Psychologic correlates of eating attitudes in Turkish female college students

Internet addiction, depressive symptoms, and anxiety symptoms are associated with the risk of eating disorders among university students in Bangladesh

The risk of developing an eating disorder among university students is higher than the general population in Bangladesh. Since psychiatric disorders (such as depression and anxiety) and addictive behaviors (e.g., internet addiction) predominantly exist among university students in the country, these may increase their vulnerability to developing an eating disorder. The association of internet addiction, depression, and anxiety with the risk of eating disorders among Bangladeshi university students is relatively unknown; therefore, this study investigates the association. This study was a cross-sectional design. Students (N = 700) from two public universities in Bangladesh completed the Patient Health Questionnaire (PHQ-9) scale, the Generalized Anxiety Disorder (GAD-7) tool, and Orman's Internet Addiction Survey (OIAS) to measure exposure variables. Eating Attitudes Test-26 (EAT-26) assessed the outcome variable. Multivariable logistic regression analysis showed that internet addiction [adjusted odds ratio (aOR) for moderate addiction = 2.15 and severe addiction = 3.95], depressive (aOR 3.04), and anxiety (aOR 2.06) symptoms were associated with an increased risk of eating disorder among study participants. Future longitudinal studies on university students are recommended to gain a better understanding about the causal factors of eating disorder to support intervention initiatives and strategies by public health practitioners and policy experts.

A factor that can yield to eating attitude disorders in university students: Self-esteem

OBJECTIVE

To determine prevalence of eating attitude disorder (EAD) and the effect of self-esteem on EAD in female university students.

Study Design: In this cross-sectional study, female university students were included. The dependent variable was EAD determined by Eating Attitude Test-40. Socio-demographic characteristics, body perception, obesity, self-compassion and self-esteem were independent variables. Logistic regression (LR) models have been established to determine the associated factors of EAD. p < 0.05 was considered significant.

Results: EAD were found in 3.3% (n = 20) of the participants (n = 600). 44.5% had low and medium self-esteem and %13.4 were overweight (body mass index (BMI) ≥ 25.0). According to LR models, after adjusted for age, increased self-esteem score (decreased self-esteem) (OR:1.8, 95%CI:1.063-3.303) and practicing popular diet (OR:12.6, 95%CI:4.439-35.904) increased the risk of EAD significantly.

Conclusion: EAD were less than expected in this group of university students. Self-esteem is an important factor affecting EAD. Students with EAD may be recommended to get psychological support as well as nutritional counseling.

Investigation of the relationship between early maladaptive schemas, temperament and eating attitude in adults

BACKGROUND

Current research on eating attitude has focused primarily on female perspective (Kapoor et al. in J Educ Health Promot 11(80):1-7, 2022; Piko et al. in J Prev Med Hyg. 63(1):83-89, 2022). To extend cross-gender approaches, this study aimed to examine the relationship between early maladaptive schemas, temperament, and eating attitude and to see whether these three concepts differ between men and women.

METHODS

The sample group consists of a total of 308 participants, 206 (66.9%) women and 102 (33.1%) men, living in Bursa and participating in the research voluntarily. In the study, Sociodemographic Data Form was used to obtain personal information of the participants, Young Schema Questionnaire-Short Form 3 was used to evaluate early maladaptive schemas, Temperament Evaluation of Memphis, Pisa, Paris and San-Diego Autoquestionnaire was used to evaluate temperament characteristics and Eating Attitude Test was used to evaluate eating attitudes.

RESULTS

As a result of the study, a moderate and positive relationship was found between the Defectiveness, Emotional Inhibition, Enmeshment/Dependence, Failure, Abandonment, Vulnerability to Harm or Illness, Negativity/Pessimism schemas and eating attitude. Among these schemas, Defectiveness was found to be the best predictor of deterioration in eating attitude. A weak and positive relationship was found between the scores obtained from the Eating Attitude Test and Cyclothymic and Irritable temperaments, and a moderate positive relationship with Anxious temperament. Among these temperaments, Anxious temperament was found to be the best predictor of deterioration in eating attitude.

CONCLUSIONS

When the results were examined, a relationship was observed between early maladaptive schemas and temperament types, and this relationship was examined in detail. The results obtained at the end of the study were discussed and suggestions were made for future studies.

Is poor sleep quality related to disordered eating behavior and mental health among university students?

