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Pehlivan MJ, Okada M, Miskovic-Wheatley J, Barakat S, Touyz S, Simpson SJ, Griffiths K, Holmes A, Maguire S. Eating disorder risk among Australian youth starting a diet in the community. Appetite 2024; 203:107685. [PMID: 39306042 DOI: 10.1016/j.appet.2024.107685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 09/13/2024] [Accepted: 09/17/2024] [Indexed: 09/28/2024]
Abstract
Dieting is a potent risk factor for eating disorder (ED) symptoms and development, which typically occur in late adolescence. However, as diets are often motivated by body image concerns (another core ED risk factor), dieters may already carry heightened ED risk. Thus, the current study aimed to document ED risk among young people starting a diet in the community. Young people (16-25 years) starting or intending to start a self-initiated diet (N = 727) provided data via a screener questionnaire, assessing containing sociodemographic factors, past and current ED symptoms and behaviours. Over a third (36.9%) screened using a validated instrument were found to be at-risk of a current ED, with 10% above the clinical cut-off. Consistent with this finding, over 10% of the sample self-reported experiencing a lifetime ED, while nearly a quarter reported symptoms consistent with an ED diagnosis with no reported formal diagnosis. Findings suggest a high level of ED risk among young people starting a diet in the community and point to the need for more proactive measures targeted at this cohort (e.g., screening, monitoring). Further education on the risks of dieting and encouragement for help-seeking in young people is indicated.
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Affiliation(s)
- Melissa J Pehlivan
- InsideOut Institute for Eating Disorders, The University of Sydney & Sydney Local Health District, NSW, 2006, Australia
| | - Mirei Okada
- The Charles Perkins Centre and School of Life and Environmental Sciences, University of Sydney, NSW, 2006, Australia
| | - Jane Miskovic-Wheatley
- InsideOut Institute for Eating Disorders, The University of Sydney & Sydney Local Health District, NSW, 2006, Australia
| | - Sarah Barakat
- InsideOut Institute for Eating Disorders, The University of Sydney & Sydney Local Health District, NSW, 2006, Australia
| | - Stephen Touyz
- InsideOut Institute for Eating Disorders, The University of Sydney & Sydney Local Health District, NSW, 2006, Australia
| | - Stephen J Simpson
- The Charles Perkins Centre and School of Life and Environmental Sciences, University of Sydney, NSW, 2006, Australia
| | - Kristi Griffiths
- InsideOut Institute for Eating Disorders, The University of Sydney & Sydney Local Health District, NSW, 2006, Australia
| | - Andrew Holmes
- The Charles Perkins Centre and School of Life and Environmental Sciences, University of Sydney, NSW, 2006, Australia
| | - Sarah Maguire
- InsideOut Institute for Eating Disorders, The University of Sydney & Sydney Local Health District, NSW, 2006, Australia.
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2
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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.
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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
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3
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Osa ML, Kelly NR, Calogero RM. Disordered eating symptoms as a function of perceived weight status and race: An intersectional examination. Body Image 2022; 43:337-347. [PMID: 36265414 DOI: 10.1016/j.bodyim.2022.09.012] [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] [Received: 02/23/2022] [Revised: 09/20/2022] [Accepted: 09/25/2022] [Indexed: 11/16/2022]
Abstract
Disordered eating (DE) exhibited by individuals with intersecting marginalized identities may be less likely to be perceived as pathological compared to DE exhibited by individuals with non-marginalized identities. The present experiment tested the intersectional impact of weight status and race stimuli on responses to DE in a college sample. Undergraduate students (N = 193, Mage = 18.57, SD = 1.88, 71 % female) read a fictional account from a female target with DE who was described as "underweight," "average weight," or "overweight," and "White" or "Black." Participants completed an in-lab survey assessing detection of and responses to DE. Three 2 (race: Black, White) x 3 (weight status: underweight, average weight, overweight) ANCOVAs revealed a main effect of weight status. DE was more likely to be detected in "underweight" than "average" and "overweight" targets (p < .001). Participants encouraged weight loss for "average" and "overweight" targets compared to "underweight" targets (p < .001) and encouraged weight restoration for "underweight" targets compared to "average weight" and "overweight" targets (p < .001). No significant effects for target race or interaction between weight status and race emerged. These findings underscore the salience of weight status in shaping perceptions of DE.
