two-factor model for the ED-15. The ED-15 had good internal consistency. It showed satisfactory concurrent validity with moderate correlations with the EDE-Q global score and contribution of unique variance to that score. Correlations indicated good convergent validity with clinical impairment and good divergent validity from depression, anxiety, and stress. The ED-15 showed a significant medium effect size change within the first four sessions of therapy. Good discriminant validity was indicated by cut-off scores used for remission, with significantly different levels of ED psychopathology and other impairments between the two groups. DISCUSSION This study adds to the four previous psychometric studies of the ED-15, confirming robustness of the English version in a clinical sample. The brevity and psychometric robustness of the ED-15 makes it a preferable measure to the Eating Disorder Examination for sessional assessment of progress in treatment.
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Affiliation(s)
- Yuan Zhou
- Flinders University Institute of Mental Health and Wellbeing, Adelaide, South Australia, Australia
| | - Mia Pellizzer
- Flinders University Institute of Mental Health and Wellbeing, Adelaide, South Australia, Australia
| | - Ella Keegan
- Flinders University Institute of Mental Health and Wellbeing, Adelaide, South Australia, Australia
| | - Tracey D Wade
- Flinders University Institute of Mental Health and Wellbeing, Adelaide, South Australia, Australia
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4
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Fabry E, Fassnacht DB, Ford R, Burns NR, O'Shea AE, Ali K. The role of self-reliance and denial in the help-seeking process for eating disorders among university students. EUROPEAN EATING DISORDERS REVIEW 2024; 32:450-457. [PMID: 38078569 DOI: 10.1002/erv.3052] [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: 08/23/2023] [Revised: 10/30/2023] [Accepted: 11/13/2023] [Indexed: 04/05/2024]
Abstract
OBJECTIVE This study investigated how self-reliance and denial influence the relationship between help-seeking attitudes and behaviour. METHOD Australian university students (N = 406) completed an online survey and females with elevated eating disorder (ED) concerns and high impairment were included in the study (N = 137). Participants completed measures of help-seeking attitudes, perceived barriers, and actual help-seeking behaviour. Via moderated logistic regression, we examined self-reliance and denial as perceived barriers to help-seeking. RESULTS Of the total sample, over 33.7% of university students reported substantial ED concerns and impairment of whom 65.0% believed they needed help. While a majority reported that help-seeking would be useful (85.4%), only a minority of participants had sought professional help for their concerns (38.7%). Self-reliance and denial were frequently endorsed barriers and moderated the relationship between help-seeking attitudes and behaviours. CONCLUSION ED concerns are common among university students and perceived barriers play a moderating role between attitudes and help-seeking. Future prevention and early intervention programs should address students' denial, while the importance of reaching out for professional help (rather than relying on themselves) could be highlighted with peer support.
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Affiliation(s)
- Esme Fabry
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia
| | - Daniel B Fassnacht
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia
- School of Health, University of the Sunshine Coast, Sippy Downs, Australia
| | - Rachael Ford
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia
| | | | - Anne E O'Shea
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia
| | - Kathina Ali
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia
- School of Health, University of the Sunshine Coast, Sippy Downs, Australia
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5
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Quiñones IC, Selkie E, Mammel KA, Haedt-Matt A, Klump KL, Burt SA, Van Huysse JL. Disordered eating in transgender and gender non-conforming youth: A comparison to community-based and clinical samples. EUROPEAN EATING DISORDERS REVIEW 2024; 32:338-349. [PMID: 37905947 DOI: 10.1002/erv.3045] [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: 07/14/2023] [Revised: 10/03/2023] [Accepted: 10/16/2023] [Indexed: 11/02/2023]
Abstract
OBJECTIVE This study investigates eating pathology in transgender and gender non-conforming (TGNC) youth compared to a community-based sample and individuals with eating disorders (EDs). METHOD Participants (ages 13-21 years) included TGNC youth from a paediatric gender clinic (N = 97), a demographically matched community-based sample of cisgender males (N = 97) and cisgender females (N = 97), and treatment-seeking patients with EDs (N = 112). The Eating Disorder Examination Questionnaire (EDE-Q) was used to assess ED cognitions and behaviours. RESULTS Transgender and gender non-conforming participants reported significantly higher EDE-Q global scores compared to the cisgender samples, but significantly lower than the ED sample. Transgender and gender non-conforming individuals reported a higher likelihood of objective binge episodes (OBEs) than the cisgender groups, albeit lower than youth with EDs. A substantial proportion of TGNC participants scored in elevated ranges on the EDE-Q global score (35% ≥ score of 3, 17% ≥ score of 4), significantly higher than cisgender males (0% ≥ score of 3, 0% ≥ score of 4) and females (9% ≥ score of 3, 3% ≥ score of 4). CONCLUSIONS Findings indicate that TGNC youth exhibit increased ED cognitions and OBEs compared to cisgender samples, highlighting the need for screening and addressing ED symptoms in this population.
