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Cleland L, Kennedy HL, Pettie MA, Kennedy MA, Bulik CM, Jordan J. Eating disorders, disordered eating, and body image research in New Zealand: a scoping review. J Eat Disord 2023; 11:7. [PMID: 36650575 PMCID: PMC9847028 DOI: 10.1186/s40337-022-00728-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 12/25/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The prevention and treatment of eating disorders relies on an extensive body of research that includes various foci and methodologies. This scoping review identified relevant studies of eating disorders, body image, and disordered eating with New Zealand samples; charted the methodologies, sample characteristics, and findings reported; and identified several gaps that should be addressed by further research. METHODS Using scoping review methodology, two databases were searched for studies examining eating disorders, disordered eating, or body image with New Zealand samples. Snowball methods were further used to identify additional relevant articles that did not appear in initial searches. Two independent reviewers screened the titles and abstracts of 473 records. Full text assessment of the remaining 251 records resulted in 148 peer-reviewed articles being identified as eligible for the final review. A search of institutional databases yielded 106 Masters and Doctoral theses for assessment, with a total of 47 theses being identified as eligible for the final review. The included studies were classified by methodology, and the extracted information included the study foci, data collected, sample size, demographic information, and key findings. RESULTS The eligible studies examined a variety of eating disorder categories including binge-eating disorder, bulimia nervosa, and anorexia nervosa, in addition to disordered eating behaviours and body image in nonclinical or community samples. Methodologies included treatment trials, secondary analysis of existing datasets, non-treatment experimental interventions, cross-sectional observation, case-control studies, qualitative and mixed-methods studies, and case studies or series. Across all of the studies, questionnaire and interview data were most commonly utilised. A wide range of sample sizes were evident, and studies often reported all-female or mostly-female participants, with minimal inclusion of males and gender minorities. There was also an underrepresentation of minority ethnicities in many studies, highlighting the need for future research to increase diversity within samples. CONCLUSION This study provides a comprehensive and detailed overview of research into eating disorders and body image in New Zealand, while highlighting important considerations for both local and international research.
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Affiliation(s)
- Lana Cleland
- Department of Psychological Medicine, University of Otago, PO Box 4345, Christchurch, 8140, New Zealand
| | - Hannah L Kennedy
- Department of Psychological Medicine, University of Otago, PO Box 4345, Christchurch, 8140, New Zealand
| | - Michaela A Pettie
- Department of Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand
| | - Martin A Kennedy
- Department of Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand
| | - Cynthia M 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 Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Jennifer Jordan
- Department of Psychological Medicine, University of Otago, PO Box 4345, Christchurch, 8140, New Zealand. .,Mental Health Clinical Research Unit, Te Whatu Ora, Waitaha, Christchurch, New Zealand.
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Giel KE, Bulik CM, Fernandez-Aranda F, Hay P, Keski-Rahkonen A, Schag K, Schmidt U, Zipfel S. Binge eating disorder. Nat Rev Dis Primers 2022; 8:16. [PMID: 35301358 PMCID: PMC9793802 DOI: 10.1038/s41572-022-00344-y] [Citation(s) in RCA: 59] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/28/2022] [Indexed: 12/30/2022]
Abstract
Binge eating disorder (BED) is characterized by regular binge eating episodes during which individuals ingest comparably large amounts of food and experience loss of control over their eating behaviour. The worldwide prevalence of BED for the years 2018-2020 is estimated to be 0.6-1.8% in adult women and 0.3-0.7% in adult men. BED is commonly associated with obesity and with somatic and mental health comorbidities. People with BED experience considerable burden and impairments in quality of life, and, at the same time, BED often goes undetected and untreated. The aetiology of BED is complex, including genetic and environmental factors as well as neuroendocrinological and neurobiological contributions. Neurobiological findings highlight impairments in reward processing, inhibitory control and emotion regulation in people with BED, and these neurobiological domains are targets for emerging treatment approaches. Psychotherapy is the first-line treatment for BED. Recognition and research on BED has increased since its inclusion into DSM-5; however, continuing efforts are needed to understand underlying mechanisms of BED and to improve prevention and treatment outcomes for this disorder. These efforts should also include screening, identification and implementation of evidence-based interventions in routine clinical practice settings such as primary care and mental health outpatient clinics.
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Affiliation(s)
- Katrin E Giel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany.