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Affiliation(s)
- Maggie L Osa
- Department of Counseling and Human Services, University of Oregon, Eugene, OR, USA; Prevention Science Institute, University of Oregon, Eugene, OR, USA.
| | - Nichole R Kelly
- Department of Counseling and Human Services, University of Oregon, Eugene, OR, USA; Prevention Science Institute, University of Oregon, Eugene, OR, USA
| | - Rachel M Calogero
- Department of Psychology, Western University, London, Ontario, Canada
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4
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Manning M, Greenfield S. University students' understanding and opinions of eating disorders: a qualitative study. BMJ Open 2022; 12:e056391. [PMID: 35906058 PMCID: PMC9344994 DOI: 10.1136/bmjopen-2021-056391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Eating disorders (EDs) affect 1.25 million people in the UK. Evidence suggests the public display stigma and poor mental health literacy (MHL) towards EDs. There is a high prevalence of EDs in university populations, so it is important to determine the MHL of this at-risk group. Qualitative research exploring the MHL of this population is incomplete. OBJECTIVE Explore university students' beliefs and opinions of EDs, their knowledge of symptoms, treatment and help sources and how these are influenced by biological sex. DESIGN A qualitative study, using semistructured interviews analysed using inductive thematic analysis. SETTING The University of Birmingham. PARTICIPANTS Seven female and seven male University of Birmingham students. RESULTS Analysis revealed six themes, each with subthemes: ED characteristics, causes, body image, seeking help, stigma and awareness. Students displayed poor awareness towards ED signs and symptoms, causes and help sources. Students were not stigmatising towards EDs, but many perceived them as a female problem and believed society to be stigmatising. Many referenced informal sources of information such as social media and expressed a desire for ED teaching. Sex did not have a significant influence on knowledge or opinions of EDs in this study; however, there were some differences, for example, some males were more likely to see EDs as a weakness and to perceive themselves as having low levels of knowledge. CONCLUSIONS University students show broad awareness of EDs; however, knowledge of certain aspects of ED-MHL including help sources and symptom recognition was lacking. Although students were not stigmatising of EDs themselves, many perceived high levels of public stigma. This, alongside poor knowledge, may delay help-seeking. Campaigns educating students and the public about EDs would aid earlier diagnosis, improving long-term outcomes. Further research into awareness and knowledge in other populations would be beneficial.
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Affiliation(s)
- Millie Manning
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Sheila Greenfield
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
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5
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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.
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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
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6
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Abstract
PURPOSE Early detection of eating disorders (EDs) could improve their prognosis, decrease morbidity and mortality, and prevent the risk of evolution towards a chronic form and somatic, psychiatric and psychosocial complications. The objective of this review was to examine the current scientific data concerning the early detection of EDs, which is one of the facets of secondary prevention. METHOD A scoping literature review was carried out following the PRISMA-ScR criteria, including all articles on ED detection published up to 2021 on PUBMED and PSYCINFO. RESULTS 43 articles were included. Anorexia nervosa and bulimia nervosa were the most widely studied disorders. The articles focused on professionals from the medical field (GPs, psychiatrists, gynaecologists, gastroenterologists and residents), from the paramedical field, from education and sport, and from the general population. The assessments conducted with the professionals receiving interventions aiming to improve detection demonstrated their efficacy. Interventions for ED detection in the general population and at school seemed less efficacious. CONCLUSION The results highlighted some lines of action to be implemented. They pointed towards improving initial and continuing education for professional carers; e-learning could be an interesting solution for continuing education. Improving training with specific instructors, school personnel and sports professionals is also one of the solutions for a better detection of EDs. Specific recommendations could be published for fitness centre professionals to help them to deal with clients suspected of having an ED. Among secondary school students and in the general population, a better dissemination of mental health literacy and the development of mental health first aid programs could help improve early detection. LEVEL OF EVIDENCE Level I: Evidence obtained from systematic reviews.
