Eating disorder behaviors and depression: a minimal relationship beyond social comparison, self-esteem, and body dissatisfaction

Physical Activity as a Means to Improve Subjective Vitality of University Students

Purpose: This study compared physical self-concept and subjective vitality of police, physical education, and psychology students. Moreover, the study investigated whether students who reported a higher level of physical activity differently rated physical self-concept and subjective vitality and whether physical activity was associated with subjective vitality. Methods: The study sample included 422 university students (249 females) from three state academic institutions: University of Criminal Investigation and Police Studies (n = 165), Faculty of Sport and Physical Education (n = 156) and Faculty of Psychology (n = 101). The mean age was 20.85 ± 3.59 years. They completed a physical self-description questionnaire, the subjective vitality scale, and a physical activity questionnaire using the Survey Monkey platform. Multivariate analysis of variance investigated the differences in physical activity, physical self and vitality, while regression analysis investigated the association of physical self and physical activity with subjective vitality. Results: Police students and physical education students reported higher levels of physical activity and perceived higher their own physical self and subjective vitality than psychology students. From the whole sample, students who were sufficiently physically active also scored higher on physical self-concept and subjective vitality. There was a significant association of physical activity level with subjective vitality. Conclusion: Physical activity was directly associated with students' subjective evaluation of their own health. It can be concluded that students should aim to attain a minimum of 150 min per week of physical activity. Students and faculties should be involved in the attainment of minimal levels of physical activity. This could improve students' subjective perception of self, along with objective measures of health and wellbeing.

What Distinguishes Males With Sexual Dysfunction Who Present to Either Psychiatrists or Urologists?

Background Organic and psychological causes are intertwined in the etiology of sexual dysfunction (SD). Another important point, as well as the importance of etiology in the treatment of sexual dysfunctions, is understanding people's approaches to the problem. This study was planned to investigate whether there is a relationship between self-esteem and body perception levels of patients with sexual dysfunction and preferential applications to urology or psychiatry outpatient clinics. Methodology The study included 125 patients who sought treatment at urology and psychiatry outpatient clinics and were diagnosed with erectile dysfunction (ED) or premature ejaculation (PE) as a result of clinical evaluation. Sociodemographic data forms, the International Erectile Function Index (IIEF-6), the Premature Ejaculation Diagnostic Tool (PEDT), the Body Image Questionnaire (BIQ), and the Self-Esteem Rating Scale (SERS), were administered to the patients. Results When the patients were evaluated according to their complaints, there was no difference between the groups in body image or self-esteem. However, when the preferential admissions were evaluated through outpatient clinics, the self-esteem and body perception levels were high in the patients who applied primarily to the psychiatry outpatient clinic (p = 0.032, p = 0.046). Conclusion Psychological factors may affect male sexual dysfunctions in treatment admissions. It is important that andrology and psychiatry doctors work in cooperation in the treatment of sexual dysfunctions.

Network analysis of eating disorder and depression symptoms among university students in the late stage of COVID-19 pandemic in China

Background

Eating disorders (EDs) and depression are common in university students, especially during the COVID-19 pandemic. The aim of this study was to elucidate characteristics of EDs and depression symptoms networks among Chinese university students in the later stage of the COVID-19 pandemic in China.

Methods

A total of 929 university students completed the SCOFF questionnaire measuring EDs and Patient Health Questionnaire with 9 items (PHQ-9) measuring depression in Guangzhou, China. The network model was applied to identify central symptoms, bridge symptoms, and important connections between SCOFF and PHQ-9 using R studio. The subgroup analyses of both genders in medical and non-medical students were further explored.

Results

In the networks of the whole sample, central symptoms included "Loss of control over eating" (EDs) and "Appetite changes" (depression). The bridge connections were between "Loss of control over eating" (EDs) and "Appetite changes" (depression), between "Deliberate vomiting" (EDs) and "Thoughts of death" (depression). "Appetite changes" (depression) and "Feeling of worthlessness" (depression) were central symptoms in both subgroups of medical and non-medical students. "Fatigue" (depression) was the central symptom in the female and medical students group. The edge between "Loss of control over eating" (EDs) and "Appetite changes" (depression) acted as a bridge in all subgroups.

