1
|
Fabry E, Fassnacht DB, Ford R, Burns NR, O'Shea AE, Ali K. The role of self-reliance and denial in the help-seeking process for eating disorders among university students. EUROPEAN EATING DISORDERS REVIEW 2024; 32:450-457. [PMID: 38078569 DOI: 10.1002/erv.3052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 10/30/2023] [Accepted: 11/13/2023] [Indexed: 04/05/2024]
Abstract
OBJECTIVE This study investigated how self-reliance and denial influence the relationship between help-seeking attitudes and behaviour. METHOD Australian university students (N = 406) completed an online survey and females with elevated eating disorder (ED) concerns and high impairment were included in the study (N = 137). Participants completed measures of help-seeking attitudes, perceived barriers, and actual help-seeking behaviour. Via moderated logistic regression, we examined self-reliance and denial as perceived barriers to help-seeking. RESULTS Of the total sample, over 33.7% of university students reported substantial ED concerns and impairment of whom 65.0% believed they needed help. While a majority reported that help-seeking would be useful (85.4%), only a minority of participants had sought professional help for their concerns (38.7%). Self-reliance and denial were frequently endorsed barriers and moderated the relationship between help-seeking attitudes and behaviours. CONCLUSION ED concerns are common among university students and perceived barriers play a moderating role between attitudes and help-seeking. Future prevention and early intervention programs should address students' denial, while the importance of reaching out for professional help (rather than relying on themselves) could be highlighted with peer support.
Collapse
Affiliation(s)
- Esme Fabry
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia
| | - Daniel B Fassnacht
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia
- School of Health, University of the Sunshine Coast, Sippy Downs, Australia
| | - Rachael Ford
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia
| | | | - Anne E O'Shea
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia
| | - Kathina Ali
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia
- School of Health, University of the Sunshine Coast, Sippy Downs, Australia
| |
Collapse
|
2
|
Lemmer D, Moessner M, Arnaud N, Baumeister H, Mutter A, Klemm SL, König E, Plener P, Rummel-Kluge C, Thomasius R, Kaess M, Bauer S. The Impact of Video-Based Microinterventions on Attitudes Toward Mental Health and Help Seeking in Youth: Web-Based Randomized Controlled Trial. J Med Internet Res 2024; 26:e54478. [PMID: 38656779 PMCID: PMC11079770 DOI: 10.2196/54478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/22/2023] [Accepted: 03/08/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Mental health (MH) problems in youth are prevalent, burdening, and frequently persistent. Despite the existence of effective treatment, the uptake of professional help is low, particularly due to attitudinal barriers. OBJECTIVE This study evaluated the effectiveness and acceptability of 2 video-based microinterventions aimed at reducing barriers to MH treatment and increasing the likelihood of seeking professional help in young people. METHODS This study was entirely web based and open access. The interventions addressed 5 MH problems: generalized anxiety disorder, depression, bulimia, nonsuicidal self-injury, and problematic alcohol use. Intervention 1 aimed to destigmatize and improve MH literacy, whereas intervention 2 aimed to induce positive outcome expectancies regarding professional help seeking. Of the 2435 participants who commenced the study, a final sample of 1394 (57.25%) participants aged 14 to 29 years with complete data and sufficient durations of stay on the video pages were randomized in a fully automated manner to 1 of the 5 MH problems and 1 of 3 conditions (control, intervention 1, and intervention 2) in a permuted block design. After the presentation of a video vignette, no further videos were shown to the control group, whereas a second, short intervention video was presented to the intervention 1 and 2 groups. Intervention effects on self-reported potential professional help seeking (primary outcome), stigma, and attitudes toward help seeking were examined using analyses of covariance across and within the 5 MH problems. Furthermore, we assessed video acceptability. RESULTS No significant group effects on potential professional help seeking were found in the total sample (F2,1385=0.99; P=.37). However, the groups differed significantly with regard to stigma outcomes and the likelihood of seeking informal help (F2,1385=3.75; P=.02). Furthermore, separate analyses indicated substantial differences in intervention effects among the 5 MH problems. CONCLUSIONS Interventions to promote help seeking for MH problems may require disorder-specific approaches. The study results can inform future research and public health campaigns addressing adolescents and young adults. TRIAL REGISTRATION German Clinical Trials Register DRKS00023110; https://drks.de/search/de/trial/DRKS00023110.
Collapse
Affiliation(s)
- Diana Lemmer
- Center for Psychotherapy Research, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
- Ruprecht-Karls University Heidelberg, Heidelberg, Germany
| | - Markus Moessner
- Center for Psychotherapy Research, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Nicolas Arnaud
- German Centre for Addiction Research in Childhood and Adolescence, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany
| | - Agnes Mutter
- Department of Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany
| | - Sarah-Lena Klemm
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Elisa König
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Ulm, Ulm, Germany
| | - Paul Plener
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Ulm, Ulm, Germany
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Christine Rummel-Kluge
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Rainer Thomasius
- German Centre for Addiction Research in Childhood and Adolescence, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Clinic of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Stephanie Bauer
- Center for Psychotherapy Research, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
- Ruprecht-Karls University Heidelberg, Heidelberg, Germany
- German Center for Mental Health (DZPG), Partner site Mannheim/Heidelberg/Ulm, Heidelberg, Germany
| |
Collapse
|
3
|
Hewitt J, Murray K. Negative body image mental health literacy in women: Exploring aesthetic and functional concerns and the role of self-objectification. Body Image 2024; 48:101657. [PMID: 38061211 DOI: 10.1016/j.bodyim.2023.101657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 10/16/2023] [Accepted: 11/24/2023] [Indexed: 03/05/2024]
Abstract
Despite its high prevalence in women, few studies have examined lay knowledge and beliefs about negative body image. Yet, studies applying mental health literacy to body image problems suggest recognition of appearance concerns is poor, which could impede help-seeking. The present study extended previous work by investigating problem recognition, beliefs and help-seeking for aesthetic and functional (physical ability focused) body image concerns in women, and the role of self-objectification in help-seeking. A within-subjects online survey design employing the mental health literacy paradigm was undertaken in a sample of 210 female-identifying adults residing in Australia (Mage = 31.25, SD = 12.76). Overall, results indicated that recognition of body image problems depicted via fictional text vignettes was limited. Moreover, recognition, as well as ratings of perceived prevalence, distress, sympathy, affective reactions, and help-seeking recommendations and intentions, were significantly greater for aesthetic compared to functional body image concerns. Self-objectification displayed significant negative associations with help-seeking recommendations for aesthetic (but not functional) concerns, and was not associated with help-seeking intentions. Findings suggest that negative body image mental health literacy is poor in women, particularly in relation to body functionality. More research is needed to facilitate help-seeking and reduce the impact of body image concerns in women.
Collapse
Affiliation(s)
- Jessica Hewitt
- School of Medicine and Psychology, College of Health and Medicine, The Australian National University, Canberra, ACT 2601, Australia.
| | - Kristen Murray
- School of Medicine and Psychology, College of Health and Medicine, The Australian National University, Canberra, ACT 2601, Australia
| |
Collapse
|
4
|
Hollett KB, Pennell JM, Carter JC. A vignette study of mental health literacy for binge-eating disorder in a self-selected community sample. J Eat Disord 2023; 11:69. [PMID: 37143163 PMCID: PMC10161539 DOI: 10.1186/s40337-023-00795-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 04/21/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND Mental health literacy has implications for mental disorder recognition, help-seeking, and stigma reduction. Research on binge-eating disorder mental health literacy (BED MHL) is limited. To address this gap, our study examined BED MHL in a community sample. METHOD Two hundred and thirty-five participants completed an online survey. Participants read a vignette depicting a female character with BED then completed a questionnaire to assess five components of BED MHL (problem recognition, perceived causes, beliefs about treatment, expected helpfulness of interventions, and expected prognosis). RESULTS About half of participants correctly identified BED as the character's main problem (58.7%). The most frequently selected cause of the problem was psychological factors (46.8%) and a majority indicated that the character should seek professional help (91.9%). When provided a list of possible interventions, participants endorsed psychologist the most (77.9%). CONCLUSIONS Compared to previous studies, our findings suggest that current BED MHL among members of the public is better, but further improvements are needed. Initiatives to increase knowledge and awareness about the symptoms, causes, and treatments for BED may improve symptom recognition, help-seeking, and reduce stigma.
Collapse
Affiliation(s)
- Kayla B Hollett
- Department of Psychology, Memorial University of Newfoundland, 230 Elizabeth Avenue, St. John's, NL, A1C 5S7, Canada
| | - Jenna M Pennell
- Department of Psychology, Memorial University of Newfoundland, 230 Elizabeth Avenue, St. John's, NL, A1C 5S7, Canada
| | - Jacqueline C Carter
- Department of Psychology, Memorial University of Newfoundland, 230 Elizabeth Avenue, St. John's, NL, A1C 5S7, Canada.
| |
Collapse
|
5
|
Foroughi N, Hay P, Mannan H. Community Women’s Lifestyle and Eating Disorders in the Era of COVID-19 Pandemic: A 15-Year Follow-Up Study. Nutrients 2023; 15:nu15071676. [PMID: 37049516 PMCID: PMC10097118 DOI: 10.3390/nu15071676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/22/2023] [Accepted: 03/25/2023] [Indexed: 04/03/2023] Open
Abstract
Most studies suggest that COVID-19 has adversely affected the quality of life and mental health, including eating disorders. However, studies have yet to examine longitudinally the impact of COVID-19 on eating disorder symptomatic individuals. This study aims to examine longitudinally the impact of the COVID-19 pandemic on the lifestyle and eating disorder symptoms of a symptomatic group of community-dwelling women. These women (n = 171) were enrolled in a longitudinal study, completed a COVID-19 modular self-report (post or Qualtrics, 2020/21), and participated in the current study. This study examined a 15th year follow-up. In 2020, 40% were tested for COVID-19. Of these, 87% had negative results; 5.3% self-isolated at home; 20.5% stopped working/studying in person; 28% continued online work/study; and 28% stopped work/studying in person. The pandemic affected sporting activities, music, and club activities (32.7% discontinued); 38% socialized in person; 16% socialized online; and 10% completely stopped socializing. Preliminary findings showed that the respondents showed no significant changes in levels of psychological distress (K10: 21.4 ± 9.8 vs. 19.0 ± 7.1, p < 0.171), and impaired quality of life (SF12: 50.9 ± 8.0 vs. 48.3 ± 9.5, p < 0.055) at 15-year follow-up. Eating disorder symptoms increased over time (EDE-Q global: 2.1 ± 1.4 vs. 2.9 ± 1.4, p < 0.013). Observed worsening of eating disorder-related symptoms during the COVID-19 pandemic may be due to interrupted eating patterns, exercise restrictions and the absence of social support. Provision and access to interventions to support those affected by eating disorders are a high priority, especially during these times. Further analyses with data imputation may find or further establish direct implications of COVID-19 in eating disorders.