The role of sleep in eating behavior has received increasing attention in recent years. This paper aimed to determine the prevalence and associations between sleep quality and mental health, anthropometric measurements, and disordered eating in university students. This cross-sectional research was conducted among 568 students (78.7% women) aged 18-25 years. Students completed a survey including demographic information, Pittsburgh Sleep Quality Index (PSQI), Eating Attitude Test-26 (EAT-26), Night Eating Questionnaire (NEQ), and Beck Depression Inventory (BDI). Anthropometric measurements were taken. Students were grouped based on poor (PSQI > 5) and good (PSQI ≤ 5) sleep quality. The students' average age was 20.32 ± 1.61 years. Additionally, 36.3% (n = 206) of the students had PSQI > 5, and these students had more frequent night eating syndrome (NES) and depressive symptoms. Students with PSQI > 5 had significantly higher total NEQ and BDI scores than students with PSQI ≤ 5. Significant positive correlations were found between sleep quality and its subscale scores with NEQ and BDI scores. When anthropometric measurements were evaluated according to gender, a significant difference was found between sleep quality and body mass index and waist/hip ratio in men only. There was a significant association between PSQI > 5 and NES after adjusting for age, sex, class standing, residency, smoking status, and alcohol consumption on logistic regression. Our results suggest that PSQI > 5 is a significant risk for the NES, but not other disordered eating behaviors or obesity. The relationship between sleep, depression, anthropometric measurements, and disordered eating should be further evaluated in future studies.

Food approach and avoidance appetitive traits in university students: A latent profile analysis

Eating behaviors are influenced by many factors including appetitive traits. Few studies have utilized latent profile analysis (LPA) to examine food approach and food avoidance appetitive traits. This study utilized LPA to define cluster profile groups based on appetitive traits in undergraduate and graduate/professional students at a large University in the southwest United States. Students completed a cross-sectional online survey in fall 2020 assessing demographic information, appetitive traits via the Adult Eating Behavior Questionnaire (AEBQ), and anxiety via the Generalized Anxiety Disorder Scale (GAD-7; higher scores indicate more severe anxiety symptoms). Appetitive traits were combined into eight scales (four food approach and four food avoidance traits). Latent profile analyses were conducted to identify homogenous subgroups of participants based on AEBQ scale scores. The final sample included 1243 students (mean age = 26.5 years, 73% female, 59% White, 57% undergraduates). LPA revealed four cluster profile groups: Cluster 1 (moderate eaters: lower than mean scores for food approach and avoidance traits), Cluster 2 (food seekers and avoiders: higher than mean scores for food approach and avoidance traits), Cluster 3 (food seekers: higher than mean scores for food approach traits), and Cluster 4 (food avoiders: higher than mean scores for food avoidance traits). Distribution of age, gender, race/ethnicity, and student status differed significantly between clusters. GAD-7 score was highest in Cluster 2 (food seekers and avoiders) and lowest in Cluster 1 (moderate eaters). Among the four LPA-defined cluster profile groups, students who endorsed both food approach and avoidance traits reported more severe anxiety symptoms compared to moderate eaters, food seekers, and food avoiders. It is useful to consider clusters of appetitive traits instead of individual appetitive traits when examining associations with physical and mental health.

The moderating effects of self and other mentalizing on the relationship between distress and disordered eating: A cross-cultural examination

OBJECTIVE

Cross-cultural comparisons that focus on underlying psychological mechanisms in disordered eating (DE) are lacking. With the aim of addressing this gap, we investigated the interplay between mentalizing, distress, and DE in two cultural groups: the ultra-Orthodox and secular Jewish societies in Israel.

METHOD

A combination of performance-based and self-report measures of two mentalizing-related constructs (emotional awareness and alexithymia), along with self-report measures of distress, DE, and values preferences, were employed in a community sample (N = 300) of ultra-Orthodox and secular Jewish women.

RESULTS

Distress predicted DE in both cultural groups, yet there were cultural differences in the moderating role of mentalizing. Both mentalizing measures moderated the distress-DE link in the secular group, but not in the ultra-Orthodox group. Furthermore, there were cultural differences in the moderating effects of self versus other mentalizing.

CONCLUSIONS

The results suggest cultural differences in the underlying psychological mechanism of DE.

Factors affecting emotional eating and eating palatable food in adults

BACKGROUND/OBJECTIVES

The aim of this study was to determine the relationship among emotional eating behavior, tendency to eat palatable foods, and several risk factors.

SUBJECTS/METHODS

This study was carried out on 2,434 persons (1,736 women and 698 men) aged between 19 and 64 years. A questionnaire form was used as a data collection tool, which consisted of items for the socio-demographic characteristics, anthropometric measurements, Emotional Appetite Questionnaire (EMAQ), and the Palatable Eating Motives Scale (PEMS).

