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Philippe FL, Carbonneau N, Fortin A, Guilbault V, Bouizegarene N, Antunes JM, Chua SN. Toward a memory perspective on eating psychopathology: An investigation of the types of childhood and adolescence memories that are associated with eating disorder symptoms. Appetite 2024; 198:107364. [PMID: 38642722 DOI: 10.1016/j.appet.2024.107364] [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: 10/03/2023] [Revised: 04/12/2024] [Accepted: 04/15/2024] [Indexed: 04/22/2024]
Abstract
The cognitive mechanisms through which specific life events affect the development and maintenance of eating disorders (ED) have received limited attention in the scientific literature. The present research aims to address this gap by adopting a memory perspective to explore the type of life events associated with eating psychopathology and how these events are encoded and reconstructed as memories. Two studies (n = 208 and n = 193) were conducted to investigate the relationship between specific memories and eating disorder psychopathology. Study 1 focused on parent-related memories, while Study 2 examined childhood/adolescence memories. Results from both studies revealed that need thwarting and shame in memories were associated with eating disorder symptoms, but only when individuals drew symbolic connections between these memories and food or eating behavior. Moreover, need thwarting and shame in such memories were associated with other eating and body image outcomes, including uncontrolled eating and body esteem. These results also held after controlling for a host of known predictors of eating disorder psychopathology, such as BMI, perfectionism, or thin ideal internalization. Overall, the present findings suggest that the reprocessing of memories symbolically and idiosyncratically linked to food and eating behavior might be a fruitful clinical intervention.
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2
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Fekih-Romdhane F, Pardini S, Hallit S, Novara C, Brytek-Matera A. A multi-country examination of the relationship between perfectionism and disordered eating: the indirect effect of obsessive beliefs and obsessive-compulsive symptoms. J Eat Disord 2024; 12:69. [PMID: 38822447 PMCID: PMC11143671 DOI: 10.1186/s40337-024-01030-y] [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: 03/17/2024] [Accepted: 05/23/2024] [Indexed: 06/03/2024] Open
Abstract
BACKGROUND Despite the extensive literature on the association between perfectionism and disordered eating (DE), only scant attention has been given to the underlying processes that may mediate this relationship. The present study aimed to contribute to existing literature by investigating the direct and indirect relations between perfectionism and DE through obsessive-compulsive disorder (OCD) symptoms and obsessive beliefs, among community adults from three different countries and cultural backgrounds (i.e. Poland, Italy and Lebanon). METHODS This is a cross-sectional study that was carried-out among 977 community adults (77.1% females, mean age: 21.94 ± 3.14 years) using the snowball sampling technique. RESULTS Obsessive-compulsive disorders (OCD) symptoms and obsessive beliefs had a partial indirect effect in the relationship between multidimensional perfectionism and disordered eating. Higher multidimensional perfectionism/obsessive beliefs were significantly associated with greater OCD symptoms and directly associated with higher DE scores. Finally, higher OCD symptoms were significantly linked to higher DE scores. CONCLUSION The preliminary results suggest that it would be helpful for clinicians to routinely include measures of perfectionism, OCD and obsessive beliefs when dealing with individuals who present DE problems. In addition, results hold promise for the combined use of perfectionism and OCD interventions as a potentially beneficial treatment option for DE concerns.
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Affiliation(s)
- Feten Fekih-Romdhane
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry "Ibn Omrane", Razi hospital, Manouba, 2010, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Susanna Pardini
- Department of General Psychology, University of Padova, Padova, 35131, Italy
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon.
- Applied Science Research Center, Applied Science Private University, Amman, Jordan.
| | - Caterina Novara
- Department of General Psychology, University of Padova, Padova, 35131, Italy
| | - Anna Brytek-Matera
- Eating Behavior Laboratory (EAT Lab), Institute of Psychology, University of Wrocław, Wrocław, 50-527, Poland.
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3
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Chaaya R, Hallit R, Malaeb D, Sakr F, Dabbous M, El Khatib S, Fekih-Romdhane F, Hallit S, Obeid S. Moderating effect of self-esteem between perfectionism and avoidant restrictive food intake disorder among Lebanese adults. BMC Psychiatry 2024; 24:325. [PMID: 38671387 PMCID: PMC11055237 DOI: 10.1186/s12888-024-05762-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 04/12/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Avoidant Restrictive Food Intake Disorder (ARFID) is a new diagnosis added to the DSM-5 characterized by pathological eating habits without body image disturbances. Previous findings demonstrated a general association between high levels of perfectionism and low levels of self-esteem in association with general eating disorders. However, research is scant when it comes to ARFID specifically. Subsequently, although self-esteem is seen to moderate the association between perfectionism and general eating disorders, this research study aims to explore the same moderation but with ARFID specifically. METHODS For this study, 515 Lebanese adults from the general Lebanese population were recruited from all over Lebanon, 60.1% of which were females. The Arabic version of the Big Three Perfectionism Scale- Short Form (BTPS-SF) was used to measure self-critical, rigid and narcissistic perfectionism; the Avoidant/Restrictive Food Intake Disorder screen (NIAS) was used to score the ARFID variable; the Arabic-Single Item Self-Esteem (A-SISE) was the scale used to measure self-esteem. RESULTS Across the different perfectionism types, self-esteem was seen to moderate the association between narcissistic perfectionism and ARFID (Beta = - 0.22; p =.006). At low (Beta = 0.77; p <.001), moderate (Beta = 0.56; p <.001) and high (Beta = 0.36; p =.001) levels of self-esteem, higher narcissistic perfectionism was significantly associated with higher ARFID scores. CONCLUSION This study brought to light some crucial clinical implications that highlight the need for interventions that help in the enhancement of self-esteem in patients with high perfectionism and ARFID. This study suggests that clinicians and healthcare professionals should focus more on risk factors influencing the development and maintenance of ARFID-like symptoms.
