1
|
Wu Y, Tang J, Meng X, Wang F, Sun X, Fan S, Ma J, Wu Y. Validation and structural exploration of the Chinese version of the Body Talk Scale. Body Image 2024; 51:101766. [PMID: 38986235 DOI: 10.1016/j.bodyim.2024.101766] [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: 01/21/2024] [Revised: 06/21/2024] [Accepted: 07/03/2024] [Indexed: 07/12/2024]
Abstract
The Body Talk Scale (BTS) measures both negative body talk (including fat talk and muscle talk) and positive body talk across genders. In this study, we translated it into Chinese and assessed its structure, reliability and validity among mainland Chinese residents. Item analyses indicated that no item deletion was necessary for this study, and both exploratory factor analysis (n = 1853) and exploratory graph analysis (n = 1583) supported the three-factor structure of the original scale. Confirmatory factor analysis showed that the scale had a good model fit with CFI= 0.95, GFI= 0.93, TLI= 0.94, and RMSEA= 0.079(90 %CI [0.075, 0.084]). The results also showed that the Chinese version of the BTS had adequate criterion-related validity,internal consistency and six-week test-retest reliability. Meanwhile, the scale has good measurement invariance with respect to gender and can be tested for gender differences. In conclusion, the BTS showed sufficient psychometric properties in a Chinese sample, making it a valid instrument for studying body talk and health status in Chinese populations.
Collapse
Affiliation(s)
- Yunchou Wu
- School of Psychology, Southwest University, Chongqing 400715, China.
| | - Jingqi Tang
- School of Psychology and Cognitive Science, East China Normal University, Shanghai 200062, China.
| | - Xiaoxuan Meng
- School of Nursing, Tianjin Medical University, Tianjin 300070, China.
| | - Fei Wang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China.
| | - Xiaonan Sun
- College of Public Health, Harbin Medical University, Harbin 150081, China.
| | - Siyuan Fan
- Department of Preventive Medicine, Yanjing Medical College, Capital Medical University, Beijing 101300, China; Beijing Chaoyang District Center for Disease Control and Prevention, Beijing 100021, China.
| | - Jiaxin Ma
- Department of Clinical Medicine, North Sichuan Medical College, Nanchong 637000, China.
| | - Yibo Wu
- School of Public Health, Peking University, Beijing 100191, China.
| |
Collapse
|
2
|
Alghamdi NA, Aldhwayan MM, Albassam RS, Asseri RF, Alyousef AF, Naaman RK, Alzuman MA, Almukhlifi AJ, Alquraishi MI. The Arabic Version of Compulsive Exercise Test among Saudi Population; Translation and Validation. Sports (Basel) 2024; 12:176. [PMID: 39058067 PMCID: PMC11280584 DOI: 10.3390/sports12070176] [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: 03/09/2024] [Revised: 05/27/2024] [Accepted: 05/29/2024] [Indexed: 07/28/2024] Open
Abstract
Compulsive exercise is a condition characterized by uncontrollable exercise behaviour that may lead to severe and harmful physical and psychological consequences. Indeed, compulsive exercise is among the early symptoms of eating disorders that may affect different age groups. Globally and among Arab countries, compulsive exercise is common, while the screening methods used to assess compulsive exercise are limited. Thus, the Compulsive Exercise Test (CET) has emerged as a tool to assess cognitive, behavioural, and emotional factors related to compulsive exercise. The CET is a self-report, Likert-type scale comprising five distinct subscales. The increase in the CET scores is more likely associated with worsened pathology. Since the Arab countries lack such an assessment tool, we aimed to translate the CET into Arabic, validate the translated version, confirm the factor structures, and assess the internal consistency of the different subscales. Herein, we used the forward-backward translation method as recommended by the World Health Organization (WHO). The overall validity index of the translated version showed a score higher than 0.78, while the scale-level content validity index based on the average calculating method (S-CVI/Ave) and the agreement method (S-CVI/UA) were 0.91 and 0.58, respectively. Moreover, we recruited 399 Arabs living in Saudi to measure the internal consistency, and the value of the substantive internal consistency with Cronbach's α was 0.81. Subsequently, four of the Arabic-CET subscales had substantive internal consistency with Cronbach's α values higher than or equal to 0.70. Furthermore, the exploratory factor analysis results supported the substantial use of the five-subscale model. Taken together, our study supports using the Arabic-CET version to measure exercise compulsiveness among Arabs.
Collapse
Affiliation(s)
- Nouf A. Alghamdi
- Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia
| | - Madhawi M. Aldhwayan
- Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia
| | - Reem S. Albassam
- Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia
| | - Rana F. Asseri
- Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia
| | - Aljouhara F. Alyousef
- Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia
| | - Reem K. Naaman
- Department of Preventive Dental Sciences, College of Dentistry, Taibah University, Madinah 42353, Saudi Arabia
| | - Manar A. Alzuman
- Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia
| | - Aseel J. Almukhlifi
- Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia
| | - Mohammed I. Alquraishi
- Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia
| |
Collapse
|
3
|
Meneguzzo P, Behrens SC, Pavan C, Toffanin T, Quiros-Ramirez MA, Black MJ, Giel KE, Tenconi E, Favaro A. Exploring weight bias and negative self-evaluation in patients with mood disorders: insights from the BodyTalk Project. Front Psychiatry 2024; 15:1407474. [PMID: 38873536 PMCID: PMC11169709 DOI: 10.3389/fpsyt.2024.1407474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 05/08/2024] [Indexed: 06/15/2024] Open
Abstract
Background Negative body image and adverse body self-evaluation represent key psychological constructs within the realm of weight bias (WB), potentially intertwined with the negative self-evaluation characteristic of depressive symptomatology. Although WB encapsulates an implicit form of self-critical assessment, its exploration among people with mood disorders (MD) has been under-investigated. Our primary goal is to comprehensively assess both explicit and implicit WB, seeking to reveal specific dimensions that could interconnect with the symptoms of MDs. Methods A cohort comprising 25 MD patients and 35 demographically matched healthy peers (with 83% female representation) participated in a series of tasks designed to evaluate the congruence between various computer-generated body representations and a spectrum of descriptive adjectives. Our analysis delved into multiple facets of body image evaluation, scrutinizing the associations between different body sizes and emotionally charged adjectives (e.g., active, apple-shaped, attractive). Results No discernible differences emerged concerning body dissatisfaction or the correspondence of different body sizes with varying adjectives. Interestingly, MD patients exhibited a markedly higher tendency to overestimate their body weight (p = 0.011). Explicit WB did not show significant variance between the two groups, but MD participants demonstrated a notable implicit WB within a specific weight rating task for BMI between 18.5 and 25 kg/m2 (p = 0.012). Conclusions Despite the striking similarities in the assessment of participants' body weight, our investigation revealed an implicit WB among individuals grappling with MD. This bias potentially assumes a role in fostering self-directed negative evaluations, shedding light on a previously unexplored facet of the interplay between WB and mood disorders.