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Affiliation(s)
- Isabel C Quiñones
- Department of Psychology, Illinois Institute of Technology, Chicago, Illinois, USA
| | - Ellen Selkie
- University of Wisconsin, Madison, Wisconsin, USA
| | - Kathleen A Mammel
- Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA
| | - Alissa Haedt-Matt
- Department of Psychology, Illinois Institute of Technology, Chicago, Illinois, USA
| | - Kelly L Klump
- Department of Psychology, Michigan State University, East Lansing, Michigan, USA
| | - S Alexandra Burt
- Department of Psychology, Michigan State University, East Lansing, Michigan, USA
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6
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Fischer-Grote L, Fössing V, Aigner M, Fehrmann E, Boeckle M. Effectiveness of Online and Remote Interventions for Mental Health in Children, Adolescents, and Young Adults After the Onset of the COVID-19 Pandemic: Systematic Review and Meta-Analysis. JMIR Ment Health 2024; 11:e46637. [PMID: 38315524 PMCID: PMC10877489 DOI: 10.2196/46637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 09/21/2023] [Accepted: 10/21/2023] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND The prevalence of mental illness increased in children, adolescents, and young adults during the COVID-19 pandemic, while at the same time, access to treatment facilities has been restricted, resulting in a need for the quick implementation of remote or online interventions. OBJECTIVE This study aimed to give an overview of randomized controlled studies examining remote or online interventions for mental health in children, adolescents, and young adults and to explore the overall effectiveness of these interventions regarding different symptoms. METHODS A systematic literature search was conducted according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines using PubMed, PsycInfo, Psyndex, Embase, and Google Scholar. A meta-analysis was conducted using a random effects model to calculate overall effect sizes for interventions using standardized mean differences (SMDs) for postintervention scores. RESULTS We identified 17 articles with 8732 participants in the final sample, and 13 were included in the quantitative analysis. The studies examined different digital interventions for several outcomes, showing better outcomes than the control in some studies. Meta-analyses revealed significant medium overall effects for anxiety (SMD=0.44, 95% CI 0.20 to 0.67) and social functioning (SMD=0.42, 95% CI -0.68 to -0.17) and a large significant effect for depression (SMD=1.31, 95% CI 0.34 to 2.95). In contrast, no significant overall treatment effects for well-being, psychological distress, disordered eating, and COVID-19-related symptoms were found. CONCLUSIONS The qualitative and quantitative analyses of the included studies show promising results regarding the effectiveness of online interventions, especially for symptoms of anxiety and depression and for training of social functioning. However, the effectiveness needs to be further investigated for other groups of symptoms in the future. All in all, more research with high-quality studies is required.
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Affiliation(s)
- Linda Fischer-Grote
- Department of Psychology and Psychodynamics, Karl Landsteiner University of Health Sciences, Krems, Austria
- Department of Clinical Psychology and Psychotherapy, University Hospital Krems, Krems, Austria
| | - Vera Fössing
- Research Centre Transitional Psychiatry, Karl Landsteiner University of Health Sciences, Krems, Austria
| | - Martin Aigner
- Department of Psychology and Psychodynamics, Karl Landsteiner University of Health Sciences, Krems, Austria
- Department of Psychiatry for Adults, University Hospital Tulln, Tulln, Austria
| | - Elisabeth Fehrmann
- Department of Psychology and Psychodynamics, Karl Landsteiner University of Health Sciences, Krems, Austria
| | - Markus Boeckle
- Research Centre Transitional Psychiatry, Karl Landsteiner University of Health Sciences, Krems, Austria
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7
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Bertollo AG, Braga GDC, Tonin PT, Luzardo AR, Bagatini MD, Ignácio ZM. The Impact of Stress from Social Isolation during the COVID-19 Pandemic on Psychiatric Disorders: An Analysis from the Scientific Literature. Brain Sci 2023; 13:1414. [PMID: 37891783 PMCID: PMC10605406 DOI: 10.3390/brainsci13101414] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/01/2023] [Accepted: 10/02/2023] [Indexed: 10/29/2023] Open
Abstract
The COVID-19 pandemic generated, in addition to severe symptoms, hospitalizations and deaths worldwide, as well as stress from the fear of the disease and social uncertainties, from restriction measures and social isolation. Stress from social isolation impacts mental health, aggravating existing conditions and triggering neuropsychiatric symptoms in individuals with biopsychosocial vulnerability. During and immediately after the period of social restriction imposed by the pandemic, the scientific community carried out several research protocols. These revealed results that relevantly demonstrate the harmful effect of the stress induced by the pandemic situation. This narrative review reports and discusses research results demonstrating impairments in psychiatric disorders such as autism spectrum disorder, dementia, eating disorders, schizophrenia, anxiety, and depression. In this sense, the community has identified a significant negative influence of social isolation on the mental health of individuals through the modification of individual routines and the absence of social interactions. Moreover, the community identified perceived differences related to the impacts on men and women. In addition to studies showing the effect of social isolation on disorders, an evaluation of protocols with some possible therapeutic intervention strategies during times of social restriction was developed.