Collapse
Affiliation(s)
- Nasim Foroughi
- Correspondence: ; Tel.: +61-(02)-4634-4580; Fax: +61-(02)-4620-3891
| | | | | |
Collapse
|
6
|
Prevention and early intervention in eating disorders: findings from a rapid review. J Eat Disord 2023; 11:38. [PMID: 36899428 PMCID: PMC9999654 DOI: 10.1186/s40337-023-00758-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 02/19/2023] [Indexed: 03/12/2023] Open
Abstract
BACKGROUND Eating disorders (EDs) are complex psychological disorders, with low rates of detection and early intervention. They can lead to significant mental and physical health complications, especially if intervention is delayed. Given high rates of morbidity and mortality, low treatment uptake, and significant rates of relapse, it is important to examine prevention, early intervention, and early recognition initiatives. The aim of this review is to identify and evaluate literature on preventative and early intervention programs in EDs. METHODS This paper is one of a series of Rapid Reviews, designed to inform the Australian National Eating Disorders Research and Translation Strategy 2021-2031, funded, and released by the Australian Government. To provide a current and rigorous review, peer-reviewed articles between 2009 and 2021 published in English were searched across three databases: ScienceDirect, PubMed and Ovid/Medline. Priority was given to high-level evidence including meta-analyses, systematic reviews, Randomised Control Trials, and large population studies. Findings from selected studies pertaining to prevention and early intervention in EDs were evaluated and are presented in this review. RESULTS In total, 130 studies were identified in the current review, 72% relating to prevention and 28% to early intervention. Most programs were theory-driven and targeted one or more ED risk factors such as thin-ideal internalisation and/or body dissatisfaction. There is reasonable evidence to support prevention programs reducing risk factors, particularly as part of school or university-based programs, with established feasibility and relatively high acceptance among students. There is increasing evidence around the use of technology (to increase dissemination potential) and for use of mindfulness approaches (targeting emotional resilience). Few longitudinal studies assessing incident cases following participation in a prevention program exist. CONCLUSIONS Although several prevention and early intervention programs have been shown to significantly reduce risk factors, promote symptom recognition, and encourage help-seeking behaviour, most of these studies have been conducted in older adolescent and university aged students, past the age of peak ED onset. One of the most targeted risk factors, body dissatisfaction, is found in girls as young as 6 years old, indicating a need for further research implementing prevention initiatives at younger ages. Follow-up research is limited; thus, the long-term efficacy and effectiveness of studied programs is unknown. Greater attention should be paid to the implementation of prevention and early intervention programs in identified high-risk cohorts or diverse groups, where a more targeted approach may be necessary.
Collapse
|
7
|
Haider K, Humer E, Weber M, Pieh C, Ghorab T, Dale R, Dinhof C, Gächter A, Probst T, Jesser A. An Assessment of Austrian School Students' Mental Health and Their Wish for Support: A Mixed Methods Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4749. [PMID: 36981657 PMCID: PMC10049003 DOI: 10.3390/ijerph20064749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/02/2023] [Accepted: 03/06/2023] [Indexed: 06/18/2023]
Abstract
The mental health of school students has been severely impacted by the aftermath of the COVID-19 pandemic. The present study used a mixed methods approach to assess students' mental health and examine their wishes for support to improve their psychological well-being. We further investigated gender and age group differences in the amount of clinically relevant mental health problems and the roles that mental health and gender had on desired support. Between April and May 2022, a total of 616 Austrian students aged between 14 and 20 participated in a cross-sectional online survey (77.4% female; 19.8% male; 2.8% non-binary) assessing wishes for support regarding mental well-being and mental health indicators (depression: PHQ-9; anxiety: GAD-7; insomnia: ISI; stress: PSS-10; eating disorders: SCOFF; alcohol abuse: CAGE). A wish for support was expressed by 46.6% of the students. Qualitative content analysis revealed that the two most important categories of desired support types were "professional help" and "someone to talk to". The group of students with a wish for support in general significantly more often showed clinically relevant depression, anxiety, insomnia, eating disorders, or high stress symptoms. Students that wished for professional help significantly more often exceeded the cut-off for clinically relevant depression, anxiety, and high stress. Those who wished for someone to talk to significantly more often exceeded the cut-off for clinically relevant eating disorders. The results indicate a great need for support for young people's mental health problems and that this need is even more urgent for students.
Collapse
Affiliation(s)
- Katja Haider
- Department of Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, 3500 Krems, Austria
| | - Elke Humer
- Department of Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, 3500 Krems, Austria
| | - Magdalena Weber
- Department of Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, 3500 Krems, Austria
- Department of Organizational Psychology, Private University of Schloss Seeburg, 5201 Seekirchen am Wallersee, Austria
| | - Christoph Pieh
- Department of Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, 3500 Krems, Austria
| | - Tiam Ghorab
- Department of Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, 3500 Krems, Austria
| | - Rachel Dale
- Department of Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, 3500 Krems, Austria
| | - Carina Dinhof
- Department of Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, 3500 Krems, Austria
| | - Afsaneh Gächter
- Department of Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, 3500 Krems, Austria
| | - Thomas Probst
- Department of Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, 3500 Krems, Austria
| | - Andrea Jesser
- Department of Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, 3500 Krems, Austria
| |
Collapse
|
8
|
McAulay C, Mond J, Outhred T, Malhi GS, Touyz S. Eating disorder features in bipolar disorder: clinical implications. J Ment Health 2023; 32:43-53. [PMID: 33573438 DOI: 10.1080/09638237.2021.1875401] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Bipolar disorder (BD) is associated with elevated rates of eating disorders (EDs), but the nature and impact of specific ED features are unclear. AIMS This study sought to identify which ED features are common in BD, and whether these relate to quality of life (QoL) impairment and body mass index (BMI). METHOD A clinical sample of 73 adults with BD completed self-report measures of health, ED features, emotion regulation ability, impulsivity, and QoL. RESULTS Binge eating (45%), excessive dietary restriction (39%), overvaluation of weight/shape (51%), purging (16%) and driven exercise (27%) were common, and associated with a poorer clinical picture, including poorer QoL and poorer emotion regulation. Furthermore, regular binge eating episodes explained a significant proportion of variance in QoL impairment after controlling for other significant predictors. The best predictors of BMI were number of medical conditions, impulsivity and positive beliefs about binge eating. CONCLUSIONS ED features that may not meet criteria for a fully diagnosable ED - particularly overvaluation of weight/shape and binge eating - warrant greater attention, as they may still significantly worsen QoL. Future research should focus on modifying existing psychological interventions to better target ED features among individuals with BD and thereby improve clinical outcomes.
Collapse
Affiliation(s)
- Claire McAulay
- Clinical Psychology Unit, University of Sydney, Sydney, Australia
| | - Jonathan Mond
- Centre for Rural Health, University of Tasmania, Launceston, Australia
| | - Tim Outhred
- Academic Department of Psychiatry, Northern Sydney Local Health District, Sydney, Australia.,Department of Psychiatry, Northern Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, Sydney, Australia
| | - Gin S Malhi
- Academic Department of Psychiatry, Northern Sydney Local Health District, Sydney, Australia.,Department of Psychiatry, Northern Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, Sydney, Australia
| | - Stephen Touyz
- Clinical Psychology Unit, University of Sydney, Sydney, Australia
| |
Collapse
|
9
|
Macpherson MC, Harrison R, Marie D, Miles LK. Investigating coaches' recognition of symptoms of eating disorders in track athletes. BMJ Open Sport Exerc Med 2022; 8:e001333. [PMID: 36071860 PMCID: PMC9394206 DOI: 10.1136/bmjsem-2022-001333] [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] [Scholar Register] [Accepted: 06/15/2022] [Indexed: 11/25/2022] Open
Abstract
Objective To determine the extent to which athletics coaches can identify evidence of an eating disorder in track athletes and what treatment advice they would provide. Methods Vignettes depicting athletes portraying symptoms consistent with anorexia nervosa (AN) and bulimia nervosa (BN) were developed and used to survey 185 UK and Irish athletics coaches (and a community sample of 105 non-coaches) regarding their ability to recognise and respond to symptoms of an eating disorder. Results Coaches were no more likely than the community sample to correctly identify an eating disorder but were more likely to suggest professional treatment for an athlete experiencing symptoms of AN (OR 1.82, 95% CI 1.02 to 3.29). For both eating disorders, higher levels of mental health literacy (AN: OR 1.06, 95% CI 1.02 to 1.11, BN: OR 1.08, 95% CI 1.04 to 1.14) and more years of coaching experience (AN: OR 1.12, 95% CI 1.03 to 1.24, BN: OR 1.07, 95% CI 1.01 to 1.16) also increased the likelihood of suggesting professional help. When considering the whole sample, participants were more likely to correctly identify an eating disorder (OR 4.67, 95% CI 2.66 to 8.20) and suggest professional treatment for AN than BN (OR 1.76, CI 1.04 to 2.97). Further, symptoms of AN were more likely to be correctly identified in female than male athletes (OR 2.26, 95% CI 1.28 to 4.06). Conclusions Although coaches were more likely than community members to recommend professional treatment to an athlete exhibiting symptoms of an eating disorder, they were no more likely to correctly identify an eating disorder in the first instance. Further work is required to enhance coaches' capacity to identify symptoms of eating disorders to ensure athletes receive appropriate interventions.
Collapse
Affiliation(s)
| | | | - Dannette Marie
- School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia
| | - Lynden K Miles
- School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia
| |
Collapse
|
10
|
Jeon M, Lee MS, Yoon JY, Bhang SY. Mental health literacy of Internet gaming disorder and problematic smartphone use among Korean teenagers. PLoS One 2022; 17:e0270988. [PMID: 35862446 PMCID: PMC9302878 DOI: 10.1371/journal.pone.0270988] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 06/21/2022] [Indexed: 11/29/2022] Open
Abstract
The last few decades have seen an increased interest in ‘Mental Health Literacy (MHL)’ which addresses knowledge and beliefs relating to mental health problems and is likely to hinder treatment-seeking behaviors. Although MHL research to date has explored various mental disorders, far too little attention has been paid to Internet Gaming Disorder (IGD) and Problematic Smartphone use (PSU). The objective of this study is to develop an MHL questionnaire for IGD and PSU by adopting the MHL approach in the previous literature and examine MHL of IGD and PSU in Korean teenagers by focusing on their ability to recognize addictions, and perceptions and help-seeking attitudes towards a person with addictions. The current study also aimed to compare Korean teenagers’ MHL depending on low- and high-risk of IGD and PSU. A total of 169 teenagers aged 10 and 16 years were recruited from schools and children’s centers in Seoul and completed the newly developed MHL questionnaire and screening questionnaires for IGD and PSU. The MHL questionnaire for IGD and PSU was designed as a vignette-based questionnaire that depicted behavioral characteristics of a severe problem with Internet and smartphone usage. Korean teenagers had a poor ability to recognize IGD and PSU and were more prone to seek parental help than professional help. The current study also showed that teenagers had better recognition of IGD than PSU and perceived that a person with IGD has a more difficult life than a person with PSU. Furthermore, a low-risk or high-risk group of IGD or PSU showed minimal differences in MHL. The current study provided empirical evidence to support a need to develop educational programs to improve Korean teenagers’ MHL for both IGD and PSU.