Collapse
Affiliation(s)
- Paolo Meneguzzo
- Department of Neuroscience, University of Padova, Padova, Italy
- Padova Neuroscience Center, University of Padova, Padova, Italy
| | - Simone C. Behrens
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany
- Max Planck Institute for Intelligent Systems, Tübingen, Germany
| | - Chiara Pavan
- Department of Medicine, University of Padova, Padova, Italy
| | - Tommaso Toffanin
- Psychiatric Unit, Padua University Hospital, Padova, Italy
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - M. Alejandra Quiros-Ramirez
- Max Planck Institute for Intelligent Systems, Tübingen, Germany
- Psychology Department, University of Konstanz, Konstanz, Germany
| | | | - Katrin E. Giel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany
| | - Elena Tenconi
- Department of Neuroscience, University of Padova, Padova, Italy
- Padova Neuroscience Center, University of Padova, Padova, Italy
| | - Angela Favaro
- Department of Neuroscience, University of Padova, Padova, Italy
- Padova Neuroscience Center, University of Padova, Padova, Italy
| |
Collapse
|
4
|
Mahdifar M, Tavakoly Sany SB, Tehrani H, Ghavami V, Vahedian Shahroodi M. Body image perception and physical activity behavior among adult population: Application of trans-theoretical model of behavior change. PLoS One 2024; 19:e0297778. [PMID: 38408055 PMCID: PMC10896515 DOI: 10.1371/journal.pone.0297778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 01/12/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND The human body changes during life, but research on how sociodemographic characteristics and physical activity (PA) related to all aspects of body image are still unclear and there is conflict in the relevant results. This study aims to examine gender-specific body image perception and physical activity in relation to BMI and sociodemographic characteristics among health employees who worked in health and medical care centers. METHODS The study was a population-based cross-sectional survey of 170 health employees (55 men and 115 women) in Binaloud, Iran. Participants completed a self-administered questionnaire, which consisted of a self-administered Multidimensional Body-Self Image Questionnaire (MBSRQ) and stages of change scales. The full version of Marcus-TTM based on the stages of physical activity changes was used based on 5 items related to regular physical activity behavior and intentions. RESULTS There were no significant differences between men and women in total body image score, body area satisfaction, and attitude. Disease orientation (p = 0.02) and health orientation (p = 0.05) were the only significant differences between men and women. The number of children, level of education, BMI, and PA had a stronger influence on body image concerns and body dissatisfaction. PA and 7 of the 10 subclasses of MBSRQ (appearance evaluation, fitness evaluation, fitness orientation, health evaluation, health orientation, and illness orientation) showed a significant difference (P<0.05) between participants in the five TTM stages. CONCLUSION The ideal body image and body satisfaction may differ by the number of children, level of education, gender, BMI, and PA. Evidence from this study supports that participants' stages of change affect their physical activity and body image perception. This result suggests a need for conducting work/home place intervention to promote adults' body image perception and body area satisfaction based on the usage-specific stage under consideration.
Collapse
Affiliation(s)
- Mozhgan Mahdifar
- Department of Health Education and Health Promotion, Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyedeh Belin Tavakoly Sany
- Department of Health, Safety, and Environment, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hadi Tehrani
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Vahid Ghavami
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Vahedian Shahroodi
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| |
Collapse
|
5
|
Möllmann A, Heinrichs N, Herwig A. A conceptual framework on body representations and their relevance for mental disorders. Front Psychol 2024; 14:1231640. [PMID: 38250111 PMCID: PMC10796836 DOI: 10.3389/fpsyg.2023.1231640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 12/11/2023] [Indexed: 01/23/2024] Open
Abstract
Many mental disorders are accompanied by distortions in the way the own body is perceived and represented (e.g., eating disorders, body dysmorphic disorder including muscle dysmorphia, or body integrity dysphoria). We are interested in the way these distortions develop and aim at better understanding their role in mental health across the lifespan. For this purpose, we first propose a conceptual framework of body representation that defines this construct and integrates different perspectives (e.g., cognitive neuroscience, clinical psychology) on body representations. The framework consists of a structural and a process model of body representation emphasizing different goals: the structural model aims to support researchers from different disciplines to structure results from studies and help collectively accumulate knowledge about body representations and their role in mental disorders. The process model is reflecting the dynamics during the information processing of body-related stimuli. It aims to serve as a motor for (experimental) study development on how distorted body representations emerge and might be changed. Second, we use this framework to review the normative development of body representations as well as the development of mental disorders that relate to body representations with the aim to further clarify the potential transdiagnostic role of body representations.
Collapse
Affiliation(s)
- Anne Möllmann
- Department of Psychology, Faculty of Psychology and Sports Science, Bielefeld University, Bielefeld, Germany
| | | | | |
Collapse
|
6
|
Dauber A, Braden A. Facial EMG startle response and self-report reactions after exposure to severely underweight and severely obese body images in individuals with disordered eating: An examination of motivational responses. Int J Psychophysiol 2023; 194:112249. [PMID: 37802389 DOI: 10.1016/j.ijpsycho.2023.112249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 09/02/2023] [Accepted: 10/02/2023] [Indexed: 10/10/2023]
Abstract
Examining appetitive and aversive responses toward body image stimuli of those with disordered eating may illuminate motivational systems unique to eating pathology. The current study extended previous literature by examining self-report and startle responses to a range of body sizes. In this cross-sectional design, female, adult participants (n = 45) were sorted into disordered eating (DE; n = 22) and healthy control (HC; n = 23) groups based on Eating Disorder Examination Questionnaire global scores that were one standard deviation above or below normative values. Participants viewed eight computer-generated female body pictures from each group: severely underweight (BMI < 16.0), average (BMI 18.5-24.99), and severely obese (BMI > 40.0). Startle responses and self-reported valence and anxiety scores were collected to assess implicit and explicit reactions. 2 × 3 ANCOVA/ANOVAs were used to examine startle responses and self-report differences between groups, in response to image types. Results indicated startle responses did not differ between groups. There was a significant main effect for body picture type (p < .001), after controlling for psychotropic medication. Startle responses were higher for severely underweight body images compared to severely obese body images, although non-significant at post-hoc. The DE group reported higher levels of anxiety and sadness when viewing body images compared to the HC group. Average bodies were rated as less anxiety provoking and more positive than severely underweight and obese bodies. Group differences in anxiety and valence scores could be due to more maladaptive cognitions related to fear of weight gain among people with disordered eating.
