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Gu SJ, Aimufua I, Pagliaccio D, Shankman SA, Steinglass JE, Auerbach RP, Walsh BT, Ranzenhofer LM. Self-referential processing in anorexia nervosa. Int J Eat Disord 2024; 57:1234-1244. [PMID: 38436447 PMCID: PMC11093709 DOI: 10.1002/eat.24176] [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: 11/29/2023] [Revised: 02/12/2024] [Accepted: 02/12/2024] [Indexed: 03/05/2024]
Abstract
OBJECTIVE Anorexia nervosa (AN) is a serious psychiatric illness associated with significant medical and psychiatric comorbidity and impairment. Theoretical models of AN and self-report studies suggest that negative self-evaluation (i.e., low self-esteem) is related to the development and maintenance of AN. The goal of this study was to extend findings from self-report methodology using a neurocognitive task that probes self-evaluation implicitly and explicitly. METHOD We compared female adolescent and adult patients with AN (n = 35) and healthy controls (HC, n = 38) on explicit (i.e., endorsement of words as self-relevant), implicit (recall, recognition, reaction time), and composite (i.e., valence index, bias score, drift rates) indices of self-evaluation. We applied a drift-diffusion model to compute the drift rates, reflecting participants' decision-making process as to whether words were self-relevant. The association between self-evaluation indices and eating disorder severity was examined. RESULTS There were significant Group × Condition interaction effects for all explicit and implicit measures (all p's ≤ .01), where the AN group endorsed, recalled, and recognized more negative relative to positive words than HC. The AN group had more negative valence index and bias scores, and slower drift rate away from negative words, reflecting more negative self-evaluation. The finding for recall was attenuated when individuals with depression were excluded. Measures of self-evaluation bias were not related to eating disorder severity. DISCUSSION Using a neurocognitive approach that includes explicit and implicit indices of bias, results suggest that patients with AN have more negative self-evaluation. Due to the cross-sectional design, additional studies are needed to further evaluate directionality. PUBLIC SIGNIFICANCE Negative self-evaluation/low self-esteem is thought to contribute to eating disorder symptoms. Findings of this study using a neurocognitive task to probe self-evaluation suggested that individuals with anorexia nervosa have more negative self-evaluation, reflected by endorsing and remembering more negative (than positive) words compared to healthy controls, and doing so faster. Targeting the construct of negative self-evaluation in treatment of AN may be warranted.
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Affiliation(s)
- Serena J. Gu
- New York State Psychiatric Institute, New York, New York, USA
| | - Ivieosa Aimufua
- New York State Psychiatric Institute, New York, New York, USA
| | - David Pagliaccio
- New York State Psychiatric Institute, New York, New York, USA
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
| | - Stewart A. Shankman
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, Illinois, USA
| | - Joanna E. Steinglass
- New York State Psychiatric Institute, New York, New York, USA
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
| | - Randy P. Auerbach
- New York State Psychiatric Institute, New York, New York, USA
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
| | - B. Timothy Walsh
- New York State Psychiatric Institute, New York, New York, USA
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
| | - Lisa M. Ranzenhofer
- New York State Psychiatric Institute, New York, New York, USA
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
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Brooks J, Walker DC, Murray K. What can my body do for me? Guided body-functionality mirror gazing task improved college women's body appreciation and body functionality orientation. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-10. [PMID: 37207308 DOI: 10.1080/07448481.2023.2209195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 03/30/2023] [Accepted: 04/23/2023] [Indexed: 05/21/2023]
Abstract
Objective: Focusing on body functionality - what the body can do - may benefit women's body image. This pilot study examined the effects of focusing on body functionality appreciation during an audio-guided mirror gazing task (F-MGT). Participants: 101 college women, M(SD)AGE = 19.49(1.31), were alternately assigned to F-MGT or a comparison with no guidance on how to examine the body, directed attention mirror gazing task (DA-MGT). Methods: Participants self-reported pre- and post-MGT body appreciation, state appearance satisfaction, and orientation to and satisfaction with physical functionality. Results: Group interactions were significant for body appreciation and functionality orientation. DA-MGT decreased body appreciation from pre- to post-MGT; F-MGT did not change. There were no significant interactions in post-MGT state appearance satisfaction or functionality satisfaction, though state appearance satisfaction increased significantly in F-MGT. Conclusions: Integrating body functionality may buffer against harmful effects of mirror gazing. Given F-MGT's brevity, additional work must assess its potential as an intervention technique.
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Affiliation(s)
- Julia Brooks
- Union College Psychology Department, Union College, Schenectady, New York, USA
| | - D Catherine Walker
- Union College Psychology Department, Union College, Schenectady, New York, USA
| | - Kristen Murray
- Research School of Psychology, Australian National University, Canberra, Australian Capital Territory, Australia
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3
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Kwon M, Li M, Chang OD. Examining the Role of Body Image Instability in Young Adult Women: Conceptualization, Development, and Psychometric Evaluation of the Vacillating Body Image Scale (VBIS). J Pers Assess 2023; 105:266-282. [PMID: 35377772 DOI: 10.1080/00223891.2022.2051532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The current study conceptualized body image instability as a maladaptive tendency to vacillate between different self-perceptions of one's overall body image and developed a corresponding measure to assess body image instability. Results from a series of studies of young adult women demonstrated the validity, reliability, and utility of the Vacillating Body Image Scale (VBIS) as a meaningful measure of body image instability. In Study 1, we found that body image instability, as assessed by the VBIS, represents a unidimensional and reliable construct. In Study 2, we found evidence for both the convergent and discriminant validity of the VBIS in relation to other individual differences measures (i.e., self-concept schema, broad personality factors). In Study 3, the concurrent criterion validity of the VBIS was supported for young adult women in relation to a range of adjustment measures. Finally, in Study 4, we found consistent evidence for the incremental validity of the VBIS in predicting subsequent variations in eating disturbances, even after controlling for global self-esteem and self-concept instability. Overall, our findings offer promising support for our contention that body image instability, as measured by the VBIS, represents an important construct for understanding eating-related disturbances and other health outcomes in young adult women.
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Affiliation(s)
- Misu Kwon
- Department of Psychology, Yonsei University, Seodaemun-gu, Korea (the Republic of)
| | - Mingqi Li
- Department of Psychology, DePaul University, Chicago, Illinois, USA
| | - Olivia D Chang
- Department of Psychology, University of Michigan, Ann Arbor, USA
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4
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Kinkel-Ram SS, Williams BM, Ortiz SN, Forrest L, Magee JC, Smith AR, Levinson CA. Testing intrusive thoughts as illness pathways between eating disorders and obsessive-compulsive disorder symptoms: a network analysis. Eat Disord 2022; 30:647-669. [PMID: 34711137 DOI: 10.1080/10640266.2021.1993705] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Obsessive-compulsive disorder (OCD) and eating disorders (EDs) frequently co-occur. Intrusive thoughts are a mechanism that may maintain this comorbidity. This study used network analysis to identify central ED-related intrusive thoughts and tested which intrusive thoughts connected ED and OCD symptoms. Two cross-sectional graphical LASSO networks were computed using a sample of 353 non-clinical participants (mean age = 35.38, SD = 9.9, 40% female, 81.6% Caucasian) with elevated disordered eating symptoms. Model 1 included just ED-related intrusive thoughts, and Model 2 included ED-related intrusive thoughts, ED, and OCD symptoms. In Model 1, we found that thoughts about one's bodily appearance (i.e., looking horrible, getting fat, gaining weight) were most central. In Model 2, we found that desire to lose weight, eating in secret, and shape dissatisfaction were most central. We identified one illness pathway (i.e., difficulty concentrating due to thoughts of food/calories) connecting intrusive thoughts, ED symptoms, and OCD symptoms. However, intrusive thoughts did not bridge ED and OCD symptoms. Hence, we found some evidence that ED-related intrusive thoughts may contribute to ED and OCD symptoms based on thought content and frequency. However, other aspects of intrusive thoughts should be considered to ascertain whether they do in fact significantly contribute to ED and OCD comorbidity. Prevention efforts targeting ED-related intrusive thoughts may attenuate ED and OCD symptoms among subclinical individuals.
