Eating disorders in teenagers in east London: a survey

The Mental Health Status of South Asian Women in Britain

This article reviews the research on the mental health status of South Asian women living in UK. It reports on the findings from epidemiological studies of the prevalence of depression, suicide, parasuicide, deliberate self-harm and eating disorders in this community. Focus is on research studies that describe cultural influences on conceptualisations and expressions of distress, help seeking behaviours and alternative coping strategies. The influence of acculturation and “culture conflict” as they impact upon women's mental health is also highlighted. The review concludes by considering, first, salient cultural and religious concepts identified in studies that may facilitate understanding South Asian women's mental ill health, and second, the urgent need to develop gender, linguistic and culturally sensitive mental health services for women of South Asian origins now citizens of UK.

EPA Guidance Mental Health Care of Migrants

Migration is an increasingly commonplace phenomenon for a number of reasons. People migrate from rural to urban areas or across borders for reasons including economic, educational or political. There is increasing recent research evidence from many countries in Europe that indicates that migrants are more prone to certain psychiatric disorders. Because of their experiences of migration and settling down in the new countries, they may also have special needs such as lack of linguistic abilities which must be taken into account using a number of strategies at individual, local and national policy levels. In this guidance document, we briefly present the evidence and propose that specific measures must be taken to improve and manage psychiatric disorders experienced by migrants and their descendants. This improvement requires involvement at the highest level in governments. This is a guidance document and not a systematic review.

Weighing in on the issue: a longitudinal analysis of the influence of selected individual factors and the sports context on the developmental trajectories of eating pathology among adolescents

Eating disorders, and related issues (e.g., body dissatisfaction, weight control behaviors), represent pressing and prevalent health problems that affect American adolescents with alarming frequency and potentially chronic consequences. However, more longitudinal research is needed to elucidate the developmental processes that increase or maintain risk for, and that protect against, eating- and weight-related problems among adolescents. Accordingly, the current study used longitudinal data from 1,050 male and female (68.0 %) adolescents (Grades 9-11)-the majority of whom were European Americans (72.2 %)-who participated in the 4-H Study of Positive Youth Development to (a) describe trajectories of adolescents' eating pathology and body dissatisfaction, (b) identify individual and contextual correlates of these pathways, (c) examine whether trajectories of eating pathology and body dissatisfaction related to adolescents' depressive symptoms, and (d) elucidate whether sports participation moderated associations between specific trajectories of eating pathology and body dissatisfaction and adolescents' depressive symptoms. Results suggest that the diverse pathways of eating pathology and body dissatisfaction that exist across middle adolescence, in combination with adolescents' sports participation, have important implications for the positive and problematic development of our youth. In addition, the findings underscore the need to evaluate the interindividual differences that exist in regard to how sports participation may relate positively and negatively to developmental outcomes.

Social network media exposure and adolescent eating pathology in Fiji

BACKGROUND

Mass media exposure has been associated with an increased risk of eating pathology. It is unknown whether indirect media exposure--such as the proliferation of media exposure in an individual's social network--is also associated with eating disorders.

AIMS

To test hypotheses that both individual (direct) and social network (indirect) mass media exposures were associated with eating pathology in Fiji.

METHOD

We assessed several kinds of mass media exposure, media influence, cultural orientation and eating pathology by self-report among adolescent female ethnic Fijians (n=523). We fitted a series of multiple regression models of eating pathology, assessed by the Eating Disorder Examination Questionnaire (EDE-Q), in which mass media exposures, sociodemographic characteristics and body mass index were entered as predictors.

RESULTS

Both direct and indirect mass media exposures were associated with eating pathology in unadjusted analyses, whereas in adjusted analyses only social network media exposure was associated with eating pathology. This result was similar when eating pathology was operationalised as either a continuous or a categorical dependent variable (e.g. odds ratio OR=1.60, 95% CI 1.15-2.23 relating social network media exposure to upper-quartile EDE-Q scores). Subsequent analyses pointed to individual media influence as an important explanatory variable in this association.

CONCLUSIONS

Social network media exposure was associated with eating pathology in this Fijian study sample, independent of direct media exposure and other cultural exposures. Findings warrant further investigation of its health impact in other populations.

Development of a measure of "acculturation" for ethnic Fijians: methodologic and conceptual considerations for application to eating disorders research

Acculturation has been examined as a risk factor for eating disorders, but interpretation of findings has been limited by inconsistent operationalization of this construct across studies. The study aim was to develop and evaluate a population-specific measure of acculturation for ethnic Fijian adolescent schoolgirls, to use in future analyses related to eating disorders. Our findings suggest that acculturation is a multidimensional construct characterized by distinct, though related, dimensions of orientation to ethnic Fijian and/or western/global culture with respect to a range of behaviors and attitudes. In contrast to theoretical models positing uni-dimensional, orthogonal, or oblique relations between cultural identities in individuals undergoing acculturation, our study findings support a heterogeneous pattern among correlations of dimensions across contrasting cultural identities. We suggest multidimensional measures of acculturation are optimal--and socio-demographic proxies inadequate--for characterization of this complex process for health research.

Child mental health differences amongst ethnic groups in Britain: a systematic review

BACKGROUND

Inter-ethnic differences have been reported for many mental health outcomes in the UK, but no systematic review on child mental health has been published. The aim of this review is to compare the population-based prevalence of child mental disorders between ethnic groups in Britain, and relate these findings to ethnic differences in mental health service use.

METHODS

A systematic search of bibliographic databases for population-based and clinic-based studies of children aged 0-19, including all ethnic groups and the main child mental disorders. We synthesised findings by comparing each minority group to the White British study sample.

