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Mohapatra D, Pemde HK, Kataria D. Disordered eating behaviors, body dissatisfaction and their determinants in Indian adolescents: A cross-sectional observational study. Indian J Psychiatry 2024; 66:165-170. [PMID: 38523766 PMCID: PMC10956595 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_717_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 12/30/2023] [Accepted: 01/15/2024] [Indexed: 03/26/2024] Open
Abstract
Objective Although the prevalence of disordered eating is maximum in high-income countries, the most significant rise occurred in East Asia and South Asia over the last three decades. Body dissatisfaction and disordered eating behaviors (DEBs) are more common than full-blown eating disorders. The cognitive distortion leading to these manifestations mainly occurs during adolescence and early adulthood. In this study, we assess the burden of DEBs in a cohort of Indian adolescents and determine their correlation with body dissatisfaction, calorie intake, and clinicosocial determinants. Methods The study was conducted from November 2016 to November 2020 and enrolled 180 adolescents of 10-18 years attending the outpatient department of a tertiary-care hospital. Subjects were screened for DEBs, using a 15-item Screening Questionnaire for Eating Distress Syndromes, and for body dissatisfaction, using Photographic-Figure-Rating-Scale. Clinicosocial interviews, dietary and anthropometric evaluation, and psychiatric screening using a Mini-International Neuropsychiatric Interview (MINI-KIDS screen) were conducted. Results DEB was present in 17.2% of adolescents, while 81.1% had body dissatisfaction and 32.2% had some psychiatric symptoms. The prevalence of DEBs in females was much higher than in males (OR = 7.89, 95%CI: 2.25-27.75, P = 0.001). More males (84.1%) reported body dissatisfaction than females (76.7%) [χ² =9.2, P = 0.010]. However, while females wished to lose weight, males desired weight gain, as measured by body dissatisfaction score (t = 2.9, P = 0.004). Apart from sex, other factors found significant in predicting DEBs in multivariate analysis were education, body dissatisfaction, BMI, and the number of siblings. Conclusion We conclude that, unlike overt eating disorders, DEBs are common in Indian adolescents. The development of DEBs is influenced by gender, education, body dissatisfaction, BMI, and the number of siblings.
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Brizzi G, Sansoni M, Di Lernia D, Frisone F, Tuena C, Riva G. The multisensory mind: a systematic review of multisensory integration processing in Anorexia and Bulimia Nervosa. J Eat Disord 2023; 11:204. [PMID: 37974266 PMCID: PMC10655389 DOI: 10.1186/s40337-023-00930-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 11/12/2023] [Indexed: 11/19/2023] Open
Abstract
Individuals with Anorexia Nervosa and Bulimia Nervosa present alterations in the way they experience their bodies. Body experience results from a multisensory integration process in which information from different sensory domains and spatial reference frames is combined into a coherent percept. Given the critical role of the body in the onset and maintenance of both Anorexia Nervosa and Bulimia Nervosa, we conducted a systematic review to examine multisensory integration abilities of individuals affected by these two conditions and investigate whether they exhibit impairments in crossmodal integration. We searched for studies evaluating crossmodal integration in individuals with a current diagnosis of Anorexia Nervosa and Bulimia Nervosa as compared to healthy individuals from both behavioral and neurobiological perspectives. A search of PubMed, PsycINFO, and Web of Sciences databases was performed to extract relevant articles. Of the 2348 studies retrieved, 911 were unique articles. After the screening, 13 articles were included. Studies revealed multisensory integration abnormalities in patients affected by Anorexia Nervosa; only one included individuals with Bulimia Nervosa and observed less severe impairments compared to healthy controls. Overall, results seemed to support the presence of multisensory deficits in Anorexia Nervosa, especially when integrating interoceptive and exteroceptive information. We proposed the Predictive Coding framework for understanding our findings and suggested future lines of investigation.
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Affiliation(s)
- Giulia Brizzi
- Applied Technology for Neuro- Psychology Laboratory, IRCCS Istituto Auxologico Italiano, Via Magnasco 2, 20149, Milan, Italy.
| | - Maria Sansoni
- Humane Technology Laboratory, Università Cattolica del Sacro Cuore, Largo Gemelli, 1, 20121, Milan, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo Gemelli, 1, 20121, Milan, Italy
| | - Daniele Di Lernia
- Applied Technology for Neuro- Psychology Laboratory, IRCCS Istituto Auxologico Italiano, Via Magnasco 2, 20149, Milan, Italy
| | - Fabio Frisone
- Humane Technology Laboratory, Università Cattolica del Sacro Cuore, Largo Gemelli, 1, 20121, Milan, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo Gemelli, 1, 20121, Milan, Italy
| | - Cosimo Tuena
- Applied Technology for Neuro- Psychology Laboratory, IRCCS Istituto Auxologico Italiano, Via Magnasco 2, 20149, Milan, Italy
| | - Giuseppe Riva
- Applied Technology for Neuro- Psychology Laboratory, IRCCS Istituto Auxologico Italiano, Via Magnasco 2, 20149, Milan, Italy
- Humane Technology Laboratory, Università Cattolica del Sacro Cuore, Largo Gemelli, 1, 20121, Milan, Italy
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Escolar-Llamazares MC, Martínez-Martín MÁ, Medina-Gómez MB, González-Alonso MY, Mercado-Val E, Lara-Ortega F. Sociodemographic Variables and Body Mass Index Associated with the Risk of Eating Disorders in Spanish University Students. Eur J Investig Health Psychol Educ 2023; 13:595-612. [PMID: 36975398 PMCID: PMC10047306 DOI: 10.3390/ejihpe13030046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 03/07/2023] [Accepted: 03/10/2023] [Indexed: 03/18/2023] Open
Abstract
Background: The passage through university is a complex experience that can heighten personal susceptibility to eating disorders. The objective of this research is to determine how gender, age, course, educational faculty, and body mass index (BMI) can influence the risk of eating disorders among university students. Method: A transversal and descriptive study is conducted with a sample of 516 Spanish students (57.2% female, 42.8% male; Mage = 21.7, SDage = 4.1) following 26 university degrees. The Inventory Eating Disorder-Reference criterion (EDI-3-RF) was administered to the students. Contingency tables were used between categorical variables with the chi-squared statistic, at a significance level of p < 0.05. The Student t-test was used for two independent samples and a one-way ANOVA test with the post hoc Bonferroni test for more than two groups. Pearson’s correlation and a simple linear regression analysis were used to analyze the relationship between the variables in its quantitative version. Results: It was found that the female students enrolled in the second year presented a greater obsession with thinness and body dissatisfaction (p = 0.029; d = 0.338); the male students practiced more physical exercise to control their weight (p = 0.003); and that students under the age of twenty (p < 0.010; d = 0.584) and students from both the Health (p = 0.0.13) and Law (p = 0.021) educational faculties showed greater bulimic behavior (d = 0.070). More females are underweight (z = 2.8), and more men are overweight (z = 2.4). Normal-weight students scored significantly higher in thinness obsession (p = 0.033). Overweight students scored significantly higher on thinness obsession (p < 0.001) and body dissatisfaction (p < 0.001). Obese students scored significantly higher on body dissatisfaction (p = 0.04). Conclusions: The data obtained in this study, reinforce the hypothesis that the female gender, at an age within the limits of early adolescence, in the first year of the degree courses, with specific university qualifications, and a high BMI constituted factors that could provoke an eating disorder. Consequently, it is necessary to implement preventive measures adapted to the circumstances of each university student.
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Affiliation(s)
- María-Camino Escolar-Llamazares
- Department of Health Sciences, University of Burgos, Paseo Comendadores s/n, 09001 Burgos, Spain
- Correspondence: (M.-C.E.-L.); (M.-B.M.-G.); Tel.: +34-619285868 (M.-C.E.-L.); +34-673262245 (M.-B.M.-G.)
| | | | - María-Begoña Medina-Gómez
- Department of Educational Sciences, University of Burgos, Avda, Villadiego, No.1., 09001 Burgos, Spain
- Correspondence: (M.-C.E.-L.); (M.-B.M.-G.); Tel.: +34-619285868 (M.-C.E.-L.); +34-673262245 (M.-B.M.-G.)
| | | | - Elvira Mercado-Val
- Department of Educational Sciences, University of Burgos, Avda, Villadiego, No.1., 09001 Burgos, Spain
| | - Fernando Lara-Ortega
- Department of Educational Sciences, University of Burgos, Avda, Villadiego, No.1., 09001 Burgos, Spain
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McCabe M, Alcaraz-Ibanez M, Markey C, Sicilia A, Rodgers RF, Aimé A, Dion J, Pietrabissa G, Lo Coco G, Caltabiano M, Strodl E, Bégin C, Blackburn MÉ, Castelnuovo G, Granero-Gallegos A, Gullo S, Hayami-Chisuwa N, He Q, Maïano C, Manzoni GM, Mellor D, Probst M, Fuller-Tyszkiewicz M. A longitudinal evaluation of a biopsychosocial model predicting BMI and disordered eating among young adults. AUSTRALIAN PSYCHOLOGIST 2023. [DOI: 10.1080/00050067.2023.2181686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Affiliation(s)
- Marita McCabe
- School of Health Sciences, Swinburne University, Hawthorn, Australia
| | - Manuel Alcaraz-Ibanez
- Health Research Center and Department of Education, University of Almeria, Almeria, Spain
| | - Charlotte Markey
- Department of Psychology, Health Sciences Centre, Rutgers University, Camden, NJ, USA
| | - Alvaro Sicilia
- Health Research Center and Department of Education, University of Almeria, Almeria, Spain
| | - Rachel F. Rodgers
- Department of Applied Psychology, North Eastern University, Boston, MA, USA
- Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, Montpellier, France
| | - Annie Aimé
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Saint-Jérôme, Canada
| | - Jacinthe Dion
- Department of Health Sciences, Université du Québec á Chicoutimi, Chicoutimi, Canada
| | - Giada Pietrabissa
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, S. Giuseppe Hospital, Oggebbio-Piancavallo, Italy
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Gianluca Lo Coco
- Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy
| | - Marie Caltabiano
- School of Psychology, James Cook University, Smithfield, Australia
| | - Esben Strodl
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia
| | | | | | - Gianluca Castelnuovo
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, S. Giuseppe Hospital, Oggebbio-Piancavallo, Italy
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | | | - Salvatore Gullo
- Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy
| | | | - Qiqiang He
- School of Health Sciences, Wuhan University, Wuhan, PR China
| | - Christoph Maïano
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Saint-Jérôme, Canada
| | - Gian Mauro Manzoni
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, S. Giuseppe Hospital, Oggebbio-Piancavallo, Italy
| | - David Mellor
- School of Psychology, Deakin University, Burwood, Australia
| | - Michel Probst
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Matthew Fuller-Tyszkiewicz
- School of Psychology, Deakin University, Burwood, Australia
- Center for Social and Early Emotional Development, Deakin University, Burwood, Australia
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Turnbull G, Lego S, Kennedy BL, Alexi J, Li YR, Engel MM, Mann G, Bayliss DM, Farrell S, Bell J. Sizing up the crowd: Assessing spatial integration difficulties in body size judgements across eating disorder symptomatology. Front Psychol 2023; 13:1003250. [PMID: 36687820 PMCID: PMC9853910 DOI: 10.3389/fpsyg.2022.1003250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 11/30/2022] [Indexed: 01/07/2023] Open
Abstract
Introduction Body size judgements are frequently biased, or inaccurate, and these errors are further exaggerated for individuals with eating disorders. Within the eating disorder literature, it has been suggested that exaggerated errors in body size judgements are due to difficulties with integration. Across two experiments, we developed a novel integration task, named the Ebbinghaus Illusion for Bodies in Virtual Reality (VR), to assess whether nearby bodies influence the perceived size of a single body. VR was used to simulate the appearance of a small crowd around a central target body. Method and Results In Experiment 1 (N = 412), participants were required to judge the size of a central female target within a crowd. Experiment 1 revealed an Ebbinghaus Illusion, in which a central female appeared larger when surrounded by small distractors, but comparatively smaller when surrounded by large distractors. In other words, the findings of Experiment 1 demonstrate that surrounding crowd information is integrated when judging an individual's body size; a novel measure of spatial integration (i.e., an Ebbinghaus Illusion for Bodies in VR). In Experiment 2 (N = 96), female participants were selected based on high (n = 43) and low (n = 53) eating disorder symptomatology. We examined whether the magnitude of this illusion would differ amongst those with elevated versus low eating disorder symptomatology, in accordance with weak central coherence theory, with the high symptomatology group displaying less spatial integration relative to the low group. The results of Experiment 2 similarly found an Ebbinghaus Illusion for Bodies in VR. However, illusion magnitude did not vary across high and low symptomatology groups. Discussion Overall, these findings demonstrate that surrounding crowd information is integrated when judging individual body size; however, those with elevated eating disorder symptomatology did not show any integration deficit on this broader measure of spatial integration.
