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Fatt SJ, Prnjak K, Buckley GL, George E, Hay P, Jeacocke N, Mitchison D. Further Validation for a Measure of Disordered Eating in an Independent Sample of Male and Female Elite Athletes: The Athletic Disordered Eating (ADE) Scale. Int J Eat Disord 2025; 58:400-410. [PMID: 39630973 DOI: 10.1002/eat.24344] [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] [Academic Contribution Register] [Received: 09/17/2024] [Revised: 11/13/2024] [Accepted: 11/14/2024] [Indexed: 12/07/2024]
Abstract
BACKGROUND Elite athletes experience unique pressures and cognitions associated with disordered eating, which may not be appropriately captured by existing tools. The Athletic Disordered Eating (ADE) scale is a recently developed and first measure of disordered eating specifically developed and validated in current and former athletes. This study aimed to provide further validation for the ADE in an independent sample of elite athletes. METHOD Participants were 237 elite athletes (M Age = 26.1, SDAge = 8.6; 75.9% female; 73.0% current athletes) participating in various sports across Australia and the United States. Participants completed an online survey including the ADE, demographic questions, and other measures of eating disorder symptoms (Eating Disorder Examination-Questionnaire Short-form, Clinical Impairment Assessment), and related constructs. Twenty-five athletes also completed a clinical interview to determine eating disorder caseness. RESULTS The four-factor structure of the ADE from the original validation was confirmed. Further, the ADE demonstrated adequate measurement invariance across male and female current and former athletes; internal consistency for the total score and each subscale; convergent and discriminant validity; and criterion-related validity-with a score of 40 balancing sensitivity and specificity against other scales with established cut-offs for a likely eating disorder. The high-risk cut-off (ADE ≥ 33) had high sensitivity but low specificity in identifying eating disorder cases, as confirmed by the clinical interview. DISCUSSION The ADE is a low-time-burden screening tool for disordered eating, validated in independent samples of diverse athletes. It should be considered for future use in screening, early identification, and monitoring treatment progress in elite athletes.
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Affiliation(s)
- Scott J Fatt
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, New South Wales, Australia
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Katarina Prnjak
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Georgina L Buckley
- Body Justice, Fitzroy, Victoria, Australia
- Department of Nursing and Allied Health, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Emma George
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, New South Wales, Australia
- School of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia
| | - Phillipa Hay
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, New South Wales, Australia
- Mental Health Services, South Western Sydney Local Health District, Camden and Campbelltown Hospital, Campbelltown, New South Wales, Australia
| | - Nikki Jeacocke
- AIS Performance, Australian Sports Commission, Canberra, New South Wales, Australia
| | - Deborah Mitchison
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, New South Wales, Australia
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Sydney, New South Wales, Australia
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Hoogenboom BJ, Capulong Z, Teeter M. Examination of the Clinical Utility of Eating Disorder and Disordered Eating Screening Tools in Young Athletes: A Scoping Review. Int J Sports Phys Ther 2025; 20:1-14. [PMID: 39758700 PMCID: PMC11698000 DOI: 10.26603/001c.126965] [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] [Academic Contribution Register] [Received: 05/07/2024] [Accepted: 11/25/2024] [Indexed: 01/07/2025] Open
Abstract
Background and Purpose Many screening tools are used to identify eating disorders (ED) and disordered eating (DE) in individuals. The purpose of this scoping review was to identify the most commonly used ED/DE screening tools for young male and female athletes. Study Design Scoping Review. Methods Following the Johanna Briggs Institute scoping review guidelines, PubMed, CINAHL Complete, PsycInfo, SPORTdiscus, and Web of Science Core Collection databases were searched using keywords related to eating disorder, disordered eating, athletes, and screening. Included articles were randomized controlled trials, cohort studies, or cross-sectional studies published in English between 2011-2023; included primarily non-aesthetic athletes aged 14-24 years; and utilized an ED/DE screening tool for diagnostic purposes. Articles were excluded if analysis of ED/DE was a secondary purpose or < 20 athletes participated. Tools utilized and demographic and outcomes data were extracted and qualitatively analyzed. Results Thirty articles were included. The Eating Attitudes Test-26 (EAT-26), the Sick, Control, One, Fat, Food (SCOFF) questionnaire, and the Eating Disorder Inventory (EDI) were most used among all included articles. Three articles examined only males and used a variety of tools. Five articles utilized a tool specifically designed for athletes: the Eating Disorder Screen for Athletes (EDSA), Brief Eating Disorder in Athletes Questionnaire (BEDA-Q) or the ATHLETE questionnaire. Discussion While the EAT-26 is most used for diagnosing ED/DE risk within young athletes, clinical utility of screening tools for male athletes is varied. Combinations of tools utilized for examining ED/DE risk in athletes are not agreed upon. Continued research is needed to assess the clinical utility of screening tools that identify ED/DE risk specifically in athletes. Tool adjustment or development for male athletes may be necessary. Level of Evidence 2a.