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Affiliation(s)
- Roni Chaaya
- School of Arts and Sciences, Social and Education Sciences Department, Lebanese American University, Jbeil, Lebanon
| | - Rabih Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, P.O. Box 446, Lebanon
- Department of Infectious Disease, Bellevue Medical Center, Mansourieh, Lebanon
- Department of Infectious Disease, Notre Dame des Secours University Hospital, Postal code 3, Byblos, Lebanon
| | - Diana Malaeb
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Fouad Sakr
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Mariam Dabbous
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Sami El Khatib
- Department of Biomedical Sciences, School of Arts and Sciences, Lebanese International University, Bekaa, Lebanon
- Center for Applied Mathematics and Bioinformatics (CAMB), Gulf University for Science and Technology (GUST), Hawally, Kuwait
| | - Feten Fekih-Romdhane
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry "Ibn Omrane", Razi hospital, 2010, Manouba, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, P.O. Box 446, Lebanon.
- Applied Science Research Center, Applied Science Private University, Amman, Jordan.
| | - Sahar Obeid
- School of Arts and Sciences, Social and Education Sciences Department, Lebanese American University, Jbeil, Lebanon.
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Esmaeili A, Esmaeeli ST. A life lost to anorexia nervosa: A case report of rapid progressive disease and its psychological aspects. Clin Case Rep 2024; 12:e8709. [PMID: 38566976 PMCID: PMC10985021 DOI: 10.1002/ccr3.8709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 02/27/2024] [Accepted: 02/29/2024] [Indexed: 04/04/2024] Open
Abstract
The prevalence of anorexia nervosa has been on the rise. Exploring key factors in treating this condition as well as psychological factors influencing the onset and maintenance of the disorder can increase the chance of treatment success.
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Affiliation(s)
- Amirreza Esmaeili
- Department of Clinical Health Psychology, School of Behavioral Science and Mental HealthIran University of Medical SciencesTehranIran
| | - Soode Tajik Esmaeeli
- Fellowship of Psychosomatic Medicine, Mental Health Research Center, Psychosocial Health Research Institute, Department of Psychiatry, School of MedicineIran University of Medical SciencesTehranIran
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5
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Longo P, Bevione F, Amodeo L, Martini M, Panero M, Abbate-Daga G. Perfectionism in anorexia nervosa: Associations with clinical picture and personality traits. Clin Psychol Psychother 2023. [PMID: 37970961 DOI: 10.1002/cpp.2931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 10/18/2023] [Accepted: 10/18/2023] [Indexed: 11/19/2023]
Abstract
Although many researchers addressed the topics, no consistent data are currently available regarding the relationship between perfectionism and personality traits in anorexia nervosa (AN). The present study aimed to assess differences between high- and low-perfectionism groups of patients with AN and to identify which variables show the strongest association with perfectionism. A group of inpatients with AN (n = 193) was recruited and completed a battery of self-report questionnaires regarding eating-related and general psychopathology, perfectionism, and personality. On the basis of perfectionism scores, patients were divided into high- and low-perfectionism groups. High-perfectionist patients displayed higher eating-related and general psychopathology; higher depressive, cyclothymic, irritable and anxious temperament, and lower self-directedness, cooperativeness and self-esteem. Perfectionism was associated with the drive for thinness, cooperativeness, self-esteem and anxious temperament. On the basis of the two personality traits most strongly correlated with perfectionism (i.e., cooperativeness and anxious temperament), patients could be correctly assigned to the high- or low-perfectionism group by an algorithm. The study suggests that perfectionism in AN is related to eating psychopathology, especially of restrictive type, and personality features such as cooperativeness and anxious temperament. These findings confirm the important role of perfectionism in AN, not only concerning eating behaviour but personality as well.
