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Sarginson C, Nicoletta J, Charlebois T, Enouy S, Tabri N. The correlates of appearance focused self-concept: personality traits, self-concept, sociocultural, and early life experience factors. J Eat Disord 2024; 12:108. [PMID: 39095922 PMCID: PMC11295510 DOI: 10.1186/s40337-024-01065-1] [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: 11/10/2023] [Accepted: 07/17/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND Theory and research indicate that an appearance focused self-concept (i.e., placing overriding importance on physical appearance for self-definition and self-worth) plays a role in the etiology and maintenance of disordered eating and eating disorders. Although the consequences of an appearance focused self-concept are palpable, less is known about its correlates. Accordingly, we examined a range of factors that may characterize appearance focused people, including personality traits (perfectionism, impulsivity, sensation-seeking, hopelessness, and anxiety sensitivity), self-concept (global self-esteem and self-concept clarity), sociocultural (thin-ideal, muscular-ideal, general attractiveness internalizations, and perceived pressure to be thin), and early life experiences (adverse childhood experiences, attachment styles) factors. METHODS Female undergraduate university students (N = 568; Mage = 19.58, SDage = 4.24) completed a questionnaire battery that included the Beliefs About Appearance Scale, Depressive Experiences Questionnaire-Self-Criticism-6 Scale, Frost-Multidimensional Perfectionism Scale, the Revised Almost Perfect Scale, Substance Use Risk Profile Scale, Self-Concept Clarity Scale, Rosenberg Self-Esteem Scale, Sociocultural Attitudes Towards Appearance Questionnaire-4 Scale, Adverse Childhood Experiences Questionnaire, Experiences in Close Relationships Scale Short Form, and the Dietary Restraint subscale of the Eating Disorders Examination Questionnaire. RESULTS Multiple regression analyses were conducted for each set of factors separately and together. For personality traits, perfectionism, impulsivity, and anxiety sensitivity were uniquely associated with appearance focused self-concept. For self-concept, global self-esteem and self-concept clarity were uniquely associated with appearance focused self-concept. For sociocultural, general attractiveness internalization, thin-ideal internalization, and perceived pressure to be thin were uniquely associated with appearance focused self-concept. For early life experiences, attachment anxiety and avoidance were uniquely associated with appearance focused self-concept. In the combined analysis, the various factors explained 54% of the variance in appearance focused self-concept. Impulsivity, global self-esteem, general attractiveness internalization, and perceived pressure to be thin were uniquely associated with appearance focused self-concept. CONCLUSIONS Results for global self-esteem were consistent with prior research. Findings for evaluative concerns perfectionism were inconsistent with prior research. We discuss future research directions to examine the link between evaluative concerns perfectionism and appearance focused self-concept. We also discuss how sociocultural factors (general attractiveness internalization and perceived pressure to be thin) and impulsivity may help cultivate an appearance focused self-concept, advancing knowledge on the characteristics of appearance-focused people.
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Affiliation(s)
- Catherine Sarginson
- Department of Psychology, Carleton University, 1125 Colonel By Drive, Ottawa, ON, K1S 5B6, Canada
| | - Juliana Nicoletta
- Department of Psychology, Carleton University, 1125 Colonel By Drive, Ottawa, ON, K1S 5B6, Canada
| | - Thalia Charlebois
- Department of Psychology, Carleton University, 1125 Colonel By Drive, Ottawa, ON, K1S 5B6, Canada
| | - Sarah Enouy
- Department of Psychology, Carleton University, 1125 Colonel By Drive, Ottawa, ON, K1S 5B6, Canada
| | - Nassim Tabri
- Department of Psychology, Carleton University, 1125 Colonel By Drive, Ottawa, ON, K1S 5B6, Canada.
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Kalika E, Hussain M, Egan H, Mantzios M. Exploration of the Mediating Role of Self-Compassion and Mindfulness on Orthorexia Nervosa and Perfectionism. Psychol Rep 2024:332941241256886. [PMID: 38835133 DOI: 10.1177/00332941241256886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2024]
Abstract
Orthorexia Nervosa (ON) is characterized by an excessive preoccupation with healthy eating, accompanied by increasingly restrictive dietary practices over time. In light of the increased attention to ON, it is noteworthy that the existing body of research, specifically with regard to mindfulness and self-compassion remains constrained in scope and depth. A total of 151 participants over the age of 18 completed scales measuring Orthorexia, Self-Compassion, Mindfulness, and Perfectionism. The findings revealed that individuals exhibiting high levels of ON tended to have low levels of self-compassion and mindfulness, along with high levels of perfectionism. Furthermore, the results indicated that self-compassion and mindfulness acted as mediators in the relationship between perfectionism and orthorexia nervosa. These findings deepen our comprehension of orthorexia and underscore the role of self-compassion and mindfulness, or their absence, as mediating factors in this context. The implications of these results and potential future directions are discussed.
