1
|
Liu P, Tan JXY. ERP correlates of self-referential processing moderate the association between pubertal status and disordered eating in preadolescence. Psychophysiology 2024; 61:e14534. [PMID: 38342692 DOI: 10.1111/psyp.14534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 12/05/2023] [Accepted: 01/22/2024] [Indexed: 02/13/2024]
Abstract
Preadolescence is a critical period for the onset of puberty and eating-related psychopathology. More advanced pubertal status is associated with elevated eating pathology. However, it was unclear whether this association was moderated by self-referential processing, an important, modifiable cognitive risk for various forms of psychopathology, including eating problems. Further, no study has examined the neural correlates of self-referential processing in relation to eating pathology. To address these gaps, we examined how the association between pubertal status and disordered eating was moderated by self-referential processing in a community sample of 115 nine-to-12-year-old preadolescents (66 girls; mean age/SD = 10.98/1.18 years; 87.5% White). Youths reported their pubertal status and disordered eating behaviors and completed an ERP version of the Self-Referent Encoding Task (SRET) to assess self-referential processing. A Principal Component Analysis of the ERP data identified an anterior late positive potential (LPP) in both the positive and negative SRET conditions. The LPP in the positive condition moderated the positive association between pubertal status and disordered eating behaviors, such that this association was significant for youths with a smaller LPP toward positive self-referential cues, but non-significant for those showing a larger LPP toward positive self-referential cues. These results suggest that a deeper processing of positive self-referential information, indicated by a potentiated LPP, may weaken the negative impact of pubertal status on disordered eating. Our findings also suggest that enhancing positive self-referential processing may be a useful tool in preventing the development of eating pathology in preadolescents, especially for those with more advanced pubertal status.
Collapse
Affiliation(s)
- Pan Liu
- Department of Psychology, University of Alberta, Edmonton, Alberta, Canada
| | - Jaron X Y Tan
- Department of Psychology, Center for Visual and Cognitive Neuroscience, North Dakota State University, Fargo, North Dakota, USA
| |
Collapse
|
2
|
Hansson E, Schmidt M. "Good food equals good health": a focus group study of adolescent boys' perceptions of eating and weight. BMC Public Health 2024; 24:258. [PMID: 38254027 PMCID: PMC10804744 DOI: 10.1186/s12889-024-17740-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 01/11/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Disordered eating refers to unhealthy, sometimes excessive eating including so-called compensatory behaviours such as extreme dieting or voluntary vomiting. Between 24% and 30% of adolescent boys are suggested to engage in disordered eating, making it a significant public health issue. However, current instruments for assessing disordered eating among adolescents have been primarily developed and validated for girls and women, which may make for flawed assessment of boys. The aim of this study is to shed light on adolescent boys' perceptions of eating, weight, and food intake to better understand their perspectives in service of disordered eating research. METHODS This exploratory study was conducted from May to November 2022 using focus groups with a total of 39 adolescent boys (aged 12-19 years) who attended 7th to 12th grade in one of four schools in Southern Sweden. In addition, participants completed a form with questions on background demographics and eating habits. The transcripts of the focus group discussions were analysed using thematic analysis. RESULTS The quantitative data showed that around one third of the adolescent boys were overweight or obese. They ate at least one meal per day with the family and ate healthy food about five days per week and unhealthy food about three. Analysis of the qualitative data yielded six themes: The intertwined relationship between food and one's health, "Don't worry, food makes you happy," "To be hungry or not. That is the question," Boys DO care about appearances, Dieting and weight gain, and Disordered eating is a tricky matter. CONCLUSION Adolescent boys appeared to have a good understanding of food and healthy eating. They also experienced body positivity and seemed to have only minor issues regarding their weight. The primarily pathological perspective used to measure disordered eating among girls seems in need of revision to adhere to boys' thoughts and ideas regarding eating and weight.
Collapse
Affiliation(s)
- Erika Hansson
- Faculty of Education, Kristianstad University, Kristianstad, Sweden.
| | - Manuela Schmidt
- Department of Quality Improvement and Leadership, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| |
Collapse
|
3
|
Chen DR, Lin LY, Levin B. Differential pathways to disordered eating for immigrant and native adolescents in Taiwan. J Eat Disord 2023; 11:54. [PMID: 37013662 PMCID: PMC10071635 DOI: 10.1186/s40337-023-00781-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 03/28/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND Few studies have investigated disparities in disordered eating between new immigrant and native adolescents in Taiwan. This study examines the differential pathways to disordered eating in these two populations. METHODS This cross-sectional study analyzed data collected from March to June 2019. In total, 729 adolescents aged between 13 and 16 years recruited from 37 classes in 3 middle schools in New Taipei City were included in the final analysis. Standardized assessment tools measured disordered eating (EAT-26) and psychological distress (BSRS-5). Generalized structural equation modeling was used to conduct the path analysis. RESULTS The prevalence of disordered eating was significantly higher in immigrant adolescents than in their native counterparts. Multipath models indicated that weight-teasing driven by overweight and obese status and weight overestimation could lead to disordered eating through psychological distress; however, the pathways differed for the two groups studied. Family weigh-teasing indirectly leads to disordered eating through psychological distress for native adolescents; by contrast, for immigrant adolescents, friend weigh-teasing indirectly leads to disordered eating through psychological distress. Additionally, weight overestimation directly leads to disordered eating and indirectly through psychological distress to disordered eating for immigrant adolescents. CONCLUSION This study offers a plausible explanation of the differences in the paths to disordered eating between immigrant and native adolescents in Taiwan, which was not reported previously. The study urges the need for school-based prevention programs to improve immigrant students' mental health.
Collapse
Affiliation(s)
- Duan-Rung Chen
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Room 636, No. 17, Xu-Zhou Rd., Taipei, 10055, Taiwan.
| | - Li-Yin Lin
- Department of Leisure Industry and Health Promotion, National Taipei University of Nursing and Health Sciences, 365 MingDe Road, Beitou District, Taipei, 11219, Taiwan
| | - Brianna Levin
- School of Nursing at Johns Hopkins University, 525 N Wolfe St, Baltimore, MD, 21205, USA
| |
Collapse
|
4
|
Prevention and early intervention in eating disorders: findings from a rapid review. J Eat Disord 2023; 11:38. [PMID: 36899428 PMCID: PMC9999654 DOI: 10.1186/s40337-023-00758-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 02/19/2023] [Indexed: 03/12/2023] Open
Abstract
BACKGROUND Eating disorders (EDs) are complex psychological disorders, with low rates of detection and early intervention. They can lead to significant mental and physical health complications, especially if intervention is delayed. Given high rates of morbidity and mortality, low treatment uptake, and significant rates of relapse, it is important to examine prevention, early intervention, and early recognition initiatives. The aim of this review is to identify and evaluate literature on preventative and early intervention programs in EDs. METHODS This paper is one of a series of Rapid Reviews, designed to inform the Australian National Eating Disorders Research and Translation Strategy 2021-2031, funded, and released by the Australian Government. To provide a current and rigorous review, peer-reviewed articles between 2009 and 2021 published in English were searched across three databases: ScienceDirect, PubMed and Ovid/Medline. Priority was given to high-level evidence including meta-analyses, systematic reviews, Randomised Control Trials, and large population studies. Findings from selected studies pertaining to prevention and early intervention in EDs were evaluated and are presented in this review. RESULTS In total, 130 studies were identified in the current review, 72% relating to prevention and 28% to early intervention. Most programs were theory-driven and targeted one or more ED risk factors such as thin-ideal internalisation and/or body dissatisfaction. There is reasonable evidence to support prevention programs reducing risk factors, particularly as part of school or university-based programs, with established feasibility and relatively high acceptance among students. There is increasing evidence around the use of technology (to increase dissemination potential) and for use of mindfulness approaches (targeting emotional resilience). Few longitudinal studies assessing incident cases following participation in a prevention program exist. CONCLUSIONS Although several prevention and early intervention programs have been shown to significantly reduce risk factors, promote symptom recognition, and encourage help-seeking behaviour, most of these studies have been conducted in older adolescent and university aged students, past the age of peak ED onset. One of the most targeted risk factors, body dissatisfaction, is found in girls as young as 6 years old, indicating a need for further research implementing prevention initiatives at younger ages. Follow-up research is limited; thus, the long-term efficacy and effectiveness of studied programs is unknown. Greater attention should be paid to the implementation of prevention and early intervention programs in identified high-risk cohorts or diverse groups, where a more targeted approach may be necessary.
Collapse
|
5
|
Intuitive Eating Behaviour among Young Malay Adults in Malaysian Higher Learning Institutions. Nutrients 2023; 15:nu15040869. [PMID: 36839227 PMCID: PMC9964300 DOI: 10.3390/nu15040869] [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: 12/01/2022] [Revised: 02/01/2023] [Accepted: 02/03/2023] [Indexed: 02/11/2023] Open
Abstract
Despite the significance of dietary knowledge interventions, there is a lack of established studies on intuitive eating behaviour among young Malay adults in Malaysia. This cross-sectional study aimed to determine the intuitive eating score, identify the intuitive eating factors, and determine the association of intuitive eating with weight-control behaviours and binge eating. A total of 367 respondents completed self-administered questionnaires on sociodemographic characteristics, namely the Intuitive Eating Scale (IES-2) and The Diabetes Eating Problems Survey (DEPS). The findings reported IES-2 mean scores of 3.52 ± 0.32 and 3.47 ± 0.35 for both men and women. No difference in total IES-2 scores was found between genders for Unconditional Permission to Eat (UPE) and Reliance on Hunger and Satiety Cue (RHSC) subscales (p > 0.05). However, among all four subscales of IES-2, there was a gender difference in the mean EPR and B-FCC subscale scores (p < 0.05). A statistically significant difference was found in intuitive eating, which refers to a belief in one's body's ability to tell one how much to eat, in women across living areas (p < 0.05). The result shows that there is a relationship between weight-control behaviour and binge eating and dieting, with the coefficient of the relationship (R2) of 0.34. As a result, intuitive eating throughout young adulthood is likely to be related to a decreased prevalence of obesity, dieting, poor weight-management behaviours, and binge eating.
Collapse
|
6
|
Ghaderi A, Bulik C, Myrälf M, Welch E. Anonymous Online Survey on Disordered Eating, Drive for Muscularity, Sexual Orientation, and Satisfaction with Life in Young Swedish Males. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:3457-3465. [PMID: 35972634 PMCID: PMC9556378 DOI: 10.1007/s10508-022-02383-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 07/13/2022] [Accepted: 07/15/2022] [Indexed: 06/15/2023]
Abstract
Psychiatric conditions in general, including eating disorders, are stigmatizing conditions. The stigma of eating disorders is even more pronounced among males. We conducted an anonymous, online survey to explore the feasibility of recruiting participants for collecting sensitive information, and the relation among eating disorders, drive for muscularity, satisfaction with life, and sexual preference in males (N = 824) aged 15-30 years in Sweden. Internet survey method was a feasible way of recruiting males and obtaining sensitive information. Drive for muscularity was positively related to eating psychopathology. Interestingly, only the attitudinal aspect of the drive for muscularity was negatively related to satisfaction with life, whereas the behavioral component of the drive for muscularity was unrelated to quality of life. Drive for muscularity and disordered eating were not significantly different across participants with various sexual orientations. Our findings corroborate and extend previous research by using an anonymous Internet-based survey that may be less contaminated by social desirability or reporting bias due to the sensitivity of some of the questions.
