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López-Gil JF, Jiménez-López E, Fernández-Rodríguez R, Garrido-Miguel M, Victoria-Montesinos D, Gutiérrez-Espinoza H, Tárraga-López PJ, Mesas AE. Prevalence of Disordered Eating and Its Associated Factors From a Socioecological Approach Among a Sample of Spanish Adolescents: The EHDLA Study. Int J Public Health 2023; 68:1605820. [PMID: 37051310 PMCID: PMC10084851 DOI: 10.3389/ijph.2023.1605820] [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: 01/26/2023] [Accepted: 03/16/2023] [Indexed: 03/29/2023] Open
Abstract
Objectives: The aim of this study was twofold: a) to establish the prevalence of adolescents with disordered eating and b) to determine the factors associated with this prevalence in a sample of Spanish adolescents from the Valle de Ricote (Region of Murcia, Spain).Methods: This cross-sectional study analyzed data from 730 adolescents (56.2% girls) from the EHDLA study. To determine the prevalence of disordered eating, the Sick, Control, One stone, Fat, Food (SCOFF) questionnaire was used. A socioecological approach was used to identify individual-, interpersonal-, or organizational-level factors associated with disordered eating.Results: The prevalence of disordered eating was 30.1%. This condition was associated with female sex (odds ratio [OR] = 2.60; 95% confidence interval [CI], 1.81–3.73), immigrant status (OR = 2.22; 95% CI, 1.51–3.25), or excess weight (OR = 2.74; 95% CI, 1.93–3.89). Furthermore, for each additional hour slept, lower odds of having disordered eating were found (OR = 0.81; 95% CI, 0.67–0.98).Discussion: Almost one-third of the sample of Spanish adolescents analyzed reported disordered eating. Female sex, immigrant status and excess weight are individual aspects that seem to be related to disordered eating among Spanish adolescents.
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Affiliation(s)
- José Francisco López-Gil
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain
- Department of Environmental Health, Harvard University T.H. Chan School of Public Health, Boston, MA, United States
- One Health Research Group, Universidad de Las Américas, Quito, Ecuador
| | - Estela Jiménez-López
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
| | | | - Miram Garrido-Miguel
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Department of Nursing, Physiotherapy and Occupational Therapy, University of Castilla-La Mancha, Toledo, Spain
| | - Desirée Victoria-Montesinos
- Faculty of Pharmacy and Nutrition, UCAM Universidad Católica San Antonio de Murcia, Murcia, Spain
- *Correspondence: Héctor Gutiérrez-Espinoza, ; Desirée Victoria-Montesinos,
| | - Héctor Gutiérrez-Espinoza
- Escuela de Fisioterapia, Universidad de las Américas, Quito, Ecuador
- *Correspondence: Héctor Gutiérrez-Espinoza, ; Desirée Victoria-Montesinos,
| | - Pedro J. Tárraga-López
- Department of Medical Sciences, Faculty of Medicine, University of Castilla-La Mancha, Albacete, Spain
| | - Arthur Eumann Mesas
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Postgraduate Program in Public Health, Universidade Estadual de Londrina, Londrina, Brazil
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Kovács-Tóth B, Oláh B, Kuritárné Szabó I, Túry F. Adverse childhood experiences increase the risk for eating disorders among adolescents. Front Psychol 2022; 13:1063693. [PMID: 36578685 PMCID: PMC9791097 DOI: 10.3389/fpsyg.2022.1063693] [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: 10/07/2022] [Accepted: 11/24/2022] [Indexed: 12/14/2022] Open
Abstract
Purpose Traumatic events often feature prominently in eating disorders. A questionnaire survey to assess the relation of eating disorder risk to the frequency of adverse childhood experiences (ACEs) and the possible association of eating disorder risk with a particular type of ACE was conducted in a community sample of Hungarian adolescents. Methods Demographic and anthropometric data, risk for eating disorders (by SCOFF questionnaire), and ACEs (by ACE score calculator) were collected from 432 adolescents aged 12-17 years. Results Adolescents who had undergone four or more ACEs were 5.7 times more likely to be in the high eating disorder risk group than those who did not report any ACEs. Cumulative maltreatment showed a greater association with overall risk for eating disorders than cumulative family dysfunction. There is an increased risk of eating disorders from emotional maltreatment (OR = 3.475), physical maltreatment (OR = 3.440), sexual maltreatment (OR = 10.973), and emotional neglect (OR = 3.331). Dysfunctional family circumstances revealed an association with household mental illness (OR = 3.401). Conclusion Our study of the connection between eating disorder risk and ACE is the first of its kind in Central and Eastern Europe. Maltreatments had a greater role than family dysfunctions in increasing the risk of eating disorders. Our findings contribute to a more precise understanding of the role that ACEs play in eating disorders. It is important to bring to clinicians' attention the importance of ACEs in the diagnosis and therapy of eating disorders and their potentially fundamental significance for therapy.
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Affiliation(s)
- Beáta Kovács-Tóth
- Institute of Behavioural Sciences, Faculty of Medicine, University of Debrecen, Debrecen, Hungary,*Correspondence: Beáta Kovács-Tóth,
| | - Barnabás Oláh
- Institute of Behavioural Sciences, Faculty of Medicine, University of Debrecen, Debrecen, Hungary,Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Ildikó Kuritárné Szabó
- Institute of Behavioural Sciences, Faculty of Medicine, University of Debrecen, Debrecen, Hungary,Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Ferenc Túry
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
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Risk of eating disorders in a representative sample of Italian adolescents: prevalence and association with self-reported interpersonal factors. Eat Weight Disord 2022; 27:701-708. [PMID: 34014507 PMCID: PMC8933299 DOI: 10.1007/s40519-021-01214-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 05/11/2021] [Indexed: 10/25/2022] Open
Abstract
PURPOSE Adolescence represents a critical period for the onset of eating disorders (EDs). The present study aimed to provide the prevalence of individuals at risk for EDs psychopathology in a representative population of adolescents aged 14-19 and to characterize this population regarding interpersonal and psychological factors. METHODS The percentage of participants at risk for EDs in a representative high school population was assessed through the SCOFF screening questionnaire (cut-off score: 3) in the total sample (N: 6551) and in gender-based subgroups for different body mass index (BMI) categories. Odds ratios for being at risk of ED (SCOFF ≥ 3) were esteemed in a multivariable analysis including self-reported parental education, quality of family and peer relationships, bullying victimization, age at first sexual intercourse, and psychological distress. RESULTS A SCOFF score ≥ 3 was found in 31.0% of participants (boys: 19.4%; girls: 44.6%), with a greater prevalence among higher BMI categories. Bad family relationships, being bullied, having the first sexual intercourse before the age of 14, and experiencing high distress were associated with this risk condition. Among girls, bad peer relationships were associated with a low-risk SCOFF score. CONCLUSION A remarkable percentage of adolescents reported significant body image or eating concerns. Screening programs are deeply needed, and particular attention should be devoted to interpersonal factors, such as the quality of family relationships and interactions with peers, which represent potential indicators of this vulnerability. LEVEL OF EVIDENCE Level V - Cross-sectional study.
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Ruchkin V, Isaksson J, Schwab-Stone M, Stickley A. Prevalence and early risk factors for bulimia nervosa symptoms in inner-city youth: gender and ethnicity perspectives. J Eat Disord 2021; 9:136. [PMID: 34674763 PMCID: PMC8529812 DOI: 10.1186/s40337-021-00479-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 09/17/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Research on risk factors associated with bulimia nervosa symptoms (BN) in ethnic minorities has been limited. This study adds to the existing literature by providing the ethnicity- and gender-specific prevalence of BN in US inner-city youth and by exploring the longitudinal associations between a clinical level of BN and early risk factors assessed one year previously. METHODS The study was conducted on a representative sample of predominantly ethnic minority youth (N = 2794; 54.1% female; age 11-16 years old (M(SD) = 12.77(1.29)); 60.0% African-American, 26.1% Hispanic American, 13.9% White). Self-reported information was obtained on BN and early risk factors (e.g., depressive and anxiety symptoms, posttraumatic stress, somatic complaints). Multivariate analysis of covariance was used to examine the longitudinal associations. RESULTS The 3-month BN prevalence was higher in girls (5.1%) than in boys (2.3%) (ratio 2.22:1). Significant differences in BN rates were found between White and African American students (higher in Whites), whereas Hispanic-Americans did not differ significantly from either group. Individuals with BN had significantly higher levels of early risk factors one year prior. CONCLUSIONS Timely recognition of BN and associated early risk factors is important for early prevention and intervention strategies.
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Affiliation(s)
- Vladislav Ruchkin
- Child and Adolescent Psychiatry Unit, Department of Neuroscience, Uppsala University, 751 85, Uppsala, Sweden. .,Child Study Center, Yale University Medical School, New Haven, CT, 06520, USA. .,Säter Forensic Psychiatric Clinic, 783 27, Säter, Sweden.
| | - Johan Isaksson
- Child and Adolescent Psychiatry Unit, Department of Neuroscience, Uppsala University, 751 85, Uppsala, Sweden.,Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Mary Schwab-Stone
- Child Study Center, Yale University Medical School, New Haven, CT, 06520, USA
| | - Andrew Stickley
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan.,Stockholm Center for Health and Social Change (SCOHOST), Södertörn University, Huddinge, Sweden
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Diagnostik, Therapie und Verlaufskontrolle des Diabetes mellitus im Kindes- und Jugendalter. DIABETOLOGE 2021. [DOI: 10.1007/s11428-021-00769-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Peter C, Brosius HB. [The role of the media in the development, course, and management of eating disorders]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2020; 64:55-61. [PMID: 33277672 PMCID: PMC7772156 DOI: 10.1007/s00103-020-03256-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 11/16/2020] [Indexed: 11/01/2022]
Abstract
Eating disorders are among the most common psychosomatic illnesses in Western societies. For some time now, the media have been blamed as one of the potential triggers of problematic eating behavior. Several studies have shown that the media convey an unrealistic ideal of beauty and that this can cause dissatisfaction with one's own body, especially among young recipients. However, two central aspects have not yet been thoroughly considered. First, there is a lack of research that focuses on people actually affected by an eating disorder and that considers the role of the media in the development, progression, and coping phase of an eating disorder. Second, there is hardly any research on how and to what extent the disease itself is addressed in the media and how such representations influence the affected group - in communication research, this is referred to as reciprocal effects. Based on previous research in this area, it can be assumed that the perception of how one's own illness is portrayed in the media can have consequences for the self-perception, well-being, and actions of ill persons. This article provides an overview of the complex role of the media in the context of an eating disorder and, above all, highlights gaps in communication research on the topic.
