Relationship between depressive mood and eating disorders in a non-clinical young female sample: a one-year longitudinal analysis of cross-lagged and simultaneous effects

Eating disorder-related functional impairment predicts greater depressive symptoms across one semester of college

Eating disorder (ED) behaviors and depression are associated with numerous negative outcomes, including lower quality of life and functional impairment. College women are at elevated risk for both. Prior research indicates ED behaviors, including binge eating, self-induced vomiting, and fasting, predict increases in future depressive symptoms. However, symptom heterogeneity in EDs is common, and all disordered eating, or its associated distress, cannot be captured by the endorsement of behaviors. Impairment that results from ED behaviors may be a comparable, or stronger, predictor of depressive symptoms. We sought to characterize the longitudinal relationship between ED-related functional impairment, ED behaviors, and depressive symptoms. College-aged women [N = 304; 72 % white, mean (SD) age = 18.45 (0.88)] completed an online survey in August (baseline), and then three months later in November (follow-up). Baseline ED-related functional impairment, but not baseline ED behaviors, significantly predicted depressive symptoms at follow-up, controlling for baseline depressive symptoms, negative affect, and body mass index. Findings indicate ED-related functional impairment is a risk factor for increases in depressive symptoms across one semester of college, irrespective of ED behavior engagement, weight status, and dispositional negative affect. Intervening upon ED-related functional impairment may reduce or prevent future depressive symptoms among college-aged women.

Personality Traits and Risk of Eating Disorders in Men: A Cross-Sectional Study

Eating disorders (EDs) have been understudied and misunderstood in men. Among the relevant factors in the risk, onset, and maintenance of EDs, personality stands out. Therefore, the aim of the study was to analyze the relationships between personality traits and risk variables for the development of EDs in men. A total of 443 male university students (mean = 22.16 years) who completed the Spanish versions of the Eating Disorder Inventory-3 (EDI-3) and the NEO Five-Factor Inventory (NEO-FFI) participated. Correlation analyses were performed, and in order to determine the predictive role of personality traits on risk scales, a hierarchical multiple regression was performed. The results showed that neuroticism was positively associated with drive for thinness, being its main predictor variable. In bulimia, the main relationships were positively associated with neuroticism and negatively with conscientiousness. As for body dissatisfaction, the main predictor variables were neuroticism and, in a negative sense, extraversion and openness to experience. In conclusion, personality traits are related to the risk of developing EDs in male university students, with neuroticism being the main associated trait.

Which came first? Bulimia and emotional symptoms: A cross-lagged panel analysis

Purpose

Researchers have found growing evidence for the comorbidity link between bulimia and emotional symptoms among Chinese female youth. However, the prospective effect of one on the other is still unclear. Therefore, a cross-lagged model was used to examine the possible underlying mechanism between bulimia and two typical emotional problems (i.e., anxiety symptoms and depressive symptoms), respectively, in the present study.

Methods

A total of 471 female college students participated in the three waves of the present study. Self-reported questionnaires were delivered to assess their bulimia, anxiety symptoms, and depressive symptoms.

Results

After controlling for earlier levels of symptoms, our finding indicated that anxiety symptoms triggered more bulimia symptoms from Time 1 to Time 2. In turn, the reciprocal cycles occurred between anxiety symptoms and bulimia symptoms from Time 2 to Time 3. More interestingly, a similar pattern was found between depressive symptoms and bulimia.

Conclusions

The persistence and reciprocal cycle between bulimia and emotional symptoms are worthy of attention. Specifically, female youth with higher levels of emotional symptoms appear to be more profound at high risk for eating-related problems afterward. Further eating-related intervention programs may also need to take the level of female youth's emotional symptoms into consideration.