Collapse
Affiliation(s)
- Mina Jeon
- Department of Psychology and Human Development, Institute of Education, University College London, London, United Kingdom
| | - Mi-Sun Lee
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Center for School Mental Health, Eulji University, Seoul, Korea
| | - Ji-Young Yoon
- Department of Social Welfare, Ewha Womans University, Seoul, Korea
| | - Soo-Young Bhang
- Center for School Mental Health, Eulji University, Seoul, Korea
- Department of Psychiatry, Eulji University School of Medicine, Nowon Eulji University Hospital, Seoul, Korea
- Nowon Community Addiction Management Center, Seoul, Korea
- * E-mail:
| |
Collapse
|
11
|
Feldhege J, Bilic S, Ali K, Fassnacht DB, Moessner M, Farrer LM, Griffiths KM, Bauer S. Knowledge and Myths about Eating Disorders in a German Adolescent Sample: A Preliminary Investigation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116861. [PMID: 35682445 PMCID: PMC9180431 DOI: 10.3390/ijerph19116861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 05/30/2022] [Accepted: 06/02/2022] [Indexed: 12/04/2022]
Abstract
Eating disorder mental health literacy (ED-MHL) refers to knowledge about the symptoms, causes, and treatment of eating disorders (EDs) and is an important factor in people’s attitudes towards individuals with EDs and help-seeking for EDs. Associations between ED-MHL, stigma, ED symptomatology, and gender were investigated in a sample of N = 194 German high school students. Knowledge and myths about EDs were assessed with 18 factual statements about EDs and agreement/disagreement with common myths about ED. Students also completed the Universal Stigma Scale (USS), the Weight Concerns Scale (WCS), and demographic items. Students judged M = 8.39 (SD = 3.40) statements correctly, while the average agreement with all ED myths was low (M = 0.19, SD = 0.14). Greater ED-MHL was associated with lower stigmatization of EDs. Male participants were less knowledgeable and more likely to agree with the ED myths. Participants displayed moderate ED-MHL; however, certain aspects such as ED risk factors or symptoms of specific disorders such as anorexia nervosa and bulimia nervosa were less well known. These results can inform the design of future MHL interventions for adolescents.
Collapse
Affiliation(s)
- Johannes Feldhege
- Center for Psychotherapy Research, Heidelberg University Hospital, 69115 Heidelberg, Germany; (S.B.); (M.M.); (S.B.)
- Correspondence:
| | - Sally Bilic
- Center for Psychotherapy Research, Heidelberg University Hospital, 69115 Heidelberg, Germany; (S.B.); (M.M.); (S.B.)
| | - Kathina Ali
- College of Education, Psychology and Social Work, Flinders University, Adelaide 5042, Australia; (K.A.); (D.B.F.)
- Órama Institute for Mental Health and Wellbeing, Flinders University, Adelaide 5042, Australia
- Research School of Psychology, Australian National University, Canberra 2601, Australia;
| | - Daniel B. Fassnacht
- College of Education, Psychology and Social Work, Flinders University, Adelaide 5042, Australia; (K.A.); (D.B.F.)
- Órama Institute for Mental Health and Wellbeing, Flinders University, Adelaide 5042, Australia
- Research School of Psychology, Australian National University, Canberra 2601, Australia;
| | - Markus Moessner
- Center for Psychotherapy Research, Heidelberg University Hospital, 69115 Heidelberg, Germany; (S.B.); (M.M.); (S.B.)
| | - Louise M. Farrer
- Centre for Mental Health Research, Australian National University, Canberra 2601, Australia;
| | - Kathleen M. Griffiths
- Research School of Psychology, Australian National University, Canberra 2601, Australia;
- College of Health & Medicine, Australian National University, Canberra 2601, Australia
| | - Stephanie Bauer
- Center for Psychotherapy Research, Heidelberg University Hospital, 69115 Heidelberg, Germany; (S.B.); (M.M.); (S.B.)
| |
Collapse
|
12
|
Fatt SJ, Mitchison D, Bussey K, Mond J. Methods used to assess insight in individuals with eating disorders: a scoping review. J Ment Health 2022:1-12. [PMID: 35543348 DOI: 10.1080/09638237.2022.2069696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 02/14/2022] [Accepted: 02/23/2022] [Indexed: 10/18/2022]
Abstract
Insight can be impaired in individuals with an eating disorder and the nature of this impairment can vary. Although this topic has been the focus of several studies and reviews, methodologies used to assess insight have received less attention. A scoping review was conducted using a systematic search of articles before January 2021 to elucidate the methodologies used to assess insight in those with an eating disorder, with discussion of strengths and limitations. A total of 3089 studies were screened, and 24 quantitative studies which assessed at least one aspect of insight in individuals with an eating disorder were included in the review. Methods of assessing insight included coding of clinical notes, low scores on measures of self-report symptoms, direct assessment of insight, vignette, and self-report single-item questions. Insight into disordered eating symptoms was most frequently assessed. Most research used samples who were female, white, diagnosed with anorexia nervosa, and were seeking or receiving treatment. In designing future research and interventions, optimal methods used to assess insight should consider the research/clinical question, available resources, and the targeted demographic. Further, descriptions of which aspects of insight are being assessed should be considered in the interpretation of both current and future findings.
Collapse
Affiliation(s)
- Scott J Fatt
- Department of Psychology, Macquarie University, Sydney, Australia
| | - Deborah Mitchison
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
| | - Kay Bussey
- Department of Psychology, Macquarie University, Sydney, Australia
| | - Jonathan Mond
- Centre for Rural Health, University of Tasmania, Launceston, Australia
| |
Collapse
|
13
|
McAndrew AJ, Menna R, Oldershaw M. Disordered eating and barriers to help-seeking: a brief report. Eat Disord 2022; 30:239-248. [PMID: 33135581 DOI: 10.1080/10640266.2020.1771166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This study explored associations between disordered eating, barriers, and attitudes towards help-seeking. A total of 198 young women completed online questionnaires assessing eating pathology, attitudes towards seeking professional psychological help, and barriers to seeking help. Higher levels of self-reported eating pathology were associated with more positive attitudes toward seeking professional help and with greater perceptions of barriers to help-seeking. An inconsistent mediation model (with suppression effect) indicated young women with higher eating pathology perceived more barriers to seeking help, which were associated with less positive attitudes towards seeking help for psychological issues; however, when barriers were held constant, eating pathology was associated with more positive attitudes towards seeking help. Results from this study highlight the need to identify and reduce barriers that impede mental health service utilization among young women with disordered eating.
Collapse
Affiliation(s)
| | - Rosanne Menna
- Department of Psychology, University of Windsor, Windsor, Ontario, Canada
| | - Marni Oldershaw
- Department of Psychology, University of Windsor, Windsor, Ontario, Canada
| |
Collapse
|
14
|
Hamilton A, Mitchison D, Basten C, Byrne S, Goldstein M, Hay P, Heruc G, Thornton C, Touyz S. Understanding treatment delay: Perceived barriers preventing treatment-seeking for eating disorders. Aust N Z J Psychiatry 2022; 56:248-259. [PMID: 34250844 DOI: 10.1177/00048674211020102] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Only a small proportion of individuals with an eating disorder will receive targeted treatment for their illness. The aim of this study was to examine the length of delay to treatment-seeking and determine the barriers preventing earlier access and utilisation of eating disorder treatment for each diagnostic group - anorexia nervosa, bulimia nervosa, binge eating disorder and other specified feeding or eating disorder. METHOD Participants were recruited as part of the TrEAT multi-phase consortium study. One hundred and nineteen Australians (13-60 years; 96.9% female) with eating disorders currently accessing outpatient treatment for their illness completed an online survey comprised of self-report measures of eating disorder severity, treatment delay and perceived barriers to treatment-seeking. The treating clinician for each participant also provided additional information (e.g. body mass index and diagnosis). RESULTS Overall, the average length of delay between onset of eating disorder symptoms and treatment-seeking was 5.28 years. Controlling for age, latency to treatment-seeking was significantly longer for individuals with bulimia nervosa and binge eating disorder compared to anorexia nervosa. However, when perceived barriers to treatment-seeking were investigated, there were no significant differences between the diagnostic groups in regard to the perceived barriers they experienced. Stigma was rated as the most impactful barrier for each diagnostic group. CONCLUSION Findings suggest that individuals with eating disorders face substantial delays in accessing appropriate treatment and that latency to treatment-seeking is often magnified for counter-stereotypical eating disorder presentations. Further research is required to investigate other factors contributing to this delay.
Collapse
Affiliation(s)
- Amber Hamilton
- School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Deborah Mitchison
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW, Australia.,Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia.,Department of Psychology, Macquarie University, Sydney, NSW, Australia
| | | | - Susan Byrne
- School of Psychology, University of Western Australia, Perth, WA, Australia.,The Swan Centre, Perth, WA, Australia
| | - Mandy Goldstein
- Department of Psychology, Macquarie University, Sydney, NSW, Australia.,Mandy Goldstein Psychology, Sydney, NSW, Australia
| | - Phillipa Hay
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW, Australia.,Wesley Hospital Eating Disorder Day Program, Sydney, NSW, Australia.,Camden and Campbelltown Hospital, SWSLHD, Campbelltown, NSW, Australia
| | - Gabriella Heruc
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW, Australia.,Appetite for Change, Sydney, NSW, Australia
| | - Christopher Thornton
- Department of Psychology, Macquarie University, Sydney, NSW, Australia.,The Redleaf Practice, Sydney, NSW, Australia
| | - Stephen Touyz
- School of Psychology, The University of Sydney, Sydney, NSW, Australia
| |
Collapse
|
15
|
Holtzhausen N, Hay P, Foroughi N, Mannan H. Predictors of healthcare use in community women with eating disorder symptoms: a longitudinal study. Australas Psychiatry 2021; 29:504-507. [PMID: 34263664 DOI: 10.1177/10398562211009264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES This study aimed to investigate associations between eating disorder mental health literacy (EDMHL), defense style, eating disorder (ED) symptom severity, psychological distress and mental-health-related quality of life (MHRQoL) and the likelihood of formal and informal healthcare use (HCU) across multiple time points. METHODS A community sample of 445 young women with ED symptoms were followed over 7 years. Questionnaires were distributed via email and postal mail across multiple time points; this study includes data from years 2 (baseline in this study), 4 and 9. The inclusion criteria was provision of HCU data at year 2. RESULTS ED symptom severity at baseline was significantly associated with greater HCU two and seven years later. Accurate identification of an ED by participants (i.e. EDMHL) at baseline was associated with greater HCU seven years later. Defense style, psychological distress, MHRQoL and other aspects of EDMHL were not significantly associated with HCU over time. CONCLUSIONS Individuals with more severe ED symptoms, and with greater EDMHL, may be more likely to seek help over time. However, individuals with EDs may not seek help directly for poorer MHRQoL and higher levels of psychological distress. This reinforces the importance of ED screening, particularly in primary care settings.