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7
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Flatt RE, Norman E, Thornton LM, Fitzsimmons-Craft EE, Balantekin KN, Smolar L, Mysko C, Wilfley DE, Taylor CB, Bulik CM. Eating disorder behaviors and treatment seeking in self-identified military personnel and veterans: Results of the National Eating Disorders Association online screening. Eat Behav 2021; 43:101562. [PMID: 34534875 PMCID: PMC8952181 DOI: 10.1016/j.eatbeh.2021.101562] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 08/12/2021] [Accepted: 09/01/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To characterize disordered eating behaviors, eating disorder (ED) risk and diagnosis, and treatment seeking behaviors in active-duty military personnel/veterans compared with civilians. METHOD Self-selecting participants (n = 113,388; 1744 were military personnel/veterans) 18+ years old completed the National Eating Disorders Association's online screen. Engagement in and frequencies of disordered eating behaviors were compared across military/veteran and civilian groups and were stratified by gender. ED risk and diagnosis and treatment seeking behaviors were also compared. RESULTS Individuals in the military/veteran group were more likely to engage in diuretic/laxative use and excessive exercise compared with civilians. Compared with civilians, the military/veteran group had a lower percentage who screened "at risk for an ED" and a higher percentage who screened for "no risk". Females in the military/veteran group were more likely to engage in diuretic/laxative use, excessive exercise, and fasting compared with female civilians; males in the military/veteran group were more likely to engage in excessive exercise and less likely to engage in vomiting than male civilians. Of the self-identified military personnel/veterans who screened positive for any ED, 86% had never received treatment, which did not differ significantly from civilians. Notably, 56.7% of those (54.1% of military/veteran group; 56.7% of civilians) who completed an optional item on intention to seek treatment (n = 5312) indicated they would not seek treatment. CONCLUSIONS Disordered eating and ED profiles, but not treatment seeking, may differ between military personnel/veterans and civilians who complete an online ED screen. Future work should emphasize treatment options and connecting respondents directly to tailored resources.
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Affiliation(s)
- Rachael E Flatt
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Elliott Norman
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Laura M Thornton
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | | | - Lauren Smolar
- National Eating Disorders Association, New York City, NY, USA
| | - Claire Mysko
- National Eating Disorders Association, New York City, NY, USA
| | - Denise E Wilfley
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - C Barr Taylor
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA; Center for m(2)Health, Palo Alto University, Palo Alto, CA, USA
| | - Cynthia M Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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8
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Fatt SJ, Mond J, Bussey K, Griffiths S, Murray SB, Lonergan A, Hay P, Pike K, Trompeter N, Mitchison D. Seeing yourself clearly: Self-identification of a body image problem in adolescents with an eating disorder. Early Interv Psychiatry 2021; 15:577-584. [PMID: 32426938 DOI: 10.1111/eip.12987] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 03/15/2020] [Accepted: 04/28/2020] [Indexed: 12/15/2022]
Abstract
AIM Many adolescents who meet diagnostic criteria for an eating disorder do not self-identify as having a problem and may consequently be less likely to seek help. Extant research investigating self-identification has been limited to specific populations (ie, girls meeting criteria for bulimic-type eating disorders). This study investigated how self-identification varied across sex, eating disorder diagnoses, and the presence of extreme eating behaviours, and how self-identification was related to help-seeking in adolescents. METHODS Participants included 1002 Australian school students (75.5% female, Mage = 15.14 years, SD = 1.40) who met DSM-5 diagnostic criteria for an eating disorder. An online survey assessed self-identification of having a body image problem, as well as sex, eating disorder diagnosis, extreme eating behaviours, help-seeking for a body image problem, and other potential correlates of self-identification (demographics, psychological distress, social function, weight and shape concerns). RESULTS Approximately, 2 in 3 adolescents with an eating disorder self-identified as having a body image problem. Girls who met criteria for a major eating disorder diagnosis, and those engaging in extreme eating behaviours, were more likely to self-identify. When adjusting for covariates, only sex remained significantly associated with self-identification. Adolescents who self-identified were 2.71 times more likely to seek help for a body image problem, adjusting for covariates. CONCLUSIONS Public health strategies ought to promote awareness regarding the different ways that body image problems might manifest among both girls and boys, as well as the potential gravity of such problems. Awareness among parents, teachers and primary care providers should also be considered.
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Affiliation(s)
- Scott J Fatt
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
| | - Jonathan Mond
- Centre for Rural Health, University of Tasmania, Launceston, Tasmania, Australia.,School of Medicine, Western Sydney University, Sydney, New South Wales, Australia
| | - Kay Bussey
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
| | - Scott Griffiths
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Stuart B Murray
- Department of Psychiatry, University of California San Francisco, San Francisco, California, USA
| | - Alexandra Lonergan
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
| | - Phillipa Hay
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, New South Wales, Australia
| | - Kathleen Pike
- Department of Psychiatry, Columbia University, New York, New York, USA
| | - Nora Trompeter
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
| | - Deborah Mitchison
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, New South Wales, Australia.,School of Medicine, Western Sydney University, Sydney, New South Wales, Australia
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9
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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.
