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Montoro-Pérez N, Montejano-Lozoya R, Martín-Baena D, Talavera-Ortega M, Rosario Gómez-Romero M. Psychometric properties of the Eating Attitudes Test-26 in Spanish schoolchildren. An Pediatr (Barc) 2024; 100:241-250. [PMID: 38604935 DOI: 10.1016/j.anpede.2024.03.042] [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: 08/02/2023] [Accepted: 01/18/2024] [Indexed: 04/13/2024] Open
Abstract
INTRODUCTION Disordered Eating Attitudes and Behaviours (DEABs) can impact both the mental and physical health of children. Early detection is crucial to prevent complications and improve outcomes. The Eating Attitudes Test-26 (EAT-26) is a widely used, cost-effective tool for assessing DEABs. OBJECTIVE To evaluate the psychometric properties of the EAT-26 by analysing its factor structure, internal consistency, convergent validity, and measurement invariance across sexes in Spanish schoolchildren. METHOD Validation study in a sample of 718 schoolchildren. The sample was randomly divided into 2 groups, each with 359 participants, and we carried out an exploratory factor analysis (EFA) and a confirmatory factor analysis (CFA) of the instrument. Subsequently, we assessed the internal consistency by means of the ordinal alpha, the convergent validity with the SCOFF questionnaire and the measurement invariance across the sexes. RESULTS The results of the EFA and CFA supported a multidimensional structure of the EAT comprising 6 factors and 21 items. These factors underlie a second-order model of DEABs. The internal consistency was adequate for most factors. The SCOFF questionnaire showed a moderate convergent validity for most of the EAT-21 factors. We found measurement invariance across the sexes. CONCLUSIONS The abbreviated EAT-21 scale exhibited modest and promising psychometric properties, making it a suitable instrument for assessing DEABs in both sexes in educational settings.
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Affiliation(s)
- Néstor Montoro-Pérez
- Department of Nursing, Faculty of Health Sciences, University of Alicante, San Vicente del Raspeig, Alicante, Spain
| | - Raimunda Montejano-Lozoya
- La Fe School of Nursing, Center attached to the University of Valencia, GREIACC Research Group, La Fe Health Research Institute (IISLAFE), Valencia, Spain..
| | - David Martín-Baena
- La Fe School of Nursing, Center attached to the University of Valencia, GREIACC Research Group, La Fe Health Research Institute (IISLAFE), Valencia, Spain
| | - Marta Talavera-Ortega
- Department of Didactics of Experimental and Social Sciences, Faculty of Education, University of Valencia, Valencia, Spain
| | - M Rosario Gómez-Romero
- La Fe School of Nursing, Center attached to the University of Valencia, GREIACC Research Group, La Fe Health Research Institute (IISLAFE), Valencia, Spain
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Gómez-Romero MR, Montoro-Pérez N, Martín-Baena D, Talavera-Ortega M, Montejano-Lozoya R. A descriptive cross-sectional study on eating disorders, suicidal thoughts, and behaviors among adolescents in the Valencian community (Spain). The pivotal role of school nurses. J Pediatr Nurs 2024; 75:1-7. [PMID: 38091926 DOI: 10.1016/j.pedn.2023.11.027] [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: 06/01/2023] [Revised: 11/27/2023] [Accepted: 11/27/2023] [Indexed: 03/08/2024]
Abstract
PURPOSE The aims of this study were: 1) to describe the rates of risk of having an Eating Disorder (ED) and the rates of suicidal thoughts and behaviors, and 2) to examine the relationship between the risk of having an ED with suicidal thoughts and behaviors in adolescents enrolled in educational centers in the Community of Valencia (Spain). DESIGN AND METHODS A cross-sectional study was conducted with 718 adolescents between September 2019 and July 2020 in five schools in the Community of Valencia (Spain). RESULTS The adolescents studied, mostly females, are at risk of having an ED (18.6% to 30.8%) and experiencing suicidal thoughts (23% to 30.7%) and behaviors (2.2% to 6.2%). A strong association was found between EDs and suicidal thoughts and behaviors in both sexes. This association was higher in females with positive EAT-26 scores (OR: 2.09; 95% CI: 1.35-3.24) and in males with positive SCOFF scores (OR: 4.66; 95% CI: 2.40-9.02). Suicidal behaviors were positively associated with both EAT-26 (OR: 2.58; 95% CI: 1.17-5.67) and SCOFF (OR: 1.89; 95% CI: 1.21-2.26) scores in females. CONCLUSIONS A considerable number of adolescents, females in particular, are at risk of having an ED and of experiencing suicidal thoughts and behaviors, establishing a strong link between EDs and suicidal tendencies. PRACTICAL IMPLICATIONS The study highlights the importance of establishing national and regional regulations to ensure the availability of school nurses in the Community of Valencia (Spain). Collaboration between school nurses, educators, and policy makers is critical to the early detection of problems and the provision of support to both adolescents and families.
