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Rozgonjuk D, Ignell J, Mech F, Rothermund E, Gündel H, Montag C. Smartphone and Instagram use, body dissatisfaction, and eating disorders: investigating the associations using self-report and tracked data. J Eat Disord 2023; 11:149. [PMID: 37667321 PMCID: PMC10478361 DOI: 10.1186/s40337-023-00865-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 08/08/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND Previous research has linked smartphone and Instagram use to higher body dissatisfaction (BD) as well as eating disorder (ED) symptomatology. However, these studies have typically been limited to using self-report measures for technology use which, as shown by scientific literature, might not be reliable. In the present work, we combine self-reported assessments as well as tracked smartphone and Instagram use. METHODS The effective sample comprised N = 119 women (34 with ED diagnosis history) who were queried about BD and ED symptomatology, and who provided the data about their smartphone and Instagram use duration for each day of the previous week. RESULTS The study results show that women with an ED diagnosis history scored higher on both BD as well as ED scales. Although women with an ED diagnosis history had higher smartphone screen time, there were no statistically significant differences in Instagram screen time. Tracked smartphone use duration was positively correlated with both BD and ED symptomatology, but the role of Instagram use needs to be further elucidated. CONCLUSIONS The results of this study show that while BD and ED symptomatology are correlated with smartphone use, it may be that Instagram use is not the main contributor to that relationship.
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Affiliation(s)
- Dmitri Rozgonjuk
- Department of Molecular Psychology, Institute of Psychology and Education, Ulm University, Helmholtzstraße 8/1, 89081, Ulm, Germany.
- Institute of Mathematics and Statistics, University of Tartu, Tartu, Estonia.
- Institute of Computer Science, University of Tartu, Tartu, Estonia.
| | - Johanna Ignell
- Department of Molecular Psychology, Institute of Psychology and Education, Ulm University, Helmholtzstraße 8/1, 89081, Ulm, Germany
| | - Franziska Mech
- Department of Molecular Psychology, Institute of Psychology and Education, Ulm University, Helmholtzstraße 8/1, 89081, Ulm, Germany
| | - Eva Rothermund
- Ulm University Medical Center, Department of Psychosomatic Medicine and Psychotherapy, Ulm University, Ulm, Germany
| | - Harald Gündel
- Ulm University Medical Center, Department of Psychosomatic Medicine and Psychotherapy, Ulm University, Ulm, Germany
| | - Christian Montag
- Department of Molecular Psychology, Institute of Psychology and Education, Ulm University, Helmholtzstraße 8/1, 89081, Ulm, Germany.
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Body-Related Attitudes, Personality, and Identity in Female Adolescents with Anorexia Nervosa or Other Mental Disorders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074316. [PMID: 35409997 PMCID: PMC8998874 DOI: 10.3390/ijerph19074316] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 04/01/2022] [Accepted: 04/03/2022] [Indexed: 12/27/2022]
Abstract
The psychological integration of body-related attitudes (BodyRA) is a critical developmental task in adolescence. Adolescents must adapt to their changing body image and body satisfaction. For young people, BodyRA (body dissatisfaction, bulimia, and drive for thinness) are connected to insecurities, which can disturb identity integration and personality development. Our goal was to evaluate the importance of BodyRA also for other mental disorders other than anorexia nervosa (AN), and the association between BodyRA with temperament and personality traits and identity diffusion. Data for the period of 2012 to 2019 were retrospectively analyzed from a convenience sample of patients in a child and adolescent psychiatric hospital (n = 114). The patients were 13 to 17 years of age and had a BMI of 11.9−36.1 kg/m2. As expected, BodyRA were found to be more pronounced in AN, as well as in borderline personality disorder (BPD), depression (DD), and attention deficit hyperactivity disorder (ADHD). BodyRA correlated significantly with internalizing problems in patients with DD (r = 0.428−0.565, p < 0.01) and BPD (r = 0.680, p < 0.01) as well as with BMI (r = 0.404, p < 0.01) in patients with DD. Moreover, we detected significant correlations with impaired identity development in patients with DD (r = 0.482−0.565, p < 0.01) and BPD (r = 0.681−0.703, p < 0.01). BodyRA also correlated significantly with the personality traits of harm avoidance (r = 0.377−0.541, p < 0.01) and self-directedness (r = −0.537−−0.635, p < 0.01) in DD. These personality traits and bulimia were used as predictors for identity diffusion in the investigated disorders of this study. We conclude that BodyRA, harm avoidance and self-directedness are associated with identity development in adolescent females with mental disorders.