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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
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10
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Flatt RE, Thornton LM, Fitzsimmons-Craft EE, Balantekin KN, Smolar L, Mysko C, Wilfley DE, Taylor CB, DeFreese JD, Bardone-Cone AM, Bulik CM. Comparing eating disorder characteristics and treatment in self-identified competitive athletes and non-athletes from the National Eating Disorders Association online screening tool. Int J Eat Disord 2021; 54:365-375. [PMID: 33252150 PMCID: PMC8006447 DOI: 10.1002/eat.23415] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 09/28/2020] [Accepted: 10/31/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVE We compared eating disorder (ED) characteristics and treatment seeking behaviors between self-identified competitive athletes and non-athletes in a large, community-based sample. METHOD During the 2018 National Eating Disorders Awareness Week, 23,920 respondents, 14.7% of whom identified as competitive athletes, completed the National Eating Disorders Association online screen. Data were collected on demographics, disordered eating behaviors, probable ED diagnosis/risk, treatment history, and intent to seek treatment. RESULTS The sample was predominantly White (81.8%), female (90.3%), and between 13 and 24 years (82.6%). Over 86% met criteria for an ED/subthreshold ED, and of those, only 2.5% were in treatment. Suicidal ideation was reported in over half of the sample. Athletes reported a significantly greater likelihood of engaging in and more frequent excessive exercise episodes than non-athletes. Athletes also reported a significantly lower likelihood of engaging in and less frequent binge-eating episodes compared with non-athletes. Athletes were more likely to screen positive for an ED/subthreshold ED than non-athletes, but percentages across all probable ED diagnoses were similar. No significant differences between athletes and non-athletes emerged on treatment history or intention to seek treatment post-screen (less than 30%). DISCUSSION Although the distribution of probable ED diagnoses was similar in athletes and non-athletes, symptom profiles related to disordered eating behavior engagement and frequency may differ. Athletes may be less likely to seek treatment due to stigma, accessibility, and sport-specific barriers. Future work should directly connect survey respondents to tailored treatment tools and increase motivation to seek treatment.
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Affiliation(s)
- Rachael E Flatt
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Laura M Thornton
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | | - Katherine N Balantekin
- Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, New York, USA
| | - Lauren Smolar
- National Eating Disorders Association, New York City, New York, USA
| | - Claire Mysko
- National Eating Disorders Association, New York City, New York, USA
| | - Denise E Wilfley
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - C Barr Taylor
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA
- Center for m2Health, Palo Alto University, Palo Alto, California, USA
| | - J D DeFreese
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Anna M Bardone-Cone
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Cynthia M Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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11
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Romano KA, Lipson SK. Dietary restraint patterns and eating disorder help-seeking. Eat Weight Disord 2021; 26:159-168. [PMID: 31853888 DOI: 10.1007/s40519-019-00833-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 12/10/2019] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE Determine whether gender differences exist in associations among central barriers to and facilitators of eating disorder (ED) help-seeking-ED stigma, negative affect, perceived ED treatment need-as a function of individuals' probability of classification within empirically derived groups characterized by different dietary restraint patterns. METHOD As part of the cross-sectional, multi-institute Healthy Bodies Study, women (n = 2215) and men (n = 986) attending three colleges and universities in 2015 completed measures of ED symptoms, affect, and ED help-seeking in an online survey. Structural equation mixture modeling was used to (1) classify women and men, separately, into distinct classes characterized by unique dietary restraint patterns and (2) test associations among the three ED help-seeking barriers and facilitators within each class. RESULTS Five dietary restraint symptoms (food amount limiting attempts, fasting, food avoidance, following food/diet rules, desiring an empty stomach) clustered within four classes among women and three classes among men, which were characterized by qualitative and quantitative similarities and differences. Further, opposite patterns were generally found in associations among the ED help-seeking barriers and facilitators for women versus men as a function of the way dietary restraint symptoms clustered within each class. For example, bivariate associations between worse ED stigma and negative affect relative to greater perceived ED treatment need were both significant only among women in their lowest restraint severity class, whereas these associations were both significant among men in their highest severity class. DISCUSSION These findings can help to increase the reach of ED intervention efforts, including increasing ED help-seeking rates. LEVEL OF EVIDENCE Level V, cross-sectional descriptive study.
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Affiliation(s)
- Kelly A Romano
- The Virginia Consortium Program in Clinical Psychology, 555 Park Avenue, Norfolk, VA, 23504, USA.