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Affiliation(s)
- Christina Peter
- Institut für Kommunikationswissenschaft, Ludwig-Maximilians-Universität München, Oettingenstr. 67, 80538, München, Deutschland.
| | - Hans-Bernd Brosius
- Institut für Kommunikationswissenschaft, Ludwig-Maximilians-Universität München, Oettingenstr. 67, 80538, München, Deutschland
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7
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Elran-Barak R, Bromberg M, Shimony T, Dichtiar R, Mery N, Nitsan L, Keinan-Boker L. Disordered eating among Arab and Jewish youth in Israel: the role of eating dinner with the family. Isr J Health Policy Res 2020; 9:27. [PMID: 32522247 PMCID: PMC7285746 DOI: 10.1186/s13584-020-00388-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 05/26/2020] [Indexed: 11/17/2022] Open
Abstract
Background Disordered eating (DE), defined as unhealthy eating attitudes and behaviors, is considered a major public health problem among adolescents. Nevertheless, rates of DE among Arab and Jewish adolescents in Israel are still unknown. Furthermore, while previous studies have highlighted the role of frequent family meals as a protective factor against DE, studies examining home family dinners relative to other common dinner options (e.g., eating at home alone, eating out of the home, not eating dinner at all) are largely unavailable. We sought to use representative data of middle and high-school children in Israel in order to identify rates of DE among Arabs and Jews, while examining the relations of home family dinners (vs. other dinner options) with DE. Methods A nationally representative school-based survey of 4926 middle and high-school children (11–19 years old) was conducted during 2015–2016. Participants indicated where and with whom they had eaten dinner the day before. The 5-item SCOFF questionnaire was used (> 2 affirmative items were considered a likely case of DE). Height and weight were measured by personnel. Results DE was more prevalent among girls (29.7%) relative to boys (12.2%), Arabs (25.1%) relative to Jews (19.5%), and older (25.3%) relative to younger (17.6%) adolescents. Arabs were more likely to eat dinner at home with parents/family (chi2 = 10.75, p = .001), or not to eat dinner at all (chi2 = 63.27, p < .001), while Jews were more likely to eat dinner alone (chi2 = 5.37, p = .021) or to eat dinner out of the home (chi2 = 67.65, p < .001). Logistic regressions (stratified by ethnicity and adjusted for gender, age, weight) revealed that family dinners acted as a protective factor against DE, relative to eating out of the home or relative to not eating dinner at all among both ethnic groups, and relative to eating dinner alone among Arabs. Conclusion There are differences between Arab and Jewish adolescents in terms of rates of yesterday’s family dinners and DE. Given that eating dinner with the family was linked with lower rates of DE, possible interventions to reduce DE may include educating parents of both Arab and Jewish adolescents regarding the importance of family meals.
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Harrison AN, James Bateman CCB, Younger-Coleman NOM, Williams MC, Rocke KD, Clato-Day Scarlett SC, Chang SM. Disordered eating behaviours and attitudes among adolescents in a middle-income country. Eat Weight Disord 2020; 25:1727-1737. [PMID: 31741253 DOI: 10.1007/s40519-019-00814-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 11/05/2019] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Adolescent-disordered eating behaviours and attitudes (DEBA) are noted to be increasing in prevalence internationally. The aim of this study was to explore the DEBAs among Jamaican adolescents and identify those adolescents most at risk. METHODS 521 high school participants (females, n = 292), ages 11-19 years, completed measures assessing socio-demographic factors, self-esteem, symptoms of anxiety and depression, behavioural factors, and anthropometry. Weight-related behaviours and attitudes were explored using the Eating Attitudes Test (EAT-26). RESULTS Thirty-one percent of participants reported engaging in at least one disordered eating behaviour, with bingeing as the most common. Female participants had significantly higher mean body mass index (p < 0.01) and mean EAT-26 score (p < 0.05) compared to males. Adolescents with EAT-26 score ≥ 20 were more desirous of being thinner (p < 0.01) and having a lighter skin complexion (p < 0.05). A greater proportion of adolescents with an EAT-26 score ≥ 20 had engaged in self-harm (p < 0.05), had smoked cigarettes (p < 0.05), had been sexually active (p < 0.01), and gave a history of sexual abuse (p < 0.01). Adolescents with overweight/obesity reported higher use of chemical weight manipulation (laxatives, diuretics, and diet pills) (p = 0.01). CONCLUSIONS Our data are consistent with the global figures showing both male and female adolescents endorsing disordered eating behaviours and attitudes (DEBAs). While this study highlights weight and shape dissatisfaction and associated DEBAs, it also raises the concern of an association with skin bleaching and elevated EAT-26 scores among Jamaican adolescents. LEVEL OF EVIDENCE Level V: cross-sectional descriptive study.
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Affiliation(s)
- Abigail N Harrison
- Department of Child and Adolescent Health, Faculty of Medical Sciences, University of the West Indies (UWI), Mona, Jamaica.
| | - Caryl C B James Bateman
- Department of Sociology, Psychology and Social Work, Faculty of Social Sciences, UWI, Mona, Jamaica
| | | | - Michelle C Williams
- Department of Child and Adolescent Health, Faculty of Medical Sciences, University of the West Indies (UWI), Mona, Jamaica
| | - Kern D Rocke
- Caribbean Institute for Health Research (CAIHR), UWI, Mona, Jamaica
| | - Stephanie C Clato-Day Scarlett
- Department of Child and Adolescent Health, Faculty of Medical Sciences, University of the West Indies (UWI), Mona, Jamaica
| | - Susan M Chang
- Caribbean Institute for Health Research (CAIHR), UWI, Mona, Jamaica
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Larsen A, Lilja M, Sturidsson K, Blatny M, Hrdlicka M, Stickley A, Ruchkin V. Bulimia symptoms in Czech youth: prevalence and association with internalizing problems. Eat Weight Disord 2020; 25:1543-1552. [PMID: 31621001 PMCID: PMC7581576 DOI: 10.1007/s40519-019-00790-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 09/30/2019] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Although clinical studies suggest that bulimia symptoms are common in youth, research on the prevalence of such symptoms and of their association with comorbid internalizing problems in the general population has been limited. This study aimed to evaluate the gender-specific prevalence of bulimia symptoms in Czech youth and explored the association between a clinical level of self-reported bulimia symptoms (CLBS) and internalizing problems by gender, controlling for age, socio-economic status and puberty status. METHOD The study was conducted on a representative national sample of Czech youth (N = 4430, 57.0% female) using self-report scales. Multivariate analysis of covariance (MANCOVA) was used to examine the associations. RESULTS The 3-month CLBS prevalence was higher in girls (11.4%) than in boys (3.8%) and in both genders a CLBS was associated with higher levels of comorbid internalizing problems. DISCUSSION Timely recognition of bulimia symptoms and associated risk factors is important for early prevention and intervention strategies. LEVEL OF EVIDENCE V, cross-sectional descriptive study (according to Oxford (UK) CEBM Levels of Evidence, 2011).
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Affiliation(s)
- Anna Larsen
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Marie Lilja
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Knut Sturidsson
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.,Säter Forensic Psychiatric Clinic, 783 27, Säter, Sweden
| | - Marek Blatny
- Department of Psychology, Faculty of Arts MU, Brno, Czech Republic
| | - Michal Hrdlicka
- Department of Child Psychiatry, Charles University Second Faculty of Medicine, University Hospital Motol, Prague, Czech Republic
| | - Andrew Stickley
- Stockholm Center for Health and Social Change (SCOHOST), Södertörn University, Huddinge, Sweden
| | - Vladislav Ruchkin
- Child and Adolescent Psychiatry Unit, Department of Neuroscience, Uppsala University, 751 85, Uppsala, Sweden. .,Child Study Center, Yale University Medical School, New Haven, CT, 06520, USA. .,Säter Forensic Psychiatric Clinic, 783 27, Säter, Sweden.
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Thielemann D, Richter F, Strauss B, Braehler E, Altmann U, Berger U. Differential Item Functioning in Brief Instruments of Disordered Eating. EUROPEAN JOURNAL OF PSYCHOLOGICAL ASSESSMENT 2019. [DOI: 10.1027/1015-5759/a000472] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Most instruments for the assessment of disordered eating were developed and validated in young female samples. However, they are often used in heterogeneous general population samples. Therefore, brief instruments of disordered eating should assess the severity of disordered eating equally well between individuals with different gender, age, body mass index (BMI), and socioeconomic status (SES). Differential item functioning (DIF) of two brief instruments of disordered eating (SCOFF, Eating Attitudes Test [EAT-8]) was modeled in a representative sample of the German population ( N = 2,527) using a multigroup item response theory (IRT) and a multiple-indicator multiple-cause (MIMIC) structural equation model (SEM) approach. No DIF by age was found in both questionnaires. Three items of the EAT-8 showed DIF across gender, indicating that females are more likely to agree than males, given the same severity of disordered eating. One item of the EAT-8 revealed slight DIF by BMI. DIF with respect to the SCOFF seemed to be negligible. Both questionnaires are equally fair across people with different age and SES. The DIF by gender that we found with respect to the EAT-8 as screening instrument may be also reflected in the use of different cutoff values for men and women. In general, both brief instruments assessing disordered eating revealed their strengths and limitations concerning test fairness for different groups.