Conclusion

Social network approaches offered promising ways of further understanding the association between EDs and depression among university students during the pandemic of COVID-19 in China. Investigations targeting central and bridge symptoms would help to develop effective treatments for both EDs and depression for this population.

The Relationship between Psychopathology, Self-esteem, Body Perception and Serum Sex Steroids in Pubertal Gynecomastia

Objective

The current study aimed to investigate the psychopathology behind gynecomastia and potential associated problems regarding self-esteem and body perception, and the relationships of these variables with sex steroid levels in adolescents with pubertal gynecomastia.

Methods

The study included 50 normal weight male adolescents aged between 11 and 18 years with gynecomastia but without any chronic organic pathology, and 50 healthy pubertal male adolescents matched for age. The adolescents underwent psychopathology assessment by Development and Well-Being Assessment interviews; self-esteem was assessed using the Rosenberg Self-Esteem Scale; body perception was evaluated using the Body Image Perception Scale, and the relationship between these variables and sex steroid levels were explored.

Results

The results of the study revealed that the gynecomastia group had significantly greater internalization disorder (χ² = 12.96, p < 0.001), and impairments in self-esteem (z = −1.975, p = 0.024) and body perception (z = −2.286, p = 0.022), and these variables were correlated with the gynecomastia stage. In the study group, cortisol levels were significantly higher (z = −2.330, p = 0.02) in adolescents with internalization disorder compared to those without, and cortisol levels increased in parallel with increased gynecomastia duration (r = 0.386, p = 0.006).

Conclusion

In our study, we found that gynecomastia, depending on its stage, may lead to internalization disorder and impair self-esteem and body perception. It was found that there was no direct relationship between these parameters and sex steroids in pubertal gynecomastia, except for high cortisol levels in adolescents with internalization disorder.

Emotional Regulation and Overeating Behaviors in Children and Adolescents: A Systematic Review

The worldwide prevalence of obesity has dramatically increased, mostly in children and adolescents. The Emotional Eating theoretical model has proposed that the failure in emotional regulation could represent a risk factor for establishing maladaptive overeating behavior that represents an inadequate response to negative emotions and allows increasing body-weight. This systematic review investigates the relationship between overeating and both emotional regulation and emotional intelligence in childhood and adolescence, considering both cross-sectional and longitudinal studies. Moreover, another goal of the review is evaluating whether emotional regulation and emotional intelligence can cause overeating behaviors. The systematic search was conducted according to the PRISMA-statement in the databases Medline, PsychArtcles, PsychInfo, PubMed, Scopus, and Web of Sciences, and allows 484 records to be extracted. Twenty-six studies were selected according to inclusion (e.g., studies focused on children and adolescents without clinical conditions; groups of participants overweight or with obesity) and exclusion (e.g., studies that adopted qualitative assessment or cognitive-affective tasks to measure emotional variables; reviews, commentary, or brief reports) criteria detailed in the methods. Cross-sectional studies showed a negative association between emotional regulation and overeating behavior that was confirmed by longitudinal studies. These findings highlighted the role of maladaptive emotion regulation on overeating and being overweight. The relationship between these constructs in children and adolescents was consistent. The results indicated the complexity of this association, which would be influenced by many physiological, psychological, and social factors. These findings underline the need for further studies focused on emotion regulation in the development of overeating. They should analyze the mediation role of other variables (e.g., attachment style, peer pressure) and identify interventions to prevent and reduce worldwide overweight prevalence.