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Gorrell S, Sanzari CM, Ziegenhardt PS, Spell J, Johnson MG, Whitlow B, Saigal M. Preventing eating pathology among elite adolescent ballet dancers: a pilot trial of the Athlete Body Project. Eat Disord 2024; 32:666-685. [PMID: 38572849 PMCID: PMC11450102 DOI: 10.1080/10640266.2024.2337525] [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] [Academic Contribution Register] [Indexed: 04/05/2024]
Abstract
Adolescent ballet dancers are commonly recognized as aesthetic athletes who are at higher risk for body dissatisfaction, disordered eating, and eating disorders. Although athletic participation can generally protect against negative mental and physical health outcomes, idealization of a body ideal specific to ballet can confer unique vulnerability for eating pathology. Despite this known vulnerability, rigorous efforts to prevent eating pathology among young dancers are lacking. Previously, we reported on a trial of the Female Athlete Body Project adapted for professional female ballet dancers. The current study tested a subsequent adaptation, the Athlete Body Project (ABP), tailored for younger dancers, including a version for boys. This non-randomized, uncontrolled pilot trial tested ABP among boys and girls in two elite ballet schools (N = 23), formatted in-person and via video-conferencing. Program delivery met benchmarks for feasibility and acceptability across gender and delivery formats, and dancers provided positive qualitative feedback. Overall results suggest the potential of ABP in intervening on pre-post eating pathology and body appreciation, and significantly decreasing drive for muscularity among young ballet dancers. Taken together, this pilot work addresses a gap in the field and advances the needed development of eating disorder prevention programming for young, high-risk aesthetic athletes.
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Affiliation(s)
- Sasha Gorrell
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
| | | | - Philippa S. Ziegenhardt
- The Australian Ballet School, Melbourne, VIC, AUSTRALIA
- Private Practice, Mecklenburg-West Pomerania, GERMANY
| | | | - Madelyn G. Johnson
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
- University at Albany, State University of New York, Albany, NY, USA
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Frazer R, Bowler AL, Condo D, Cox G, Pelly F, Slater G. Commonly Used Indicators of Low Energy Availability Risk Fail to Identify Female Amateur Soccer Players With Measured Low Energy Availability During Preseason. Int J Sport Nutr Exerc Metab 2024; 34:387-396. [PMID: 39209286 DOI: 10.1123/ijsnem.2024-0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Academic Contribution Register] [Received: 01/05/2024] [Revised: 06/16/2024] [Accepted: 07/03/2024] [Indexed: 09/04/2024]
Abstract
This study aimed to determine energy availability (EA) and within-day energy balance (WDEB) in female soccer players during preseason and also explored eating disorder risk and athlete food choice. We hypothesized commonly used indicators of low energy availability (LEA) risk would correlate with measured EA and WDEB variables, and that food choice determinants would differ according to EA. Eleven National Premier League female soccer players participated in this observational cross-sectional study over 3 weeks. Assessment of resting metabolic rate and physique traits, including bone mineral density, was conducted during Weeks 1 or 3. During Week 2, dietary intake, energy expenditure, and continuous monitor-derived glucose were measured for 5 days. EA was calculated daily and WDEB calculated hourly with deficits/surpluses carried continuously. Questionnaires were administered throughout the 3 weeks, including the Athlete Food Choice Questionnaire, the Eating Disorders Screen for Athletes, and the Low Energy Availability in Females Questionnaire. Resting metabolic rate ratio, bone mineral density, Low Energy Availability in Females Questionnaire, and Eating Disorders Screen for Athletes scores were used as indicators of LEA risk. EA averaged 30.7 ± 7.5 kcals·kg fat-free mass-1·day-1. Approximately one-third (36%) of athletes were at risk of an eating disorder, while approximately half (45%) were identified at risk of the female athlete triad via Low Energy Availability in Females Questionnaire, compared with approximately one-third (36%) of athletes identified with EA < 30 kcal·kg fat-free mass-1·day-1. No athlete achieved EA >45 kcal·kg fat-free mass-1·day-1, and no indicator of LEA risk was associated with calculated EA or WDEB. However, overnight glycemic variability was positively correlated with measured EA (r = .722, p = .012).