- Center of Excellence for Eating Disorders (KOMET), Tübingen, Germany.
| | - Cynthia M Bulik
- Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Fernando Fernandez-Aranda
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Phillipa Hay
- Translational Health Research Institute, Western Sydney University, Sydney, NSW, Australia
- Camden and Campbelltown Hospitals, SWSLHD, Campbelltown, NSW, Australia
| | | | - Kathrin Schag
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany
- Center of Excellence for Eating Disorders (KOMET), Tübingen, Germany
| | - Ulrike Schmidt
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany
- Center of Excellence for Eating Disorders (KOMET), Tübingen, Germany
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3
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Barber JA, Ivezaj V, Barnes RD. Comparing physical activity in individuals with overweight/obesity with and without binge eating disorder. Obes Sci Pract 2018; 4:134-140. [PMID: 29670751 PMCID: PMC5893463 DOI: 10.1002/osp4.154] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Revised: 12/21/2017] [Accepted: 12/22/2017] [Indexed: 01/14/2023] Open
Abstract
Objective Differential participation in physical activity (PA) may partially explain the health discrepancies between individuals with or without binge-eating disorder (BED). Yet, little is known about the PA habits of individuals with overweight/obesity and how those patterns may differ based on BED status. PA patterns and exercise self-efficacy were examined in individuals with overweight/obesity, with and without BED. Design Ninety-seven participants with overweight/obesity self-reported their PA via the Godin Leisure-Time Questionnaire and the Paffenbarger PA Questionnaire. Exercise self-efficacy was assessed with the Marcus 5-item Exercise Self-Efficacy scale. Based on the Eating Disorder Examination, 27.8% (n = 27) of the participants met BED criteria. Participants were primarily female (n = 75, 77.3%), on average 47.5 years old (standard deviation = 10.4), and predominantly White/Not Hispanic (n = 67, 69.1%) or African-American/Not Hispanic (n = 18, 18.6%). Results Hierarchical regressions, accounting for significant differences in body mass index between those with and without BED, showed that the Marcus 5-item Exercise Self-Efficacy Scale (but not BED status) was significantly related to PA. BED status also was unrelated to likelihood of reaching Centres for Disease Control PA guidelines, and 44.3% of all participants reported no participation in weekly sports/recreation activities. Conclusions Both groups participated in relatively little purposeful and moderate/strenuous PA. Exercise self-efficacy may be important to assess and address among treatment seeking individuals with and without BED who struggle with excess weight.
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Affiliation(s)
- J. A. Barber
- Psychology 116BVA Connecticut Healthcare SystemWest HavenCTUSA
- Department of PsychiatryYale University School of MedicineNew HavenCTUSA
| | - V. Ivezaj
- Department of PsychiatryYale University School of MedicineNew HavenCTUSA
| | - R. D. Barnes
- Department of PsychiatryYale University School of MedicineNew HavenCTUSA
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4
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Lydecker JA, Grilo CM. Does your child's weight influence how you judge yourself as a parent? A cross-sectional study to define and examine parental overvaluation of weight/shape. Prev Med 2017; 105:265-270. [PMID: 28987340 PMCID: PMC5659758 DOI: 10.1016/j.ypmed.2017.10.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 10/02/2017] [Accepted: 10/03/2017] [Indexed: 12/23/2022]
Abstract
Parents are integral stakeholders in children's health and development, and yet there is a dearth of research on parental attitudes and parents' personal weight and eating psychopathology, which have the potential to influence pediatric obesity and eating disorder treatments meaningfully. Overvaluation of weight/shape is a core concept in eating-disorder assessment and treatment defined as self-evaluation excessively based on weight/shape, which research has demonstrated to be clinically important psychopathology. A novel and related concept, parental overvaluation of weight/shape, could be defined as parents' self-evaluation unduly based on their child's weight/shape, yet this concept has not been studied and its clinical importance is unknown. The aim of this study was to examine the distinctiveness of parental overvaluation of weight/shape from personal overvaluation of weight/shape, and to examine associations of parental overvaluation with parents' psychopathology and children's weight and eating behaviors. The current study examined differences among parents with (n=134) and without (n=872) parental overvaluation using a cross-sectional design. Parental overvaluation was more common among parents with binge-eating disorder and bulimia than obesity and healthy-weight. Parental overvaluation was modestly associated with personal overvaluation. Parents with and without parental overvaluation differed on personal eating-disorder psychopathology and children's weight and eating behaviors. Importantly, differences remained after adjusting for personal overvaluation and child BMI. This study highlights a novel construct-parental overvaluation-associated with, but distinct from, parental eating disorders and personal overvaluation. Parental overvaluation may warrant clinical attention among parents seeking pediatric obesity or eating-disorder treatment, or treatment for personal eating disorders.