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Affiliation(s)
- Eliza Kalika
- Department of Psychology, Birmingham City University, Birmingham, UK
| | - Misba Hussain
- Department of Psychology, Birmingham City University, Birmingham, UK
| | - Helen Egan
- Department of Psychology, Birmingham City University, Birmingham, UK
| | - Michail Mantzios
- Department of Psychology, Birmingham City University, Birmingham, UK
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Nicoletta J, Mosco R, Enouy S, Tabri N. Momentary appearance focused self-concept is associated with dietary restraint and binge eating in female university students: An experience sampling study. Int J Eat Disord 2024; 57:1245-1252. [PMID: 38450762 DOI: 10.1002/eat.24170] [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: 11/27/2023] [Revised: 02/02/2024] [Accepted: 02/02/2024] [Indexed: 03/08/2024]
Abstract
OBJECTIVE Appearance focused self-concept (i.e., overvaluing the importance of appearance for self-definition and self-worth) is theorized to predict dietary restraint and binge eating in the short-term (e.g., daily life). Yet, no research has examined whether appearance focused self-concept increases within-persons during a day and if such increases are linked to greater dietary restraint and binge eating for that day. We addressed this gap in knowledge. METHOD Sixty-three female university students completed four items from the Beliefs About Appearance Scale as a measure of appearance focused self-concept six times per day (9 am, 11 am, 1 pm, 3 pm, 5 pm, and 7 pm) for 14 days. Daily at 9 pm, they completed measures of dietary restraint and binge eating for that day. RESULTS Analyzing data from 555 days, latent growth curve analyses revealed a small-to-moderate linear increase in appearance focused self-concept from 9 am to 3 pm that plateaued from 3 to 7 pm. A more rapid linear increase in appearance focused self-concept from 9 am to 3 pm was associated with greater binge-eating frequency during that day, but not with dietary restraint. The findings were observed when adjusting for between-day appearance focused self-concept at 9 am, which was positively associated with dietary restraint and binge-eating frequency. DISCUSSION Findings are discussed in relation to research on appearance focused self-concept as a risk factor for disordered eating. Findings are also discussed in relation to how sociocultural factors may increase appearance focused self-concept over time. Future research should delve into the within-day dynamic interplay between appearance focused self-concept and disordered eating. PUBLIC SIGNIFICANCE Our study revealed a noteworthy increase in the importance women attach to their appearance over the course of a day, correlating with increased binge eating during that day. Additionally, heightened appearance importance at the onset of a day was associated with more dietary restraint and binge eating during that day. These findings suggest a shorter timescale for the connection between appearance importance and disordered eating than previously understood.
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Affiliation(s)
- Juliana Nicoletta
- Department of Psychology, Carleton University, Ottawa, Ontario, Canada
| | - Rose Mosco
- Department of Psychology, Carleton University, Ottawa, Ontario, Canada
| | - Sarah Enouy
- Department of Psychology, Carleton University, Ottawa, Ontario, Canada
- Mental Health and Well-being Research and Training Hub (MeWeRTH), Carleton University, Ottawa, Ontario, Canada
| | - Nassim Tabri
- Department of Psychology, Carleton University, Ottawa, Ontario, Canada
- Mental Health and Well-being Research and Training Hub (MeWeRTH), Carleton University, Ottawa, Ontario, Canada
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Huynh PA, Miles S, Nedeljkovic M. Perfectionism as a moderator of the relationship between orthorexia nervosa and obsessive-compulsive symptoms. Eat Weight Disord 2024; 29:6. [PMID: 38198059 PMCID: PMC10781834 DOI: 10.1007/s40519-023-01629-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 11/27/2023] [Indexed: 01/11/2024] Open
Abstract
PURPOSE Orthorexia nervosa (ON), a proposed disorder describing an obsessive focus on "healthy" eating, is characterised as having overlapping symptoms with obsessive-compulsive disorder. However, ON/obsessive-compulsive (OC) symptom relationships are inconsistently reported. The current study aimed to investigate if the contribution of OC symptoms and beliefs explain variability in ON symptoms and determine if perfectionism, a transdiagnostic factor, moderates the ON/OC symptom relationship. METHODS The study comprised 190 participants (Mage = 28.63, SDage = 9.88; 80% female) recruited via an undergraduate research programme, social media, advocacy organisations, and a participant registry. Participants completed an online questionnaire assessing ON, OC, and perfectionism symptoms. RESULTS A linear regression analysis found OC symptoms and beliefs explained 22.9% variability in ON symptoms (p < 0.001, f2 = 0.38) and perfectionism moderated the ON/OC symptom relationship, where higher levels of perfectionism with higher levels of OC symptoms was associated with higher levels of ON symptoms, explaining 2.2% variability (p = .01, f2 = 0.03). CONCLUSION OC symptoms appear more common in ON than previous studies indicate. However, the interaction between perfectionism and OC symptoms may drive obsessions in ON. Findings help refine our current understanding of ON phenomenology with implications for ON treatment development. Future research should further explore perfectionism in ON phenomenology. LEVEL OF EVIDENCE Level V (Opinions of respected authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees).