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Affiliation(s)
- Rebekka Frazer
- School of Health, University of the Sunshine Coast, Sippy Downs, QLD, Australia
| | - Amy-Lee Bowler
- Faculty of Health Services and Medicine, Bond University, Robina, QLD, Australia
| | - Dominique Condo
- Centre for Sport Research, Deakin University, Burwood, VIC, Australia
| | - Gregory Cox
- Faculty of Health Services and Medicine, Bond University, Robina, QLD, Australia
| | - Fiona Pelly
- School of Health, University of the Sunshine Coast, Sippy Downs, QLD, Australia
| | - Gary Slater
- School of Health, University of the Sunshine Coast, Sippy Downs, QLD, Australia
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Palermo M, Rancourt D, Juarascio A. Athlete-specific risk factors for the development of disordered eating behaviors in first-year college athletes. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:3015-3024. [PMID: 36595568 DOI: 10.1080/07448481.2022.2151842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Academic Contribution Register] [Received: 11/01/2021] [Revised: 10/04/2022] [Accepted: 11/21/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVE The current study tested whether proposed sport-related risk factors for disordered eating behaviors were associated with increases in disordered eating over first-year college athletes' first four months of collegiate sport participation. PARTICIPANTS Participants included a sample of first-year college athletes (N = 59, 45% female) from a Division I National Collegiate Athletics Association (DI) university. METHOD This follow-up study tested whether 1) wearing a uniform that emphasizes body concerns, 2) participating in a lean sport, and 3) perceived pressure for thinness from coaches and teammates would lead to increases in weight/shape concerns and disordered eating behaviors over the first four months of collegiate sport participation. RESULTS Wearing a uniform that emphasizes body concerns and perceived coach pressure for thinness predicted increases in weight/shape concern. Both teammate and coach pressure for thinness predicted increases in restrained eating behaviors. CONCLUSION Findings suggest that there are identifiable, athlete-specific risk factors for the development of disordered eating behaviors among first-year college athletes.
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Affiliation(s)
- Madeline Palermo
- Department of Psychology, University of South Florida, Tampa, Florida, USA
| | - Diana Rancourt
- Department of Psychology, University of South Florida, Tampa, Florida, USA
| | - Adrienne Juarascio
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
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Buckley GL, Lassemillante ACM, Cooke MB, Belski R. The Development and Validation of a Disordered Eating Screening Tool for Current and Former Athletes: The Athletic Disordered Eating (ADE) Screening Tool. Nutrients 2024; 16:2758. [PMID: 39203894 PMCID: PMC11356912 DOI: 10.3390/nu16162758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Academic Contribution Register] [Received: 08/01/2024] [Revised: 08/12/2024] [Accepted: 08/13/2024] [Indexed: 09/03/2024] Open
Abstract
BACKGROUND Current and former athletes are one of the most at-risk population groups for disordered eating (DE), impacting their dietary practices, body composition, performance and health during and following their athletic careers. Few comprehensive DE screening tools exist for this group. To help address this, the current study utilised a mixed-methods approach of Classic Test Theory (CTT) and Item Response Theory (IRT) to develop and validate a DE screening tool suitable for current and former athletes. METHODS Novel scale development methodologies were used to develop and assess the validity (content, face, cross-cultural, construct), test-retest reliability, internal consistency reliability, factor analysis and Rasch analysis of a new DE scale. RESULTS A new validated Athletic Disordered Eating (ADE) screening tool was created, with 17 items and four subscales (food control, bingeing, body control, body discontent), with an internal consistency reliability of 0.91, excellent content and construct validity, an Intraclass Correlation Coefficient of 0.97 and excellent Rasch model fit. CONCLUSIONS The ADE screening tool has been dually developed for research purposes and as a clinically applicable screening tool to detect DE in current and former athletes and is suitable for a global use across sporting categories, diverse genders and levels of competition.
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Affiliation(s)
- Georgina L. Buckley
- Body Justice, Victoria St., Fitzroy, VIC 3065, Australia
- Department of Nursing and Allied Health, Swinburne University of Technology, John St., Hawthorn, VIC 3122, Australia
| | - Annie-Claude M. Lassemillante
- Sport, Performance and Nutrition Research Group, School of Allied Health, Human Services and Sport, La Trobe University, Plenty Rd. & Kingsbury Dr., Bundoora, VIC 3086, Australia (M.B.C.)
| | - Matthew B. Cooke
- Sport, Performance and Nutrition Research Group, School of Allied Health, Human Services and Sport, La Trobe University, Plenty Rd. & Kingsbury Dr., Bundoora, VIC 3086, Australia (M.B.C.)
| | - Regina Belski
- Sport, Performance and Nutrition Research Group, School of Allied Health, Human Services and Sport, La Trobe University, Plenty Rd. & Kingsbury Dr., Bundoora, VIC 3086, Australia (M.B.C.)