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Affiliation(s)
- Desiree Thielemann
- Institute of Psychosocial Medicine and Psychotherapy, Jena University Hospital, Germany
| | - Felicitas Richter
- Institute of Psychosocial Medicine and Psychotherapy, Jena University Hospital, Germany
| | - Bernd Strauss
- Institute of Psychosocial Medicine and Psychotherapy, Jena University Hospital, Germany
| | - Elmar Braehler
- Department of Medical Psychology and Medical Sociology, Leipzig University Hospital, Germany
- Department of Psychosomatic Medicine and Psychotherapy, Universal Medical Center Mainz, Germany
| | - Uwe Altmann
- Institute of Psychosocial Medicine and Psychotherapy, Jena University Hospital, Germany
| | - Uwe Berger
- Institute of Psychosocial Medicine and Psychotherapy, Jena University Hospital, Germany
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Seiffge-Krenke I. Essstörungen: Entwicklungspsychologische und entwicklungspsychopathologische Perspektive. KINDHEIT UND ENTWICKLUNG 2019. [DOI: 10.1026/0942-5403/a000291] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Zusammenfassung. Der vorliegende Beitrag betrachtet Essstörungen unter entwicklungspsychologischer und entwicklungspsychopathologischer Perspektive. Körperbildstörungen, gestörtes Essverhalten und der Einfluss beider Eltern werden in den Kontext der normalen Mädchenentwicklung gestellt und insbesondere der Einfluss der Freundinnen und der neuen Medien herausgearbeitet. Bereits bei nicht essgestörten Jugendlichen fallen extremes Diätieren und ängstliche Körperkontrolle, aber auch elterliche problematische Kommunikationsstile und die oft schädlichen Interaktionen mit Gleichaltrigen auf. Die Grenze zu pathologischen Phänomenen ist entsprechend schwer zu ziehen. Hinzukommen hohe Komorbiditäten zwischen verschiedenen Essstörungen und mit internalisierenden und externalisierenden psychischen Störungen. Zeitgeschichtliche Phänomene wie die „holy anorexia“ der vergangenen Jahrhunderte und die gegenwärtig beobachtbare Zunahme an Essstörungen bei Jungen und der Wunsch, das Geschlecht zu verändern (Transgender) werden ebenso betrachtet wie kulturelle Einflüsse („Is fat beautiful?“). In diesem Zusammenhang wird auch der Frage nachgegangen, ob Essstörungen zugenommen haben und welchen Beitrag die neuen Medien dabei möglicherweise haben.
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[Symptoms of eating disorders in children and adolescents: frequencies and risk factors : Results from KiGGS Wave 2 and trends]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2019; 62:1195-1204. [PMID: 31529180 DOI: 10.1007/s00103-019-03005-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Eating disorders are of high clinical and societal relevance. They are among the most common chronic mental illnesses in adulthood, but show a high incidence rate and peak of disease onset even in adolescence. Eating disorders are associated with far-reaching costs, such as acute or chronic comorbidities and educational or professional attainment.Thus, from a public mental health perspective, it is essential to explore symptoms and risk factors of eating disorders and to monitor prevalence rates across time to evaluate the relevance and effectiveness of prevention measures.In the present study, the recent prevalence of eating disorder symptoms among 11- to 17-year-old children and adolescents living in Germany is reported based on the Health Interview and Examination Survey for Children and Adolescents (KiGGS Wave 2, 2014-2017, N = 6599, 51.7% boys) and compared to the prevalence rates 10 years ago (KiGGS Baseline, 2003-2006, N = 6633, 51.5% boys). Moreover, we investigate a selection of risk factors for eating disorder symptoms.In KiGGS Wave 2, 19.8% of the children and adolescents showed eating disorder symptoms, a drop of 2.8 percentage points in the prevalence rate as compared to the KiGGS Baseline. The drop in the prevalence rate pertains to 11- to 13-year-old boys while the risk for 14- to 17-year-old adolescents and particularly among girls remained comparably high. Children and adolescents with emotional problems, low family cohesion, low self-efficacy, or who perceive themselves as too thick or thin, show an increased risk for eating disorder symptoms.Previous approaches and possible supplements for the prevention of eating disorders are discussed.
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Feldhege J, Moessner M, Stieler C, van Stipelen J, Bauer S. Wissen und Einstellungen zu Essstörungen bei Jugendlichen mit türkischem Migrationshintergrund. PSYCHOTHERAPEUT 2018. [DOI: 10.1007/s00278-018-0327-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Lee GY, Park EJ, Kim YR, Kwag KH, Park JH, An SH, Lee JH, Sim JH, Treasure J. Feasibility and acceptability of a prevention program for eating disorders (Me, You and Us) adapted for young adolescents in Korea. Eat Weight Disord 2018; 23:673-683. [PMID: 28871526 DOI: 10.1007/s40519-017-0436-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 08/23/2017] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The aim of this study was to assess the adaptability and acceptability of a prevention program. METHODS A total of 169 Korean students (83 boys and 86 girls) with a mean age of 12.3 years from a 6th grade class at an elementary school participated in the study. Mental health social workers delivered Me, You and Us, a school-based body image intervention program originally developed in the UK, through a set of six sessions. The participants were assessed in terms of their body satisfaction and self-esteem before the program, after the program, and at 1-month follow-up. They were also surveyed about their satisfaction and acceptability levels after the program. RESULTS At baseline, girls had lower body satisfaction and self-esteem than boys, and their body satisfaction and self-esteem improved after the program. The improved body satisfaction was maintained at the 1-month follow-up. The efficacy of the program on body satisfaction was positively correlated with the frequency of their baseline level of "fat talk." The program was more effective in girls with possible symptoms of an eating disorder at baseline. 93.7% of boys and 77.4% of girls responded that they enjoyed the program. CONCLUSIONS The program Me, You and Us was well-accepted by early adolescents in Korea and it can play a role in increasing body satisfaction and self-esteem by reducing "fat talk" in 6th grade students. LEVEL OF EVIDENCE Level III, cohort study with intervention.
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Affiliation(s)
- Gi Young Lee
- Institute of Eating Disorders and Mental Health, Inje University, Seoul, Republic of Korea
| | - Eun Jin Park
- Department of Psychiatry, Ilsan Paik Hospital, Inje University, Goyang, Republic of Korea.,Goyang Child and Adolescent Community Mental Health Center, Goyang, Republic of Korea
| | - Youl-Ri Kim
- Institute of Eating Disorders and Mental Health, Inje University, Seoul, Republic of Korea. .,Department of Neuropsychiatry, Seoul Paik Hospital, Inje University, Seoul, Republic of Korea.
| | - Kyung Hwa Kwag
- Institute of Human, Environment and Future, Inje University, Kimhae, Republic of Korea
| | - Jin Hong Park
- Institute of Eating Disorders and Mental Health, Inje University, Seoul, Republic of Korea.,Department of Neuroscience, Scripps Graduate Program, The Scripps Research Institute, Jupiter, FL, USA
| | - So Hyun An
- Institute of Eating Disorders and Mental Health, Inje University, Seoul, Republic of Korea
| | - Ji Hyun Lee
- Goyang Child and Adolescent Community Mental Health Center, Goyang, Republic of Korea
| | - Jeong Hun Sim
- Goyang Child and Adolescent Community Mental Health Center, Goyang, Republic of Korea
| | - Janet Treasure
- Section of Eating Disorders, Department of Psychological Medicine, King's College London, Institute of Psychiatry, London, UK
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Zeiler M, Wagner G, Philipp J, Nitsch M, Truttmann S, Dür W, Karwautz A, Waldherr K. The Mental Health in Austrian Teenagers (MHAT) Study: design, methodology, description of study population. NEUROPSYCHIATRIE : KLINIK, DIAGNOSTIK, THERAPIE UND REHABILITATION : ORGAN DER GESELLSCHAFT ÖSTERREICHISCHER NERVENÄRZTE UND PSYCHIATER 2018; 32:121-132. [PMID: 29948852 PMCID: PMC6132433 DOI: 10.1007/s40211-018-0273-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Accepted: 03/19/2018] [Indexed: 11/23/2022]
Abstract
Profound epidemiological data on the prevalence of mental health disorders and respective risk and protective factors is a prerequisite for adequate prevention, intervention and service planning. Children and adolescents are regarded as high priority groups for prevention in this field because of the high chronicity and individual burden of mental health disorders. The Mental Health in Austrian Teenagers (MHAT)-Study is the first epidemiological study based on a large representative sample of adolescents (N > 3700) in Austria in order to obtain the prevalence of a wide range of behavioral problems and psychiatric disorders. Adolescents are recruited from multiple settings (schools, course providers for early school leavers and psychiatric clinics) in order to enhance the representativity of the sample. A “gold-standard” two-stage design (screening questionnaire and diagnostic interviews) is used to obtain psychiatric diagnoses that are based on the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders which was published by the American Psychiatric Association in 2013. This paper aims at presenting the study design and methodology of the MHAT study, describing the study population as well as discussing relevant strengths and limitations.
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Affiliation(s)
- Michael Zeiler
- Department for Child and Adolescent Psychiatry, Eating Disorders Unit, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.,Ludwig Boltzmann Institute Health Promotion Research, Vienna, Austria
| | - Gudrun Wagner
- Department for Child and Adolescent Psychiatry, Eating Disorders Unit, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Julia Philipp
- Department for Child and Adolescent Psychiatry, Eating Disorders Unit, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Martina Nitsch
- Ludwig Boltzmann Institute Health Promotion Research, Vienna, Austria.,FernFH Distance Learning University of Applied Sciences, Zulingergasse 4, 2700, Wiener Neustadt, Austria
| | - Stefanie Truttmann
- Department for Child and Adolescent Psychiatry, Eating Disorders Unit, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Wolfgang Dür
- Ludwig Boltzmann Institute Health Promotion Research, Vienna, Austria.,Department of Sociology, University of Vienna, Rooseveltplatz 2, 1090, Vienna, Austria
| | - Andreas Karwautz
- Department for Child and Adolescent Psychiatry, Eating Disorders Unit, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Karin Waldherr
- Ludwig Boltzmann Institute Health Promotion Research, Vienna, Austria. .,FernFH Distance Learning University of Applied Sciences, Zulingergasse 4, 2700, Wiener Neustadt, Austria.