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Affiliation(s)
- Phillipa Ann Huynh
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn Campus, PO Box 218, Hawthorn, VIC, 3122, Australia.
| | - Stephanie Miles
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
- Orygen, Melbourne, VIC, Australia
- Department of Psychological Sciences, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Maja Nedeljkovic
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn Campus, PO Box 218, Hawthorn, VIC, 3122, Australia
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Foyster M, Sultan N, Tonkovic M, Govus A, Burton-Murray H, Tuck CJ, Biesiekierski JR. Assessing the presence and motivations of orthorexia nervosa among athletes and adults with eating disorders: a cross-sectional study. Eat Weight Disord 2023; 28:101. [PMID: 38070009 PMCID: PMC10710386 DOI: 10.1007/s40519-023-01631-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 11/29/2023] [Indexed: 12/18/2023] Open
Abstract
PURPOSE Orthorexia nervosa involves restricting diet based on quality rather than quantity. Although orthorexia is well reported in many at-risk populations, limited data addresses its presence in individuals with eating disorder history (EDs) or athletes. We aimed to identify the presence and potential drivers of orthorexia in adults with EDs and endurance athletes, compared to control subjects. METHODS Participants ≥ 18y included: people with a diagnosed eating disorder (ED as per DSM-5); endurance athletes (training/competing ≥ 5 h/week); or control subjects. Participants (n = 197) completed an online survey assessing orthorexia (eating habits questionnaire, EHQ), eating motivations (TEMS-B) and compulsive exercise (CET). RESULTS ED had the highest orthorexia symptom severity (92.0 ± 3.02, n = 32), followed by athletes (76.2 ± 2.74, n = 54) and controls (71.0 ± 1.80, n = 111) (F (2) = 18.2, p < 0.001). A strong positive correlation existed between weight control motives and higher orthorexia symptom severity (r = 0.54, 95% CI [1.35, 2.36], p < 0.001), while a weak negative association existed between Hunger and Pleasure motives and higher orthorexia symptom severity (r = 0.23, 95% CI [- 2.24, - 0.34], p = 0.008; r = 0.26, 95% CI [- 2.11, - 0.47], p = 0.002, respectively). A moderate positive relationship was found between CET and orthorexia symptom severity (95% CI [1.52, 3.12], p < 0.001). CONCLUSION Adults with ED history and endurance athletes have greater orthorexia symptom severity compared to control. Clinicians working with at-risk populations should screen patients and be aware of red-flags of orthorexic traits, desire to control weight, and compulsive exercise behavior. LEVEL OF EVIDENCE III: Evidence obtained from cohort studies.
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Affiliation(s)
- Mandy Foyster
- Department of Dietetics, Nutrition and Sport, La Trobe University, Bundoora, VIC, Australia
| | - Nessmah Sultan
- Department of Dietetics, Nutrition and Sport, La Trobe University, Bundoora, VIC, Australia
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, VIC, Australia
| | - Matilda Tonkovic
- Department of Dietetics, Nutrition and Sport, La Trobe University, Bundoora, VIC, Australia
| | - Andrew Govus
- Department of Dietetics, Nutrition and Sport, La Trobe University, Bundoora, VIC, Australia
| | - Helen Burton-Murray
- Division of Gastroenterology, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Caroline J Tuck
- Department of Dietetics, Nutrition and Sport, La Trobe University, Bundoora, VIC, Australia
- Department of Nursing and Allied Health, Swinburne University, Hawthorn, VIC, Australia
| | - Jessica R Biesiekierski
- Department of Dietetics, Nutrition and Sport, La Trobe University, Bundoora, VIC, Australia.