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Affiliation(s)
- Amanda Gollo Bertollo
- Laboratory of Physiology Pharmacology and Psychopathology, Graduate Program in Biomedical Sciences, Federal University of Fronteira Sul, Chapecó 89815-899, SC, Brazil;
| | - Geórgia de Carvalho Braga
- Cell Culture Laboratory, Graduate Program in Biomedical Sciences, Federal University of Fronteira Sul, Chapecó 89815-899, SC, Brazil; (G.d.C.B.); (M.D.B.)
| | | | - Adriana Remião Luzardo
- Research Laboratory in Health Management, Innovation and Technologies, Graduate Program in Nursing, Federal University of Fronteira Sul, Chapecó 89815-899, SC, Brazil;
| | - Margarete Dulce Bagatini
- Cell Culture Laboratory, Graduate Program in Biomedical Sciences, Federal University of Fronteira Sul, Chapecó 89815-899, SC, Brazil; (G.d.C.B.); (M.D.B.)
| | - Zuleide Maria Ignácio
- Laboratory of Physiology Pharmacology and Psychopathology, Graduate Program in Biomedical Sciences, Federal University of Fronteira Sul, Chapecó 89815-899, SC, Brazil;
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8
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Bonfanti RC, Sideli L, Teti A, Musetti A, Cella S, Barberis N, Borsarini B, Fortunato L, Sechi C, Micali N, Lo Coco G. The Impact of the First and Second Wave of the COVID-19 Pandemic on Eating Symptoms and Dysfunctional Eating Behaviours in the General Population: A Systematic Review and Meta-Analysis. Nutrients 2023; 15:3607. [PMID: 37630798 PMCID: PMC10458761 DOI: 10.3390/nu15163607] [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: 07/26/2023] [Revised: 08/11/2023] [Accepted: 08/15/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND The aim of this systematic review and meta-analysis was to examine the prevalence of feeding and eating disorder (FED) symptoms or dysfunctional eating behaviours (DEB) in the general population during the COVID-19 outbreak. METHOD We searched eligible articles in biomedical databases from 1 January 2020 to 31 March 2022. Prevalence rates of FED or DEB changes between pre-pandemic and pandemic time and correlation with psychological distress were pooled with a meta-analysis using a random-effects model. Heterogeneity was tested using I-squared (I2) statistics. A total of 186 studies with 406,076 participants met the inclusion criteria. RESULTS The more prevalent FED or DEB during the COVID-19 outbreak were: body image concerns (52%, 95% CI 0.38, 0.66), binge eating (40%, 95% CI 0.25, 0.55), and overeating (40%, 95% CI = 0.32-0.48). Pooled data of longitudinal studies (k = 8) only showed a significant difference in the prevalence of weight gain from pre-pandemic to the pandemic time. Finally, increased levels of psychological distress (k = 35) positively correlated with some ED symptoms. CONCLUSION This meta-analysis evidenced a negative impact of the pandemic on eating symptoms and DEB in the general population.
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Affiliation(s)
| | - Lucia Sideli
- Department of Human Science, LUMSA University, 00193 Rome, Italy;
| | - Arianna Teti
- Department of Psychology, Educational Science and Human Movement, University of Palermo, 90128 Palermo, Italy; (A.T.); (L.F.); (G.L.C.)
| | - Alessandro Musetti
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, 43121 Parma, Italy
| | - Stefania Cella
- Observatory on Eating Disorders, Department of Psychology, University of Campania “Luigi Vanvitelli”, 81100 Caserta, Italy;
| | - Nadia Barberis
- Department of Health Sciences, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy;
| | - Bianca Borsarini
- Mental Health Services in the Capital Region of Denmark, Eating Disorders Research Unit, Psychiatric Centre Ballerup, 2750 Ballerup, Denmark; (B.B.); (N.M.)
| | - Lucia Fortunato
- Department of Psychology, Educational Science and Human Movement, University of Palermo, 90128 Palermo, Italy; (A.T.); (L.F.); (G.L.C.)
| | - Cristina Sechi
- Department of Pedagogy, Psychology, Philosophy, University of Cagliari, 09123 Cagliari, Italy;
| | - Nadia Micali
- Mental Health Services in the Capital Region of Denmark, Eating Disorders Research Unit, Psychiatric Centre Ballerup, 2750 Ballerup, Denmark; (B.B.); (N.M.)
| | - Gianluca Lo Coco
- Department of Psychology, Educational Science and Human Movement, University of Palermo, 90128 Palermo, Italy; (A.T.); (L.F.); (G.L.C.)