Collapse
Affiliation(s)
- Nicol Holtzhausen
- School of Medicine, Western Sydney University, Penrith South, NSW, Australia
| | - Phillipa Hay
- Translational Health Research Institute, School of Medicine, Western Sydney University, Penrith South, NSW, Australia
| | - Nasim Foroughi
- Translational Health Research Institute, School of Medicine, Western Sydney University, Penrith South DC, NSW, Australia
| | - Haider Mannan
- Translational Health Research Institute, School of Medicine, Western Sydney University, Penrith South DC, NSW, Australia
| |
Collapse
|
16
|
Feldhege JM, Gulec H, Moessner M, Stieler C, van Stipelen J, Bauer S. Stigmatization and attitudes toward eating disorders: a comparison between native German adolescents, Turkish immigrant adolescents in Germany, and native Turkish adolescents. J Ment Health 2021; 31:99-108. [PMID: 34569396 DOI: 10.1080/09638237.2021.1979484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND AND AIMS The purpose of this study was to investigate the attitudes toward eating disorders in native German adolescents (Germans), adolescents with Turkish migration background in Germany (Immigrants), and native Turkish adolescents (Turks). METHOD A total of 507 adolescents (N = 139 Germans; N = 126 Immigrants; N = 242 Turks) read a vignette describing a 16-year-old female with bulimic symptoms. Participants completed questionnaires on mental health literacy, stigmatization, desirability of eating disorder-related behaviors and acquaintance with bulimic symptoms. RESULTS Adolescents living in Germany were more likely to recognize the vignette as an eating disorder than Turks. Immigrants were more similar to Germans in mental health literacy of eating disorders than Turks. However, in terms of stigmatizing attitudes, immigrants blamed more than Germans, Turks being intermediate on this variable. In Turks, higher desirability of eating disorder-related behaviors was associated with an increased acquaintance with bulimic symptoms and decreased evaluations of impairment. Higher mental health literacy was associated with less blame in Germans. CONCLUSIONS Migration background was associated with increased mental health literacy of eating disorders but did not result in reduced stigma. Differences in attitudes toward eating disorders indicate the need for differential interventions across the groups.
Collapse
Affiliation(s)
| | - Hayriye Gulec
- Department of Psychology, Bursa Uludag University, Bursa, Turkey
| | - Markus Moessner
- Center for Psychotherapy Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Christiane Stieler
- Klinik für Suchttherapie und Entwöhnung, Psychiatrisches Zentrum Nordbaden, Wiesloch, Germany
| | - Jhana van Stipelen
- Refugio Villingen-Schwenningen e. V., Psychosoziales Zentrum für traumatisierte Flüchtlinge, Villingen-Schwenningen, Germany
| | - Stephanie Bauer
- Center for Psychotherapy Research, University Hospital Heidelberg, Heidelberg, Germany
| |
Collapse
|
17
|
Worsfold KA, Sheffield JK. Practitioner eating disorder detection: The influence of health mindset, thin-ideal internalization, orthorexia and gender role. Early Interv Psychiatry 2021; 15:296-305. [PMID: 32196980 DOI: 10.1111/eip.12940] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 12/19/2019] [Accepted: 01/27/2020] [Indexed: 11/27/2022]
Abstract
AIMS The current study sought to determine what factors inhibited psychologists, naturopaths and fitness instructors from detecting an eating disorder (ED), and the discipline differences across these factors. METHODS Participants of the online study were 115 health practitioners who consisted of 35 psychologists, 50 naturopathic and 30 fitness practitioners. A vignette describing a female experiencing a sub-threshold bulimic variant without purging was presented alongside ED mental health literacy items such as assessing one's ability to detect a problem. Additional items examined factors that may inhibit detection, including practitioners' level of: thin-ideal internalization, orthorexia, health or fitness mindset (a newly developed scale measuring health and fitness obsessiveness) and gender role identity. RESULTS A significant number of naturopaths and fitness instructors (20% and 33.3%, respectively) were found to have elevated orthorexia scores. Similarly, psychologists had the greatest tendency to internalize the thin-ideal (M = 3.60), which was comparable to levels seen in recent research for 20- to 21-year-old females with EDs. The two largest factors inhibiting ED detection were the strength of a health mindset and gender role identity. Practitioners who had higher health mindset scores or who associated with gender identities higher in masculinity traits (ie, either androgynous or masculine gender roles) were more likely to miss detecting an ED. CONCLUSIONS While many present ED studies focus upon assessing and changing client cognitions, this study emphasizes the need for further research regarding training interventions to address practitioner cognitions and gender role biases, which may in turn improve ED detection.
Collapse
Affiliation(s)
- Kate A Worsfold
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia.,Compass Health Group, Gold Coast, Queensland, Australia
| | - Jeanie K Sheffield
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| |
Collapse
|
18
|
Savoy S, Hance MA, Pelfrey SE, Khaleghi N, Zemanek R. Normative feedback and intentions to help friends with bulimic symptoms. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2021; 69:118-122. [PMID: 31513474 DOI: 10.1080/07448481.2019.1656213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 06/13/2019] [Accepted: 08/06/2019] [Indexed: 06/10/2023]
Abstract
The current study examined accuracy in estimating campus norms for eating disorder (ED) pathology and the impact of normative feedback on intentions to help friends. Participants: The sample included 130 undergraduate women. Method: Participants estimated prevalence of ED pathology and were randomly assigned to normative feedback or a control condition. Vignettes were presented describing bulimic and sleep disorder symptoms. After presentation of each vignette, participants reported sympathy for and intentions to help friends with similar symptoms. Results: Nine ED pathology estimates were significantly higher than comparison values documented in a larger survey of women attending their university in the previous year. Those who received normative feedback reported lower intentions to help and lower sympathy for a student with bulimic symptoms compared to sleep disorder symptoms. Conclusion: Results raise the possibility that normative feedback could reduce support for friends with bulimic symptoms.
Collapse
Affiliation(s)
- Sarah Savoy
- Department of Psychology, Stephen F. Austin State University, Nacogdoches, TX, USA
| | - Margaret A Hance
- Department of Psychology and Counseling, Arkansas State University, Jonesboro, AR, USA
| | - Sarah E Pelfrey
- Department of Psychology, Stephen F. Austin State University, Nacogdoches, TX, USA
| | - Neusha Khaleghi
- Department of Psychology, Stephen F. Austin State University, Nacogdoches, TX, USA
| | - Rani Zemanek
- Department of Psychology, Stephen F. Austin State University, Nacogdoches, TX, USA
| |
Collapse
|
19
|
Mond JM, Arrighi A. Perceived acceptability of anorexia and bulimia in women with and without eating disorder symptoms. AUSTRALIAN JOURNAL OF PSYCHOLOGY 2020. [DOI: 10.1111/j.1742-9536.2011.00033.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Jonathan M. Mond
- School of Sociology, The Australian National University, Canberra, ACT, Australia
| | - Anais Arrighi
- Department of Community Safety, Queensland Government, Rockhampton, Queensland, Australia
| |
Collapse
|
20
|
Holtzhausen N, Mannan H, Foroughi N, Hay P. Effects associated with the use of healthcare for eating disorders by women in the community: a longitudinal cohort study. BMJ Open 2020; 10:e033986. [PMID: 32859658 PMCID: PMC7454177 DOI: 10.1136/bmjopen-2019-033986] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES This study examined formal and informal healthcare use (HCU) in community women with disordered eating, and associations of HCU with mental health-related quality of life (MHRQoL), psychological distress, mental health literacy (MHL) and eating disorder (ED) symptoms over time. HYPOTHESIS We hypothesised that HCU would lead to improvement in ED symptom severity, MHRQoL, MHL and psychological distress. DESIGN, SETTING, PARTICIPANTS Data were from years 2, 4 and 9 of a longitudinal cohort of 443 community women (mean age 30.6, SE 0.4 years) with a range of ED symptoms, randomly recruited from the Australian Capital Territory electoral role or via convenience sampling from tertiary education centres. Data were collected using posted/emailed self-report questionnaires; inclusion criteria were completion of the HCU questionnaire at time point of 2 years (baseline for this study). HCU was measured using a multiple-choice question on help seeking for an eating problem. To test the effect of HCU over time on MHRQoL (Short Form-12 score), psychological distress (Kessler Psychological Distress Scale score), ED symptom severity (Eating Disorder Examination Questionnaire score) and ED-MHL, linear or logistic mixed-effects regression analyses were used. RESULTS 20% of participants sought ED-specific help at baseline; more than half of participants sought help that was not evidence based. HCU at baseline was significantly associated with improved MHRQoL and ED symptom severity and decreased psychological distress over time (Cohen's d all >0.3, ie, small). HCU was not significantly associated with MHL over time. The predictive ability of the fitted models ranged from 32.18% to 42.42% for psychological distress and MHL treatment, respectively. CONCLUSIONS Formal and informal HCU were associated with small improvements in ED symptoms, MHRQoL and psychological distress but not with improved MHL. Informal services in ED management should be investigated further along with efforts to improve ED-MHL.
Collapse
Affiliation(s)
- Nicol Holtzhausen
- Translational Health Research Institute, School of Medicine, Western Sydney University, Penrith South, New South Wales, Australia
| | - Haider Mannan
- Translational Health Research Institute, School of Medicine, Western Sydney University, Penrith South, New South Wales, Australia
| | - Nasim Foroughi
- Translational Health Research Institute, School of Medicine, Western Sydney University, Penrith South, New South Wales, Australia
| | - Phillipa Hay
- Translational Health Research Institute, School of Medicine, Western Sydney University, Penrith South, New South Wales, Australia
- Campbelltown Hospital Mental Health, South West Sydney Local Health District, Campbelltown, New South Wales, Australia
| |
Collapse
|
21
|
Blackstone SR, Sangiorgio C, Johnson AK. Peer Recognition of Disordered Eating Behaviors: Implications for Improving Awareness through Health Education. AMERICAN JOURNAL OF HEALTH EDUCATION 2020. [DOI: 10.1080/19325037.2020.1740120] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
|
22
|
Bullivant B, Rhydderch S, Griffiths S, Mitchison D, Mond JM. Eating disorders "mental health literacy": a scoping review. J Ment Health 2020; 29:336-349. [PMID: 32041463 DOI: 10.1080/09638237.2020.1713996] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background: While it is apparent that much has been learned about "mental health literacy" (MHL) relating to certain mental health problems, such as depression, in recent years, what has been learned about MHL relating to eating disorders (ED-MHL) is unclear.Aims: A scoping review was conducted to inform the current state of knowledge in this field.Methods: A systematic search of relevant literature published between 1997 and 2017 was followed by a narrative synthesis of the findings.Results: The number of eligible studies increased from 32 in 1997-2001 to 98 in 2012-2017 (total = 264). Most studies originated from North America or Europe, recruited individuals with EDs receiving treatment or college students and included both female and male or only female participants. The majority of studies examined MHL relating to anorexia nervosa or bulimia nervosa and examined attitudes which facilitate recognition and appropriate help-seeking and knowledge and beliefs about professional help available.Conclusion: Interest in ED-MHL is increasing and there is now a considerable body of research addressing some aspects of ED-MHL in a range of study populations. Notable gaps in the literature exist, including a paucity of information about ED-MHL relating to EDs other than anorexia nervosa and bulimia nervosa, ED behaviour in males and the use of self-help interventions. We hope the findings will provide an incentive to further research in these and other aspects of ED-MHL.