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Affiliation(s)
- Janet A Lydecker
- Department of Psychiatry, Yale School of Medicine, United States.
| | - Carlos M Grilo
- Department of Psychiatry, Yale School of Medicine, United States
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5
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Schaumberg K, Welch E, Breithaupt L, Hübel C, Baker JH, Munn-Chernoff MA, Yilmaz Z, Ehrlich S, Mustelin L, Ghaderi A, Hardaway AJ, Bulik-Sullivan EC, Hedman AM, Jangmo A, Nilsson IAK, Wiklund C, Yao S, Seidel M, Bulik CM. The Science Behind the Academy for Eating Disorders' Nine Truths About Eating Disorders. EUROPEAN EATING DISORDERS REVIEW 2017; 25:432-450. [PMID: 28967161 PMCID: PMC5711426 DOI: 10.1002/erv.2553] [Citation(s) in RCA: 131] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 08/16/2017] [Accepted: 08/18/2017] [Indexed: 12/13/2022]
Abstract
OBJECTIVE In 2015, the Academy for Eating Disorders collaborated with international patient, advocacy, and parent organizations to craft the 'Nine Truths About Eating Disorders'. This document has been translated into over 30 languages and has been distributed globally to replace outdated and erroneous stereotypes about eating disorders with factual information. In this paper, we review the state of the science supporting the 'Nine Truths'. METHODS The literature supporting each of the 'Nine Truths' was reviewed, summarized and richly annotated. RESULTS Most of the 'Nine Truths' arise from well-established foundations in the scientific literature. Additional evidence is required to further substantiate some of the assertions in the document. Future investigations are needed in all areas to deepen our understanding of eating disorders, their causes and their treatments. CONCLUSIONS The 'Nine Truths About Eating Disorders' is a guiding document to accelerate global dissemination of accurate and evidence-informed information about eating disorders. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
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Affiliation(s)
- Katherine Schaumberg
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Elisabeth Welch
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Lauren Breithaupt
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Psychology, George Mason University, Fairfax, VA, USA
| | - Christopher Hübel
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- MRC Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Jessica H Baker
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Zeynep Yilmaz
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Stefan Ehrlich
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
- Eating Disorder Treatment and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Linda Mustelin
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Public Health and Institute for Molecular Medicine Finland FIMM, University of Helsinki, Helsinki, Finland
| | - Ata Ghaderi
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Andrew J Hardaway
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Emily C Bulik-Sullivan
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Anna M Hedman
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Andreas Jangmo
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Ida A K Nilsson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska Hospital, Stockholm, Sweden
| | - Camilla Wiklund
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Shuyang Yao
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Maria Seidel
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
- Eating Disorder Treatment and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Cynthia M Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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6
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Lydecker JA, Grilo CM. Children of parents with BED have more eating behavior disturbance than children of parents with obesity or healthy weight. Int J Eat Disord 2017; 50:648-656. [PMID: 27859458 PMCID: PMC5429220 DOI: 10.1002/eat.22648] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 10/18/2016] [Accepted: 10/20/2016] [Indexed: 11/06/2022]
Abstract
OBJECTIVE A limited literature suggests an association between parental eating disorders and child eating-disorder behaviors although this research has focused primarily on restrictive-type eating disorders and very little is known about families with binge-eating disorder (BED). METHODS The current study focused on parents (N = 331; 103 fathers and 226 mothers), comparing parents with core features of BED (n = 63) to parents with obesity and no eating disorder (OB; n = 85) and parents with healthy-weight and no eating disorder (HW; n = 183). RESULTS Parents with BED were significantly more likely than OB and HW parents to report child binge eating, and more likely than HW parents to report child overeating. Parents with BED felt greater responsibility for child feeding than OB parents, and felt more concern about their child's weight than OB and HW parents. Dietary restriction of the child by the parents was related to child binge eating, overeating, and child overweight, and parental group was related to child binge eating (parental BED), overeating (parental BED), and child weight (parental OB). DISCUSSION Parents with BED report greater disturbance in their children's eating than OB and HW parents, and OB parents report higher child weight than HW parents. This suggests that it is important to consider both eating-disorder psychopathology and obesity in clinical interventions and research. Our cross-sectional findings, which require experimental and prospective confirmations, provide preliminary evidence suggesting potential factors in families with parental BED and obesity to address in treatment and prevention efforts for pediatric eating disorders and obesity. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2017; 50:648-656).