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Love AA, Zickgraf HF, Sonneville KR, Mankowski A, Carson TL, Hazzard VM. Cross-sectional and longitudinal associations between higher weight and eating disorder risk among collegiate athletes. J Sci Med Sport 2024; 27:270-275. [PMID: 38331631 DOI: 10.1016/j.jsams.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Academic Contribution Register] [Received: 09/22/2023] [Revised: 01/12/2024] [Accepted: 01/19/2024] [Indexed: 02/10/2024]
Abstract
OBJECTIVES To examine whether higher weight status is associated with increased eating disorder risk in athletes. DESIGN Study 1 used cross-sectional (N = 942) and longitudinal (N = 483) data collected over a five-year period from Division I athletes at a Midwestern university. Study 2 used cross-sectional data from athletes competing at various levels at universities across the United States (N = 825). METHODS Weight and height were measured in Study 1 and self-reported in Study 2; higher weight was defined as body mass index ≥ 25 kg/m2. Eating disorder risk was assessed with preliminary (Study 1) and final (Study 2) versions of the Eating Disorders Screen for Athletes. Study 1 examined weight status in relation to both concurrent and one-year changes in Eating Disorder Screen for Athletes score. Study 2 examined weight status in relation to both the Eating Disorders Screen for Athletes score and elevated eating disorder risk using the established Eating Disorders Screen for Athletes cut-off. All models adjusted for gender and sport type; Study 2 additionally adjusted for race/ethnicity, age, and competition level. RESULTS Across studies, higher weight status was significantly associated with increased eating disorder risk among athletes. This association was observed both cross-sectionally and longitudinally, and the prevelence of elevated eating disorder risk was 43 % greater among athletes with higher weight status than among those without higher weight status. CONCLUSIONS Despite existing stereotypes that eating disorders tend to occur with low weight status, findings highlight the importance of screening all athletes for eating disorders, regardless of their weight status.
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Affiliation(s)
- Anna A Love
- Department of Psychology, University at Albany, State University of New York, United States of America.
| | - Hana F Zickgraf
- Department of Pediatrics, Emory University, United States of America; Rogers Behavioral Health, United States of America
| | - Kendrin R Sonneville
- Department of Nutritional Sciences, University of Michigan School of Public Health, United States of America
| | | | - Traci L Carson
- Department of Obstetrics and Gynecology, Emory University, United States of America
| | - Vivienne M Hazzard
- Division of Epidemiology & Community Health, University of Minnesota School of Public Health, United States of America
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McLean CP, Chen Z, Song R, Le J, Fielding J, Sharp G. Development and preliminary validation of a novel eating disorder screening tool for vegetarians and vegans: the V-EDS. J Eat Disord 2024; 12:4. [PMID: 38195575 PMCID: PMC10775595 DOI: 10.1186/s40337-024-00964-7] [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] [Academic Contribution Register] [Received: 07/16/2023] [Accepted: 01/03/2024] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND Eating disorders have one of the highest mortality of all mental illnesses but are associated with low rates of screening and early intervention. In addition, there remains considerable uncertainty regarding the use of current standardised screening tools in measuring eating pathology in vegetarians and vegans. With these groups presenting as potential at-risk groups for disordered eating development, the present study aimed to develop and preliminary validate a novel eating disorder screening tool, the Vegetarian Vegan Eating Disorder Screener (V-EDS). METHODS We utilised a mixed-methods approach, comprising four phases. RESULTS A conceptual framework was developed from 25 community, clinician, and lived experience interviews and used to derive a preliminary set of 163 items (Phase 1). Phase 2 piloted the items to establish face and content validity through cognitive debriefing interviews of 18 additional community, clinician, and lived experience participants, resulting in a reduced, revised questionnaire of 53 items. Phase 3 involved scale purification using Item Response Theory in analysis of 230 vegetarians and 230 vegans resulting in a further reduced 18-item questionnaire. Phase 4 validated the screening tool in a large community sample of 245 vegetarians and 405 vegans using traditional psychometric analysis, finding the V-EDS supports a unidimensional factor structure with excellent internal consistency (α = 0.95-0.96) and convergent validity (0.87-0.88), and moderate discriminate validity (0.45-0.55). CONCLUSIONS This study provided strong initial support for the psychometric validity and theoretical assumptions of the novel V-EDS screening tool. The V-EDS has the potential to increase early intervention rates for vegetarians and vegans experiencing eating disorder symptoms, further supporting advocacy and treatment approaches for these expanding dietary groups.