Collapse
Affiliation(s)
- Bianca Bullivant
- Faculty of Medicine, Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, The University of Sydney, Sydney, Australia.,Department of Psychology, Macquarie University, Sydney, Australia
| | - Suzie Rhydderch
- Department of Psychology, Macquarie University, Sydney, Australia
| | - Scott Griffiths
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Deborah Mitchison
- Department of Psychology, Macquarie University, Sydney, Australia.,School of Medicine, Western Sydney University, Sydney, Australia
| | - Jonathan M Mond
- Department of Psychology, Macquarie University, Sydney, Australia.,Centre for Rural Health, University of Tasmania, Launceston, Australia
| |
Collapse
|
23
|
O'Connor C, McNamara N, O'Hara L, McNicholas M, McNicholas F. How do people with eating disorders experience the stigma associated with their condition? A mixed-methods systematic review. J Ment Health 2019; 30:454-469. [PMID: 31711324 DOI: 10.1080/09638237.2019.1685081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Public opinion research shows that eating disorders (EDs) are a major target of stigmatisation. To understand the implications of this stigma, research investigating how stigma is experienced by individuals with EDs is critical. AIM This paper aims to collate, evaluate and synthesise the extant empirical research illuminating how people with EDs experience the stigma associated with their condition. METHOD A systematic mixed-methods literature search was performed. Articles that met a specified set of inclusion criteria underwent a quality assessment and thematic synthesis. RESULTS Twenty-nine articles were included in the review. Studies were mostly qualitative and of reasonable methodological quality. The literature was characterised by five research themes, illuminating (i) the nature and prevalence of stigma experienced, (ii) stigma in families, (iii) stigma in healthcare contexts, (iv) self-stigmatisation and illness concealment, and (v) stigma resistance. CONCLUSIONS The reviewed research showed that people with EDs have extensive experience of stigma in diverse settings. They report that stigma has negative implications for their psychological wellbeing and likelihood of help-seeking. However, research also shows that people with EDs actively seek to resist and challenge stigma. The review identifies the outstanding gaps and weaknesses in this literature.
Collapse
Affiliation(s)
- Cliodhna O'Connor
- School of Psychology, University College Dublin, Dublin, Ireland.,School of Medicine & Medical Science, University College Dublin, Dublin, Ireland
| | - Niamh McNamara
- Department of Psychology, Nottingham Trent University, Nottingham, UK
| | - Lesley O'Hara
- School of Medicine & Medical Science, University College Dublin, Dublin, Ireland.,St. John of God Hospitaller Services, Dublin, Ireland
| | | | - Fiona McNicholas
- School of Medicine & Medical Science, University College Dublin, Dublin, Ireland.,St. John of God Hospitaller Services, Dublin, Ireland.,Our Lady's Hospital for Sick Children, Crumlin, Ireland
| |
Collapse
|
24
|
Worsfold KA, Sheffield JK. The perceived knowledge, skill and clinical practice of psychologists, naturopaths and fitness instructors when working with eating disorders. Early Interv Psychiatry 2019; 13:1263-1270. [PMID: 30488566 DOI: 10.1111/eip.12764] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 09/14/2018] [Accepted: 11/04/2018] [Indexed: 11/30/2022]
Abstract
AIMS When it comes to working with eating disorders (EDs), few studies have explored: the clinical practice; service provision barriers; and self-perceptions of knowledge/skill and the ability to detect EDs in practice against measured ability to do so, of common health providers including psychologists, naturopaths and fitness instructors. METHODS Of the 115 participants, 90.4% were female with a mean age of 40.77 years (SD = 10.80 years) and comprised: 35 psychologists, 50 naturopathic and 30 fitness practitioners. Participants completed a 23-item survey measuring clinical practice behaviours including assessment and early intervention services, practitioner service barriers, perceived ED knowledge and skill. RESULTS Only 1 in 20 indicated using standardized surveys to screen for EDs, with 72% indicating reluctance to universally screen clients, with a key barrier being that ED symptoms were typically not the presenting issue. For practitioners who missed detecting EDs in practice, 53.6% indicated this was because weight fell within the normal range or because the client did not present with an ED so they did not think to screen for one (39.29%). In terms of interventions, most (79%) were providing services to clients with EDs, with over one-third providing weight-loss advice, potentially contributing to a harmful weight-centric/dieting treatment approach. Despite most practitioners delivering services, 85.7% felt unable to treat some clients appropriately, primarily due to a lack of skill (52.6%). CONCLUSIONS Further training is imperative to improve universal screening and evidence-based early intervention practices, which may be particularly helpful for naturopaths and fitness instructors who more commonly perceived their knowledge to be low.
Collapse
Affiliation(s)
- Kate A Worsfold
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia.,Compass Health Group, Gold Coast, Queensland, Australia
| | - Jeanie K Sheffield
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| |
Collapse
|
25
|
Wang C, Barlis J, Do KA, Chen J, Alami S. Barriers to Mental Health Help Seeking at School for Asian– and Latinx–American Adolescents. SCHOOL MENTAL HEALTH 2019. [DOI: 10.1007/s12310-019-09344-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
26
|
Foroughi N, Zhu KCY, Smith C, Hay P. The perceived therapeutic benefits of complementary medicine in eating disorders. Complement Ther Med 2019; 43:176-180. [DOI: 10.1016/j.ctim.2019.01.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 01/30/2019] [Accepted: 01/30/2019] [Indexed: 11/26/2022] Open
|
27
|
Feldhege J, Moessner M, Stieler C, van Stipelen J, Bauer S. Wissen und Einstellungen zu Essstörungen bei Jugendlichen mit türkischem Migrationshintergrund. PSYCHOTHERAPEUT 2018. [DOI: 10.1007/s00278-018-0327-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
28
|
Griffiths S, Rossell SL, Mitchison D, Murray SB, Mond JM. Pathways into treatment for eating disorders: A quantitative examination of treatment barriers and treatment attitudes. Eat Disord 2018; 26:556-574. [PMID: 30222057 DOI: 10.1080/10640266.2018.1518086] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Most individuals with eating disorders do not receive treatment for their eating disorder. Closing this "treatment gap" requires a quantitative examination of individuals' attitudes towards accessing various types of treatment and of individuals' perceived barriers to seeking treatment. Thus, we recruited a sample of 425 individuals with either diagnosed or undiagnosed eating disorders and asked them to complete a survey assessing treatment attitudes, treatment barriers, and eating disorder symptom severity. Undiagnosed individuals reported more positive attitudes towards novel Internet- and smartphone-delivered treatments, and stronger barriers relating to eating disorders mental health literacy, than diagnosed individuals. Nevertheless, both diagnosed and undiagnosed individuals were broadly more positive towards established (i.e., non-novel) treatments than novel treatments. The strongest barriers to seeking treatment were fear of losing control, fear of change, and finding motivation to change. Eating disorder symptoms were positively associated with the strength of most treatment barriers. Results were broadly unchanged after adjusting for individuals' past experiences of treatment. In conclusion, the development and dissemination of novel treatments and the provision of eating disorders mental health literacy may offer promising potential pathways into treatment for individuals with undiagnosed eating disorders. Nevertheless, researchers must pay attention to and improve, individuals' attitudes towards accessing these novel treatments. The positive correlations of symptom severity with treatment barrier strength highlights the importance of early intervention for individuals with eating disorders. Finally, the fear of losing control may be a uniquely salient treatment barrier for individuals with eating disorders that requires greater attention in future research on eating disorder treatment seeking.
Collapse
Affiliation(s)
- Scott Griffiths
- a Melbourne School of Psychological Sciences , University of Melbourne , Melbourne , Australia
| | - Susan L Rossell
- b Centre for Mental Health, Faculty of Health Arts and Design , Swinburne University , Melbourne , Australia.,c Psychiatry , St Vincent's Hospital , Melbourne , Australia.,d Monash Alfred Psychiatry Research Centre , Central Clinical School Monash University and Alfred Hospital , Melbourne , Australia
| | - Deborah Mitchison
- e Department of Psychology , Macquarie University , Sydney , Australia
| | - Stuart B Murray
- f Department of Psychiatry , University of California San Francisco , San Francisco , CA , USA
| | - Jonathan M Mond
- g Centre for Rural Health , University of Tasmania , Launceston , Australia.,h Centre for Health Research , Western Sydney University , Sydney , Australia
| |
Collapse
|
29
|
Skromanis S, Cooling N, Rodgers B, Purton T, Fan F, Bridgman H, Harris K, Presser J, Mond J. Health and Well-Being of International University Students, and Comparison with Domestic Students, in Tasmania, Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1147. [PMID: 29865174 PMCID: PMC6025303 DOI: 10.3390/ijerph15061147] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Revised: 05/29/2018] [Accepted: 05/30/2018] [Indexed: 01/29/2023]
Abstract
International students comprise an increasingly larger proportion of higher education students globally. Empirical evidence about the health and well-being of these students is, however, limited. We sought to examine the health and well-being of international students, primarily from Asian countries, attending the University of Tasmania, Australia, using domestic students as a comparison group. Ethics approval was given to invite (via email) all currently enrolled students to participate in the study by completing a pilot-tested, online survey. The survey was completed by 382 international students (response rate = 8.9%) and 1013 domestic students (9.2%). Independent samples t-tests, analysis of variance (ANOVA) and chi-square tests were used for bivariate comparisons between international and domestic students, and between subgroups of international students. Regression models were used to examine the associations between student status (international vs. domestic) and health outcomes, controlling for demographic and enrolment variables. International students, particularly male students, were found to be at increased risk of several adverse health outcomes while also being less likely to seek help for mental health and related problems. The findings indicate the need for accessible, targeted, culturally-sensitive health promotion and early intervention programs.
Collapse
Affiliation(s)
- Sarah Skromanis
- Centre for Rural Health, University of Tasmania, Launceston 7250, Australia.
| | - Nick Cooling
- School of Medicine, University of Tasmania, Hobart 7000, Australia.
| | - Bryan Rodgers
- School of Demography, Australian National University, Canberra 0200, Australia.
| | - Terry Purton
- Centre for Rural Health, University of Tasmania, Launceston 7250, Australia.
| | - Frances Fan
- School of Education, University of Tasmania, Launceston 7250, Australia.
| | - Heather Bridgman
- Centre for Rural Health, University of Tasmania, Launceston 7250, Australia.
| | - Keith Harris
- School of Medicine, University of Tasmania, Hobart 7000, Australia.
| | - Jennifer Presser
- School of Medicine, University of Tasmania, Hobart 7000, Australia.
| | - Jonathan Mond
- Centre for Rural Health, University of Tasmania, Launceston 7250, Australia.
- School of Medicine, Western Sydney University, Sydney 2560, Australia.
| |
Collapse
|
30
|
Worsfold KA, Sheffield JK. Eating disorder mental health literacy: What do psychologists, naturopaths, and fitness instructors know? Eat Disord 2018; 26:229-247. [PMID: 29173080 DOI: 10.1080/10640266.2017.1397420] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
At present, there are no known studies investigating the eating disorder mental health literacy (ED-MHL) of common frontline health providers such as psychologists, naturopaths, and fitness instructors. Little research also exists around practitioner knowledge for the spectrum of eating disorders. The current study sought to fill these research gaps and comprised 115 health practitioners who completed an online survey. A fictional vignette describing a female (Sarah) experiencing a subthreshold bulimic variant without purging was presented alongside common ED-MHL items. Almost 4 in 10 psychologists, 7 in 10 natural therapists, and 8 in 10 fitness instructors failed to detect a general eating disorder, with the latter two groups more likely to believe the problem was a self-esteem issue. Perceived helpfulness of people and interventions varied from best practice clinical guidelines, with physical/medical risk management not prioritized, pharmacotherapy viewed poorly, and doctors seen as one of the least helpful people. Although Sarah's problem was seen as severe and highly common (which may speak to the volume of undetected eating disorders), alarmingly 36.7% of fitness instructors viewed her predicament as desirable given weight lost. This novel study highlights the need for specific training interventions to improve health practitioners' ED-MHL, particularly around atypical eating disorder presentations, which may facilitate earlier detection and help-seeking for evidence-based interventions rather than expenditure on unhelpful or even harmful treatments, leading to improved community health and lives saved.