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Affiliation(s)
- Paola Longo
- Eating disorders Center, Department of Neuroscience, University of Turin, Turin, Italy
| | - Francesco Bevione
- Eating disorders Center, Department of Neuroscience, University of Turin, Turin, Italy
| | - Laura Amodeo
- Eating disorders Center, Department of Neuroscience, University of Turin, Turin, Italy
| | - Matteo Martini
- Eating disorders Center, Department of Neuroscience, University of Turin, Turin, Italy
| | - Matteo Panero
- Eating disorders Center, Department of Neuroscience, University of Turin, Turin, Italy
| | - Giovanni Abbate-Daga
- Eating disorders Center, Department of Neuroscience, University of Turin, Turin, Italy
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Stornæs AV, Sundgot-Borgen J, Pettersen G, Rosenvinge JH, Nordin-Bates SM. Mental health profiles among 13-16-year-Old Norwegian talent and mainstream students - A prospective person-centered analytical approach. PSYCHOLOGY OF SPORT AND EXERCISE 2023; 68:102474. [PMID: 37665914 DOI: 10.1016/j.psychsport.2023.102474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 05/05/2023] [Accepted: 06/06/2023] [Indexed: 09/06/2023]
Abstract
OBJECTIVES To contribute further knowledge about symptoms of anxiety, depression, body concerns, and self-worth among young talent development (TD) and mainstream students by exploring the indicators within-person combinations prospectively, aiming to identify distinct profiles. METHODS We included 946 students, n = 168 (45% girls) from three TD sports schools and one ballet class, n = 778 (52% girls) from ten mainstream schools. All were 13-14 years at T1 and 15-16 years at T2. Descriptive statistics were examined via variable-centered approaches: ANOVA and cross-tabulations. Mental health profiles were explored via person-centered approaches: latent profile and latent transition analysis, including profile stability over two years and school type, gender, and perfectionism association with profiles. RESULTS TD girls' and boys' anxiety and depression scores did not differ, but girls reported more weight-shape concerns. Mainstream schoolgirls fared worse compared to all others. Four retained profiles (distressed-body concerned, dissatisfied, moderate mentally healthy, mentally healthy) showed distinct patterns of co-occurring anxiety, depression, weight-shape concerns, and self-worth. Profile stability was high overall (72-93%). The highest proportion of TD boys was in the mentally healthy, TD girls and mainstream boys in moderate, and mainstream girls within the dissatisfied profile. Noteworthy transitions: TD boys who transitioned were likely changing to healthier profiles and girls to unhealthier. Unhealthier profiles were associated with socially prescribed perfectionism. CONCLUSION TD students fared relatively better than mainstream students. Still, considerable proportions of girls were identified in the unhealthiest profiles. These findings involving young TD and mainstream students propose a need for specific follow-up measures to promote mental health.
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Affiliation(s)
| | | | - Gunn Pettersen
- Department of Health and Care Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
| | - Jan H Rosenvinge
- Department of Psychology, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
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7
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Egan SJ, Neal J, Ure S, Callaghan T, Ho P, Shafran R, Wade TD. The development of co-designed parent-supported cognitive behaviour therapy for perfectionism in adolescents with eating disorders: initial feasibility and acceptability. J Eat Disord 2023; 11:138. [PMID: 37592307 PMCID: PMC10433624 DOI: 10.1186/s40337-023-00860-6] [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: 06/09/2023] [Accepted: 08/03/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND Perfectionism is significantly associated with symptoms of eating disorders in adolescents. Studies to date have not examined parent-supported CBT for perfectionism in eating disorders (CBT-P-ED). We co-designed the treatment and conducted a feasibility trial. METHODS Eight parents of adolescents with eating disorders (M age = 48.75 years, 100% female) engaged in three co-design workshops to create a parent-supported CBT-P-ED self-help intervention. A further 10 parents (M age 41.8 years, 50% female) and their adolescent offspring (n = 10, M age 15.4 years, 60% female, 50% with self-reported diagnosis of anorexia nervosa) participated in a feasibility trial and provided feedback on the intervention. RESULTS The parents who engaged in the co-design workshops suggested several areas to optimise the perfectionism intervention, including using plain language, the impact of parental perfectionism, how to engage with their adolescent in treatment and the importance of increasing eating disorder specific material. Feedback from the feasibility trial suggested that the intervention was acceptable and feasible with 100% of parents and adolescents saying it was useful, and no attrition. CONCLUSIONS Parent-supported CBT-P-ED appears to be feasible. Future research is now required in a randomised controlled trial.
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Affiliation(s)
- Sarah J Egan
- enAble Institute and School of Population Health, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia.