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Affiliation(s)
- Georgia Turnbull
- School of Psychological Science, University of Western Australia, Crawley, WA, Australia,*Correspondence: Georgia Turnbull,
| | - Sophia Lego
- School of Psychological Science, University of Western Australia, Crawley, WA, Australia
| | - Briana L. Kennedy
- School of Psychological Science, University of Western Australia, Crawley, WA, Australia
| | - Joanna Alexi
- School of Psychological Science, University of Western Australia, Crawley, WA, Australia
| | - Yanqi R. Li
- School of Psychological Science, University of Western Australia, Crawley, WA, Australia
| | - Manja M. Engel
- Faculty of Social and Behavioural Sciences, Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, Netherlands
| | - Georgina Mann
- School of Psychological Science, University of Western Australia, Crawley, WA, Australia
| | - Donna M. Bayliss
- School of Psychological Science, University of Western Australia, Crawley, WA, Australia
| | - Simon Farrell
- School of Psychological Science, University of Western Australia, Crawley, WA, Australia
| | - Jason Bell
- School of Psychological Science, University of Western Australia, Crawley, WA, Australia
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Abstract
Instagram has grown in popularity among young adults and adolescents and is currently the second-favorite social network in the world. Research on its relationship to mental well-being is still relatively small and has yielded contradictory results. This study explores the relationship between time spent on Instagram and depressive symptoms, self-esteem, and disordered eating attitudes in a nonclinical sample of female Instagram users aged 18-35 years. In addition, it explores the mediating role of social comparison. A total of 1172 subjects completed a one-time-only online survey. Three different mediation analyses were performed to test the hypotheses that social comparison on Instagram mediates the association time spent on Instagram with depressive symptoms (model 1), self-esteem (model 2), and disordered eating attitudes (model 3). All three models showed that the relationship between intensity of Instagram use and the respective mental health indicator is completely mediated by the tendency for social comparison on Instagram.
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Wu J, Lin Z, Liu Z, He H, Bai L, Lyu J. Secular trends in the incidence of eating disorders in China from 1990 to 2017: a joinpoint and age-period-cohort analysis. Psychol Med 2022; 52:946-956. [PMID: 32744194 DOI: 10.1017/s0033291720002706] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Eating disorders (ED) have increasingly become a global topic of concern for public health. A better understanding of ED incidence is a basic requirement for improving its management. However, the temporal trend of ED incidence in China is still unknown. METHODS The incidence rates of ED from 1990 to 2017 were collected from the Global Burden of Disease Study 2017 database according to the following: subtype, i.e. anorexia nervosa (AN) and bulimia nervosa (BN); sex; and age group. The average annual percent changes and relative risks were calculated using joinpoint regression and the age-period-cohort model, respectively. RESULTS From 1990 to 2017, age-standardized incidence rates of ED continued to increase in males and females, and this variation trend was observed in AN and BN. Joinpoint regression analysis showed that the incidence rates increased in all age groups. Adolescents had the highest risk of developing ED, followed by young adults. Age effects were the most influential risk factor for ED incidence. Period effects showed that the risk of developing ED continuously increased with increasing time periods in BN, but not in ED and AN. Concerning the cohort effects, people born after the 1990s presented a higher risk of ED, though they presented a lower risk of BN as compared to the whole cohort. CONCLUSIONS ED incidence rates continue to increase in China, particularly among adolescents and young adults. Further etiological studies are needed to explain these increases and to facilitate the early identification of high-risk individuals.
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Affiliation(s)
- Jiayuan Wu
- School of Public Health, Xi'an Jiaotong University, Xi'an 710061, Shaanxi, China
- Department of Clinical Research, The Affiliated Hospital of Guangdong Medical University, Zhanjiang524001, Guangdong, China
| | - Zhixiong Lin
- Department of Psychiatry, The Affiliated Hospital of Guangdong Medical University, Zhanjiang524001, Guangdong, China
| | - Zhou Liu
- Department of Neurology, The Affiliated Hospital of Guangdong Medical University, Zhanjiang524001, Guangdong, China
| | - Hairong He
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, China
| | - Ling Bai
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, China
| | - Jun Lyu
- School of Public Health, Xi'an Jiaotong University, Xi'an 710061, Shaanxi, China
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, 510632, Guangdong, China
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eLoriCorps Immersive Body Rating Scale and eLoriCorps Mobile Versions: Validation to Assess Body Image Disturbances from Allocentric and Egocentric Perspectives in a Nonclinical Sample of Adolescents. J Clin Med 2022; 11:jcm11051156. [PMID: 35268247 PMCID: PMC8910931 DOI: 10.3390/jcm11051156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 01/28/2022] [Accepted: 02/19/2022] [Indexed: 12/17/2022] Open
Abstract
A growing number of studies have used virtual reality (VR) for the assessment and treatment of body image disturbances (BIDs). This study, conducted in a community sample of adolescents, documents the convergent and discriminant validity between (a) the traditional paper-based Figure Rating Scale (paper-based FRS), (b) the VR-based Body Rating Scale (eLoriCorps-IBRS 1.1), and (c) the mobile app-based Body Rating Scale (eLoriCorps-IBRS 1.1-Mobile). A total of 93 adolescents (14 to 18 years old) participated in the study. Body dissatisfaction and body distortion were assessed through the paper-based FRS, the eLoriCorps-IBRS 1.1 and the eLoriCorps-IBRS 1.1-Mobile. Eating disorder symptoms, body image avoidance, and social physique anxiety were also measured. Correlation analyses were performed. Overall, the results showed a good and statistically significant convergence between allocentric perspectives as measured by the paper-based FRS, the eLoriCorps-IBRS 1.1 and the eLoriCorps-IBRS 1.1-Mobile. As expected, the egocentric perspective measured in VR produced different results from the allocentric perspective, and from cognitive–attitudinal–affective dimensions of BIDs, with the exception of body distortion. These differences support the discriminant validity of the egocentric perspective of eLoriCorps-IBRS 1.1 and are consistent with emerging evidence, highlighting a difference between experiencing the body from an egocentric (i.e., the body as a subject) and allocentric (i.e., the body as an object) perspective. The egocentric perspective could reflect a perceptual–sensory–affective construction of BIDs, whereas allocentric measures seem to be more related to a cognitive–affective–attitudinal construction of BIDs. Moreover, the results support the validity of the eLoriCorps-IBRS 1.1-Mobile with promising perspectives of implementation among young populations.
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Koposov RA, Stickley A, Ruchkin V. Bulimia Symptoms in Russian Youth: Prevalence and Association With Internalizing Problems. Front Psychiatry 2022; 12:797388. [PMID: 35126206 PMCID: PMC8811208 DOI: 10.3389/fpsyt.2021.797388] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 12/23/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND There has been limited research on bulimia symptoms in adolescents from the general population outside the United States. This study aimed to evaluate the prevalence of bulimia symptoms in Russian youth and explore the associations between a clinical level of self-reported probable bulimia nervosa (BN) and internalizing problems, binge drinking and functional impairment by gender. METHODS Data were collected from a representative sample of school students (N = 2,515, 59.5% female) from Northern Russia [age M (SD) = 14.89 ± 1.13 years]. Probable BN and internalizing psychopathology were assessed using self-report scales. Chi-square and independent sample t-tests were used to compare respondents' demographic characteristics and disordered eating behaviors. GLM multivariate analysis of covariance was used to assess the associations between probable BN, functional impairment and mental health problems (MHP) by gender. RESULTS Analyses showed that the 3-month prevalence of probable BN was higher in girls (3.9%) than in boys (1.2%). Probable BN was associated with depressive and anxiety symptoms, somatic anxiety, somatic complaints, binge drinking and functional impairment. Boys reported a higher level of problem scores in relation to probable BN. CONCLUSIONS Our findings suggest that bulimia symptoms are prevalent in Russian adolescents and are associated with MHP and functional impairment. Timely recognition of bulimia symptoms and associated MHP is important for early prevention and intervention strategies.
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Affiliation(s)
- Roman A. Koposov
- Regional Centre for Child and Youth Mental Health and Child Welfare, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway
- Sechenov First Moscow State Medical University, Moscow, Russia
| | - Andrew Stickley
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
- Stockholm Center for Health and Social Change, Södertörn University, Huddinge, Sweden
| | - Vladislav Ruchkin
- Child and Adolescent Psychiatry Unit, Department of Neuroscience, Uppsala University, Uppsala, Sweden
- Child Study Center, Yale University Medical School, New Haven, CT, United States
- Säter Forensic Psychiatric Clinic, Säter, Sweden
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Scarpina F, Bastoni I, Villa V, Mendolicchio L, Castelnuovo G, Mauro L, Sedda A. Self-perception in anorexia nervosa: When the body becomes an object. Neuropsychologia 2022; 166:108158. [PMID: 35033502 DOI: 10.1016/j.neuropsychologia.2022.108158] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 01/11/2022] [Accepted: 01/11/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Women with anorexia nervosa (AN) act as if they have a larger body, as evidenced in obstacle avoidance tasks, where an allocentric perspective is adopted. This alteration emerges not only when they perform, but also when they imagine movements. However, no previous study has investigated own body centered tasks. As such, in this study we aim at documenting if women with AN show an altered behaviour also when the task requires a first-person perspective. METHOD We explored the performance of eleven woman affected by AN compared to eighteen matched controls, in two motor imagery tasks based on a self-frame of reference, the Hand Laterality Task and the Mental Motor Chronometry Task. Moreover, two control tasks relative to visual imagery were administered. RESULTS In the Hand Laterality Task, affected participants did not adopt a motor strategy to judge hands laterality (i.e. no biomechanical constraints effect). Crucially, they also showed an altered behavior in the control task. Similarly, they did not show the expected isochrony in the Mental Motor Chronometry Task, when actions pertained the left (but not the right) hand, in absence of any difference in the control task. CONCLUSIONS Our findings reveal altered imagery processes in AN. Specifically, affected participants adopt a third-person, rather than a first-person perspective, even when the task requires to imagine their own body in an internal frame of reference. In other words, participants with AN objectify body stimuli. Different mechanisms (i.e., checking behaviour; mirror self-reflection; altered multisensory integration) can explain such an altered imagery in AN.