- Old Dominion University, 250 Mills Godwin Building, Norfolk, VA, 23529, USA.
| | - Sarah K Lipson
- Department of Health Law Policy and Management, Boston University School of Public Health, 715 Albany Street, Boston, MA, 02118, USA
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12
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Fatt SJ, Mond J, Bussey K, Griffiths S, Murray SB, Lonergan A, Hay P, Trompeter N, Mitchison D. Help-seeking for body image problems among adolescents with eating disorders: findings from the EveryBODY study. Eat Weight Disord 2020; 25:1267-1275. [PMID: 31376110 DOI: 10.1007/s40519-019-00759-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Accepted: 07/23/2019] [Indexed: 11/26/2022] Open
Abstract
PURPOSE Little is known regarding correlates of help-seeking for a body image problem in adolescents with an eating disorder. This study provides the first population-based investigation of help-seeking correlates among adolescents with an eating disorder. METHODS Australian adolescents (N = 1002, 75.5% female, mean age = 15.14, SD = 1.40) who met operational diagnostic criteria for an eating disorder completed a survey assessing help-seeking, and potential correlates of help-seeking (sex, age, body mass index, socio-economic status, migrant status, sexuality, eating disorder diagnosis, psychological distress, and quality of life). RESULTS Only 10.1% of participants reported having sought help. Bivariate analyses revealed that increased likelihood of help-seeking was associated with female sex, sexual minority status, being born outside Australia, older age, having a major eating disorder (compared to having an unspecified or other specified feeding or other eating disorder diagnosis), higher psychological distress, and reduced psychological and social functioning. Older age, being born outside of Australia, and having a major eating disorder were significant independent correlates of help-seeking. CONCLUSIONS Very few adolescents with an eating disorder seek help for a body image problem. Promoting early, appropriate help-seeking among those who are younger and/or those with less well-known disorders may be particularly important. LEVEL OF EVIDENCE Level III, case-control analytic study.
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Affiliation(s)
- Scott J Fatt
- Department of Psychology, Centre for Emotional Health, Macquarie University, Balaclava Road, North Ryde, Sydney, NSW, 2109, Australia.
- Human Behaviour Lab, Department of Psychiatry, UNSW, Sydney, Australia.
| | - Jonathan Mond
- Centre for Rural Health, University of Tasmania, Launceston, Australia
- School of Medicine, Western Sydney University, Sydney, Australia
| | - Kay Bussey
- Department of Psychology, Centre for Emotional Health, Macquarie University, Balaclava Road, North Ryde, Sydney, NSW, 2109, Australia
| | - Scott Griffiths
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Stuart B Murray
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA
| | - Alexandra Lonergan
- Department of Psychology, Centre for Emotional Health, Macquarie University, Balaclava Road, North Ryde, Sydney, NSW, 2109, Australia
| | - Phillipa Hay
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
| | - Nora Trompeter
- Department of Psychology, Centre for Emotional Health, Macquarie University, Balaclava Road, North Ryde, Sydney, NSW, 2109, Australia
| | - Deborah Mitchison
- Department of Psychology, Centre for Emotional Health, Macquarie University, Balaclava Road, North Ryde, Sydney, NSW, 2109, Australia
- School of Medicine, Western Sydney University, Sydney, Australia
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Fitzsimmons-Craft EE, Balantekin KN, Graham AK, DePietro B, Laing O, Firebaugh ML, Smolar L, Park D, Mysko C, Funk B, Taylor CB, Wilfley DE. Preliminary data on help-seeking intentions and behaviors of individuals completing a widely available online screen for eating disorders in the United States. Int J Eat Disord 2020; 53:1556-1562. [PMID: 32542896 PMCID: PMC7978480 DOI: 10.1002/eat.23327] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 05/26/2020] [Accepted: 05/27/2020] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Scaling an online screen that provides referrals may be key in closing the treatment gap for eating disorders (EDs), but we need to understand respondents' help-seeking intentions and behaviors after receiving screen results. This study reported on these constructs among respondents to the National Eating Disorders Association online screen who screened positive or at high risk for an ED. METHOD Respondents completed the screen over 18 months (February 9, 2018-August 28, 2019). Those screening positive or at high risk for an ED (n = 343,072) had the option to provide data on help-seeking intentions (after screen completion) and behaviors (2-month follow-up). RESULTS Of eligible respondents, 4.8% (n = 16,396) provided data on help-seeking intentions, with only 33.7% of those reporting they would seek help. Only 7.6% of eligible respondents opted in to the 2-month follow-up, with 10.6% of those completing it (n = 2,765). Overall, 8.9% of respondents to the follow-up reported being in treatment when they took the screen, 15.5% subsequently initiated treatment, and 75.5% did not initiate/were not already in treatment. DISCUSSION Preliminary results suggest that among the small minority who provided data, only one-third expressed help-seeking intentions and 16% initiated treatment. Online screening should consider ways to increase respondents' motivation for and follow-through with care.