RESULTS

A positive significant correlation was observed between the BMI groups and the negative emotions, negative situations, and negative total scores of EMAQ (P < 0.01). The regression results on negative subscales showed that a one unit increase in BMI resulted in a 0.293 unit increase in negative situations scores, a 0.626 unit increase in negative emotions scores, and a 0.919 unit increase in negative total EMAQ scores. When the BMI groups and PEMS subscale scores were examined, a significant relationship was found in the social motives, rewarding, and conformity subscales (P < 0.01). A one unit increase in BMI increased the coping motives scores by 0.077 units.

CONCLUSIONS

The emotional states have a significant effect on the eating behavior. On the other hand, an increase in eating attacks was observed, particularly in people who were under the effect of a negative emotion or situation. Nevertheless, there were some limitations of the study in terms of quantitative determination of the effects of this eating behavior depending on the BMI.

Study of bodyweight and eating attitude among female university members in the Kingdom of Saudi Arabia: A comparison between different methods of weight assessment

Background:

The economic transition in Saudi Arabia imposed negative consequences leading to an increase in the prevalence of obesity and its sequelae. Despite the commitment of high authorities in KSA to combat obesity, so far 25% of Saudis are still obese. The association between obesity, disordered eating attitude, and body image needs to be addressed.

Aim:

To explore the relationship between obesity, eating attitude, and body image satisfaction among students and employees at Princess Nourah University (PNU) and to compare the different modalities of assessing body weight.

Methods:

A cross-sectional study using a convenient sampling technique comprised of 550 participants. Obesity was assessed by anthropometric measurements and body composition monitor (BF511). Eating attitude test (EAT26) was used to determine eating attitude while body image satisfaction score was determined using body shape questionnaire (BSQ).

Results:

Around 382 (69.5%) students and 168 employees participated in the study. Obesity was significantly higher among employees (48.2%) vs students (27.7%) (P < 0.001). Body fat composition showed significant positive correlations ranging from weak-to-moderate (0.13 to 0.44) with other body measurements for students and employees. The disordered eating attitude was maximized among obese compared to other BMI groups (P < 0.05). Percentage of disordered eating attitude score correlated positively with BMI: 35.2% vs 52.3% among underweight and obese, respectively (P = 0.001). There was no statistical difference in eating attitudes between students and employees. BSQ score correlates positively with BMI (P < 0.001), it was 36.73 ± 18.68 vs 57.92 ± 18.50 for underweight and obese, respectively. The effect of BMI on body image score was 19.1%.

Discussion and Conclusion:

Obesity remains a significant health problem among Saudi females. Increased BMI is associated with increased disordered food attitude and the effect of BMI on body image score was minimal.

Correlates of orthorexia nervosa among a representative sample of the Lebanese population

INTRODUCTION

Orthorexia nervosa (ON), or the pathological preoccupation and "fixation on healthy food" has been emerging as a new eating disorder. A limited amount of literature exists today on the prevalence of ON. The objective of the current study was to assess factors associated with ON tendencies and behaviors among a representative sample of the Lebanese population.

METHODS

This was a cross-sectional study, conducted between January and May 2018, which enrolled 811 participants from all Lebanese governorates. The ORTHO-15 scale was used to evaluate ON tendencies and behaviors among participants. Scores below 40 indicate the presence of ON.

RESULTS

The results showed that 589 (75.2%) participants had ON tendencies and behaviors. The results of the multivariable analysis taking the ORTHO-15 score as the dependent variable, showed that female gender (Beta = - 0.739), starving to lose weight (Beta = - 0.859), convincing others to follow a diet (Beta = - 0.971), thinking that eating out is unhealthy (Beta = - 0.931) and increased EAT (eating attitudes test) scores (Beta = - 0.087) were associated with higher level of orthorexia tendencies and behaviors (lower ORTHO-15 scores).

CONCLUSION

A highly unexpected prevalence of ON tendencies and behaviors was found in our sample. The Lebanese population might have high preoccupation behavior towards healthy and proper nutrition. Social awareness and behavioral intervention programs are warranted to follow a healthy diet and lifestyle behaviors, and consequently overcome ON.

LEVEL OF EVIDENCE

Level 5, cross-sectional descriptive study.

Prevalence of mental health problems among medical students in China: A meta-analysis

BACKGROUND

The prevalence of mental health problems in medical students has continuously increased and is higher than the prevalence of mental health problems in students with other majors, which could lead to undesirable consequences for the students and their future patients. In China, the current states of medical education and healthcare workplaces differ in certain areas from those in Western or other Asian countries. However, the mental health status of Chinese medical students has not been systematically analyzed.

OBJECTIVES

The purpose of this meta-analysis was to summarize the prevalence of mental health problems in Chinese medical students.