- Discipline of Psychology, School of Population Health, Curtin University, Perth, Australia.
| | - Jamie Neal
- Discipline of Psychology, School of Population Health, Curtin University, Perth, Australia
| | - Sarah Ure
- Discipline of Psychology, School of Population Health, Curtin University, Perth, Australia
| | - Thomas Callaghan
- Discipline of Psychology, School of Population Health, Curtin University, Perth, Australia
| | - Pheobe Ho
- Eating Disorders Program, Perth Children's Hospital, Perth, Australia
- Eating Disorders Program, Centre for Clinical Interventions, Perth, Australia
| | - Roz Shafran
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Tracey D Wade
- Flinders Institute for Mental Health and Wellbeing, College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia
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8
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Bills E, Greene D, Stackpole R, Egan SJ. Perfectionism and eating disorders in children and adolescents: A systematic review and meta-analysis. Appetite 2023; 187:106586. [PMID: 37196843 DOI: 10.1016/j.appet.2023.106586] [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: 12/12/2022] [Revised: 04/28/2023] [Accepted: 04/29/2023] [Indexed: 05/19/2023]
Abstract
There is a consistent link between perfectionism and eating disorders, however no meta-analysis to date has synthesized this literature in children and adolescents. We hypothesized that there would be significant, small pooled correlations between perfectionism dimensions and eating disorder symptoms in children and adolescents. Published, peer-reviewed articles with standardised measures of perfectionism and eating disorder symptoms were included. Articles were excluded if the age range was over 18 years. Overall, 39 studies were included (N = 13,954 participants, M age = 13.7 years). Total perfectionism (r = 0.25), perfectionistic strivings (r = 0.21), and perfectionistic concerns (r = 0.31) had significant positive associations with eating disorder symptoms. Most studies were rated as fair or good quality. Limitations included high heterogeneity, insufficient studies to investigate age as a moderator, the inclusion of only English articles, and predominately cross-sectional studies which precluded causal inference. Higher perfectionism was associated with greater eating disorder symptoms in children and adolescents. Future research should focus on longitudinal studies of eating disorder symptoms in children and adolescents.
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Affiliation(s)
- Elizabeth Bills
- Discipline of Psychology, School of Population Health, Curtin University, Perth, Australia
| | - Danyelle Greene
- Australian Institute for Business and Economics, Faculty of Business, Economics and Law, University of Queensland, Brisbane, Australia
| | - Rose Stackpole
- Discipline of Psychology, School of Population Health, Curtin University, Perth, Australia
| | - Sarah J Egan
- Discipline of Psychology, School of Population Health, Curtin University, Perth, Australia; enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia.
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Osenk I, Johnson C, Wade TD. A Pragmatic Randomized Controlled Trial Targeting Perfectionism in Young Adolescents. SCHOOL MENTAL HEALTH 2023; 15:151-164. [PMID: 36092281 PMCID: PMC9446653 DOI: 10.1007/s12310-022-09540-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2022] [Indexed: 11/19/2022]
Abstract
Perfectionism has adverse impacts on mental health and academic outcomes. We evaluated a 5-lesson classroom intervention for young adolescents delivered by teachers for impact on perfectionism, well-being, self-compassion, academic motivation and negative affect, at post-intervention and 3-month follow-up. Classes (N = 636 students, M age = 13.68, SD = 0.60) were randomized to intervention (n = 343) or classes as usual (n = 293). Data were analyzed using linear mixed models adjusted for baseline observation and clustering. At post-intervention no differences were found between the groups. At 3-month follow-up, anxiety showed a significant increase in the control group with no increase in the intervention group (d = 0.23; 95% CI: 0.05, 0.40); females in the control group had a significant decrease in well-being from post-intervention to 3 month follow-up compared to the intervention group (d = 0.33; 95% CI: 0.08, 0.58); students with high levels of perfectionistic concerns in the intervention had significantly lower perfectionistic strivings at 3 month follow-up than the control group ((d = 0.34, 95% CI: 0.19, 0.49). This intervention shows promising results when delivered by teachers. Australian New Zealand Clinical Trials Registry (ANZCTR) Trial Number: ACTRN12621000457842 (April 19, 2021). Supplementary Information The online version contains supplementary material available at 10.1007/s12310-022-09540-3.
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Affiliation(s)
- Ivana Osenk
- Blackbird Initiative, Flinders Institute for Mental Health and Wellbeing, Flinders University, Adelaide, South Australia Australia
| | - Catherine Johnson
- Blackbird Initiative, Flinders Institute for Mental Health and Wellbeing, Flinders University, Adelaide, South Australia Australia
| | - Tracey D Wade
- Blackbird Initiative, Flinders Institute for Mental Health and Wellbeing, Flinders University, Adelaide, South Australia Australia
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De Pasquale C, Morando M, Platania S, Sciacca F, Hichy Z, Di Nuovo S, Quattropani MC. The Roles of Anxiety and Self-Esteem in the Risk of Eating Disorders and Compulsive Buying Behavior. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16245. [PMID: 36498319 PMCID: PMC9735669 DOI: 10.3390/ijerph192316245] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 11/29/2022] [Accepted: 12/01/2022] [Indexed: 06/17/2023]
Abstract
In contemporary society, following the sudden changes that occur, different forms of addiction are becoming popular. Of note are the new addictions and concepts of poly-dependencies that involve common behaviors and trap people who suffering from them in a vicious circle. The main goal of this study is to investigate the possible mediating role that self-esteem had between trait anxiety and two specific new addictions: compulsive buying behavior and eating disorders. Furthermore, it was verified through a multigroup analysis that trait anxiety had a greater effect on eating disorders in a group of compulsive consumers. Three-hundred and fifty-two participants (67.9% women) were enrolled to participate in this study. The results showed that there was a direct effect of trait anxiety on eating disorders and on compulsive buying behavior; self-esteem mediated the effect of trait anxiety on eating disorders and compulsive buying behavior with specific differences; multi-group analysis showed differences in anxiety's effect on eating disorders between compulsive and non-compulsive consumers; the group of compulsive consumers revealed a significant and stronger effect of trait anxiety on eating disorders in all domains identified. Further research is recommended to better understand the predictors of these disorders and to contribute to a more effective preventive intervention.