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Affiliation(s)
| | - Katherine N Balantekin
- Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, New York, USA
| | - Andrea K Graham
- Department of Medical Social Sciences, Northwestern University, Chicago, Illinois, USA
| | - Bianca DePietro
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Olivia Laing
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Marie-Laure Firebaugh
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Lauren Smolar
- National Eating Disorders Association, New York, New York, USA
| | - Dan Park
- National Eating Disorders Association, New York, New York, USA
| | - Claire Mysko
- National Eating Disorders Association, New York, New York, USA
| | - Burkhardt Funk
- Institute of Information Systems, Leuphana University, Lüneburg, Germany
| | - C Barr Taylor
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA
- Center for m2Health, Palo Alto University, Palo Alto, California, USA
| | - Denise E Wilfley
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
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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]
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15
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Fitzsimmons-Craft EE, Karam AM, Monterubio GE, Taylor CB, Wilfley DE. Screening for Eating Disorders on College Campuses: a Review of the Recent Literature. Curr Psychiatry Rep 2019; 21:101. [PMID: 31522343 PMCID: PMC7025756 DOI: 10.1007/s11920-019-1093-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
PURPOSE OF REVIEW This paper provides a review of the recent literature on screening for eating disorders (EDs) on college campuses, and reports on methodology, prevalence rates, treatment receipt, and ED screening tools. RECENT FINDINGS Recent research highlights relatively high prevalence rates of EDs among students on college campuses, with the majority of studies demonstrating elevated prevalence compared to the general population. Among students who screened positive for an ED, approximately 20% or less reported having received treatment for their ED. Findings also revealed various recruitment strategies, methods, ED screening tools, and clinical cutoffs used to study this topic, making it challenging to draw firm conclusions about prevalence of EDs on college campuses. Recent research on ED screening on college campuses reveals that EDs are a significant problem among college students, and there is a marked treatment gap between those who need care and those who receive it. Implications and future research are discussed.
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Affiliation(s)
- Ellen E Fitzsimmons-Craft
- Department of Psychiatry, Washington University School of Medicine, Mailstop 8134-29-2100, 660 S. Euclid Ave., St. Louis, MO, 63110, USA.
| | - Anna M Karam
- Department of Psychiatry, Washington University School of Medicine, Mailstop 8134-29-2100, 660 S. Euclid Ave., St. Louis, MO, 63110, USA
| | - Grace E Monterubio
- Department of Psychiatry, Washington University School of Medicine, Mailstop 8134-29-2100, 660 S. Euclid Ave., St. Louis, MO, 63110, USA
| | - C Barr Taylor
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
- Center for m2Health, Palo Alto University, Palo Alto, CA, USA
| | - Denise E Wilfley
- Department of Psychiatry, Washington University School of Medicine, Mailstop 8134-29-2100, 660 S. Euclid Ave., St. Louis, MO, 63110, USA
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16
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Fitzsimmons-Craft EE, Balantekin KN, Graham AK, Smolar L, Park D, Mysko C, Funk B, Taylor CB, Wilfley DE. Results of disseminating an online screen for eating disorders across the U.S.: Reach, respondent characteristics, and unmet treatment need. Int J Eat Disord 2019; 52:721-729. [PMID: 30761560 PMCID: PMC6555644 DOI: 10.1002/eat.23043] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 01/27/2019] [Accepted: 01/28/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The treatment gap between those who need and those who receive care for eating disorders is wide. Scaling a validated, online screener that makes individuals aware of the significance of their symptoms/behaviors is a crucial first step for increasing access to care. The objective of the current study was to determine the reach of disseminating an online eating disorder screener in partnership with the National Eating Disorders Association (NEDA), as well to examine the probable eating disorder diagnostic and risk breakdown of adult respondents. We also assessed receipt of any treatment. METHOD Participants completed a validated eating disorder screen on the NEDA website over 6 months in 2017. RESULTS Of 71,362 respondents, 91.0% were female, 57.7% 18-24 years, 89.6% non-Hispanic, and 84.7% White. Most (86.3%) screened positive for an eating disorder. In addition, 10.2% screened as high risk for the development of an eating disorder, and only 3.4% as not at risk. Of those screening positive for an eating disorder, 85.9% had never received treatment and only 3.0% were currently in treatment. DISCUSSION The NEDA online screen may represent an important eating disorder detection tool, as it was completed by >71,000 adult respondents over just 6 months, the majority of whom screened positive for a clinical/subclinical eating disorder. The extremely high percentage of individuals screening positive for an eating disorder who reported not being in treatment suggests a wide treatment gap and the need to offer accessible, affordable, evidence-based intervention options, directly linked with screening.