Measuring perfectionism, impulsivity, self-esteem and social anxiety: Cross-national study in emerging adults from eight countries

This study assessed the measurement invariance of selected self-report measures of perfectionism, impulsivity, self-esteem and social anxiety in samples of emerging adults from eight different countries. Participants (N = 6272) completed the Multidimensional Perfectionism Scale (MPS), the UPPS-P Impulsive Behavior Scale, the 5-item Rosenberg Self-Esteem Scale (5-item RSES) and the Social Interaction Anxiety Scale (SIAS-6). Multigroup confirmatory factor analysis was run to examine cross-measure equivalence. Evidence for structural invariance was found for all questionnaires, while weak invariance was supported only for the 5-item RSES and the SIAS-6, and a partial weak invariance was found for the MPS and the UPPS-P. No measure achieved strong invariance. Strict invariance was achieved for the 5-item RSES, whereas only a partial strict invariance was supported for the MPS, UPPS-P and SIAS-6. These results suggest that perfectionism, impulsivity, self-esteem, and social anxiety are subjected to linguistic/cultural influence as well as to the effects of socio-demographic variables and can be evaluated by using the selected measures in eight different countries worldwide - but results should be interpreted with caution.

What are the emotions underlying feeling fat and fear of weight gain?

BACKGROUND

Eating disorders (EDs) are most always accompanied by cognitive-affective comorbidities, such as anxiety and depression. In addition to these common comorbidities, EDs are unique in that they are characterized by affective symptoms centered on body image and weight. Two of these primary, yet understudied, affective symptoms are feelings of fatness and fears of weight gain, which are theorized to be maintaining symptoms of EDs and are highly common in those with EDs. Despite the importance of these symptoms, there is no research characterizing which cognitive-affective symptoms contribute to feelings of fatness and fears of weight gain.

METHODS

The current study (N=168 individuals with an ED) tested cross-sectional and prospective models of cognitive-affect variables (negative affect, guilt, shame, fear of negative evaluation, anxiety sensitivity, and depression) to identify which thoughts and emotions were uniquely associated and prospectively predicted feelings of fatness and fear of weight gain.

RESULTS

Depression both cross-sectionally and prospectively predicted feeling fat over and above all other forms of affect. Fears of negative evaluation and depression were uniquely associated with fears of weight gain, and shame prospectively predicted fear of weight gain.

LIMITATIONS

Variables were self-reported, and the sample primarily consisted of women. Fear of weight gain and feelings of fatness were assessed using single items.

CONCLUSIONS

This research suggests that depression may be an important intervention target when individuals with an ED report feeling fat. Additionally, treatment targeting fear of negative evaluation, depression, and shame may decrease fears of weight gain.

A preliminary trial of an online dissonance-based eating disorder intervention

OBJECTIVE

We conducted a controlled randomized preliminary trial of an expanded online version of the Body Project (n = 46) compared to an assessment-only control condition (n = 36) via a longitudinal design (baseline, postintervention, 2-month follow-up) in a community sample of women (N = 82) with clinical (n = 53) and subclinical (n = 29) eating disorder symptoms.

METHOD

The traditional content of the Body Project was modified to include verbal, written, and behavioral exercises designed to dissuade objectification and maladaptive social comparison and adapted to an online format. Body dissatisfaction, self-esteem, self-objectification, thin-ideal internalization, maladaptive social comparison, trait anxiety, positive affect, negative affect, and eating disorder symptomatology were evaluated in the control and the online expanded Body Project condition at baseline, postintervention, and 2-month follow-up.

RESULTS

A 2 (condition: online expanded Body Project, control) × 3 (time: baseline, postintervention, 2-month follow-up) mixed factorial multivariate analysis of variance (MANOVA) was conducted to examine statistically significant group differences. As predicted, results indicated a statistically significant condition × time interaction.

CONCLUSIONS

Participants in the expanded online Body Project condition showed significant reductions in eating disorder symptoms and several associated psychological risk correlates from baseline to postintervention and follow-up; contrary to predictions, eating disorder symptoms and risk correlates were not significantly lower in the online expanded Body Project condition compared to the waitlist control condition at postintervention or 2-month follow-up.