Collapse
Affiliation(s)
- Aubrey Dauber
- Bowling Green State University Psychology Department, 822 E. Merry Street, Bowling Green, OH, 43403, United States of America.
| | - Abby Braden
- Bowling Green State University Psychology Department, 822 E. Merry Street, Bowling Green, OH, 43403, United States of America.
| |
Collapse
|
7
|
Todisco P, Meneguzzo P, Garolla A, Antoniades A, Vogazianos P, Tozzi F. Preparing for the next pandemic by understanding the impact of COVID-19 mitigation measures on patients with eating Disorders: observations from an inpatient setting. Int J Psychiatry Clin Pract 2023; 27:323-329. [PMID: 37293936 DOI: 10.1080/13651501.2023.2221318] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 05/30/2023] [Indexed: 06/10/2023]
Abstract
OBJECTIVE The COVID-19 pandemic overwhelmed eating disorder (ED) services worldwide. Data suggests a worsening of psychopathology and an increased request for specialised treatments. Still, the studies are mostly based on experimental protocols with underpowered short-term opportunistic experimental designs. Thus, this study aims to assess the clinical and psychological differences between patients admitted to a specialised ED Unit before and after the COVID-19 breakout. METHODS Consecutive patients admitted from June 2014 to February 2022 in a specialised EDs Unit were enrolled. A total sample of 498 individuals was enrolled in this retrospective study, collecting demographic and psychopathological data at admission. RESULTS An increase in the admission of patients with anorexia nervosa has been reported, with lower age and higher levels of specific and general psychopathology, especially linked to body uneasiness. CONCLUSIONS Results are put into the context of the preparation for the next pandemic that may require similar mitigation measures as COVID-19 to ensure the impact on existing and new patients. Covering an extended period with validated tools, our results might help psychiatric services to reassess their treatment pathways after the pandemic, helping clinicians to delineate future treatment interventions.KEYPOINTSAfter the COVID-19 breakdown, there was an increase in the admission of patients with anorexia nervosa to specialised services.More severe psychopathology was not accompanied by lower body mass index.Specialised eating disorders services should face sudden changes in patients' requests for treatment.Understanding the impact of the Covid-19 pandemic and the resulting mitigation measures taken can lead to better preparations for the next pandemic.
Collapse
Affiliation(s)
- Patrizia Todisco
- Eating Disorders Unit, Casa di Cura 'Villa Margherita', Arcugnano, VI, Italy
| | - Paolo Meneguzzo
- Department of Neuroscience, University of Padova, Padova, Italy
- Padova Neuroscience Center, University of Padova, Padova, Italy
| | - Alice Garolla
- Eating Disorders Unit, Casa di Cura 'Villa Margherita', Arcugnano, VI, Italy
| | | | - Paris Vogazianos
- Behavioral Sciences Department, European University, Egkomi, Cyprus
| | - Federica Tozzi
- Research & Development, Stremble Ventures LTD, Limassol, Cyprus
| |
Collapse
|
8
|
Horndasch S, Sharon E, Eichler A, Graap H, Moll GH, Kratz O. Heart Rate as a Correlate for the Emotional Processing of Body Stimuli in Anorexia Nervosa. Behav Sci (Basel) 2023; 13:bs13030215. [PMID: 36975240 PMCID: PMC10045133 DOI: 10.3390/bs13030215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 02/22/2023] [Accepted: 02/27/2023] [Indexed: 03/06/2023] Open
Abstract
In anorexia nervosa, aberrant emotional reactions toward body stimuli have been discussed. We investigated heart rate as a physiological marker when viewing body stimuli and hypothesized altered HR reactions toward those highly significant and emotional stimuli in anorexia nervosa. In total, 37 anorexia nervosa patients and 43 control participants viewed pictures of women of five different weight categories, while their cardiac activity was recorded. R-R intervals following picture onset were determined, and means were calculated for three distinct time periods. The overall change in HR relative to baseline across all picture categories was greater in the patient group than in the control group (significant effect of “group”, p = 0.002, partial η2 = 0.120). A significant decrease in HR 2 to 8 s after picture presentation was found for pictures of women of extreme weight in both participant groups (significant “category ∗ time segment interaction”, p = 0.01, partial η2 = 0.037) and correlated with scores of sociocultural attitudes toward the appearance for the extremely underweight category (r = −0.33, p = 0.005). Therefore, differential HR reactions for anorexia nervosa patients and control participants were found for body stimuli in general. The highest HR decelerations in response to pictures of strongly underweight and overweight women may reflect emotional processes such as anxiety due to social comparison.
Collapse
Affiliation(s)
- Stefanie Horndasch
- Department of Child and Adolescent Mental Health, University of Erlangen-Nuremberg, 91054 Erlangen, Germany
- Correspondence: ; Tel.: +49-9131-8539123
| | - Elisabeth Sharon
- Department of Child and Adolescent Mental Health, University of Erlangen-Nuremberg, 91054 Erlangen, Germany
| | - Anna Eichler
- Department of Child and Adolescent Mental Health, University of Erlangen-Nuremberg, 91054 Erlangen, Germany
| | - Holmer Graap
- Department of Psychosomatic Medicine and Psychotherapy, University of Erlangen-Nuremberg, 91054 Erlangen, Germany
| | - Gunther H. Moll
- Department of Child and Adolescent Mental Health, University of Erlangen-Nuremberg, 91054 Erlangen, Germany
| | - Oliver Kratz
- Department of Child and Adolescent Mental Health, University of Erlangen-Nuremberg, 91054 Erlangen, Germany
| |
Collapse
|
9
|
Perceived Body Image towards Disordered Eating Behaviors and Supplement Use: A Study of Mauritian Gym-Goers. PSYCH 2023. [DOI: 10.3390/psych5010009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Purpose: Individuals with body image distortions tend to develop an obsession with calorie intake and weight, leading to compounded coping strategies such as modified eating behaviors, supplement use, and excessive exercise. In the local context, little is known about the equation connecting body image to improper eating behaviors and other potential coping mechanisms. This study primarily aims at critically identifying the nexus between features of disordered eating behavior including supplement use, and body image. Methodology: A probabilistic randomized sample of 305 gym members was assessed based on their level of body satisfaction and its influence on their eating habits and supplement use through a structured survey. Findings: Only 37% of the participants were satisfied with their body image. The results concurred with the notion of a poor body image influencing body esteem (χ2 (10) = 137.21, p < 0.05; Cramer V = 0.474). While exercise motivated the use of supplements, a significant relationship was also observed between disordered eating habits and supplement use (χ2 (4) = 48.63, p < 0.05; Cramer V = 0.399). A predictive model was successfully drawn inclusive of the disordered eating behaviors dimensions as a potent predictor of body image (χ2 (56) = 397.12, p < 0.001. Implications: This study presents an in-depth analysis of the magnitude of disordered eating behaviors with respect to individuals in the local fitness industry, and the need for professional support programs toward the re-alignment of body image in an effort to curtail the development of eating disorders in Mauritian gym-goers.
Collapse
|
10
|
Masselman I, de Jong PJ, Glashouwer KA. Subjective disgust and facial electromyography responses towards unedited and morphed overweight self-pictures in women with varying levels of eating disorder symptomatology. EUROPEAN EATING DISORDERS REVIEW 2023; 31:98-109. [PMID: 35929599 PMCID: PMC10087951 DOI: 10.1002/erv.2940] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 06/13/2022] [Accepted: 07/02/2022] [Indexed: 12/13/2022]
Abstract
Individuals with an eating disorder (ED) often report to be disgusted by their body. Body-related self-disgust could play an important role in the development and maintenance of EDs. We investigated if women with relatively high ED symptom scores indeed respond with disgust upon exposure to their body as indexed by facial electromyography (fEMG) of the m. levator labii superioris and self-report. Given that one's self-disgust may increase/decrease depending on the relative distance of the own body to the thin ideal, we also assessed women's disgust for overweight- and thin-morphs of their body. Female undergraduate students (N = 104) were photographed and presented with their (morphed) body pictures, next to disgust-relevant and overweight body control pictures. Higher levels of ED symptoms were associated with stronger self-reported disgust to unedited body-pictures and overweight-morphs. Disgust to thin-morphs was unrelated to ED symptoms. Participants generally showed heightened facial disgust towards overweight morphs, yet the strength of facial disgust was unrelated to ED symptoms. Thus, the findings provide evidence for the involvement of heightened body-related self-disgust in ED symptomatology, albeit only on the basis of self-report.