Collapse
Affiliation(s)
- Ata Ghaderi
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, 17177, Stockholm, Sweden.
- Stockholm Health Care Services, Region Stockholm, Stockholm Centre for Eating Disorders, Stockholm, Sweden.
| | - Cynthia Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, USA
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, USA
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Mattias Myrälf
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Elisabeth Welch
- Stockholm Health Care Services, Region Stockholm, Stockholm Centre for Eating Disorders, Stockholm, Sweden
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
7
|
Koppenburg C, Saxer F, Vach W, Lüchtenberg D, Goesele A. Eating disorder risks and awareness among female elite cyclists: an anonymous survey. BMC Sports Sci Med Rehabil 2022; 14:172. [PMID: 36151580 PMCID: PMC9502946 DOI: 10.1186/s13102-022-00563-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 09/06/2022] [Indexed: 11/25/2022]
Abstract
Background Eating disorders (EDs) are an increasingly recognized concern in professional sports. Previous studies suggests that both female gender and endurance sports put athletes at risk. Female elite cyclists are hence of specific interest. The present study aimed at evaluating the distribution of the individual risk of ED in this group. Further the association between individual risk and both the awareness for the topic ED and the deviation from “normal” weight was depicted. Methods Female cyclists registered with the Union Cycliste Internationale were contacted via email or facebook and asked to complete a survey comprising age, weight, the Eating-Attitude-Test (EAT-26), and questions regarding ED awareness. The observed distribution of the EAT-26 score was compared to results from previous studies in normal subjects and athletes. The distribution of the ED awareness was described and ED awareness was correlated with the EAT-26 score. Both the deviation from ideal weight and the body mass index (BMI) were correlated with the EAT-26 score. Results Of the 409 registered athletes 386 could be contacted, 122 completed the questionnaire. Age ranged from 20-44yrs, BMI from 17.0 to 24.6 kg/m2. In the EAT-26, 39 cyclists (32.0%) scored above 20 points indicating a potential benefit from clinical evaluation, 34 cyclists (27.9%) scored 10–19 points suggesting disordered eating. Sixteen athletes (13.2%) had been treated for an ED. About 70% of athletes had been pressured to lose weight. The mean EAT-26 score was above the average observed in normal female populations. It was also above the average observed in many female athlete populations, but lower than in other leanness focussed sports. More than 80%of athletes perceived elite cyclists at risk for developing ED. Increased ED awareness and deviation from the ideal weight were associated with higher EAT-26 scores, but not the body mass index. Conclusion Female cyclists are at risk of developing ED and they are aware of this risk. To improve their health and well-being, increased efforts to support elite cyclists and their teams in preventive activities and early detection are crucial. Supplementary Information The online version contains supplementary material available at 10.1186/s13102-022-00563-6.
Collapse
Affiliation(s)
- C Koppenburg
- Department of Sport Sciences, University of Konstanz, Postfach 30, D-78457, Konstanz, Germany.,Crossklinik Basel, Bundesstr. 1, CH-4054, Basel, Switzerland
| | - F Saxer
- Basel Academy for Quality and Research in Medicine, Steinenring 6, CH- 4051, Basel, Switzerland.,University of Basel, Petersplatz 1, CH-4001, Basel, Switzerland.,Novartis Institutes for Biomedical Research, Novartis Campus, CH-4051, Basel, Switzerland
| | - W Vach
- Basel Academy for Quality and Research in Medicine, Steinenring 6, CH- 4051, Basel, Switzerland.
| | - D Lüchtenberg
- Department of Sport Sciences, University of Konstanz, Postfach 30, D-78457, Konstanz, Germany
| | - A Goesele
- Crossklinik Basel, Bundesstr. 1, CH-4054, Basel, Switzerland.,University of Basel, Petersplatz 1, CH-4001, Basel, Switzerland
| |
Collapse
|
8
|
Riva A, Pigni M, Albanese ND, Falbo M, Di Guardo S, Brasola E, Biso F, Nacinovich R. Eating Disorders in Children and Adolescent Males: A Peculiar Psychopathological Profile. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11449. [PMID: 36141722 PMCID: PMC9517020 DOI: 10.3390/ijerph191811449] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 08/29/2022] [Accepted: 09/03/2022] [Indexed: 06/16/2023]
Abstract
(1) Background: Eating Disorders (EDs) are severe psychiatric disorders with high rates of mortality, multiple medical and psychiatric comorbidities associated, and often chronic illness. Historically, EDs are among the most gendered of psychiatric illnesses, and male presentations have been perceived as rare and unusual. This perception resulted in the systematic underrepresentation of males in research on Eds, and as consequence, in a scarcity of research investigating clinical and psychological features in this population. (2) Methods: The present study aims to evaluate clinical and psychopathological features in a sample of 287 children and adolescents, 27 males and 260 females with EDs, in order to identify similarities and differences. (3) Results: Males were younger than females, with similar medical and clinical conditions, but a different distribution of typology of EDs in middle childhood and middle adolescents. The Eating Disorders Inventory-3, TAS-20 for alexithymia and CDI for depressive symptoms' profiles are similar, while males showed higher scores at the global indexes of Symptom Checklist 90-Revised test in early adolescence. (4) Conclusions: Results suggest gender-specific similarities and differences in clinical and psychological features in children and adolescent males, which may require specific diagnosis and treatment.
Collapse
Affiliation(s)
- Anna Riva
- Child and Adolescent Mental Health Department, ASST Monza University of Milano-Bicocca, 20900 Monza, Italy
| | - Maria Pigni
- Child and Adolescent Mental Health Department, ASST Monza University of Milano-Bicocca, 20900 Monza, Italy
| | - Nunzia Delia Albanese
- Child and Adolescent Mental Health Department, ASST Monza University of Milano-Bicocca, 20900 Monza, Italy
| | - Mariella Falbo
- Child and Adolescent Mental Health Department, ASST Monza University of Milano-Bicocca, 20900 Monza, Italy
| | - Simona Di Guardo
- Child and Adolescent Mental Health Department, ASST Monza University of Milano-Bicocca, 20900 Monza, Italy
| | - Eleonora Brasola
- Child and Adolescent Mental Health Department, ASST Monza University of Milano-Bicocca, 20900 Monza, Italy
| | - Francesco Biso
- Department of Business Engineering, Tor Vergata University of Rome, 00133 Rome, Italy
| | - Renata Nacinovich
- Child and Adolescent Mental Health Department, ASST Monza University of Milano-Bicocca, 20900 Monza, Italy
| |
Collapse
|
9
|
Yoon CY, Mason SM, Loth K, Jacobs DR. Adverse childhood experiences and disordered eating among middle-aged adults: Findings from the coronary artery risk development in young adults study. Prev Med 2022; 162:107124. [PMID: 35787840 DOI: 10.1016/j.ypmed.2022.107124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 05/30/2022] [Accepted: 06/27/2022] [Indexed: 11/17/2022]
Abstract
Adverse childhood experiences (ACEs) include childhood abuse, neglect, and household substance abuse. Childhood abuse is a risk factor for disordered eating (DEB). Less well established are associations of childhood neglect and household substance abuse with DEB, and little research has examined ACE associations with DEB in middle adulthood. The objective of this study was to examine associations between ACEs and DEBs among middle-aged adults and examine sex differences. ACEs prior to age 18 were retrospectively assessed in the Coronary Artery Risk Development in Young Adults study in 2000-2001 (N = 3340, ages 32 to 46). DEB outcomes (i.e., concerns about weight and shape, anxiety about eating or food, unhealthy weight control behaviors, chronic dieting, overeating, and binge eating) were assessed in 1995-1996 (ages 27 to 41). Modified Poisson regressions estimated risk ratios (RRs) for associations of a history of any ACE, each ACE, and cumulative ACEs with DEB outcomes. Among women, emotional abuse, physical neglect, and emotional neglect were each modestly associated with most DEBs (RRs = 1.21-1.35, 1.21-1.45, and 1.23-1.41 across DEBs, respectively) after adjustment for sociodemographic variables, BMI, and depressive symptoms. A cumulative ACE score was associated with all DEBs in a stepwise manner (p for trend ≤0.05) except concerns about weight and shape and overeating. Among men, emotional abuse was most consistently related to the majority of DEBs (RRs = 1.23-1.92); household substance abuse was modestly associated with overeating (RR = 1.26, 95% CI = 1.04-1.53). ACEs were cumulatively associated with unhealthy weight control behaviors, overeating, and binge eating (p for trend <0.01).
Collapse
Affiliation(s)
- Cynthia Y Yoon
- University of Minnesota, School of Public Health, Division of Epidemiology and Community Health, Minneapolis, MN 55454, USA; University of Houston, Department of Health and Human Performance, Houston, TX 77204, USA.