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Affiliation(s)
- Janet A. Lydecker
- Department of Psychiatry; Yale School of Medicine; New Haven Connecticut
| | - Carlos M. Grilo
- Department of Psychiatry; Yale School of Medicine; New Haven Connecticut
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7
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Thaler L, Steiger H. Eating Disorders and Epigenetics. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 978:93-103. [PMID: 28523542 DOI: 10.1007/978-3-319-53889-1_5] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Eating disorders (EDs) are characterized by intense preoccupation with shape and weight and maladaptive eating practices. The complex of symptoms that characterize EDs often arise through the activation of latent genetic potentials by environmental exposures, and epigenetic mechanisms are believed to link environmental exposures to gene expression. This chapter provides an overview of genetic factors acting in the etiology of EDs. It then provides a background to the hypothesis that epigenetic mechanisms link stresses such as obstetric complications and childhood abuse as well as effects of malnutrition to eating disorders (EDs). The chapter then summarizes the emerging body of literature on epigenetics and EDs-mainly studies on DNA methylation in samples of anorexia and bulimia. The available evidence base suggests that an epigenetically informed perspective contributes in valuable ways to the understanding of why people develop EDs.
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Affiliation(s)
- Lea Thaler
- Eating Disorders Continuum, Douglas Institute, Montreal West Island Integrated University Health and Social Services Centre, 6875 LaSalle Blvd, Verdun, QC, Canada, H4H 1R3. .,Psychiatry Department, McGill University, Montréal, QC, Canada, H3A 1Y2.
| | - Howard Steiger
- Eating Disorders Continuum, Douglas Institute, Montreal West Island Integrated University Health and Social Services Centre, 6875 LaSalle Blvd, Verdun, QC, Canada, H4H 1R3.,Psychiatry Department, McGill University, Montréal, QC, Canada, H3A 1Y2
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8
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Blomquist KK, Grilo CM. Family histories of anxiety in overweight men and women with binge eating disorder: A preliminary investigation. Compr Psychiatry 2015; 62:161-9. [PMID: 26343481 PMCID: PMC4583821 DOI: 10.1016/j.comppsych.2015.07.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 07/06/2015] [Accepted: 07/14/2015] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE A preliminary examination of the significance of family histories of anxiety in the expression of binge eating disorder (BED) and associated functioning. METHODS Participants were 166 overweight patients with BED assessed using diagnostic interviews. Participants were administered a structured psychiatric history interview about their first-degree relatives (parents, siblings, children) (N=897) to determine lifetime diagnoses of DSM-IV anxiety disorders and completed a battery of questionnaires assessing current and historical eating and weight variables and associated psychological functioning (depression). RESULTS BED patients with a family history of anxiety disorder were significantly more likely than BED patients without a family history of anxiety disorder to have lifetime diagnoses of anxiety disorders and mood disorders but not substance use disorders. A family history of anxiety was not significantly associated with timing or sequencing of age at onset of anxiety disorder, binge eating, dieting, or obesity, or with variability in current levels of binge eating, eating disorder psychopathology, or psychological functioning. CONCLUSIONS Although replication with direct interview method is needed, our preliminary findings suggest that a family history of anxiety confers greater risk for comorbid anxiety and mood disorders but is largely unrelated to the development of binge eating, dieting, or obesity and unrelated to variability in eating disorder psychopathology or psychological functioning in overweight patients with BED.
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Affiliation(s)
| | - Carlos M Grilo
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States; Department of Psychology, Yale University, New Haven, CT, United States
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9
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Abstract
Over the past decade, considerable advances have been made in understanding genetic influences on eating pathology. Eating disorders aggregate in families, and twin studies reveal that additive genetic factors account for approximately 40% to 60% of liability to anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED). Molecular genetics studies have been undertaken to identify alterations in deoxyribonucleic acid sequence and/or gene expression that may be involved in the pathogenesis of disordered eating behaviors, symptoms, and related disorders and to uncover potential genetic variants that may contribute to variability of treatment response. This article provides an in-depth review of the scientific literature on the genetics of AN, BN, and BED including extant studies, emerging hypotheses, future directions, and clinical implications.
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Affiliation(s)
- Sara E Trace
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina 27599, USA.