Collapse
Affiliation(s)
- Irina Masselman
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, Netherlands
| | - Peter J de Jong
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, Netherlands
| | - Klaske A Glashouwer
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, Netherlands.,Department of Eating Disorders, Accare Child and Adolescent Psychiatry, Groningen, Netherlands
| |
Collapse
|
11
|
Galvin J, Evans EH, Talbot CV, Wilson C, Richards G. The associations between autistic traits and disordered eating/drive for muscularity are independent of anxiety and depression in females but not males. PLoS One 2022; 17:e0276249. [PMID: 36251679 PMCID: PMC9576073 DOI: 10.1371/journal.pone.0276249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 10/03/2022] [Indexed: 11/19/2022] Open
Abstract
Previous research has shown a positive correlation between autistic traits and eating disorder symptoms, and this relationship appears to be independent of co-occurring mental health status. The current study followed a pre-registered analysis plan with the aim to investigate a previously unconsidered factor in the relationship between autistic traits and disorders of eating and body image: the drive for muscularity. Participants (N = 1068) completed the Autism Spectrum Quotient (AQ), Hospital Anxiety and Depression Scale (HADS), Eating Attitudes Test-26 (EAT-26) and Drive for Muscularity Scale (DMS). Positive correlations between AQ and EAT-26 and AQ and DMS were observed. In females, AQ remained significantly correlated with EAT-26 and DMS when controlling for co-occurring anxiety and depression symptoms, but this was not the case in males. These findings demonstrate the moderating role of sex, and the need to consider autistic traits in individuals diagnosed with, or at a heightened risk for, disorders of eating and body image.
Collapse
Affiliation(s)
- John Galvin
- Department of Psychology, Birmingham City University, Birmingham, United Kingdom
| | | | | | - Claire Wilson
- School of Education, University of Strathclyde, Glasgow, United Kingdom
| | - Gareth Richards
- Faculty of Medical Sciences, School of Psychology, Newcastle University, Newcastle upon Tyne, United Kingdom
| |
Collapse
|
12
|
Time evaluation and its accuracy in eating disorders: differences in relation to interoceptive awareness. Eat Weight Disord 2022; 27:2551-2560. [PMID: 35410413 PMCID: PMC9556400 DOI: 10.1007/s40519-022-01394-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 03/14/2022] [Indexed: 11/22/2022] Open
Abstract
PURPOSE Time evaluation has been poorly studied in eating disorder (ED) patients despite its relationship with body awareness, which is a core psychopathological feature in EDs and is influenced by impulsivity, interoception, and working memory. This study aims to evaluate time estimation and its accuracy across the ED spectrum in connection with specific and general psychopathology. METHODS A group of 215 women was enrolled in a computerized task involving the estimation of 1-min intervals. Impulsivity and body awareness constructs (self-monitoring, depersonalization, interoceptive deficit) were evaluated and examined for significant correlations with time estimation and the accuracy of the measure. RESULTS Patients with EDs showed an impaired ability to estimate time, with an accuracy that positively correlated with compulsive self-monitoring (p = 0.03). Differences between diagnostic subgroups showed an overestimation of time in anorexia nervosa patients and an underestimation of time in binge eating disorder patients, whose time estimation was also less accurate. CONCLUSION The relationship between time estimation and compulsive self- monitoring might corroborate the presence of an imbalanced integration of information in patients with EDs that was not present in the community women included in the study. Time perception should be further evaluated in the ED field, and longitudinal changes due to psychopathological recovery or BMI changes should be examined. LEVEL OF EVIDENCE Level III: Evidence obtained from a well-designed cohort or case-control analytic study.
Collapse
|
13
|
Grajek M, Krupa-Kotara K, Grot M, Kujawińska M, Helisz P, Gwioździk W, Białek-Dratwa A, Staśkiewicz W, Kobza J. Perception of the Body Image in Women after Childbirth and the Specific Determinants of Their Eating Behavior: Cross-Sectional Study (Silesia, Poland). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191610137. [PMID: 36011771 PMCID: PMC9407984 DOI: 10.3390/ijerph191610137] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/29/2022] [Accepted: 08/13/2022] [Indexed: 05/27/2023]
Abstract
Background: Episodes of loss of control over eating during pregnancy affect up to 36% of women during this period. Many women experience natural concerns about weight gain and body-shape changes during pregnancy and the postpartum period, and food cravings and fluctuations in eating patterns during these periods are physiological phenomena. However, pregnancy and the postpartum period may be an additional determinant of eating disorders. Women who perceive their own bodies as significantly deviating from the presented ideal are more likely to experience anxiety/anxiety related to it and also tend to exhibit abnormal eating behaviors. The perception of one’s body figure also plays an important role in maintaining psychological balance Aim: The aim of this study was to assess the perception of body image by postpartum women. The essence of the study was to see if there were psychomarkers associated with lack of control over eating, food restriction, and emotionally motivated eating in the study population. Material and methods: The study was conducted during the fall and winter of 2021. A total of 288 women participated in the study. The age of the subjects ranged from 21 to 45 years. Results: It was found that 198 women (68.8%) were dissatisfied with their current body weight and figure. Respondents with higher post-pregnancy body mass index showed dissatisfaction with their body shape (49.8%; H = 13.042; p = 0.001). Both body satisfaction and BMI level were significant components of the occurrence of pathological phenomena associated with the TFEQ-13 subscales (p < 0.05). Conclusions: Excessive focus on food restriction as well as lack of control over eating had some association with negative self-perception of body image, mainly in the form of body weight dissatisfaction. Eating behaviors showed an association with BMI level and weight satisfaction after pregnancy.