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, VIC, Australia.
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Novara C, Piasentin S, Mattioli S, Pardini S, Maggio E. Perfectionism or Perfectionisms in Orthorexia Nervosa. Nutrients 2023; 15:3289. [PMID: 37571233 PMCID: PMC10421058 DOI: 10.3390/nu15153289] [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: 07/04/2023] [Revised: 07/20/2023] [Accepted: 07/23/2023] [Indexed: 08/13/2023] Open
Abstract
Purpose: Perfectionism is considered a transdiagnostic construct that characterises eating disorders (EDs) and obsessive-compulsive disorder (OCD) and that could also depict orthorexia nervosa (ON). The principal aim of this study was to investigate what dimensions of perfectionism mostly represent ON. Moreover, it was evaluated if dieting impacted the presence of orthorexic features and perfectionistic behaviour. Methods: The sample consisted of two groups-the "Diet" (n = 93), and the "No Diet" (n = 94) groups-composed of people with high and low orthorexic tendencies, respectively. Participants filled out self-report questionnaires to investigate orthorexic tendencies and different facets of perfectionism. Results: Analyses highlighted that people with high orthorexic tendencies showed higher perfectionistic features and that ON had a significant relationship with different facets of perfectionism. No interactions with diet were found. Therefore, no other differences were highlighted when the group type (Diet/No Diet) was considered. Conclusions: Regardless of diet, different facets of perfectionism characterise ON: perfectionism as a personality trait and perfectionism related to EDs and to obsessive-compulsive features. Our results evidenced that perfectionism could also be considered a useful construct in the conceptualization of orthorexia nervosa.
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Affiliation(s)
- Caterina Novara
- Department of General Psychology, University of Padova, Via Venezia 8, 35131 Padova, Italy
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Merhy G, Moubarak V, Hallit R, Obeid S, Hallit S. The indirect role of orthorexia nervosa and eating attitudes in the association between perfectionism and muscle dysmorphic disorder in Lebanese male University students - results of a pilot study. BMC Psychiatry 2023; 23:55. [PMID: 36670380 PMCID: PMC9854036 DOI: 10.1186/s12888-023-04549-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 01/16/2023] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The literature highly concentrates on disorders related to body image among women but only minimally when it comes to the male population; hence, in order to provide general practitioners, and primary care physicians in general, and psychiatrists in particular, with additional information concerning muscle dysmorphia among male university students in Lebanon, this study seemed essential, and was therefore conducted to (1) identify the prevalence of MDD, and (2) evaluate the indirect effect of eating attitudes in general and orthorexia nervosa in particular, in the association between perfectionism and muscle dysmorphic disorder (MDD) among a sample of male university students. METHODS In this cross-sectional study conducted between September 2021 and May 2022, 396 male university students from multiple universities in Lebanon filled the online Arabic questionnaire. RESULTS The results showed that 26 (6.6%) of the participants had MDD. Orthorexia nervosa and eating attitudes mediated the association between perfectionism and MDD; higher perfectionism was significantly associated with higher ON and more inappropriate eating; higher ON and more inappropriate eating were significantly associated with higher MDD, whereas perfectionism had a significant total direct effect on MDD. The high prevalence of MDD among male university students in Lebanon implies further investigation on the national level in the country. CONCLUSION Awareness campaigns among the university students could be adopted at the national level to increase the level of knowledge on the concepts of obsessive self-destructive perfectionism, orthorexia nervosa and muscle dysmorphia.
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Affiliation(s)
- Georges Merhy
- grid.444434.70000 0001 2106 3658School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Verginia Moubarak
- grid.444434.70000 0001 2106 3658School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Rabih Hallit
- grid.444434.70000 0001 2106 3658School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon ,Infectious Disease Department, Notre Dame des Secours University Hospital Center, Street 93, Byblos, Postal Code 3, Lebanon ,Infectious Disease Department, Bellevue Medical Center, Mansourieh, Lebanon
| | - Sahar Obeid
- grid.411323.60000 0001 2324 5973Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon. .,Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon. .,Applied Science Research Center, Applied Science Private University, Amman, Jordan.
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Coelho SG, Tabri N, Kerman N, Lefebvre T, Longpre S, Williams RJ, Kim HS. The Perceived Causes of Problems with Substance Use, Gambling, and Other Behavioural Addictions from the Perspective of People with Lived Experience: a Mixed-Methods Investigation. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00900-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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