Bi-directional associations between depressive symptoms and eating disorder symptoms in early adolescence

Despite frequently co-occurring, the temporal relationship between depression and eating disorder symptoms remains poorly understood. This exploratory study sought to investigate the reciprocal relationship between depressive symptoms and (1) shape and weight dissatisfaction, (2) shape and weight overvaluation, (3) preoccupation with shape or weight, (4) preoccupation with food, (5) dietary restraint and (6) binge eating in early adolescence. Adolescents (N = 1393) aged between 11.4 and 13.9 years (M = 12.50, SD = 0.38) completed the Centre for Epidemiological Depression Scale-Revised and Eating Disorder Examination Questionnaire-Adolescent version at the beginning of secondary school (T1) and 12-months later (T2). Cross-lagged models were created to assess the reciprocal relationship between depressive symptoms and ED symptoms. Depressive symptoms at T1 predicted shape and weight dissatisfaction, shape and weight overvaluation, preoccupation with shape or weight, preoccupation with food, dietary restraint and binge eating at T2. Shape and weight dissatisfaction and binge eating were the only ED symptoms at T1 to predict depressive symptoms at T2. Findings suggest young adolescents who experience depressive symptoms in their first year of secondary school are at-risk of developing ED symptoms over the subsequent 12-month period.

Exercising Alone or Exercising With Others and Mental Health Among Middle-Aged and Older Adults: Longitudinal Analysis of Cross-Lagged and Simultaneous Effects

BACKGROUND

Although the beneficial effects of physical activity and exercise on mental health are well known, the optimal conditions for them for benefitting mental health are still unclear. Engaging in exercise with others might have more desirable effects on mental health than engaging in exercise alone. This study examined the associations between exercising alone, exercising with others, and mental health among middle-aged and older adults.

METHODS

Baseline and 1-year follow-up surveys were conducted with 129 individuals. Time spent exercising alone or with others was measured using a 7-day diary survey. Total physical activity was objectively measured using an accelerometer. Mental well-being was assessed using the simplified Japanese version of the World Health Organization Five Well-Being Index, and mental distress was assessed using the Japanese version of the Kessler Distress Scale (K6).

RESULTS

Cross-lagged and simultaneous effects models revealed that exercising with others positively influenced mental well-being. Exercising alone and total physical activity did not significantly influence mental well-being. Neither total physical activity, exercising alone, nor exercising with others was significantly associated with mental distress.

CONCLUSION

Engaging in exercise with others could be effective in improving mental well-being relative to engaging in exercise alone.

An examination of direct, indirect and reciprocal relationships between perfectionism, eating disorder symptoms, anxiety, and depression in children and adolescents with eating disorders

OBJECTIVE

Perfectionism is a transdiagnostic factor across eating disorders, anxiety, and depression. Previous research has shown anxiety mediates the relationship between perfectionism and eating disorders in adults. The aim of this study was to investigate the relationships between anxiety/depression, perfectionism and eating disorder symptoms in children and adolescents with eating disorders.

METHOD

Structural equation modeling was used to investigate three models in a clinical sample of children and adolescents (N = 231, M age = 14.5, 100% female): (1) anxiety and depression as mediators of the relationship between perfectionism and eating disorder symptoms, (2) eating disorder symptoms as a mediator of the relationship between perfectionism and anxiety and/or depression, and (3) perfectionism as a mediator of the relationship between anxiety/depression and eating disorders.

RESULTS

Results indicated that both models 1 and 2 fit the data well, while model 3 provided a poor fit. These findings suggest that in clinical populations of children and adolescents, anxiety and depression mediate the relationship between perfectionism and eating disorder symptoms, and there is also a reciprocal relationship whereby eating disorders mediate the association between perfectionism, and anxiety and/or depression.

DISCUSSION

The results highlight the importance of further research to determine whether targeting perfectionism is helpful in the treatment of eating disorders and comorbid anxiety and depression in young people. It would be useful for clinicians to consider assessing for and treating perfectionism directly when it is elevated in children and adolescents with eating disorders.