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Koch SAJ, Alexy U, Diederichs T, Buyken AE, Roßbach S. The relevance of restrained eating behavior for circadian eating patterns in adolescents. PLoS One 2018; 13:e0197131. [PMID: 29791516 PMCID: PMC5965828 DOI: 10.1371/journal.pone.0197131] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 04/26/2018] [Indexed: 01/10/2023] Open
Abstract
Background Restrained Eating, i.e. the tendency to restrict dietary intake to control body-weight, often emerges during adolescence and may result in changes in circadian eating patterns. Objective The objective of the present investigation was to determine the cross-sectional relevance of restrained eating for characteristics of circadian eating pattern in adolescents and whether changes in restrained eating are accompanied by concurrent changes in circadian eating pattern over the course of adolescence. Methods Two questionnaires assessing restrained eating (Score 0–30) with parallel 3-day weighed dietary records from two different time points were available from 209 (♂:101, ♀:108) 11–18 year old adolescents of the DONALD study. Mixed linear regression models were used to analyze whether restrained eating was associated with eating occasion frequency, snack frequency and morning and evening energy intake [in % of daily energy intake, %E]. Linear regression models were used to examine whether changes in restrained eating were associated with changes in the mentioned variables. Results Among girls, greater restrained eating was cross-sectionally associated with higher morning energy intake (p = 0.03). Further, there was a tendency towards lower evening energy intake with higher levels of restrained eating for the whole sample (p = 0.06). No cross-sectional associations were found with eating occasion or snack frequency. Each one-point increase in restrained eating during adolescence was related to a concurrent decrease in eating occasion frequency by 0.04 (95% CI -0.08; -0.01, p = 0.02) and in evening energy intake by 0.36%E (95% CI -0.70; -0.03, p = 0.04). A tendency towards decreasing snack frequency with increasing restrained eating was observed (β = -0.03, 95% CI -0.07; 0.00, p = 0.07). No association was found between changes in restrained eating and concurrent changes in morning energy intake. Conclusion We found indications for cross-sectional and prospective associations between restrained eating and chronobiological aspects of food intake in adolescents. Our results suggest that restrained eating should be considered a relevant determinant of circadian eating patterns.
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Affiliation(s)
- Stefanie A. J. Koch
- DONALD Study, Nutritional Epidemiology, Department of Nutrition and Food Sciences, Faculty of Agriculture, University of Bonn, Bonn, North Rhine-Westphalia, Germany
| | - Ute Alexy
- DONALD Study, Nutritional Epidemiology, Department of Nutrition and Food Sciences, Faculty of Agriculture, University of Bonn, Bonn, North Rhine-Westphalia, Germany
- * E-mail:
| | - Tanja Diederichs
- DONALD Study, Nutritional Epidemiology, Department of Nutrition and Food Sciences, Faculty of Agriculture, University of Bonn, Bonn, North Rhine-Westphalia, Germany
- Public Health Nutrition, Institute of Nutrition, Consumption and Health, Faculty of Natural Sciences, University Paderborn, Paderborn, North Rhine-Westphalia, Germany
| | - Anette E. Buyken
- DONALD Study, Nutritional Epidemiology, Department of Nutrition and Food Sciences, Faculty of Agriculture, University of Bonn, Bonn, North Rhine-Westphalia, Germany
- Public Health Nutrition, Institute of Nutrition, Consumption and Health, Faculty of Natural Sciences, University Paderborn, Paderborn, North Rhine-Westphalia, Germany
| | - Sarah Roßbach
- DONALD Study, Nutritional Epidemiology, Department of Nutrition and Food Sciences, Faculty of Agriculture, University of Bonn, Bonn, North Rhine-Westphalia, Germany
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The Efficacy of a Universal School-Based Prevention Program for Eating Disorders among German Adolescents: Results from a Randomized-Controlled Trial. J Youth Adolesc 2018; 47:1317-1331. [DOI: 10.1007/s10964-018-0852-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 03/28/2018] [Indexed: 10/17/2022]
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Schuck K, Munsch S, Schneider S. Body image perceptions and symptoms of disturbed eating behavior among children and adolescents in Germany. Child Adolesc Psychiatry Ment Health 2018; 12:10. [PMID: 29410705 PMCID: PMC5782362 DOI: 10.1186/s13034-018-0216-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 01/16/2018] [Indexed: 12/23/2022] Open
Abstract
THEORETICAL BACKGROUND Body image distortions such as perception biases are assumed to be precursors of eating disorders (ED). This study aims to investigate body image perceptions and symptoms of disturbed eating behavior among a sample of 11-17 year-old students in Germany. METHODS A cross-sectional survey study was carried out among 1524 students of twelve secondary schools from all school types in North Rhine-Westphalia (Germany). A naturalistic photograph-rating consisting of photographs of young women's bodies was used to examine children's perceptions of female bodies (i.e., perceived average body size and perceived ideal body size of young women). Also, symptoms of disturbed eating behavior were examined. RESULTS Compared to statistical data, children and adolescents underestimated the average body size of young women by more than two BMI-points (estimated average BMI = 20), with no differences between boys and girls. Also, girls and boys generally held a slim female thin-ideal (perceived ideal BMI = 19.5), which is nearly three BMI-points below the average body size in the young female population. Girls showed a slightly stronger female thin-ideal than boys. Among all subgroups, early-adolescent girls (13-14 years) displayed the strongest thin-ideal internalization. Nearly one-third of this group perceived a BMI below 18 as ideal female body size. Symptoms of disturbed eating behavior were common among youth and most frequent among adolescent girls (15-17 years). Girls who displayed a bias towards underestimation of female body size and girls who displayed an underweight female thin-ideal were more likely to report harmful dieting behaviors and psychological distress associated with eating, body, and weight. CONCLUSIONS This study found that 11-17 year-old girls and boys do not show accurate judgements regarding the average body size of young women. Instead, there is systematic and significant underestimation, indicating considerable perception biases, which may constitute a risk factor for the development and maintenance of ED. Symptoms of disturbed eating behavior were common, especially among girls, and associated with body-related perceptions. Future research will need to clarify the severity and course of these symptoms.
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Affiliation(s)
- Kathrin Schuck
- Mental Health Research and Treatment Center, Ruhr-University Bochum, Massenbergstrasse 9-13, 44787 Bochum, Germany
| | - Simone Munsch
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Fribourg, Rue P.A. de Faucigny 2, 1700 Fribourg, Switzerland
| | - Silvia Schneider
- Mental Health Research and Treatment Center, Ruhr-University Bochum, Massenbergstrasse 9-13, 44787 Bochum, Germany
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Viborg N, Wångby-Lundh M, Lundh LG, Wallin U, Johnsson P. Disordered eating in a Swedish community sample of adolescent girls: subgroups, stability, and associations with body esteem, deliberate self-harm and other difficulties. J Eat Disord 2018; 6:5. [PMID: 29588853 PMCID: PMC5863806 DOI: 10.1186/s40337-018-0189-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 02/14/2018] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The developmental study of subtypes of disordered eating (DE) during adolescence may be relevant to understand the development of eating disorders. The purpose of the present study was to identify subgroups with different profiles of DE in a community sample of adolescent girls aged 13-15 years, and to study the stability of these profiles and subgroups over a one-year interval in order to find patterns that may need to be addressed in further research and prevention. METHODS Cluster analysis according to the LICUR procedure was performed on five aspects of DE, and the structural and individual stability of these clusters was analysed. The clusters were compared with regard to BMI, body esteem, deliberate self-harm, and other kinds of psychological difficulties. RESULTS The analysis revealed six clusters (Multiple eating problems including purging, Multiple eating problems without purging, Social eating problems, Weight concerns, Fear of not being able to stop eating, and No eating problems) all of which had structurally stable profiles and five of which showed stability at the individual level. The more pronounced DE clusters (Multiple eating problems including/without purging) were consistently associated with higher levels of psychological difficulties and lower levels of body esteem. Furthermore, girls that reported purging reported engaging in self-harm to a larger extent. CONCLUSIONS Subgroups of 13-15 year old girls show stable patterns of disordered eating that are associated with higher rates of psychological impairment and lower body esteem. The subgroup of girls who engage in purging also engage in more deliberate self-harm.
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Affiliation(s)
- Njördur Viborg
- 1Department of Psychology, Lund University, Box 213, 221 00 Lund, Sweden
| | | | - Lars-Gunnar Lundh
- 1Department of Psychology, Lund University, Box 213, 221 00 Lund, Sweden
| | - Ulf Wallin
- Skånevård Sund, Child and Adolescent Psychiatry, Eating Disorders Centre Lund, Sweden, Baravägen 1, 221 85 Lund, Sweden
| | - Per Johnsson
- 1Department of Psychology, Lund University, Box 213, 221 00 Lund, Sweden
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21
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Efficacy of a prevention program for eating disorders in schools: a cluster-randomized controlled trial. BMC Psychiatry 2017; 17:293. [PMID: 28800753 PMCID: PMC5553667 DOI: 10.1186/s12888-017-1454-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 08/03/2017] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Previous prevention programs in the school context have not addressed both genders, have been time-consuming, or have had deficits in the evaluation method. The aim of the present study was to evaluate the impact of a universal prevention program for female and male adolescents on eating disorder pathology and related risk factors. METHODS Between February 2012 and July 2014, 2515 students in 23 schools from 8th or 11th grade were assessed for eligibility in this longitudinal cluster-randomized controlled trial with a six months follow-up. Of those students, 2342 were cluster-randomized to the intervention condition which received a six school hours universal prevention program or to the no treatment control condition. RESULTS The complete case population comprised 724 students in the intervention (54.3% female, M = 14.3 years, SD = 1.61) and 728 in the control condition (57.0% female, M = 14.7 years, SD = 1.63). Random-effects analysis of covariance on the primary outcome showed no significant differences between the intervention and control groups in their eating disorder pathology change scores six months after the intervention. Regarding secondary outcomes, participants in the intervention group showed a greater increase in knowledge about eating disorders both after the intervention (p < .001, ES = 1.06) and six months later (p = .01, ES = 0.40). Greater reductions in anxiety severity were observed in the intervention group post-intervention (p = .02, ES = 0.22) which was not maintained at the six months follow-up. Results differed between participants from grade 8 and 11. CONCLUSION The present universal prevention program can be particularly recommended for adolescents from grade 11. TRIAL REGISTRATION ISRCTN 97989348.