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Affiliation(s)
| | - Néstor Montoro-Pérez
- GREIACC Research Group, La Fe Health Research Institute, Valencia, Spain; Department of Nursing, Faculty of Health Sciences, Person-centred Care and Health Outcomes Innovation Group, University of Alicante, Spain.
| | - David Martín-Baena
- GREIACC Research Group, La Fe Health Research Institute, Valencia, Spain
| | - Marta Talavera-Ortega
- Department of Didactics of Experimental and Social Sciences, Faculty of Teaching, University of Valencia, Valencia, Spain
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Namimi-Halevi C, Dor C, Stark AH, Dichtiar R, Bromberg M, Sinai T. Attention-deficit hyperactivity disorder is associated with disordered eating in adolescents. Pediatr Res 2023:10.1038/s41390-023-02925-3. [PMID: 38049648 DOI: 10.1038/s41390-023-02925-3] [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: 04/21/2023] [Revised: 09/28/2023] [Accepted: 10/12/2023] [Indexed: 12/06/2023]
Abstract
AIM Attention-deficit hyperactivity disorder (ADHD) and disordered eating (DE) are both highly prevalent among adolescents, but their relationship is understudied. This study examines their possible association in a nationally representative sample of adolescents. METHODS Participants in the Israeli Youth Health and Nutrition Survey (2015-2016), a cross-sectional, school-based study, completed self-administered questionnaires, including the SCOFF questionnaire, and underwent anthropometric measurements. An affirmative reply to at least two SCOFF items was considered a DE case. Multivariable logistic regression evaluated the ADHD-DE association and the associations between ADHD and individual SCOFF items, controlling for age, sex, socioeconomic status, and body mass index. RESULTS Of 4616 participants (12-18 years, 50.2% male), 654 reported an ADHD diagnosis. DE prevalence among ADHD adolescents was significantly higher than the non-ADHD group (50.2% vs. 43.9%, p = 0.003). Controlling for potential covariates, the association between ADHD and DE remained significant (OR = 1.409; 95% CI: 1.170-1.697), as did associations between ADHD and three SCOFF items. No difference in DE prevalence was found between stimulant-treated (n = 287) and untreated (n = 326) adolescents with ADHD. CONCLUSION Adolescents with ADHD are more likely to experience DE. As DE can herald an imminent eating disorder, early identification is crucial. Further studies are needed to determine the ADHD-DE relationship's causality. IMPACT Disordered eating (DE) and attention-deficit hyperactivity disorder (ADHD) are common among adolescents, and significantly affect health and well-being. This study examined the association between ADHD and DE in adolescents using the SCOFF questionnaire. Following adjustment for sociodemographic variables and BMI z-score, ADHD was associated with a 41% increased odds for DE. This study established the association between ADHD and DE, using a well-known questionnaire, in a large, nationally representative sample of adolescents. Monitoring eating behaviors and attitudes among adolescents with ADHD should be a priority, to minimize the risk of developing an eating disorder and its harmful consequences.