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9
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Monthuy-Blanc J, Corno G, Abou Chabake S. Exploring the impact of the COVID-19 pandemic on perceptual disturbances and dysfunctional eating attitudes and behaviors: A review of the literature. Front Psychol 2023; 14:1139261. [PMID: 37008865 PMCID: PMC10050699 DOI: 10.3389/fpsyg.2023.1139261] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 02/27/2023] [Indexed: 03/17/2023] Open
Abstract
From the outbreak of the novel coronavirus 2019 (COVID-19) a new physical and social distancing environment has changed our lives and, more particularly, the way of perceiving oneself, as well as eating attitudes and behaviors. An increasing number of studies have highlighted a risky scenario in terms of negative perceptions of one’s body as well as disordered eating and eating disorder patterns in both clinical and general population. With regard to this postulate, this literature review posits two main concepts—perceptual disturbances and dysfunctional eating attitudes and behaviors—in the general and (sub-)clinical populations, to provide an understanding of these phenomena during the COVID-19 pandemic. The main objective of this article is to provide a comprehensive and critical review of published scientific literature about perceptual disturbances (i.e., negative body image, body image disturbances, low body esteem) and dysfunctional eating attitudes and behaviors, including disordered eating (e.g., restrictive eating, binge-eating episodes, overeating, emotional eating) and eating disorders features in community (i.e., general population) and clinical and sub-clinical samples worldwide during the COVID-19 pandemic. The PubMed, ScienceDirect, Ebsco, and Google Scholar databases were searched. The initial search produced 42 references. Scientific publications from March 2020 to April 2022 were included, and among the works compiled, only published research articles have been retained. Purely theoretical papers were also excluded. The final selection consisted of 21 studies, covering both community, clinical (i.e., eating disorder population), and sub-clinical samples. The details of the results are discussed taking into consideration the potential impact of changes in the way we perceive ourselves and interact with others (e.g., the popularity of videoconferencing and the over-use of social network sites due to social isolation) as well as changes in eating attitudes and behaviors, physical activity and exercise (e.g., as an emotional response to the insecurity generated by the pandemic context), in community and (sub-)clinical samples. The discussion sheds light on two outcomes: (1) a summary of findings with methodological considerations; (2) an intervention continuum to deal with the consequences of the COVID-19 pandemic; (3) and a final conclusion.
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Affiliation(s)
- Johana Monthuy-Blanc
- Loricorps Research Unit, Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada
- Department of Sciences of Education, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
- *Correspondence: Johana Monthuy-Blanc,
| | - Giulia Corno
- Loricorps Research Unit, Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada
- Department of Psychology and Psychoeducation, Laboratory of Cyberpsychology, Université du Québec en Outaouais, Gatineau, QC, Canada
| | - Sara Abou Chabake
- Loricorps Research Unit, Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada
- Department of Psychology, LESPOIR Research Laboratory, Université de Montréal, Montréal, QC, Canada
- Department of Psychology, TRAJETS Research Laboratory, Université de Montréal, Montréal, QC, Canada
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10
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Allen KL, Mountford VA, Elwyn R, Flynn M, Fursland A, Obeid N, Partida G, Richards K, Schmidt U, Serpell L, Silverstein S, Wade T. A framework for conceptualising early intervention for eating disorders. EUROPEAN EATING DISORDERS REVIEW 2023; 31:320-334. [PMID: 36426567 PMCID: PMC10100476 DOI: 10.1002/erv.2959] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 09/27/2022] [Accepted: 11/10/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE This paper outlines the evidence base for early intervention for eating disorders; provides a global overview of how early intervention for eating disorders is provided in different regions and settings; and proposes policy, service, clinician and research recommendations to progress early intervention for eating disorders. METHOD AND RESULTS Currently, access to eating disorder treatment often takes many years or does not occur at all. This is despite neurobiological, clinical and socioeconomic evidence showing that early intervention may improve outcomes and facilitate full sustained recovery from an eating disorder. There is also considerable variation worldwide in how eating disorder care is provided, with marked inequalities in treatment provision. Despite these barriers, there are existing evidence-based approaches to early intervention for eating disorders and progress is being made in scaling these. CONCLUSIONS We propose action steps for the field that will transform eating disorder service provision and facilitate early detection, treatment and recovery for everyone affected by eating disorders, regardless of age, socioeconomic status and personal characteristics.