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Affiliation(s)
| | - Brenna M Williams
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky, USA
| | - Shelby N Ortiz
- Department of Psychology, Miami University, Oxford, Ohio, USA
| | - Lauren Forrest
- Department of Psychology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Joshua C Magee
- Department of Psychology, Miami University, Oxford, Ohio, USA
| | - April R Smith
- Department of Psychology, Auburn University, Auburn, Alabama, USA
| | - Cheri A Levinson
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky, USA
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Efficacy of Eat Breathe Thrive: A randomized controlled trial of a yoga-based program. Body Image 2022; 42:427-439. [PMID: 35985168 DOI: 10.1016/j.bodyim.2022.07.009] [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: 09/20/2021] [Revised: 07/11/2022] [Accepted: 07/12/2022] [Indexed: 11/21/2022]
Abstract
Evidence positions yoga as a promising intervention for enhancing positive embodiment and supporting the prevention of, and recovery from, eating disorders (EDs) by reducing ED symptomatology and building skills that facilitate an ongoing, embodied sense of wellbeing. However, yoga-based programs are few and rigorous literature on their efficacy is limited. This study examined the efficacy and feasibility of a yoga-based program called Eat Breathe Thrive (EBT) which aims to prevent EDs and support embodiment. Participants (N = 168, 93.5 % women) from a community sample in the United States and United Kingdom, ages 18-65, were randomly allocated to a 2-h, 7-week EBT program or waitlist-control condition. Compared to controls, EBT participants experienced significant decreases in ED behaviors, depression, and difficulties regulating emotions. They reported significantly greater use of mindfulness skills, such as interoceptive awareness, mindful self-care, and mindful eating. After a single session, participants reported immediate improvement in their sense of well-being, indicating increased state positive embodiment. Most effects were sustained at 6-month follow-up. The majority of individuals attended most sessions. Self-reported treatment integrity was excellent. Directions for future research are proposed. Results support the efficacy and feasibility of an integrated yoga intervention that fosters positive ways of inhabiting the body.
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Myers TA. What about being a feminist is protective? An examination of constructs related to feminist beliefs as moderators of the relationship between media awareness and thin-ideal internalization. Body Image 2022; 41:248-261. [PMID: 35306357 DOI: 10.1016/j.bodyim.2022.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 02/23/2022] [Accepted: 03/02/2022] [Indexed: 11/25/2022]
Abstract
Feminist beliefs have been identified as a potential protective factor in the relationship between media awareness and thin-ideal internalization; however, the precise reason why feminist beliefs serve this role is unclear. A series of three studies examined the reasons why feminist beliefs may be protective in non-student samples, considering as possible explanations open-minded thinking, critical thinking, and media attitudes and literacy. Study 1 showed that the moderating role of feminist beliefs on the relationship between media awareness and thin-ideal internalization held in a non-undergraduate sample. Study 2 found that feminist beliefs and self-identifying as a feminist were related to open-minded thinking, critical thinking, and media attitudes and literacy. Study 3 found that most of these constructs did not serve the same moderating role as feminist beliefs. However, a complex relationship emerged when both feminist self-identification and media attitudes and literacy were considered simultaneously as moderators, adding to the literature emphasizing that self-identifying as a feminist has a protective role over and above that of merely holding feminist beliefs. These results suggest that feminist beliefs may be a unique combination of these constructs or that there may be yet a different reason why feminist beliefs are protective against thin-ideal internalization.
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Rogers CB, Webb JB, Bauert L, Carelock J. Feasibility and Acceptability of a Guided Self-Help, Text-Messaging Intervention to Promote Positive Body Image of Emerging Adult Women. Front Glob Womens Health 2022; 3:849836. [PMID: 35572213 PMCID: PMC9099092 DOI: 10.3389/fgwh.2022.849836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 04/11/2022] [Indexed: 11/15/2022] Open
Abstract
The predominant approach of existing eating disorder prevention programs targets risk factors for development; furthermore, burgeoning evidence suggests that promotion of protective factors against eating disorders (e.g., positive body image) is also a worthy avenue for prevention efforts. The present study considered existing literature gaps in the design of an 8-week guided self-help intervention meant to address the risk for disordered eating through the improvement of positive body image and enhancement of current adaptive functioning. The intervention incorporated elements of weight-inclusive health promotion (e.g., Health at Every Size; HAES) alongside positive psychology and third-wave behavioral interventions [e.g., self-compassion, mindful eating, Acceptance and Commitment Therapy (ACT)] to promote engagement in mindful-self-care. This mixed-methods study evaluated the feasibility and acceptability of the text-messaging based intervention in a diverse sample of cisgender college women (N = 30; 30% Black; 30% bisexual) at risk for disordered eating. Results indicated a high level of engagement and satisfaction with the intervention. Proof of concept was preliminarily supported by the observed significant changes in variables of interest (i.e., body appreciation, positive embodiment, mindful self-care, intuitive eating, self-compassion, disordered eating, and body image dissatisfaction) across the intervention. Overall, results of this study suggest that the use of a guided self-help program based in technology which seeks to reduce risk factors for disordered eating while also supporting adaptive functioning may be indicated for emerging adult women. This article will discuss how the present study provides the groundwork for continued development of innovative and remotely accessible interventions which promote positive body image.
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Affiliation(s)
- Courtney B. Rogers
- Cherokee Health Systems, Knoxville, TN, United States
- *Correspondence: Courtney B. Rogers
| | - Jennifer B. Webb
- Health Psychology PhD Program, University of North Carolina at Charlotte, Charlotte, NC, United States
| | - Lia Bauert
- Health Psychology PhD Program, University of North Carolina at Charlotte, Charlotte, NC, United States
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8
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Stice E, Bohon C, Gau JM, Rohde P. Factors that predict persistence versus non-persistence of eating disorder Symptoms: A prospective study of high-risk young women. Behav Res Ther 2021; 144:103932. [PMID: 34280585 DOI: 10.1016/j.brat.2021.103932] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 07/02/2021] [Accepted: 07/13/2021] [Indexed: 10/20/2022]
Abstract
Investigate baseline factors that prospectively predict persistence versus non-persistence of behavioral and cognitive eating disorder symptoms because knowledge of maintenance factors, which is limited, could inform the design of more effective eating disorder treatments. Data from 4 prevention trials that targeted young women with body image concerns (N = 1952; M age 19.7, SD 5.7) and collected interview-assessed data on behavioral and cognitive symptoms over 1-year follow-up were combined to address this aim. Greater binge eating severity predicted binge eating persistence. Greater dieting, binge eating frequency and severity, weight/shape overvaluation, and feeling fat predicted compensatory behavior persistence. Lower BMI predicted low BMI persistence. Greater thin-ideal internalization, body dissatisfaction, dieting, negative affect, binge eating frequency, binge eating severity, compensatory behaviors, weight/shape overvaluation, fear of fatness or weight gain, and feeling fat predicted weight/shape overvaluation persistence. Greater thin-ideal internalization, dieting, compensatory behaviors, weight/shape overvaluation, fear of fatness or weight gain, and feeling fat predicted persistence of fear of fatness or weight gain. Results provide support for intervention targets of several extant eating disorder treatments and identified novel maintenance factors not commonly targeted in treatments (e.g., negative affect). Results also imply that certain features of eating disorders predict symptom persistence.
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Affiliation(s)
- Eric Stice
- Stanford University, Psychiatry and Behavioral Sciences, 401 Quarry Road, Stanford, CA, 94305-5719, USA.
| | - Cara Bohon
- Stanford University, Psychiatry and Behavioral Sciences, 401 Quarry Road, Stanford, CA, 94305-5719, USA.
| | - Jeff M Gau
- Oregon Research Institute, 1776 Millrace Drive, Eugene, OR, 97403, USA.
| | - Paul Rohde
- Oregon Research Institute, 1776 Millrace Drive, Eugene, OR, 97403, USA.