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Palermo M, Choquette EM, Ahlich E, Rancourt D. Food and alcohol disturbance by athlete status: the roles of drive for thinness, drive for muscularity, and sex. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2021; 69:905-912. [PMID: 31995459 DOI: 10.1080/07448481.2020.1713791] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Revised: 11/15/2019] [Accepted: 12/22/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE This study investigated the association between self-identified athlete status and Food and Alcohol Disturbance (FAD) behaviors, and whether this association was moderated by drives for thinness or muscularity, and sex. PARTICIPANTS 575 individuals (77.6% female, 40.0% identifying as athletes) recruited from a large southeastern university. METHODS Participants completed online measures of athletic identity, drives for muscularity and thinness, FAD behaviors, and demographic variables. RESULTS Compared to non-athletes, male athletes with higher drive for muscularity endorsed more alcohol effects behaviors; female athletes endorsed the inverse relationship. Higher drive for thinness was associated with more diet and exercise behaviors among all participants, and extreme weight control behaviors among athletes. CONCLUSIONS Athlete status moderated the associations between drives for thinness/muscularity and FAD Alcohol Effects and Extreme Weight Control Behaviors. Regardless of athlete status, college students with higher drive for thinness are at risk for engaging in more FAD Diet & Exercise behaviors.
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Affiliation(s)
- Madeline Palermo
- Department of Psychology, University of South Florida, Tampa, Florida, USA
| | - Emily M Choquette
- Department of Psychology, University of South Florida, Tampa, Florida, USA
| | - Erica Ahlich
- Department of Psychology, University of South Florida, Tampa, Florida, USA
| | - Diana Rancourt
- Department of Psychology, University of South Florida, Tampa, Florida, USA
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Spatial hand representation in anorexia nervosa: a controlled pilot study. Sci Rep 2021; 11:19724. [PMID: 34611215 PMCID: PMC8492666 DOI: 10.1038/s41598-021-99101-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 09/13/2021] [Indexed: 11/30/2022] Open
Abstract
Body representation distortion (BRD) is a core criterion of Anorexia Nervosa (AN), and is usually assessed subjectively, focusing on body shape. We aimed to develop a new assessment to evaluate body representation independently from socially-mediated body image, on a body part with low emotional salience (hands). In a monocentric open label pilot study, we measured hand representations based on explicit (verbal) and implicit (tactile) instructions. Participants, with eyes closed, had to point targeted locations (knuckles and nails of each finger) based on verbal instructions and tactile stimulations to evaluate body representations respectively. Ratios between hand width and finger length were compared between AN (n = 31) and controls (n = 31) and correlated with current body mass index, AN subtype and disease duration. To control that hand distortion was specific to body representation, we also assessed object representation. Hand representation’s width/length ratio was significantly increased in patients with AN, whereas no difference was found in object representation. We found no correlation between hand wideness and clinical traits related to eating disorders. Our results propose that BRD is not limited to body parts with high emotional salience, strengthening the hypothesis that anorexia nervosa is associated with profound unspecific BRD.
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Marzola E, Longo P, Sardella F, Delsedime N, Abbate-Daga G. Rehospitalization and "Revolving Door" in Anorexia Nervosa: Are There Any Predictors of Time to Readmission? Front Psychiatry 2021; 12:694223. [PMID: 34366923 PMCID: PMC8342847 DOI: 10.3389/fpsyt.2021.694223] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 06/08/2021] [Indexed: 12/27/2022] Open
Abstract
Objective: Anorexia nervosa (AN) is a severe psychiatric illness with multifactorial etiology and unsatisfactory treatment outcomes. Hospitalization is required for a substantial number of patients, and readmission (RA) commonly occurs. Some individuals need multiple hospitalizations sometimes over a short amount of time, thus, delineating the "revolving door" (RD) phenomenon. However, very little is known about readmissions and their frequency in AN. Therefore, we aimed to longitudinally investigate readmissions in AN in order to: (a) characterize patients with AN who need readmission (i.e., RA-AN), sometimes rapidly (RD-AN); (b) ascertain differences between RA-AN and non-RA-AN groups during baseline hospitalization; (c) investigate as to whether clinical or psychometric parameters worsened on RA; and (d) analyze predictors of time-to-readmission in AN. Methods: A total of 170 inpatients with AN were enrolled at their baseline hospitalization; all their subsequent rehospitalizations were recorded with a longitudinal design by which each patient has been observed for 3 years. Patients were classified as RD-AN if requiring a readmission <12 months since last discharge. Clinical characteristics were measured upon admission and discharge for each hospitalization, and at all time points, patients completed questionnaires assessing eating and general psychopathology, and body shape concerns. Results: Sixty-seven patients (39.4%) needed at least one readmission and 62 (92.5% of RA-AN) reported RD. Compared with non-RA-AN, those with RA-AN were younger, reported a shorter duration of illness, and were more frequently diagnosed with AN-BP. Also, greater severity of anxious and depressive symptoms and body shape concerns emerged in the RA-AN group. The outcome of baseline hospitalization did not differ between groups, and only depressive symptoms worsened at readmission. Shorter duration of AN and low weight gain during baseline hospitalization predicted early readmission but did not survive statistical control. In contrast, high scores on drive for thinness upon baseline hospital entry robustly predicted a shorter time to readmission even after statistical control. Discussion: Individuals with AN who require readmission do so over a short period notwithstanding a positive treatment outcome during their baseline hospitalization. Shorter time-to-readmission can be predicted mostly in case of marked drive for thinness and poor weight gain at baseline hospital admission.