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Affiliation(s)
- Karina L Allen
- Eating Disorders Outpatients Service, Maudsley Hospital, South London and Maudsley NHS Foundation Trust, London, UK.,Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Victoria A Mountford
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,LightHouse Arabia, Dubai, United Arab Emirates
| | - Rosiel Elwyn
- Thompson Institute, University of the Sunshine Coast, Gubbi Gubbi Country, Queensland, Australia
| | - Michaela Flynn
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | - Nicole Obeid
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Georgina Partida
- Eating Disorders Outpatients Service, Maudsley Hospital, South London and Maudsley NHS Foundation Trust, London, UK
| | - Katie Richards
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Ulrike Schmidt
- Eating Disorders Outpatients Service, Maudsley Hospital, South London and Maudsley NHS Foundation Trust, London, UK.,Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Lucy Serpell
- Department of Clinical, Educational and Health Psychology, University College London, London, UK.,Eating Disorder Service, North East London NHS Foundation Trust, Essex, UK
| | | | - Tracey Wade
- Flinders Institute for Mental Health and Wellbeing, Flinders University, Adelaide, South Australia, Australia
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11
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Radunz M, Ali K, Wade TD. Pathways to improve early intervention for eating disorders: Findings from a systematic review and meta-analysis. Int J Eat Disord 2023; 56:314-330. [PMID: 36346008 DOI: 10.1002/eat.23845] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 10/11/2022] [Accepted: 10/16/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Treatment-seeking rates among eating disorder (ED) populations are relatively low, with only one in four individuals seeking help. Previous research has identified many factors that might be associated with help-seeking in EDs, but to date no review has investigated the quantitative association between these factors and actual help-seeking behavior. The aim of the current review was to synthesize the relevant quantitative literature on factors (i.e., perceived barriers, characteristics associated with treatment seeking, demographic variables) associated with help-seeking using meta-analytic strategies, as well as provide recommendations on future early intervention research strategies to promote early help-seeking. METHOD Overall, 19 studies were included, identifying 141 perceived barriers (e.g., stigma) or individual characteristics (e.g., BMI, duration of illness) and 56 demographic variables (e.g., ethnicity), which were synthesized into 24 unique variables. RESULTS Less help-seeking was predicted by higher levels of denial and less perceived ability of others to provide help. DISCUSSION Given the small number of studies these results should be considered preliminary. Future studies should consider barriers to help-seeking when creating early intervention approaches. To improve help-seeking rates we suggest the use of targeted psychoeducational materials and co-design with people with lived experience when developing new strategies. PUBLIC SIGNIFICANCE The present study addresses a significant gap in the literature by synthesizing factors associated with help-seeking, with the aim of informing early intervention strategies to promote early help-seeking in eating disorder populations. Denial of illness and perceived inability of others to provide help were associated with lower help-seeking. Future studies should consider barriers to help-seeking and co-design with people with lived experience when creating new early intervention strategies.
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Affiliation(s)
- Marcela Radunz
- Flinders University, Adelaide, South Australia, Australia.,Blackbird Initiative, Flinders Institute for Mental Health and Wellbeing, Adelaide, South Australia, Australia
| | - Kathina Ali
- Flinders University, Adelaide, South Australia, Australia.,Blackbird Initiative, Flinders Institute for Mental Health and Wellbeing, Adelaide, South Australia, Australia
| | - Tracey D Wade
- Flinders University, Adelaide, South Australia, Australia.,Blackbird Initiative, Flinders Institute for Mental Health and Wellbeing, Adelaide, South Australia, Australia
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12
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Palermo M, Rancourt D. Investigating engagement in maladaptive and adaptive exercise behaviors before and during COVID-19. Eat Weight Disord 2022; 27:2685-2691. [PMID: 35596838 PMCID: PMC9123289 DOI: 10.1007/s40519-022-01413-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 04/30/2022] [Indexed: 11/29/2022] Open
Abstract
PURPOSE Evidence suggests that the coronavirus (COVID-19) pandemic has resulted in increased mental health concerns (e.g., anxiety) and there is ample discussion of how the pandemic has resulted in increases in weight control strategies (e.g., maladaptive exercise behaviors). It remains unclear, however, if maladaptive exercise behaviors are on the rise among non-clinical samples. The objective of this study was to examine college students' engagement in exercise behaviors (both adaptive and maladaptive) before and during COVID-19. METHOD This study compared reports of compulsive exercise, weight and shape exercise, and positive and healthy exercise in two separate samples recruited from a large southeastern university. Sample 1 was collected pre-COVID-19 (August 2019-February 2020) and Sample 2 was collected during COVID-19 (August 2020-April 2021). Case-control matched samples were generated for this study (N = 144; 52.1% male). Three separate analysis of covariance models tested the differences between (1) adaptive exercise; (2) compulsive exercise; and (3) weight and shape exercise in pre- and during COVID-19 samples, controlling for sex. RESULTS Individuals in the during COVID-19 sample reported significantly more compulsive exercise (p < .001), weight and shape exercise (p < .001), and adaptive exercise (p < .001) compared to individuals in the pre-COVID-19 sample. Effects were of medium to large sizes. CONCLUSION Consistent with reports from the research literature and popular press, the current study observed that both adaptive and maladaptive exercise were higher among college students during COVID-19 compared to pre-COVID-19. LEVEL OF EVIDENCE Level V: Opinions of authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees.