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Affiliation(s)
- Federica Scarpina
- "Rita Levi Montalcini" Department of Neurosciences, University of Turin, Italy; I.R.C.C.S. Istituto Auxologico Italiano, U.O. di Neurologia e Neuroriabilitazione, Ospedale San Giuseppe, Piancavallo (VCO), Italy.
| | - Ilaria Bastoni
- I.R.C.C.S. Istituto Auxologico Italiano, U.O. dei Disturbi del Comportamento Alimentare, Ospedale San Giuseppe, Piancavallo (VCO), Italy; I.R.C.C.S. Istituto Auxologico Italiano, Laboratorio di Psicologia, Ospedale San Giuseppe, Piancavallo (VCO), Italy
| | - Valentina Villa
- I.R.C.C.S. Istituto Auxologico Italiano, U.O. dei Disturbi del Comportamento Alimentare, Ospedale San Giuseppe, Piancavallo (VCO), Italy; I.R.C.C.S. Istituto Auxologico Italiano, Laboratorio di Psicologia, Ospedale San Giuseppe, Piancavallo (VCO), Italy
| | - Leonardo Mendolicchio
- I.R.C.C.S. Istituto Auxologico Italiano, Laboratorio di Psicologia, Ospedale San Giuseppe, Piancavallo (VCO), Italy
| | - Gianluca Castelnuovo
- I.R.C.C.S. Istituto Auxologico Italiano, Laboratorio di Psicologia, Ospedale San Giuseppe, Piancavallo (VCO), Italy; Psychology Department, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Leonardo Mauro
- "Rita Levi Montalcini" Department of Neurosciences, University of Turin, Italy; I.R.C.C.S. Istituto Auxologico Italiano, U.O. di Neurologia e Neuroriabilitazione, Ospedale San Giuseppe, Piancavallo (VCO), Italy
| | - Anna Sedda
- Psychology Department, School of Social Sciences, Heriot-Watt University, Edinburgh, UK; Centre for Applied Behavioural Sciences, School of Social Sciences, Heriot-Watt University, UK
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Taniguchi E. Role of parental confirmation in body dissatisfaction and body change behaviors among college men. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2021; 69:520-528. [PMID: 31730753 DOI: 10.1080/07448481.2019.1684299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 09/02/2019] [Accepted: 10/20/2019] [Indexed: 06/10/2023]
Abstract
To examine how the components of confirmation (i.e., acceptance and challenge) from mother and father have an indirect effect on college men's body dissatisfaction through self-concept, and if body dissatisfaction, in turn, is related to body change behaviors. Participants: College men (N = 237) aged 18-25 from two large universities completed an online survey. Methods: Structural equation modeling was conducted to test hypothesized mediation model. Results: Maternal acceptance had negative indirect effects on body dissatisfaction through self-concept, and body dissatisfaction, in turn, was positively related to body change behaviors. Mother challenge emerged as a near-significant direct and positive predictor of muscularity enhancement behaviors. None of the paternal variables significantly contributed to the model. Conclusions: Mother acceptance may contribute to sons' positive view of self and their appearance, potentially reducing the likelihood of their engagement in body change behaviors. Intervention can target parent-child communication and enhancement of college men's self-concept.
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Affiliation(s)
- Emiko Taniguchi
- Department of Communicology, University of Hawaii at Manoa, Honolulu, Hawaii, USA
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12
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Horvath SA, Kolp HM, Andersen CV, Johnson EE, Racine SE, Borsari B, Stuart GL, Gidycz CA, Shorey RC. Emotion dysregulation moderates the relationship between alcohol use and eating pathology among heavy-drinking college men. J Clin Psychol 2021; 77:1763-1775. [PMID: 33971020 DOI: 10.1002/jclp.23157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 04/02/2021] [Accepted: 04/12/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVES There is limited research examining the relationship between alcohol use and eating pathology in men or factors that may moderate this association. The current study investigated the relationship between alcohol use and eating pathology, and examined emotion dysregulation as a moderator of this association, among heavy-drinking college men. METHOD Men mandated to receive an alcohol intervention (N = 88; average age = 19 years) completed questionnaires related to alcohol use, emotion dysregulation, and eating pathology. RESULTS Results demonstrated positive relationships between alcohol use and some eating pathology, and a significant interaction between alcohol use and emotion dysregulation. However, results were contrary to hypotheses, such that there was a positive relationship between alcohol use and eating pathology at low levels of emotion dysregulation. CONCLUSION Future studies should continue to examine the overall presentation of eating pathology in men and investigate factors that may impact the relationship between alcohol use and eating pathology.
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Affiliation(s)
- Sarah A Horvath
- Department of Psychology, Ohio University, Athens, Ohio, USA
| | - Haley M Kolp
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | | | - Ellen E Johnson
- Department of Psychology, Ohio University, Athens, Ohio, USA
| | - Sarah E Racine
- Department of Psychology, McGill University, Montreal, Qubec, Canada
| | - Brian Borsari
- Department of Psychiatry, University of California, San Francisco, California, USA
| | - Gregory L Stuart
- Department of Psychology, University of Tennessee, Knoxville, Tennessee, USA
| | | | - Ryan C Shorey
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
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13
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Trends in the prevalence and disability-adjusted life years of eating disorders from 1990 to 2017: results from the Global Burden of Disease Study 2017. Epidemiol Psychiatr Sci 2020; 29:e191. [PMID: 33283690 PMCID: PMC7737181 DOI: 10.1017/s2045796020001055] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
AIM Eating disorders have increasingly become a public health concern globally. This study aimed to reveal the burden of eating disorders at the global, regional and national levels using the Global Burden of Disease (GBD) Study 2017 data. METHODS We extracted the age-standardised rates (ASRs) of prevalence and disability-adjusted life years (DALYs) and their 95% uncertainty intervals (UIs) of eating disorders, including anorexia nervosa and bulimia nervosa, between 1990 and 2017 from the GBD 2017 data. The estimated annual percentage changes (EAPCs) were calculated to quantify the secular trends of the burden of eating disorders. RESULTS The ASRs of prevalence and the DALYs of eating disorders continuously increased worldwide from 1990 to 2017 by an average of 0.65 (95% UI: 0.59-0.71) and 0.66 (95% UI: 0.60-0.72), respectively. The burden of eating disorders was higher in females than in males, but the increment in ASRs was greater in males than in females over time. In 2017, the highest burden of eating disorders was observed in the high sociodemographic index (SDI) regions, especially Australasia (ASR of prevalence = 807.13, 95% UI: 664.20-982.30; ASR of DALYs = 170.74, 95% UI: 113.43-244.14, per 100 000 population), Western Europe and high-income North America. However, the most significant increment of the burden of eating disorders was observed in East Asia (EAPC for prevalence = 2.23, 95% UI: 2.14-2.32; EAPC for DALYs = 2.22, 95% UI: 2.13-2.31), followed by South Asia. An increasing trend in the burden of eating disorders at the national level was observed among most countries or territories. The countries with the top three highest increasing trends were Equatorial Guinea, Bosnia and Herzegovina and China. Positive associations were found between the burden estimates and the SDI levels in almost all geographic regions during the observed 28-year period. We also found that the human development indexes in 2017 were positively correlated with the EAPCs of the ASRs of prevalence (ρ = 0.222, P = 0.002) and DALYs (ρ = 0.208, P = 0.003). CONCLUSION The highest burden of eating disorders remains in the high-income western countries, but an increasing trend was observed globally and in all SDI-quintiles, especially in Asian regions that were highly populous. These results could help governments worldwide formulate suitable medical and health policies for the prevention and early intervention of eating disorders.
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Imperatori C, Massullo C, Carbone GA, Farina B, Colmegna F, Riboldi I, Giacomo ED, Clerici M, Dakanalis A. Electroencephalographic (EEG) alterations in young women with high subclinical eating pathology levels: a quantitative EEG study. Eat Weight Disord 2020; 25:1631-1642. [PMID: 31667777 DOI: 10.1007/s40519-019-00801-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 10/17/2019] [Indexed: 12/16/2022] Open
Abstract
PURPOSE To explore electroencephalographic (EEG) alterations in young women with different eating disorder (ED) psychopathology levels. METHODS Thirty-seven young women completed general and ED psychopathology (i.e., the ED Examination Questionnaire; EDE-Q) measures. EEG power spectra data were investigated in two conditions: (a) 5 min of resting state (RS) and (b) 5 min of RS after a single taste of a milkshake (ML-RS). EEG analyses were performed using exact Low-Resolution Electromagnetic Tomography software (eLORETA). RESULTS Cluster analysis performed on the EDE-Q responses revealed a group of 17 women with high levels of ED pathology falling into the subclinical (i.e., sub-threshold) EDs category and a group of 20 women with low levels of ED pathology (controls). In the RS conditions, no significant modifications were observed between groups. Compared to controls, women with subclinical EDs showed an increase in theta activity in the parieto-occipital areas in the ML-RS condition. After controlling for body mass index and general psychopathology, theta activity in these brain structures was positively associated with EDE-Q global and subscale (restraint, shape and weight concern) scores. CONCLUSIONS Our results may reflect the neurophysiological substrate of ED psychopathology core features like shape/weight concerns. Previous brain imaging and qEEG studies with full-syndrome ED patients also underscored the involvement of parieto-occipital areas in ED pathophysiology. These studies also found brain alterations in the RS condition, not observed here. This is notable given that full-syndrome and subclinical EDs are considered as different manifestations of the same disease along a severity spectrum. LEVEL OF EVIDENCE Level V, cross-sectional, electroencephalographic, descriptive study.
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Affiliation(s)
- Claudio Imperatori
- Department of Human Sciences, European University of Rome, Via degli Aldobrandeschi 190, 00163, Rome, Italy
| | - Chiara Massullo
- Department of Human Sciences, European University of Rome, Via degli Aldobrandeschi 190, 00163, Rome, Italy
| | - Giuseppe Alessio Carbone
- Department of Human Sciences, European University of Rome, Via degli Aldobrandeschi 190, 00163, Rome, Italy
| | - Benedetto Farina
- Department of Human Sciences, European University of Rome, Via degli Aldobrandeschi 190, 00163, Rome, Italy
| | - Fabrizia Colmegna
- Department of Psychiatry, San Gerardo Hospital, ASST Monza, Via G. B. Pergolesi 33, 20900, Monza, Italy
| | - Ilaria Riboldi
- Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 48, 20900, Monza, Italy
| | - Ester Di Giacomo
- Department of Psychiatry, San Gerardo Hospital, ASST Monza, Via G. B. Pergolesi 33, 20900, Monza, Italy.,Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 48, 20900, Monza, Italy
| | - Massimo Clerici
- Department of Psychiatry, San Gerardo Hospital, ASST Monza, Via G. B. Pergolesi 33, 20900, Monza, Italy.,Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 48, 20900, Monza, Italy
| | - Antonios Dakanalis
- Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 48, 20900, Monza, Italy.