Collapse
Affiliation(s)
- Kate A Worsfold
- a School of Psychology , The University of Queensland , Brisbane , Queensland , Australia.,b Compass Health Group , Gold Coast , Queensland , Australia
| | - Jeanie K Sheffield
- a School of Psychology , The University of Queensland , Brisbane , Queensland , Australia
| |
Collapse
|
31
|
Abstract
Disordered eating is common among young women, but rates of help-seeking are remarkably low. Studies attempting to understand how disordered eating is perceived by young women have exposed participants to fictional vignettes that describe characters exhibiting eating pathologies, and assessed beliefs about the women's issues. These studies have informed our understanding of how young women perceive disordered eating in other women, but do not address the question of how disordered eating is perceived in oneself. In the present study, we randomly assigned 204 young women (ages 18-25 years) to one of two conditions (self or other). In each condition, participants read a hypothetical vignette in which the main character (the participant herself [self] or another female student [other]) exhibited disordered eating, and answered questions about her behavior and her need for help. Data were analyzed using Pearson correlations, chi square tests, multiple regression analyses, multinomial logistic regressions, and independent samples t-tests. Overall, results supported the existence of a broad discrepancy in how young women perceive disordered eating in themselves versus in other women. Specifically, relative to women who read the vignette about another individual, women who read the vignette about themselves were more likely to attribute their behavior to a general mental health issue (as opposed to an eating disorder); to believe that they were able to cope with their problem alone; and to believe that they did not need to seek help for their eating behaviors (despite perceiving fewer barriers to doing so). These findings highlight the need for empirical research to consider this self-other discrepancy when using findings to inform the development of disordered eating prevention and intervention programs; if not considered, we risk developing programs based on information that may not accurately represent the young women in need of services.
Collapse
Affiliation(s)
| | - Rosanne Menna
- a Department of Psychology , University of Windsor , Windsor , Ontario , Canada
| |
Collapse
|
32
|
Palavras MA, Hay P, Filho CADS, Claudino A. The Efficacy of Psychological Therapies in Reducing Weight and Binge Eating in People with Bulimia Nervosa and Binge Eating Disorder Who Are Overweight or Obese-A Critical Synthesis and Meta-Analyses. Nutrients 2017; 9:nu9030299. [PMID: 28304341 PMCID: PMC5372962 DOI: 10.3390/nu9030299] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 03/10/2017] [Accepted: 03/14/2017] [Indexed: 02/07/2023] Open
Abstract
Recurrent binge eating episodes, the core feature of Bulimia Nervosa (BN) and Binge Eating Disorder (BED), are frequently comorbid with obesity. Psychological interventions, notably Cognitive Behavioural Therapy (CBT), are effective for binge eating reduction in BED or BN but less so for weight loss. Behavioural Weight Loss Therapy (BWLT) shows effectiveness for binge eating reduction and weight loss but the latter appears poorly sustained over time. Our aim was to review evidence for efficacy of psychological therapies for BN/BED associated with overweight or obesity in reducing binge frequency and weight. A systematic search for randomized controlled trials with adult samples who had BN or BED was conducted considering articles in English, French, Spanish and Portuguese with no restrictions for the timeline publication ending in March 2016. A quality appraisal of the trials and meta-analyses comparing BWLT to CBT were done. This review identified 2248 articles for screening and 19 published articles were selected. No trials of BN were identified. This review found CBT was favoured compared to BWLT with regard to short-term binge eating reduction. However, insufficient evidence was found for superiority for BWLT efficacy compared to CBT considering binge eating remission, reduction of binge eating frequency and weight loss. More research is needed to test the efficacy of psychological treatments for BED or BN with co-morbid overweight or obesity, including trials evaluating binge eating remission and weight loss in the long-term.
Collapse
Affiliation(s)
- Marly Amorim Palavras
- Eating Disorders Program (PROATA), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo 04038-000, Brazil.
- School of Medicine, Western Sydney University, Sydney 2751, Australia.
| | - Phillipa Hay
- CAPES Foundation, Ministry of Education of Brazil, Brasilia 70047-900, Brazil.
- Centre for Health Research, School of Medicine, Western Sydney University, Sydney 2751, Australia.
| | - Celso Alves Dos Santos Filho
- Eating Disorders Program (PROATA), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo 04038-000, Brazil.
| | - Angélica Claudino
- Eating Disorders Program (PROATA), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo 04038-000, Brazil.
| |
Collapse
|
33
|
Ali K, Farrer L, Fassnacht DB, Gulliver A, Bauer S, Griffiths KM. Perceived barriers and facilitators towards help-seeking for eating disorders: A systematic review. Int J Eat Disord 2017; 50:9-21. [PMID: 27526643 DOI: 10.1002/eat.22598] [Citation(s) in RCA: 208] [Impact Index Per Article: 29.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 07/11/2016] [Accepted: 07/12/2016] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To systematically review the literature on perceived barriers and facilitators of help-seeking for eating disorders. METHOD Three databases (PubMed, PsychInfo, Cochrane) were searched using keywords and Medical Subject Headings (MeSH) terms. Retrieved abstracts (N = 3493) were double screened and relevant papers (n = 13) were double coded. Qualitative and quantitative studies were included if they reported perceived barriers and facilitators towards seeking help for eating disorders. Barriers and facilitators were extracted from the included papers and coded under themes. The most prominent barriers and facilitators were determined by the number of studies reporting each theme. RESULTS Eight qualitative, three quantitative, and two mixed-methods studies met the inclusion criteria for the current review. The most prominent perceived barriers to help-seeking were stigma and shame, denial of and failure to perceive the severity of the illness, practical barriers (e.g., cost of treatment), low motivation to change, negative attitudes towards seeking help, lack of encouragement from others to seek help and lack of knowledge about help resources. Facilitators of help-seeking were reported in six studies, with the most prominent themes identified as the presence of other mental health problems or emotional distress, and concerns about health. DISCUSSION Programs targeting prevention and early intervention for eating disorders should focus on reducing stigma and shame, educating individuals about the severity of eating disorders, and increasing knowledge around help-seeking pathways for eating disorders. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2017; 50:9-21).
Collapse
Affiliation(s)
- Kathina Ali
- Centre for Mental Health Research, the Australian National University, Canberra, Australia
| | - Louise Farrer
- Centre for Mental Health Research, the Australian National University, Canberra, Australia
| | - Daniel B Fassnacht
- Research School of Psychology, the Australian National University, Canberra, Australia
| | - Amelia Gulliver
- Centre for Mental Health Research, the Australian National University, Canberra, Australia
| | - Stephanie Bauer
- Center for Psychotherapy Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Kathleen M Griffiths
- Centre for Mental Health Research, the Australian National University, Canberra, Australia
| |
Collapse
|
34
|
Abstract
Stigmatizing attitudes toward eating disorders (EDs) may lead to reduced treatment seeking. We aimed to estimate the prevalence of stigmatizing trends and beliefs related to anorexia nervosa (AN) and bulimia nervosa (BN), and the associations with the experiential knowledge of the problem, in a large sample of Italian undergraduates. A total of 2109 participants completed an online survey including questionnaires related to stigmatizing beliefs toward AN and BN, and personal contacts with people with EDs. Undergraduates reported almost overlapping low levels of stigmatizing trends for AN and BN, apart from personal responsibility and social distance. Those aged 18 to 25 and living with family held higher stigmatizing attitudes. Stigma was lower in underweight participants and in those (12%) reporting a previous ED diagnosis. Although not improving stigmatizing attitudes, 83% of the sample was familiar with people with an ED. Antistigma actions to increase awareness on EDs and to improve treatment-seeking behaviors are needed.
Collapse
|
35
|
Quality of life as a vulnerability and recovery factor in eating disorders: a community-based study. BMC Psychiatry 2016; 16:328. [PMID: 27724943 PMCID: PMC5057465 DOI: 10.1186/s12888-016-1033-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 09/07/2016] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Emerging evidence suggests that changes in quality of life (QoL) predicts later changes in eating disorder (ED) symptoms. The objective of this study was to explore individual sufferers' perspectives on the influence of QoL on the onset, maintenance, and/or remission of ED symptoms. METHOD 19 women from the community with a history of eating disorders (n = 13 currently symptomatic; n = 6 recovered) were interviewed about their observations on the relationship between QoL and ED symptoms over time in their own lives. Interviews were audio-taped and transcribed, and then thematically analysed. RESULTS Thematic analysis uncovered two major themes: 1. QoL as a Vulnerability Factor, and 2. QoL as a Recovery Factor. In relation to the first theme, onset of ED symptoms was discussed by women in this study as having been triggered by impairment in QoL, including a general sense of lacking control in life, stress, abusive intimate relationships, poor role modelling from family, physical impairment related to obesity, peer pressure, and weight-related teasing. On the other hand, and in relation to the second theme, subsequent improvement in QoL was nominated as central to symptom improvement and recovery. QoL improvement was described by participants differently, but included increased general satisfaction in life, emotional maturation, prioritising and improving physical health, the development of a supportive intimate relationship and social relationships, and having children. CONCLUSIONS Impairment in QoL may act as a trigger for the onset and maintenance of ED symptoms, whereas improvement in QoL may be central to eating disorder improvement and eventual recovery. Treatment should involve consideration of a core focus on QoL improvement as a potential 'backdoor' approach to improving ED symptoms.
Collapse
|
36
|
Gratwick-Sarll K, Bentley C, Harrison C, Mond J. Poor self-recognition of disordered eating among girls with bulimic-type eating disorders: cause for concern? Early Interv Psychiatry 2016; 10:316-23. [PMID: 25112818 DOI: 10.1111/eip.12168] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Accepted: 06/19/2014] [Indexed: 11/27/2022]
Abstract
AIM Bulimic-type eating disorders are common among young women and associated with high levels of distress and disability and low uptake of mental health care. We examined self-recognition of disordered eating and factors associated with this among female adolescents with bulimic-type eating disorders (n = 139) recruited from a large, population-based sample. METHODS A vignette of a fictional character with bulimia nervosa was presented, followed by a series of questions addressing the nature and treatment of the problem described. One of these questions required participants to indicate whether they currently had a problem such as the one described. Self-report measures of eating disorder symptoms, general psychological distress and quality of life were also completed. RESULTS More than half of participants (58%) did not believe that they currently had a problem with their eating. In multivariable analysis, impairment in emotional well-being and self-induced vomiting were the only variables independently associated with self-recognition. Participants who recognized a problem with their eating were more likely to have sought treatment for an eating problem than those who did not. CONCLUSIONS Recognition of disordered eating among adolescents with bulimic-type eating disorders may be poor and this may be a factor in low uptake of mental health care. Health promotion efforts may need to address the misconception that only bulimic-type disorders involving self-induced vomiting are pathological.