| | - Susan M Mason
- University of Minnesota, School of Public Health, Division of Epidemiology and Community Health, Minneapolis, MN 55454, USA
| | - Katie Loth
- University of Minnesota, Department of Family Medicine and Community Health, Minneapolis, MN 55454, USA
| | - David R Jacobs
- University of Minnesota, School of Public Health, Division of Epidemiology and Community Health, Minneapolis, MN 55454, USA
| |
Collapse
|
10
|
Bryant E, Spielman K, Le A, Marks P, Touyz S, Maguire S, Brennan L, Bryant E, Byrne S, Caldwell B, Calvert S, Carroll B, Castle D, Caterson I, Chelius B, Chiem L, Clarke S, Conti J, Crouch L, Dammery G, Dzajkovski N, Fardouly J, Feneley J, Foroughi N, Fuller-Tyszkiewicz M, Fursland A, Gonzalez-Arce V, Gouldthorp B, Griffin K, Griffiths S, Hambleton A, Hannigan A, Hart M, Hart S, Hay P, Hickie I, Kay-Lambkin F, King R, Kohn M, Koreshe E, Krug I, Le A, Linardon J, Long R, Long A, Madden S, Maguire S, Maloney D, Marks P, McLean S, Meddick T, Miskovic-Wheatley J, Mitchison D, O’Kearney R, Paterson R, Paxton S, Pehlivan M, Pepin G, Phillipou A, Piccone J, Pinkus R, Raykos B, Rhodes P, Rieger E, Rodan S, Rockett K, Russell J, Russell H, Salter F, Sawyer S, Shelton B, Singh U, Smith S, Smith E, Spielman K, Squire S, Thomson J, Tiggemann M, Touyz S, Utpala R, Vartanian L, Wallis A, Ward W, Wells S, Wertheim E, Wilksch S, Williams M, Touyz S, Maguire S. Screening, assessment and diagnosis in the eating disorders: findings from a rapid review. J Eat Disord 2022; 10:78. [PMID: 35672777 PMCID: PMC9175461 DOI: 10.1186/s40337-022-00597-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 05/21/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Limited screening practices, minimal eating disorder training in the healthcare professions, and barriers related to help-seeking contribute to persistent low rates of eating disorder detection, significant unmet treatment need, and appreciable associated disease burden. The current review sought to broadly summarise the literature and identify gaps relating to the screening, assessment, and diagnosis of eating disorders within Western healthcare systems. METHODS This paper forms part of a Rapid Review series scoping the evidence base for the field of eating disorders, conducted to inform the Australian National Eating Disorders Research and Translation Strategy 2021-2031, funded and released by the Australian Government. ScienceDirect, PubMed and Ovid/Medline were searched for studies published between 2009 and mid 2021 in English. High-level evidence such as meta-analyses, large population studies and Randomised Control Trials were prioritised through purposive sampling. Data from selected studies relating to Screening, Assessment and Diagnosis of eating disorders were synthesised and are disseminated in the current review. RESULTS Eighty seven studies were identified, 38% relating to screening and 62% to assessment and diagnosis. The majority of screening studies were conducted in university student samples, showing high prevalence but only modest improvements in help-seeking in those studies that followed up post-screen. In healthcare settings, clinicians continue to have difficulty identifying eating disorder presentations, particularly Binge Eating Disorder, Other Specified Feeding or Eating Disorders, and sub-threshold eating disorders. This is preceded by inadequate and frequently homogenous screening mechanisms and exacerbated by considerable personal and health-system barriers, including self-stigma and lack of resourcing. While all groups are at risk of delayed or no diagnosis, those at particular risk include LGBTQ+ and gender diverse individuals, individuals living in larger bodies, and males. CONCLUSIONS A majority of individuals with eating disorders remain undiagnosed and untreated despite a high prevalence of these conditions and increased advocacy in recent years. Research into improving detection and clinician diagnostic skill is extremely limited. Innovative empirical research is strongly recommended to address significant individual and health-system barriers currently preventing appropriate and timely intervention for many. Limited screening in healthcare settings and low rates of eating disorder training in the healthcare professions are just some of the barriers to help-seeking which may contribute to delayed intervention and diagnosis in the eating disorders. This has significant impacts, prolonging treatment when it is finally received, and increasing healthcare costs for both the individual and the healthcare system. The current review is part of a larger Rapid Review series conducted to inform the development of Australia's National Eating Disorders Research and Translation Strategy 2021-2031. A Rapid Review is designed to comprehensively summarise a body of literature in a short timeframe, often to guide policy-making and address urgent health concerns. The Rapid Review synthesises the current evidence-base and identifies gaps in eating disorder research and care, in order to guide decision making and address urgent health concerns. This paper gives a critical overview of the scientific literature relating to the current state of screening, assessment, and diagnosis of eating disorders within Western healthcare systems that may inform health policy and research in an Australian context. It covers screening initiatives in both general and high-risk populations; personal, clinician and healthcare system challenges relating to help-seeking; and obstacles to accurate and timely clinical diagnosis across the eating disorders.
Collapse
Affiliation(s)
- Emma Bryant
- InsideOut Institute for Eating Disorders, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
| | - Karen Spielman
- InsideOut Institute for Eating Disorders, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Anvi Le
- Healthcare Management Advisors, Melbourne, VIC, Australia
| | - Peta Marks
- InsideOut Institute for Eating Disorders, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | | | - Stephen Touyz
- InsideOut Institute for Eating Disorders, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Sarah Maguire
- InsideOut Institute for Eating Disorders, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.,Sydney Local Health District, New South Wales Health, Sydney, Australia
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
11
|
Chen DR, Sun G, Levin B. Gender-specific responses to multifaceted factors associated with disordered eating among adolescents of 7th to 9th grade. J Eat Disord 2022; 10:5. [PMID: 35012675 PMCID: PMC8751146 DOI: 10.1186/s40337-021-00524-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 12/15/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The prevalence of disordered eating is increasing among adolescents in Asia. The prevalence and predictors of disordered eating in boys have often gone unrecognized. This study examined gender-specific responses to multifaceted factors associated with disordered eating, including personal, behavioral, family, and school-related characteristics. METHODS After excluding responses with incomplete information, a sample of 729 adolescents (48.97% boys) between the ages of 13 and 16 were surveyed through convenience sampling from 37 classrooms in three junior high schools in New Taipei City of Taiwan were analyzed. The Eating Attitudes Test-26 questionnaire was used to identify disordered eating. RESULTS No difference in the prevalence of disordered eating between the genders was found. Adolescent girls exhibit a preoccupation with fatness and a desire to be thinner, whereas boys are more likely to engage in extreme dieting behaviors such as vomiting, keeping the stomach empty, and avoiding sweets. Girls engaging in disordered eating reported relatively high levels of interpersonal stress involving family member weight-teasing, low peer acceptance, and high peer pressure to control weight. High intensity of regular exercise was found in girls with disordered eating. The perception of body weight is a more critical factor of engaging in disordered eating for boys than girls. Adolescents with immigrant parents were associated with disordered eating among both genders. CONCLUSIONS Changing gender-specific weight-related norms in schools and families is essential to reduce the prevalence of disordered eating, particularly among girls. Future studies using representative samples to confirm this study's findings are warranted.
Collapse
Affiliation(s)
- Duan-Rung Chen
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, No. 17, Xu-Zhou Road, Taipei, 100, Taiwan.
| | - Grace Sun
- University of Southern California, Los Angeles, CA, USA
| | - Brianna Levin
- Global Health Program, College of Public Health, National Taiwan University, Taipei, Taiwan
| |
Collapse
|
12
|
Yoon C, Emery RL, Hazzard VM, Mason SM, Neumark-Sztainer D. Adverse experiences as predictors of maladaptive and adaptive eating: Findings from EAT 2018. Appetite 2022; 168:105737. [PMID: 34627979 PMCID: PMC9505995 DOI: 10.1016/j.appet.2021.105737] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 10/04/2021] [Accepted: 10/05/2021] [Indexed: 01/03/2023]
Abstract
Adverse experiences, such as childhood abuse and other violence victimization, are associated with problematic eating. However, whether different types of adversity relate to both maladaptive and adaptive eating behaviors is unclear. This study examined the associations of different adverse experiences with maladaptive (i.e., overeating and binge eating) and adaptive (i.e., intuitive eating and mindful eating) eating by gender. Data were derived from the EAT-2018 (Eating and Activity over Time) study (N = 1411, aged 18-30 years in 2017-2018). Modified Poisson regressions were used to examine the associations between adverse experiences and the prevalence of maladaptive eating. Linear regressions were used to examine the associations between adverse experiences and adaptive eating scores. Each adverse experience was associated with greater prevalence of maladaptive eating and lower adaptive eating scores. Among women, intimate partner sexual violence was strongly associated with more overeating (PR = 2.1 [95% CI = 1.4-3.1]) and binge eating (PR = 2.4 [95% CI = 1.5-3.9]), and less mindful eating (β = -0.6, [95% CI = -0.8, -0.3]); being attacked, beaten, or mugged was most associated with less intuitive eating (β = -0.5, [95% CI = -0.8, -0.2]). Among men, being attacked, beaten, or mugged was strongly associated with more overeating (PR = 2.1 [95% CI = 1.2-3.5]) and binge eating (PR = 3.2 [95% CI = 1.6-6.5]); intimate partner physical violence was strongly associated with less intuitive eating (β = -0.6, [95% CI = -0.9, -0.2]); childhood emotional abuse was strongly associated with less mindful eating (β = -0.8, [95% CI = -1.0, -0.5]). To improve eating behaviors, adverse life experiences and the potential impact on maladaptive and adaptive eating should be considered.
Collapse
Affiliation(s)
- Cynthia Yoon
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA 55454,University of Houston, Department of Health and Human Performance, Houston, TX 77006
| | - Rebecca L. Emery
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA 55454
| | - Vivienne M. Hazzard
- Sanford Center for Biobehavioral Research, 120 Eight St S, Fargo, ND 58103, USA
| | - Susan M. Mason
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA 55454
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA 55454
| |
Collapse
|
13
|
Pinna F, Suprani F, Deiana V, Lai L, Manchia M, Paribello P, Somaini G, Diana E, Nicotra EF, Farci F, Ghiani M, Cau R, Tuveri M, Cossu E, Loy E, Crapanzano A, Grassi P, Loviselli A, Velluzzi F, Carpiniello B. Depression in Diabetic Patients: What Is the Link With Eating Disorders? Results of a Study in a Representative Sample of Patients With Type 1 Diabetes. Front Psychiatry 2022; 13:848031. [PMID: 35782445 PMCID: PMC9243395 DOI: 10.3389/fpsyt.2022.848031] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 05/25/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND PURPOSE Comorbidity between diabetes and depression, and diabetes and eating disorders (ED) conveys significant diagnostic, clinical and therapeutic implications. The present study was conducted on a sample of adult outpatients affected by Type 1 Diabetes (T1DM) to assess lifetime prevalence of ED; current prevalence of depression and Disturbed Eating Behaviors (DEB) and their impact on glycemic control. We hypothesized that patients with depression would have higher rates of lifetime ED and current DEB. We hypothesized a significant and independent association between DEB and the prevalence of depression. MATERIALS AND METHODS The study was carried out using a cross-sectional design in a sample of 172 diabetic patients with T1DM aged from 17 to 55 years. Lifetime prevalence of ED according to DSM-5 criteria was assessed by means of the Module H modified of the Structured Clinical Interview for DSM-IV Axis I Disorder (SCID-I). The following questionnaires were used: Beck Depression Inventory-IA version (BDI-IA) and Diabetes Eating Problems Survey-Revised (DEPS-R), to assess respectively the current presence of depression and DEB. Socio-demographic, clinical, and laboratory data were also collected. RESULTS High rates of depression (35.5%) and DEB (19.2%) were observed in our sample of 172 adult outpatients with T1DM. Lifetime history of ED was present in 20.9% of the sample and was more frequently diagnosed in patients with current depression (34.4% vs. 13.9%, p = 0.002). Higher levels of DEB at DEPS-R significantly increased the odds of depression (adjOR: 1.09; 95% CI: 1.03-1.15; p = 0.003). The presence of DEB was associated with poor glycemic control. On the other hand, no association was found between depression and metabolic compensation. CONCLUSION Adult patients with T1DM and depression should be screened for ED and DEB. Treating DEB could positively impact both mood and glycemic control in this population. Further studies should be carried out on a larger patient population using a longitudinal design and an accurate method of evaluation to explore the complex relationship between diabetes, depression, ED, and DEB. Future research should investigate treatment strategies for DEB in T1DM patients and their impact on both psychopathological and metabolic outcomes.