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Affiliation(s)
- Enrica Marzola
- Department of Neuroscience "Rita Levi Montalcini", Eating Disorders Center, University of Turin, Turin, Italy
| | - Paola Longo
- Department of Neuroscience "Rita Levi Montalcini", Eating Disorders Center, University of Turin, Turin, Italy
| | - Federica Sardella
- Department of Neuroscience "Rita Levi Montalcini", Eating Disorders Center, University of Turin, Turin, Italy
| | - Nadia Delsedime
- Department of Neuroscience "Rita Levi Montalcini", Eating Disorders Center, University of Turin, Turin, Italy
| | - Giovanni Abbate-Daga
- Department of Neuroscience "Rita Levi Montalcini", Eating Disorders Center, University of Turin, Turin, Italy
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Kahn M, Brunstein-Klomek A, Hadas A, Snir A, Fennig S. Early changes in depression predict outcomes of inpatient adolescent anorexia nervosa. Eat Weight Disord 2020; 25:777-785. [PMID: 30963421 DOI: 10.1007/s40519-019-00686-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 04/02/2019] [Indexed: 11/28/2022] Open
Abstract
PURPOSE The aim of this study was to investigate the predictive value of early changes in depression levels during inpatient treatment of adolescent anorexia nervosa (AN). METHODS Fifty-six adolescents (88% girls) aged 10-18 years (M = 15.35, SD = 2.23) diagnosed with AN were assessed at admission and 1 month following admission to an inpatient setting. Depression levels and eating disorder symptoms were reported at both assessments. Re-hospitalization within 12 months of discharge was documented using official national records. RESULTS Whereas depression levels at baseline were found equivalent between subsequently re-hospitalized and non-re-hospitalized patients, at 1 month after admission patients who were later re-hospitalized had higher levels of depression compared to those who were not re-hospitalized. These differences remained significant after controlling for weight gain and anti-depressant medication intake. We additionally found that the proportion of boys in the non-re-hospitalized group was substantially larger than their proportion in the re-hospitalized group. CONCLUSIONS Our results suggest that depression at the point of hospital admission may not be a reliable predictor of treatment outcomes, and highlight the risk of relapse in AN patients whose depression levels do not alleviate after a month of inpatient treatment. Clinicians should consider providing more adjusted and intensive attention to such patients in their efforts to facilitate remission. LEVEL OF EVIDENCE III Well-designed cohort study.
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Affiliation(s)
- Michal Kahn
- Schneider Children's Medical Center, Petah Tikva, Israel. .,The School of Psychological Sciences, Tel-Aviv University, Tel-Aviv, Israel.
| | - Anat Brunstein-Klomek
- Schneider Children's Medical Center, Petah Tikva, Israel.,The School of Psychology, Interdisciplinary Center, Herzlyia, Israel
| | - Arie Hadas
- Schneider Children's Medical Center, Petah Tikva, Israel
| | - Avigal Snir
- Schneider Children's Medical Center, Petah Tikva, Israel
| | - Silvana Fennig
- Schneider Children's Medical Center, Petah Tikva, Israel.,Sackler Medical School, Tel-Aviv University, Tel-Aviv, Israel
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Wang K, Liang R, Yu X, Shum DHK, Roalf D, Chan RCK. The thinner the better: Evidence on the internalization of the slimness ideal in Chinese college students. Psych J 2020; 9:544-552. [PMID: 32043314 DOI: 10.1002/pchj.346] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Revised: 09/17/2019] [Accepted: 12/03/2019] [Indexed: 11/06/2022]
Abstract
Internalization of the "thin ideal" is a risk factor for eating pathology. It is unclear how pervasive the thin ideal is among young Chinese. In the current study, 97 participants reported their subjective willingness to be thin and their eating-disorder-related weight-controlling behaviors, and then finished a picture judgment task to implicitly detect their perception of the importance of thinness to attractiveness. Hierarchical linear modeling was used to analyze the data. Among female participants, 79.59% wanted a thinner body. Participants' level of willingness to be thin correlated positively with frequency of eating-disorder-related weight-controlling behaviors, r = .47, p < .05. In the implicit task, the judgment of others' attractiveness correlated negatively with body mass index (BMI) evaluation, and this relationship was stronger for women's pictures than for men's pictures. Additionally, an individual's willingness to be thin enhanced the relationship between BMI evaluation and attractiveness judgment. The notion "the thinner the better" seems to be widely accepted among young Chinese.
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Affiliation(s)
- Kui Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Rui Liang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xinyang Yu
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - David H K Shum
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China.,School of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong Kong, China.,School of Applied Psychology and Menzies Health Institute of Queensland, Griffith University, Gold Coast, Australia
| | - David Roalf
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.,Translational Neuropsychology and Applied Cognitive Neuroscience Laboratory, Shanghai Mental Health Centre, Shanghai Jiaotong University School of Medicine, Shanghai, China
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