Perceptions of gender ideals predict outcome of eating disorders in adolescent girls

Prediction of weight increase in anorexia nervosa

BACKGROUND

Anorexia nervosa (AN) is a serious psychiatric disorder with high mortality rates a poor outcome and no empirically supported treatment of choice for adults. Weight increase is essential for recovery from AN why research exploring important contributors is crucial.

AIMS

The current study examined the importance of motivation to change eating behaviour, treatment expectations and experiences, eating disorder symptomatology, self-image and treatment alliance for predicting weight increase.

METHODS

Female patients (n = 89) between 18 and 46 years of age with AN were assessed pre-treatment and at 6- and 36-month follow-ups with interviews and self-report questionnaires. At the 6-month follow-up the response rates differed from n = 58 (65%) to 66 (74%), and at the 36-month follow-up the response rates differed from n = 71 (80%) to 82 (92%).

RESULTS

At treatment start, expressed motivation to change eating habits, social insecurity and self-neglect were predictors of weight increase from 0 to 6 months, while duration, the time from onset to entering treatment, body dissatisfaction and interoceptive awareness were predictors of weight increase from 0 to 36 months.

CONCLUSIONS

In designing treatment for adult patients with AN, it is essential to include multifaceted interventions addressed to patients' motivation to change, social relations, negative self-image and body dissatisfaction in order to achieve weight increase. Early detection and thereby short duration is an additional important factor that contributes to weight increase.

A longitudinal study of motives for wishing to be thinner and weight-control practices in 7- to 18-year-old Swedish girls

The main aim of this seven-year longitudinal study, of 411 Swedish pre-adolescent girls (aged 7-11 years, Year 1), was to examine a wish to be thinner, dieting attempts, described motives for wishing to be thinner and weight-control practices. A further aim was to examine to what extent body mass index (BMI) accounted for motives for wishing to be thinner and weight-control practices. A wish to be thinner and dieting attempts increased significantly with increasing age between the ages of 9 and 18. The most frequently reported motive for wishing to be thinner was to 'feel better about yourself'. Categories that emerged from the qualitative analysis of self-described motives for the wish to be thinner were, for example, to 'correspond to the societal ideal' and to 'wear particular clothes'. A majority of the girls adopted weight-control practices that would be considered as healthy, but extreme weight-control practices increased with age. Girls with BMIs over the 75th percentile reported a greater number of motives for wishing to be thinner and used extreme weight-control practices significantly more often than the other girls. However, of the girls who changed BMI from above the 75th percentile to under the 75th percentile, 34.1% reported that they had not used any weight-control practices at all. Our results show that girls at a very early age are aware of the 'thin' ideal in our society, wish to be thinner and try to lose weight. The results point to the importance of detecting girls who wish to be thinner as early as possible. If we can employ preventive action in time, it is possible that dieting behaviour will never develop.

Family climate and recovery in adolescent onset eating disorders: a prospective study

OBJECTIVE

This prospective study investigated the self-assessed family climate of adolescent patients and their parents during treatment of and recovery from eating disorders.

METHOD

One hundred two girls aged 13-17 years with eating disorders, answered the self-report Family Climate Scale (FCS) and Eating Disorders Inventory for Children at initial assessment and after 18 and 36 months. The FCS was also answered by their parents at the same time points.

RESULTS

Self-assessed family climate and eating disorder symptoms were similar for recovered (R) and nonrecovered (NR) adolescents at initial assessment and at 18 months. At 36 months, FCS Closeness was higher for R, and FCS Distance was lower for R compared with NR. Parents of R adolescents had higher scores on FCS Closeness and lower scores on FCS Chaos compared with parents of NR adolescents at the 36-month follow-up.

CONCLUSION

Self-reported family climate was associated with recovery. Changes in eating disorder symptoms preceded changes in family climate.

Self-silencing and anger regulation as predictors of disordered eating among adolescent females

The main purpose of this study was to examine how self-silencing, emotional regulation, and body-esteem differentiated healthy eating from different patterns of disordered eating. A community sample of adolescent females was classified as either: 1) Restrained Eaters (n=104, M(age)=14.48); 2) Emotional Eaters (n=125, M(age)=14.52); or, 3) Healthy Eaters (n=396, M(age)=13.71). A discriminant function analysis revealed two significant functions. The first function differentiated the two disordered eating groups (i.e., the restrained and emotional eaters) from the healthy group, with the disordered eating groups scoring significantly higher on levels of self-silencing and anger regulation, and lower on body-esteem. The second function differentiated between the restrained and emotional eaters, with the emotional eaters reporting higher levels of externalized self-perception and anger, and lower levels of body-esteem. The results suggest that body-esteem and anger suppression were the most influential variables in differentiating between groups. The findings are discussed in terms of the implications for disordered eating prevention and treatment programs.