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Kliem S, Schmidt R, Vogel M, Hiemisch A, Kiess W, Hilbert A. An 8-item short form of the Eating Disorder Examination-Questionnaire adapted for children (ChEDE-Q8). Int J Eat Disord 2017; 50:679-686. [PMID: 28122128 DOI: 10.1002/eat.22658] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 11/24/2016] [Accepted: 11/24/2016] [Indexed: 11/09/2022]
Abstract
Eating disturbances are common in children placing a vulnerable group of them at risk for full-syndrome eating disorders and adverse health outcomes. To provide a valid self-report assessment of eating disorder psychopathology in children, a short form of the child version of the Eating Disorder Examination (ChEDE-Q) was psychometrically evaluated. Similar to the EDE-Q, the ChEDE-Q provides assessment of eating disorder psychopathology related to anorexia nervosa, bulimia nervosa, and binge-eating disorder; however, the ChEDE-Q does not assess symptoms of avoidant/restrictive food intake disorder, pica, or rumination disorder. In 1,836 participants ages 7 to 18 years, recruited from two independent population-based samples, the factor structure of the recently established 8-item short form EDE-Q8 for adults was examined, including measurement invariance analyses on age, gender, and weight status derived from objectively measured weight and height. For convergent validity, the ChEDE-Q global score, body esteem scale, strengths and difficulties questionnaire, and sociodemographic characteristics were used. Item characteristics and age- and gender-specific norms were calculated. Confirmatory factor analysis revealed good model fit for the 8-item ChEDE-Q. Measurement invariance analyses indicated strict invariance for all analyzed subgroups. Convergent validity was provided through associations with well-established questionnaires and age, gender, and weight status, in expected directions. The newly developed ChEDE-Q8 proved to be a psychometrically sound and economical self-report assessment tool of eating disorder psychopathology in children. Further validation studies are needed, particularly concerning discriminant and predictive validity.
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Affiliation(s)
- Sören Kliem
- Criminological Research Institute of Lower Saxony, Hannover, Germany.,Technical University of Braunschweig, Department of Psychology, Braunschweig, Germany
| | - Ricarda Schmidt
- University of Leipzig Medical Center, Integrated Research and Treatment Center Adiposity Diseases, Department of Medical Psychology and Medical Sociology, Department of Psychosomatic Medicine and Psychotherapy, Leipzig, Germany
| | - Mandy Vogel
- Hospital for Children and Adolescents, Department for Woman and Child Health, Center for Pediatric Research, University of Leipzig Medical Center, Leipzig, Germany.,LIFE Leipzig Research Center for Civilization Diseases, University of Leipzig Medical Center, Leipzig, Germany
| | - Andreas Hiemisch
- Hospital for Children and Adolescents, Department for Woman and Child Health, Center for Pediatric Research, University of Leipzig Medical Center, Leipzig, Germany.,LIFE Leipzig Research Center for Civilization Diseases, University of Leipzig Medical Center, Leipzig, Germany
| | - Wieland Kiess
- Hospital for Children and Adolescents, Department for Woman and Child Health, Center for Pediatric Research, University of Leipzig Medical Center, Leipzig, Germany.,LIFE Leipzig Research Center for Civilization Diseases, University of Leipzig Medical Center, Leipzig, Germany
| | - Anja Hilbert
- University of Leipzig Medical Center, Integrated Research and Treatment Center Adiposity Diseases, Department of Medical Psychology and Medical Sociology, Department of Psychosomatic Medicine and Psychotherapy, Leipzig, Germany
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Richter F, Strauss B, Braehler E, Adametz L, Berger U. Screening disordered eating in a representative sample of the German population: Usefulness and psychometric properties of the German SCOFF questionnaire. Eat Behav 2017; 25:81-88. [PMID: 27354266 DOI: 10.1016/j.eatbeh.2016.06.022] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 04/11/2016] [Accepted: 06/15/2016] [Indexed: 10/21/2022]
Abstract
The prevention of eating disorders and the identification of high-risk individuals are essential for the public health sector. There is need for sensitive and specific screening instruments of disordered eating that can be applied in universal samples as an initial step into disease prevention. The SCOFF is a screening instrument for disordered eating, frequently used in international and cross-cultural contexts to detect individuals at risk. The objective of this research is to evaluate whether the SCOFF can be used as a screening tool for disordered eating in universal samples. This is the first study which examined the psychometric properties of the German version of the SCOFF in a general population sample. A representative sample (N=2527) of the German population, aged 14-95years, was recruited. Psychometric properties were determined including reliability, concurrent and construct validity, and factor structure. The prevalence of disordered eating was assessed. The prevalence of disordered eating in the general population was 10%. Using the established cutoff point of ≥2, values for diagnostic accuracy were 26% (sensitivity), 97% (specificity), 80% (positive predictive value), and 74% (negative predictive value). Factorial analyses revealed an excellent model fit of a unidimensional model. Due to its low sensitivity and a high percentage of false negatives, there are limitations in using the German version of the SCOFF in general population samples with wide age ranges.
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Affiliation(s)
- Felicitas Richter
- Jena University Hospital, Institute of Psychosocial Medicine and Psychotherapy, Stoystr. 3, D-07740 Jena, Germany.
| | - Bernhard Strauss
- Jena University Hospital, Institute of Psychosocial Medicine and Psychotherapy, Stoystr. 3, D-07740 Jena, Germany.
| | - Elmar Braehler
- Leipzig University Hospital, Department of Medical Psychology and Medical Sociology, Philipp-Rosenthal-Straße 55, D-04103 Leipzig, Germany; Universal Medical Center Mainz, Department of Psychosomatic Medicine and Psychotherapy, Untere Zahlbacher Str. 8, D-55131 Mainz, Germany.
| | - Luise Adametz
- Jena University Hospital, Institute of Psychosocial Medicine and Psychotherapy, Stoystr. 3, D-07740 Jena, Germany.
| | - Uwe Berger
- Jena University Hospital, Institute of Psychosocial Medicine and Psychotherapy, Stoystr. 3, D-07740 Jena, Germany.
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Estecha Querol S, Fernández Alvira JM, Mesana Graffe MI, Nova Rebato E, Marcos Sánchez A, Moreno Aznar LA. Nutrient intake in Spanish adolescents SCOFF high-scorers: the AVENA study. Eat Weight Disord 2016; 21:589-596. [PMID: 27100226 DOI: 10.1007/s40519-016-0282-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2015] [Accepted: 04/01/2016] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To evaluate whether adolescents with a positive score in a screening tool for possible eating disorders (ED) have a different diet intake in comparison with those with a negative score. METHODS Cross-sectional study performed in 235 adolescents (37.9 % boys) from Zaragoza (Spain). Age, gender, BMI, maternal education, nutrient intake (7-day record) and screening tool for detecting ED [sick control on fat food test (SCOFF)] were assessed. ANCOVA test was used to determine nutrient intake differences (namely energy, macronutrients and micronutrients) according to the SCOFF total score (SCOFF ≥2 indicates a possible case of ED). ANCOVA test was adjusted by age, maternal education and BMI. This research was based on data from the cross-sectional multicenter Alimentación y Valoración del Estado Nutricional en Adolescentes españoles (Feeding and Assessment of Nutritional status of Spanish Adolescents) study. RESULTS The proportion of adolescents with possible symptoms of ED was 21.7 %. Girls SCOFF high-scorers (SCOFF+) mean daily energy intake was significantly lower than in those SCOFF low-scorers (SCOFF-) (P < 0.001); however, in boys there was no difference. Both in girls and boys, there were no statistically significant differences according to SCOFF questionnaire for macronutrient intake, adjusted by daily energy intake. Concerning micronutrients, in girls with SCOFF+ sodium, potassium, phosphorus, iron, zinc, vitamin B2 and niacin intakes were significantly lower than in those with SCOFF-; however, in boys, there were no differences. CONCLUSIONS Adolescent girls with current possible symptoms of ED presented lower total energy intake and several micronutrients intake compared with their peers without ED.
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Affiliation(s)
- Sara Estecha Querol
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, 12 Pedro Cerbuna rd, 50009, Zaragoza, Spain.
| | - Juan Miguel Fernández Alvira
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, 12 Pedro Cerbuna rd, 50009, Zaragoza, Spain.,Centro Nacional de Investigaciones Cardiovasculares Carlos III, 3 Melchor Fernández Almagro rd, 28029, Madrid, Spain
| | - María Isabel Mesana Graffe
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, 12 Pedro Cerbuna rd, 50009, Zaragoza, Spain
| | - Esther Nova Rebato
- Immunonutrition Research Group, Institute of Food Science, Technology and Nutrition (ICTAN)-CSIC, 10 José Antonio Novais rd, 28040, Madrid, Spain
| | - Ascensión Marcos Sánchez
- Immunonutrition Research Group, Institute of Food Science, Technology and Nutrition (ICTAN)-CSIC, 10 José Antonio Novais rd, 28040, Madrid, Spain
| | - Luis Alberto Moreno Aznar
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, 12 Pedro Cerbuna rd, 50009, Zaragoza, Spain
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Hammerle F, Huss M, Ernst V, Bürger A. Thinking dimensional: prevalence of DSM-5 early adolescent full syndrome, partial and subthreshold eating disorders in a cross-sectional survey in German schools. BMJ Open 2016; 6:e010843. [PMID: 27150185 PMCID: PMC4861098 DOI: 10.1136/bmjopen-2015-010843] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Investigating for the first time in Germany Diagnostic and Statistical Manual Fifth Edition (DSM-5) prevalences of adolescent full syndrome, Other Specified Feeding or Eating Disorder (OSFED), partial and subthreshold anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (BED). METHOD A national school-based cross-sectional survey with nine schools in Germany was undertaken that was aimed at students from grades 7 and 8. Of the 1775 students who were contacted to participate in the study, 1654 participated (participation rate: 93.2%). The sample consisted of 873 female and 781 male adolescents (mean age=13.4 years). Prevalence rates were established using direct symptom criteria with a structured inventory (SIAB-S) and an additional self-report questionnaire (Eating Disorder Inventory 2 (EDI-2)). RESULTS Prevalences for full syndrome were 0.3% for AN, 0.4% for BN, 0.5% for BED and 3.6% for OSFED-atypical AN, 0% for BN (low frequency/limited duration), 0% for BED (low frequency/limited duration) and 1.9% for purging disorder (PD). Prevalences of partial syndrome were 10.9% for AN (7.1% established with cognitive symptoms only, excluding weight criteria), 0.2% for BN and 2.1% for BED, and of subthreshold syndrome were 0.8% for AN, 0.3% for BN and 0.2% for BED. Cases on EDI-2 scales were much more pronounced with 12.6-21.1% of the participants with significant sex differences. CONCLUSIONS The findings were in accordance with corresponding international studies but were in contrast to other German studies showing much higher prevalence rates. The study provides, for the first time, estimates for DSM-5 prevalences of eating disorders in adolescents for Germany, and evidence in favour of using valid measures for improving prevalence estimates. TRIAL REGISTRATION NUMBER DRKS00005050; Results.