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10
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Berge JM, Wall M, Larson N, Eisenberg ME, Loth KA, Neumark-Sztainer D. The unique and additive associations of family functioning and parenting practices with disordered eating behaviors in diverse adolescents. J Behav Med 2012. [PMID: 23196919 DOI: 10.1007/s10865-012-9478-1] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
To examine the unique and additive associations of family functioning and parenting practices with adolescent disordered eating behaviors (i.e., dieting, unhealthy weight control behaviors, binge eating). Data from EAT (Eating and Activity in Teens) 2010, a population-based study assessing eating and activity among racially/ethnically and socio-economically diverse adolescents (n = 2,793; mean age = 14.4, SD = 2.0; age range = 11-19) was used. Logistic regression models were used to examine associations between adolescent dieting and disordered eating behaviors and family functioning and parenting variables, including interactions. All analyses controlled for demographics and body mass index. Higher family functioning, parent connection, and parental knowledge about child's whereabouts (e.g. who child is with, what they are doing, where they are at) were significantly associated with lower odds of engaging in dieting and disordered eating behaviors in adolescents, while parent psychological control was associated with greater odds of engaging in dieting and disordered eating behaviors. Although the majority of interactions were non-significant, parental psychological control moderated the protective relationship between family functioning and disordered eating behaviors in adolescent girls. Clinicians and health care providers may want to discuss the importance of balancing specific parenting behaviors, such as increasing parent knowledge about child whereabouts while decreasing psychological control in order to enhance the protective relationship between family functioning and disordered eating behaviors in adolescents.
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Affiliation(s)
- Jerica M Berge
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Phillips Wangensteen Building, 516 Delaware Street SE, Minneapolis, MN, 55455, USA,
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11
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Root TL, Thornton L, Lindroos AK, Stunkard AJ, Lichtenstein P, Pedersen NL, Rasmussen F, Bulik CM. Shared and unique genetic and environmental influences on binge eating and night eating: a Swedish twin study. Eat Behav 2010; 11:92-8. [PMID: 20188292 PMCID: PMC2830904 DOI: 10.1016/j.eatbeh.2009.10.004] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2009] [Revised: 09/20/2009] [Accepted: 10/23/2009] [Indexed: 11/30/2022]
Abstract
We applied twin methodology to female and male twin pairs to further understand the nature of the relation between two behaviors associated with eating disorders-binge eating (BE) and night eating (NE) in an effort to determine the extent of overlap of genetic and environmental factors influencing liability to these behaviors. We calculated heritability estimates for males and females for each behavior and applied bivariate twin modeling to the female data to estimate the genetic and environmental correlation between these two traits. Data on BE and NE were derived from the Swedish Twin study of Adults: Genes and Environment (STAGE) of the Swedish Twin Registry (STR; N=11,604). Prevalence estimates revealed sex differences with females more likely to endorse BE and males more likely to endorse NE. In males, we were only able to estimate univariate heritabilities due to small sample sizes: The heritability for BE was 0.74 [95% CI=(0.36, 0.93)] and for NE was 0.44 [95% CI=(0.24, 0.61)]. The best fitting bivariate model for females included additive genetic and unique environmental factors as well as the genetic correlation between BE and NE. Heritability estimates were 0.70 [95% CI=(0.26, 0.77)] for BE and 0.35 [95% CI=(0.17, 0.52)] for NE. The genetic correlation, 0.66 [95% CI=(0.48, 0.96)] suggests considerable overlap in the genetic factors influencing liability to BE and NE. In females, there is considerable overlap in the genetic factors that contribute to these traits, but the incomplete overlap allows for the influence of independent genetic and environmental factors as well. BE and NE in females are therefore best conceptualized as related but not identical traits.
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Affiliation(s)
- Tammy L. Root
- Department of Psychiatry, University of North Carolina at Chapel Hill
| | - Laura Thornton
- Department of Psychiatry, University of North Carolina at Chapel Hill
| | | | | | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Nancy L. Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden, Department of Psychology, University of Southern California, Los Angeles, CA
| | - Finn Rasmussen
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Cynthia M. Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Department of Nutrition, University of North Carolina at Chapel Hill
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12
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Abstract
Family, twin, and adoption studies of anorexia nervosa (AN), bulimia nervosa (BN), binge-eating disorder (BED), and the proposed purging disorder presentation (PD) have consistently demonstrated that genetic factors contribute to the variance in liability to eating disorders. In addition, endophenotypes and component phenotypes of eating disorders have been evaluated and provide further insight regarding genetic factors influencing eating disorders and eating disorder diagnostic criteria. Many of these phenotypes have demonstrated substantial heritability. This chapter reviews biometrical genetic methods and current findings from family and twin studies that investigate the role of genes and environment in the etiology of eating disorders. We review the methodology used to estimate heritability, the results of these studies, and discuss the implications of this research for the basic conceptualization of eating disorders and the future value of twin modeling in the molecular genetic era.