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Affiliation(s)
- Concetta De Pasquale
- Section Philosophy and Social Sciences, Department of Educational Sciences, University of Catania, 95124 Catania, Italy
| | - Martina Morando
- Section Psychology, Department of Educational Sciences, University of Catania, 95124 Catania, Italy
| | - Silvia Platania
- Section Psychology, Department of Educational Sciences, University of Catania, 95124 Catania, Italy
| | - Federica Sciacca
- Section Psychology, Department of Educational Sciences, University of Catania, 95124 Catania, Italy
| | - Zira Hichy
- Section Psychology, Department of Educational Sciences, University of Catania, 95124 Catania, Italy
| | - Santo Di Nuovo
- Section Psychology, Department of Educational Sciences, University of Catania, 95124 Catania, Italy
| | - Maria Catena Quattropani
- Section Psychology, Department of Educational Sciences, University of Catania, 95124 Catania, Italy
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Cresswell C, Watson HJ, Jones E, Howell JA, Egan SJ. The role of compulsive exercise in the relationship between perfectionism and eating disorder pathology in underweight adolescents with eating disorders. Eat Behav 2022; 47:101683. [PMID: 36410135 DOI: 10.1016/j.eatbeh.2022.101683] [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: 03/13/2022] [Revised: 11/09/2022] [Accepted: 11/10/2022] [Indexed: 11/16/2022]
Abstract
Perfectionism has a strong association with eating disorders. Research in non-clinical adults has suggested that perfectionism has both direct and indirect effects on eating disorder symptoms, and that compulsive exercise is a potential mediator. The aim of this study was to understand whether perfectionism is associated with eating disorder symptoms, both directly and indirectly through compulsive exercise in underweight adolescents with eating disorders. Participants were 149 female adolescents (M = 14.90 years, age range 13-17) with eating disorders from the Helping to Outline Paediatric Eating Disorders (HOPE) Project, an ongoing, registry study of individuals consecutively referred individuals to a statewide eating disorder service. The majority had a diagnosis of anorexia nervosa restricting type (66 %), followed by unspecified feeding or eating disorder (21 %), and anorexia nervosa binge-eating purging type (13 %). To test the model, path analyses with bootstrapping were conducted. All paths were statistically significant, including the indirect effect from perfectionism to eating disorder pathology via the mediator of compulsive exercise, and the direct effect of perfectionism on eating disorder pathology. Overall, this research provides further evidence that compulsive exercise may be one factor that can explain the relationship between perfectionism and eating disorder symptoms. Future research should seek to determine the relative efficacy of approaches for the treatment of eating disorders in adolescents which target perfectionism and compulsive exercise.
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Affiliation(s)
- Camilla Cresswell
- Discipline of Psychology, School of Population Health, Curtin University, Perth, Australia
| | - Hunna J Watson
- Discipline of Psychology, School of Population Health, Curtin University, Perth, Australia; Department of Psychiatry, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, United States; Division of Pediatrics, School of Medicine, The University of Western Australia, Perth, Australia
| | - Emily Jones
- Eating Disorders Program, Child and Adolescent Health Service, Perth, Australia
| | - Joel A Howell
- Discipline of Psychology, School of Population Health, Curtin University, Perth, Australia; Centre for Clinical Interventions, Perth, Australia
| | - Sarah J Egan
- Discipline of Psychology, School of Population Health, Curtin University, Perth, Australia; enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia.
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12
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O'Brien A, Anderson R, Mazzucchelli T, Egan SJ. A protocol for unguided internet self-help cognitive behaviour therapy for perfectionism in adolescents at-risk of eating disorders. Internet Interv 2022; 29:100565. [PMID: 36034181 PMCID: PMC9399281 DOI: 10.1016/j.invent.2022.100565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 07/31/2022] [Accepted: 08/08/2022] [Indexed: 12/03/2022] Open
Abstract
UNLABELLED Perfectionism has a strong association with eating disorders, anxiety and depression. Unguided internet cognitive behaviour therapy for perfectionism has demonstrated efficacy in female adolescents without elevated eating disorder symptoms. No research to date has examined unguided internet cognitive behaviour therapy for perfectionism for adolescents with elevated eating disorder symptoms as an indicated prevention for eating disorders and co-occurring symptoms of anxiety and depression. The protocol outlines the plan for a randomised controlled trial of a co-designed, unguided internet cognitive behaviour therapy for perfectionism with female adolescents with elevated symptoms of eating disorders. The intervention will be a 4-week programme compared to a waitlist control. Outcomes on eating disorder symptoms, anxiety and depression will be measured pre and post intervention and follow-up. TRIAL REGISTRATION This trial was registered on 23 September 2020 with the Australian New Zealand Clinical Trials Registry (ACTRN12620000951954P).