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Affiliation(s)
- Chen Namimi-Halevi
- Israel Center for Disease Control, Israel Ministry of Health, Ramat Gan, Israel
| | - Chen Dor
- Israel Center for Disease Control, Israel Ministry of Health, Ramat Gan, Israel
| | - Aliza H Stark
- School of Nutritional Sciences, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Rita Dichtiar
- Israel Center for Disease Control, Israel Ministry of Health, Ramat Gan, Israel
| | - Michal Bromberg
- Israel Center for Disease Control, Israel Ministry of Health, Ramat Gan, Israel
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tali Sinai
- Israel Center for Disease Control, Israel Ministry of Health, Ramat Gan, Israel.
- School of Nutritional Sciences, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel.
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Valladares-Garrido D, Quiroga-Castañeda PP, Berrios-Villegas I, Zila-Velasque JP, Anchay-Zuloeta C, Chumán-Sánchez M, Vera-Ponce VJ, Pereira-Victorio CJ, Failoc-Rojas VE, Díaz-Vélez C, Valladares-Garrido MJ. Depression, anxiety, and stress in medical students in Peru: a cross-sectional study. Front Psychiatry 2023; 14:1268872. [PMID: 38090694 PMCID: PMC10715266 DOI: 10.3389/fpsyt.2023.1268872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 10/26/2023] [Indexed: 02/01/2024] Open
Abstract
Objective To determine the prevalence and factors associated with depressive, anxious, and stress symptoms in medical students in Peru, during the second pandemic wave of COVID-19. Methods We conducted an analytical cross-sectional study in 405 medical students from a university in northern Peru. The DASS-21 instrument was used to evaluate mental health outcomes (depression, anxiety, and stress), and to investigate their association with socio-educational characteristics. Results We found a prevalence of depressive, anxious, and stress symptoms of 71.6% (95% CI: 66.94-75.95), 71.9% (95% CI: 67.2-76.2), and 62.7% (95% CI: 57.8-67.4); respectively. Students with eating behavior disorders had a higher prevalence of depressive symptoms (PR: 1.35), anxious symptoms (PR: 1.27), and stress symptoms (PR: 1.31). The prevalence of depressive symptoms (PR: 1.57), anxious symptoms (PR: 1.27), and stress symptoms (PR: 1.24) increased in students who did not report regular physical activity. In addition, having almost always academic exhaustion increased the prevalence of depressive symptoms (PR: 1.46), stress symptoms (PR: 1.72). On the contrary, the prevalence of depressive symptoms (PR: 0.79), anxious symptoms (PR: 0.73) and stress symptoms (PR: 0.82) decreased in male students. Students who reported sleeping 8 or more hours daily had a lower prevalence of stress symptoms (PR: 0.82). Conclusion Symptoms of depression and anxiety occurred in 7 out of 10 students, and stress in 6 out of 10. Among the factors associated with the presence of anxiety, depression, and stress were eating behavior disorder and not regularly exercising. Periodic evaluations of mental symptomatology are required and counseling should be promoted in medical schools.