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Affiliation(s)
| | | | - Andrea K. Graham
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
| | - Lauren Smolar
- National Eating Disorders Association, New York, NY, USA
| | - Dan Park
- National Eating Disorders Association, New York, NY, USA
| | - Claire Mysko
- National Eating Disorders Association, New York, NY, USA
| | - Burkhardt Funk
- Institute of Information Systems, Leuphana University, Lüneburg, Germany
| | - C. Barr Taylor
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
- Center for mHealth, Palo Alto University, Palo Alto, CA, USA
| | - Denise E. Wilfley
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
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Grillot CL, Keel PK. Barriers to seeking treatment for eating disorders: The role of self-recognition in understanding gender disparities in who seeks help. Int J Eat Disord 2018; 51:1285-1289. [PMID: 30488569 DOI: 10.1002/eat.22965] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 09/17/2018] [Accepted: 09/19/2018] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Previous research suggests that men with eating disorders are less likely to seek treatment than are women. Given stereotypes linked to eating disorders, men may be less likely to recognize when they have an eating disorder, which could act as a barrier to treatment-seeking. METHOD The current study examined differences in self-recognition and treatment-seeking behavior by gender, controlling for other covariates, in participants with probable DSM-5 eating disorders drawn from a larger community-based sample. RESULTS Being female and self-recognition were both associated with increased likelihood of treatment-seeking while accounting for other potential covariates, including race/ethnicity, age, BMI, and comorbid disorders. DISCUSSION Results indicate that self-recognition is a barrier to seeking treatment for both genders and does not account for help-seeking differences between women and men. Findings have implications for interventions to address barriers to treatment-seeking for eating disorders.
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Affiliation(s)
| | - Pamela K Keel
- Department of Psychology, Florida State University, Tallahassee, Florida
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18
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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.
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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
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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.
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Affiliation(s)
| | - Rosanne Menna
- a Department of Psychology , University of Windsor , Windsor , Ontario , Canada
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20
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Slewa-Younan S, Yaser A, Guajardo MGU, Mannan H, Smith CA, Mond JM. The mental health and help-seeking behaviour of resettled Afghan refugees in Australia. Int J Ment Health Syst 2017; 11:49. [PMID: 28855961 PMCID: PMC5571658 DOI: 10.1186/s13033-017-0157-z] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 08/20/2017] [Indexed: 02/02/2023] Open
Abstract
Background Psychological trauma, in particular, posttraumatic stress disorder (PTSD) and depression, are highly prevalent among resettled refugees. However, little is known regarding the mental health status and associated help-seeking behaviour of resettled Afghan refugees in Australia. Methods A sample of 150 resettled Afghan refugees (74 males; mean age 32.8 years, SD = 12.2) living in Adelaide, South Australia were recruited. Self-reported measures of PTSD, depression, exposure to traumatic events, functional impairment, self-recognition of PTSD symptomatology and help-seeking behaviours were completed. Multivariate analysis of variables associated with help-seeking was conducted. Results Forty-four percent of participants met criteria for clinically significant PTSD symptoms and all but one participant reported being exposed to 1 or more traumatic and/or conflict related events, such as ‘losing your property and wealth’. Moreover, 14.7% of participants had symptoms suggestive of clinically significant depression. General practitioners were the most common source of help in relation to mental health problems, with very few participants (4.6%) seeking help from specialist trauma and torture mental health services. Self-recognition of having a PTSD related mental health problem and functional impairment levels were both found to be independent predictors of help-seeking (p ≤ .05). Conclusions The findings provide further evidence for high rates of PTSD symptomatology and low uptake of mental care among resettled refugees. Poor self-recognition of the presence and/or adverse impact of PTSD symptoms may need to be targeted in mental health promotion programs designed to improve “mental health literacy” and thereby promote early and appropriate help-seeking where this is needed.