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Imperatori C, Massullo C, Carbone GA, Farina B, Colmegna F, Riboldi I, Giacomo ED, Clerici M, Dakanalis A. Electroencephalographic (EEG) alterations in young women with high subclinical eating pathology levels: a quantitative EEG study. Eat Weight Disord 2020; 25:1631-1642. [PMID: 31667777 DOI: 10.1007/s40519-019-00801-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 10/17/2019] [Indexed: 12/16/2022] Open
Abstract
PURPOSE To explore electroencephalographic (EEG) alterations in young women with different eating disorder (ED) psychopathology levels. METHODS Thirty-seven young women completed general and ED psychopathology (i.e., the ED Examination Questionnaire; EDE-Q) measures. EEG power spectra data were investigated in two conditions: (a) 5 min of resting state (RS) and (b) 5 min of RS after a single taste of a milkshake (ML-RS). EEG analyses were performed using exact Low-Resolution Electromagnetic Tomography software (eLORETA). RESULTS Cluster analysis performed on the EDE-Q responses revealed a group of 17 women with high levels of ED pathology falling into the subclinical (i.e., sub-threshold) EDs category and a group of 20 women with low levels of ED pathology (controls). In the RS conditions, no significant modifications were observed between groups. Compared to controls, women with subclinical EDs showed an increase in theta activity in the parieto-occipital areas in the ML-RS condition. After controlling for body mass index and general psychopathology, theta activity in these brain structures was positively associated with EDE-Q global and subscale (restraint, shape and weight concern) scores. CONCLUSIONS Our results may reflect the neurophysiological substrate of ED psychopathology core features like shape/weight concerns. Previous brain imaging and qEEG studies with full-syndrome ED patients also underscored the involvement of parieto-occipital areas in ED pathophysiology. These studies also found brain alterations in the RS condition, not observed here. This is notable given that full-syndrome and subclinical EDs are considered as different manifestations of the same disease along a severity spectrum. LEVEL OF EVIDENCE Level V, cross-sectional, electroencephalographic, descriptive study.
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Affiliation(s)
- Claudio Imperatori
- Department of Human Sciences, European University of Rome, Via degli Aldobrandeschi 190, 00163, Rome, Italy
| | - Chiara Massullo
- Department of Human Sciences, European University of Rome, Via degli Aldobrandeschi 190, 00163, Rome, Italy
| | - Giuseppe Alessio Carbone
- Department of Human Sciences, European University of Rome, Via degli Aldobrandeschi 190, 00163, Rome, Italy
| | - Benedetto Farina
- Department of Human Sciences, European University of Rome, Via degli Aldobrandeschi 190, 00163, Rome, Italy
| | - Fabrizia Colmegna
- Department of Psychiatry, San Gerardo Hospital, ASST Monza, Via G. B. Pergolesi 33, 20900, Monza, Italy
| | - Ilaria Riboldi
- Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 48, 20900, Monza, Italy
| | - Ester Di Giacomo
- Department of Psychiatry, San Gerardo Hospital, ASST Monza, Via G. B. Pergolesi 33, 20900, Monza, Italy.,Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 48, 20900, Monza, Italy
| | - Massimo Clerici
- Department of Psychiatry, San Gerardo Hospital, ASST Monza, Via G. B. Pergolesi 33, 20900, Monza, Italy.,Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 48, 20900, Monza, Italy
| | - Antonios Dakanalis
- Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 48, 20900, Monza, Italy.
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Pacanowski CR, Diers L, Crosby RD, Mackenzie M, Neumark-Sztainer D. Yoga's impact on risk and protective factors for disordered eating: a pilot prevention trial. Eat Disord 2020; 28:513-541. [PMID: 32964818 DOI: 10.1080/10640266.2020.1763110] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Yoga has been proposed as a strategy for improving risk and protective factors for eating disorders, but few prevention trials have been conducted. The purpose of this pilot study was to assess the feasibility and acceptability of a yoga series in female college students (n = 52). Participants were randomized to a yoga intervention (three 50-minute yoga classes/week for 10 weeks conducted by certified yoga teachers who received a 3-day intensive training) or a control group. Risk and protective factors, assessed at baseline, 5 and 10 weeks, included body dissatisfaction, negative affect, loneliness, self-compassion, positive affect, and mindfulness. Mixed models controlling for baseline levels of outcome variables were run. On average, participants attended 20 out of 30 yoga classes, and the majority of participants reported high levels of satisfaction with the yoga series. Appearance orientation decreased and positive affect increased in the yoga group relative to the control group. After controlling for baseline levels, the yoga group had a significantly higher positive affect than the control group. Changes in other outcomes were not statistically significant, as compared to the control condition. Future yoga research directions are discussed including education about body image, measure and sample selection, and use of an implementation science framework.
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Affiliation(s)
- C R Pacanowski
- Department of Behavioral Health and Nutrition, University of Delaware , Newark, Delaware, USA
| | | | - R D Crosby
- Sanford Center for Bio-Behavioral Research , Fargo, North Dakota, USA
| | - M Mackenzie
- Department of Behavioral Health and Nutrition, University of Delaware , Newark, Delaware, USA
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Wayment HA, Eiler BA, Cavolo K. Self-Evaluation Strategies in College Women Trying to Lose Weight: The Relative Use of Objective and Social Comparison Information. Front Psychol 2020; 11:1254. [PMID: 32587554 PMCID: PMC7298133 DOI: 10.3389/fpsyg.2020.01254] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 05/14/2020] [Indexed: 01/13/2023] Open
Abstract
We examined patterns of self-evaluative information use in a sample of college women who were trying to lose weight (N = 306). Participants described their weight loss experiences and answered questions about their self-evaluative activity via an online survey. The analysis strategy examined the relative use of four types of self-evaluative information (objective, upward social comparison, lateral social comparison, and downward social comparison) to meet three basic self-evaluative motives (accurate self-assessment, self-enhancement, and self-improvement). We also examined the role that dissatisfaction, uncertainty, importance, and self-esteem played in the relative use of information and the relationship of these factors on weight loss success. Our findings support previous research showing the primacy of accurate and self-improvement motives in the domain of weight loss and the usefulness of lateral social comparison information for meeting all three motives. Women evaluating their weight reported using upward social comparison information most often, followed by objective information. Lateral and upward social comparison information were rated as more useful than downward social comparison information for meeting accuracy and self-improvement motives. Both lateral and downward social comparison information were reported as especially useful for self-enhancement, with upward social comparison information rated as least useful. Our study utilized an integrative approach for understanding self-evaluative processes in the area of college women's weight loss. We found general support for our hypotheses regarding well-documented patterns of social comparison information usefulness for meeting three self-evaluative motives. Our data also support earlier research arguing that it is important to view information use in the context of multiple self-evaluative motives.
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Affiliation(s)
- Heidi A Wayment
- Department of Psychological Sciences, Northern Arizona University, Flagstaff, AZ, United States
| | - Brian A Eiler
- Department of Psychology, Davidson College, Davidson, NC, United States
| | - Keragan Cavolo
- Department of Psychological Sciences, Northern Arizona University, Flagstaff, AZ, United States
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12
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Chang OD. The stakes of self-worth: Examining contingencies of self-worth to clarify the association between global self-esteem and eating disturbances in college women. J Clin Psychol 2020; 76:2283-2295. [PMID: 32578888 DOI: 10.1002/jclp.23006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE The present study tested a hypothesized mediation model in which the seven contingencies of self-worth proposed by Crocker and Wolfe mediate the association between global self-esteem and eating disturbances in college women. METHOD This study utilized a sample of 408 college women. Path analysis was used to produce a model in which the association between global self-esteem and eating disturbances was accounted for through contingencies of self-worth. RESULTS The finalized model indicated that self-worth based on appearance and competition mediated the link between global self-esteem and both drive for thinness and bulimic symptoms. Self-worth based on virtue mediated the link between global self-esteem and bulimic symptoms. CONCLUSION The present findings clarify facets of self-worth accounting for the association between global self-esteem and eating disturbances in college women, and point to how self-worth based on one's appearance, or the ability to outdo others, is centrally implicated in this relationship.