Eating Disorders in Sport: Comparing Eating Disorder Symptomatology in Athletes and Non-Athletes During Intensive Eating Disorder Treatment

The current study tested if athlete patients differed from non-athlete patients in measures of eating disorder (ED) and related pathology. Athlete (n = 91 in Study 1; n = 39 in Study 2) and non-athlete (n = 76 in Study 1; n = 26 in Study 2) patients completed self-report measures, and body mass index (BMI) was calculated. Athlete patients had significantly lower ED symptomatology and depression than non-athlete patients (ps < .05). ED impairment, worry, psychosocial functioning, BMI, obsessive-compulsiveness, and compulsive exercise did not significantly differ between groups (ps > .08). Greater ED symptomatology was associated with higher psychosocial functioning among athlete patients and higher obsessive-compulsive symptoms and compulsive exercise among non-athlete patients. This is a novel study comparing ED symptomatology and related measures of mental health in athlete and non-athlete patients engaged in residential or partial hospitalization ED treatment. Future research should further investigate how participation in high-level sport impacts the presentation, treatment, and outcome of individuals with EDs.

Disordered eating attitudes and emotional/behavioral adjustment in Greek adolescents

PURPOSE

The aim of this study was to examine the relationship between disordered eating attitudes and emotional/behavioral adjustment in Greek adolescents as well as the moderating role of gender and body mass index (BMI) in this relationship.

METHODS

Ninety adolescents, 11-18 years old, were assessed using anthropometric measurements; demographics, eating attitudes and level of emotional/behavioral adjustment were examined via self-reported questionnaires.

RESULTS

Disordered eating attitudes were prevalent in 17.8% of the sample. A significant relationship was found between disordered eating attitudes and Youth Self-Report (YSR) anxiety score (r = .22, p < .05). Gender significantly moderated the relationship between YSR anxiety symptoms and Eating Attitudes Test (EAT) scores (b = .59, p = .01) and this effect held true for the EAT bulimia subscale (b = .20, p = .03), but not for the dieting or the oral control subscales. Contrary to our hypothesis, BMI did not moderate the relationship between EAT and YSR anxiety sub-scores (b = .13, p > .05).

CONCLUSION

Girls with elevated anxiety levels appear to be at risk for exhibiting disordered eating attitudes, especially bulimic behaviors. This finding highlights the importance of developing gender-based preventive interventions tailored to these specific emotional/behavioral aspects.

LEVEL OF EVIDENCE

Level V, cross-sectional descriptive study.

The unique associations of self-criticism and shame-proneness to symptoms of disordered eating and depression

This study examined the unique associations of shame-proneness and self-criticism to symptoms of disordered eating and depression among 186 undergraduate students. The study also tested the degree to which self-criticism and shame-proneness accounted for the association between disordered eating and depressive symptoms. Both shame-proneness and self-criticism were significantly related to disordered eating and depressive symptoms. Self-criticism was significantly associated with disordered eating and depressive symptoms, over-and-above shame-proneness, but the reverse was not true. Controlling for shame-proneness, self-criticism also accounted for a significant proportion of the covariance between disordered eating and depressive symptoms, suggesting that self-criticism could account for some of the comorbidity between depression and eating disorders. Findings suggest that self-criticism may have incremental utility above-and-beyond shame-proneness as part of a transdiagnostic underlying cognitive substrate for depression and disordered eating. Implications emerge for future research and clinical practice.

Interaction between the FTO gene, body mass index and depression: meta-analysis of 13701 individuals

BackgroundDepression and obesity are highly prevalent, and major impacts on public health frequently co-occur. Recently, we reported that having depression moderates the effect of the FTO gene, suggesting its implication in the association between depression and obesity.AimsTo confirm these findings by investigating the FTO polymorphism rs9939609 in new cohorts, and subsequently in a meta-analysis.MethodThe sample consists of 6902 individuals with depression and 6799 controls from three replication cohorts and two original discovery cohorts. Linear regression models were performed to test for association between rs9939609 and body mass index (BMI), and for the interaction between rs9939609 and depression status for an effect on BMI. Fixed and random effects meta-analyses were performed using METASOFT.ResultsIn the replication cohorts, we observed a significant interaction between FTO, BMI and depression with fixed effects meta-analysis (β = 0.12, P = 2.7 × 10^-4) and with the Han/Eskin random effects method (P = 1.4 × 10^-7) but not with traditional random effects (β = 0.1, P = 0.35). When combined with the discovery cohorts, random effects meta-analysis also supports the interaction (β = 0.12, P = 0.027) being highly significant based on the Han/Eskin model (P = 6.9 × 10^-8). On average, carriers of the risk allele who have depression have a 2.2% higher BMI for each risk allele, over and above the main effect of FTOConclusionsThis meta-analysis provides additional support for a significant interaction between FTO, depression and BMI, indicating that depression increases the effect of FTO on BMI. The findings provide a useful starting point in understanding the biological mechanism involved in the association between obesity and depression.