Collapse
Affiliation(s)
- Federica Pinna
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Federico Suprani
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Valeria Deiana
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Lorena Lai
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Mirko Manchia
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy.,Department of Pharmacology, Dalhousie University, Halifax, NS, Canada
| | - Pasquale Paribello
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Giulia Somaini
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Enrica Diana
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | | | - Fernando Farci
- Unit of Diabetology, Azienda Sanitaria Locale Cagliari, Quartu Sant'Elena, Italy
| | - Mariangela Ghiani
- Unit of Diabetology, Azienda Sanitaria Locale Cagliari, Quartu Sant'Elena, Italy
| | - Rossella Cau
- Unit of Diabetology, Azienda Sanitaria Locale Cagliari, Quartu Sant'Elena, Italy
| | - Marta Tuveri
- Endocrinology and Diabetes Unit, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Efisio Cossu
- Endocrinology and Diabetes Unit, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Elena Loy
- Endocrinology and Diabetes Unit, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Andrea Crapanzano
- Department of Counseling, San Francisco State University, San Francisco, CA, United States
| | - Paola Grassi
- Department of Education, Psychology and Philosophy, University of Cagliari, Cagliari, Italy
| | - Andrea Loviselli
- Endocrinology and Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Fernanda Velluzzi
- Endocrinology and Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Bernardo Carpiniello
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| |
Collapse
|
14
|
Yeargin S, Torres-McGehee TM, Emerson D, Koller J, Dickinson J. Hydration, Eating Attitudes and Behaviors in Age and Weight-Restricted Youth American Football Players. Nutrients 2021; 13:nu13082565. [PMID: 34444723 PMCID: PMC8401195 DOI: 10.3390/nu13082565] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 07/19/2021] [Accepted: 07/21/2021] [Indexed: 01/17/2023] Open
Abstract
There is a paucity of research examining hydration and nutrition behaviors in youth American football players. A potentially unique risk factor are league restrictions based on weight (WR) or age (AR). The purpose of this study was to examine hydration status between WR and AR leagues. The secondary purpose was to describe eating patterns in players. An observational cohort design with 63 youth football players (10 ± 1 yrs, 148.2 ± 9.4 cm, 44.9 ± 15.3 kg) was utilized. Independent variables were league (AR (n = 36); WR (n = 27)) and activity type (practice (PX = 8); game (GM = 3)). Dependent variables were hydration status (urine osmolality; percent change in body mass (%BM)), eating attitudes (Children’s Eating Attitude Test (ChEAT-26)) and self-reported frequency of meals. On average, players arrived activity mildly hypohydrated (830 ± 296 mOsm/kg) and %BM was minimal (−0.1 ± 0.7%) during events. Players consumed 2 ± 1 meals and 1 ± 1 snack before events. The ChEAT-26 survey reported 21.6% (n = 8) of players were at risk for abnormal eating attitudes. Among these players, eating binges, vomiting, excessive exercise and drastic weight loss were reported. Youth American football players arrived activity mildly hypohydrated and consumed enough fluid during activity to maintain euhydration. Abnormal eating attitudes and the use of unhealthy weight loss methods were reported by some youth American football players.
Collapse
Affiliation(s)
- Susan Yeargin
- Exercise Science Department, Arnold School of Public Health University of South Carolina, Columbia, SC 29208, USA;
- Correspondence:
| | - Toni M. Torres-McGehee
- Exercise Science Department, Arnold School of Public Health University of South Carolina, Columbia, SC 29208, USA;
| | - Dawn Emerson
- Department of Physical Therapy, Rehabilitation Sciences, and Athletic Training, School of Health Professions University of Kansas Medical Center, Kansas City, KS 66160, USA;
| | | | - John Dickinson
- Palmetto Health/USC Orthopedic Center, Columbia, SC 29203, USA;
| |
Collapse
|
15
|
The Peer Context of Dieting: The Relationship between Young Adults' Dieting Frequency and Their Friends' Weight-Related Characteristics. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15122744. [PMID: 30563072 PMCID: PMC6313730 DOI: 10.3390/ijerph15122744] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 12/03/2018] [Accepted: 12/04/2018] [Indexed: 11/17/2022]
Abstract
Previous research found that weight-related behaviors and body weight tends to be similar between individuals and peers. Rather little is known how different domains of weight-related behaviors co-evolve in peer networks. Hence, this study explores how young adults' self-reported dieting relates to perceived body weight and weight control behaviors of their peers. A Swedish two-wave panel survey with ego-centric network data was analyzed with negative binomial regression models. Nineteen-year-old men and women in the first wave, and 23-year-olds in the follow-up sample were examined. Men at age 19 showed an increased dieting propensity when being exposed to underweight peers. Compared to men, women's dieting at age 19 was more strongly related to their own body image concerns, and peers' weight-related behaviors like physical exercising and unhealthy eating. The associations between dieting and peers' weight-related characteristics for men and women deteriorated from age 19 to age 23. The findings suggest that women's dieting-in comparison to dieting in men-is more strongly related to the peer context. The decrease in associations between men's and women's dieting and peers' weight-related characteristics from age 19 to age 23 may reflect a weakened importance of the peer context in early adulthood.
Collapse
|
16
|
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.
Collapse
|
17
|
Attachment and eating: A meta-analytic review of the relevance of attachment for unhealthy and healthy eating behaviors in the general population. Appetite 2018; 123:410-438. [DOI: 10.1016/j.appet.2017.10.043] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 10/13/2017] [Accepted: 10/31/2017] [Indexed: 01/21/2023]
|
18
|
Prospective Relations between Overeating, Loss of Control Eating, Binge Eating, and Depressive Symptoms in a School-Based Sample of Adolescents. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2017; 45:693-703. [PMID: 27401881 DOI: 10.1007/s10802-016-0186-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
A sample of 353 community adolescents (grades 9 to 12, 57.6 % female) participated in a 2-wave longitudinal study of eating behaviors (overeating, loss of control eating [LOC], and binge eating) and depression. The study addresses 4 hypotheses. (1) The prospective relations between eating behaviors and depressive symptoms will be reciprocal, with each predicting the other over time. (2) These relations will be stronger for girls than for boys. (3) These relations will be stronger for adolescents with high (not low) body mass index (BMI). (4) LOC will show incremental predictive utility in relation to depressive symptoms over and above overeating. Evidence supported reciprocal relations between binge eating and depressive symptoms and between overeating and depressive symptoms, but not between LOC and depressive symptoms. Sex and BMI did not substantially moderate these relations. Taken separately, overeating but not LOC predicted depressive symptoms. Taken together, neither predictor was significant controlling for the other. Results raise questions about the importance of LOC alone in predicting depressive symptoms in adolescence.
Collapse
|
19
|
Gan WY, Yeoh WC. Associations between body weight status, psychological well-being and disordered eating with intuitive eating among Malaysian undergraduate university students. Int J Adolesc Med Health 2017; 32:/j/ijamh.ahead-of-print/ijamh-2017-0095/ijamh-2017-0095.xml. [PMID: 28902620 DOI: 10.1515/ijamh-2017-0095] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 06/22/2017] [Indexed: 02/06/2023]
Abstract
Intuitive eating, which can be defined as reliance on physiological hunger and satiety cues to guide eating, has been proposed as a healthy weight management strategy. To date, there has not been a published study on intuitive eating in the context of Malaysia. Therefore, this cross-sectional study aims to determine associations between body weight status, psychological well-being and disordered eating behaviors with intuitive eating among undergraduate university students. A total of 333 undergraduate respondents (21.3% males and 78.7% females) from three randomly selected faculties in a public university in Malaysia participated in this study. Respondents completed a self-administered questionnaire which featured socio-demographic characteristics, intuitive eating, self-esteem, body appreciation, general unconditional acceptance, body acceptance by others, body function and disordered eating. Body weight, height, body fat percentage and waist circumference were measured. The results from this study revealed that there was no difference (t = 0.067, p = 0.947) in intuitive eating scores between males (75.69 ± 7.16) and females (75.62 ± 7.90). Multiple linear regression results have shown that body appreciation (β = 0.385, p < 0.001) and disordered eating (β = -0.168, p = 0.001) were significant predictors of intuitive eating, which accounted for 19.6% of the variance in intuitive eating. Health promotion programs should highlight the importance of enhancing body appreciation and preventing disordered eating behaviors among university students in order to promote intuitive eating as one of the healthy weight management approaches.
Collapse
Affiliation(s)
- Wan Ying Gan
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400Serdang, Selangor,Malaysia
| | - Wei Ching Yeoh
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia 43400 Serdang, Selangor, Malaysia
| |
Collapse
|
20
|
Pinna F, Diana E, Sanna L, Deiana V, Manchia M, Nicotra E, Fiorillo A, Albert U, Nivoli A, Volpe U, Atti AR, Ferrari S, Medda F, Atzeni MG, Manca D, Mascia E, Farci F, Ghiani M, Cau R, Tuveri M, Cossu E, Loy E, Mereu A, Mariotti S, Carpiniello B. Assessment of eating disorders with the diabetes eating problems survey - revised (DEPS-R) in a representative sample of insulin-treated diabetic patients: a validation study in Italy. BMC Psychiatry 2017; 17:262. [PMID: 28724422 PMCID: PMC5518128 DOI: 10.1186/s12888-017-1434-8] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 07/13/2017] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The purpose of the study was to evaluate in a sample of insulin-treated diabetic patients, with type 1 or type 2 diabetes, the psychometric characteristics of the Italian version of the DEPS-R scale, a diabetes-specific self-report questionnaire used to analyze disordered eating behaviors. METHODS The study was performed on 211 consecutive insulin-treated diabetic patients attending two specialist centers. Lifetime prevalence of eating disorders (EDs) according to DSM-IV and DSM-5 criteria were assessed by means of the Module H of the Structured Clinical Interview for DSM IV Axis I Disorder and the Module H modified, according to DSM-5 criteria. The following questionnaires were administered: DEPS-R and the Eating Disorder Inventory - 3 (EDI-3). Test/retest reproducibility was assessed on a subgroup of 70 patients. The factorial structure, internal consistency, test-retest reliability and concurrent validity of DEPS-R were assessed. RESULTS Overall, 21.8% of the sample met criteria for at least one DSM-5 diagnosis of ED. A "clinical risk" of ED was observed in 13.3% of the sample. Females displayed higher scores at DEPS-R, a higher percentage of at least one diagnosis of ED and a higher clinical risk for ED. A high level of reproducibility and homogeneity of the scale were revealed. A significant correlation was detected between DEPS-R and the 3 ED risk scales of EDI-3. CONCLUSIONS The data confirmed the overall reliability and validity of the scale. In view of the significance and implications of EDs in diabetic patients, it should be conducted a more extensive investigation of the phenomenon by means of evaluation instruments of demonstrated validity and reliability.