Longitudinal Bi-directional Effects of Disordered Eating, Depression and Anxiety

OBJECTIVE

The present study aims to explore the potentially longitudinal bi-directional effects of disordered eating (DE) symptoms with depression and anxiety.

METHOD

Participants were 189 (49.5% male) adolescents from Melbourne, Australia. DE, depressive and anxiety symptoms were assessed at approximately 15, 16.5 and 18.5 years of age.

RESULTS

Analysis of longitudinal bi-directional effects assessed via cross-lagged models indicated that DE symptoms of eating and shape/weight concerns were risk factors for anxiety. Results also showed that depression was a risk factor for eating concerns.

CONCLUSION

Our findings provide preliminary evidence that preventative measures designed to target concerns about eating and shape/weight might be most efficacious in reducing the transmission of effects between symptoms of DE, depression and anxiety. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

A systematic review and meta-analysis on the longitudinal relationship between eating pathology and depression

OBJECTIVE

Undertake a meta-analysis to provide a quantitative synthesis of longitudinal studies that assessed the direction of effects between eating pathology and depression. A second aim was to use meta-regression to account for heterogeneity in terms of study-level effect modifiers.

METHOD

A systematic review was conducted on 42 studies that assessed the longitudinal relationship between eating pathology and depression. Of these 42 studies, multilevel random-effects meta-analyses were conducted on 30 eligible studies.

RESULTS

Meta-analysis results showed that eating pathology was a risk factor for depression (rm  = 0.13) and that depression was a risk factor for eating pathology (rm  = 0.16). Meta-regression analyses showed that these effects were significantly stronger for studies that operationalized eating pathology as an eating disorder diagnosis versus eating pathology symptoms, and for studies that operationalized the respective outcome measure as a categorical variable (e.g., a diagnosis of a disorder or where symptoms were "present"/"absent") versus a continuous measure. Results also showed that in relation to eating pathology type, the effect of an eating disorder diagnosis and bulimic symptoms on depression was significantly stronger for younger participants.

DISCUSSION

Eating pathology and depression are concurrent risk factors for each other, suggesting that future research would benefit from identifying factors that are etiological to the development of both constructs.

RESUMEN OBJETIVO

Llevar a cabo un meta-análisis para proporcionar una síntesis cuantitativa de los estudios longitudinales que evaluaron la dirección de los efectos entre la alimentación patológica y la depresión. Un segundo objetivo fue utilizar la meta-regresión para dar cuenta de la heterogeneidad en términos de modificadores del efecto a nivel de estudio. MÉTODO: Una revisión sistemática se llevó a cabo en 42 estudios que evaluaron la relación longitudinal entre la alimentación patológica y la depresión. De estos 42 estudios, se realizaron meta-análisis de multinivel de efectos aleatorios en 30 estudios elegibles.

RESULTADOS

Los resultados del meta-análisis mostraron que la alimentación patológica era un factor de riesgo para depresión (rm=0.13) y que la depresión era un factor de riesgo para la alimentación patológica (rm=0.16). Los análisis de meta-regresión mostraron que estos efectos eran significativamente más fuertes para estudios que operacionalizaban la alimentación patológica como un diagnóstico de trastorno de la conducta alimentaria versus síntomas de alimentación patológica, y para los estudios que operacionalizaban la medida respectiva de resultado como una variable categórica (e.g., un diagnóstico de trastorno o cuando los síntomas estaban "presentes"/"ausentes") versus una medida continua. Los resultados mostraron que en relación al tipo de alimentación patológica, el efecto de un diagnóstico de trastorno de la conducta alimentaria y síntomas bulímicos en la depresión era significativamente más fuerte para participantes más jóvenes. DISCUSIÓN: La alimentación patológica y la depresión son factores de riesgo concurrentes uno para el otro, lo que sugiere que la investigación futura se beneficiaría de identificar factores que son etiológicos al desarrollo de ambos constructos. © 2015 Wiley Periodicals, Inc. (Int J Eat Disord 2016;49:439-454).