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Affiliation(s)
- Olivia D Chang
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA
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13
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Serra R, Kiekens G, Vanderlinden J, Vrieze E, Auerbach RP, Benjet C, Claes L, Cuijpers P, Demyttenaere K, Ebert DD, Tarsitani L, Green JG, Kessler RC, Nock MK, Mortier P, Bruffaerts R. Binge eating and purging in first-year college students: Prevalence, psychiatric comorbidity, and academic performance. Int J Eat Disord 2020; 53:339-348. [PMID: 31868255 DOI: 10.1002/eat.23211] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 12/03/2019] [Accepted: 12/03/2019] [Indexed: 01/12/2023]
Abstract
BACKGROUND Binge eating and purging behaviors (BPB) are common among college students, but evidence is scant on prevalence and associations of BPB with mental health problems and objective academic performance. This study aims to investigate: (a) 12-month prevalence of BPB among college first-year students, (b) comorbidity patterns of BPB with various mental health problems, and (c) the association of BPB with objective academic functioning. METHODS Using data from the Leuven College Surveys (Belgium), as part of the World Mental Health Surveys International College Student initiative, we cross-sectionally assessed 12-month BPB and mental health problems among college first-year students (n = 4,889; response rate = 73.2%) at the beginning of the academic year. Objective measures of academic functioning (final grades, expressed in academic year percentage "AYP" [0-100%] and academic failure) were obtained from administrative records at the end of the academic year. RESULTS Twelve-month prevalence of BPB was 7.6% (7.3%binge eating and 1.0%purging), with higher rates among females than males. Bivariate models showed an association between BPB and numerous mental health problems (ORs = 3.4-18.4). Multivariate models showed associations with non-suicidal self-injury, post-traumatic stress, internalizing/externalizing problems and suicidal ideation. After controlling for sociodemographic characteristics and comorbid mental health problems, BPB were still associated with lower AYP (-4.1 to -11.2% range) and elevated odds of academic year failure (ORs = 1.4-4.2). CONCLUSIONS BPB (especially binge eating) are relatively common and associated with mental health problems, comparatively low academic performance, and higher risk of academic failure among college first-year students. Further study is needed to examine the causal dynamics underlying these associations.
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Affiliation(s)
- Riccardo Serra
- Department of Human Neurosciences and Mental Health, Sapienza University of Rome, Rome, Italy
| | - Glenn Kiekens
- Department of Neurosciences, Center for Public Health Psychiatry, KU Leuven, Leuven, Belgium
| | | | - Elske Vrieze
- Universitair Psychiatrisch Centrum KU Leuven, Leuven, Belgium
| | - Randy P Auerbach
- Division of Child and Adolescent Psychiatry, Columbia University, New York, New York.,Division of Clinical Developmental Neuroscience, Sackler Institute, New York, New York
| | - Corina Benjet
- National Institute of Psychiatry Ramon de la Fuente Muñiz, Mexico City, Mexico
| | - Laurence Claes
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium.,Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Pim Cuijpers
- Department of Clinical, Neuro, and Developmental Psychology, Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands
| | - Koen Demyttenaere
- Department of Neurosciences, Center for Public Health Psychiatry, KU Leuven, Leuven, Belgium
| | - David D Ebert
- Department for Psychology, Clinical Psychology and Psychotherapy, Friedrich-Alexander University Erlangen Nuremberg, Erlangen, Germany
| | - Lorenzo Tarsitani
- Department of Human Neurosciences and Mental Health, Sapienza University of Rome, Rome, Italy
| | - Jennifer Greif Green
- Wheelock College of Education and Human Development, Boston University, Boston, Massachusetts
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
| | - Matthew K Nock
- Department of Psychology, Harvard University, Cambridge, Massachusetts
| | - Phillippe Mortier
- Department of Neurosciences, Center for Public Health Psychiatry, KU Leuven, Leuven, Belgium.,Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), CIBER en Epidemiología y SaludPública (CIBERESP), Madrid, Spain
| | - Ronny Bruffaerts
- Department of Neurosciences, Center for Public Health Psychiatry, KU Leuven, Leuven, Belgium.,Institute for Social Research, Population Studies Center, University of Michigan, Ann Arbor, Michigan
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14
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Wolf NM, Elklit A. Child Maltreatment and Disordered Eating in Adulthood: a Mediating Role of PTSD and Self-Esteem? JOURNAL OF CHILD & ADOLESCENT TRAUMA 2020; 13:21-32. [PMID: 32318225 PMCID: PMC7163900 DOI: 10.1007/s40653-018-0224-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The current study investigated relationships between different experiences of child maltreatment (CM) and disordered eating (DE) in a large population-based sample of Danish young adults. Participants completed a structured interview comprising socio-demographic, psychological and physical domains. Questions regarding CM, DE, PTSD symptoms and self-esteem were analyzed using chi-square-tests, ANOVAs, hierarchical regression, and multiple mediation analyses. Participants with a history of CM experienced higher levels of DE than non-abused individuals. PTSD symptoms and self-esteem appeared to differentially mediate the relationship between three classes of CM and DE. Whereas the relation between emotional and sexual abuse with DE was partially mediated via participants' level of PTSD symptoms and self-esteem with emotional abuse having a stronger impact on self-esteem and sexual abuse more strongly influencing PTSD symptoms, the relation between polyvictimization and DE was fully mediated by PTSD and self-esteem, mainly due to the indirect effect via PTSD.
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Affiliation(s)
- Nele Marie Wolf
- National Center of Psychotraumatology, University of Southern Denmark, Odense, Denmark
- Present Address: Alexianer Center of Psychotraumatology, Michaelshovener Str. 11, 50999 Cologne, Germany
| | - Ask Elklit
- National Center of Psychotraumatology, University of Southern Denmark, Odense, Denmark
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15
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Alcaraz-Ibáñez M, Sicilia A, Paterna A. Examining the associations between the Big Five personality traits and body self-conscious emotions. Psych J 2019; 9:392-401. [PMID: 31795021 DOI: 10.1002/pchj.324] [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: 04/08/2019] [Revised: 08/26/2019] [Accepted: 10/21/2019] [Indexed: 11/11/2022]
Abstract
This study examined the relationships between the Big Five personality traits and body-related self-conscious emotions in a sex-balanced sample of Spanish undergraduates (N = 748). After controlling for sex, age, and weight discrepancy, neuroticism (positive for shame and guilt), extraversion (negative for shame and positive for pride), conscientiousness (negative for shame and positive for pride), and openness (negative for shame and guilt) emerged as significant cross-sectional predictors of body-related self-conscious emotions. No moderation effect by sex was observed. The explained variance ranged from 10% (hubristic pride) to 26% (shame). Young adults possessing greater than ideally assumed body weight, high levels of neuroticism, and low levels of extraversion, conscientiousness, and openness may be especially vulnerable to body-image disturbances.
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Affiliation(s)
- Manuel Alcaraz-Ibáñez
- Departamento de Educación and Centro de Investigación en Salud, Universidad de Almería, Almería, Spain
| | - Alvaro Sicilia
- Departamento de Educación and Centro de Investigación en Salud, Universidad de Almería, Almería, Spain
| | - Adrian Paterna
- Departamento de Educación and Centro de Investigación en Salud, Universidad de Almería, Almería, Spain
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16
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Dakanalis A, Clerici M, Stice E. Prevention of eating disorders: current evidence-base for dissonance-based programmes and future directions. Eat Weight Disord 2019; 24:597-603. [PMID: 31147968 DOI: 10.1007/s40519-019-00719-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 05/21/2019] [Indexed: 12/11/2022] Open
Affiliation(s)
- Antonios Dakanalis
- Department of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, 20900, Monza, Italy.
| | - Massimo Clerici
- Department of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, 20900, Monza, Italy
| | - Eric Stice
- Oregon Research Institute, 1776 Millrace Drive, Eugene, OR, 97403, USA
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17
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Al-Mutawa N, Schuilenberg SJ, Justine R, Kulsoom Taher S. Modesty, Objectification, and Disordered Eating Patterns: A Comparative Study between Veiled and Unveiled Muslim Women Residing in Kuwait. Med Princ Pract 2019; 28:41-47. [PMID: 30453295 PMCID: PMC6558344 DOI: 10.1159/000495567] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 11/19/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The common thread running through all forms of sexual objectification is the experience of being treated as a body (or collection of body parts) valued predominantly for its use to (or consumption by) others. If girls and women adopt a peculiar view of the self, an effect called self-objectification, this may contribute to depression, sexual dysfunction, and eating disorders. The objective of this study is to investigate the impact of modesty (in terms of veiling, i.e., hijab) on objectification, by others and by the self, body image, and behaviors indicative of eating disturbance in veiled and unveiled Muslim women in Kuwait. METHODS This is a community-based, cross-sectional study conducted through an online survey. The respondents were females living in Kuwait. RESULTS Unveiled women experienced more objectification by others than veiled women. There were no significant differences found between veiled and unveiled women in self-objectification and eating disorder symptomatology. There is a significant negative relationship between modesty of clothing and objectification by others. No significant relationship was found between modesty of clothing and the self-objectification and eating disorder scales. For the objectification by others scale, data show that there is a positive relationship between this scale and eating disorders. Eating disorders were found to have a negative relationship with self-objectification. CONCLUSION The results of the study are significant as they clearly demonstrate a weak negative relationship between clothing preferences/affiliations and eating disorders.