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15
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Hazzard VM, Loth KA, Berge JM, Larson NI, Fulkerson JA, Neumark-Sztainer D. Does exposure to controlling parental feeding practices during adolescence predict disordered eating behaviors 8 years later in emerging adulthood? Pediatr Obes 2020; 15:e12709. [PMID: 32794367 PMCID: PMC7501224 DOI: 10.1111/ijpo.12709] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 07/15/2020] [Indexed: 01/04/2023]
Abstract
OBJECTIVES To examine how exposure to controlling parental feeding practices during adolescence is associated with disordered eating behaviors in emerging adulthood. METHODS Data were analyzed from 543 males and 769 females (Mage at baseline = 14.5 years, Mage at follow-up = 22.7 years) and their parents who participated in the population-based EAT 2010-2018 and Project F-EAT studies. Parental food restriction and pressure-to-eat practices were assessed with items from the Child Feeding Questionnaire. Regression models predicted chronic dieting, unhealthy weight control behaviors, and binge eating, adjusted for demographic covariates, adiposity, and outcome at baseline. RESULTS Overall, exposure to controlling parental feeding practices during adolescence was not associated with disordered eating behaviors at eight-year follow-up, with one exception. Among males, maternal pressure-to-eat was associated with greater risk of chronic dieting in emerging adulthood. CONCLUSIONS By emerging adulthood, other factors may be more salient with regard to disordered eating outcomes than parental feeding practices during adolescence.
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Affiliation(s)
| | - Katie A. Loth
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Jerica M. Berge
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Nicole I. Larson
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | | | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
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16
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" eLoriCorps Immersive Body Rating Scale": Exploring the Assessment of Body Image Disturbances from Allocentric and Egocentric Perspectives. J Clin Med 2020; 9:jcm9092926. [PMID: 32927847 PMCID: PMC7564525 DOI: 10.3390/jcm9092926] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 09/01/2020] [Accepted: 09/02/2020] [Indexed: 12/27/2022] Open
Abstract
The first objective of this study was to test the convergent and discriminant validity between the “eLoriCorps Immersive Body Rating Scale” and the traditional paper-based figure rating scale (FRS). The second objective was to explore the contribution of the egocentric virtual reality (VR) perspective of eLoriCorps to understanding body image disturbances (BIDs). The sample consisted of 53 female and 13 male adults. Body size dissatisfaction, body size distortion, perceived body size, and ideal body size were assessed. Overall, outcomes showed good agreement between allocentric perspectives as measured via VR and the FRS. The egocentric VR perspective produced different results compared to both the allocentric VR perspective and the FRS. This difference revealed discriminant validity and suggested that eLoricorps’ egocentric VR perspective might assess something different from the traditional conception of body dissatisfaction, which an allocentric VR perspective generally assesses. Finally, the egocentric VR perspective in assessing BIDs deserves to be studied more extensively to explore the possibility of finding two types of body image distortion: (a) an egocentric perceptual body distortion, referring to internal body sensation affected by intra-individual changes, and (b) an allocentric perceptual body distortion, referring to external body benchmarks constructed by inter-individual comparison occurring in a given cultural context.
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17
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Lander R, Heled E, Gur E. Executive functioning and spatial processing in anorexia nervosa: an experimental study and its significance for the allocentric lock theory. Eat Weight Disord 2020; 25:1039-1047. [PMID: 31209765 DOI: 10.1007/s40519-019-00728-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 06/04/2019] [Indexed: 12/28/2022] Open
Abstract
PURPOSE The allocentric lock theory (ALT) suggests that people with eating disorders have difficulties in multisensory integration in two reference frames-egocentric and allocentric, whereby the egocentric, but not allocentric, is impaired. This leads to a distorted body image that contributes to the development and maintenance of the disorder. The current study aimed to explore a facet of the ALT, namely, the visuo-spatial aspect, and its relation to cognitive flexibility in patients with anorexia nervosa (AN). METHODS Fifty-five participants took part in the study: 20 AN patients and 35 controls, matched by age and education. The object perspective taking test (OPTT) and the mental rotation test (MRT), tapping egocentric and allocentric representations, respectively, and a set-shifting task were administered. The brief symptom inventory was used to measure overall levels of distress. RESULTS AN patients showed higher level of distress. They performed poorer on the OPTT and set-shifting task but not on the MRT. The OPTT and MRT were correlated for controls but not for AN patients, while the set-shifting task and body mass index were associated with the OPTT but not with the MRT for the AN patients. CONCLUSIONS The findings support the ALT by demonstrating impaired visual egocentric representations and intact allocentric visual functions in AN patients, with cognitive flexibility associated only with the egocentric frame. Therefore, egocentric frame impairment in AN patients may be influenced by visual perception and cognitive flexibility deficiency. LEVEL OF EVIDENCE Level III: case-control analytic study.
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Affiliation(s)
- Ravid Lander
- Department of Psychology, Ariel University, Ariel, Israel
| | - Eyal Heled
- Department of Psychology, Ariel University, Ariel, Israel. .,Neurological Rehabilitation Unit, Sheba Medical Center, Ramat Gan, Israel.
| | - Eitan Gur
- Department of Eaing Disorders, Sheba Medical Center, Ramat Gan, Israel
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18
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Serino S, Scarpina F, Chirico A, Dakanalis A, Di Lernia D, Colombo D, Catallo V, Pedroli E, Riva G. Gulliver's virtual travels: active embodiment in extreme body sizes for modulating our body representations. Cogn Process 2020; 21:509-520. [PMID: 32506217 PMCID: PMC7679308 DOI: 10.1007/s10339-020-00977-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Accepted: 04/27/2020] [Indexed: 12/23/2022]
Abstract
It is noted that the perceptual experience of body and space can be modulated by changing the action capabilities or by manipulating the perceived body dimensions through a multisensory stimulation. This study adds to pre-existing literature by investigating the alterations in bodily experience following embodiment to both enlarged and shrunked bodies, while participants actively navigated in a virtual environment. A normal-sized body served as a reference condition. After each embodied navigation, participants estimated the height and width of three different body parts. Results revealed that the embodiment over shrunked body induced a significant reduction in participants' body image, while no changes were reported after the embodiment over the enlarged body. Findings were discussed in terms of previous literature exploring the constraints implicated in the ownership over different bodies.
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Affiliation(s)
- S Serino
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano IRCCS, Via Magnasco 2, 20149, Milan, Italy.
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo Gemelli, 1, 20100, Milan, Italy.
- MySpace Lab, Department of Clinical Neuroscience, University Hospital Lausanne (CHUV), Avenue Pierre Decker 5 CH-1011, Lausanne, Switzerland.
| | - F Scarpina
- Istituto Auxologico Italiano, IRCCS, U.Odi Neurologia e Neuoriabilitazione, Ospedale San Giuseppe, Via Cadorna, 90, 28824, Piancavallo (VCO), Italy
- "Rita Levi Montalcini" Department of Neuroscience, University of Turin, Via Cherasco, 15, 10126, Turin, Italy
| | - A Chirico
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo Gemelli, 1, 20100, Milan, Italy
| | - A Dakanalis
- Department of Brain and Behavioral Sciences, University of Pavia Italy, Piazza Botta, 6, 27100, Pavia, Italy
- Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 48, 20900, Monza, Italy
| | - D Di Lernia
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo Gemelli, 1, 20100, Milan, Italy
| | - D Colombo
- Department of Basic Psychology, Clinic and Psychobiology, Universitat Jaume I, Av. Sos Baynat, s/n, 12071, Castellón, Spain
| | - V Catallo
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano IRCCS, Via Magnasco 2, 20149, Milan, Italy
| | - E Pedroli
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano IRCCS, Via Magnasco 2, 20149, Milan, Italy
- Faculty of Psychology, eCampus University, Via Isimbardi, 10, 22060, Novedrate, Italy
| | - G Riva
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano IRCCS, Via Magnasco 2, 20149, Milan, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo Gemelli, 1, 20100, Milan, Italy
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19
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Navarro J, Cebolla A, Llorens R, Borrego A, Baños RM. Manipulating Self-Avatar Body Dimensions in Virtual Worlds to Complement an Internet-Delivered Intervention to Increase Physical Activity in Overweight Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17114045. [PMID: 32517117 PMCID: PMC7312466 DOI: 10.3390/ijerph17114045] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 06/01/2020] [Accepted: 06/02/2020] [Indexed: 01/13/2023]
Abstract
Virtual reality has been found to be a useful tool for positively influencing relevant psychological variables in order to increase physical activity (PA), especially in the overweight population. This study investigates the use of avatars and their physical variations to extend the effectiveness of existing interventions to promote PA. The main objective is to analyze the influence of the avatars' body dimensions on the efficacy of an Internet intervention to increase PA levels and improve other relevant variables (motivation toward PA, enjoyment, anxiety, self-efficacy, and PA goals). A total of 42 overweight women received a brief online intervention, and they were randomly assigned to one of three conditions: the "Ideal avatar" (IAC: participants are represented by avatars with ideal body dimensions); the "Real avatar" (RAC: participants are represented by avatars with participants' current body dimensions); and the "Non avatar" (NAC: participants are not represented by avatars). Results showed that the online intervention was effective in increasing PA practice and self-efficacy expectations. However, manipulating the body dimensions of avatars did not improve this intervention, although ideal avatars helped to reduce the anxiety experienced during PA in this population.
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Affiliation(s)
- Jessica Navarro
- Department of Personality, Evaluation and Psychological Treatment, University of Valencia, 46010 Valencia, Spain; (A.C.); (R.M.B.)
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute, 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-96-386-44-12
| | - Ausiàs Cebolla
- Department of Personality, Evaluation and Psychological Treatment, University of Valencia, 46010 Valencia, Spain; (A.C.); (R.M.B.)
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute, 28029 Madrid, Spain
| | - Roberto Llorens
- Neurorehabilitation and Brain Research Group, Instituto de investigación e Innovación en Bioingenieria, Universitat Politécnica de Valencia, 46022 Valencia, Spain; (R.L.); (A.B.)
- NEURORHB, Servicio de Neurorrehabilitación de Hospitales Vithas, 46007 Valencia, Spain
| | - Adrián Borrego
- Neurorehabilitation and Brain Research Group, Instituto de investigación e Innovación en Bioingenieria, Universitat Politécnica de Valencia, 46022 Valencia, Spain; (R.L.); (A.B.)
| | - Rosa M. Baños
- Department of Personality, Evaluation and Psychological Treatment, University of Valencia, 46010 Valencia, Spain; (A.C.); (R.M.B.)