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Affiliation(s)
- Courtney P McLean
- Department of Neuroscience, Monash University, 99 Commercial Rd, Melbourne, VIC, Australia.
| | - Zhibin Chen
- Department of Neuroscience, Monash University, 99 Commercial Rd, Melbourne, VIC, Australia
| | - Richard Song
- University of Melbourne, Grattan Street, Parkville, VIC, Australia
- Alfred Hospital, 55 Commercial Rd, Melbourne, VIC, Australia
| | - Jessica Le
- Alfred Hospital, 55 Commercial Rd, Melbourne, VIC, Australia
| | - Joanne Fielding
- Department of Neuroscience, Monash University, 99 Commercial Rd, Melbourne, VIC, Australia
| | - Gemma Sharp
- Department of Neuroscience, Monash University, 99 Commercial Rd, Melbourne, VIC, Australia
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Iwasa-Madge K, Sesbreno E. A Proposed Conceptual Sport Nutrition Approach for Athlete Development and Assessment: The Athlete Nutrition Development Approach. SPORTS MEDICINE - OPEN 2022; 8:142. [PMID: 36480056 PMCID: PMC9732172 DOI: 10.1186/s40798-022-00532-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Academic Contribution Register] [Received: 01/28/2022] [Accepted: 11/12/2022] [Indexed: 12/13/2022]
Abstract
Appropriate dietary intake can improve athletes' health and sport performance and is a direct result of eating behaviours. Therefore, assessing and shaping athletes' eating behaviours and dietary intake is critical to the provision of sport nutrition services. As such, nutrition practitioners must also consider the determinants of eating behaviours. However, dietary intake, eating behaviours, and its determinants are inconsistently defined in the literature, requiring nutrition practitioners to navigate a complicated landscape of concepts and terminology. This is further complicated by limitations in practically measuring and influencing eating behaviours and dietary intake. The proposed Athlete Nutrition Development Approach was developed to aid practitioners in servicing decisions through the athlete development process, through a three-tiered approach to sport nutrition service delivery. Tier 1 addresses the determinants of eating behaviours, Tier 2 directly addresses eating behaviours and dietary intake, and Tier 3 addresses the consequences of dietary intake in relation to health and sport performance. Each tier includes tools for assessment and development.
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Affiliation(s)
| | - Erik Sesbreno
- Institut National du Sport du Quebec, Montreal, QC Canada ,grid.14709.3b0000 0004 1936 8649McGill University, Montreal, QC Canada ,French-Speaking Research Network for Athlete Health Protection and Performance (ReFORM), Montreal, QC Canada
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Forys WJ, Tokuhama-Espinosa T. The Athlete's Paradox: Adaptable Depression. Sports (Basel) 2022; 10:105. [PMID: 35878116 PMCID: PMC9320389 DOI: 10.3390/sports10070105] [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] [Academic Contribution Register] [Received: 03/15/2022] [Revised: 06/22/2022] [Accepted: 06/27/2022] [Indexed: 02/01/2023] Open
Abstract
We proposed that an athlete's depressive symptoms may be different from the general population in etiology if considered from the context of a depressive disorder. By shifting focus from a limited notion of symptoms onto a comprehensive model of depression, the full scope of the phenomenon becomes clearer. This paper investigated the relationship between neurotransmitters and allostatic load to explain the incidence of depression among elite athletes. This literature review extensively analyzed exercise-induced neurohormonal imbalance resulting in depressive states among athletes. The research revealed that 5-HTTLPR polymorphism, brain-derived neurotrophic factor (BDNF), extensive psychological demands, social stigma, and overtraining syndrome (OTS) may all contribute to a unique version of depression. The research revealed that the biological standards of athletes differ from those of non-athletes, to the point that the new model may be useful, thereby introducing the new term "Adaptable Depression (AD)" to the literature. This framework suggests a new direction for future research to precisely measure the neurotransmitter-related brain changes that result in "Adaptable Depression" in athletes and to establish a better understanding of the depressive tipping point.