Shared risk factors for mood-, eating-, and weight-related health outcomes

OBJECTIVE

Given the overlap among depressive symptoms, disordered eating, and overweight, identifying shared risk factors for these conditions may inform public health interventions. This study aimed to examine cross-sectional and prospective relationships among these 3 conditions, and identify potential shared eating-related and psychosocial variable risk factors (i.e., body dissatisfaction, dieting, teasing experiences).

METHOD

A population-based sample (n = 1,902) self-reported depressive symptoms, disordered eating (binge eating, extreme weight control behaviors), weight status, and several putative risk factors (body satisfaction, dieting frequency, weight-related teasing) at 5-year intervals spanning early/middle adolescence, middle adolescence/early young adulthood, and early/middle young adulthood.

RESULTS

There was moderate overlap among depressive symptoms, disordered eating, and overweight at each time point, and moderate stability in each condition over time. Body dissatisfaction and dieting were the most potent shared risk factors for later depressive symptoms, disordered eating, and overweight among males and females (ps < .05).

CONCLUSIONS

Depressive symptoms, disordered eating, and overweight share several risk factors, including dieting and body dissatisfaction, which may be effective targets for interventions aiming to simultaneously prevent these 3 conditions.

High prevalence of vitamin D deficiency and insufficiency in adolescent inpatients diagnosed with eating disorders

OBJECTIVE

Previous studies assessing vitamin D status in adolescents with eating disorders showed inconsistent results. The aim of the current study was to assess vitamin D status in a large cohort of adolescent inpatients with eating disorders and its relation to bone mineral density (BMD) and depression.

METHOD

25-Hydroxyvitamin D (25OHD), calcium, phosphorus, and alkaline phosphatase levels as well as BMD and depression were assessed on admission in 87 inpatients (aged 16 ± 2 years, females = 81) with eating disorders [anorexia nervosa (AN) = 64; bulimia nervosa (BN) = 5; eating disorders not otherwise specified-binge/purge type (EDNOS-B/P) = 18].

RESULTS

Mean 25OHD levels were 24.1 ± 7.5 ng/ml (25.0 ± 7.6, 25.4 ± 9.9, and 22.0 ± 9.9 ng/ml in patients with AB, BN, and EDNOS-B/P, respectively). Vitamin D deficiency (<15 ng/ml) was found in 7.8% of the patients, and insufficiency (15-20 ng/ml) in 22.2%. Only 16.7% had levels >32 ng/ml, considered optimal by some experts. No associations were found between 25OHD levels and BMD or comorbid depression. 25OHD levels during winter were significantly lower than summer levels (p < .001). Mean lumbar spine BMD z-score in patients with AN and EDNOS-B/P type was low (-1.5 ± 1.1) and correlated with body mass index standard deviation score (p = .03).

DISCUSSION

Adolescents with eating disorders show a high prevalence of vitamin D deficiency and insufficiency. Given the risk of osteoporosis in this population, 25OHD levels found in this group may not offer optimal bone protection. Vitamin D levels should be routinely checked and supplementation should be administered as required.