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute, 28029 Madrid, Spain
- Polibienestar Institute, 46022 Valencia, Spain
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20
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Williamson G, Guidinger C, Kelly NR. Low body mass and ethnic identity exploration exacerbate the association between body image concerns and loss of control eating in Hispanic/Latino men. Int J Eat Disord 2020; 53:180-190. [PMID: 31490573 DOI: 10.1002/eat.23168] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 08/19/2019] [Accepted: 08/21/2019] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Although Hispanic/Latino populations have some of the highest rates of obesity in the United States, little is known about their loss of control (LOC) eating, a robust predictor of excess weight gain. This study examined the association between body image concerns and LOC eating frequency in a sample of young Hispanic/Latino men. Body mass index (BMI), ethnic identity, and acculturation were examined as potential moderators. METHOD The sample included 271 Hispanic/Latino men between the ages of 18 and 30 years (Mage = 23.89 ± 3.54; MBMI = 26.46 ± 5.82). Participants completed an online survey and reported on height, weight, and demographic characteristics; concerns with muscularity and body fat; LOC eating frequency in the last 28 days; ethnic identity; and perceived acculturation. RESULTS Negative binomial regression models were conducted, adjusting for BMI, income, education, and presence of a psychiatric diagnosis. Concerns with muscularity and body fat were positively associated with LOC eating frequency (ps < .001). Low BMI exacerbated the link between concerns with body fat and LOC eating frequency (p = .03). The positive association between concerns with muscularity and LOC eating frequency was exacerbated among those who reported low ethnic identity exploration (p = .01). While acculturation did not function as a moderator (ps = .14-.27), it was inversely associated with LOC eating frequency (p < .001). DISCUSSION BMI and ethnic identity are important individual factors to consider in the link between body image concerns and LOC eating among young Hispanic/Latino men.
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Affiliation(s)
- Gina Williamson
- Counseling Psychology and Human Services, University of Oregon, Eugene, Oregon.,The Prevention Science Institute, University of Oregon, Eugene, Oregon
| | - Claire Guidinger
- Counseling Psychology and Human Services, University of Oregon, Eugene, Oregon.,The Prevention Science Institute, University of Oregon, Eugene, Oregon
| | - Nichole R Kelly
- Counseling Psychology and Human Services, University of Oregon, Eugene, Oregon.,The Prevention Science Institute, University of Oregon, Eugene, Oregon
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21
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Alcaraz-Ibáñez M, Sicilia A, Paterna A. Examining the associations between the Big Five personality traits and body self-conscious emotions. Psych J 2019; 9:392-401. [PMID: 31795021 DOI: 10.1002/pchj.324] [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: 04/08/2019] [Revised: 08/26/2019] [Accepted: 10/21/2019] [Indexed: 11/11/2022]
Abstract
This study examined the relationships between the Big Five personality traits and body-related self-conscious emotions in a sex-balanced sample of Spanish undergraduates (N = 748). After controlling for sex, age, and weight discrepancy, neuroticism (positive for shame and guilt), extraversion (negative for shame and positive for pride), conscientiousness (negative for shame and positive for pride), and openness (negative for shame and guilt) emerged as significant cross-sectional predictors of body-related self-conscious emotions. No moderation effect by sex was observed. The explained variance ranged from 10% (hubristic pride) to 26% (shame). Young adults possessing greater than ideally assumed body weight, high levels of neuroticism, and low levels of extraversion, conscientiousness, and openness may be especially vulnerable to body-image disturbances.
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Affiliation(s)
- Manuel Alcaraz-Ibáñez
- Departamento de Educación and Centro de Investigación en Salud, Universidad de Almería, Almería, Spain
| | - Alvaro Sicilia
- Departamento de Educación and Centro de Investigación en Salud, Universidad de Almería, Almería, Spain
| | - Adrian Paterna
- Departamento de Educación and Centro de Investigación en Salud, Universidad de Almería, Almería, Spain
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22
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Dondzilo L, Rodgers RF, Turnbull G, Bell J. The importance of motivational orientation towards the muscular ideal versus the stigmatised burdensome body in male body dissatisfaction. Body Image 2019; 31:81-87. [PMID: 31476658 DOI: 10.1016/j.bodyim.2019.08.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 08/23/2019] [Accepted: 08/24/2019] [Indexed: 10/26/2022]
Abstract
Internalisation of the muscular ideal is a vulnerability factor for body dissatisfaction in males. It is unclear, however, whether body dissatisfaction results from approach towards the muscular ideal versus fear of the stigmatised burdensome body. The current study sought to address this gap by assessing both approach and avoidance motivation regarding muscular and non-muscular bodies, respectively, and evaluating the unique associations between approach-avoidance tendencies and body dissatisfaction. Eighty-three male undergraduate students completed an implicit measure of approach-avoidance tendencies, the Stimulus Response Compatibility task, and a self-report measure of trait body dissatisfaction. Results revealed that participants were quicker to approach than to avoid muscular bodies; however, there were no differences in approach vs. avoidance tendencies regarding non-muscular bodies. Furthermore, in a multiple regression model comprising motivational bias scores regarding muscular and non-muscular bodies, only an approach bias towards muscular bodies predicted unique variance in body dissatisfaction. These findings are novel in showing an implicit approach motivation towards the muscular ideal in male undergraduates. Furthermore, in this population, motivational orientation towards the muscular ideal, versus the stigmatised burdensome body, seems to be more tightly associated with body dissatisfaction.
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Affiliation(s)
- Laura Dondzilo
- School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia.
| | - Rachel F Rodgers
- APPEAR, Department of Applied Psychology, Northeastern University, Boston, United States; Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHRU Montpellier, France
| | - Georgia Turnbull
- School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia
| | - Jason Bell
- School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia
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Diniz E, Bernardes SF, Castro P. Self- and Other-Dehumanization Processes in Health-Related Contexts: A Critical Review of the Literature. REVIEW OF GENERAL PSYCHOLOGY 2019. [DOI: 10.1177/1089268019880889] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Dehumanization is an everyday, pervasive phenomenon in health contexts. Given its detrimental consequences to health care, much research has been dedicated to understanding and promoting the humanization of health services. However, health care service research has neglected the sociopsychological processes involved in the dehumanization of self and others, in formal but also informal health-related contexts. Drawing upon sociopsychological models of dehumanization, this article will bridge this gap by presenting a critical review of studies on everyday meaning-making and person perception processes of dehumanization in health-related contexts. A database search was conducted in PsycINFO, Web of Science, Scopus, and PubMed, using a combination of keywords on dehumanization and health/illness/body; 3,229 references were screened; 95 full texts were assessed for eligibility; 59 studies were included. Most studies focused on informal contexts, reflecting a decontextualized and one-sided view of dehumanization (i.e., not integrating actors’ and victims’ perspectives). Despite the dominant focus on self-dehumanization, emerging perspectives uncover the role of processes that deny human uniqueness to others, and their individual determinants and consequences for mental health. A few studies bring to light the functions of a variety of dehumanizing body metaphors on self- and other-dehumanization. These trends in the literature leave several gaps, which are here critically analyzed to inform future research.
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Affiliation(s)
- Eva Diniz
- ISCTE-Instituto Universitário de Lisboa (ISCTE-IUL), Centro de Investigação e Intervenção Social (CIS-IUL), Lisbon, Portugal
| | - Sónia F. Bernardes
- ISCTE-Instituto Universitário de Lisboa (ISCTE-IUL), Centro de Investigação e Intervenção Social (CIS-IUL), Lisbon, Portugal
| | - Paula Castro
- ISCTE-Instituto Universitário de Lisboa (ISCTE-IUL), Centro de Investigação e Intervenção Social (CIS-IUL), Lisbon, Portugal
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Dakanalis A, Clerici M, Stice E. Prevention of eating disorders: current evidence-base for dissonance-based programmes and future directions. Eat Weight Disord 2019; 24:597-603. [PMID: 31147968 DOI: 10.1007/s40519-019-00719-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 05/21/2019] [Indexed: 12/11/2022] Open
Affiliation(s)
- Antonios Dakanalis
- Department of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, 20900, Monza, Italy.
| | - Massimo Clerici
- Department of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, 20900, Monza, Italy
| | - Eric Stice
- Oregon Research Institute, 1776 Millrace Drive, Eugene, OR, 97403, USA
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Abstract
OBJECTIVE The literature on eating disorders in older males is still very limited. We assessed the relationship between aging male symptomatology and eating behavior in middle-aged and older men. METHOD We distributed anonymous questionnaires to men aged 40-75 years living in or near Innsbruck, Austria, covering demographic items, current eating disorder symptoms (as defined by DSM-5), and associated measures of eating pathology, body image, and sports activity (including exercise addiction). We also administered the Aging Males' Symptoms scale (AMS), and classified respondents as "high-AMS" (AMS score ≥37; N = 82) or "low-AMS" (AMS score <37; N = 386). RESULTS High-AMS men reported a significantly higher mean current BMI, a greater prevalence of eating disorder symptoms, higher scores on the Eating Disorder Examination Questionnaire, greater risk of exercise addiction, and more negative body image than low-AMS men. DISCUSSION We found a marked association between aging-male symptomatology and eating-disorder symptomatology in aging men. Our findings suggest that clinicians should carefully inquire about eating disorder symptoms in men aged 40 and above reporting aging-male symptomatology. Importantly, several men in the study reported "purging" via excessive exercise (as opposed to the more common methods of vomiting or use of laxatives or diuretics), and therefore this should be a subject of inquiry in clinical evaluations. To pursue these findings, subsequent studies of eating disorders in older men should consider assessing endocrinological measures, particularly testosterone levels, and should use longitudinal designs.
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Affiliation(s)
- Kai K Kummer
- a Department of Psychiatry, Psychotherapy and Psychosomatics , Medical University of Innsbruck , Innsbruck , Austria
| | - Harrison G Pope
- b McLean Hospital/Harvard Medical School , Belmont , MA , USA
| | - James I Hudson
- b McLean Hospital/Harvard Medical School , Belmont , MA , USA
| | - Georg Kemmler
- a Department of Psychiatry, Psychotherapy and Psychosomatics , Medical University of Innsbruck , Innsbruck , Austria
| | | | - Barbara Mangweth-Matzek
- a Department of Psychiatry, Psychotherapy and Psychosomatics , Medical University of Innsbruck , Innsbruck , Austria
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Corno G, Serino S, Cipresso P, Baños RM, Riva G. Assessing the Relationship Between Attitudinal and Perceptual Component of Body Image Disturbance Using Virtual Reality. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2019; 21:679-686. [PMID: 30421995 DOI: 10.1089/cyber.2018.0340] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Body image disturbance (BID) affects quality of life even in the absence of clinically diagnosable eating pathology, and numerous studies have shown its crucial role in the emergence and maintenance of eating disorders. This study aimed at exploring attitudinal and perceptual components of BID using a novel virtual reality (VR)-based paradigm. A community sample of women (N = 27) recreated in VR their perceived body in both an allocentric (third-person view) and egocentric (first-person view) perspective. Specifically, women were able to choose between a wide range of three-dimensional bodies spanning body mass index 12.5-42.5 kg/m2. Attitudinal indexes of BID (body dissatisfaction, body uneasiness, and body image avoidance) were assessed through questionnaires. Attitudinal components predicted the perceptual BID only in the allocentric perspective. Specifically, overestimation was predicted by body image avoidance, while underestimation was predicted by body uneasiness. Furthermore, a common predictor of underestimation and overestimation was body dissatisfaction. In line with the allocentric lock hypothesis, the current results seem to confirm the presence of two different mechanisms underlying BID: one related to real-time perception-driven inputs (egocentric frame) and one related to abstract knowledge, beliefs, and attitudes related to a person's body (allocentric frame). These findings contribute to a better understanding of the nature and mechanisms underlying BID and provide additional evidence about the suitability of using VR for exploring and assessing body image-related components and disturbances.