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Affiliation(s)
- Weronika Jasmina Forys
- Division of Continuing Education, Harvard University, 51 Brattle Street, Cambridge, MA 01238, USA
| | - Tracey Tokuhama-Espinosa
- Faculty of Arts and Sciences, Extension School, Harvard University, 51 Brattle Street, Cambridge, MA 01238, USA;
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Abstract
PURPOSE OF REVIEW The availability of psychometrically sound assessment instruments for assessing eating disorder symptomatology is crucial for both clinical practice and research. The purpose of the current review is to provide the reader with a list of psychometrically validated assessments for adults that are available within the field of eating disorders. Eating disorder interviews and self-report questionnaires were identified using online literature searches, reviewing previous review articles, and via research and/or clinical experience of the authors. The focus of the review was on (1) standard assessments that were frequently used in eating disorder research (such as the Eating Disorder Examination and Eating Attitudes Test), and (2) newer assessments that were developed over the past 5 years. Information compiled on each instrument included the purpose of the assessment, scores that can be derived, psychometric information, translations in other languages, and availability for use in research and clinical settings. RECENT FINDINGS Several recent trends in assessment instruments were identified including updates based upon Diagnostic and Statistical Manual criteria, briefer assessments, assessments for specific populations, and assessment of specific clinical features observed in people with eating disorders. SUMMARY The current review provides eating disorder clinicians and researchers a guide for making informed decisions about the selection of eating disorder assessments.
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Affiliation(s)
- Lauren M. Schaefer
- Sanford Center for Bio-behavioral Research, Fargo, ND, USA
- University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA
| | - Ross D. Crosby
- Sanford Center for Bio-behavioral Research, Fargo, ND, USA
- University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA
| | - Paulo P.P. Machado
- Psychotherapy and Psychopathology Research Unit – Psychology Research Centre, School of Psychology, University of Minho, Braga, Portugal
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12
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Flatt RE, Thornton LM, Fitzsimmons-Craft EE, Balantekin KN, Smolar L, Mysko C, Wilfley DE, Taylor CB, DeFreese JD, Bardone-Cone AM, Bulik CM. Comparing eating disorder characteristics and treatment in self-identified competitive athletes and non-athletes from the National Eating Disorders Association online screening tool. Int J Eat Disord 2021; 54:365-375. [PMID: 33252150 PMCID: PMC8006447 DOI: 10.1002/eat.23415] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Academic Contribution Register] [Received: 07/17/2020] [Revised: 09/28/2020] [Accepted: 10/31/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVE We compared eating disorder (ED) characteristics and treatment seeking behaviors between self-identified competitive athletes and non-athletes in a large, community-based sample. METHOD During the 2018 National Eating Disorders Awareness Week, 23,920 respondents, 14.7% of whom identified as competitive athletes, completed the National Eating Disorders Association online screen. Data were collected on demographics, disordered eating behaviors, probable ED diagnosis/risk, treatment history, and intent to seek treatment. RESULTS The sample was predominantly White (81.8%), female (90.3%), and between 13 and 24 years (82.6%). Over 86% met criteria for an ED/subthreshold ED, and of those, only 2.5% were in treatment. Suicidal ideation was reported in over half of the sample. Athletes reported a significantly greater likelihood of engaging in and more frequent excessive exercise episodes than non-athletes. Athletes also reported a significantly lower likelihood of engaging in and less frequent binge-eating episodes compared with non-athletes. Athletes were more likely to screen positive for an ED/subthreshold ED than non-athletes, but percentages across all probable ED diagnoses were similar. No significant differences between athletes and non-athletes emerged on treatment history or intention to seek treatment post-screen (less than 30%). DISCUSSION Although the distribution of probable ED diagnoses was similar in athletes and non-athletes, symptom profiles related to disordered eating behavior engagement and frequency may differ. Athletes may be less likely to seek treatment due to stigma, accessibility, and sport-specific barriers. Future work should directly connect survey respondents to tailored treatment tools and increase motivation to seek treatment.
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Affiliation(s)
- Rachael E Flatt
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Laura M Thornton
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | | - Katherine N Balantekin
- Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, New York, USA
| | - Lauren Smolar
- National Eating Disorders Association, New York City, New York, USA
| | - Claire Mysko
- National Eating Disorders Association, New York City, New York, USA
| | - Denise E Wilfley
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - C Barr Taylor
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA
- Center for m2Health, Palo Alto University, Palo Alto, California, USA
| | - J D DeFreese
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Anna M Bardone-Cone
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Cynthia M Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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