Neural patterns underlying social comparisons of personal performance

Humans often evaluate their abilities by comparing their personal performance with that of others. For this process, it is critical whether the comparison turns out in one's favor or against it. Here, we investigate how social comparisons of performance are encoded and integrated on the neural level. We collected functional magnetic resonance images while subjects answered questions in a knowledge quiz that was related to their profession. After each question, subjects received a feedback about their personal performance, followed by a feedback about the performance of a reference group who had been quizzed beforehand. Based on the subjects' personal performance, we divided trials in downward and upward comparisons. We found that upward comparisons correlated with activity in the dorsolateral prefrontal cortex and the anterior insula. Downward comparisons were associated with increased activation in the ventral striatum (VS), the medial orbitofrontal cortex and the ventral anterior cingulate cortex (ACC). The extent to which subjects outperformed the reference group modulated the activity in the VS and in the dorsal ACC. We suggest that the co-activation of the VS and the dorsal ACC contributes to the integration of downward comparisons into the evaluation of personal performance.

German version of the Multidimensional Body-Self Relations Questionnaire - Appearance Scales (MBSRQ-AS): confirmatory factor analysis and validation

The Multidimensional Body-Self Relations Questionnaire (MBSRQ) is a widely used questionnaire that measures body image as a multidimensional construct. The Appearance Scales (AS) of the MBSRQ (Appearance Evaluation, Appearance Orientation, Body Areas Satisfaction, Overweight Preoccupation and Self-Classified Weight) are subscales which facilitate a parsimonious assessment of appearance-related aspects of body image. The current study tested the psychometric properties and factor structure of a German translation of the MBSRQ-AS. Participants were n=230 female patients with the SCID diagnosis of an eating disorder and n=293 female healthy controls. In a confirmatory factor analysis, convincing goodness-of-fit indices emerged. The subscales of the questionnaire yielded good reliability and convergent and discriminant validity coefficients, with most items showing excellent characteristics. Like the English version, the German adaptation of the questionnaire can be recommended for a multidimensional assessment of appearance-related aspects of body image in both research and clinical practice.

Disordered eating links to body-relevant and body-irrelevant influences on self-evaluation

We investigated eating- and weight-related correlates of self-evaluation influences (SEIs) and examined the extent to which such SEIs can be both over- and undervalued and the extent to which measurement strategy affects SEIs. A female undergraduate sample (n = 549) completed 3 measures of SEI importance and questionnaires assessing disordered eating (DE), body mass index (BMI), and depression. SEI measures included Likert scale, rank ordering, and pairwise forced choice; a subset (n = 62) also completed the Shape- and Weight-Based Self-Esteem Scale (SAWBS). Only rank ordering, forced choice, and SAWBS constrain choices among SEIs, such that prioritizing one SEI necessarily deprioritizes another, which reflects real-world restrictions on individuals' allotment of time and energy (e.g., spending hours exercising daily necessarily reduces time available for other activities). By any measure, women with DE overvalue body shape and weight. The constraining measures reveal systematic undervaluation of intelligence and achievement among women with DE and an enhanced effect of DE on the overvaluation of weight and on the undervaluation of being a good person among those with higher BMI. Depressed women's self-evaluations overemphasize appearance and underemphasize interpersonal relationships. Self-evaluations of women with DE are marked by both over- and undervaluation of relevant SEIs; the overvaluation of shape and weight in DE may be associated with costs. Future use of constraining measures, such as forced choice or rank ordering, may enhance our understanding of both over- and underemphasized SEIs among women with DE.

Changing the course of comorbid eating disorders and depression: what is the role of public health interventions in targeting shared risk factors?

Public health has a productive history of improving global health due to its focus on reaching large populations using effective and scalable interventions. Yet, the marriage between evidence-based science and the implementation of community/public health interventions within mental illness remains underdeveloped. Research suggests that major depression is the most commonly cited comorbidity for eating disorders (EDs). Thus, identification of public health strategies that jointly impact depression and EDs, including shared risk factors, has the potential to significantly impact mental health suffering. The primary aim of this paper is to examine and discuss such public health approaches as well as explore cues taken from public health efforts to inform future directions in research and clinical practice. As a comprehensive review of all public health initiatives that address EDs and depression is beyond the scope of this paper, this paper reviews a series of programs/approaches that either are of large scale and/or have received empirical support. In particular, public health related interventions that aim to reduce variable risk factors associated with EDs and depression, as well as interventions that aim to reduce continuous measures of ED and depression symptoms are reviewed. To date, despite significant progress in modifying risk factors for EDs and depression, the field still lacks a public health study that has been appropriately designed and/or adequately powered to assess true ED/depression prevention effects. Further, although several programs show promise, many widely disseminated approaches lack empirical support, raising concerns about the potential for waste of limited resources. In summary, although the combination of prevention and public health based approaches appear to have merit when trying to move the needle on risk factors and symptoms associated with EDs and/or depression, further research is needed to investigate the reach and effectiveness of large scale dissemination efforts of such endeavors.