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13
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Javaras KN, Laird NM, Reichborn-Kjennerud T, Bulik CM, Pope HG, Hudson JI. Familiality and heritability of binge eating disorder: results of a case-control family study and a twin study. Int J Eat Disord 2008; 41:174-9. [PMID: 18095307 DOI: 10.1002/eat.20484] [Citation(s) in RCA: 89] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To estimate the familiality and heritability of binge eating disorder (BED). METHOD We used a new ACE structural equation model to estimate heritability from a case-control family study of BED conducted in the Boston area. The sample consisted of 150 overweight/obese probands with lifetime BED by DSM-IV criteria, 150 overweight/obese probands without lifetime BED, and 888 of their first-degree relatives. We compared our findings with those from a study of binge eating (in the absence of compensatory behaviors) among 7,831 Norwegian twins. RESULTS The prevalence of BED differed by sex and by age. In the case-control family study, BED was found to aggregate in families, and heritability was estimated as 57% (CI: 30-77%). Including shared environment did not substantially improve the model's fit, nor did allowing sex-specific heritability. Findings from the twin study were similar. CONCLUSION BED appears to aggregate in families and have a significant genetic component.
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Affiliation(s)
- Kristin N Javaras
- Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts, USA.
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14
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Abstract
This review summarizes the research advances of the past decade regarding the role of human genetic differences in energy and nutrient intake as well as in eating behavior phenotypes and selected eating disorders. The evidence for familial aggregation and heritability based on twin and nuclear family study designs is summarized. Genome-wide linkage scans and quantitative trait loci identified to date are discussed. DNA sequence variants in candidate genes are reviewed. Single genes associated with classical eating disorders are also incorporated. Epigenetic events will need to be incorporated in future studies designed to investigate the effects of DNA variants on dietary phenotypes. Understanding the relative contribution of global genetic variation and of DNA sequence variants in specific genes is important in the effort to influence dietary habits in a healthier direction.
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Affiliation(s)
- Tuomo Rankinen
- Human Genomics Laboratory, Pennington Biomedical Research Center, Baton Rouge, Louisiana 70808-4124, USA.
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15
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Decaluwé V, Braet C, Moens E, Van Vlierberghe L. The association of parental characteristics and psychological problems in obese youngsters. Int J Obes (Lond) 2006; 30:1766-74. [PMID: 16607384 DOI: 10.1038/sj.ijo.0803336] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The aim of the present study was to examine to what extent parental psychological characteristics and parental behavior are related to psychological problems in obese youngsters. RESEARCH METHODS Data were collected from 196 families having an overweight youngster (range 10-16 years old) (mean body mass index (BMI)=31.2; s.d.=5.3) seeking weight-loss treatment and compared with data from normal weight samples. Behavior problems were measured using the Child Behavior Checklist; the Child version of the Eating Disorder Examination was used to assess eating disorder psychopathology. Parental psychopathology was measured using the Symptom Checklist-90; parenting behavior was assessed with the Ghent Parental Behavior Scale. RESULTS Parental psychopathology was prevalent in 59.6% of mothers and 35.7% of fathers. Youngsters exceeding the cutoff for problem behavior ranged between 41.4 and 53.1%. Children's problem behavior was most associated with psychopathology in the mother (r=0.40 for Internalizing and r=0.37 for Externalizing; both P<0.01). The research findings further revealed that the effects of maternal psychopathology were partly mediated by a specific form of parenting behavior, namely Inconsistent discipline, although the effect was stronger for Externalizing behavior (explained variance: 10%) than for Internalizing behavior (explained variance: 4%). No evidence was found for a mediator effect from parenting behavior on the eating disorder symptoms of the obese youngsters. However, several direct relations emerged, suggesting a negative association between a child's eating disorder symptoms and Positive parenting behavior by the mother (r= -0.20 for Eating concern; r= -0.18 for Restraint eating; r= -0.16 for Shape concern; all P<0.05) as well as by the father (r= -0.25 for Eating concern; r= -0.25 for Weight concern; both P<0.01; r= -0.21 for Shape concern; P<0.05). DISCUSSION Parental characteristics were associated with psychological problems in obese youngsters, not only in a direct way but also indirectly. The effects were partly mediated by a particular ineffective parenting style, namely inconsistent discipline on the part of the mother. Pediatric obesity treatments should focus more on parenting behaviors and parental characteristics.