Collapse
Affiliation(s)
- Mateusz Grajek
- Department of Public Health, Department of Public Health Policy, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, 41-902 Bytom, Poland
| | - Karolina Krupa-Kotara
- Department of Epidemiology, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, 41-902 Bytom, Poland
| | - Martina Grot
- Department of Public Health, Department of Public Health Policy, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, 41-902 Bytom, Poland
| | - Maria Kujawińska
- Department of Public Health, Department of Public Health Policy, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, 41-902 Bytom, Poland
| | - Paulina Helisz
- Department of Public Health, Department of Public Health Policy, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, 41-902 Bytom, Poland
| | - Weronika Gwioździk
- Department of Public Health, Department of Public Health Policy, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, 41-902 Bytom, Poland
| | - Agnieszka Białek-Dratwa
- Department of Human Nutrition, Department of Dietetics, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, 41-808 Zabrze, Poland
| | - Wiktoria Staśkiewicz
- Department of Technology and Food Quality Evaluation, Department of Dietetics, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, 41-808 Zabrze, Poland
| | - Joanna Kobza
- Department of Public Health, Department of Public Health Policy, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, 41-902 Bytom, Poland
| |
Collapse
|
14
|
Voges MM, Quittkat HL, Schöne B, Vocks S. Giving a Body a Different Face—How Men and Women Evaluate Their Own Body vs. That of Others. Front Psychol 2022; 13:853398. [PMID: 35586240 PMCID: PMC9108869 DOI: 10.3389/fpsyg.2022.853398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 04/05/2022] [Indexed: 11/13/2022] Open
Abstract
Eating disorders affect women more than men. Women reportedly dislike their body shape more and appreciate it less than do men. One factor influencing body image might be the application of different standards for oneself than for other people when evaluating bodies. To investigate this possibility, we determined whether the application of double standards is different between men and women. We presented 57 women and 54 men (aged 18–30 and of average weight) with pictures of their own bodies and pictures of average weight, overweight, and “ideal” bodies attached to the participants’ own face and to another person’s face. Participants were instructed to evaluate their emotional reaction to the pictures and then rate the various pictures on aspects of attractiveness, body fat, and muscle mass. The degree of the double standard was defined as the difference between ratings of what appeared to be one’s own body and what appeared to be someone else’s according to the presented face. The analyses revealed, firstly, that both genders applied self-deprecating double standards when viewing overweight and average-weight bodies. Women, but not men, also showed self-deprecating double standards when viewing the ideal body and their own body. By contrast, men applied fewer double standards when viewing the ideal body and self-enhancing double standards when viewing their own body. The study suggests that young, average-weight men are more or less satisfied with their own bodies, whereas young, average-weight women tend to apply a stricter standard for themselves than for others, thus devaluing their own bodies. This vulnerability to body image is hypothesized as contributing to the prevalence of eating disorders in women.
Collapse
Affiliation(s)
- Mona M. Voges
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Osnabrück University, Osnabrück, Germany
- *Correspondence: Mona M. Voges,
| | - Hannah L. Quittkat
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Osnabrück University, Osnabrück, Germany
| | - Benjamin Schöne
- Department of Experimental Psychology, Institute of Psychology, Osnabrück University, Osnabrück, Germany
| | - Silja Vocks
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Osnabrück University, Osnabrück, Germany
| |
Collapse
|
15
|
Addressing Weight Bias in the Cisgender Population: Differences between Sexual Orientations. Nutrients 2022; 14:nu14091735. [PMID: 35565703 PMCID: PMC9099522 DOI: 10.3390/nu14091735] [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] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 04/12/2022] [Accepted: 04/20/2022] [Indexed: 01/11/2023] Open
Abstract
(1) Background: Weight bias (WB) is an implicit psychological construct that can influence attitudes, beliefs, body experience, and evaluation of specific psychopathology relationships. Sexual orientation has played a crucial role in developing and maintaining psychiatric conditions linked to body evaluation, but few studies have evaluated possible connected biases. Thus, the paper aims to assess potential relationships between sexual orientation and WB, looking at potential roles in specific psychopathology; (2) Methods: A total of 836 cisgender subjects participated in an online survey, aged between 18 and 42 years old. Two specific aspects of WB were evaluated with validated scales about beliefs about obese people and fat phobia. Demographic variables, as well as depression and eating concerns were evaluated; (3) Results: Gay men and bisexual women showed higher levels of fat phobia, depression, and eating concerns. Regression analysis showed that sexual orientation significantly predicted fat phobia (p < 0.001) and beliefs about obese people (p = 0.014); (4) Conclusions: This study confirms the vulnerability of gay men and bisexual women to cognitive bias about their own bodies, showing a potential vulnerability about body and weight concerns.
Collapse
|
16
|
Leonkiewicz M, Wawrzyniak A. The relationship between rigorous perception of one's own body and self, unhealthy eating behavior and a high risk of anorexic readiness: a predictor of eating disorders in the group of female ballet dancers and artistic gymnasts at the beginning of their career. J Eat Disord 2022; 10:48. [PMID: 35410315 PMCID: PMC8996514 DOI: 10.1186/s40337-022-00574-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 04/01/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND A group that is particularly exposed to eating disorders are young sportswomen who practice aesthetic disciplines, for whom it is important to keep a slim figure. Hence, the purpose of the study was to present the assessment of perception of one's own body and self as well as nutritional behavior in the group of ballet dancers and artistic gymnasts (BGA, n = 60) aged 10-12 against the background of the peer group (K, n = 60) and to determine the relationship between the studied elements, as well as anorexic readiness risk assessment to help diagnose premorbid stage of eating disorders with full symptoms. METHODS Anthropometric measurements (height, body weight) and the assessment of adipose tissue were performed. Using a questionnaire, data on physical activity, perception of one's own body and self, and selected eating behaviors were collected. RESULTS Underweight was observed in nearly half of the girls from the BGA group and the content of adipose tissue was significantly lower. Girls from the BGA group were characterized by overestimation of body size (p = 0.032), the need to improve their appearance/body (p = 0.025) and wanting to be the best in many areas of life (p = 0.002) significantly more often than in the K group. Moreover, they significantly more often limited the consumption of fats and carbohydrates (p = 0.044) and felt angry with themselves after too large of a meal (p = 0.050). It was shown that unhealthy eating behavior in the BGA group was significantly associated with rigorous self-perception (r = 0.42; p < 0.001). Students from the BGA group were more often exposed to a higher risk of anorexic readiness (p = 0.001). In a detailed analysis, it was found that eating behaviors, such as fasting, limiting the consumption of fats and carbohydrates, and avoiding eating under stress, were associated with feelings of dissatisfaction with oneself, the belief that appearance is extremely important in achieving life success and the need to improve appearance. CONCLUSION The obtained research results can be used as a source of information for specialists (including dietitians and psychologists), for the preparation of educational and repair programs in the group of ballet dancers or artistic gymnasts aged 10-12, including nutritional education and psychological care.