Collapse
Affiliation(s)
- Federica Pinna
- Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy.
| | - Enrica Diana
- 0000 0004 1755 3242grid.7763.5Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
| | - Lucia Sanna
- 0000 0004 1755 3242grid.7763.5Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
| | - Valeria Deiana
- 0000 0004 1755 3242grid.7763.5Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
| | - Mirko Manchia
- 0000 0004 1755 3242grid.7763.5Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy ,0000 0004 1936 8200grid.55602.34Department of Pharmacology, Dalhousie University, Halifax, NS Canada
| | - Eraldo Nicotra
- 0000 0004 1755 3242grid.7763.5Department of Pedagogy, Psychology, Philosophy, University of Cagliari, Cagliari, Italy
| | - Andrea Fiorillo
- 0000 0001 0790 385Xgrid.4691.aDepartment of Psychiatry, University of Naples SUN, Naples, Italy
| | - Umberto Albert
- 0000 0001 2336 6580grid.7605.4Rita Levi Montalcini Department of Neuroscience, Anxiety and Mood Disorders Unit, University of Turin, Turin, Italy
| | - Alessandra Nivoli
- 0000 0001 2097 9138grid.11450.31Psychiatric Institute, Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy
| | - Umberto Volpe
- 0000 0001 0790 385Xgrid.4691.aDepartment of Psychiatry, University of Naples SUN, Naples, Italy
| | - Anna Rita Atti
- 0000 0004 1757 1758grid.6292.fDepartment of Biomedical and Neuro Motor Sciences, University of Bologna, Bologna, Italy
| | - Silvia Ferrari
- 0000000121697570grid.7548.eDepartment of Diagnostic-Clinical Medicine and Public Health, University of Modena & Reggio Emilia, Modena, Italy
| | - Federica Medda
- 0000 0004 1755 3242grid.7763.5Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
| | - Maria Gloria Atzeni
- 0000 0004 1755 3242grid.7763.5Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
| | - Daniela Manca
- 0000 0004 1755 3242grid.7763.5Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
| | - Elisa Mascia
- 0000 0004 1755 3242grid.7763.5Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
| | - Fernando Farci
- Unit of Diabetology, ASL-Cagliari, Quartu Sant’Elena, Italy
| | | | - Rossella Cau
- Unit of Diabetology, ASL-Cagliari, Quartu Sant’Elena, Italy
| | - Marta Tuveri
- Endocrinology and Diabetes Unit, AOU-Cagliari, Monserrato, Italy
| | - Efisio Cossu
- Endocrinology and Diabetes Unit, AOU-Cagliari, Monserrato, Italy
| | - Elena Loy
- Endocrinology and Diabetes Unit, AOU-Cagliari, Monserrato, Italy
| | - Alessandra Mereu
- 0000 0004 1755 3242grid.7763.5Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
| | - Stefano Mariotti
- Endocrinology and Diabetes Unit, AOU-Cagliari, Monserrato, Italy ,0000 0004 1755 3242grid.7763.5Department of Medical Sciences, University of Cagliari, Monserrato, Italy
| | - Bernardo Carpiniello
- 0000 0004 1755 3242grid.7763.5Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
| |
Collapse
|
21
|
Nagata JM, Golden NH, Leonard MB, Copelovitch L, Denburg MR. Assessment of Sex Differences in Fracture Risk Among Patients With Anorexia Nervosa: A Population-Based Cohort Study Using The Health Improvement Network. J Bone Miner Res 2017; 32:1082-1089. [PMID: 28019700 PMCID: PMC5413380 DOI: 10.1002/jbmr.3068] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 12/16/2016] [Accepted: 12/21/2016] [Indexed: 12/20/2022]
Abstract
Though previous studies have demonstrated an increased fracture risk in females with anorexia nervosa (AN), fracture risk in males is not well characterized. The objective of this study was to examine sex differences in fracture risk and site-specific fracture incidence in AN. We performed a population-based retrospective cohort study using The Health Improvement Network (THIN; a large database of anonymized electronic medical records collected at primary care clinics throughout the United Kingdom). The median calendar year for the start of the observation period was 2004-2005. We identified 9239 females and 556 males <60 years of age with AN, and 97,889 randomly selected sex-, age-, and practice-matched participants without eating disorders (92,329 females and 5560 males). Multivariable Cox regression was used to estimate the hazard ratio (HR) for incident fracture. Median age at start of observation was 29.8 years in females and 30.2 years in males. The HR for fracture associated with AN differed by sex and age (interaction p = 0.002). Females with AN had an increased fracture risk at all ages (HR, 1.59; 95% confidence interval [CI], 1.45 to 1.75). AN was associated with a higher risk of fracture among males >40 years of age (HR, 2.54; 95% CI, 1.32 to 4.90; p = 0.005) but not among males ≤40 years. Females with AN had a higher risk of fracture at nearly all anatomic sites. The greatest excess fracture risk was noted at the hip/femur (HR, 5.59; 95% CI, 3.44 to 9.09) and pelvis (HR, 4.54; 95% CI, 2.42 to 8.50) in females and at the vertebrae (HR, 7.25; 95% CI, 1.21 to 43.45) for males with AN. AN was associated with higher incident fracture risk in females across all age groups and in males >40 years old. Sites of highest fracture risk include the hip/femur and pelvis in females and vertebrae in males with AN. © 2016 American Society for Bone and Mineral Research.
Collapse
Affiliation(s)
- Jason M Nagata
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Neville H Golden
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Mary B Leonard
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Lawrence Copelovitch
- Department of Pediatrics, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Michelle R Denburg
- Department of Pediatrics, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| |
Collapse
|
22
|
Nagata JM, Golden NH, Peebles R, Long J, Leonard MB, Chang AO, Carlson JL. Assessment of sex differences in bone deficits among adolescents with anorexia nervosa. Int J Eat Disord 2017; 50:352-358. [PMID: 27611361 PMCID: PMC6613779 DOI: 10.1002/eat.22626] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 08/19/2016] [Accepted: 08/21/2016] [Indexed: 01/27/2023]
Abstract
OBJECTIVE The objective of this study was to compare sex differences in bone deficits among adolescents with anorexia nervosa (AN) and to identify other correlates of bone health. METHOD Electronic medical records of all patients 9-20 years of age with a DSM-5 diagnosis of AN who were evaluated by the eating disorders program at Stanford with dual-energy X-ray absorptiometry (DXA) between March 1997 and February 2011 were retrospectively reviewed. Whole body bone mineral content Z-scores and bone mineral density (BMD) Z-scores at multiple sites were recorded using the Bone Mineral Density in Childhood Study (BMDCS) reference data. RESULTS A total of 25 males and 253 females with AN were included, with median age 15 years (interquartile range [IQR] 14-17) and median duration of illness 9 months (IQR 5-13). Using linear regression analyses, no significant sex differences in bone deficits were found at the lumbar spine, total hip, femoral neck, or whole body when controlling for age, %mBMI, and duration of illness. Lower %mBMI was significantly associated with bone deficits at all sites in adjusted models. DISCUSSION This is the first study to evaluate sex differences in bone health among adolescents with AN, using novel DSM-5 criteria for AN and robust BMDCS reference data. We find no significant sex differences in bone deficits among adolescents with AN except for a higher proportion of females with femoral neck BMD Z-scores <-1. Degree of malnutrition was correlated with bone deficits at all sites. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2017; 50:352-358).
Collapse
Affiliation(s)
- Jason M. Nagata
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California, USA
| | - Neville H. Golden
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California, USA
| | - Rebecka Peebles
- Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Jin Long
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California, USA
| | - Mary B. Leonard
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California, USA
| | - Audrey O. Chang
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California, USA
| | - Jennifer L. Carlson
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California, USA
| |
Collapse
|
23
|
Pinna F, Milia P, Mereu A, di Santa Sofia SL, Puddu L, Fatteri F, Ghiani A, Lai A, Sanna L, Carpiniello B. Validation of the Italian version of the Compensatory Eating and Behaviors in Response to Alcohol Consumption Scale (CEBRACS). Eat Behav 2015; 19:120-6. [PMID: 26356633 DOI: 10.1016/j.eatbeh.2015.08.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Revised: 06/08/2015] [Accepted: 08/26/2015] [Indexed: 11/16/2022]
Abstract
The aim of the study was to evaluate, in a representative sample of high school students, the psychometric characteristics of the Italian version of the CEBRACS scale (Rahal et al., 2011), a questionnaire investigating compensatory eating behaviors correlated with alcohol consumption. These behaviors are adopted to make up for calories consumed through the drinking of alcohol and/or to enhance the intoxicative effects of alcohol. Study participants were selected from an initial sample of 965 students. Out of the 965 youths originally recruited, 640 (376 males and 264 females) reported drinking alcohol over the previous 3 months, and were considered eligible for the purpose of the study. The following questionnaires were administered: CEBRACS, Alcohol Use Disorders Identification Test (AUDIT) (Saunders, 1993), and the Eating Disorder Inventory-3 (EDI-3) (Garner, 2004). Test/retest reproducibility was evaluated on a subgroup of 189 youths. The factorial structure, internal consistency, test–retest reliability and concurrent validity of CEBRACS were evaluated. Factor analysis of inter-item correlation indicated 5 factors as being better suited to describe data, with an estimated 68.85% variance: "Alcohol Effect, "Laxative Use", "Dietary Restraint and Exercise", "Diuretic Use", "Restriction and Vomiting". A high degree of reproducibility and homogeneity (ICC = 0.806; Cronbach's Alpha = 0.886) of the scale was detected. A significant correlation was revealed between CEBRACS, the three eating disorder risk scales comprised in EDI-3 and scores and clinical risk yielded by AUDIT. The overall reliability and validity of the CEBRACS scale was confirmed in an extensive sample of Italian students, highlighting a satisfactory construct validity, good internal consistency and good degree of reproducibility. In view of the relevance of the problem, associated with serious health risks, a more widespread investigation of the phenomenon should be conducted using evaluation tools of proven validity and reliability on both representative samples of the general population and clinical samples.
Collapse
Affiliation(s)
- Federica Pinna
- University of Cagliari, Department of Public Health, Clinical and Molecular Medicine, Italy
| | - Paola Milia
- University of Cagliari, Department of Public Health, Clinical and Molecular Medicine, Italy
| | - Alessandra Mereu
- University of Cagliari, Department of Public Health, Clinical and Molecular Medicine, Italy
| | | | - Laura Puddu
- University of Cagliari, Department of Public Health, Clinical and Molecular Medicine, Italy
| | - Francesca Fatteri
- University of Cagliari, Department of Public Health, Clinical and Molecular Medicine, Italy
| | - Alice Ghiani
- University of Cagliari, Department of Public Health, Clinical and Molecular Medicine, Italy
| | - Alice Lai
- University of Cagliari, Department of Public Health, Clinical and Molecular Medicine, Italy
| | - Lucia Sanna
- University of Cagliari, Department of Public Health, Clinical and Molecular Medicine, Italy
| | - Bernardo Carpiniello
- University of Cagliari, Department of Public Health, Clinical and Molecular Medicine, Italy.
| |
Collapse
|
24
|
Rauof M, Ebrahimi H, Asghari Jafarabadi M, Malek A, Babapour Kheiroddin J. Prevalence of Eating Disorders Among Adolescents in the Northwest of Iran. IRANIAN RED CRESCENT MEDICAL JOURNAL 2015; 17:e19331. [PMID: 26568851 PMCID: PMC4640058 DOI: 10.5812/ircmj.19331] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Revised: 08/10/2014] [Accepted: 08/31/2014] [Indexed: 11/26/2022]
Abstract
Background: Perceived sociocultural pressure to be thin has an important impact on disordered eating during early and middle adolescence, but less is known about late adolescence. Adolescents face special problems that are less common during childhood. Several studies indicate that the prevalence of eating disorders has been increased among adolescents. Objectives: The aim of the present study was to investigate the occurrence, prevalence and correlates of eating disorders (ED) among adolescents in two cities of Iran, Urmia and Tabriz. Patients and Methods: This was a cross-sectional survey in which 1990 adolescent boys and girls were selected through multistage random sampling. The study was based on self-report questionnaires including eating attitudes test (EAT-26) and DSM-IV criteria for the presence of eating disorders. To analyze the obtained data we calculated measures of central tendency and dispersion, linear and logistic regression and Fisher’s exact test. Results: According to diagnostic criteria of EAT-26, 492 students (24.2%) were at risk of ED and scored above the recommended cut-off point on EAT-26. Among 1990 students, a total of 51 cases (0.25%) of eating disorder (14 anorexia nervosa, 18 bulimia nervosa, and 19 eating disorder not otherwise specified) were diagnosed. Conclusions: The obtained prevalence of ED in our study was higher than previous studies in Iran. We found high numbers of boys with ED. Overweight adolescents were shown to be more susceptible to strict dieting than normal-weight adolescents. These results suggest that it is necessary to provide screening and treatment services for Iranian adolescents. Further research is needed to develop intervention programs to control eating disorders among Iranian adolescents.