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Affiliation(s)
- Giulia Corno
- 1 Applied Technology for Neuro-Psychology Lab, I.R.C.C.S. Istituto Auxologico Italiano , Milan, Italy
| | - Silvia Serino
- 1 Applied Technology for Neuro-Psychology Lab, I.R.C.C.S. Istituto Auxologico Italiano , Milan, Italy .,2 Department of Psychology, Università Cattolica del Sacro Cuore , Milan, Italy
| | - Pietro Cipresso
- 1 Applied Technology for Neuro-Psychology Lab, I.R.C.C.S. Istituto Auxologico Italiano , Milan, Italy .,2 Department of Psychology, Università Cattolica del Sacro Cuore , Milan, Italy
| | - Rosa M Baños
- 3 Departamento Personalidad, Evaluación y Tratamientos Psicológicos, Universitat de Valencia , Valencia, Spain .,4 CIBER Pathophysiology of Obesity and Nutrition (CB06/03), Carlos III Institute of Health , Madrid, Spain
| | - Giuseppe Riva
- 1 Applied Technology for Neuro-Psychology Lab, I.R.C.C.S. Istituto Auxologico Italiano , Milan, Italy .,2 Department of Psychology, Università Cattolica del Sacro Cuore , Milan, Italy
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Timko CA, DeFilipp L, Dakanalis A. Sex Differences in Adolescent Anorexia and Bulimia Nervosa: Beyond the Signs and Symptoms. Curr Psychiatry Rep 2019; 21:1. [PMID: 30637488 PMCID: PMC6559358 DOI: 10.1007/s11920-019-0988-1] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE OF REVIEW We review research related to sex differences in eating disorders (EDs) in adolescents. Prior work has explored clinical differences; thus, we examine literature in areas identified as playing an etiological or maintenance role in EDs including: genetics, hormones, neurocognitive inefficiencies, and reward circuitry. RECENT FINDINGS Sex steroids appear to a play role in the unmasking of genetic risk for development of EDs and puberty may be a heightened period of risk for females. While neurocognitive differences have been well studied in adults with ED, research with adolescents has been less conclusive. Recent work suggests that neural circuitry involved in reward and punishment may play role in development and maintenance of EDs in females. Males are underrepresented in these areas of research. Given known sex differences in healthy adolescents, it is likely there are sex differences in the putative biological etiology/maintenance of EDs. Males should be included in future research.
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Affiliation(s)
- C Alix Timko
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
- Department of Child and Adolescent Psychiatry and Behavioral Science, Robert's Center for Pediatric Research, 2716 South Street, 8-212, Philadelphia, PA, 19146, USA.
| | - Levi DeFilipp
- Department of Child and Adolescent Psychiatry and Behavioral Science, Robert's Center for Pediatric Research, 2716 South Street, 8-212, Philadelphia, PA, 19146, USA
| | - Antonios Dakanalis
- Department of Medicine and Surgery, University of Milano Bicocca, Cadore 48, 20900, Monza, Italy
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Abstract
Disordered eating (DE) is known to predominate among girls, and historically studies have focused primarily on them. This cross-sectional study aimed to investigate the characteristics of adolescent and young adult males at risk of DE. Participants (N = 2269; 15-24 years) in a study assessing their lifestyle were divided into two groups based on the SCOFF five-question screening tool: a SCOFF[+] group for participants at risk of disordered eating, and a SCOFF[-] group for everyone else. SCOFF[+] participants were more likely to be overweight and obese; have a lower socio-economic status and non-Swiss parents; experience weight issues; and report a chronic condition, poorer emotional well-being and a less positive attitude towards life. With 10% of males at risk of DE, clinicians should be aware of their specific characteristics, which should be considered red flags. DE is no longer a female-specific issue.
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Giraldo-O'Meara M, Belloch A. Escalation from normal appearance related intrusive cognitions to clinical preoccupations in Body Dysmorphic Disorder: A cross-sectional study. Psychiatry Res 2018; 265:137-143. [PMID: 29704773 DOI: 10.1016/j.psychres.2018.04.047] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 03/22/2018] [Accepted: 04/13/2018] [Indexed: 10/17/2022]
Abstract
Current cognitive approaches to Body Dysmorphic Disorder (BDD) assume that appearance-related intrusive cognitions and their functional consequences characterize the disorder, in a similar way that obsessive intrusive thoughts characterize the Obsessive-Compulsive Disorder (OCD). This study explores whether normal but unwanted appearance-related intrusive thoughts (AITs), escalate to clinical AITs when they are dysfunctionally appraised and instigate counterproductive neutralizing strategies. From a sample of 344 non-clinical individuals who reported a highly upsetting AIT during the past three months two subgroups were extracted according to their high (n = 68) and low (n = 276) vulnerability to BDD. The subjects in the high-risk group obtained significantly higher scores on the frequency of the most disturbing AIT and its emotional impact, interference, and appraisals evaluated with the Appearance Intrusions Questionnaire (AIQ). Additionally, two subgroups of 15 subjects each, with high and low risk to BDD, were formed and their scores were compared to 10 patients with BDD. The AIT had a greater emotional negative impact and more severe consequences on individuals with BDD compared to individuals at high-risk of BDD, which in turn, reported worse consequences of the AIT than those at low-risk. These results empirically support the similarities between BDD and OCD regarding their functional and phenomenological characteristics.
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Affiliation(s)
- Martha Giraldo-O'Meara
- Department of Personality Psychology, Research Unit for Obsessive-Compulsive and Related Disorders (I'TOC), Facultad de Psicología, Universidad de Valencia, Spain. http://www.itoc.org.es
| | - Amparo Belloch
- Department of Personality Psychology, Research Unit for Obsessive-Compulsive and Related Disorders (I'TOC), Facultad de Psicología, Universidad de Valencia, Spain.
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30
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Personality and eating and weight disorders: an open research challenge. Eat Weight Disord 2018; 23:143-147. [PMID: 29177759 DOI: 10.1007/s40519-017-0463-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Accepted: 11/08/2017] [Indexed: 10/18/2022] Open
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Dakanalis A, Alix Timko C, Colmegna F, Riva G, Clerici M. Evaluation of the DSM-5 severity ratings for anorexia nervosa in a clinical sample. Psychiatry Res 2018; 262:124-128. [PMID: 29428775 DOI: 10.1016/j.psychres.2018.02.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 01/11/2018] [Accepted: 02/02/2018] [Indexed: 10/18/2022]
Abstract
We examined the validity and utility of the DSM-5 severity ratings for anorexia nervosa (AN) in a clinical (treatment-seeking) sample (N = 273; 95.6% women). Participants classified with mild, moderate, severe, and extreme severity of AN based on their measured body mass index, differed significantly from each other in eating disorder features, putative maintenance factors, and illness-specific functional impairment (medium effect sizes). However, they were statistically indistinguishable in psychiatric-disorder comorbidity and distress, demographics, and age-of-AN onset. The implications of our findings, providing limited support for the DSM-5 severity ratings for AN, and directions for future research are outlined.
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Affiliation(s)
- Antonios Dakanalis
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy; Department of Brain and Behavioral Sciences, University of Pavia, Italy.
| | - C Alix Timko
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, USA; Children's Hospital of Philadelphia, Philadelphia, USA
| | - Fabrizia Colmegna
- Mental Health Department, San Gerardo Monza Health and Social Care Trust, Monza, Italy
| | - Giuseppe Riva
- Department of Psychology, Catholic University of Milan, Italy; Applied Technology for Neuro-Psychology Laboratory, Istituto Auxologico Italiano, Milan, Italy
| | - Massimo Clerici
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy; Mental Health Department, San Gerardo Monza Health and Social Care Trust, Monza, Italy
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32
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Riva G, Dakanalis A. Altered Processing and Integration of Multisensory Bodily Representations and Signals in Eating Disorders: A Possible Path Toward the Understanding of Their Underlying Causes. Front Hum Neurosci 2018; 12:49. [PMID: 29483865 PMCID: PMC5816057 DOI: 10.3389/fnhum.2018.00049] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 01/26/2018] [Indexed: 01/25/2023] Open
Abstract
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM V) eating problems are the clinical core of eating disorders (EDs). However, the importance of shape and weight overvaluation symptoms in these disorders underlines the critical role of the experience of the body in the etiology of EDs. This article suggests that the transdiagnostic centrality of these symptoms in individuals with EDs may reflect a deficit in the processing and integration of multisensory bodily representations and signals. Multisensory body integration is a critical cognitive and perceptual process, allowing the individual to protect and extend her/his boundaries at both the homeostatic and psychological levels. To achieve this goal the brain integrates sensory data arriving from real-time multiple sensory modalities and internal bodily information with predictions made using the stored information about the body from conceptual, perceptual, and episodic memory. In this view the emotional, visual, tactile, proprioceptive and interoceptive deficits reported by many authors in individuals with EDs may reflect a broader impairment in multisensory body integration that affects the individual's abilities: (a) to identify the relevant interoceptive signals that predict potential pleasant (or aversive) consequences; and (b) to modify/correct the autobiographical allocentric (observer view) memories of body related events (self-objectified memories). Based on this view, the article also proposes a strategy, based on new technologies (i.e., virtual reality and brain/body stimulation), for using crossmodal associations to reactivate and correct the multisensory body integration processes.
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Affiliation(s)
- Giuseppe Riva
- Centro Studi e Ricerche di Psicologia della Comunicazione, Università Cattolica del Sacro Cuore, Milan, Italy
- Applied Technology for Neuro-Psychology Laboratory, Istituto Auxologico Italiano (IRCCS), Milan, Italy
| | - Antonios Dakanalis
- Department of Medicine and Surgery, Università degli Studi di Milano Bicocca, Milan, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
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33
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Dakanalis A, Colmegna F, Zanetti MA, Di Giacomo E, Riva G, Clerici M. Evaluation of the DSM-5 Severity Specifier for Bulimia Nervosa in Treatment-Seeking Youth. Child Psychiatry Hum Dev 2018; 49:137-145. [PMID: 28510006 DOI: 10.1007/s10578-017-0735-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
A new severity specifier for bulimia nervosa (BN), based on the frequency of inappropriate weight compensatory behaviours (e.g., laxative misuse, self-induced vomiting, fasting, diuretic misuse, and excessive exercise), has been added to the most recent (fifth) edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a means of addressing variability and heterogeneity in the severity of the disorder. While existing research provides support for the DSM-5 severity specifier for BN in adult patients, evidence for its validity and clinical utility in youth is currently lacking. To address this gap, data from 272 treatment-seeking adolescents with DSM-5 BN (94.2% female, M age = 15.3 years, SD 1.7) were analysed to examine whether these patients, sub-grouped based on the DSM-5 severity definitions, would show meaningful differences in a broad range of clinical variables and demographic and physical characteristics. Analyses revealed that participants categorized with mild, moderate, severe, and extreme severity of BN significantly differed from each other in 15 variables regarding eating disorder pathological features and putative maintenance factors (i.e., core low self-esteem, perfectionism, social appearance anxiety, body surveillance, and mood intolerance), health-related quality of life and comorbid psychiatric (i.e., affective and anxiety) disorders (large effect sizes). Between-group differences in demographics, body mass index, or age-of-BN onset were not observed. Collectively, our findings provide support for the utility of the frequency of inappropriate weight compensatory behaviours as a severity indicator for BN and suggest that age-at-onset of BN is probably more disorder- than severity-dependent. Implications for future research are outlined.