Collapse
Affiliation(s)
- Kassandra Gratwick-Sarll
- Research School of Psychology, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Caroline Bentley
- Research School of Psychology, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Carmel Harrison
- Research School of Psychology, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Jonathan Mond
- Research School of Psychology, Australian National University, Canberra, Australian Capital Territory, Australia.,Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
| |
Collapse
|
37
|
Wagner AF, Stefano EC, Cicero DC, Latner JD, Mond JM. Eating disorder features and quality of life: Does gender matter? Qual Life Res 2016; 25:2603-2610. [PMID: 27048498 DOI: 10.1007/s11136-016-1283-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2016] [Indexed: 11/27/2022]
Abstract
PURPOSE This study examined whether gender moderates the associations between eating disorder features and quality-of-life impairment and whether eating disorder features can explain gender differences in quality of life in a sample of undergraduate students. METHODS The SF-12 Physical and Mental Component Summary Scales were used to measure health-related quality of life (HRQoL), and the Eating Disorders Examination Questionnaire (EDE-Q) was used to quantify eating disorder behaviors and cognitions. These self-report forms were completed by undergraduate men and women (n = 709). RESULTS Gender was a significant predictor of mental HRQoL, such that women in this sample reported poorer mental HRQoL than men. Eating disorder cognitions were the strongest predictor of undergraduate students' mental and physical HRQoL, while binge eating negatively predicted their physical HRQoL only. Gender was not found to moderate the associations between eating disorder features and HRQoL, and eating disorder cognitions were found to mediate the association between gender and mental HRQoL such that a proportion of the difference between undergraduate men and women's mental HRQoL was attributable to eating disorder cognitions. CONCLUSION This study provided further evidence of the significant impact of eating disorder features, particularly eating disorder cognitions, on HRQoL. The finding that gender did not moderate the relationships between eating disorder features and HRQoL indicates the importance of investigating these features in both men and women in future research.
Collapse
Affiliation(s)
- Allison F Wagner
- Department of Psychology, University of Hawai`i at Manoa, 2530 Campus Road, Honolulu, HI, 96822, USA.
| | - Emily C Stefano
- Department of Psychology, University of Hawai`i at Manoa, 2530 Campus Road, Honolulu, HI, 96822, USA
| | - David C Cicero
- Department of Psychology, University of Hawai`i at Manoa, 2530 Campus Road, Honolulu, HI, 96822, USA
| | - Janet D Latner
- Department of Psychology, University of Hawai`i at Manoa, 2530 Campus Road, Honolulu, HI, 96822, USA
| | | |
Collapse
|
38
|
Moessner M, Minarik C, Özer F, Bauer S. Can an internet-based program for the prevention and early intervention in eating disorders facilitate access to conventional professional healthcare? J Ment Health 2016; 25:441-447. [PMID: 26850624 DOI: 10.3109/09638237.2016.1139064] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND The majorities of individual suffering from eating disorders do not seek or receive adequate professional treatment. Internet-based approaches promise to facilitate access to conventional healthcare by providing an easy-access, low-threshold contact. AIM The current study investigated whether an Internet-based program for the prevention and early intervention for eating disorders (ProYouth) may contribute to the actual and intended uptake of professional care. Characteristics of individuals who seek help are explored as well as barriers to help-seeking. METHOD The sample included 453 ProYouth participants who were surveyed three months after registration. Actual help-seeking behavior, intended help-seeking, potential help-seeking, and barriers to help-seeking were assessed. RESULTS Within three months of participation, 43 individuals (9.5%) took up treatment, 32 (7.8%) intended to start treatment, and 163 (43.1%) of the remaining reported that they would seek professional help in case of need (potential help-seeking). Approximately 50% of (potential) help-seekers stated that participation in ProYouth has changed their attitude towards help-seeking. Mental health literacy and shame/stigma were the most frequently mentioned barriers. CONCLUSIONS This is the first study indicating that an online program for prevention and early intervention may serve as facilitator in accessing conventional healthcare.
Collapse
Affiliation(s)
- Markus Moessner
- a Center for Psychotherapy Research, University Hospital Heidelberg , Heidelberg , Germany and
| | | | - Fikret Özer
- a Center for Psychotherapy Research, University Hospital Heidelberg , Heidelberg , Germany and
| | - Stephanie Bauer
- a Center for Psychotherapy Research, University Hospital Heidelberg , Heidelberg , Germany and
| |
Collapse
|
39
|
Affiliation(s)
- Jonathan M Mond
- a Department of Psychology , Macquarie University , Sydney , New South Wales , Australia.,b Research School of Psychology , The Australian National University , Canberra , Australian Capital Territory , Australia.,c School of Medicine , Western Sydney University , Campbelltown , New South Wales , Australia
| |
Collapse
|
40
|
Comparing cognitive behavioural therapy for eating disorders integrated with behavioural weight loss therapy to cognitive behavioural therapy-enhanced alone in overweight or obese people with bulimia nervosa or binge eating disorder: study protocol for a randomised controlled trial. Trials 2015; 16:578. [PMID: 26683478 PMCID: PMC4683762 DOI: 10.1186/s13063-015-1079-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 11/24/2015] [Indexed: 01/13/2023] Open
Abstract
Background Around 40 % of individuals with eating disorders of recurrent binge eating, namely bulimia nervosa and binge eating disorder, are obese. In contrast to binge eating disorder, currently there is no evidence base for weight management or weight loss psychological therapies in the treatment of bulimia nervosa despite their efficacy in binge eating disorder. Thus, a manualised therapy called HAPIFED (Healthy APproach to weIght management and Food in Eating Disorders) has been developed. HAPIFED integrates the leading evidence-based psychological therapies, cognitive behavioural therapy-enhanced (CBT-E) and behavioural weight loss treatment (BWLT) for binge eating disorder and obesity respectively. The aim of the present study is to detail the protocol for a randomised controlled trial (RCT) of HAPIFED versus CBT-E for people with bulimia nervosa and binge eating disorder who are overweight/obese. Method/Design A single-blind superiority RCT is proposed. One hundred Brazilian participants aged ≥ 18 years, with a diagnosis of bulimia nervosa or binge eating disorder, BMI > 27 to < 40 kg/m2, will be recruited from both community and clinics and individually randomised to a therapy arm. Five groups of ten participants will receive the experimental intervention (HAPIFED) and the other five groups of ten the control intervention (CBT-E). Both therapies are manualised, and in this RCT will comprise 1 individual session and 29 office-based group sessions over 6 months. Assessment points will be at baseline, end of therapy, and 6 and 12 months after end of therapy. The primary outcome of this intervention will be reduced weight. Secondary outcomes will be improved metabolic indicators of weight management, reduction in eating disorder symptoms including improved control over eating, improved adaptive function, physical and mental health-related quality of life, and reduced levels of depression and anxiety. Discussion This study will be the first to investigate a psychological therapy that aims to assist weight management in people with co-morbid overweight or obesity bulimia nervosa as well as with binge eating disorder. It will have the potential to improve health outcomes for the rapidly increasing number of adults with co-morbid obesity and binge eating disorder or bulimia nervosa. Trial registration US National Institutes of Health clinical trial registration number NCT02464345, date of registration 1 June 2015. Electronic supplementary material The online version of this article (doi:10.1186/s13063-015-1079-1) contains supplementary material, which is available to authorized users.
Collapse
|
41
|
McLean SA, Paxton SJ, Massey R, Hay PJ, Mond JM, Rodgers B. Identifying Persuasive Public Health Messages to Change Community Knowledge and Attitudes About Bulimia Nervosa. JOURNAL OF HEALTH COMMUNICATION 2015; 21:178-187. [PMID: 26383053 DOI: 10.1080/10810730.2015.1049309] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Addressing stigma through social marketing campaigns has the potential to enhance currently low rates of treatment seeking and improve the well-being of individuals with the eating disorder bulimia nervosa. This study aimed to evaluate the persuasiveness of health messages designed to reduce stigma and improve mental health literacy about this disorder. A community sample of 1,936 adults (48.2% male, 51.8% female) from Victoria, Australia, provided (a) self-report information on knowledge and stigma about bulimia nervosa and (b) ratings of the persuasiveness of 9 brief health messages on dimensions of convincingness and likelihood of changing attitudes. Messages were rated moderately to very convincing and a little to moderately likely to change attitudes toward bulimia nervosa. The most persuasive messages were those that emphasized that bulimia nervosa is a serious mental illness and is not attributable to personal failings. Higher ratings of convincingness were associated with being female, with having more knowledge about bulimia nervosa, and with lower levels of stigma about bulimia nervosa. Higher ratings for likelihood of changing attitudes were associated with being female and with ratings of the convincingness of the corresponding message. This study provides direction for persuasive content to be included in social marketing campaigns to reduce stigma toward bulimia nervosa.
Collapse
Affiliation(s)
- Siân A McLean
- a School of Psychology and Public Health , La Trobe University , Melbourne , Victoria , Australia
| | - Susan J Paxton
- a School of Psychology and Public Health , La Trobe University , Melbourne , Victoria , Australia
| | - Robin Massey
- a School of Psychology and Public Health , La Trobe University , Melbourne , Victoria , Australia
| | - Phillipa J Hay
- b Centre for Health Research, School of Medicine , University of Western Sydney , Sydney , New South Wales , Australia
| | - Jonathan M Mond
- c Department of Psychology , Macquarie University , Sydney , New South Wales , Australia
| | - Bryan Rodgers
- d Australian Demographic & Social Research Institute , Australian National University , Canberra , ACT , Australia
| |
Collapse
|
42
|
Stigmatizing attitudes and beliefs toward bulimia nervosa: the importance of knowledge and eating disorder symptoms. J Nerv Ment Dis 2015; 203:259-63. [PMID: 25751709 DOI: 10.1097/nmd.0000000000000275] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Widely held stigmatizing attitudes and beliefs toward bulimic eating disorders may lead to self-blame and reduced treatment seeking. Knowledge and familiarity with mental disorders may help decrease associated stigma. However, these relationships are not well understood in bulimia nervosa (BN). A community sample of 1828 adults aged 18 to 70 years completed a survey assessing stigmatizing attitudes and beliefs toward BN, knowledge and familiarity with the disorder, as well as levels of eating disorder symptoms. Knowledge of BN was negatively associated with three dimensions of stigmatization, personal responsibility (ρ = -0.28), unreliability (ρ = -0.19), and advantages of BN (ρ = -0.23). Familiarity revealed no association with stigmatization. Both men and women with high levels of eating disorder symptoms perceived BN as less serious than the participants with low levels of symptoms. Increasing community knowledge about bulimia may help mitigate stigmatization and perceived barriers to treatment.
Collapse
|
43
|
Mitchison D, Morin A, Mond J, Slewa-Younan S, Hay P. The bidirectional relationship between quality of life and eating disorder symptoms: a 9-year community-based study of Australian women. PLoS One 2015; 10:e0120591. [PMID: 25812047 PMCID: PMC4374670 DOI: 10.1371/journal.pone.0120591] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2014] [Accepted: 01/24/2015] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Studies that have investigated quality of life (QoL) in eating disorders (EDs) have been focussed on the impact of the ED on QoL and little is known regarding the possible reciprocal impact of QoL on EDs. The aim of this study was to provide a first-time investigation of possible bidirectional relationships between EDs and both health-related QoL (HRQoL) and psychological distress (PD). METHOD Structural equation modeling was applied to longitudinal data collected from a community sample of Australian women (N = 828) surveyed at baseline, five annual follow-ups, and again after nine years. Participants reported height and weight (from which body mass index, BMI, was calculated) and completed measures of ED symptoms (Eating Disorder Examination Questionnaire), HRQoL (12-item Medical Outcomes Study Short Form), and PD (Kessler Psychological Distress Scale). RESULTS Overall, evidence was found for a bidirectional relationship, whereby ED symptoms predicted reduced HRQoL and greater PD over time, while lower levels of HRQoL and greater PD in turn predicted increased levels of ED symptoms. These relationships were stable, observable within 12 months, and remained observable over a time period of at least four years. However, also observed were some inconsistent findings where ED symptoms predicted a short term (one year) improvement in mental HRQoL. This short term boost was not sustained at longer follow-ups. CONCLUSIONS Not only do ED symptoms impact on HRQoL and PD, but perceived poor HRQoL and PD also contribute to ED symptom development or exacerbation. This supports a movement away from symptom-centric approaches whereby HRQoL is conceptualized as a passive outcome expected to be rectified by addressing ED symptoms. Improvement in QoL and PD might rather be viewed as targets to be pursued in their own right under broader approaches in the treatment of EDs.