Collapse
Affiliation(s)
- Magdalena Leonkiewicz
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (WULS-SGGW), Warsaw, Poland.
| | - Agata Wawrzyniak
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (WULS-SGGW), Warsaw, Poland
| |
Collapse
|
17
|
Budde LI, Wilms S, Föcker M, Dalhoff A, Müller JM, Wessing I. Influence of Identity Development on Weight Gain in Adolescent Anorexia Nervosa. Front Psychiatry 2022; 13:887588. [PMID: 35693950 PMCID: PMC9186337 DOI: 10.3389/fpsyt.2022.887588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 05/03/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Anorexia Nervosa (AN) typically begins during early adolescence, an important phase of personality development. A substantial proportion of adolescent AN patients shows impaired personality functioning, which might be a relevant but understudied aspect of illness severity. The developmental status of identity as key element of personality is suggested to influence inpatient treatment outcome in adolescents with AN. METHODS This study analyzed existing data of N = 60 adolescents with AN. Multilevel models assessed the influence of identity functioning, measured by the Assessment of Identity Development in Adolescence (AIDA) at admission, on weight gain [BMI (body mass index), BMI-SDS (BMI standard deviation score)] during 10 weeks of inpatient treatment. Moreover, the influence of other indicators of illness severity, i.e., eating disorders and comorbid psychopathologies, was explored. RESULTS As expected, higher AIDA scores negatively influenced the course of weight gain. A similar effect was observed for other psychopathology measures, especially body image distortion. In general, higher weight at admission was associated with less weight gain. Higher weight at admission was also predicted by higher other psychopathology measures, but not AIDA scores. CONCLUSION The course of weight gain during inpatient treatment was hampered in adolescent AN patients who have difficulties developing a stable identity. Unlike other aspects of psychopathology, this was independent of the initial weight. Thus, in addition to the level of underweight and other aspects of psychopathology, difficulties in identity development constitute a relevant aspect of illness severity in AN. This recommends consideration of identity development during treatment.
Collapse
Affiliation(s)
- Lynn I Budde
- Department of Child and Adolescent Psychiatry, University Hospital Münster, Münster, Germany
| | - Simon Wilms
- Department of Child and Adolescent Psychiatry, University Hospital Münster, Münster, Germany
| | - Manuel Föcker
- Department of Child and Adolescent Psychiatry, University Hospital Münster, Münster, Germany
| | - Anke Dalhoff
- Department of Child and Adolescent Psychiatry, University Hospital Münster, Münster, Germany
| | - Joerg M Müller
- Department of Child and Adolescent Psychiatry, University Hospital Münster, Münster, Germany
| | - Ida Wessing
- Department of Child and Adolescent Psychiatry, University Hospital Münster, Münster, Germany
| |
Collapse
|
18
|
Wang R, Gan Y, Wang X, Li J, Lipowska M, Izydorczyk B, Guo S, Lipowski M, Yang Y, Fan H. The Mediating Effect of Negative Appearance Evaluation on the Relationship Between Eating Attitudes and Sociocultural Attitudes Toward Appearance. Front Psychiatry 2022; 13:776842. [PMID: 35370824 PMCID: PMC8964953 DOI: 10.3389/fpsyt.2022.776842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 02/09/2022] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE Body-image disturbance and eating disorders are significant physical and mental health problems in China. Attitudes toward the body are thought to work in conjunction with other established risk factors for dietary pathology, which include body dissatisfaction, dieting, and negative effects. Negative appearance evaluation may be valuable for extending our understanding of measuring factors and potential causal relationships associated with body image and eating problems. Therefore, this study aimed to determine the association between negative appearance evaluation and a combination of eating attitudes and sociocultural attitudes toward appearance and the mediating effect of negative appearance evaluation on the relationship between eating attitudes and sociocultural attitudes toward appearance. METHODS We invited 339 Chinese adults to undergo the Eating Attitudes Test (EAT-26), the Fear of Negative Appearance Evaluation Scale (FNAES), and the Sociocultural Attitudes toward Appearance (SATAQ-3) scale, and used AMOS 24.0 for model construction and mediating effects testing. RESULTS There was a significant positive correlation between EAT-26 scores and FNAES (p < 0.001) and SATAQ-3 scores (p < 0.001), and all dimensions except internalization general were significantly positively correlated (p < 0.05). There was a significant positive correlation between FNAES and SATAQ-3 scores for all dimensions (p < 0. 01). There was no significant direct effect of eating attitude on sociocultural attitude toward appearance; however, there was a significant mediating effect of fear of negative appearance evaluation. CONCLUSION Our results demonstrate that negative appearance evaluation fully mediates the relationship between eating attitudes and sociocultural attitudes toward appearance. An individual's attitude toward eating affects negative body perceptions and thus their perception of their own body shape. Our exploration of the specific effects of eating attitudes on body perception provides a psychological basis for guidance and developing interventions regarding attitudes toward the body.
Collapse
Affiliation(s)
- Ruohang Wang
- School of Psychology, Beijing Sport University, Beijing, China
| | - Youteng Gan
- School of Psychology, Beijing Sport University, Beijing, China
| | - Xueyu Wang
- School of Psychology, Beijing Sport University, Beijing, China
| | - Jianye Li
- Department of Psychology, Gdañsk University of Physical Education and Sport, Gdańsk, Poland
| | | | | | - Shuai Guo
- Department of Psychology, Gdañsk University of Physical Education and Sport, Gdańsk, Poland
| | - Mariusz Lipowski
- Department of Psychology, Gdañsk University of Physical Education and Sport, Gdańsk, Poland
| | - Yin Yang
- School of Psychology, Beijing Sport University, Beijing, China
| | - Hongying Fan
- School of Psychology, Beijing Sport University, Beijing, China
| |
Collapse
|
19
|
A Multi-Faceted Evaluation of Impulsivity Traits and Early Maladaptive Schemas in Patients with Anorexia Nervosa. J Clin Med 2021; 10:jcm10245895. [PMID: 34945191 PMCID: PMC8703582 DOI: 10.3390/jcm10245895] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/13/2021] [Accepted: 12/14/2021] [Indexed: 12/12/2022] Open
Abstract
(1) Background: patients with Anorexia Nervosa (AN) are classified either as restrictive (ANr) or binge/purge (ANbp) according to the absence or presence of impulsive eating and compensatory behaviors. The aim of the present study was to assess the levels of impulsivity in both AN subtypes and to explore whether individual differences in impulsivity may be explained by differences in the presence of early maladaptive schemas. (2) Methods: the sample group included 122 patients with ANr, 112 patients with ANbp, and 131 healthy women (HW). All of these participants completed the UPPS-P scale for an assessment of impulsive behaviors and the Young Schema Questionnaire (YSQ-S3) for an assessment of early maladaptive schemas. (3) Results: the patients with ANbp displayed higher levels of impulsivity compared with the patients with ANr and HW. Patients with AN, especially the restrictive subtype, also reported higher levels of early maladaptive schemas than HW, and regression analyses revealed that specific maladaptive schemas partially explain the variability in impulsivity in both patients and HW. (4) Conclusions: it appears that maladaptive beliefs developed during childhood or adolescence may predict the development of impulsivity, a personality trait usually associated with maladaptive behaviors, and appears to be prevalent among ANbp patients. The clinical effects of this, as well as directions for future study, are also discussed in this paper.