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Affiliation(s)
- Antonios Dakanalis
- Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 48, 20900, Monza, Italy. .,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
| | | | | | - Ester Di Giacomo
- Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 48, 20900, Monza, Italy
| | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Laboratory, Istituto Auxologico Italiano, Milan, Italy.,Department of Psychology, Catholic University, Milan, Italy
| | - Massimo Clerici
- Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 48, 20900, Monza, Italy.,Department of Mental Health, San Gerardo Hospital, Monza, Italy
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Dakanalis A, Zanetti MA, Colmegna F, Riva G, Clerici M. Classifying binge eating-disordered adolescents based on severity levels. J Adolesc 2018; 62:47-54. [DOI: 10.1016/j.adolescence.2017.10.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 10/04/2017] [Accepted: 10/09/2017] [Indexed: 11/25/2022]
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Ciao AC, Ohls OC, Pringle KD. Should body image programs be inclusive? A focus group study of college students. Int J Eat Disord 2018; 51:82-86. [PMID: 29105805 DOI: 10.1002/eat.22794] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 10/10/2017] [Accepted: 10/10/2017] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Most evidence-based body image programs for college students (e.g., the Body Project) are designed for female-only audiences, although body dissatisfaction is not limited to female-identified individuals. Furthermore, programs do not explicitly discuss diversity, although individuals with marginalized gender, racial, and sexual identities may be particularly vulnerable to body image disturbances. Making programs more inclusive may increase their disseminability. METHOD This qualitative study examined the feasibility of adapting the Body Project for universal and inclusive use with college students. Participants (N = 36; M age = 21.66 years; 73% female-identified; 20% sexual minority; 23% racial minority) attended one of five semi-structured focus groups to explore the inclusivity of appearance-based cultural norms using adapted Body Project activities and discuss the feasibility of universal and inclusive interventions. Inductive qualitative content analysis with three-rater consensus identified focus group themes. RESULTS There was consensus that inclusive interventions could have a positive impact (broadening perspectives, normalizing body image concerns, increasing awareness) despite potential barriers (poor diversity representation, vulnerability). There was strong consensus regarding advice for facilitating inclusive interventions (e.g., skilled facilitation, education, increasing diversity). DISCUSSION Results suggest that inclusive body image programs are desirable and provide a framework for creating the EVERYbody Project, a program for more universal audiences.
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Affiliation(s)
- Anna C Ciao
- Department of Psychology, Western Washington University, Bellingham, Washington
| | - Olivia C Ohls
- Department of Psychology, Western Washington University, Bellingham, Washington
| | - Kevin D Pringle
- Department of Psychology, Western Washington University, Bellingham, Washington
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Lin YC, Strong C, Tsai MC, Lin CY, Fung XC. Validating Sizing Them Up: A parent-proxy weight-related quality-of-life measure, with community-based children. Int J Clin Health Psychol 2018; 18:81-89. [PMID: 30487913 PMCID: PMC6220913 DOI: 10.1016/j.ijchp.2017.10.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 10/23/2017] [Indexed: 12/02/2022] Open
Abstract
Background/Objective: A weight-related Quality of Life (QoL) questionnaire elicits parents' perceptions to understand the impacts of weight on children's QoL. Sizing Them Up, a parent-proxy of a weight-related instrument, is a proper measure for the purpose, but its psychometric properties have not been validated on a non-clinical child population. This study aimed to thoroughly examine the psychometric properties of the Sizing Them Up on a non-clinical child population. Methods: Children from Taiwan (M age = 11; SD = 1.02; N = 236) filled out a weight-related QoL instrument (Sizing Me Up) while their parents completed Sizing Them Up and two generic QoL instruments. Confirmatory factor analysis (CFA), concurrent validity, and known-group validity were conducted. Results: CFA supported the factor structure of Sizing Them Up. The concurrent validity of the Sizing Them Up total score was satisfactory: r = .46 to .53 with other QoL instruments. Known-group validity was supported as obese children had significantly lower Sizing Them Up total score than did normal-weight and underweight children. Conclusions: We extended the use of Sizing Them Up from clinically obese children to a community-based sample of underweight as well as overweight children. Healthcare providers may use Sizing Them Up to measure the weight-related QoL for children.
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Affiliation(s)
- Yi-Ching Lin
- Department of Early Childhood and Family Education, College of Education, National Taipei University of Education, Taiwan
| | - Carol Strong
- Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Taiwan
| | - Meng-Che Tsai
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Taiwan
| | - Chung-Yin Lin
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Xavier C.C. Fung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
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37
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Risk and maintenance factors for young women's DSM-5 eating disorders. Arch Womens Ment Health 2017; 20:721-731. [PMID: 28733894 DOI: 10.1007/s00737-017-0761-6] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 07/11/2017] [Indexed: 01/22/2023]
Abstract
Recent research with young women attending colleges, who are at the average age of eating disorder (ED) onset, established that the ED symptoms are not only prevalent but also relatively stable over the college period. Nonetheless, our knowledge regarding the course and modifiable factors associated with both the onset and maintenance of diagnosable (DSM-5) EDs in this population is limited. The objective of this report was to address these key research gaps. Data were examined from 2713 women who completed assessments of potential vulnerability factors and EDs in the autumn semester of the first (baseline) and fourth (follow-up) college years. A total of 13.1% of the sample met DSM-5 criteria for an ED diagnosis at baseline. At 4-year follow-up, 7.6% of the sample met DSM-5 criteria for an ED, with 67.5% of these cases representing women who had maintained an ED diagnosis from baseline, and 32.5% representing new onset EDs. Elevated appearance-ideal internalization, body dissatisfaction, self-objectification, dieting, and negative affectivity at baseline as well as changes in these factors between assessments all predicted onset and maintenance of DSM-5 EDs at 4-year follow-up. Self-objectification (thinking about and monitoring the body's appearance from an external observer's perspective) was the largest contributor to both ED onset and maintenance. In addition to enhancing our knowledge about the course of young women's (DSM-5) EDs during college, this work highlights potentially similar psychological foci for prevention and treatment efforts. Implications for improving existing preventive and treatment approaches are outlined.
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Solomon-Krakus S, Sabiston CM. Body checking is associated with weight- and body-related shame and weight- and body-related guilt among men and women. Body Image 2017; 23:80-84. [PMID: 28886393 DOI: 10.1016/j.bodyim.2017.08.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 08/07/2017] [Accepted: 08/15/2017] [Indexed: 10/18/2022]
Abstract
This study examined whether body checking was a correlate of weight- and body-related shame and guilt for men and women. Participants were 537 adults (386 women) between the ages of 17 and 74 (Mage=28.29, SD=14.63). Preliminary analyses showed women reported significantly more body-checking (p<.001), weight- and body-related shame (p<.001), and weight- and body-related guilt (p<.001) than men. In sex-stratified hierarchical linear regression models, body checking was significantly and positively associated with weight- and body-related shame (R2=.29 and .43, p<.001) and weight- and body-related guilt (R2=.34 and .45, p<.001) for men and women, respectively. Based on these findings, body checking is associated with negative weight- and body-related self-conscious emotions. Intervention and prevention efforts aimed at reducing negative weight- and body-related self-conscious emotions should consider focusing on body checking for adult men and women.
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Affiliation(s)
- Shauna Solomon-Krakus
- Faculty of Kinesiology & Physical Education, University of Toronto, Harbord Street, Toronto, Ontario M5S 2W6, Canada
| | - Catherine M Sabiston
- Faculty of Kinesiology & Physical Education, University of Toronto, Harbord Street, Toronto, Ontario M5S 2W6, Canada.
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Cornelissen KK, McCarty K, Cornelissen PL, Tovée MJ. Body size estimation in women with anorexia nervosa and healthy controls using 3D avatars. Sci Rep 2017; 7:15773. [PMID: 29150646 PMCID: PMC5693901 DOI: 10.1038/s41598-017-15339-z] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 10/16/2017] [Indexed: 01/22/2023] Open
Abstract
A core feature of anorexia nervosa is an over-estimation of body size. However, quantifying this over-estimation has been problematic as existing methodologies introduce a series of artefacts and inaccuracies in the stimuli used for judgements of body size. To overcome these problems, we have: (i) taken 3D scans of 15 women who have symptoms of anorexia (referred to henceforth as anorexia spectrum disorders, ANSD) and 15 healthy control women, (ii) used a 3D modelling package to build avatars from the scans, (iii) manipulated the body shapes of these avatars to reflect biometrically accurate, continuous changes in body mass index (BMI), (iv) used these personalized avatars as stimuli to allow the women to estimate their body size. The results show that women who are currently receiving treatment for ANSD show an over-estimation of body size which rapidly increases as their own BMI increases. By contrast, the women acting as healthy controls can accurately estimate their body size irrespective of their own BMI. This study demonstrates the viability of combining 3D scanning and CGI techniques to create personalised realistic avatars of individual patients to directly assess their body image perception.
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Affiliation(s)
- Katri K Cornelissen
- Department of Psychology, Northumbria University, Newcastle Upon Tyne, NE1 8ST, United Kingdom
| | - Kristofor McCarty
- Department of Psychology, Northumbria University, Newcastle Upon Tyne, NE1 8ST, United Kingdom
| | - Piers L Cornelissen
- Department of Psychology, Northumbria University, Newcastle Upon Tyne, NE1 8ST, United Kingdom
| | - Martin J Tovée
- School of Psychology, Lincoln University, Lincoln, LN6 7TS, United Kingdom.