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Affiliation(s)
- Naif Al-Mutawa
- Faculty of Medicine, Kuwait University, Jabriya, Kuwait,
| | | | - Rumia Justine
- Soor Center for Professional Therapy and Assessment, Kuwait City, Kuwait
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18
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Inducing negative affect using film clips with general and eating disorder-related content. Eat Weight Disord 2018; 23:775-784. [PMID: 29423687 DOI: 10.1007/s40519-018-0485-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 01/26/2018] [Indexed: 10/18/2022] Open
Abstract
The aim of the present study was to select appropriate film clips with a general vs. eating disorder (ED)-related content to induce negative affect. More specifically, the study examined the subjective emotional experience (valence, arousal, anxiety, induction of somatic symptoms, and ability to control reactions during film clips) of Greek-Cypriot university students (N = 79) in response to three types of film clips: general unpleasant, ED-specific unpleasant, and emotionally neutral. In addition, the study aimed to compare the emotional reactions to the aforementioned clips between two groups of participants differing on their risk for ED (high vs. low). Preliminary results indicate the clips with general content ("The Champ") and with ED-specific content ("Binge eating") that are most effective in inducing negative affect and differentiating between risk groups. These clips provide an effective method for emotion induction that can be used for assessing the emotional experience of individuals with ED symptoms, since their emotional experience is significantly implicated in the development and maintenance of their symptoms (Merwin, Clin Psychol Sci Pract 18(3):208-214, 2011).Level of evidence No level of evidence, Experimental Study.
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19
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Mills J, Fuller-Tyszkiewicz M. Nature and consequences of positively-intended fat talk in daily life. Body Image 2018; 26:38-49. [PMID: 29883899 DOI: 10.1016/j.bodyim.2018.05.004] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 05/21/2018] [Accepted: 05/21/2018] [Indexed: 10/14/2022]
Abstract
The current study used ecological momentary assessment to explore the frequency, trait predictors, and momentary consequences of positively-intended fat talk, a specific sub-type of fat talk that involves making negative comments about one's own appearance with the view to making someone else feel better. A total of 135 women aged 18-40 completed trait measures of appearance-based comparisons, thin-ideal internalisation, body shame, and body surveillance, before completing a state-based component, involving six short surveys delivered via a smartphone app at random points during the day for seven days. Findings indicate that both self- and other-fat talk are common in daily social interactions, and that individuals with higher levels of trait negative body image were more likely to engage in fat talk. Self-fat talk negatively impacted state body satisfaction levels. Possible theoretical and practical implications are outlined.
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Affiliation(s)
- Jacqueline Mills
- School of Psychology, Faculty of Health, Deakin University, Australia.
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20
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Personality and eating and weight disorders: an open research challenge. Eat Weight Disord 2018; 23:143-147. [PMID: 29177759 DOI: 10.1007/s40519-017-0463-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Accepted: 11/08/2017] [Indexed: 10/18/2022] Open
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21
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Dakanalis A, Alix Timko C, Colmegna F, Riva G, Clerici M. Evaluation of the DSM-5 severity ratings for anorexia nervosa in a clinical sample. Psychiatry Res 2018; 262:124-128. [PMID: 29428775 DOI: 10.1016/j.psychres.2018.02.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 01/11/2018] [Accepted: 02/02/2018] [Indexed: 10/18/2022]
Abstract
We examined the validity and utility of the DSM-5 severity ratings for anorexia nervosa (AN) in a clinical (treatment-seeking) sample (N = 273; 95.6% women). Participants classified with mild, moderate, severe, and extreme severity of AN based on their measured body mass index, differed significantly from each other in eating disorder features, putative maintenance factors, and illness-specific functional impairment (medium effect sizes). However, they were statistically indistinguishable in psychiatric-disorder comorbidity and distress, demographics, and age-of-AN onset. The implications of our findings, providing limited support for the DSM-5 severity ratings for AN, and directions for future research are outlined.
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Affiliation(s)
- Antonios Dakanalis
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy; Department of Brain and Behavioral Sciences, University of Pavia, Italy.
| | - C Alix Timko
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, USA; Children's Hospital of Philadelphia, Philadelphia, USA
| | - Fabrizia Colmegna
- Mental Health Department, San Gerardo Monza Health and Social Care Trust, Monza, Italy
| | - Giuseppe Riva
- Department of Psychology, Catholic University of Milan, Italy; Applied Technology for Neuro-Psychology Laboratory, Istituto Auxologico Italiano, Milan, Italy
| | - Massimo Clerici
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy; Mental Health Department, San Gerardo Monza Health and Social Care Trust, Monza, Italy
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22
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Does Yoga Help College-Aged Women with Body-Image Dissatisfaction Feel Better About Their Bodies? SEX ROLES 2018. [DOI: 10.1007/s11199-018-0917-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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23
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Riva G, Dakanalis A. Altered Processing and Integration of Multisensory Bodily Representations and Signals in Eating Disorders: A Possible Path Toward the Understanding of Their Underlying Causes. Front Hum Neurosci 2018; 12:49. [PMID: 29483865 PMCID: PMC5816057 DOI: 10.3389/fnhum.2018.00049] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 01/26/2018] [Indexed: 01/25/2023] Open
Abstract
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM V) eating problems are the clinical core of eating disorders (EDs). However, the importance of shape and weight overvaluation symptoms in these disorders underlines the critical role of the experience of the body in the etiology of EDs. This article suggests that the transdiagnostic centrality of these symptoms in individuals with EDs may reflect a deficit in the processing and integration of multisensory bodily representations and signals. Multisensory body integration is a critical cognitive and perceptual process, allowing the individual to protect and extend her/his boundaries at both the homeostatic and psychological levels. To achieve this goal the brain integrates sensory data arriving from real-time multiple sensory modalities and internal bodily information with predictions made using the stored information about the body from conceptual, perceptual, and episodic memory. In this view the emotional, visual, tactile, proprioceptive and interoceptive deficits reported by many authors in individuals with EDs may reflect a broader impairment in multisensory body integration that affects the individual's abilities: (a) to identify the relevant interoceptive signals that predict potential pleasant (or aversive) consequences; and (b) to modify/correct the autobiographical allocentric (observer view) memories of body related events (self-objectified memories). Based on this view, the article also proposes a strategy, based on new technologies (i.e., virtual reality and brain/body stimulation), for using crossmodal associations to reactivate and correct the multisensory body integration processes.
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Affiliation(s)
- Giuseppe Riva
- Centro Studi e Ricerche di Psicologia della Comunicazione, Università Cattolica del Sacro Cuore, Milan, Italy
- Applied Technology for Neuro-Psychology Laboratory, Istituto Auxologico Italiano (IRCCS), Milan, Italy
| | - Antonios Dakanalis
- Department of Medicine and Surgery, Università degli Studi di Milano Bicocca, Milan, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
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24
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Dakanalis A, Colmegna F, Zanetti MA, Di Giacomo E, Riva G, Clerici M. Evaluation of the DSM-5 Severity Specifier for Bulimia Nervosa in Treatment-Seeking Youth. Child Psychiatry Hum Dev 2018; 49:137-145. [PMID: 28510006 DOI: 10.1007/s10578-017-0735-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
A new severity specifier for bulimia nervosa (BN), based on the frequency of inappropriate weight compensatory behaviours (e.g., laxative misuse, self-induced vomiting, fasting, diuretic misuse, and excessive exercise), has been added to the most recent (fifth) edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a means of addressing variability and heterogeneity in the severity of the disorder. While existing research provides support for the DSM-5 severity specifier for BN in adult patients, evidence for its validity and clinical utility in youth is currently lacking. To address this gap, data from 272 treatment-seeking adolescents with DSM-5 BN (94.2% female, M age = 15.3 years, SD 1.7) were analysed to examine whether these patients, sub-grouped based on the DSM-5 severity definitions, would show meaningful differences in a broad range of clinical variables and demographic and physical characteristics. Analyses revealed that participants categorized with mild, moderate, severe, and extreme severity of BN significantly differed from each other in 15 variables regarding eating disorder pathological features and putative maintenance factors (i.e., core low self-esteem, perfectionism, social appearance anxiety, body surveillance, and mood intolerance), health-related quality of life and comorbid psychiatric (i.e., affective and anxiety) disorders (large effect sizes). Between-group differences in demographics, body mass index, or age-of-BN onset were not observed. Collectively, our findings provide support for the utility of the frequency of inappropriate weight compensatory behaviours as a severity indicator for BN and suggest that age-at-onset of BN is probably more disorder- than severity-dependent. Implications for future research are outlined.