Collapse
|
20
|
Broomfield C, Noetel M, Stedal K, Hay P, Touyz S. Establishing consensus for labeling and defining the later stage of anorexia nervosa: A Delphi study. Int J Eat Disord 2021; 54:1865-1874. [PMID: 34459513 DOI: 10.1002/eat.23600] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 08/16/2021] [Accepted: 08/17/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Varied perspectives on the later stage of anorexia nervosa (AN) have left the field of eating disorders without a consistent label or definition for this subpopulation. As a result, diverse criteria when recruiting participants have led to incomparable results across research studies and a lack of guidance when assessing and treating patients in the clinical context. The aim of the current study was to develop consensus-based guidelines on the labeling and defining of the later stage of AN. METHOD Utilizing the Delphi methodology, a professional panel of experts (N = 21) participated in three rounds of questionnaires. Five open-ended questions (Round 1) were analyzed using content analysis to form statements relating to a classification system for labeling and defining the later stage of AN. A total of 80 statements were rated in terms of panelists' level of agreement (Rounds 2 and 3). RESULTS Consensus was achieved for 28.8% of statements and a further 16.3% of statements reached near consensus in the second and third round of questionnaires. Two labels were identified with five defining features achieving consensus. DISCUSSION Findings from the study suggest an alternative approach to labeling be adopted with consensus-based guidelines established for defining the later stage of AN. Implications that may occur from a unified classification system are explored with longitudinal research required to assess the impact on patients experiencing the later stage of AN.
Collapse
Affiliation(s)
- Catherine Broomfield
- School of Psychology, Brain and Mind Institute, University of Sydney, Sydney, Australia
| | - Melissa Noetel
- School of Psychology, Brain and Mind Institute, University of Sydney, Sydney, Australia
| | - Kristin Stedal
- Regional Department of Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Ullevål HF, Oslo, Norway
| | - Phillipa Hay
- Translational Health Research Institute, Western Sydney University, Sydney, Australia
| | - Stephen Touyz
- InsideOut Institute, Charles Perkins Centre, The University of Sydney, Sydney, Australia
| |
Collapse
|
21
|
There Are Predictors of Eating Disorders among Internet Use Characteristics-A Cross-Sectional Study on the Relationship between Problematic Internet Use and Eating Disorders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910269. [PMID: 34639567 PMCID: PMC8508531 DOI: 10.3390/ijerph181910269] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 09/24/2021] [Accepted: 09/25/2021] [Indexed: 12/12/2022]
Abstract
The aims of this cross-sectional study were: (i) to establish the prevalence of problematic Internet use (PIU) and eating disorders (EDs) among Polish students; (ii) to investigate potential correlations between the two phenomena; and (iii) to identify predictors of eating disorders among socio-demographic and Internet use characteristics in this population. To this end, a total of 1008 Polish students aged 18-40, completed the Problematic Internet Use Test (TPIU22), the Eating Attitudes Test (EAT-26) and a self-designed Socio-demographic and Internet Use Survey. Men received more PIU scores (p < 0.001), while women received more EAT-26 scores (p < 0.05) with a significant correlation observed between those variables (rho = 0.212; p < 0.001). The strongest predictors of EDs were as follows: preoccupation with the Internet, neglect of sleep in favor of Internet use, alleviation of negative feelings while online, higher mean number of hours spent online on weekends for academic and work-related purposes, extracurricular activity, lower height and higher BMI. An association has been demonstrated between problematic internet use and eating disorders. Somewhat surprisingly, our results suggest that people at risk of EDs use the Internet primarily to fulfill their routine duties. Nevertheless, further research is needed to establish the causality of EDs and PIU.
Collapse
|
22
|
Broomfield C, Stedal K, Touyz S. The Neuropsychological Profile of Severe and Enduring Anorexia Nervosa: A Systematic Review. Front Psychol 2021; 12:708536. [PMID: 34408714 PMCID: PMC8365190 DOI: 10.3389/fpsyg.2021.708536] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 06/30/2021] [Indexed: 11/13/2022] Open
Abstract
Characteristics of Severe and Enduring Anorexia Nervosa (SE-AN) are being investigated to differentiate the patients experiencing SE-AN from those at earlier stages of the AN disease. The current systematic review was the first step in exploring neuropsychological functioning as a potentially identifying characteristic for long-term presentations. With a subgroup of AN patients reflecting a unique neuropsychological profile that is proportionate to the quantity of patients that go on to develop SE-AN, it was the aim of this review to assess neuropsychological functioning in the later stage of the disease. In accordance with PRISMA guidelines, a literature search was conducted using four electronic databases (PsycINFO, MEDLINE, Web of Science, and Scopus) for neuropsychological research on AN participants with a seven or more year illness duration. Datasets that met inclusion criteria were screened for SE-AN participants (N = 166) and neuropsychological data extracted together with potentially confounding variables and information required to conduct a quality assessment. In research investigating decision-making, participants with a SE-AN presentation demonstrated significantly lower functioning compared to healthy controls. There was conflicting evidence for differences in intellectual functioning and set-shifting abilities with no variability indicated in central coherence, memory, attention, reasoning, or processing speed. If findings from this preliminary analysis are confirmed through empirical research, implications include earlier identification of SE-AN patients and more effective treatment development.
Collapse
Affiliation(s)
| | - Kristin Stedal
- Regional Department for Eating Disorders, Oslo University Hospital, Ullevål, Norway
| | - Stephen Touyz
- Inside Out Institute, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| |
Collapse
|
23
|
Meneguzzo P, Tenconi E, Todisco P, Favaro A. Cognitive remediation therapy for anorexia nervosa as a rolling group intervention: Data from a longitudinal study in an eating disorders specialized inpatient unit. EUROPEAN EATING DISORDERS REVIEW 2021; 29:770-782. [PMID: 34118097 PMCID: PMC8453548 DOI: 10.1002/erv.2848] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 05/21/2021] [Indexed: 12/12/2022]
Abstract
Objective Cognitive remediation therapy (CRT) has been proposed as an add‐on treatment approach that could increase the engagement in treatment of anorexia nervosa (AN) patients and reduce maintaining factors, but prior studies have evaluated CRT in individual and group settings, difficult protocols for rehabilitation settings. Our aim is to evaluate the CRT rolling protocol implementation in an inpatient specialised unit. Methods A historical longitudinal controlled study was designed to include 31 AN patients for the CRT program, and 28 AN patients treated as usual. The CRT rolling group was implemented in a multidisciplinary inpatient rehabilitation ward with both adolescent and adult patients and an 8‐weeks protocol. To evaluate the treatment implementation effect, different self‐administered questionnaires were used. Results The study found greater improvements of the CRT group in clinical symptomatology (p = 0.039), flexibility (p = 0.003), self‐confidence about the ability to change (p < 0.001), and less short‐term focus (p < 0.001), with no differences between restrictive and binge‐purging patients. Conclusion This study demonstrates that CRT rolling group protocol is feasible in an inpatient treatment setting and may improve a rehabilitation program's outcome. Our results have shown how CRT can influence cognitive styles considered AN maintenance factors, positively affecting both restrictive and binge‐purge type. Cognitive remediation therapy (CRT) could be implemented in an inpatient setting with a rolling protocol CRT improves flexibility, drive to change, and therapy engagement No differences between restrictive or binge/purge subgroups Both adolescent and adult patients improved their cognitive styles
Collapse
Affiliation(s)
- Paolo Meneguzzo
- Department of Neuroscience, University of Padova, Padova, Italy.,Eating Disorders Unit, Casa di Cura 'Villa Margherita', Arcugnano, Vicenza, Italy
| | - Elena Tenconi
- Department of Neuroscience, University of Padova, Padova, Italy.,Padova Neuroscience Center, University of Padova, Padova, Italy
| | - Patrizia Todisco
- Eating Disorders Unit, Casa di Cura 'Villa Margherita', Arcugnano, Vicenza, Italy
| | - Angela Favaro
- Department of Neuroscience, University of Padova, Padova, Italy.,Padova Neuroscience Center, University of Padova, Padova, Italy
| |
Collapse
|
24
|
Meneguzzo P, Behrens SC, Favaro A, Tenconi E, Vindigni V, Teufel M, Skoda EM, Lindner M, Quiros-Ramirez MA, Mohler B, Black M, Zipfel S, Giel KE, Pavan C. Body Image Disturbances and Weight Bias After Obesity Surgery: Semantic and Visual Evaluation in a Controlled Study, Findings from the BodyTalk Project. Obes Surg 2021; 31:1625-1634. [PMID: 33405179 PMCID: PMC8012323 DOI: 10.1007/s11695-020-05166-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 12/01/2020] [Accepted: 12/09/2020] [Indexed: 12/14/2022]
Abstract
Purpose Body image has a significant impact on the outcome of obesity surgery. This study aims to perform a semantic evaluation of body shapes in obesity surgery patients and a group of controls. Materials and Methods Thirty-four obesity surgery (OS) subjects, stable after weight loss (average 48.03 ± 18.60 kg), and 35 overweight/obese controls (MC), were enrolled in this study. Body dissatisfaction, self-esteem, and body perception were evaluated with self-reported tests, and semantic evaluation of body shapes was performed with three specific tasks constructed with realistic human body stimuli. Results The OS showed a more positive body image compared to HC (p < 0.001), higher levels of depression (p < 0.019), and lower self-esteem (p < 0.000). OS patients and HC showed no difference in weight bias, but OS used a higher BMI than HC in the visualization of positive adjectives (p = 0.011). Both groups showed a mental underestimation of their body shapes. Conclusion OS patients are more psychologically burdened and have more difficulties in judging their bodies than overweight/obese peers. Their mental body representations seem not to be linked to their own BMI. Our findings provide helpful insight for the design of specific interventions in body image in obese and overweight people, as well as in OS.
