The relation between Bulimic symptoms and the social withdrawal syndrome during early adolescence

A test of the social withdrawal syndrome hypothesis of bulimia nervosa

BACKGROUND

The study examined the social withdrawal syndrome (SWS) hypothesis of bulimia nervosa (BN). According to the hypothesis, eating disorders such as BN are associated with a coherent set of social withdrawal cognitions, affect, and behavior.

PARTICIPANTS AND PROCEDURE

Eight-eight young female adults completed a standardized measure of bulimic symptoms and measures of social withdrawal (affective withdrawal, trust beliefs in close others, and disclosure). Participants were engaged in a laboratory-based peer interaction which yielded the SWS measure of perceived lack of social connectiveness.

RESULTS

Bulimic symptoms were associated with each measure of social withdrawal. Structural equation modeling analysis confirmed that those measures contributed to a coherent latent factor which was associated with bulimic symptoms.

CONCLUSIONS

The findings supported the social withdrawal syndrome hypothesis of BN and have implications for the detection and treatment of eating disorders.

Trust Beliefs in Significant Others, Interpersonal Stress, and Internalizing Psychopathology of Adolescents with Psychiatric Disorders

This study examined relations between trust beliefs in significant others (TBSO), interpersonal stress, and internalizing psychopathology for adolescents with psychiatric disorders. Two hundred and thirty-four adolescents from an acute inpatient unit (154 females, M_age = 14.72 years, SD = 1.39 years) completed standardized scales/interviews that assessed TBSO (mother, father, teacher, peers and TBSO as a total score), interpersonal stress, and internalizing psychopathology. It was found that adolescents' TBSO and trust beliefs in each significant other were negatively associated with interpersonal stress and internalizing psychopathology. The findings confirmed that the relation between the adolescents' interpersonal stress and internalizing psychopathology was moderated by TBSO, trust beliefs in mother, and trust beliefs in peers. The findings supported the conclusion that holding elevated TBSO (particularly trust beliefs in mother and peers) by adolescents with psychiatric disorders promotes their psychosocial adjustment including their resilience to the effects of interpersonal stress on internalizing psychopathology.

Depressive Symptoms and Trust of Healthcare Provider in Rural Adolescents: Relationships and Predictors

The purpose of this study was to evaluate associations among depressive symptoms, trust of healthcare provider, and health behavior in adolescents who live in a rural area. Two hundred twenty-four adolescents aged 14-19 years old attending public high school in the Midwestern United States were surveyed. Results showed a diagnosis of depression, trust of healthcare provider, health awareness, and stress management predicted depressive symptoms in adolescents living in a rural area. Healthcare providers should take extra care to promote trust in the healthcare provider-patient relationship with adolescents and to follow guidelines for annual screening of adolescents for depressive symptoms. Nursing implications include adolescent psychoeducation to improve health awareness and stress management.

Associations between Trust of Healthcare Provider and Body Mass Index in Adolescents

Adolescent obesity continues to be a serious concern around the world, placing young people at risk for chronic conditions and early death. Research has shown that social relationships are important in making health behavior changes, such as following health-care recommendations for eating and physical activity. Specifically, the trust of health-care providers has been shown to be important in making health behavior change. Evidence suggests that obese young adults are less trusting of health-care providers than their healthy weight peers, but it is not known if this also applies to obese adolescents. The purpose of this secondary analysis study was to determine relationships between the trust of health-care providers and body mass index percentile in adolescents. Participants were 224 adolescents aged 14-19 years attending a public high school in the Midwestern United States. The Wake Forest Physician Trust scale measured the trust of health-care providers. Height and weight were collected at a school screening; body mass index percentile categories were determined according to age- and sex-adjusted body mass index percentiles. One-way analysis of variance and post hoc Tukey tests showed trust scores varied significantly between body mass index percentile categories of girls. Results suggest it may be necessary for health-care providers to make additional efforts to build trust with obese adolescent girls than with other groups of adolescents.

Reciprocal Prospective Relationships Between Loneliness and Weight Status in Late Childhood and Early Adolescence

Adolescents who do not conform to weight ideals are vulnerable to disapproval and victimization from peers in school. But, missing from the literature is a prospective examination of weight status and feelings of loneliness that might come from those experiences. Using data from the Québec Longitudinal Study of Child Development, we filled that gap by examining the prospective associations between loneliness and weight status when the sample was aged 10-13 years. At ages 10, 12, and 13 years, 1042 youth (572 females; 92% from French speaking homes) reported on their loneliness and were weighed and measured. Family income sufficiency was included in our analyses given its relationship with weight status, but also its possible link with loneliness during early adolescence. The findings showed that (1) weight status and loneliness were not associated concurrently; (2) weight status predicted increases in loneliness from ages 12 to 13 years; and (3) loneliness predicted increases in weight from ages 12 to 13 years among female adolescents, but weight loss among male adolescents. The fact that loneliness was involved in weight gain for females suggests that interventions focused on reducing loneliness and increasing connection with peers during early adolescence could help in reducing obesity.

Obesity and the Social Withdrawal Syndrome

The relation between obesity and Social Withdrawal Syndrome (SWS) was examined using the data gathered by Rotenberg, Bharathi, Davies, and Finch (2013). One hundred and 35 undergraduates (80 females; Mage=21years-10months) completed standardized scales that assessed the SWS (low emotional trust beliefs in close others, low disclosure to close others, and high loneliness). BMI was calculated from self-reported weight and height. As hypothesized, quadratic relations were found in which participants with BMI>30 (i.e., obese) demonstrated the SWS pattern of low emotional trust beliefs in close others, low disclosure to close others, and high loneliness. As further evidence, lower emotional trust in close others, lower disclosure to close others, and greater loneliness were found for obese participants (>30 BMI, n=27) than both normal weight (<25 BMI, n=67) and overweight participants (25 to 30 BMI, n=41). The findings confirmed the hypothesis that obesity was associated with the SWS. The findings suggested that the lack of trust in others by obese individuals contributes to their unwillingness to seek out help for health and psychosocial problems.