METHODS

All cross-sectional studies that investigated the prevalence of any mental health problem among Chinese medical students were retrieved from the following databases: EMBASE, PubMed, PsycINFO, OVID, the Cochrane Database of Systematic Reviews, and the Cochrane Central Register of Controlled Trials. We accepted each individual trial's inclusion and exclusion criteria for participants. The National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies was adopted to appraise the methodological quality of each study. RevMan (version 5.3) was used to analyze the data.

RESULTS

Ten cross-sectional studies involving a total of 30,817 Chinese medical students were included. The prevalence of depression, anxiety, suicidal ideation, and eating disorders were 29%, 21%, 11%, and 2%, respectively. Subgroup analysis revealed no significant differences in the prevalence of depression and suicidal ideation between genders and no significant difference in the prevalence of depression between individuals of different ages (20 years and older or younger than 20 years).

CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS

Chinese medical students have relatively high prevalence of depression, anxiety, and suicidal ideation but a low prevalence of eating disorders. Mental health problems in Chinese medical students should be taken seriously, and timely screening of and proper intervention in these mental health problems are highly recommended.

Predicting eating disturbances in Turkish adult females: Examining the role of intimate partner violence and perfectionism

We examined the relationships between intimate partner violence (IPV), perfectionism, and eating disturbances, namely, excessive dieting and bulimia, in a sample of 149 Turkish female college students. Results of conducting hierarchical regression analyses indicated that IPV accounted for significant variance in both excessive dieting and bulimic symptoms. The inclusion of perfectionism was found to predict additional variance in eating disturbances, beyond IPV. Specifically, we found parental expectations to be a significant predictor of dieting, and personal standards, doubts about actions, and parental criticism to be significant predictors of bulimia. Some implications for understanding eating disturbances in Turkish women are discussed.

Eating Attitudes and Related Factors in Turkish Nursing Students

Background:

Changing eating behaviors might trigger obesity, deficiency, anorexia nervosa, bulimia nervosa, and reactive eating disorders.

Objectives:

This study aimed to determine eating attitudes of nursing students in the western Black-Sea region of Turkey as well as to examine the effects of demographic features, self-esteem, body image, income level, and family structure on their eating attitudes.

Materials and Methods:

This cross-sectional study was conducted on 310 nursing students between January and February 2014. Data were collected using the personal information form, Eating Attitudes Test (EAT), Rosenberg Self-Esteem Scale (RSES), Beck Depression Scale (BDS), Body-Cathexis Scale (BCS), and Body Mass Index (BMI). Data were evaluated by descriptive statistics, independent samples t-test, one-way ANOVA, Kruskal-Wallis test, and Pearson correlation analysis.

Results:

About 30.0% of Turkish nursing students had negative eating attitudes. There was a significant positive correlation between the BDS and EAT scores (P < 0.001). There was a significant negative correlation between RSES scores and EAT scores of nursing students (P < 0.001). A statistically significant difference was found between the father’s occupation (P < 0.05) and mother’s working condition (P < 0.05), and the students’ eating attitudes.

Conclusions:

Psychological status, self-esteem, economic level, and place of residence of nursing students may be the potential factors for eating disorders.

Prevalence of Eating Disorder Risk and Associations with Health-related Quality of Life: Results from a Large School-based Population Screening

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.

Orthorexia Nervosa in Turkish Dietitians

The purpose of this study was to determine the prevalence of orthorexia nervosa in dietitians, as assessed by administering ORTO-15, Eating Attitudes Test-40 (EAT-40) and Maudsley Obsessive-Compulsive Inventory (MOCI). Our study included 117 dietitians (Ankara). Orto-15 test scores below 40 points was considered indicative of orthorexia, while higher scores indicated a normal eating behavior. It was found that participants with ORTO-15 scores less than 40 had higher scores for EAT-40 and MOCI (p < 0.05). The results showed a significant negative correlation between the ORTO-15 and EAT-40 scores and BMI values. In that respect, further investigation with dietitians into orthorexia nervosa is recommended.

Disordered eating attitudes in Egyptian antipsychotic naive patients with schizophrenia

OBJECTIVES

The study aimed to test in a sample of Egyptian antipsychotic naive patients the hypotheses that the disordered eating attitudes co-occur with schizophrenia in a higher frequency than would be expected by chance in the general population and that the disordered eating comorbidity would be associated with more severe schizophrenia psychopathology. Previous studies have been mostly concerned with the impact of the antipsychotics. Studies relating abnormal eating behavior to the schizophrenia psychopathology rather than to its treatment are lacking.