Toward understanding the role of body dissatisfaction in the gender differences in depressive symptoms and disordered eating: a longitudinal study during adolescence

This study was aimed at examining whether body dissatisfaction in early adolescence contributes to the development of gender differences in depressive symptoms and disordered eating across early to mid-adolescence, testing both a mediation hypothesis (higher levels of body dissatisfaction in girls, provided body dissatisfaction is a predictor of psychopathology beyond the effect of gender) and a moderation hypothesis (more detrimental effect of body dissatisfaction in girls). A community-based sample initially comprising 882 (49.55% female) adolescents (M(age) = 12.85) was followed-up after 2 and 4 years. Multilevel models were used to analyze the data. Results supported the mediation hypothesis for depressive symptoms and disordered eating, and the moderation hypothesis for disordered eating. Whereas gender differences in depressive symptoms may be simply linked to dissimilar levels of body dissatisfaction in girls and boys, gender differences in disordered eating may arise from both dissimilar levels and effects of body dissatisfaction for each gender.

Body-related social comparison and disordered eating among adolescent females with an eating disorder, depressive disorder, and healthy controls

The purpose of this study was to investigate the association between body-related social comparison (BRSC) and eating disorders (EDs) by: (a) comparing the degree of BRSC in adolescents with an ED, depressive disorder (DD), and no psychiatric history; and (b) investigating whether BRSC is associated with ED symptoms after controlling for symptoms of depression and self-esteem. Participants were 75 girls, aged 12–18 (25 per diagnostic group). To assess BRSC, participants reported on a 5-point Likert scale how often they compare their body to others’. Participants also completed a diagnostic interview, Eating Disorders Inventory-2 (EDI-2), Beck Depression Inventory-II (BDI-II), and Rosenberg Self-Esteem Scale (RSE). Compared to adolescents with a DD and healthy adolescents, adolescents with an ED engaged in significantly more BRSC (p ≤ 0.001). Collapsing across groups, BRSC was significantly positively correlated with ED symptoms (p ≤ 0.01), and these associations remained even after controlling for two robust predictors of both ED symptoms and social comparison, namely BDI-II and RSE. In conclusion, BRSC seems to be strongly related to EDs. Treatment for adolescents with an ED may focus on reducing BRSC.

Psychological distress as a mediator in the relationships between biopsychosocial factors and disordered eating among Malaysian university students

The mechanism linking biopsychosocial factors to disordered eating among university students is not well understood especially among Malaysians. This study aimed to examine the mediating role of psychological distress in the relationships between biopsychosocial factors and disordered eating among Malaysian university students. A self-administered questionnaire measured self-esteem, body image, social pressures to be thin, weight-related teasing, psychological distress, and disordered eating in 584 university students (59.4% females and 40.6% males). Body weight and height were measured. Structural equation modeling analysis revealed that the partial mediation model provided good fit to the data. Specifically, the relationships between self-esteem and weight-related teasing with disordered eating were mediated by psychological distress. In contrast, only direct relationships between body weight status, body image, and social pressures to be thin with disordered eating were found and were not mediated by psychological distress. Furthermore, multigroup analyses indicated that the model was equivalent for both genders but not for ethnic groups. There was a negative relationship between body weight status and psychological distress for Chinese students, whereas this was not the case among Malay students. Intervention and prevention programs on psychological distress may be beneficial in reducing disordered eating among Malaysian university students.