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Affiliation(s)
- Antonios Dakanalis
- Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 48, 20900, Monza, Italy. .,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
| | | | | | - Ester Di Giacomo
- Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 48, 20900, Monza, Italy
| | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Laboratory, Istituto Auxologico Italiano, Milan, Italy.,Department of Psychology, Catholic University, Milan, Italy
| | - Massimo Clerici
- Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 48, 20900, Monza, Italy.,Department of Mental Health, San Gerardo Hospital, Monza, Italy
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25
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Jones BA, Haycraft E, Bouman WP, Brewin N, Claes L, Arcelus J. Risk Factors for Eating Disorder Psychopathology within the Treatment Seeking Transgender Population: The Role of Cross-Sex Hormone Treatment. EUROPEAN EATING DISORDERS REVIEW 2018; 26:120-128. [DOI: 10.1002/erv.2576] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 11/30/2017] [Accepted: 12/04/2017] [Indexed: 11/08/2022]
Affiliation(s)
- Bethany Alice Jones
- Nottingham Centre for Transgender Health; Nottingham UK
- School of Sport, Exercise, and Health Sciences; Loughborough University; UK
| | - Emma Haycraft
- School of Sport, Exercise, and Health Sciences; Loughborough University; UK
| | | | - Nicola Brewin
- Leicestershire Eating Disorder Service, Bennion Centre; Glenfield Hospital; Leicester UK
| | - Laurence Claes
- Faculty of Psychology and Education Sciences; KU Leuven; Leuven Belgium
- Faculty of Medicine and Health Sciences (CAPRI); University of Antwerp; Antwerp Belgium
| | - Jon Arcelus
- Nottingham Centre for Transgender Health; Nottingham UK
- Institute of Mental Health, School of Medicine; University of Nottingham; Nottingham UK
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26
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Dakanalis A, Zanetti MA, Colmegna F, Riva G, Clerici M. Classifying binge eating-disordered adolescents based on severity levels. J Adolesc 2018; 62:47-54. [DOI: 10.1016/j.adolescence.2017.10.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 10/04/2017] [Accepted: 10/09/2017] [Indexed: 11/25/2022]
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27
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Risk and maintenance factors for young women's DSM-5 eating disorders. Arch Womens Ment Health 2017; 20:721-731. [PMID: 28733894 DOI: 10.1007/s00737-017-0761-6] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 07/11/2017] [Indexed: 01/22/2023]
Abstract
Recent research with young women attending colleges, who are at the average age of eating disorder (ED) onset, established that the ED symptoms are not only prevalent but also relatively stable over the college period. Nonetheless, our knowledge regarding the course and modifiable factors associated with both the onset and maintenance of diagnosable (DSM-5) EDs in this population is limited. The objective of this report was to address these key research gaps. Data were examined from 2713 women who completed assessments of potential vulnerability factors and EDs in the autumn semester of the first (baseline) and fourth (follow-up) college years. A total of 13.1% of the sample met DSM-5 criteria for an ED diagnosis at baseline. At 4-year follow-up, 7.6% of the sample met DSM-5 criteria for an ED, with 67.5% of these cases representing women who had maintained an ED diagnosis from baseline, and 32.5% representing new onset EDs. Elevated appearance-ideal internalization, body dissatisfaction, self-objectification, dieting, and negative affectivity at baseline as well as changes in these factors between assessments all predicted onset and maintenance of DSM-5 EDs at 4-year follow-up. Self-objectification (thinking about and monitoring the body's appearance from an external observer's perspective) was the largest contributor to both ED onset and maintenance. In addition to enhancing our knowledge about the course of young women's (DSM-5) EDs during college, this work highlights potentially similar psychological foci for prevention and treatment efforts. Implications for improving existing preventive and treatment approaches are outlined.
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28
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Dakanalis A, Bartoli F, Caslini M, Crocamo C, Zanetti MA, Riva G, Clerici M, Carrà G. Validity and clinical utility of the DSM-5 severity specifier for bulimia nervosa: results from a multisite sample of patients who received evidence-based treatment. Eur Arch Psychiatry Clin Neurosci 2017; 267:823-829. [PMID: 27435722 DOI: 10.1007/s00406-016-0712-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2016] [Accepted: 07/10/2016] [Indexed: 02/06/2023]
Abstract
A new "severity specifier" for bulimia nervosa (BN), based on the frequency of inappropriate weight compensatory behaviours (IWCBs), was added to the DSM-5 as a means of documenting heterogeneity and variability in the severity of the disorder. Yet, evidence for its validity in clinical populations, including prognostic significance for treatment outcome, is currently lacking. Existing data from 281 treatment-seeking patients with DSM-5 BN, who received the best available treatment for their disorder (manual-based cognitive behavioural therapy; CBT) in an outpatient setting, were re-analysed to examine whether these patients subgrouped based on the DSM-5 severity levels would show meaningful and consistent differences on (a) a range of clinical variables assessed at pre-treatment and (b) post-treatment abstinence from IWCBs. Results highlight that the mild, moderate, severe, and extreme severity groups were statistically distinguishable on 22 variables assessed at pre-treatment regarding eating disorder pathological features, maintenance factors of BN, associated (current) and lifetime psychopathology, social maladjustment and illness-specific functional impairment, and abstinence outcome. Mood intolerance, a maintenance factor of BN but external to eating disorder pathological features (typically addressed within CBT), emerged as the primary clinical variable distinguishing the severity groups showing a differential treatment response. Overall, the findings speak to the concurrent and predictive validity of the new DSM-5 severity criterion for BN and are important because a common benchmark informing patients, clinicians, and researchers about severity of the disorder and allowing severity fluctuation and patient's progress to be tracked does not exist so far. Implications for future research are outlined.
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Affiliation(s)
- Antonios Dakanalis
- Department of Brain and Behavioral Sciences, University of Pavia, P.Za Botta 11, 27100, Pavia, Italy. .,Department of Medicine and Surgery Translational, University of Milano Bicocca, Via Cadore 48, 20900, Monza, Italy.
| | - Francesco Bartoli
- Department of Medicine and Surgery Translational, University of Milano Bicocca, Via Cadore 48, 20900, Monza, Italy
| | - Manuela Caslini
- Department of Medicine and Surgery Translational, University of Milano Bicocca, Via Cadore 48, 20900, Monza, Italy
| | - Cristina Crocamo
- Department of Medicine and Surgery Translational, University of Milano Bicocca, Via Cadore 48, 20900, Monza, Italy
| | - Maria Assunta Zanetti
- Department of Brain and Behavioral Sciences, University of Pavia, P.Za Botta 11, 27100, Pavia, Italy
| | - Giuseppe Riva
- Department of Psychology, Catholic University, Largo Gemelli 1, 20123, Milan, Italy.,Applied Technology for Neuro-Psychology Laboratory, Istituto Auxologico Italiano, IRCCS, Via Ariosto 13, 20145, Milan, Italy
| | - Massimo Clerici
- Department of Medicine and Surgery Translational, University of Milano Bicocca, Via Cadore 48, 20900, Monza, Italy
| | - Giuseppe Carrà
- Department of Medicine and Surgery Translational, University of Milano Bicocca, Via Cadore 48, 20900, Monza, Italy.,Division of Psychiatry, Faculty of Brain Sciences, University College of London, Gower Street, London, WC1E 6BT, UK
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29
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da Silva WR, Marôco J, Ochner CN, Campos JADB. Male body dissatisfaction scale (MBDS): proposal for a reduced model. Eat Weight Disord 2017; 22:515-525. [PMID: 28766259 DOI: 10.1007/s40519-017-0420-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Accepted: 07/13/2017] [Indexed: 11/27/2022] Open
Abstract
AIMS To evaluate the psychometric properties of the male body dissatisfaction scale (MBDS) in Brazilian and Portuguese university students; to present a reduced model of the scale; to compare two methods of computing global scores for participants' body dissatisfaction; and to estimate the prevalence of participants' body dissatisfaction. METHODS A total of 932 male students participated in this study. A confirmatory factor analysis (CFA) was used to assess the scale's psychometric properties. Multi-group analysis was used to test transnational invariance and invariance in independent samples. The body dissatisfaction score was calculated using two methods (mean and matrix of weights in the CFA), which were compared. Finally, individuals were classified according to level of body dissatisfaction, using the best method. RESULTS The MBDS model did not show adequate fit for the sample and was, therefore, refined. Thirteen items were excluded and two factors were combined. A reduced model of 12 items and 2 factors was proposed and shown to have adequate psychometric properties. There was a significant difference (p < 0.001) between the methods for calculating the score for body dissatisfaction, since the mean overestimated the scores. Among student participants, the prevalence of body dissatisfaction with musculature and general appearance was 11.2 and 5.3%, respectively. CONCLUSIONS The reduced bi-factorial model of the MBDS showed adequate validity, reliability, and transnational invariance and invariance in independent samples for Brazilian and Portuguese students. The new proposal for calculating the global score was able to more accurately show their body dissatisfaction. No level of evidence Basic Science.