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Affiliation(s)
- Amy O'Brien
- Discipline of Psychology, School of Population Health, Curtin University, GPO Box U1987, Perth 6845, Australia
| | - Rebecca Anderson
- Discipline of Psychology, School of Population Health, Curtin University, GPO Box U1987, Perth 6845, Australia,enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Trevor Mazzucchelli
- Discipline of Psychology, School of Population Health, Curtin University, GPO Box U1987, Perth 6845, Australia,enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Sarah J. Egan
- Discipline of Psychology, School of Population Health, Curtin University, GPO Box U1987, Perth 6845, Australia,enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia,Corresponding author at: enAble Institute and School of Population Health, Curtin University, Australia.
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Compulsive Study Behaviors Are Associated with Eating Disorders and Have Independent Negative Effects on Well-Being: A Structural Equation Model Study among Young Musicians. SUSTAINABILITY 2022. [DOI: 10.3390/su14148617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Compulsive overworking and eating disorders (EDs) show considerable similarities in terms of risk factors (e.g., rigid perfectionism), clinical manifestation (e.g., excessive controlling behaviors), and consequences (e.g., physical exhaustion and depression). This study aimed to examine the hypotheses that compulsive study behaviors (conceptualized as study addiction) are related to EDs and that they have independent negative effects on well-being among young musicians, who constitute a highly vulnerable population for these types of problematic behaviors. The relatively high prevalence of study addiction and its pronounced negative relationship with psychosocial functioning make it a pending challenge for sustainable education. A total of 255 students from various music academies in Poland took part in the study. The Bergen Study Addiction Scale, assessing compulsive studying (conceptualized as addictive behavior), the Eating Attitude Test-26 (EAT-26), the Perceived Stress Scale, the Hospital Anxiety and Depression Scale, and the quality-of-life measure were used. A structural equation model was investigated. Study addiction was positively related to the general factor of EDs and the social pressure component. Both problematic behaviors showed negative and independent effects on the well-being of young musicians. EDs may be 8 to 16 times more prevalent among the students of music academies who are addicted to studying than among the general population. About 80% of those students showing all seven symptoms of study addiction exhibited at least mild depression, while more than half had clinically significant levels of depression. Almost 90% had clinically significant levels of anxiety. Without addressing co-occurring study addiction and eating disorders, including their commonalities and idiosyncrasies, their prevention and treatment cannot be effective and it will substantially affect the sustainability of education and work.
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Gürkan KP, Aydoğdu NG, Dokuzcan DA, Yalçinkaya A. The effects of nurses' perceived stress and life satisfaction on their emotional eating behaviors. Perspect Psychiatr Care 2022; 58:1048-1054. [PMID: 34212367 DOI: 10.1111/ppc.12897] [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: 10/25/2020] [Revised: 05/24/2021] [Accepted: 05/29/2021] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To examine the effects of the nurses' perceived stress and life satisfaction on their emotional eating behaviors. DESIGN AND METHODS A cross-sectional study was conducted among a random sample of 297 nurses in a research hospital. FINDINGS There is a negative correlation between nurses' emotional eating and life satisfaction (β = -0.192, p < 0.001), and a positive correlation between emotional eating and perceived stress (β = 0.392, p < 0.001). Perceived stress, life satisfaction, and marital status constituted 24% of the factors affecting emotional eating behaviors. PRACTICE IMPLICATIONS Psychiatric nurses would benefit from developing effective training programs that support nurses in making healthy lifestyle choices.