Collapse
Affiliation(s)
- Paolo Meneguzzo
- Department of Neuroscience, University of Padova, via Giustiniani 2, 35128, Padova, Italy.
| | - Simone Claire Behrens
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany.,Max Planck Institute for Intelligent Systems, Tübingen, Germany
| | - Angela Favaro
- Department of Neuroscience, University of Padova, via Giustiniani 2, 35128, Padova, Italy.,Padova Neuroscience Center, University of Padova, Padova, Italy
| | - Elena Tenconi
- Department of Neuroscience, University of Padova, via Giustiniani 2, 35128, Padova, Italy.,Padova Neuroscience Center, University of Padova, Padova, Italy
| | - Vincenzo Vindigni
- Department of Neuroscience, University of Padova, via Giustiniani 2, 35128, Padova, Italy
| | - Martin Teufel
- Clinic for Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, LVR University-Hospital Essen, Essen, Germany
| | - Eva-Maria Skoda
- Clinic for Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, LVR University-Hospital Essen, Essen, Germany
| | - Marion Lindner
- Clinic for Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, LVR University-Hospital Essen, Essen, Germany
| | - M Alejandra Quiros-Ramirez
- Max Planck Institute for Intelligent Systems, Tübingen, Germany.,Psychology Department, University of Konstanz, Konstanz, Germany
| | - Betty Mohler
- Max Planck Institute for Intelligent Systems, Tübingen, Germany
| | - Michael Black
- Max Planck Institute for Intelligent Systems, Tübingen, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany
| | - Katrin E Giel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany
| | - Chiara Pavan
- Department of Medicine, University of Padova, Padova, Italy
| |
Collapse
|
25
|
Marzola E, Longo P, Sardella F, Delsedime N, Abbate-Daga G. Rehospitalization and "Revolving Door" in Anorexia Nervosa: Are There Any Predictors of Time to Readmission? Front Psychiatry 2021; 12:694223. [PMID: 34366923 PMCID: PMC8342847 DOI: 10.3389/fpsyt.2021.694223] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 06/08/2021] [Indexed: 12/27/2022] Open
Abstract
Objective: Anorexia nervosa (AN) is a severe psychiatric illness with multifactorial etiology and unsatisfactory treatment outcomes. Hospitalization is required for a substantial number of patients, and readmission (RA) commonly occurs. Some individuals need multiple hospitalizations sometimes over a short amount of time, thus, delineating the "revolving door" (RD) phenomenon. However, very little is known about readmissions and their frequency in AN. Therefore, we aimed to longitudinally investigate readmissions in AN in order to: (a) characterize patients with AN who need readmission (i.e., RA-AN), sometimes rapidly (RD-AN); (b) ascertain differences between RA-AN and non-RA-AN groups during baseline hospitalization; (c) investigate as to whether clinical or psychometric parameters worsened on RA; and (d) analyze predictors of time-to-readmission in AN. Methods: A total of 170 inpatients with AN were enrolled at their baseline hospitalization; all their subsequent rehospitalizations were recorded with a longitudinal design by which each patient has been observed for 3 years. Patients were classified as RD-AN if requiring a readmission <12 months since last discharge. Clinical characteristics were measured upon admission and discharge for each hospitalization, and at all time points, patients completed questionnaires assessing eating and general psychopathology, and body shape concerns. Results: Sixty-seven patients (39.4%) needed at least one readmission and 62 (92.5% of RA-AN) reported RD. Compared with non-RA-AN, those with RA-AN were younger, reported a shorter duration of illness, and were more frequently diagnosed with AN-BP. Also, greater severity of anxious and depressive symptoms and body shape concerns emerged in the RA-AN group. The outcome of baseline hospitalization did not differ between groups, and only depressive symptoms worsened at readmission. Shorter duration of AN and low weight gain during baseline hospitalization predicted early readmission but did not survive statistical control. In contrast, high scores on drive for thinness upon baseline hospital entry robustly predicted a shorter time to readmission even after statistical control. Discussion: Individuals with AN who require readmission do so over a short period notwithstanding a positive treatment outcome during their baseline hospitalization. Shorter time-to-readmission can be predicted mostly in case of marked drive for thinness and poor weight gain at baseline hospital admission.
Collapse
Affiliation(s)
- Enrica Marzola
- Department of Neuroscience "Rita Levi Montalcini", Eating Disorders Center, University of Turin, Turin, Italy
| | - Paola Longo
- Department of Neuroscience "Rita Levi Montalcini", Eating Disorders Center, University of Turin, Turin, Italy
| | - Federica Sardella
- Department of Neuroscience "Rita Levi Montalcini", Eating Disorders Center, University of Turin, Turin, Italy
| | - Nadia Delsedime
- Department of Neuroscience "Rita Levi Montalcini", Eating Disorders Center, University of Turin, Turin, Italy
| | - Giovanni Abbate-Daga
- Department of Neuroscience "Rita Levi Montalcini", Eating Disorders Center, University of Turin, Turin, Italy
| |
Collapse
|