METHOD

In this case-control cross-sectional study, 50 consecutive antipsychotic naive patients, newly attending the psychiatric outpatient clinic, University Hospital, Zagazig, Egypt, with a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, diagnosis of schizophrenia, were assessed by the Positive and Negative Syndrome Scale and compared with 50 nonpsychiatric controls using the Eating Attitudes Test (EAT40).

RESULTS

Patients with schizophrenia had an EAT40 mean score (23.4 ± 7.8) higher than that of controls (19.7 ± 7.2) (P = .015). Prevalence of disordered eating (defined by a score of ≥ 30 on the EAT40) in these patients was higher than in the control group (30% vs 12%, P = .027). Comparison between schizophrenia patients with and without disordered eating showed no significant differences in demographic and a number of clinical variables, but they differed in their scores on lifestyle characteristics and anthropometric measures. The group of patients with disordered eating had also higher scores on total and all scale factors but not on the negative symptom scale.

CONCLUSIONS

Data of this study show, perhaps for the first time, that "disordered" eating attitudes, as measured by the EAT40, are higher in a group of Egyptian patients with schizophrenia than in controls. However, the lack of difference between patients with and without disordered eating in terms of demographic and a number of clinical characteristics fail to explain the hypothesis that schizophrenia with disordered eating is a distinct subtype of schizophrenia. Data indicate, on the other hand, that the presence of disordered eating behavior in patients with schizophrenia is associated with the expression of more active psychotic symptoms.

Socio-demographic and clinical characteristics of individuals with diagnoses of eating disorder in a university hospital in Istanbul

OBJECTIVE

This paper reports the first-ever description of a clinical eating disorder population from Turkey. The aim of this study was to examine the socio-demographic and clinical characteristics of individuals with diagnosis of eating disorders (IDED) referred to a university psychiatry clinic in Istanbul between 2003 and 2009.

METHOD

The diagnoses and subtype of 111 IDEDs, the referral type to the hospital, setting of treatment, and state of involuntary hospitalization were evaluated by interview and semi-structured questionnaire.

RESULTS

The clinical sample included 64 individuals with anorexia nervosa (AN), 38 with bulimia nervosa (BN), and 9 with eating disorder not otherwise specified (EDNOS), including only one male. Younger individuals and those with a lower BMI were significantly more likely to be family referred and hospitalized involuntarily.

DISCUSSION

The overall socio-demographic features of the sample are generally consistent with data collected in other communities. However, aspects of the clinical features, referral types of eating disorders and subtypes exhibit some characteristics peculiar to our sample.

Symptoms of disordered eating, body shape, and mood concerns in male and female Chinese medical students

OBJECTIVE

This cross-sectional study explored the prevalence of disordered eating attitudes, body shape concerns, and social anxiety and depressive symptoms in male and female medical students in China.

METHOD

Four hundred eighty-seven students from Central South University (Hunan Province, Changsha City, China) completed the following self-report measures: Eating Attitudes Test-26, Eating Disorders Assessment Questionnaire, Body Shape Questionnaire, Swansea Muscularity Attitudes Questionnaire, Social Interaction Anxiety Scale, and the Self-Rating Depression Scale.

RESULTS

A comparatively lower rate of at-risk eating attitudes (2.5%) and eating disorders (0.90%) were found compared to those reported in other studies. Significantly more female (3.2%) than male (1.2%) students had abnormal eating attitudes with 4 female students meeting Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria for bulimia nervosa. Significant relationships were observed between eating attitudes, body shape concern, social anxiety, depression, and body mass index. For females, the most significant correlate of distorted eating attitudes was body shape concern, whereas for male students, social anxiety and concern with muscle size and shape were most strongly correlated with distorted eating attitudes.

A Spanish version of the Family Assessment Device

INTRODUCTION

This paper presents the results of a study on the psychometric properties of an authorized Spanish version of the McMaster Family Assessment Device, a self-report measure of family functioning.

MATERIALS AND METHODS

The study sample comprised 60 psychiatric patients and their family member and 60 controls, without mental health problems, and their family member.

RESULTS

Compared to other studies, all subscales displayed adequate temporal stability and acceptable reliability. While the instrument discriminated well between the two groups of families on all subscales, the results nevertheless indicated limitations in the inter-item discriminant capacity of the "Roles" subscale. Factor analysis resulted in a three-factor model that does not coincide with the established structure of this instrument.

CONCLUSION

Proposals to improve and adapt questionnaire are discussed with a view to make it applicable to cultures other than the one it was developed. Theoretical models relating to psychosocial aspects such as family functioning, albeit compatible in some areas, should be viewed with caution in cultures different to that in which the model originates.