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Affiliation(s)
- Shameran Slewa-Younan
- Mental Health, School of Medicine, Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith South DC, Sydney, NSW Australia.,Centre for Mental Health, Melbourne, School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Anisa Yaser
- Mental Health, School of Medicine, Western Sydney University, Sydney, Australia
| | - Maria Gabriela Uribe Guajardo
- Mental Health, School of Medicine, Translational Health Research Institute, Western Sydney University, Sydney, Australia
| | - Haider Mannan
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
| | - Caroline A Smith
- National Institute of Complementary Medicine, Western Sydney University, Sydney, Australia
| | - Jonathan M Mond
- Centre for Rural Health, University of Tasmania, Hobart, Australia.,School of Medicine, Translational Health Research Institute, Western Sydney University, Sydney, Australia
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Higgins MK, Bulik CM, Bardone-Cone AM. Factors associated with self-identification of an eating disorder history among Latinas meeting criteria for past or current eating disorders. Int J Eat Disord 2016; 49:1032-1035. [PMID: 27436725 DOI: 10.1002/eat.22583] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/08/2016] [Indexed: 11/10/2022]
Abstract
OBJECTIVE This paper compared Latinas who self-identified as having had an eating disorder (ED) with those who did not (despite both groups meeting criteria for an ED history) on ED pathology and mental health stigma. METHOD Seventy-seven Latinas completed an online survey. RESULTS All 77 participants met criteria for lifetime EDs, and 92% met current criteria for an ED; however, 47% did not report having an ED history vs. 53% did report an ED history. There was no difference on binge eating frequency. Those who endorsed an ED history engaged in more compensatory behaviors, had higher EAT-26 scores, and were less fearful of stigmatization due to seeking mental health treatment. Those reporting an ED history were more likely to have met criteria for anorexia nervosa or bulimia nervosa, generally more recognizable EDs than binge eating disorder and other specified feeding or eating disorders, than those who did not report an ED history. DISCUSSION Latinas with certain patterns of eating pathology and those with less fear of being stigmatized due to seeking mental health treatment were more likely to endorse an ED history, which has implications for treatment seeking. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:1032-1035).
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Affiliation(s)
- M K Higgins
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Cynthia M Bulik
- Departments of Psychiatry and Nutrition, University of North Carolina at Chapel Hill, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Anna M Bardone-Cone
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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22
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Cruwys T, Platow MJ, Rieger E, Byrne DG, Haslam SA. The social psychology of disordered eating: The Situated Identity Enactment model. EUROPEAN REVIEW OF SOCIAL PSYCHOLOGY 2016. [DOI: 10.1080/10463283.2016.1229891] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Tegan Cruwys
- School of Psychology, The University of Queensland, St Lucia, QLD 4072, Australia
- Research School of Psychology, Australian National University, Acton, ACT, 0200, Australia
| | - Michael J. Platow
- Research School of Psychology, Australian National University, Acton, ACT, 0200, Australia
| | - Elizabeth Rieger
- Research School of Psychology, Australian National University, Acton, ACT, 0200, Australia
| | - Don G. Byrne
- Research School of Psychology, Australian National University, Acton, ACT, 0200, Australia
| | - S. Alexander Haslam
- School of Psychology, The University of Queensland, St Lucia, QLD 4072, Australia
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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.
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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
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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.
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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
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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.
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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
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27
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Gratwick-Sarll K, Bentley C. Improving eating disorders mental health literacy: a preliminary evaluation of the "Should I say something?" workshop. Eat Disord 2014; 22:405-19. [PMID: 24964314 DOI: 10.1080/10640266.2014.925764] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
A repeated measures, uncontrolled, preliminary evaluation of a single 3-hour workshop-"Should I Say Something?"-aimed at improving eating disorders mental health literacy, was conducted in a sample of 177 university undergraduates. Following participation in the workshop, significant increases in eating disorder recognition and knowledge, and significant decreases in stigmatizing attitudes, were reported by participants. Moreover, 85% of participants reported that they provided assistance to someone whom they suspected had a mental health condition, including an eating disorder, during the 3-month follow-up period. This study provides preliminary evidence that "Should I Say Something?" may be effective in improving the mental health literacy of young people.
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Affiliation(s)
- Kassandra Gratwick-Sarll
- a Research School of Psychology , Australian National University , Canberra , Australian Capital Territory , Australia
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