Collapse
Affiliation(s)
- Maryam Rauof
- Department of Psychiatric Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, IR Iran
| | - Hossein Ebrahimi
- Department of Psychiatric Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, IR Iran
- Corresponding Author: Hossein Ebrahimi, Department of Psychiatric Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences Tabriz, IR Iran. Tel: +98-4114751709, Fax: +98-4114796969, E-mail:
| | - Mohammad Asghari Jafarabadi
- Health Services Management Research Center, Department of Biostatistics and Epidemiology, Tabriz University of Medical Sciences, Tabriz, IR Iran
| | - Ayyoub Malek
- Research Center of Psychiatry and Behavioral Sciences, Department of Psychiatry, Tabriz University of Medical Sciences, Tabriz, IR Iran
| | - Jalil Babapour Kheiroddin
- Department of Psychology, Faculty of Educational Sciences and Psychology, Tabriz University, Tabriz, IR Iran
| |
Collapse
|
25
|
Toufexis MD, Hommer R, Gerardi DM, Grant P, Rothschild L, D'Souza P, Williams K, Leckman J, Swedo SE, Murphy TK. Disordered eating and food restrictions in children with PANDAS/PANS. J Child Adolesc Psychopharmacol 2015; 25:48-56. [PMID: 25329522 PMCID: PMC4340640 DOI: 10.1089/cap.2014.0063] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Sudden onset clinically significant eating restrictions are a defining feature of the clinical presentation of some of the cases of pediatric acute-onset neuropsychiatric syndrome (PANS). Restrictions in food intake are typically fueled by contamination fears; fears of choking, vomiting, or swallowing; and/or sensory issues, such as texture, taste, or olfactory concerns. However, body image distortions may also be present. We investigate the clinical presentation of PANS disordered eating and compare it with that of other eating disorders. METHODS We describe 29 patients who met diagnostic criteria for PANS. Most also exhibited evidence that the symptoms might be sequelae of infections with Group A streptococcal bacteria (the pediatric autoimmune neuropsychiatric disorder associated with streptococcal infections [PANDAS] subgroup of PANS). RESULTS The clinical presentations are remarkable for a male predominance (2:1 M:F), young age of the affected children (mean=9 years; range 5-12 years), acuity of symptom onset, and comorbid neuropsychiatric symptoms. CONCLUSIONS The food refusal associated with PANS is compared with symptoms listed for the new Diagnostic and Statistical Manual of Mental Disorders, 5th ed. (DSM-V) diagnosis of avoidant/restrictive food intake disorder (ARFID). Treatment implications are discussed, as well as directions for further research.
Collapse
Affiliation(s)
- Megan D. Toufexis
- Division of Pediatric Neuropsychiatry, Rothman Center, Department of Pediatrics, University of South Florida, St. Petersburg, Florida
| | - Rebecca Hommer
- Pediatrics & Developmental Neuroscience Branch, National Institute of Mental Health, Bethesda, Maryland
| | - Diana M. Gerardi
- Division of Pediatric Neuropsychiatry, Rothman Center, Department of Pediatrics, University of South Florida, St. Petersburg, Florida
| | - Paul Grant
- Pediatrics & Developmental Neuroscience Branch, National Institute of Mental Health, Bethesda, Maryland
| | - Leah Rothschild
- Pediatrics & Developmental Neuroscience Branch, National Institute of Mental Health, Bethesda, Maryland
| | - Precilla D'Souza
- Pediatrics & Developmental Neuroscience Branch, National Institute of Mental Health, Bethesda, Maryland
| | - Kyle Williams
- Pediatric Neuropsychiatry and Immunology Clinic, Massachusetts General Hospital, Boston, Massachusetts.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - James Leckman
- Child Study Center, Yale University School of Medicine, New Haven, Connecticut
| | - Susan E. Swedo
- Pediatrics & Developmental Neuroscience Branch, National Institute of Mental Health, Bethesda, Maryland
| | - Tanya K. Murphy
- Division of Pediatric Neuropsychiatry, Rothman Center, Department of Pediatrics, University of South Florida, St. Petersburg, Florida.,Department of Psychiatry, University of South Florida, Tampa, Florida
| |
Collapse
|
26
|
Severe growing-up phobia, a condition explained in a 14-year-old boy. Case Rep Psychiatry 2015; 2014:706439. [PMID: 25610691 PMCID: PMC4283456 DOI: 10.1155/2014/706439] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Revised: 11/19/2014] [Accepted: 11/26/2014] [Indexed: 11/17/2022] Open
Abstract
We present the clinical case of a 14-year-old boy with gerascophobia or an excessive fear of aging, who felt his body development as a threat, to the point where he took extreme measures to stop or otherwise hide growth. He had a history of separation anxiety, sexual abuse, and suffering bullying. He presented with anxious and depressive symptoms and food restriction, criticized his body image, had negative feelings towards the maturation process, suffered at the thought of being rejected, and was preoccupied with certain physical characteristics. We conducted an analysis of biological, psychological, and environmental factors and their possible interactions and established treatment with psychotherapy and fluoxetine. Because of the favorable results, this approach could be considered a good option in such cases.
Collapse
|
27
|
Abstract
Despite their high prevalence, associated morbidity and mortality, and available treatment options, eating disorders (EDs) continue to be underdiagnosed by pediatric professionals. Many adolescents go untreated, do not recover, or reach only partial recovery. Higher rates of EDs are seen now in younger children, boys, and minority groups; EDs are increasingly recognized in patients with previous histories of obesity. Medical complications are common in both full and subthreshold EDs and affect every organ system. No single cause of EDs has emerged, although neurobiological and genetic predispositions are emerging as important. Recent treatment paradigms acknowledge that they are not caused by families or chosen by patients. EDs present differently in pediatric populations, and providers should have a high index of suspicion using new Diagnostic and Statistical Manual, 5th edition diagnostic criteria because early intervention can affect prognosis. Outpatient family-based treatment focused on weight restoration, reducing blame, and empowering caregivers has emerged as particularly effective; cognitive behavioral therapy, individual therapy, and higher levels of care may also be appropriate. Pharmacotherapy is useful in specific contexts. Full weight restoration is critical, often involves high-calorie diets, and must allow for continued growth and development; weight maintenance is typically inappropriate in pediatric populations. Physical, nutritional, behavioral, and psychological health are all metrics of a full recovery, and pediatric EDs have a good prognosis with appropriate care. ED prevention efforts should work toward aligning with families and understanding the impact of antiobesity efforts. Primary care providers can be key players in treatment success.
Collapse
Affiliation(s)
- Kenisha Campbell
- The Craig Dalsimer Division of Adolescent Medicine, Department of Pediatrics, Perelman School of Medicine at The University of Pennsylvania, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Rebecka Peebles
- The Craig Dalsimer Division of Adolescent Medicine, Department of Pediatrics, Perelman School of Medicine at The University of Pennsylvania, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| |
Collapse
|
28
|
Alvarenga MDS, Carvalho PHB, Philippi ST, Scagliusi FB. Propriedades psicométricas da Escala de Atitudes Alimentares Transtornadas para adultos do sexo masculino. JORNAL BRASILEIRO DE PSIQUIATRIA 2013. [DOI: 10.1590/s0047-20852013000400002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJETIVO: Avaliar as propriedades psicométricas da Escala de Atitudes Alimentares Transtornadas (EAAT) para o sexo masculino. MÉTODOS: Duzentos e vinte e oito universitários (18-39 anos) responderam à EAAT, originalmente desenvolvida e validada para o sexo feminino. A consistência interna foi avaliada pelo Alpha de Cronbach e a validade convergente, por meio do coeficiente de correlação de Pearson comparando os escores da EAAT, do Teste de Atitudes Alimentares (EAT) e da Escala de Restrição (RS). A reprodutibilidade foi avaliada aplicando a escala numa subamostra (n = 38) com um mês de intervalo utilizando o coeficiente de correlação intraclasse (CCI). A validade known-groups foi obtida comparando o escore dos universitários na EAAT com o escore de homens com diagnóstico de transtornos alimentares (TA) (n = 28). RESULTADOS: A consistência interna da escala foi de 0,63. O escore da EAAT foi correlacionado com a EAT (r = 0,65) e RS (r = 0,51), e o CCI entre o teste e o reteste foi de 0,948. A análise known-groups diferenciou pacientes com TA de estudantes universitários (p < 0,001). CONCLUSÕES: A escala apresentou propriedades psicométricas adequadas e pode ser utilizada em estudos com homens adultos - uma vez que o constructo é pouco explorado em homens. Recomenda-se, de qualquer forma, uma revisão da escala e desenvolvimento de instrumentos específicos para o público masculino.
Collapse
|
29
|
Ahrén JC, Chiesa F, Koupil I, Magnusson C, Dalman C, Goodman A. We are family--parents, siblings, and eating disorders in a prospective total-population study of 250,000 Swedish males and females. Int J Eat Disord 2013; 46:693-700. [PMID: 23740699 DOI: 10.1002/eat.22146] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/22/2013] [Indexed: 11/11/2022]
Abstract
OBJECTIVE We examined how parental characteristics and other aspects of family background were associated with the development of eating disorders (ED) in males and females. METHOD We used register data and record linkage to create the prospective, total-population study the Stockholm Youth Cohort. This cohort comprises all children and adolescents who were ever residents in Stockholm County between 2001 and 2007, plus their parents and siblings. Individuals born between 1984 and 1995 (N = 249, 884) were followed up for ED from age 12 to end of 2007. We used Cox regression modeling to investigate how ED incidence was associated with family socioeconomic position, parental age, and family composition. RESULTS In total, 3,251 cases of ED (2,971 females; 280 males) were recorded. Higher parental education independently predicted a higher rate of ED in females [e.g., adjusted hazard ratio (HR) 1.69 (95% CI: 1.42, 2.02) for degree-level vs. elementary-level maternal education], but not in males [HR 0.73 (95% CI: 0.42, 1.28), p < 0.001 for gender interaction]. In females, an increasing number of full-siblings was associated with lower rate of ED [e.g., fully adjusted HR 0.92 (95% CI: 0.88, 0.97) per sibling], whereas an increasing number of half-siblings was associated with a higher rate [HR 1.05 (95% CI: 1.01, 1.09) per sibling]. DISCUSSION The effect of parental education on ED rate varies between males and females, whereas the effect of number of siblings varies according to whether they are full or half-siblings. A deeper understanding of these associations and their underlying mechanisms may provide etiological insights and inform the design of preventive interventions.