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Affiliation(s)
- Kübra P Gürkan
- Department of Public Health Nursing, Faculty of Nursing, Dokuz Eylül University, İnciraltı, Izmir, Turkey
| | - Nihal G Aydoğdu
- Department of Public Health Nursing, Faculty of Health Science, Erzurum Teknik University, Erzurum, Turkey
| | - Deniz A Dokuzcan
- Department of Public Health Nursing, Faculty of Health Science, Balıkesir University, Balıkesir, Turkey
| | - Ayşen Yalçinkaya
- University of Health Sciences, İzmir Bozyaka Education and Research Hospital, Izmir, Turkey
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Pamies-Aubalat L, Quiles Marcos Y, Torregrosa Díez MS. Psychosocial profile related to disordered eating attitudes in Spanish adolescents. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03164-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
AbstractDifferent psychosocial variables are related to disordered eating attitudes in adolescents, especially in girls. But some studies show that the variables involved in eating disorders may be different in boys and girls. The aim of this study was to analyse the psychosocial profile related to disordered eating attitudes in adolescents of both sexes, separately. Method: a cross-sectional study was conducted in 1630 Spanish adolescents, 890 of whom were girls with an average age of 14 (SD = 1.34) selected from secondary schools in the province of Alicante through random sampling stratified by school year. Results: The cluster analysis showed two profiles in both sexes. One profile presents high disordered eating attitudes, where the highest scores were in body dissatisfaction, perfectionism, pressure to lose weight and social comparison, and the lowest scores were for self-esteem. This contrasts with the other profile that presents low disordered eating attitudes. The logistic regression model showed that girls were 3.8 times more likely to have disordered eating attitudes if they dieted, experienced body dissatisfaction and compared themselves socially with their peers. Disordered eating attitudes in boys was 3.3 times greater when they experienced body dissatisfaction and pressure to lose weight. Conclusion: These results showed that both sexes present similar profiles. Girls and boys present disordered eating attitudes when they have low self-esteem, body dissatisfaction, self-oriented and socially prescribed perfectionism, comparison with peers, pressure to lose weight, or are on a diet. In future studies, it will be necessary to develop further longitudinal studies which could help to shed light on the risks and protective factors of eating disorders.
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Novack K, Dufour R, Picard L, Booij L, Chadi N. An Intensive Ambulatory Care Program for Adolescents with Eating Disorders Combining In-Person and Virtual Care: Protocol for a Single-Site Naturalistic Trial (Preprint). JMIR Res Protoc 2022; 11:e37420. [DOI: 10.2196/37420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 09/18/2022] [Accepted: 09/21/2022] [Indexed: 11/13/2022] Open
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Stricker J, Kröger L, Küskens A, Gieselmann A, Pietrowsky R. No perfect sleep! A systematic review of the link between multidimensional perfectionism and sleep disturbance. J Sleep Res 2022; 31:e13548. [DOI: 10.1111/jsr.13548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 12/23/2021] [Accepted: 12/26/2021] [Indexed: 01/23/2023]
Affiliation(s)
- Johannes Stricker
- Department of Experimental Psychology Heinrich Heine University Düsseldorf Düsseldorf Germany
| | - Lasse Kröger
- Department of Psychology University of Trier Trier Germany
| | - Anna Küskens
- Department of Experimental Psychology Heinrich Heine University Düsseldorf Düsseldorf Germany
| | - Annika Gieselmann
- Department of Experimental Psychology Heinrich Heine University Düsseldorf Düsseldorf Germany
| | - Reinhard Pietrowsky
- Department of Experimental Psychology Heinrich Heine University Düsseldorf Düsseldorf Germany
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Blackburn M, Methot-Jones T, Molnar DS, Zinga D, Spadafora N, Tacuri N. Assessing changes to adolescent health-promoting behaviors following the onset of the COVID-19 pandemic: A multi-methods exploration of the role of within-person combinations of trait perfectionism. PERSONALITY AND INDIVIDUAL DIFFERENCES 2022; 189:111492. [PMID: 35001996 PMCID: PMC8719941 DOI: 10.1016/j.paid.2021.111492] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 11/30/2021] [Accepted: 12/24/2021] [Indexed: 01/31/2023]
Abstract
The current work provides a multi-methods exploration of how within-person subtypes of self-oriented perfectionism (SOP) and socially prescribed perfectionism (SPP) were related to shifts in health-promoting behaviors among adolescents following the onset of the COVID-19 pandemic. Study One tested the 2 × 2 and tripartite models of perfectionism through a quantitative test of how such subtypes predicted changes in health behaviors pre-pandemic to intra-pandemic among 202 adolescents (M = 17.86, SD = 1.421). Results indicated that the combination of high SOP/high SPP was linked to the most maladaptive changes to health-promoting behaviors, supporting the tripartite model. Study Two aimed to contextualize these findings by analyzing semi-structured interviews with 31 adolescent self-identified perfectionists (M = 15.97, SD = 1.991) during the initial lockdown mandate. Results indicated that participants experienced a welcome break and found more time to engage in health-promoting behaviors. However, those high in SOP – regardless of their level of SPP – had more difficulty relaxing due to a resistance to relenting their perfectionistic standards. Altogether, these findings support the exacerbating role of SOP when combined with SPP posited by the tripartite model of perfectionism with respect to adolescents' health-promoting behaviors during the COVID-19 pandemic.