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40
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Pascual-Vera B, Belloch A. Functional links of obsessive, dysmorphic, hypochondriac, and eating-disorders related mental intrusions. Int J Clin Health Psychol 2017; 18:43-51. [PMID: 30487909 PMCID: PMC6220904 DOI: 10.1016/j.ijchp.2017.09.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 09/11/2017] [Indexed: 11/17/2022] Open
Abstract
Unwanted mental intrusions (UMIs) are the normal variants of obsessions in Obsessive-Compulsive Disorder (OCD), preoccupations about defects in Body Dysmorphic Disorder (BDD), images about illness in Hypochondriasis (HYP), and thoughts about eating in Eating Disorders (EDs). The aim was to examine the similarities and differences in the functional links of four UMI contents, adopting a within-subject perspective. Method: 438 university students and community participants (M age = 29.84, SD = 11.41; 70.54% women) completed the Questionnaire of Unpleasant Intrusive Thoughts (QUIT) to assess the functional links (emotions, appraisals, and neutralizing/control strategies) of the most upsetting UMIs with OCD, BDD, HYP and EDs-contents. Results: HYP-related intrusions caused the highest emotional impact, OCD-related intrusions were the most interfering, and EDs-related intrusions interfered the least. The four UMI were equally ego-dystonic. Women appraised OCD-related intrusions more dysfunctionally, but men appraised the four intrusive contents similarly. All UMI instigated the urge to "do something", to keep them under control and/or neutralizing them. Conclusions: Similarities among the functional links of intrusions related to OCD, BDD, HYP and EDs contents support their transdiagnostic nature and they might contribute to understanding common factors in these disorders.
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Affiliation(s)
- Belén Pascual-Vera
- Research and Treatment Unit for Obsessions and Compulsions (I'TOC), Universidad de Valencia, Spain
| | - Amparo Belloch
- Research and Treatment Unit for Obsessions and Compulsions (I'TOC), Universidad de Valencia, Spain
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41
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da Silva WR, Marôco J, Ochner CN, Campos JADB. Male body dissatisfaction scale (MBDS): proposal for a reduced model. Eat Weight Disord 2017; 22:515-525. [PMID: 28766259 DOI: 10.1007/s40519-017-0420-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Accepted: 07/13/2017] [Indexed: 11/27/2022] Open
Abstract
AIMS To evaluate the psychometric properties of the male body dissatisfaction scale (MBDS) in Brazilian and Portuguese university students; to present a reduced model of the scale; to compare two methods of computing global scores for participants' body dissatisfaction; and to estimate the prevalence of participants' body dissatisfaction. METHODS A total of 932 male students participated in this study. A confirmatory factor analysis (CFA) was used to assess the scale's psychometric properties. Multi-group analysis was used to test transnational invariance and invariance in independent samples. The body dissatisfaction score was calculated using two methods (mean and matrix of weights in the CFA), which were compared. Finally, individuals were classified according to level of body dissatisfaction, using the best method. RESULTS The MBDS model did not show adequate fit for the sample and was, therefore, refined. Thirteen items were excluded and two factors were combined. A reduced model of 12 items and 2 factors was proposed and shown to have adequate psychometric properties. There was a significant difference (p < 0.001) between the methods for calculating the score for body dissatisfaction, since the mean overestimated the scores. Among student participants, the prevalence of body dissatisfaction with musculature and general appearance was 11.2 and 5.3%, respectively. CONCLUSIONS The reduced bi-factorial model of the MBDS showed adequate validity, reliability, and transnational invariance and invariance in independent samples for Brazilian and Portuguese students. The new proposal for calculating the global score was able to more accurately show their body dissatisfaction. No level of evidence Basic Science.
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Affiliation(s)
- Wanderson Roberto da Silva
- Department of Food and Nutrition, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Campus (Araraquara), São Paulo, Brazil
| | - João Marôco
- William James Center for Research (WJCR), Institute of Psychological, Social and Life Sciences (ISPA), Lisbon, Portugal
| | - Christopher N Ochner
- Hospital Corporation of America, Physician Services Group, Fort Lauderdale, FL, USA
| | - Juliana Alvares Duarte Bonini Campos
- Department of Food and Nutrition, School of Pharmaceutical Sciences (UNESP), São Paulo State University (UNESP), Rodovia Araraquara-Jaú, km 01, Araraquara, SP, Brazil.
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42
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Dakanalis A, Riva G, Gaudio S, Clerici M. Cognitive-behavioral or psychodynamic therapy for people with bulimia nervosa. Eat Weight Disord 2017; 22:555-556. [PMID: 28674751 DOI: 10.1007/s40519-017-0412-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Accepted: 06/18/2017] [Indexed: 11/29/2022] Open
Affiliation(s)
- Antonios Dakanalis
- Department of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, 20900, Monza, Italy. .,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
| | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Laboratory, IRCSS Istituto Auxologico Italiano, Milan, Italy.,Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Santino Gaudio
- Department of Neuroscience, Functional Pharmacology, Uppsala University, Uppsala, Sweden
| | - Massimo Clerici
- Department of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, 20900, Monza, Italy
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Dakanalis A, Colmegna F, Riva G, Clerici M. Validity and utility of the DSM-5 severity specifier for binge-eating disorder. Int J Eat Disord 2017; 50:917-923. [PMID: 28245061 DOI: 10.1002/eat.22696] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Revised: 02/06/2017] [Accepted: 02/10/2017] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To test both the concurrent and predictive significance of the new DSM-5 severity specifier for binge-eating disorder (BED) in adult outpatients. METHOD Existing data from 195 adults with DSM-5 BED who received evidence-based treatment (manual-based cognitive-behavioral therapy) in an outpatient setting were re-analysed to examine whether these patients sub-grouped according to the DSM-5 severity levels, defined by the frequency of binge-eating (BE) episodes, would show meaningful differences in a range of variables of clinical interest assessed at pre-treatment and end-of treatment abstinence from BE. RESULTS Participants categorized with mild (33.3% of the sample), moderate (35.4%), severe (15.9%), and extreme (15.4%) severity of BED, based on their pre-treatment clinician-rated frequency of BE episodes, differed significantly from each other in physical characteristics (body mass index) and another sixteen variables of clinical interest assessed at pre-treatment regarding eating disorder psychopathology and putative maintenance factors, lifetime and current psychiatric disorder comorbidity, general psychiatric distress, and psychosocial impairment. The four DSM-5 severity groups were statistically indistinguishable in demographics or age-of-BED onset. However, significant between-group differences were observed in the treatment outcome, i.e., abstinence from BE, achieved by 98.5%, 66.7%, 38.7% and 6.7% of participants categorized with mild, moderate, severe, and extreme severity respectively. The outcome analyses repeated in the completer sample (n = 187) yielded the same pattern of the aforementioned intent-to-treat (N = 195) results. DISCUSSION The findings provide support for the severity specifier for BED introduced in the DSM-5 as a means of addressing within-group variability in severity.
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Affiliation(s)
- Antonios Dakanalis
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan/Monza, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Fabrizia Colmegna
- Mental Health Department, San Gerardo Monza Health and Social Care Trust, Monza, Italy
| | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Laboratory, Istituto Auxologico Italiano, Milan, Italy.,Department of Psychology, Catholic University, Milan, Italy
| | - Massimo Clerici
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan/Monza, Italy.,Mental Health Department, San Gerardo Monza Health and Social Care Trust, Monza, Italy
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Avargues-Navarro ML, Borda-Mas M, Asuero-Fernández R, Pérez-San-Gregorio MÁ, Martín-Rodríguez A, Beato-Fernández L, Bardone-Cone AM, Sánchez-Martín M. Purging behaviors and therapeutic prognosis of women with eating disorders treated in a healthcare context. Int J Clin Health Psychol 2017; 17:120-127. [PMID: 30487887 PMCID: PMC6220928 DOI: 10.1016/j.ijchp.2017.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 03/16/2017] [Indexed: 11/19/2022] Open
Abstract
Background/Objective: The evidence on efficacy of cognitive-behavioral interventions in Eating Disorders (ED) still shows inconclusive results with respect to the role of purging behaviors, more so in uncontrolled situations. Evolution of ED patients with and without purging behavior was studied 30 months after start of a multicomponent treatment. Method: 162 women (87 purging, 75 non-purging) treated in outpatient or hospitals + outpatient care units in Spain participated. The evaluation instruments were: BSQ, EAT-40, EDI, STAI, BDI and BITE. Results: At the beginning of the treatment, participants with purging behavior showed higher bulimic symptomatology, more body dissatisfaction, drive for thinness, perfectionism and ineffectiveness, anxiety and depressive symptomatology. After thirty months, intervention produced improvement in ED characteristics, emotional alterations and personal development variables, in both groups, but less in patients with no purging behavior. The effect of intervention was stronger in purging patients and variables with larger effect size: body dissatisfaction, bulimic symptomatology and anxiety. Conclusions: Purging behaviors must be considered in the design of these treatments with a view to prognosis.
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Affiliation(s)
- María Luisa Avargues-Navarro
- Universidad de Sevilla, Spain
- Corresponding author. Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, Facultad de Psicología, Universidad de Sevilla, C/Camilo José Cela s/n. 41018 Sevilla.
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Dakanalis A, Riva G, Serino S, Colmegna F, Clerici M. Classifying Adults with Binge Eating Disorder Based on Severity Levels. EUROPEAN EATING DISORDERS REVIEW 2017; 25:268-274. [DOI: 10.1002/erv.2518] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 03/18/2017] [Accepted: 03/20/2017] [Indexed: 11/11/2022]
Affiliation(s)
- Antonios Dakanalis
- University of Milan-Bicocca, Milan/Monza and University of Pavia; Pavia Italy
| | - Giuseppe Riva
- Istituto Auxologico Italiano; Milan and Catholic University; Milan Italy
| | | | | | - Massimo Clerici
- University of Milan-Bicocca, Milan/Monza and San Gerardo Hospital; Monza Italy
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46
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Lucena-Santos P, Carvalho SA, Oliveira MDS, Pinto-Gouveia J. Body-Image Acceptance and Action Questionnaire: Its deleterious influence on binge eating and psychometric validation. Int J Clin Health Psychol 2017; 17:151-160. [PMID: 30487890 PMCID: PMC6220905 DOI: 10.1016/j.ijchp.2017.03.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 03/06/2017] [Indexed: 11/24/2022] Open
Abstract
Background/Objectives: This study aimed to explore the psychometric properties of BI-AAQ (Body-Image Acceptance and Action Questionnaire) and the body image psychological flexibility role as a mediator in a pervasive path towards binge eating in Brazilian samples. Method: This cross-sectional study was conducted in clinical (overweight or obese women currently in treatment for weight loss; n= 330) and non-clinical (general population; n= 682) groups of women. Results: BI-AAQ has one-factor structure, excellent internal consistency, ability to detect differences between groups and measurement invariance across samples. It was also negatively associated with self-compassion and positively associated with binge eating severity, drive for thinness and self-criticism. Conclusions: This study provides data confirming the robust psychometric properties of BI-AAQ in qualitatively different samples. Furthermore, an additional study conducted in a clinical sample of women with overweight or obesity revealed that body image psychological inflexibility has emerged as a partial and significant mediator of the effect of self-criticism and drive for thinness on binge eating severity.
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Affiliation(s)
- Paola Lucena-Santos
- Cognitive-Behavioral Research Centre (CINEICC), University of Coimbra, Portugal
| | - Sérgio A Carvalho
- Cognitive-Behavioral Research Centre (CINEICC), University of Coimbra, Portugal
| | - Margareth da Silva Oliveira
- Evaluation and Treatment in Cognitive-Behavioral Therapies - Research Group (GAAPCC), Pontifical Catholic University of Rio Grande do Sul, Brazil
| | - José Pinto-Gouveia
- Cognitive-Behavioral Research Centre (CINEICC), University of Coimbra, Portugal
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