Eating Disorders of the Adolescent: Current Issues in Etiology, Assessment, and Treatment

Figure Preference, Body Dissatisfaction, and Body Distortion in Adolescence

The present study was designed to evaluate gender and age effects on three multidimensional factors (i.e., figure preference, body dissatisfaction, and body distortion) that potentiate eating-related problems among adolescents. Data from 454 students (X age 15.03) found females preferred afigure significantly thinner than their current status, whereas males were generally pleased with their body proportions. This discrepancy resulted in significant gender differences in idealfigure preference and body dissatisfaction. School level (high school vs. middle school) by gender, two-way ANOVA comparisons found an interactional effect, with high schoolfemales evidencing significantly higher levels of body dissatisfaction and distortion than the middle schoolfemales and males. Further analysis with females found body dissatisfaction increased with age in a linear configuration, whereas body distortion followed a curvilinear pattern.

Relationships between psychological stress, coping and disordered eating: A review

Abstract Objective: Psychological stress and inadequate coping skills have been hypothesized to play important roles in the etiology of disordered eating. This paper reviews the empirical evidence which has emerged regarding the proposed relationships among stress. coping skills and various forms of disordered eating.

METHOD

A search of psychological and medical databases was conducted to identify studies examining life events, and other types of psychological stress and coping strategies, in relation to the onset of disordered eating.

RESULTS

Despite methodological limitations such as the use of non-representative samples and retrospective methodologies, evidence of relationships between stress. coping and disordered eating was obtained in the majority of studies reviewed.

DISCUSSION

The implications of these findings am discussed and suggestions for future research, including the utilization of longitudinal. prospective studies, am presented.

Examining the construct validity of the Eating Disorder Inventory

The construct validity of the Eating Disorder Inventory (EDI) was examined in 3 samples. An archival clinic sample (n = 318) of women completed the EDI, a structured interview, and the Millon Clinical Multiaxial Inventory-II (MCMI-II). Confirmatory factor analyses (CFAs) indicated that neither null nor 1-factor models of the EDI fit item-level or item-parcel data. The proposed 8-factor model did not fit at the item level but did fit item-parcel data. Reliability estimates of the 8 scales ranged from .82 to .93, and low-to-moderate interscale correlations among the eating and weight-related scales provided partial support for convergent validity. EDI personality scales showed moderate interscale correlations and were associated with MCMI-II scales. A final CFA of the EDI scales supported a 2-factor model (Eating and Weight, Personality) of the 8 EDI scales. Strong associations between depression and several EDI scale scores were found in a treatment study sample (n = 50). The archival clinic sample scored significantly higher on the 8 EDI scales than the nonpatient college comparison sample (n = 487).

Body image in middle school children

The study purpose was to examine the relationship between sex, age, body mass index (BMI), and fitness level on the body image of 388 middle school children. Participants completed affective (social physique anxiety) and subjective evaluation (body dissatisfaction) body image measures and the 1-mile run/walk as an objective fitness measure. It was found that: (a) the females reported more social physique anxiety and body dissatisfaction than the males; (b) body dissatisfaction, especially for the females, was prevalent, (c) BMI was positively related to the body image measures; (d) for the males only, age was negatively related to the body image measures; (e) body dissatisfaction was negatively related to fitness levels; and (f) after controlling for BMI (and age for the males), fitness level was not a significant predictor of body dissatisfaction. The results indicate that body dissatisfaction was prevalent and early interventions with youth may be required.

The Eating Disorder Inventory in evaluation of impaired eating behaviour in subjects requesting nutritional consultation

The present study evaluated impaired eating behaviour in women seeking participation in a diet-based programme of weight reduction or achievement of ideal body weight. Forty-seven obese, 42 overweight and 14 normal-weight subjects, attending an Italian university outpatient clinic completed the Eating Disorder Inventory (EDI). Forty-eight mothers of primary school children (25 normal-weight and 23 overweight) were used as controls. The EDI consists of 8 subscales, 3 evaluating psychopathology related to eating disorders (drive for thinness, bulimia, body dissatisfaction) and 5 evaluating general psychopathology (intereoceptive awareness, ineffectiveness, maturity fears, perfectionism, interpersonal distrust). Significantly altered scores in the first three subscales were observed both in normal-weight and overweight outpatients compared to the controls. The overweight outpatients scored higher than the obese patients in terms of drive for thinness and bulimia and higher than the normal-weight women for terms of bulimia, body dissatisfaction and drive for thinness. The overweight controls scored significantly higher than the normal-weight controls in the first three subscales in the remaining subscales, mean values were also higher in the overweight group, though significance was only reached in the interpersonal distrust and interoceptive awareness subscales. Impaired eating behaviour is frequent in subjects seeking participation in weight reduction or ideal body weight achievement programmes.

Earliest recollections in anorexia and bulimia

Earliest Recollections (ER) are very useful as they reveal information about a person's main aims and lifestyle, according to the Individual Psychology assumption of the inner coherence of the personality. This paper looks at the utility of analyzing ER in psychopathological research, diagnosis and therapy. Its purpose is to compare particular ER in a group of anorectic outpatients, a group of bulimic outpatients and in a control group. The results provide further evidence that ER are a useful instrument to identify various aspects of family dynamics, particular pathological nuclei which are often of the borderline type. They can also help to overcome the initial hostility towards any therapy that is often present in anorectic and assist the therapist early on in drawing a mental picture of the premises for understanding the lifestyle of the subject both as a child, and now as a patient.

Eating Disorders Inventory-2: cognitive-behavioral dimensions with nonclinical adolescents

The EDI-2 was administered to 122 nonclinical females aged 12 to 18 years. Although group means were within the normal range, 30% of the subjects were abnormally preoccupied with body proportions, and 4% were pathologically weight fixated. Three risk groups were identified on the basis of high composite factor scores: (a) the Psychological Distress group indicated substantial apprehension about social adequacy, personal intimacy, emotional security, and anger control; (b) the Body-image Dysphoria group were all preoccupied with weight and body proportions at levels commensurate with diagnosed anorexics; and (c) the Behavioral Disparity group endorsed unrealistically high standards for behavior and feelings of virtue/power through behavioral restraint, yet a willingness to engage in binging and/or purging behaviors.