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Affiliation(s)
- Florian Hammerle
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Michael Huss
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Verena Ernst
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Arne Bürger
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Würzburg, Wuerzburg, Germany
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Schlüter N, Schmidt R, Kittel R, Tetzlaff A, Hilbert A. Loss of control eating in adolescents from the community. Int J Eat Disord 2016; 49:413-20. [PMID: 26711325 DOI: 10.1002/eat.22488] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 11/10/2015] [Accepted: 11/11/2015] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Loss of control (LOC) eating is a salient indicator of eating disorder psychopathology in adolescents and is associated with marked distress. While research has focused on the relevance of episode size, clinical significance of LOC eating frequency has rarely been explored. Therefore, this study aimed at identifying LOC eating prevalence with respect to its recurrence and associated variables in a community-based sample. METHOD Participants were 1,643 adolescents, aged 12-20 years (62.4% female). Based on EDE-Q self-report, participants were categorized as those reporting recurrent (N = 156; 9.5%), nonrecurrent (N = 226; 13.8%), and no LOC eating (N = 1261; 76.7%). RESULTS Adolescents with recurrent LOC eating reported clinically relevant and significantly greater eating disorder psychopathology, functional impairment, and distress because of LOC eating, and a significantly higher body mass index (BMI, kg/m(2) ) than adolescents with nonrecurrent and those without LOC eating. DISCUSSION These results underline that LOC eating is a common eating behavior among adolescents in the community associated with clinical characteristics of eating disorders, and could therefore be a risk factor for developing full- or partial-syndrome eating disorders. Further research on the classification of eating disorders in adolescents with LOC eating and severity indicators is warranted.
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Affiliation(s)
- Nora Schlüter
- Integrated Research and Treatment Center Adiposity Diseases, Department of Medical Psychology and Medical Sociology, Leipzig University Medical Center, 04103, Leipzig, Germany
| | - Ricarda Schmidt
- Integrated Research and Treatment Center Adiposity Diseases, Department of Medical Psychology and Medical Sociology, Leipzig University Medical Center, 04103, Leipzig, Germany
| | - Rebekka Kittel
- Integrated Research and Treatment Center Adiposity Diseases, Department of Medical Psychology and Medical Sociology, Leipzig University Medical Center, 04103, Leipzig, Germany
| | - Anne Tetzlaff
- Integrated Research and Treatment Center Adiposity Diseases, Department of Medical Psychology and Medical Sociology, Leipzig University Medical Center, 04103, Leipzig, Germany
| | - Anja Hilbert
- Integrated Research and Treatment Center Adiposity Diseases, Department of Medical Psychology and Medical Sociology, Leipzig University Medical Center, 04103, Leipzig, Germany
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Bächle C, Stahl-Pehe A, Rosenbauer J. Disordered eating and insulin restriction in youths receiving intensified insulin treatment: Results from a nationwide population-based study. Int J Eat Disord 2016; 49:191-6. [PMID: 26395028 DOI: 10.1002/eat.22463] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2015] [Revised: 08/28/2015] [Accepted: 08/30/2015] [Indexed: 01/29/2023]
Abstract
OBJECTIVE This Germany-wide population-based study sought to estimate the prevalence of disordered eating and insulin restriction (IR) among 819 youths aged 11-21 years with early-onset type 1 diabetes (T1D) and a disease duration of at least 10 years. METHODS All respondents answered the five-item SCOFF screening questionnaire for eating disorders (EDs) and reported on the frequency of IR and clinical outcomes. Screening for disordered eating was positive when more than two SCOFF items were answered affirmatively. Frequent IR was defined as IR occurring more than five times per week. RESULTS A total of 28.2%/9.2% of the female/male patients were SCOFF-positive without IR and 4.2%/5.3% reported frequent IR but were SCOFF-negative; 2.7%/1.9% screened positive for both disordered eating and IR. Patients with disordered eating, frequent IR, or both showed significantly worse glycemic control and partly more inpatient-treated diabetic ketoacidoses than patients who screened negative. DISCUSSION Approximately one in three female and one in six male patients with early-onset long-duration T1D reported disordered eating and/or frequent IR. Because of their association with worse outcomes, both disordered eating and IR should be considered in T1D care irrespective of sex, age at onset, and diabetes duration.
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Affiliation(s)
- Christina Bächle
- German Diabetes Center, Leibniz Institute for Diabetes Research, Instiute for Biometrics and Epidemiology, Düsseldorf, Germany.,German Center for Diabetes Research (DZD), Partner Düsseldorf, Germany
| | - Anna Stahl-Pehe
- German Diabetes Center, Leibniz Institute for Diabetes Research, Instiute for Biometrics and Epidemiology, Düsseldorf, Germany.,German Center for Diabetes Research (DZD), Partner Düsseldorf, Germany
| | - Joachim Rosenbauer
- German Diabetes Center, Leibniz Institute for Diabetes Research, Instiute for Biometrics and Epidemiology, Düsseldorf, Germany.,German Center for Diabetes Research (DZD), Partner Düsseldorf, Germany
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Saßmann H, Albrecht C, Busse-Widmann P, Hevelke LK, Kranz J, Markowitz JT, Marshall LF, Meurs S, de Soye IH, Lange K. Psychometric properties of the German version of the Diabetes Eating Problem Survey-Revised: additional benefit of disease-specific screening in adolescents with Type 1 diabetes. Diabet Med 2015; 32:1641-7. [PMID: 25919651 DOI: 10.1111/dme.12788] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/23/2015] [Indexed: 12/15/2022]
Abstract
AIM To examine the psychometric properties of the German version of the abbreviated 16-item Diabetes Eating Problem Survey-Revised in a sample of young people with Type 1 diabetes. METHODS A total of 246 young people, aged 11-19 years, with Type 1 diabetes from six pediatric diabetes centres in Germany were assessed using the Diabetes Eating Problem Survey-Revised. In addition, they underwent screening with two generic tools as well as the WHO five-question well-being index. A clinician's report was also obtained. RESULTS The Diabetes Eating Problem Survey-Revised was found to have good internal consistency (Cronbach's α = 0.84). The Diabetes Eating Problem Survey-Revised scores significantly correlated with those provided by the non-specific screening tools (r = 0.37, P ≤ 0.000 and r = 0.50, P ≤ 0.000 for boys and r = 0.62, P ≤ 0.000 and r = 0.79, P ≤ 0.000 for girls), indicating convergent validity. The mean (sd) total of the scores was 12.0 (9.6). Criterion validity was confirmed against HbA1c value, BMI standard deviation score and expert (clinician) report. Of the boys included in the study, 11 scored higher than the threshold score on the Diabetes Eating Problem Survey-Revised, of whom only three (27%) were classified as 'suspected to have a disordered eating behaviour' by their clinicians. CONCLUSIONS The Diabetes Eating Problem Survey-Revised delivered more specific information than generic screening instruments and identified more young people with eating disorders than did clinician report, especially regarding the detection of boys at risk. The results of this study support the utility of the German version of the Diabetes Eating Problem Survey-Revised to identify eating disorders in young people with Type 1 diabetes at an early stage. (German Clinical Trials Registry no.: DRKS00004699).
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Affiliation(s)
- H Saßmann
- Hannover Medical School, Medical Psychology, Hannover, Germany
| | - C Albrecht
- Clinical Centre Augsburg, Clinic for Children and Juveniles, Bunter Kreis GmbH, Team Diabetes, Augsburg, Germany
| | - P Busse-Widmann
- Dritter Orden Clinic Munich, Paediatric and Youth Medicine Clinic, Munich, Germany
| | - L K Hevelke
- Hannover Medical School, Medical Psychology, Hannover, Germany
| | - J Kranz
- University of Tübingen, Children's Hospital, Department III, Tübingen, Germany
| | - J T Markowitz
- Joslin Diabetes Center, Pediatric, Adolescent, and Young Adult Section, Boston, MA, USA
| | - L F Marshall
- University Medical Centre Schleswig Holstein Lübeck, Hospital for Child and Adolescent Medicine, Lübeck, Germany
| | - S Meurs
- Children's Hospital Passau Dritter Orden, Social Paediatric Centre, Passau, Germany
| | - I H de Soye
- Clinical Centre Nürnberg Süd, Children's Hospital, Nürnberg, Germany
| | - K Lange
- Hannover Medical School, Medical Psychology, Hannover, Germany
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Augner C. Depressive symptoms and perceived chronic stress predict test anxiety in nursing students. CENTRAL EUROPEAN JOURNAL OF NURSING AND MIDWIFERY 2015. [DOI: 10.15452/cejnm.2015.06.0018] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Zeiler M, Waldherr K, Philipp J, Nitsch M, Dür W, Karwautz A, Wagner G. Prevalence of Eating Disorder Risk and Associations with Health-related Quality of Life: Results from a Large School-based Population Screening. EUROPEAN EATING DISORDERS REVIEW 2015; 24:9-18. [PMID: 26010077 DOI: 10.1002/erv.2368] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 04/13/2015] [Accepted: 04/20/2015] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The objective of this study was to investigate the prevalence of eating disorder (ED) risk as well as associated psychopathology and health-related quality of life (HrQoL) in a large population sample of Austrian adolescents. METHOD A sample of 3610 adolescents aged 10-18 years was recruited from 261 schools representative for the Austrian population. The SCOFF questionnaire was used to identify participants at risk for EDs, and the Youth Self-Report and KIDSCREEN were used to assess general psychopathology and HrQoL. RESULTS In total, 30.9% of girls and 14.6% of boys were screened at risk for EDs. SCOFF scores were significantly associated with internalising and externalising behavioural problems as well as HrQoL after controlling for sex, age and body mass index. The SCOFF score further turned out to be an independent predictor of HrQoL. DISCUSSION The high prevalence of ED risk among Austrian adolescents points out the need for prevention in this field. Variables indicating eating pathology should be included in general mental health screenings.