RESULTS

31 population-based and 18 clinic-based studies met the inclusion criteria. Children in the main minority groups have similar or better mental health than White British children for common disorders, but may have higher rates for some less common conditions. The causes of these differences are unclear. There may be unmet need for services among Pakistani and Bangladeshi children.

CONCLUSION

Inter-ethnic differences exist but are largely unexplained. Future studies should address the challenges of cross-cultural psychiatry and investigate reasons for inter-ethnic differences.

Modularity and the social mind: are psychologists too self-ish?

A modular view of the mind implies that there is no unitary "self" and that the mind consists of a set of informationally encapsulated systems, many of which have functions associated with navigating an inherently ambiguous and competitive social world. It is proposed that there are a set of cognitive mechanisms--a social cognitive interface (SCI)--designed for strategic manipulation of others' representations of one's traits, abilities, and prospects. Although constrained by plausibility, these mechanisms are not necessarily designed to maximize accuracy or to maintain consistency with other encapsulated representational systems. The modular view provides a useful framework for talking about multiple phenomena previously discussed under the rubric of the self.

Ethnicity, gender and mental health: social worker perspectives

BACKGROUND

This paper draws on a two-year Department of Health research study on social worker conceptualisations of ethnicity, gender and mental health. The findings and discussion are placed within the 'culturalist' and an 'integrative' perspective on the mental health needs of Asian women. It is argued that the culturalist perspective has led to an overemphasis of individual and group differences in theoretical and practice debates, and by design or default has resulted in an under-emphasis of the interconnections between 'race', ethnicity, gender and social class, as well as an underemphasis on the adequacy and appropriateness of existing service provision. The importance of the latter is highlighted in its integrative nature in pointing to the interconnections between race, ethnicity, gender and social class.

AIMS

To study professional perspectives to enhance understanding of the interconnections of ethnicity, gender, social class and mental health, to promote improved policy, provision and practice.

METHODS

Semi-structured interviews with social work professionals to obtain their perceptions of Bangladeshi women's mental illness, well-being, sources of stress and service provision.

RESULTS

In understanding the mental health situation of Bangladeshi women, a thematic analysis identified a multiplicity of factors including poverty, poor and overcrowded housing, racism, language, culture, religion, and gender and patriarchy. Low use of social services by Bangladeshi women, combined with fear and mistrust and lack of familiarity, raised important concerns about unmet need.

CONCLUSIONS

Social worker perceptions demonstrate an understanding that suggests that the experience of ethnicity is gendered and that gender relations are ethnically distinct and impacted by social class. The paper highlights the importance of understanding patriarchy and gender relations, as well as the wider context of race and ethnicity and the interconnections between ethnicity, gender and social class.

It doesn't happen here: eating disorders in an ethnically diverse sample of economically disadvantaged, urban college students

The bulk of eating disorder studies have focused on white, middle-upper class women, excluding ethnically and economically diverse women and men. Accordingly, our knowledge of prevalence rates and risk factors is reliant on this narrow literature. To expand upon the current literature, we examined eating disorders in ethnically diverse low-income, urban college students. We surveyed 884 incoming freshmen during an orientation class to assess the frequency of eating disorder diagnosis and the risk factors of child physical abuse and sexual abuse before and after age 13. We found 10% of our sample received an eating disorder diagnosis, 12.2% of the women and 7.3% of the men. The majority of these students were Latino/a or "other," with White women receiving the fewest diagnoses. For all women, both child physical abuse and both indices of sexual abuse contributed equally to the development of an eating disorder. For men only the sexual abuse indices contributed to an eating disorder diagnosis. These results indicate that ethnic minority populations do suffer from relatively high rates of self-reported eating disorders and that a history of trauma is a significant risk factor for eating disorders in these diverse populations of both women and men.

Restraint and eating concern in North European and East Asian women with and without eating disorders in Australia and Singapore

OBJECTIVE

To investigate eating disorder psychopathology, restraint and eating concern in young women with and without an eating disorder from two different ethnic groups in Australia and Singapore.

METHOD

The relationship of Eating Disorder Examination Questionnaire Global, Restraint and Eating Concern scores to cultural orientation and sociocultural factors was analysed in 154 women with and without an eating disorder. Participants were from the following backgrounds: North European Australian, East Asian Australian, Singaporean Chinese and North European expatriates in Singapore.

RESULTS

Women with eating disorders had similar psychopathology across the cultural groups. Among controls, Singaporean Chinese reported significantly greater overall eating disorder psychopathology than other cultural groups and greater restraint than North European Australians/expatriates. Eating concern was not associated with cultural group overall or acculturation to Western culture. Dissatisfaction with family functioning, socioeconomic status and education level were not significantly associated with any of the eating disorder measures.

CONCLUSION

In eating disorder psychopathology, the specific symptom of eating concern may transcend cultural influences.

Teasing, acculturation, and cultural conflict: Psychosocial correlates of body image and eating attitudes among South Asian women

The current study examined sociocultural correlates of body dissatisfaction and maladaptive eating attitudes among 74 South Asian American women. Participants completed measures assessing three forms of teasing--general appearance, weight/shape, and ethnic--as well as thin-ideal internalization, acculturation, cultural conflict, body dissatisfaction, and maladaptive eating attitudes. Results indicated that all three types of teasing and cultural conflict were significantly related to body dissatisfaction and maladaptive eating attitudes. Cultural conflict was found to mediate the relationship between ethnic teasing and body dissatisfaction. Neither thin-ideal internalization nor acculturation was significantly associated with either body dissatisfaction or maladaptive eating attitudes. However, body dissatisfaction was found to mediate the relationship between weight/shape teasing and maladaptive eating attitudes. Implications of these findings and possible future directions for research on South Asian American women are discussed.