Collapse
Affiliation(s)
- Jennie C Ahrén
- CHESS (Centre for Health Equity Studies), Karolinska Institutet/Stockholm University, Stockholm, Sweden
| | | | | | | | | | | |
Collapse
|
30
|
McGee RE, Thompson NJ. Disordered Eating and Forced Sex Among Adolescent Males. JOURNAL OF MEN'S HEALTH 2013. [DOI: 10.1089/jomh.2013.00027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
31
|
Klump KL. Puberty as a critical risk period for eating disorders: a review of human and animal studies. Horm Behav 2013; 64:399-410. [PMID: 23998681 PMCID: PMC3761220 DOI: 10.1016/j.yhbeh.2013.02.019] [Citation(s) in RCA: 149] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Revised: 02/27/2013] [Accepted: 02/27/2013] [Indexed: 11/25/2022]
Abstract
This article is part of a Special Issue "Puberty and Adolescence". Puberty is one of the most frequently discussed risk periods for the development of eating disorders. Prevailing theories propose environmentally mediated sources of risk arising from the psychosocial effects (e.g., increased body dissatisfaction, decreased self-esteem) of pubertal development in girls. However, recent research highlights the potential role of ovarian hormones in phenotypic and genetic risk for eating disorders during puberty. The goal of this paper is to review data from human and animal studies in support of puberty as a critical risk period for eating disorders and evaluate the evidence for hormonal contributions. Data are consistent in suggesting that both pubertal status and pubertal timing significantly impact risk for most eating disorders in girls, such that advanced pubertal development and early pubertal timing are associated with increased rates of eating disorders and their symptoms in both cross-sectional and longitudinal research. Findings in boys have been much less consistent and suggest a smaller role for puberty in risk for eating disorders in boys. Twin and animal studies indicate that at least part of the female-specific risk is due to genetic factors associated with estrogen activation at puberty. In conclusion, data thus far support a role for puberty in risk for eating disorders and highlight the need for additional human and animal studies of hormonal and genetic risk for eating disorders during puberty.
Collapse
Affiliation(s)
- Kelly L Klump
- Department of Psychology, Michigan State University, 316 Physics Rd., East Lansing, MI 48824-1116, USA.
| |
Collapse
|
32
|
Pedlow CT, Niemeier HM. Sociotropic cognition and eating disordered attitudes and behavior in young adults. Eat Behav 2013; 14:95-101. [PMID: 23557802 DOI: 10.1016/j.eatbeh.2012.10.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2011] [Revised: 07/25/2012] [Accepted: 10/03/2012] [Indexed: 10/27/2022]
Abstract
Sociotropic cognition is a mindset characterized by a strong need for social approval and fear of interpersonal rejection. Sociotropic cognition has been associated with depression and health risk behavior in women, but few studies have specifically addressed eating disordered attitudes and behaviors, and studies including men are lacking. The purpose of the present study was to assess the influence of sociotropic cognition on eating-related attitudes and behaviors in men and women. Participants were N=362 undergraduate students (51% female; mean age=19.2±1.43) who completed measures of sociotropic cognition, depressed mood, eating disordered attitudes and behaviors, body shape satisfaction, and physical activity. Using hierarchical regression, the results demonstrated that sociotropic cognition was associated with greater dietary restraint, body shape, eating, and weight concerns, emotional eating, and global eating disordered score. Body shape dissatisfaction and emotional eating were found to mediate the relationship between sociotropic cognition and eating disordered behaviors. Sociotropic cognition appears to be an important predictor of body shape dissatisfaction and eating disordered behaviors in a non-clinical sample. Individuals high in sociotropic cognition may engage in eating disordered behavior in response to fears of social evaluation. These findings have implications for prevention and treatment of eating disorders. Cognitive-behavioral intervention strategies are suggested to reduce sociotropic cognition and its influence on eating disordered behavior.
Collapse
Affiliation(s)
- C Teal Pedlow
- Department of Psychology, University of Massachusetts Dartmouth, North Dartmouth, MA 02747-2300, USA.
| | | |
Collapse
|
33
|
Austin SB, Nelson LA, Birkett MA, Calzo JP, Everett B. Eating disorder symptoms and obesity at the intersections of gender, ethnicity, and sexual orientation in US high school students. Am J Public Health 2013; 103:e16-22. [PMID: 23237207 PMCID: PMC3558764 DOI: 10.2105/ajph.2012.301150] [Citation(s) in RCA: 149] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2012] [Indexed: 01/22/2023]
Abstract
OBJECTIVES We examined purging for weight control, diet pill use, and obesity across sexual orientation identity and ethnicity groups. METHODS Anonymous survey data were analyzed from 24 591 high school students of diverse ethnicities in the federal Youth Risk Behavioral Surveillance System Survey in 2005 and 2007. Self-reported data were gathered on gender, ethnicity, sexual orientation identity, height, weight, and purging and diet pill use in the past 30 days. We used multivariable logistic regression to estimate odds of purging, diet pill use, and obesity associated with sexual orientation identity in gender-stratified models and examined for the presence of interactions between ethnicity and sexual orientation. RESULTS Lesbian, gay, and bisexual (LGB) identity was associated with substantially elevated odds of purging and diet pill use in both girls and boys (odds ratios [OR] range = 1.9-6.8). Bisexual girls and boys were also at elevated odds of obesity compared to same-gender heterosexuals (OR = 2.3 and 2.1, respectively). CONCLUSIONS Interventions to reduce eating disorders and obesity that are appropriate for LGB youths of diverse ethnicities are urgently needed.
Collapse
Affiliation(s)
- S Bryn Austin
- Division of Adolescent and Young Adult Medicine at Boston Children's Hospital, Boston, MA 02115, USA.
| | | | | | | | | |
Collapse
|
34
|
Leal GVDS, Philippi ST, Polacow VO, Cordás TA, Alvarenga MDS. O que é comportamento de risco para transtornos alimentares em adolescentes? JORNAL BRASILEIRO DE PSIQUIATRIA 2013. [DOI: 10.1590/s0047-20852013000100009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJETIVO: Caracterizar comportamento de risco para transtornos alimentares (TA) e sua frequência entre adolescentes em uma revisão da literatura nacional e internacional. MÉTODOS: Foi realizada uma busca bibliográfica por meio de uma revisão integrativa nas bases de dados PubMed (US National Library of Medicine)e Lilacs e no portal SciELO,utilizando-se os descritores relacionados à "eating disorder risk behavior". Foram selecionados artigos publicados nos últimos 10 anos, nos idiomas português, espanhol e inglês, e especificamente com adolescentes. Foram avaliados 76 artigos e analisados a nomenclatura e os instrumentos utilizados para avaliar comportamento de risco para TA e sua prevalência. RESULTADOS: Encontrou-se uma série de termos para avaliar risco para TA. A metodologia mais utilizada foi a de questionários e escalas, destacando-se o EAT-26 ou 40 e o BITE, dentre os mais frequentes; a prevalência de risco variou de 0,24% a 58,4%. CONCLUSÃO: Diferentes nomenclaturas e instrumentos são utilizados para avaliar comportamento de risco para TA entre adolescentes, com grande amplitude nos resultados de prevalência. Maior padronização de termos e metodologia de avaliação permitiriam melhor comparação entre estudos epidemiológicos em diferentes localidades.
Collapse
|
35
|
Latzer Y, Azaiza F, Tzischinsky O. Not just a western girls' problem: eating attitudes among Israeli-Arab adolescent boys and girls. INTERNATIONAL JOURNAL OF ADOLESCENCE AND YOUTH 2012. [DOI: 10.1080/02673843.2012.747973] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
|
36
|
Bratland-Sanda S, Sundgot-Borgen J. Eating disorders in athletes: overview of prevalence, risk factors and recommendations for prevention and treatment. Eur J Sport Sci 2012; 13:499-508. [PMID: 24050467 DOI: 10.1080/17461391.2012.740504] [Citation(s) in RCA: 205] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The prevalence of disordered eating and eating disorders vary from 0-19% in male athletes and 6-45% in female athletes. The objective of this paper is to present an overview of eating disorders in adolescent and adult athletes including: (1) prevalence data; (2) suggested sport- and gender-specific risk factors and (3) importance of early detection, management and prevention of eating disorders. Additionally, this paper presents suggestions for future research which includes: (1) the need for knowledge regarding possible gender-specific risk factors and sport- and gender-specific prevention programmes for eating disorders in sports; (2) suggestions for long-term follow-up for female and male athletes with eating disorders and (3) exploration of a possible male athlete triad.
Collapse
Affiliation(s)
- Solfrid Bratland-Sanda
- a Department of Sport and Outdoor Life Science , Telemark University College , Bø , Norway
| | | |
Collapse
|
37
|
Baker JH, Thornton LM, Lichtenstein P, Bulik CM. Pubertal development predicts eating behaviors in adolescence. Int J Eat Disord 2012; 45:819-26. [PMID: 22522282 PMCID: PMC3404161 DOI: 10.1002/eat.22022] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/23/2012] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Early maturing girls are at increased risk for disordered eating. However, it is unclear if the association between puberty and disordered eating continues throughout pubertal development and if a similar association is exhibited in boys. METHOD Participants included 1340 same- and 624 opposite-sex twins from the Swedish Twin Study of Child and Adolescent Development. Pubertal development was assessed at age 13-14 with the pubertal development scale. General disordered eating, measured with the eating disorder inventory-2 (EDI) was assessed at age 16-17, and dieting and purging behaviors were assessed at both ages 16-17 and 19-20. We applied analysis of variance and logistic regression analyses to determine whether pubertal development in early-to-mid adolescence predicted eating disorder-related behaviors in late adolescence and young adulthood. RESULTS Pubertal development in early-to-mid adolescence was significantly associated with EDI scores and dieting in late adolescence. No significant association was observed between pubertal development and dieting and purging in young adulthood. DISCUSSION Complex combinations of cultural and biological influences likely converge during pubertal development increasing vulnerability to disordered eating. The impact of pubertal development on disordered eating appears to be limited to the adolescent period.