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Affiliation(s)
- Michael Zeiler
- Ludwig Boltzmann Institute Health Promotion Research, Austria
| | - Karin Waldherr
- Ludwig Boltzmann Institute Health Promotion Research, Austria.,Ferdinand Porsche Distance University of Applied Sciences (FernFH), Austria
| | - Julia Philipp
- Department for Child and Adolescent Psychiatry, Medical University of Vienna, Austria
| | - Martina Nitsch
- Ludwig Boltzmann Institute Health Promotion Research, Austria
| | - Wolfgang Dür
- Ludwig Boltzmann Institute Health Promotion Research, Austria
| | - Andreas Karwautz
- Department for Child and Adolescent Psychiatry, Medical University of Vienna, Austria
| | - Gudrun Wagner
- Department for Child and Adolescent Psychiatry, Medical University of Vienna, Austria
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[Chronic and vaccine-preventable diseases in children and adolescents in Germany: results of the KiGGS study: first follow up (KiGGS wave 1)]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2015; 57:779-88. [PMID: 24950827 DOI: 10.1007/s00103-014-1976-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The German Health Interview and Examination Survey for Children and Adolescents (KiGGS) 2003-2006 is the first nationwide comprehensive study on the health of children and adolescents living in Germany. The KiGGS first interview follow-up is a telephone interview study that collected, among other things, data on a number of chronic and vaccine-preventable diseases in 2009-2012 and is a combined cross-sectional and longitudinal study based on a population registry sample from the 167 KiGGS study points. The analysis is based on 12,368 respondents (7913 KiGGS follow-up participants aged 7-17 years, response 72 % and 4455 newly recruited 0- to 6-year-olds, response 42 %). Based on parent reports the lifetime prevalence of both chickenpox and pertussis has decreased in the population targeted by recently changed vaccination recommendations. For measles the prevalence remained unsatisfactorily high in each investigated age group. Of the children and adolescents aged 0-17 years 16 % (95 % confidence interval CI 15.2-17.0 %) had a long-standing chronic health condition according to the parents. Of these, however, only one in five was affected in their routine daily activities. The lifetime prevalence in 7- to 17-year-olds was 1.2 % (0.9-1.6) for epilepsy (0.4 % for the past 12 months), 5.0 % (4.4-5.7) for migraine, 0.2 % (0.1-0.3) for diabetes and in 0 to 6-year-olds 2.0 % (1.5-2.6) for heart conditions and 3.1 % (2.5-3.8) for febrile seizures with a -prevalence in 0 to 2-year-olds which are most affected of 1.0 % (0.6-1.6) in the past 12 months. The vast majority of children and adolescents in Germany are in good or very good health as suggested by other results reported in this issue; however, chronic conditions are not rare and need continuous monitoring. These results confirm that implementation of the vaccination recommendations of the German Standing Committee on Vaccination (STIKO) can lead to effective prevention of infectious diseases in Germany.
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Weigel A, Gumz A, Uhlenbusch N, Wegscheider K, Romer G, Löwe B. Preventing eating disorders with an interactive gender-adapted intervention program in schools: study protocol of a randomized controlled trial. BMC Psychiatry 2015; 15:21. [PMID: 25884195 PMCID: PMC4337195 DOI: 10.1186/s12888-015-0405-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Accepted: 02/02/2015] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND There are a high number of adolescents who are at risk of developing an eating disorder. There is, therefore, a strong need to implement prevention programs aimed at reducing the incidence of eating disorders at this critical age. Among other factors, successful prevention programs have been shown to be interactive, carried out by professionals, focused on educational as well as psychosocial elements and have taken risk factors as well as resources into account. The objective of this study protocol is to present the design of a new prevention program for eating disorders in schools. METHODS/DESIGN The gender-adapted prevention program extends over six school hours. It contains interactive and educational elements about eating disorders and their treatment. Participants pass through different exercises and reflect on the influences of the media, self-esteem, body perception and individual resources. A cluster-randomized controlled trial is chosen to evaluate the program. Based on an estimated effect size of d = 0.3 a total of 1848 participants are enrolled in the study. Eating disorder risk, internalization of Western beauty ideals, body dissatisfaction, self-concept as well as anxiety and symptoms of depression are measured before and immediately after the intervention as well as at a six-month follow-up. In addition, the intervention group evaluates the different components of the program. DISCUSSION The study intends to test the practicability and efficacy of an interactive, gender-adapted ED prevention program in schools. Moreover, it will provide valuable information about the occurrence of eating disorder risk factors in school-aged children. TRIAL REGISTRATION ISRCTN97989348; Registered 19 December 2012.
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Affiliation(s)
- Angelika Weigel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf & Schön Klinik Hamburg Eilbek, Martinistraße 52, 20246, Hamburg, Germany.
| | - Antje Gumz
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf & Schön Klinik Hamburg Eilbek, Martinistraße 52, 20246, Hamburg, Germany. .,Psychologische Hochschule Berlin, Am Köllnischen Park 2, 10179, Berlin, Germany.
| | - Natalie Uhlenbusch
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf & Schön Klinik Hamburg Eilbek, Martinistraße 52, 20246, Hamburg, Germany.
| | - Karl Wegscheider
- Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
| | - Georg Romer
- Clinic of Children and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Medical Center Münster, Schmeddingstr. 50, 48149, Münster, Germany.
| | - Bernd Löwe
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf & Schön Klinik Hamburg Eilbek, Martinistraße 52, 20246, Hamburg, Germany.
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Baechle C, Castillo K, Straßburger K, Stahl-Pehe A, Meissner T, Holl RW, Giani G, Rosenbauer J. Is disordered eating behavior more prevalent in adolescents with early-onset type 1 diabetes than in their representative peers? Int J Eat Disord 2014; 47:342-52. [PMID: 24375553 DOI: 10.1002/eat.22238] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Revised: 12/03/2013] [Accepted: 12/05/2013] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Despite modern therapeutic regimens, youths with Type 1 diabetes may be at increased risk of mental and behavioral disorders. In this study, the prevalence of disordered eating behavior (DEB) in intensely treated children and adolescents with early-onset Type 1 diabetes and peers from the general population was compared. METHOD Data from 629 patients from a population-based, nationwide survey (54.1% male, mean age 15.3 years) with early-onset Type 1 diabetes of at least 10 years duration were compared with data from 6,813 participants of the German KiGGS study (51.3% male, mean age 14.6 years). The generic SCOFF questionnaire was used as screening instrument to identify participants with symptoms of DEB. Both groups were compared with multivariable regression analysis adjusting for sociodemographic covariates. RESULTS 31.2% of the female and 11.7% of the male diabetic patients and 28.9% of the females and 15.2% of the males in the comparison group were SCOFF-positive (SCOFF score ≥2; p > .05). The odds for symptoms of eating disorders were 3.7% higher in female and 4.3% lower in male patients with diabetes than in the comparison group, but the differences were not significant. 20.5% of the female and 18.5% of the male diabetic patients reported insulin restriction at least three times per week. DISCUSSION Children and adolescents with early-onset Type 1 diabetes of long duration do not seem to be more frequently SCOFF-positive than peers. However, as insulin restriction is practiced in a substantial portion of patients, attention for insulin restriction in diabetes care is essential.
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Affiliation(s)
- Christina Baechle
- German Diabetes Centre, Institute for Biometrics and Epidemiology, Düsseldorf, Germany
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Schlack R, Petermann F. Prevalence and gender patterns of mental health problems in German youth with experience of violence: the KiGGS study. BMC Public Health 2013; 13:628. [PMID: 23819775 PMCID: PMC3727956 DOI: 10.1186/1471-2458-13-628] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Accepted: 06/13/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Research examining mental health in violence-affected youth in representative samples is rare. Using data from the nationally representative German Health Interview and Examination Survey for Children and Adolescents (KiGGS) this study reports on gender-specific prevalence rates and associations of a broad range of internalizing and externalizing mental health problems: emotional problems, conduct problems, ADHD, disordered eating, somatic pain and substance use in youth variously affected by violence. While internalizing is generally more common in girls and externalizing in boys, observations of prior non-normative studies suggest reverse associations once an individual is affected by violence. The occurrence of such "gender cross-over effects" is therefore examined in a representative sample. METHODS The sample consisted of 6,813 adolescents aged 11 to 17 from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS): Applying multivariate logistic regression analyses, associations between each type of violence history and mental health indicator were determined for perpetrators, victims, and perpetrating victims of youth violence. Moderating effects of gender were examined by using product term interaction. RESULTS Victim status was associated primarily with internalizing problems, while perpetrators were more prone to externalizing problems. Perpetrating victims stood out with respect to the number and strength of risk associations with all investigated mental health indicators. However, the risk profiles of all violence-affected youth included both internalizing and externalizing mental health problems. Gender cross-over effects were found for girls and boys: despite lower overall prevalence, girls affected by violence were at far higher risk for conduct problems and illicit drug use; by contrast, somatic pain, although generally lower in males, was positively associated with perpetrator status and perpetrating victim status in boys. All violence-affected youth exhibited significantly higher rates of cumulative mental health problems. CONCLUSIONS The results highlight the importance of violence for the mental health of youth. They reveal a particular vulnerability as a function of gender. Implications for policy making, clinical practice and research are discussed.
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Affiliation(s)
- Robert Schlack
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Strasse 62-66, 12101 Berlin, Germany.
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Therapieansätze bei Adipositas und ihren Folgeerkrankungen bei jugendlichen Patienten mit Migrationshintergrund. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2013; 56:543-50. [DOI: 10.1007/s00103-012-1640-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Hartmann A, Hilbert A. Psychosoziale Folgen von Adipositas im Kindes- und Jugendalter und Strategien zu deren Behandlung. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2013; 56:532-8. [DOI: 10.1007/s00103-012-1637-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Giel KE, Zipfel S, Schweizer R, Braun R, Ranke MB, Binder G, Ehehalt S. Eating disorder pathology in adolescents participating in a lifestyle intervention for obesity: associations with weight change, general psychopathology and health-related quality of life. Obes Facts 2013; 6:307-16. [PMID: 23941969 PMCID: PMC5644671 DOI: 10.1159/000354534] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Accepted: 03/13/2013] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The aim of this study was to identify the prevalence of eating disorder symptoms in obese adolescents participating in a lifestyle intervention for weight loss and to investigate possible relationships with weight change, general psychopathology, and health-related quality of life (HRQOL). METHOD At the beginning and after completion of a 6-month lifestyle intervention, 41 participants (20 females; age: 13.7 ± 1.4 years) reported on core symptoms of eating disorders (SCOFF), self-esteem (Rosenberg Self-Esteem Scale, RSES), and HRQOL (Questionnaire for Measuring Health-Related Quality of Life in Children and Adolescents, KINDL), while parents filled in a questionnaire assessing their children's internalizing and externalizing behavioral problems (Child Behavior Checklist, CBCL). RESULTS Compared to age-matched normative samples, patients showed increased behavior problems and an impaired HRQOL. 43% of the patients were screened positive for an eating disorder pathology, and this subgroup showed an increased psychopathological burden compared to patients that were screened negative. The lifestyle intervention resulted in a significant weight loss which was unaffected by the presence of an eating disorder pathology. The screening rate for eating disorders remained stable after the intervention. CONCLUSION The large overlap, mutual interaction, and high burden of eating and weight problems in children and adolescents underpin the need for an integrated view in both prevention and treatment approaches in pediatric obesity.