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Affiliation(s)
- Melissa Blackburn
- Department of Child and Youth Studies, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, ON L2S 3A1, Canada
| | - Tabitha Methot-Jones
- Department of Child and Youth Studies, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, ON L2S 3A1, Canada
| | - Danielle S Molnar
- Department of Child and Youth Studies, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, ON L2S 3A1, Canada
| | - Dawn Zinga
- Department of Child and Youth Studies, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, ON L2S 3A1, Canada
| | - Natalie Spadafora
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Suite 201A, 175 Longwood Rd. S., Hamilton, ON L8P 0A1, Canada
| | - Natalie Tacuri
- Department of Child and Youth Studies, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, ON L2S 3A1, Canada
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Psychological Risk Factors for the Development of Restrictive and Bulimic Eating Behaviors: A Polish and Vietnamese Comparison. Nutrients 2021; 13:nu13030910. [PMID: 33799636 PMCID: PMC8001869 DOI: 10.3390/nu13030910] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/02/2021] [Accepted: 03/09/2021] [Indexed: 12/14/2022] Open
Abstract
The aim of this paper is to identify psychological factors which are culture specific or common predictors for restrictive and bulimic behaviors towards eating for young women raised in different cultures. The study included 661 young women from Poland (n = 233) and Vietnam (n = 428). Subjects filled-in the Eating Disorders Inventory (EDI-3) and the Multidimensional Body-Self Relations Questionnaire-Appearance Scales (MBSRQ-AS), and body measurements were collected to calculate anthropometric indices. Women form Vietnam were less satisfied with their appearance than were their Polish peers, but Vietnamese showed a lower level of preoccupation with being overweight and fear of obesity. Intercultural differences indicate that Vietnamese women show greater intensities for psychological variables, connected with restrictive and bulimic eating behaviors, verified in the research model: low self-esteem, personal alienation, interpersonal insecurity, interpersonal alienation, emotional dysregulation, interoceptive deficits, perfectionism and asceticism, and anxiety.
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Merwin RM, Moskovich AA, Babyak M, Feinglos M, Honeycutt LK, Mooney J, Freeman SP, Batchelder H, Sangvai D. An open trial of app-assisted acceptance and commitment therapy (iACT) for eating disorders in type 1 diabetes. J Eat Disord 2021; 9:6. [PMID: 33407910 PMCID: PMC7789378 DOI: 10.1186/s40337-020-00357-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 12/01/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Eating disorders (EDs) among individuals with type 1 diabetes (T1D) increase the risk of early and severe diabetes-related medical complications and premature death. Conventional eating disorder (ED) treatments have been largely ineffective for T1D patients, indicating the need to tailor treatments to this patient population and the unique conditions under which ED symptoms emerge (in the context of a chronic illness with unrelenting demands to control blood glucose, diet and exercise). The current study was a pilot open trial of iACT, a novel intervention for EDs in T1D grounded in Acceptance and Commitment Therapy (ACT). iACT was based on the premise that ED symptoms emerge as individuals attempt to cope with T1D and related emotional distress. iACT taught acceptance and mindfulness as an alternative to maladaptive avoidance and control, and leveraged personal values to increase willingness to engage in T1D management, even when it was upsetting (e.g., after overeating). A tailored mobile application ("app") was used in between sessions to facilitate the application of ACT skills in the moment that individuals are making decisions about their diabetes management. METHODS Adults with T1D who met criteria for an ED completed 12 sessions of iACT (with three optional tapering sessions). In addition to examining whether treatment was acceptable and feasible (the primary aim of the study), the study also examined whether iACT was associated with increased psychological flexibility (i.e., the ability to have distressing thoughts/feelings about diabetes while pursuing personally meaningful values), and improvements in ED symptoms, diabetes management and diabetes distress. RESULTS Treatment was acceptable to T1D patients with EDs and feasible to implement. Participants reported increased psychological flexibility with diabetes-related thoughts/feelings, and less obstruction and greater progress in pursuing personal values. There were large effects for change in ED symptoms, diabetes self-management and diabetes distress from baseline to end-of-treatment (Cohen's d = .90-1.79). Hemoglobin A1c also improved, but the p-value did not reach statistical significance, p = .08. CONCLUSIONS Findings provide preliminary evidence for iACT to improve outcomes for T1D patients with EDs and support further evaluation of this approach in a controlled trial. TRIAL REGISTRATION NCT02980627 . Registered 8 July 2016.
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Affiliation(s)
- Rhonda M Merwin
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, DUMC Box 3842, Durham, NC, 27712, USA.
| | - Ashley A Moskovich
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, DUMC Box 3842, Durham, NC, 27712, USA
| | - Michael Babyak
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, DUMC Box 3842, Durham, NC, 27712, USA
| | - Mark Feinglos
- Department of Medicine, Division of Endocrinology, Metabolism and Nutrition, Duke University Medical Center, Durham, NC, USA
| | - Lisa K Honeycutt
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, DUMC Box 3842, Durham, NC, 27712, USA
| | - Jan Mooney
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, DUMC Box 3842, Durham, NC, 27712, USA
| | - Sara P Freeman
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, DUMC Box 3842, Durham, NC, 27712, USA
| | - Heather Batchelder
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, DUMC Box 3842, Durham, NC, 27712, USA
| | - Devdutta Sangvai
- Department of Family Medicine and Community Health, Duke University Medical Center, Durham, NC, USA
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