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Affiliation(s)
- Madeline Palermo
- Department of Psychology, University of South Florida, 4202 E Fowler Ave., Tampa, FL, 33202, USA.
| | - Diana Rancourt
- Department of Psychology, University of South Florida, 4202 E Fowler Ave., Tampa, FL, 33202, USA
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13
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Harriger JA, Pfund GN. Looking beyond zoom fatigue: The relationship between video chatting and appearance satisfaction in men and women. Int J Eat Disord 2022; 55:923-932. [PMID: 35506428 DOI: 10.1002/eat.23722] [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: 08/31/2021] [Revised: 04/13/2022] [Accepted: 04/15/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The COVID-19 pandemic led to a transition to the utilization of video chatting services as the main form of communication for work, family, and friends. However, the repercussions of this change are not fully known, and issues regarding appearance satisfaction are particularly salient. The purpose of the current study was to examine the relationship between video chatting and appearance satisfaction in a sample of men and women. METHOD The current study utilizes cross-sectional data from 618 participants (Age: M = 33.2; 54.1% women) to evaluate whether average video chat usage predicts appearance satisfaction, and whether this association is dependent upon appearance comparison or self-objectification. RESULTS Results indicated that individuals who spent more time video chatting reported higher appearance satisfaction. Additionally, appearance comparison and self-objectification were not significant moderators, and the association between video chat usage and appearance satisfaction did not differ based on gender. Usage of the touch-up feature, gallery view, and amount of time spent looking at oneself were associated with appearance comparisons, while adjusting lighting and camera angles and amount of time spent looking at oneself were associated with self-objectification. DISCUSSION The results may indicate that while overall time spent video chatting may be associated with lower appearance concerns, examination of the usage of specific features on video chatting platforms may be important to assess in the future. PUBLIC SIGNIFICANCE This study demonstrates that overall time spent video chatting may be associated with lower appearance concerns. The usage, however, of specific features on video chatting platforms, such as touch-up feature, gallery view, and amount of time spent looking at oneself were associated with appearance comparisons. Additionally, adjusting lighting and camera angles, and amount of time spent looking at oneself are associated with self-objectification.
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Affiliation(s)
- Jennifer A Harriger
- Department of Social Science, Pepperdine University, Malibu, California, USA
| | - Gabrielle N Pfund
- Department of Psychological & Brain Sciences, University of Washington in St. Louis, Saint Louis, Missouri, USA
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14
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Schneider J, Pegram G, Gibson B, Talamonti D, Tinoco A, Craddock N, Matheson E, Forshaw M. A mixed-studies systematic review of the experiences of body image, disordered eating, and eating disorders during the COVID-19 pandemic. Int J Eat Disord 2022; 56:26-67. [PMID: 35322449 PMCID: PMC9087368 DOI: 10.1002/eat.23706] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 03/05/2022] [Accepted: 03/05/2022] [Indexed: 01/21/2023]
Abstract
OBJECTIVES This systematic review assessed the influence of the COVID-19 pandemic and associated restrictions on body image, disordered eating (DE), and eating disorder outcomes. METHODS After registration on PROSPERO, a search was conducted for papers published between December 1, 2019 and August 1, 2021, using the databases PsycINFO, PsycARTICLES, CINAHL Plus, AMED, MEDLINE, ERIC, EMBASE, Wiley, and ProQuest (dissertations and theses). RESULTS Data from 75 qualitative, quantitative, and mixed-methods studies were synthesized using a convergent integrated approach and presented narratively within four themes: (1) disruptions due to the COVID-19 pandemic; (2) variability in the improvement or exacerbation of symptoms; (3) factors associated with body image and DE outcomes; (4) unique challenges for marginalized and underrepresented groups. Disruptions due to the pandemic included social and functional restrictions. Although most studies reported a worsening of concerns, some participants also reported symptom improvement or no change as a result of the pandemic. Factors associated with worse outcomes included psychological, individual, social, and eating disorder-related variables. Individuals identifying as LGBTQ+ reported unique concerns during COVID-19. DISCUSSION There is large variability in individuals' responses to COVID-19 and limited research exploring the effect of the pandemic on body image, DE, and eating disorder outcomes using longitudinal and experimental study designs. In addition, further research is required to investigate the effect of the COVID-19 pandemic on body image and eating concerns among minoritized, racialized, underrepresented, or otherwise marginalized participants. Based on the findings of this review, we make recommendations for individuals, researchers, clinicians, and public health messaging. PUBLIC SIGNIFICANCE This review of 75 studies highlights the widespread negative impacts that the COVID-19 pandemic and associated restrictions have had on body image and disordered eating outcomes. It also identifies considerable variations in both the improvement and exacerbation of said outcomes that individuals, researchers, clinicians, and other public health professionals should be mindful of if we are to ensure that vulnerable people get the tailored support they require.