Collapse
Affiliation(s)
- Jessica H. Baker
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC
| | - Laura M. Thornton
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Cynthia M. Bulik
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC,Department of Nutrition, University of North Carolina, Chapel Hill, NC
| |
Collapse
|
38
|
Dooley-Hash S, Banker JD, Walton MA, Ginsburg Y, Cunningham RM. The prevalence and correlates of eating disorders among emergency department patients aged 14-20 years. Int J Eat Disord 2012; 45:883-90. [PMID: 22570093 DOI: 10.1002/eat.22026] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/11/2012] [Indexed: 12/15/2022]
Abstract
OBJECTIVE This study describes the rates of eating disorders in patients who present to the emergency department (ED) for any reason and examines the relationship between eating disorders, depression, and substance use in these patients. METHOD ED patients aged 14-20 years (n = 942) completed a computerized questionnaire. Analyses were conducted comparing individuals who screened positive for an eating disorder with those who did not based on demographics (gender, age, race, and public assistance), body mass index, substance use, and depression. RESULTS Sixteen percent of patients screened positive for an eating disorder. These patients were more likely to also screen positive for depression and substance use. Males accounted for 26.6% of all eating disorders, and no difference was seen in rates across ethnic or income groups. DISCUSSION Eating disorders are common amongst all patients aged 14-20 years presenting to the ED and are associated with high rates of psychiatric comorbidity.
Collapse
Affiliation(s)
- Suzanne Dooley-Hash
- Department of Emergency Medicine, University of Michigan, Ann Arbor, MI, USA.
| | | | | | | | | |
Collapse
|
39
|
López-Guimerà G, Neumark-Sztainer D, Hannan P, Fauquet J, Loth K, Sánchez-Carracedo D. Unhealthy weight-control behaviours, dieting and weight status: a cross-cultural comparison between North American and Spanish adolescents. EUROPEAN EATING DISORDERS REVIEW 2012; 21:276-83. [PMID: 23055262 DOI: 10.1002/erv.2206] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2012] [Revised: 09/03/2012] [Accepted: 09/20/2012] [Indexed: 01/07/2023]
Abstract
The aim of the current study was to examine and compare dieting and unhealthy weight-control behaviours (UWCB) in population-based samples in two large urban areas in Spain (Barcelona) and in the USA (Twin Cities of Minneapolis and St. Paul, Minnesota). Additionally, use of UWCB across weight categories was explored in both samples. Participants included 1501 adolescents from Barcelona (48% girls, 52% boys) and 2793 adolescents from the Twin Cities (53% girls, 47% boys). The main outcome measures were dieting, UWCB (less extreme and extreme) and weight status. Although dieting and UWCB were prevalent in both samples, particularly among girls, the prevalence was higher in the US sample. In both countries, the report of dieting and use of UWCB was highest among overweight and obese youth. Prevention interventions that address the broad spectrum of eating and weight-related problems should be warranted in light of the high prevalence and co-occurrence of overweight and unhealthy weight-related behaviours.
Collapse
Affiliation(s)
- Gemma López-Guimerà
- Dept. of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Bellaterra Cerdanyola del Vallès, Barcelona, Spain.
| | | | | | | | | | | |
Collapse
|
40
|
|
41
|
Ambresin AE, Belanger RE, Chamay C, Berchtold A, Narring F. Body dissatisfaction on top of depressive mood among adolescents with severe dysmenorrhea. J Pediatr Adolesc Gynecol 2012; 25:19-22. [PMID: 22217652 DOI: 10.1016/j.jpag.2011.06.014] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2011] [Revised: 06/29/2011] [Accepted: 06/29/2011] [Indexed: 11/30/2022]
Abstract
OBJECTIVES This study aims to determine whether adolescent girls with severe dysmenorrhea (SD) have different psychological characteristics from their peers. STUDY DESIGN Cross-sectional survey (SMASH 02). SETTINGS Nationally representative sample of adolescents attending post-mandatory education. PARTICIPANTS N = 7548, of whom 3340 were females, aged 16-20 years. INTERVENTION Self-administered, anonymous survey consisted of 565 items on 4 main topics: sociodemographic determinants of health, health status, health behaviors, and health care use. OUTCOMES Body image variables, mental health, and associated variables like sexual abuse and health perceptions. Bivariate analysis and binomial logistic regression controlling for explanatory variables were performed. RESULTS 12.4% (95% confidence interval [CI]: 11.0-14) declared SD. Compared to their peers, subjects with SD were more likely to report depressive symptoms (adjusted odds ratio [AOR]: 1.73; 95% CI: 1.38-2.15), have a higher gynecological age (AOR: 1.13; 95% CI: 1.05-1.20), and attend vocational school (AOR: 1.33; 95% CI: 1.00-1.76). Moreover, the proportion of those reporting dissatisfaction with their body appearance was higher (AOR: 1.50; 95% CI: 1.02-2.22). CONCLUSION Patients with SD not only show a different profile from their peers in terms of their mental health academic track and gynecological age, but they are also more dissatisfied with their body appearance. Clinicians should pay particular attention to patients with SD and offer them a global evaluation, bearing in mind what factors can be associated with SD.
Collapse
|
42
|
The association between overweight and illegal drug consumption in adolescents: is there an underlying influence of the sociocultural environment? PLoS One 2011; 6:e27358. [PMID: 22110632 PMCID: PMC3217959 DOI: 10.1371/journal.pone.0027358] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2011] [Accepted: 10/14/2011] [Indexed: 12/28/2022] Open
Abstract
Background The aims of the study were to: a) Examine the distribution of gender-stratified body mass index (BMI), eating attitudes and use of addictive substances, under the hypothesis of a confluent prevalence of weight abnormalities, eating disorders and substance abuse. b) Demonstrate the extent to which family, peer-related and psychosocial factors are common elements in categories of compulsive behaviour. Methodology/Principal Findings In the present cross-sectional study, data were collected through self reported questionnaires administered to a large sample of 33,185 15–19 years old adolescents (ESPAD®Italia), divided into weight categories based on the BMI percentile distribution. Multinomial analyses were adopted to address the influence of social, family, leisure time factors, Eating Attitude Test (EAT26) on the association between weight categories and drug use. Recent drugs use was more frequent in overweight and underweight adolescents (p<0.05), especially in females. An EAT26 score ≥20 was more common in overweight adolescents. Multinomial analysis abolished the relationship between overweight and the use of most drugs, implicating self-esteem, parents' educational level, and friendships as mediators of the association. Within the overweight category, adolescents reporting recent drug use, showed greater frequency of having drug-abusing friends (∼80%), and severe problems with parents and school (∼30%) compared to overweight adolescents without recent drug use. Conclusion The frequent association of overweight and substance use and the presence of common underlying social factors, highlights the need for an interdisciplinary approach involving individual-focused treatment models as well as public health, social and environmental changes to reduce food- and substances-related problems.
Collapse
|
43
|
Bratland-Sanda S, Sundgot-Borgen J. Symptoms of Eating Disorders, Drive for Muscularity and Physical Activity Among Norwegian Adolescents. EUROPEAN EATING DISORDERS REVIEW 2011; 20:287-93. [DOI: 10.1002/erv.1156] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2010] [Revised: 07/16/2011] [Accepted: 07/20/2011] [Indexed: 11/08/2022]
|
44
|
Gan WY, Mohd Nasir MT, Zalilah MS, Hazizi AS. Direct and indirect effects of sociocultural influences on disordered eating among Malaysian male and female university students. A mediation analysis of psychological distress. Appetite 2011; 56:778-83. [DOI: 10.1016/j.appet.2011.03.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2011] [Revised: 03/09/2011] [Accepted: 03/16/2011] [Indexed: 10/18/2022]
|
45
|
|
46
|
|
47
|
Fonseca H, Matos MG. Are adolescent weight-related problems and general well-being essentially an issue of age, gender or rather a pubertal timing issue? J Pediatr Endocrinol Metab 2011; 24:251-6. [PMID: 21823519 DOI: 10.1515/jpem.2011.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To compare the characteristics of a set of weight-related and well-being variables among adolescents according to gender and age. It was hypothesised that time of puberty, not age in itself, might be the turning point for gender dissimilarities. METHODS Data were drawn from the Portuguese 2006 HBSC/WHO database and were disaggregated by gender and age group. Groups were compared for dieting, body image, health perception and happiness variables on the bivariate level using cross-tabulations. Separate analysis of the dependent variables was further conducted for 11-year-olds comparing males with pre- and post-menarche females. RESULTS Dieting and a negative body image were consistently more prevalent among girls and increased with age. At 11 years significantly more post-menarche girls were dieting and dissatisfied with their body image than boys and their pre-menarche counterparts. A poor self-rated health and the perception of unhappiness tended to be more common among older adolescents and among girls. CONCLUSIONS Pubertal timing, and not age in itself, appears as the turning point for gender dissimilarities. Both gender- and age-specific differences as well as pubertal timing have to be taken into account by any physician when assessing an adolescent in order to be able to adapt the intervention.
Collapse
Affiliation(s)
- Helena Fonseca
- Department of Paediatrics, Hospital de Santa Maria, Lisboa, Portugal.
| | | |
Collapse
|
48
|
Abstract
The incidence and prevalence of eating disorders in children and adolescents has increased significantly in recent decades, making it essential for pediatricians to consider these disorders in appropriate clinical settings, to evaluate patients suspected of having these disorders, and to manage (or refer) patients in whom eating disorders are diagnosed. This clinical report includes a discussion of diagnostic criteria and outlines the initial evaluation of the patient with disordered eating. Medical complications of eating disorders may affect any organ system, and careful monitoring for these complications is required. The range of treatment options, including pharmacotherapy, is described in this report. Pediatricians are encouraged to advocate for legislation and policies that ensure appropriate services for patients with eating disorders, including medical care, nutritional intervention, mental health treatment, and care coordination.
Collapse
|
49
|
Risk and protective factors for disturbed eating: a 7-year longitudinal study of eating attitudes and psychological factors in adolescent girls and their parents. Eat Weight Disord 2010; 15:e208-18. [PMID: 21406944 DOI: 10.1007/bf03325302] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
The aims of this seven-year longitudinal study of 228 girls (9- and 13-yr olds) were to examine 1) the predictive value of eating attitudes, a wish to be thinner, dieting, perfectionism, self-esteem and Body Mass Index; 2) the girls' parents' eating attitudes and perfectionism in relation to the development of disturbed eating attitudes, seven years later; and 3) whether normal body weight, healthy eating attitudes and low perfectionism together with high self-esteem might operate as protective factors for the later development of disturbed eating attitudes. The pre-adolescent girls (9-yr olds) "wish to be thinner" and fathers' EAT scores contributed most to the prediction of disturbed eating attitudes seven years later. Corresponding analysis for the adolescent girls (13-yr olds) showed that a "wish to be thinner" and mothers' rating on perfectionism contributed most to the prediction of disturbed eating attitudes seven years later. Protective factors were low BMI and more healthy eating attitudes - especially moderated by high selfesteem, and a low-to-medium degree of perfectionism. High self-esteem appeared to be a protective factor when the girls had a high degree of perfectionism. These results suggest that it is important to focus on healthy eating attitudes at home to prevent overweight in early childhood, enhance self-esteem and to take a critical stand toward the thinness ideal in our society.
Collapse
|
50
|
|