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Affiliation(s)
- V Decaluwé
- 1Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
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16
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Abstract
Zusammenfassung. Während die Anorexia nervosa und Bulimia nervosa bei Jugendlichen ein deutliches Forschungsinteresse gefunden haben, liegen bislang wenige Befunde zur “Binge-Eating“-Störung (BED) im Kindes- und Jugendalter vor. Im vorliegenden Beitrag werden überblicksartig die Merkmale, Epidemiologie und Entstehung der Essanfallssymptomatik bzw. der BED bei Kindern und Jugendlichen beschrieben. Anfallsartiges Essen ist durch fehlende Kontrolle über das Essen, Essen in Abwesenheit von Hunger, heimliches und emotionales Essen gekennzeichnet. Dieses Symptombild spiegelt sich in den aktuellen Diagnosekriterien nicht adäquat wider. Die Symptomatik einer BED geht mit einer erhöhten essstörungsspezifischen und allgemeinen Psychopathologie sowie mit einem erhöhten Körpergewicht einher. Diagnostische Verfahren und Ansätze zur psychologischen Psychotherapie werden vorgestellt.
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Affiliation(s)
- Anja Hilbert
- Department of Psychiatry, Washington University in St. Louis, USA
| | - Simone Munsch
- Institut für Psychologie, Universität Basel, Schweiz
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17
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Reichborn-Kjennerud T, Bulik CM, Tambs K, Harris JR. Genetic and environmental influences on binge eating in the absence of compensatory behaviors: a population-based twin study. Int J Eat Disord 2004; 36:307-14. [PMID: 15478129 DOI: 10.1002/eat.20047] [Citation(s) in RCA: 81] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The current study explores the extent to which genetic and environmental factors influence liability to binge eating in the absence of compensatory behaviors (BE) in a population-based sample of twins. METHOD Questionnaire data on 8,045 same-sex and opposite-sex twins, aged 18-31 years, from a Norwegian twin registry were used to assess BE during the last 6 months. RESULTS The best-fitting biometrical model suggested that the heritability of BE was 41% (95% confidence interval [CI]: 0.31-0.50). Individual environmental factors accounted for the rest of the variance (59%; 95% CI: 0.50-0.69). No significant sex differences were found, but the statistical power to detect such effects was low. Shared environmental influences on the liability to BE in males could not be ruled out. DISCUSSION The findings indicate significant additive genetic influences on BE, supporting the validity of the core features of binge eating disorder as a diagnostic category.
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Affiliation(s)
- Ted Reichborn-Kjennerud
- Division of Epidemiology, Department of Mental Health, The Norwegian Institute of Public Health, N-0403 Oslo, Norway.
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18
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Dymek-Valentine M, Rienecke-Hoste R, Alverdy J. Assessment of binge eating disorder in morbidly obese patients evaluated for gastric bypass: SCID versus QEWP-R. Eat Weight Disord 2004; 9:211-6. [PMID: 15656016 DOI: 10.1007/bf03325069] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE Binge eating disorder (BED) has been hypothesized to be associated with poor outcome in gastric bypass surgery (GBP). However, past studies have yielded inconsistent results regarding BED and surgical outcome, which may be due to the variety of measures used to assess BED. The present study examines the utility of two commonly used BED diagnostic tools: the Structured Clinical Interview (SCID) and the Questionnaire of Eating and Weight Patterns-Revised (QEWP-R). METHOD Subjects were 168 adult patients evaluated for GBP. BED was assessed using the SCID and the RESULTS 27% of the sample received a diagnosis of BED using the QEWP-R, compared with 14% using the SCID. Agreement using Cohen's kappa was 0.37. Compared to sub-non-concordant diagnoses of BED, subjects with concordant diagnoses scored on a measure of self-esteem. DISCUSSION Although both diagnostic tools use the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV) criteria, each yielded different results. Further studies are needed to determine the most accurate method of assessing BED in this population.
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Affiliation(s)
- M Dymek-Valentine
- Department of Psychiatry, Center for Advanced Medicine, The University of Chicago, Chicago, IL, USA.