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Affiliation(s)
- Jekaterina Schneider
- Centre for Appearance Research, Department of Health and Social SciencesUniversity of the West of EnglandBristolUK
| | - Georgina Pegram
- Centre for Appearance Research, Department of Health and Social SciencesUniversity of the West of EnglandBristolUK
| | - Benjamin Gibson
- School of Psychology, Faculty of HealthLiverpool John Moores UniversityLiverpoolUK
| | - Deborah Talamonti
- Research Centre and Centre EPICMontreal Heart InstituteMontrealQuebecCanada
| | - Aline Tinoco
- Centre for Appearance Research, Department of Health and Social SciencesUniversity of the West of EnglandBristolUK
| | - Nadia Craddock
- Centre for Appearance Research, Department of Health and Social SciencesUniversity of the West of EnglandBristolUK
| | - Emily Matheson
- Centre for Appearance Research, Department of Health and Social SciencesUniversity of the West of EnglandBristolUK
| | - Mark Forshaw
- School of Psychology, Faculty of HealthLiverpool John Moores UniversityLiverpoolUK
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15
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Linardon J, Messer M, Rodgers RF, Fuller‐Tyszkiewicz M. A systematic scoping review of research on COVID-19 impacts on eating disorders: A critical appraisal of the evidence and recommendations for the field. Int J Eat Disord 2022; 55:3-38. [PMID: 34773665 PMCID: PMC8646470 DOI: 10.1002/eat.23640] [Citation(s) in RCA: 91] [Impact Index Per Article: 45.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 10/31/2021] [Accepted: 11/02/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Research investigating the effects of COVID-19 on eating disorders is growing rapidly. A comprehensive evaluation of this literature is needed to identify key findings and evidence gaps to better inform policy decisions related to the management of eating disorders during and after this crisis. We conducted a systematic scoping review synthesizing and appraising this literature. METHOD Empirical research on COVID-19 impacts on eating disorder severity, prevalence, and demand for treatment was searched. No sample restrictions were applied. Findings (n = 70 studies) were synthesized across six themes: (a) suspected eating disorder cases during COVID-19; (b) perceived pandemic impacts on symptoms; (c) symptom severity pre versus during the pandemic; (d) pandemic-related correlates of symptom severity; (e) impacts on carers/parents; and (f) treatment experiences during COVID-19. RESULTS Pandemic impacts on rates of probable eating disorders, symptom deterioration, and general mental health varied substantially. Symptom escalation and mental health worsening during-and due to-the pandemic were commonly reported, and those most susceptible included confirmed eating disorder cases, at-risk populations (young women, athletes, parent/carers), and individuals highly anxious or fearful of COVID-19. Evidence emerged for increased demand for specialist eating disorder services during the pandemic. The forced transition to online treatment was challenging for many, yet telehealth alternatives seemed feasible and effective. DISCUSSION Evidence for COVID-19 effects is mostly limited to participant self-report or retrospective recall, cross-sectional and descriptive studies, and samples of convenience. Several novel pathways for future research that aim to better understand, monitor, and support those negatively affected by the pandemic are formulated.
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Affiliation(s)
- Jake Linardon
- School of PsychologyDeakin UniversityGeelongVictoriaAustralia,Center for Social and Early Emotional DevelopmentDeakin UniversityBurwoodVictoriaAustralia
| | - Mariel Messer
- School of PsychologyDeakin UniversityGeelongVictoriaAustralia
| | - Rachel F. Rodgers
- APPEAR, Department of Applied PsychologyNortheastern UniversityBostonMassachusettsUSA,Department of Psychiatric Emergency & Acute CareLapeyronie Hospital, CHRU MontpellierMontpellierFrance,Department of PsychologySapienza University of RomeRomeItaly
| | - Matthew Fuller‐Tyszkiewicz
- School of PsychologyDeakin UniversityGeelongVictoriaAustralia,Center for Social and Early Emotional DevelopmentDeakin UniversityBurwoodVictoriaAustralia
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16
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Dogan-Sander E, Kohls E, Baldofski S, Rummel-Kluge C. More Depressive Symptoms, Alcohol and Drug Consumption: Increase in Mental Health Symptoms Among University Students After One Year of the COVID-19 Pandemic. Front Psychiatry 2021; 12:790974. [PMID: 34975589 PMCID: PMC8716753 DOI: 10.3389/fpsyt.2021.790974] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 11/24/2021] [Indexed: 01/08/2023] Open
Abstract
Background: As the majority of studies examining mental health during the pandemic are cross-sectional, little is known about the changes in mental health during the pandemic, especially in university students. Most studies indicate a worsening of mental health conditions. This study aimed to evaluate the mental health status of German university students during the third wave of the pandemic in 2021 and to compare the results to a sample of a congruent cross-sectional study from 2020. Methods: Two cross-sectional and anonymous online surveys among university students were conducted (first survey: July-August 2020, N = 3,382; second survey: March-April 2021, N = 5,642). Mental health status was assessed with standardized measures (depressive symptoms, alcohol and drug consumption, and eating disorder symptoms), and social and emotional aspects of the COVID-19 pandemic were assessed. In addition to descriptive statistics and group comparisons of the two survey samples from 2020 and 2021, respectively, risk and protective factors related to mental health were analyzed. Results: There were significant differences in severities of depressive symptoms and alcohol and drug consumption between the two online surveys from 2020 and 2021. Findings suggest an increase in the severity of depressive symptoms as well as alcohol and drug consumption. Significantly more respondents reported suicidal ideation in the survey from 2021. Lower self-efficacy, less social support and lower resilience as well as higher perceived stress and more loneliness were reported by the participants of the survey from 2021 compared to 2020. Regarding factors predicting mental health symptoms, being female was a positive predictor for hazardous alcohol use and anorexia nervosa in comparison to men. Further, younger age, being diverse, higher perceived stress and loneliness were positive predictors for all mental health outcomes. Conclusion: This study reveals an increase in severities of depressive symptoms, including suicidal ideation, drug and alcohol consumption among students. Being diverse, younger age, higher perceived stress and loneliness were mutual risk factors for higher depressive and eating disorder symptoms as well as alcohol consumption. Universities and health care policy should recognize and address mental health issues of young adults during ongoing times of crisis and invest in easy-to-access interventions.