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Affiliation(s)
- Katrin E Giel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany.
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Wick K, Leipold-Haas S, Dye L, Strauß B. Bindungsmuster, Figurzufriedenheit und auffälliges Essverhalten bei 13- bis 18-jährigen weiblichen und männlichen Jugendlichen. KINDHEIT UND ENTWICKLUNG 2012. [DOI: 10.1026/0942-5403/a000088] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Als potentielle Risikofaktoren für die Entwicklung von Essstörungen sind unsichere Bindung sowie Unzufriedenheit mit dem eigenen Körper bekannt. Diese Studie untersucht den Zusammenhang von Bindungsmustern, Figurzufriedenheit und Essverhalten bei einer nicht-klinischen Stichprobe von Jugendlichen beiderlei Geschlechts. Folgende Variablen wurden bei 13- bis 18-jährigen Mädchen und Jungen (n = 851) an neun Schulen in Jena (Thüringen) erhoben: Bindungsmuster (dt. Version der Adult Attachment Scale, AAS), Figurzufriedenheit (Stunkard Skalen) und Essverhalten (dt. Version des Eating Attitudes Test, EAT-26D). In einem Gesamtmodell stellt die Einschätzung zu dick zu sein das größte Risiko für die Entwicklung einer Essstörung dar (OR = 8,9), gefolgt vom weiblichen Geschlecht (OR = 3,9), Übergewicht (OR = 3,4) sowie unsicherer Bindung (OR = 2,6). Die Ergebnisse bestätigen den positiven Zusammenhang zwischen Bindungsmuster, Figurzufriedenheit und Essverhalten auch für eine jugendliche, nicht-klinische Stichprobe von Jungen und Mädchen und ergeben damit wichtige Implikationen für primär- und sekundärpräventive Interventionen.
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Affiliation(s)
- Katharina Wick
- Institut für Psychosoziale Medizin und Psychotherapie, Universitätsklinikum Jena, Friedrich-Schiller-Universität Jena
| | - Steffi Leipold-Haas
- Institut für Psychosoziale Medizin und Psychotherapie, Universitätsklinikum Jena, Friedrich-Schiller-Universität Jena
| | - Louise Dye
- Human Appetite Research Unit, Institute of Psychological Sciences, University of Leeds
| | - Bernhard Strauß
- Institut für Psychosoziale Medizin und Psychotherapie, Universitätsklinikum Jena, Friedrich-Schiller-Universität Jena
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Kappel V, Thiel A, Holzhausen M, Jaite C, Schneider N, Pfeiffer E, Lehmkuhl U, Salbach-Andrae H. Eating Disorder Inventory-2 (EDI-2). DIAGNOSTICA 2012. [DOI: 10.1026/0012-1924/a000069] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Das Eating Disorder Inventory-2 (EDI-2; Paul & Thiel, 2005 ) ist ein mehrdimensionales psychometrisches Selbstberichtsinstrument zur Erfassung pathologischen Essverhaltens und anderer für Anorexia nervosa (AN) und Bulimia nervosa (BN) relevanter psychopathologischer Variablen bei Erwachsenen. In der vorliegenden Arbeit wird über die bisher noch fehlende Normierung an einer deutschen nicht-klinischen Stichprobe von 1754 SchülerInnen im Alter von 10 bis 20 Jahren (MAlter = 15.8, SD = 1.7) berichtet. Zusätzlich werden erste geschlechtsspezifische Werte für 66 Patientinnen mit AN (MAlter = 16.2, SD = 1.7) und 22 Patientinnen mit BN (MAlter = 16.8, SD = 1.5) beschrieben. Die hier vorgestellten Normen für Kinder und Jugendliche sowie eine bereits vorgenommene psychometrische Evaluation ( Salbach-Andrae et al., 2010 ) ermöglichen zukünftig den Einsatz des EDI-2 in dieser Altersgruppe. Unabhängig von der Antwortversion können interna-tionale Vergleiche anhand geschlechtsspezifischer (und für weibliche Stichproben altersspezifischer) Normen vorgenommen werden.
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Hölling H, Schlack R, Kamtsiuris P, Butschalowsky H, Schlaud M, Kurth B. Die KiGGS-Studie. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2012; 55:836-42. [DOI: 10.1007/s00103-012-1486-3] [Citation(s) in RCA: 114] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Große J, Daufratshofer C, Igel U, Grande G. Community-based health promotion for socially disadvantaged mothers as health managers of their families: strategies for accessing the target group and their effectiveness. J Public Health (Oxf) 2012. [DOI: 10.1007/s10389-011-0486-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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„Ich bin zu dick!“. Monatsschr Kinderheilkd 2012. [DOI: 10.1007/s00112-011-2542-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Augner C. Associations of subjective sleep quality with depression score, anxiety, physical symptoms and sleep onset latency in students. Cent Eur J Public Health 2011; 19:115-7. [PMID: 21739905 DOI: 10.21101/cejph.a3647] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Sleep quality is strongly associated with parameters of mental and physical health and therefore a major public health issue. We wanted to evaluate this association in young and healthy students by a survey. Further, we aimed to detect the relevance of sleep onset latency and sleep duration for sleep quality. METHODS A group of young nursing and technical students was surveyed (N = 196) with the objective to measure subjective sleep quality, sleep onset latency, sleep duration, depression score, physical symptoms, trait-anxiety, and pathological eating behaviours. RESULTS Subjective sleep quality was strongly negative correlated with depression score (Pearson's r = -0.57), physical symptoms (r = -0.51) and trait-anxiety (r = -0.54) (p < 0.001 for all three). Subjective sleep quality's association with sleep onset latency was stronger than with sleep duration. Further, high depression score (odds ratio OR = 3.90; 95% confidence interval CI = 1.88-8.06) and long sleep onset latency (OR = 3.56; 95% CI = 1.65-7.69) were the best predictors of poor subjective sleep quality. CONCLUSIONS This study supports evidence that links physical and mental symptoms with poor sleep quality. Especially important is the fact that we found this connection in young and basically healthy adults. Taking into account that poor sleep quality has major negative long term impact on health, prevention programmes should focus especially on the association between depressive symptoms and subjective sleep quality that is significantly influenced by sleep onset latency.
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Affiliation(s)
- Christoph Augner
- IGGMB--Research Institute for Basic and Frontier Questions of Medicine and Biotechnology, Health Research Institute, University Clinics of the Paracelsus Medical University, Salzburg, Austria.
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Körperunzufriedenheit bei weiblichen und männlichen Jugendlichen: Eine geschlechtervergleichende Betrachtung von Verbreitung, Prädiktoren und Folgen. Prax Kinderpsychol Kinderpsychiatr 2011; 60:285-303. [DOI: 10.13109/prkk.2011.60.4.285] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Editorial. Prax Kinderpsychol Kinderpsychiatr 2011; 60:249-52. [DOI: 10.13109/prkk.2011.60.4.249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Swanson SA, Crow SJ, Le Grange D, Swendsen J, Merikangas KR. Prevalence and correlates of eating disorders in adolescents. Results from the national comorbidity survey replication adolescent supplement. ACTA ACUST UNITED AC 2011; 68:714-23. [PMID: 21383252 DOI: 10.1001/archgenpsychiatry.2011.22] [Citation(s) in RCA: 957] [Impact Index Per Article: 73.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
CONTEXT Eating disorders are severe conditions, but little is known about the prevalence or correlates of these disorders from population-based surveys of adolescents. OBJECTIVES To examine the prevalence and correlates of eating disorders in a large, reprefentative sample of US adolescents. DESIGN Cross-sectional survey of adolescents with face-to-face interviews using a modified version of the Composite International Diagnostic Interview. SETTING Combined household and school adolescent samples. PARTICIPANTS Nationally representative sample of 10,123 adolescents aged 13 to 18 years. MAIN OUTCOME MEASURES Prevalence and correlates of eating disorders and subthreshold conditions. RESULTS Lifetime prevalence estimates of anorexia nervosa, bulimia nervosa, and binge-eating disorder were 0.3%, 0.9%, and 1.6%, respectively. Important differences were observed between eating disorder subtypes concerning sociodemographic correlates, psychiatric comorbidity, role impairment, and suicidality. Although the majority of adolescents with an eating disorder sought some form of treatment, only a minority received treatment specifically for their eating or weight problems. Analyses of 2 related subthreshold conditions suggest that these conditions are often clinically significant. CONCLUSIONS Eating disorders and subthreshold eating conditions are prevalent in the general adolescent population. Their impact is demonstrated by generally strong associations with other psychiatric disorders, role impairment, and suicidality. The unmet treatment needs in the adolescent population place these disorders as important public health concerns.
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Affiliation(s)
- Sonja A Swanson
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD 20892, USA
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Associations between problematic mobile phone use and psychological parameters in young adults. Int J Public Health 2011; 57:437-41. [PMID: 21290162 DOI: 10.1007/s00038-011-0234-z] [Citation(s) in RCA: 169] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2010] [Revised: 12/09/2010] [Accepted: 12/23/2010] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVES This study aims to address possible associations between excessive or dysfunctional use of mobile phones and certain psychological variables. METHODS Our study focuses on Problematic Mobile Phone Use (PU) in 196 young adults. A survey was arranged to measure PU, daily mobile phone use in minutes, use of short message service (SMS) and also included psychological and health variables (e.g., chronic stress, depression). RESULTS Statistic analysis indicates that chronic stress, low emotional stability, female gender, young age, depression, and extraversion are associated with PU. CONCLUSIONS Future research needs to clarify the causality of these findings and should also intend to develop concepts for a more meaningful use of mobile phone and related technologies.
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