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Affiliation(s)
- Wanderson Roberto da Silva
- Department of Food and Nutrition, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Campus (Araraquara), São Paulo, Brazil
| | - João Marôco
- William James Center for Research (WJCR), Institute of Psychological, Social and Life Sciences (ISPA), Lisbon, Portugal
| | - Christopher N Ochner
- Hospital Corporation of America, Physician Services Group, Fort Lauderdale, FL, USA
| | - Juliana Alvares Duarte Bonini Campos
- Department of Food and Nutrition, School of Pharmaceutical Sciences (UNESP), São Paulo State University (UNESP), Rodovia Araraquara-Jaú, km 01, Araraquara, SP, Brazil.
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Dakanalis A, Colmegna F, Riva G, Clerici M. Validity and utility of the DSM-5 severity specifier for binge-eating disorder. Int J Eat Disord 2017; 50:917-923. [PMID: 28245061 DOI: 10.1002/eat.22696] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Revised: 02/06/2017] [Accepted: 02/10/2017] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To test both the concurrent and predictive significance of the new DSM-5 severity specifier for binge-eating disorder (BED) in adult outpatients. METHOD Existing data from 195 adults with DSM-5 BED who received evidence-based treatment (manual-based cognitive-behavioral therapy) in an outpatient setting were re-analysed to examine whether these patients sub-grouped according to the DSM-5 severity levels, defined by the frequency of binge-eating (BE) episodes, would show meaningful differences in a range of variables of clinical interest assessed at pre-treatment and end-of treatment abstinence from BE. RESULTS Participants categorized with mild (33.3% of the sample), moderate (35.4%), severe (15.9%), and extreme (15.4%) severity of BED, based on their pre-treatment clinician-rated frequency of BE episodes, differed significantly from each other in physical characteristics (body mass index) and another sixteen variables of clinical interest assessed at pre-treatment regarding eating disorder psychopathology and putative maintenance factors, lifetime and current psychiatric disorder comorbidity, general psychiatric distress, and psychosocial impairment. The four DSM-5 severity groups were statistically indistinguishable in demographics or age-of-BED onset. However, significant between-group differences were observed in the treatment outcome, i.e., abstinence from BE, achieved by 98.5%, 66.7%, 38.7% and 6.7% of participants categorized with mild, moderate, severe, and extreme severity respectively. The outcome analyses repeated in the completer sample (n = 187) yielded the same pattern of the aforementioned intent-to-treat (N = 195) results. DISCUSSION The findings provide support for the severity specifier for BED introduced in the DSM-5 as a means of addressing within-group variability in severity.
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Affiliation(s)
- Antonios Dakanalis
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan/Monza, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Fabrizia Colmegna
- Mental Health Department, San Gerardo Monza Health and Social Care Trust, Monza, Italy
| | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Laboratory, Istituto Auxologico Italiano, Milan, Italy.,Department of Psychology, Catholic University, Milan, Italy
| | - Massimo Clerici
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan/Monza, Italy.,Mental Health Department, San Gerardo Monza Health and Social Care Trust, Monza, Italy
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31
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Dakanalis A, Riva G, Serino S, Colmegna F, Clerici M. Classifying Adults with Binge Eating Disorder Based on Severity Levels. EUROPEAN EATING DISORDERS REVIEW 2017; 25:268-274. [DOI: 10.1002/erv.2518] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 03/18/2017] [Accepted: 03/20/2017] [Indexed: 11/11/2022]
Affiliation(s)
- Antonios Dakanalis
- University of Milan-Bicocca, Milan/Monza and University of Pavia; Pavia Italy
| | - Giuseppe Riva
- Istituto Auxologico Italiano; Milan and Catholic University; Milan Italy
| | | | | | - Massimo Clerici
- University of Milan-Bicocca, Milan/Monza and San Gerardo Hospital; Monza Italy
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Tolosa-Sola I, Gunnard K, Giménez Muniesa C, Casals L, Grau A, Farré JM. Body dissatisfaction and eating disorder symptomatology: Which factors interfere with sexuality in women with eating disorders? J Health Psychol 2017; 24:1526-1535. [PMID: 28810426 DOI: 10.1177/1359105317695425] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Body dissatisfaction is a relevant aspect in both eating disorders and sexuality. Using Stice's model, this study aimed to evaluate the relationship between these variables in eating disorder patients compared with healthy controls. Statistically significant correlations between body dissatisfaction and sexuality were found in the whole sample. The clinical group had higher rates of body dissatisfaction and sexual impairment. Within the clinical group, the participants with a greater drive for thinness showed higher sexual dysfunctions. These results suggest that sexuality should be systematically explored in eating disorders. Higher rates of drive for thinness may be associated with greater sexual impairment.
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Affiliation(s)
| | | | | | | | - Antoni Grau
- 3 Institut de Trastorns Alimentaris (ITA), Spain
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33
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Testing the DSM-5 severity indicator for bulimia nervosa in a treatment-seeking sample. Eat Weight Disord 2017; 22:161-167. [PMID: 27650858 DOI: 10.1007/s40519-016-0324-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2016] [Accepted: 09/12/2016] [Indexed: 10/21/2022] Open
Abstract
PURPOSE This study tested the new DSM-5 severity criterion for bulimia nervosa (BN) based on the frequency of inappropriate weight compensatory behaviors in a treatment-seeking sample. METHODS Participants were 345 adults with DSM-5 BN presenting for treatment. They were sub-grouped based on DSM-5 severity levels and compared on a range of variables of clinical interest and demographics. RESULTS Based on DSM-5 severity definitions, 27.2 % of the sample was categorized with mild, 26.1 % with moderate, 24.9 % with severe, and 21.8 % with extreme severity of BN. Analyses revealed that the four (mild, moderate, severe, and extreme) severity groups of BN significantly differed from each other in eating disordered and body-related attitudes and behaviors, factors involved in the maintenance process of the disorder, comorbid psychiatric disorders, psychological distress, and psychosocial impairment (medium-to-large effect sizes). No significant between-group differences were observed in demographics, body mass index, or at the age when BN first occurred, lending some credence to recent suggestions that age-at-onset of BN may be more a disorder- than a severity-dependent variable. CONCLUSIONS Collectively, our findings provide support for the severity indicator for BN introduced in the DSM-5 as a means of addressing heterogeneity and variability in the severity of the disorder.
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Abstract
Stigmatizing attitudes toward eating disorders (EDs) may lead to reduced treatment seeking. We aimed to estimate the prevalence of stigmatizing trends and beliefs related to anorexia nervosa (AN) and bulimia nervosa (BN), and the associations with the experiential knowledge of the problem, in a large sample of Italian undergraduates. A total of 2109 participants completed an online survey including questionnaires related to stigmatizing beliefs toward AN and BN, and personal contacts with people with EDs. Undergraduates reported almost overlapping low levels of stigmatizing trends for AN and BN, apart from personal responsibility and social distance. Those aged 18 to 25 and living with family held higher stigmatizing attitudes. Stigma was lower in underweight participants and in those (12%) reporting a previous ED diagnosis. Although not improving stigmatizing attitudes, 83% of the sample was familiar with people with an ED. Antistigma actions to increase awareness on EDs and to improve treatment-seeking behaviors are needed.