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Affiliation(s)
- Ezgi Dogan-Sander
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Elisabeth Kohls
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
- Department of Psychiatry and Psychotherapy, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Sabrina Baldofski
- Department of Psychiatry and Psychotherapy, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Christine Rummel-Kluge
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
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17
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Czepczor-Bernat K, Modrzejewska J, Modrzejewska A, Matusik P. Do COVID-19-Related Stress, Being Overweight, and Body Dissatisfaction Contribute to More Disordered Eating in Polish Women?-A Cluster Analysis Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:13100. [PMID: 34948710 PMCID: PMC8701286 DOI: 10.3390/ijerph182413100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 12/08/2021] [Accepted: 12/11/2021] [Indexed: 12/23/2022]
Abstract
We hypothesized that women who are overweight, experiencing COVID-19-related stress, and with high body dissatisfaction would have significantly greater disordered eating than those of healthy weight, without stress, and with low body dissatisfaction. Participants (N = 1354 women; Mage= 31.89 years, SD = 11.14) filled in the Contour Drawing Rating Scale, the Emotional Overeating Questionnaire, the Eating Motivation Survey, the Mindful Eating Questionnaire, and a COVID-19-related stress measure and sociodemographic survey. The cluster analysis technique revealed four distinct clusters: (a) Cluster 1 (N = 314): healthy body weight, no COVID-related stress, and low body dissatisfaction (M = 1.19); (b) Cluster 2 (N = 131): overweight, no COVID-related stress, and high body dissatisfaction (M = 2.41); (c) Cluster 3 (N = 597): healthy body weight, COVID-related stress, and low body dissatisfaction (M = 1.27); (d) Cluster 4 (N = 312): overweight, COVID-related stress, and high body dissatisfaction (M = 2.84). Generally, our outcomes partially support our hypothesis, as higher levels of some types of disordered eating were observed in women who were overweight with COVID-related stress and high body dissatisfaction (Cluster 4) as compared with women with healthy body weight, no COVID-related stress, and with low levels of body dissatisfaction (Cluster 1). Our results indicate that both body weight status, as well as COVID-19-related stress and body dissatisfaction, may contribute to the intensity of disordered eating. During future epidemic-related quarantines, this may be an argument in favor of organizing support regarding emotional functioning, body image, and eating behaviors, particularly for the most vulnerable groups-including overweight and obese women.
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Affiliation(s)
| | - Justyna Modrzejewska
- Institute of Pedagogy, University of Bielsko-Biala, 43-309 Bielsko-Biala, Poland;
| | - Adriana Modrzejewska
- Department of Psychology, School of Health Sciences in Katowice, Medical University of Silesia in Katowice, 40-055 Katowice, Poland;
| | - Paweł Matusik
- Department of Pediatrics, Pediatric Obesity and Metabolic Bone Diseases, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-055 Katowice, Poland;
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18
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Wade T, Pennesi JL, Zhou Y. Ascertaining an efficient eligibility cut-off for extended Medicare items for eating disorders. Australas Psychiatry 2021; 29:519-522. [PMID: 34266291 DOI: 10.1177/10398562211028632] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Currently eligibility for expanded Medicare items for eating disorders (excluding anorexia nervosa) require a score ⩾ 3 on the 22-item Eating Disorder Examination-Questionnaire (EDE-Q). We compared these EDE-Q "cases" with continuous scores on a validated 7-item version of the EDE-Q (EDE-Q7) to identify an EDE-Q7 cut-off commensurate to 3 on the EDE-Q. METHODS We utilised EDE-Q scores of female university students (N = 337) at risk of developing an eating disorder. We used a receiver operating characteristic (ROC) curve to assess the relationship between the true-positive rate (sensitivity) and the false-positive rate (1-specificity) of cases ⩾ 3. RESULTS The area under the curve showed outstanding discrimination of 0.94 (95% CI: .92-.97). We examined two specific cut-off points on the EDE-Q7, which included 100% and 87% of true cases, respectively. CONCLUSION Given the EDE-Q cut-off for Medicare is used in conjunction with other criteria, we suggest using the more permissive EDE-Q7 cut-off (⩾2.5) to replace use of the EDE-Q cut-off (⩾3) in eligibility assessments.
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Affiliation(s)
- Tracey Wade
- Blackbird Initiative, Órama Institute, Flinders University, South Australia, Australia
| | - Jamie-Lee Pennesi
- Department of Psychology, San Diego State University, San Diego, California
| | - Yuan Zhou
- Blackbird Initiative, Órama Institute, Flinders University, South Australia, Australia
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