Collapse
Affiliation(s)
- Deborah Mitchison
- School of Medicine, University of Western Sydney, Sydney, Australia
- * E-mail:
| | - Alexandre Morin
- Institute for Positive Psychology and Education, Australian Catholic University, Sydney, Australia
| | - Jonathan Mond
- School of Medicine, University of Western Sydney, Sydney, Australia
- Department of Psychology, Faculty of Human Sciences, Macquarie University, Canberra, Australia
- Research School of Psychology, Australian National University, Sydney, Australia
| | | | - Phillipa Hay
- Centre for Health Research, School of Medicine, University of Western Sydney, Sydney, Australia
- School of Medicine, James Cook University, Townsville, Australia
| |
Collapse
|
44
|
Star A, Hay P, Quirk F, Mond J. Perceived discrimination and favourable regard toward underweight, normal weight and obese eating disorder sufferers: implications for obesity and eating disorder population health campaigns. BMC OBESITY 2015. [PMID: 26217519 PMCID: PMC4511013 DOI: 10.1186/s40608-014-0032-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Background Obesity stigma has been shown to increase binge eating, whilst positive regard for eating disorders (EDs) may increase dietary restriction which can also lead to binge eating and weight gain. In the context of increasing prevalence of both obesity and EDs exploring community attitudes towards these illnesses may uncover new variables worthy of consideration in population health campaigns. The aim of the study was to explore community perceived stigma and conversely favourable regard toward eating disorder (ED) sufferers of varying weight status, and understand how the attitudes of obese individuals may differ from those of non-obese individuals. Data for this purpose were derived from interviews with individuals participating in a general population health survey. Vignettes of an underweight female with Anorexia Nervosa (AN), a normal weight male with an atypical eating disorder (NWED) and an obese female with Binge Eating Disorder (BED) were presented to three randomly selected sub-samples of n = 983, 1033 and 1030 respectively. Questions followed that assessed participants’ attitudes towards and beliefs about the person described in the vignette and their eating behaviours. Results Sixty-six per cent of participants who responded to the obese BED vignette believed that there would be discrimination against the person described (primarily because of her weight). Corresponding figures were for the AN and NWED vignettes were 48% and 35%, respectively. A positive regard for weight-loss or body-image-enhancing ED behaviours was reported ‘occasionally’ or more often by 8.8% of respondents to the AN vignette and by 27.5% of respondents to the NWED vignette. Positive regard for ED behaviours was significantly more likely in obese participants (AN: 15%; NWED: 43%). Conclusion The findings support integrated ED and obesity prevention programs that address weight stigma and the social desirability of ED behaviours in vulnerable individuals.
Collapse
Affiliation(s)
- Anita Star
- Private Practice, Albury, 2640 New South Wales Australia ; School of Medicine and Dentistry, James Cook University, Townsville, Queensland 4811 Australia
| | - Phillipa Hay
- School of Medicine and Dentistry, James Cook University, Townsville, Queensland 4811 Australia ; School of Medicine, University of Western Sydney, Locked bag 1797, Penrith, New South Wales 2751 Australia
| | - Frances Quirk
- School of Medicine and Dentistry, James Cook University, Townsville, Queensland 4811 Australia ; School of Medicine, Deakin University, Melbourne, 3125 Victoria Australia ; Research Directorate, Barwon Health, Geelong, 3220 Victoria Australia
| | - Jonathan Mond
- School of Medicine, University of Western Sydney, Locked bag 1797, Penrith, New South Wales 2751 Australia ; Department of Psychology, Macquarie University, Sydney, New South Wales 2129 Australia
| |
Collapse
|
45
|
Bentley C, Gratwick-Sarll K, Mond J. Perceived psychosocial impairment associated with eating disorder features: responses to a mental health literacy intervention. J Eat Disord 2015; 3:46. [PMID: 26635962 PMCID: PMC4668649 DOI: 10.1186/s40337-015-0084-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2015] [Accepted: 11/26/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Whether and to what extent young adults are aware of the adverse impact of eating disorder features (EDF) on psychosocial functioning is unclear, although such awareness may affect the experience and behavior of sufferers. The aim of the current study was to examine young adults' perceptions of psychosocial impairment associated with EDF, and the potential effect on these perceptions of an eating disorders "mental health literacy" (ED-MHL) intervention. METHODS Undergraduate students (male: n = 35; female: n = 141) completed self-report questionnaires prior to, immediately following, and 3 months after completion of a 3-h ED-MHL intervention. Perceived psychosocial impairment associated with EDF-binge eating, purging, extreme dietary restriction, overvaluation of weight/shape, and excessive exercise-was assessed at each time point. RESULTS At all 3 time points, EDF were considered to have a 'slightly negative' to 'very negative' impact on psychosocial functioning. Prior to the intervention, binge eating, purging and extreme dietary restriction were generally considered to have a greater negative impact than excessive exercise and overvaluation of weight/shape. Three months after the ED-MHL intervention, participants reported greater perceived impairment associated with excessive exercise and overvaluation; while perceptions of psychosocial impairment associated with binge eating, purging and dietary restriction remained largely unchanged. Females perceived greater impairment associated with EDF than males did immediately after the intervention, but not at the 3-month follow-up. CONCLUSIONS The adverse effects on psychosocial functioning of binge eating, purging and extreme dietary restriction appear to be readily recognized by young people. Awareness of the adverse effects of excessive exercise and overvaluation may be poorer, but amenable to improvement by means of a relatively simple intervention. These features may warrant particular attention in health promotion programs.
Collapse
Affiliation(s)
- Caroline Bentley
- Research School of Psychology, Australian National University, Canberra, ACT 0200 Australia
| | | | - Jonathan Mond
- Research School of Psychology, Australian National University, Canberra, ACT 0200 Australia ; Department of Psychology, Macquarie University, Sydney, Australia
| |
Collapse
|
46
|
McLean SA, Paxton SJ, Massey R, Hay PJ, Mond JM, Rodgers B. Stigmatizing attitudes and beliefs about bulimia nervosa: gender, age, education and income variability in a community sample. Int J Eat Disord 2014; 47:353-61. [PMID: 24277701 DOI: 10.1002/eat.22227] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/25/2013] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Stigmatizing attitudes towards eating disorders negatively impacts treatment seeking. To determine the effect of interventions to reduce stigma, a measure of stigma that is simple to implement is required. This study aimed to develop a measure of stigmatizing attitudes and beliefs towards bulimia nervosa (SAB-BN) and evaluate the distribution of beliefs across gender, age, education, and income groups. METHOD Participants were 1828 community adults (890 men; 938 women) aged 18-65 sampled from the Australian Electoral Roll responded to a mailed questionnaire. Participants provided demographic information and completed the SAB-BN questionnaire. RESULTS Five components of stigmatizing attitudes and beliefs were identified; advantages of BN, minimization/low seriousness, unreliability, social distance, and personal responsibility. Stigma was low except on social distance and personal responsibility sub-scales, which indicated negative attitudes toward people with bulimia. Men compared with women and lower compared with higher education and income groups held significantly higher stigmatizing attitudes and beliefs. There were few differences between age groups in stigma. Differences between demographic groups provides evidence for known-groups validity. DISCUSSION The SAB-BN questionnaire provides a potentially useful tool for evaluating stigma in relation to BN. Results provide insight into components of stigma and the demographic groups to whom interventions should be targeted.
Collapse
Affiliation(s)
- Siân A McLean
- School of Psychological Science, La Trobe University, Melbourne, Victoria, Australia
| | | | | | | | | | | |
Collapse
|
47
|
Knightsmith P, Sharpe H, Breen O, Treasure J, Schmidt U. 'My teacher saved my life' versus 'Teachers don't have a clue': an online survey of pupils' experiences of eating disorders. Child Adolesc Ment Health 2014; 19:131-137. [PMID: 32878388 DOI: 10.1111/camh.12027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/07/2013] [Indexed: 12/20/2022]
Abstract
BACKGROUND Eating disorders (ED) have a peak rate of onset in school-aged children. Little is known about pupils' experiences of ED within a school setting. METHOD Five hundred and eleven 11- to 19-year-old school pupils completed an online questionnaire exploring their experiences of ED (72% female, 28% male). Responses were analysed using content analysis principles. RESULTS Of the participants, 38% had a current or past ED, 49% of these had never received a formal diagnosis. Of the respondents, 59% saw a need to raise ED awareness. Only 7% would confide in a teacher about an ED. CONCLUSIONS Efforts are needed to break down barriers to disclosure and support teachers to play an effective role in the detection and early intervention for ED.
Collapse
Affiliation(s)
- Pooky Knightsmith
- Division of Psychological Medicine, Institute of Psychiatry, King's College London, London SE5 8AF, UK
| | - Helen Sharpe
- Division of Psychological Medicine, Institute of Psychiatry, King's College London, London SE5 8AF, UK
| | - Olivia Breen
- Division of Psychological Medicine, Institute of Psychiatry, King's College London, London SE5 8AF, UK
| | - Janet Treasure
- Division of Psychological Medicine, Institute of Psychiatry, King's College London, London SE5 8AF, UK
| | - Ulrike Schmidt
- Division of Psychological Medicine, Institute of Psychiatry, King's College London, London SE5 8AF, UK
| |
Collapse
|
48
|
|
49
|
Exploring Indices of Disordered Eating Literacy in Male and Female Athletes: Knowledge Gaps and Lay Beliefs as Predictors of Attitudes Toward Help-Seeking. JOURNAL OF CLINICAL SPORT PSYCHOLOGY 2013. [DOI: 10.1123/jcsp.7.4.275] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The aim of this pilot study was to explore disordered eating (DE) literacy in male and female athletes and to examine whether any gender differences were present. A related aim was to examine the moderating effect of gender on the relationship between indices of DE literacy and attitudes toward help-seeking for DE. A nonclinical sample of 133 (37% male) athletes from a variety of sports and competitive levels were recruited to complete an online questionnaire addressing a range of topics linked to DE literacy. Chi-square analysis indicated no significant gender differences on indicators of DE literacy. Findings from the survey revealed a number of beliefs conducive to low or inappropriate help-seeking for DE. The results highlight the importance of exploring DE literacy in athletes to develop more targeted interventions for this specific population.
Collapse
|
50
|
Bauer S, Papezova H, Chereches R, Caselli G, McLoughlin O, Szumska I, van Furth E, Ozer F, Moessner M. Advances in the prevention and early intervention of eating disorders: The potential of Internet-delivered approaches. ACTA ACUST UNITED AC 2013. [DOI: 10.1016/j.mhp.2013.10.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|