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Tan CS, Fuller-Tyszkiewicz M, Utpala R, Yeung VWL, De Paoli T, Loughan S, Krug I. Western Cultural Identification Explains Variations in the Objectification Model for Eating Pathology Across Australian Caucasians and Asian Women. Front Psychol 2016; 7:1578. [PMID: 27790176 PMCID: PMC5063856 DOI: 10.3389/fpsyg.2016.01578] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 09/29/2016] [Indexed: 11/13/2022] Open
Abstract
Objective: To assess differences in trait objectifying measures and eating pathology between Australian Caucasians and Asian women living in Australia and in Hong Kong with high and low levels of western cultural identification (WCI) and to see if exposure to objectifying images had an effect on state-objectification. A further aim was to assess using path analyses whether an extended version of the objectification model, including thin-ideal internalization, differed depending on the level of WCI. Method: A total of 424 participants comprising 162 Australian Caucasians and 262 Asians (n = 183 currently residing in Australia and n = 79 living in Hong Kong) took part in the study. Of the overall Asian sample, 133 individuals were classified as high-WCI and 129 participants as low-WCI. Participants were randomly allocated into one of two conditions, presenting either objectifying images of attractive and thin Asian and Caucasian female models (objectification group, n = 204), or showing neutral images of objects (e.g., chairs, tables; control group, n = 220). Subsequently, participants were asked to complete a series of questionnaires assessing objectification processes and eating pathology. Results: Findings revealed that the Caucasian group presented with significantly higher internalization and body surveillance scores than either of the two Asian groups and also revealed higher scores on trait-self-objectification than the low-WCI Asian sample. As regards to the effects of objectifying images on state self-objectification, we found that ratings were higher after exposure to women than to control objects for all groups. Finally, multi-group analyses revealed that our revised objectification model functioned equally across the Caucasian and the high-WCI Asian group, but differed between the Caucasian and the low-WCI Asian group. Conclusion: Our findings outline that individuals with varying levels of WCI might respond differently to self-objectification processes. Levels of WCI should therefore be taken into consideration when working with women from different cultural backgrounds.
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Affiliation(s)
- Charmain S Tan
- Melbourne School of Psychological Sciences, The University of MelbourneMelbourne, VIC, Australia; Department of Psychology, National University of Singapore, SingaporeSingapore
| | - Matthew Fuller-Tyszkiewicz
- Centre for Social and Early Emotional Development, School of Psychology, Deakin UniversityMelbourne, VIC, Australia; School of Psychology, Deakin University, DeakinMelbourne, VIC, Australia
| | - Ranjani Utpala
- Department of Psychology, National University of Singapore, Singapore Singapore
| | | | - Tara De Paoli
- Melbourne School of Psychological Sciences, The University of Melbourne Melbourne, VIC, Australia
| | - Stephen Loughan
- Department of Psychology, University of Edinburgh Edinburgh, UK
| | - Isabel Krug
- Melbourne School of Psychological Sciences, The University of Melbourne Melbourne, VIC, Australia
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Dakanalis A, Pla-Sanjuanelo J, Caslini M, Volpato C, Riva G, Clerici M, Carrà G. Predicting onset and maintenance of men's eating disorders. Int J Clin Health Psychol 2016; 16:247-255. [PMID: 30487868 PMCID: PMC6225078 DOI: 10.1016/j.ijchp.2016.05.002] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2015] [Accepted: 05/09/2016] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND/OBJECTIVE Eating disorders (EDs) represent serious yet understudied mental health issues, particularly amongst young adult men attending colleges, who are at the average age of onset. Despite this and recent evidence that in young adult men the core ED symptoms are prevalent and remain relatively stable over the college period, little is known about factors associated with both the onset and maintenance of diagnosable EDs in this population. This work sought to address these research gaps. METHOD Logistic regression analyses were conducted using data from an on-going longitudinal study of eating and mental health issues to examine the influence of theoretically relevant factors in predicting the onset and maintenance of men's (DSM-5) EDs at 4-year follow-up (N = 2,507). RESULTS Body dissatisfaction, self-objectification, appearance-ideal internalization, dieting, and negative affectivity were all predictors of ED onset and maintenance. Self-objectification was the largest contributor to both ED onset and maintenance. CONCLUSIONS The findings highlight potentially similar psychosocial foci for prevention and treatment efforts. Implications for improving existing preventive and treatment approaches are discussed.
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Affiliation(s)
| | | | | | | | - Giuseppe Riva
- Catholic University of Milan, Italty
- Istituto Auxologico Italiano, Italy
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Dakanalis A, Timko AC, Clerici M, Riva G, Carrà G. Objectified Body Consciousness (OBC) in Eating Psychopathology. Assessment 2016; 24:252-274. [DOI: 10.1177/1073191115602553] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Objectified body consciousness (OBC) appears to play a crucial role in eating and body-related disturbances, which typically emerge during adolescence. The 24-item OBC Scale (OBCS) has been employed in eating disorder (ED) research and school-based adolescent samples, but evidence for its psychometric proprieties exists only in adult (nonclinical) populations. We evaluated (a) the construct validity and reliability of the 24-item OBCS with data collected from 1,259 adolescent girls and boys from the community (Study 1) and 643 adolescents of both genders with an ED (Study 2) and (b) whether the instrument functions similarly and equivalently measures the underlying construct(s) across gender and samples (i.e., test of measurement equivalence/invariance; Study 3). Results upheld the three-factor structure and measurement equivalence/invariance of the 24-item OBCS across gender and samples. OBCS subscale scores were internally consistent and stable over a 4-week period. OBCS subscales discriminated community participants with high and low ED symptom levels with fair accuracy, as well as community participants from those with an ED. They were also associated with five constructs closely related to both OBC and ED psychopathology. Latent mean comparisons across samples and gender were performed and discussed. Implications and directions for future research are also outlined.
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Affiliation(s)
- Antonios Dakanalis
- University of Pavia, Pavia, Italy
- University of Milano-Bicocca, Milan, Italy
| | | | | | - Giuseppe Riva
- Istituto Auxologico Italiano, Milan, Italy
- Catholic University of Milan, Milan, Italy
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Dakanalis A, Clerici M, Caslini M, Gaudio S, Serino S, Riva G, Carrà G. Predictors of initiation and persistence of recurrent binge eating and inappropriate weight compensatory behaviors in college men. Int J Eat Disord 2016; 49:581-90. [PMID: 27062291 DOI: 10.1002/eat.22535] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2015] [Revised: 02/21/2016] [Accepted: 02/21/2016] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The transition to college is considered as a risk period for the development of behavioral symptoms of eating disorders (BSEDs) and some evidence suggests that, amongst men, these symptoms occurring on a regular basis remain relatively stable over the college period. Nevertheless, little is known about factors associated with persistent engagement in and initiation of recurrent (or regular) binge eating and inappropriate weight compensatory behaviors in this population. The objective of this report was to address these research gaps. METHOD Data were examined from 2,555 male first-year college students who completed an assessment of potential vulnerability factors and BSEDs at the beginning of the autumn semester (baseline) and nine months later (end of the spring semester; follow-up). RESULTS Elevated negative affectivity, body dissatisfaction, self-objectification, and lower self-esteem at baseline were predictive of persistent engagement in regular binge eating and four compensatory behaviors (self-induced vomiting, laxative/diuretic abuse, fasting, exercise) at follow-up, as well as initiation of all these behaviors occurring regularly (i.e., at least weekly for 3 months). Self-objectification (thinking and monitoring the body's outward appearance from a third-person perspective) emerged as the largest contributor of both the initiation and persistence of all behavioral symptoms. DISCUSSION Data emphasize that the same psychological factors underlie initiation and persistence of recurrent BSEDs and should shape the focus of future interventions for college men. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:581-590).
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Affiliation(s)
- Antonios Dakanalis
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.,Department of Surgery and Interdisciplinary Medicine, University of Milan-Bicocca, Milan, Italy
| | - Massimo Clerici
- Department of Surgery and Interdisciplinary Medicine, University of Milan-Bicocca, Milan, Italy
| | - Manuela Caslini
- Department of Surgery and Interdisciplinary Medicine, University of Milan-Bicocca, Milan, Italy
| | - Santino Gaudio
- Centre for Integrated Research, University Campus Bio-Medico, Rome, Italy.,Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Silvia Serino
- Department of Psychology, Catholic University, Milan, Italy
| | - Giuseppe Riva
- Department of Psychology, Catholic University, Milan, Italy.,Applied Technology for Neuropsychology Laboratory, Istituto Auxologico Italiano, Milan, Italy
| | - Giuseppe Carrà
- Department of Surgery and Interdisciplinary Medicine, University of Milan-Bicocca, Milan, Italy.,Division of Psychiatry, Faculty of Brain Sciences, University College of London, London, United Kingdom
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