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19
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Devlin MJ, Goldfein JA, Dobrow I. What is this thing called BED? Current status of binge eating disorder nosology. Int J Eat Disord 2003; 34 Suppl:S2-18. [PMID: 12900982 DOI: 10.1002/eat.10201] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Although binge eating has been recognized as a clinically relevant behavior among the obese for more than four decades, the concept of binge eating disorder (BED) as a distinct psychiatric diagnosis is of much more recent origin. This article presents four ways of conceptualizing BED: a distinct disorder in its own right, as a variant of bulimia nervosa, as a useful behavioral subtype of obesity, and as a behavior that reflects psychopathology among the obese. It also summarizes the evidence supporting and disconfirming each model. METHOD The literature subsequent to the development of DSM-IV regarding the reliability and validity of BED and related conditions was reviewed selectively. RESULTS The preponderance of the evidence suggests that BED differs importantly from purging bulimia nervosa and that BED is not a strikingly useful behavioral subtype of obesity. DISCUSSION Further study is needed to definitively determine the validity of BED as a distinct eating disorder.
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Affiliation(s)
- Michael J Devlin
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA.
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20
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Abstract
OBJECTIVE Current controversy exists regarding the status of binge eating disorder (BED) as a diagnostic entity. A critique of the literature is provided to address the question of whether BED represents a clinically significant syndrome. METHOD The scientific evidence is considered through addressing five questions that are key in evaluating the clinical utility of any mental disorder. RESULTS Individuals with BED meaningfully differ from individuals without eating disorders, and share important similarities to, yet are distinct from, individuals with anorexia nervosa (AN) and bulimia nervosa (BN). BED is associated with co-occurring physical and mental illnesses, as well as impaired quality of life and social functioning. Questions about the course of the disorder and the optimal treatment regimen for the syndrome need to be explored further. DISCUSSION BED's distinctive combination of core eating disorder psychopathology, and other co-occurring physical and psychiatric conditions, impaired psychosocial functioning, and overweight constitute an eating disorder of clinical severity and a significant public health problem.
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Affiliation(s)
- Denise E Wilfley
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri 63110, USA
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21
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Ross LT, Gill JL. Eating disorders: relations with inconsistent discipline, anxiety, and drinking among college women. Psychol Rep 2002; 91:289-98. [PMID: 12353794 DOI: 10.2466/pr0.2002.91.1.289] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Since as many as 20% of all college women report symptoms of eating disorders, the present study examined the relationship between self-reported eating disorder symptoms. anxiety, drinking, and retrospective reports of inconsistent parenting during childhood. 101 college women, 85% Euro-Americans of mean age 19 yr., completed an anonymous survey including questions from the Eating Disorder Index-1, the Retrospective Family Unpredictability Scale, the Trait Anxiety Scale, and measures of drinking in the previous month. Eating disorder symptoms correlated with self-reported drinking quantity, anxiety, and retrospective ratings of inconsistent discipline. This appears to be the first time eating disorder symptoms have been associated with inconsistent discipline. Implications for etiology and treatment of eating disorders are discussed.
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22
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Abstract
Adolescence and young adulthood mark the convergence of substantial biologic and social change. Individuals differ in their innate capacity to tolerate change. Research suggests that some of the personality characteristics that are fundamental to individuals with eating disorders may render them particularly vulnerable to the impact of a changing body and changing social demands. The fact that eating disorders emerge primarily during adolescence and often run a protracted course can deprive the afflicted individual of the core social, emotional, and biologic developmental processes that normally occur during this time of life.
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Affiliation(s)
- Cynthia M Bulik
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, 800 East Leigh Street, Richmond, VA 23298-0126, USA.
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23
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ROSS LISATHOMSON. EATING DISORDERS: RELATIONS WITH INCONSISTENT DISCIPLINE, ANXIETY, AND DRINKING AMONG COLLEGE WOMEN. Psychol Rep 2002. [DOI: 10.2466/pr0.91.5.289-298] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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McGarvey EL, Kryzhanovskaya LA, Koopman C, Waite D, Canterbury RJ. Incarcerated Adolescents' Distress and Suicidality in Relation to Parental Bonding Styles. CRISIS 1999. [DOI: 10.1027//0227-5910.20.4.164] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This study examines the relationships between the bonding style of an incarcerated adolescent with parents and his/her current feelings of self-esteem, hopelessness, and suicidal thoughts and attempts. It also investigates differences between bonding to mother and bonding to father. Some 296 incarcerated adolescents were interviewed using the Parental Bonding Instrument. Significant relationships were found between youths' self-esteem, hopelessness, and suicidal behavior and their bonding style. Youths whose parent(s) had a parental bonding style of affectionless control reported the greatest distress, and youths whose parent(s) had an optimal bonding style reported the least distress. Differences were found between bonding styles with the mother and with the father. Attachment theory may be useful in targeting incarcerated youths who have affectionless control bonding with parent(s) for special interventions since these youths are most at risk for psychosocial problems.
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