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Affiliation(s)
- Danai Valladares-Garrido
- Escuela de Medicina, Universidad Cesar Vallejo, Trujillo, Peru
- Oficina de Salud Ocupacional, Hospital de Apoyo II Santa Rosa, Piura, Peru
| | | | | | - J. Pierre Zila-Velasque
- Universidad Nacional Daniel Alcides Carrión, Facultad de Medicina Humana, Pasco, Peru
- Red Latinoamericana de Medicina en La Altitud e Investigación (REDLAMAI), Pasco, Peru
| | - Claudia Anchay-Zuloeta
- Facultad de Medicina, Universidad de San Martín de Porres, Chiclayo, Peru
- Sociedad Científica de Estudiantes de Medicina Veritas (SCIEMVE), Chiclayo, Peru
| | - Marisella Chumán-Sánchez
- Facultad de Medicina, Universidad de San Martín de Porres, Chiclayo, Peru
- Sociedad Científica de Estudiantes de Medicina Veritas (SCIEMVE), Chiclayo, Peru
| | - Víctor J. Vera-Ponce
- Instituto de Investigación en Ciencias Biomédicas, Universidad Ricardo Palma, Lima, Peru
- Universidad Tecnológica del Perú, Lima, Peru
| | | | - Virgilio E. Failoc-Rojas
- Unidad de Investigación para Generación y Síntesis de Evidencia en Salud, Universidad San Ignacio de Loyola, Lima, Peru
| | - Cristian Díaz-Vélez
- Escuela de Medicina, Universidad Privada Antenor Orrego, Trujillo, Peru
- Red Peruana de Salud Colectiva, Lima, Peru
| | - Mario J. Valladares-Garrido
- Facultad de Medicina, Universidad de San Martín de Porres, Chiclayo, Peru
- South American Center for Education and Research in Public Health, Universidad Norbert Wiener, Lima, Peru
- Oficina de Epidemiología, Hospital Regional Lambayeque, Chiclayo, Peru
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López-Gil JF, García-Hermoso A, Smith L, Firth J, Trott M, Mesas AE, Jiménez-López E, Gutiérrez-Espinoza H, Tárraga-López PJ, Victoria-Montesinos D. Global Proportion of Disordered Eating in Children and Adolescents: A Systematic Review and Meta-analysis. JAMA Pediatr 2023; 177:363-372. [PMID: 36806880 PMCID: PMC9941974 DOI: 10.1001/jamapediatrics.2022.5848] [Citation(s) in RCA: 28] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 11/30/2022] [Indexed: 02/22/2023]
Abstract
Importance The 5-item Sick, Control, One, Fat, Food (SCOFF) questionnaire is the most widely used screening measure for eating disorders. However, no previous systematic review and meta-analysis determined the proportion of disordered eating among children and adolescents. Objective To establish the proportion among children and adolescents of disordered eating as assessed with the SCOFF tool. Data Sources Four databases were systematically searched (PubMed, Scopus, Web of Science, and the Cochrane Library) with date limits from January 1999 to November 2022. Study Selection Studies were required to meet the following criteria: (1) participants: studies of community samples of children and adolescents aged 6 to 18 years and (2) outcome: disordered eating assessed by the SCOFF questionnaire. The exclusion criteria included (1) studies conducted with young people who had a diagnosis of physical or mental disorders; (2) studies that were published before 1999 because the SCOFF questionnaire was designed in that year; (3) studies in which data were collected during COVID-19 because they could introduce selection bias; (4) studies based on data from the same surveys/studies to avoid duplication; and (5) systematic reviews and/or meta-analyses and qualitative and case studies. Data Extraction and Synthesis A systematic review and meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline. Main Outcomes and Measures Proportion of disordered eating among children and adolescents assessed with the SCOFF tool. Results Thirty-two studies, including 63 181 participants, from 16 countries were included in this systematic review and meta-analysis. The overall proportion of children and adolescents with disordered eating was 22.36% (95% CI, 18.84%-26.09%; P < .001; n = 63 181) (I2 = 98.58%). Girls were significantly more likely to report disordered eating (30.03%; 95% CI, 25.61%-34.65%; n = 27 548) than boys (16.98%; 95% CI, 13.46%-20.81%; n = 26 170) (P < .001). Disordered eating became more elevated with increasing age (B, 0.03; 95% CI, 0-0.06; P = .049) and body mass index (B, 0.03; 95% CI, 0.01-0.05; P < .001). Conclusions and Relevance In this systematic review and meta-analysis, the available evidence from 32 studies comprising large samples from 16 countries showed that 22% of children and adolescents showed disordered eating according to the SCOFF tool. Proportion of disordered eating was further elevated among girls, as well as with increasing age and body mass index. These high figures are concerning from a public health perspective and highlight the need to implement strategies for preventing eating disorders.
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Affiliation(s)
- José Francisco López-Gil
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Antonio García-Hermoso
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Navarra, Spain
| | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, United Kingdom
| | - Joseph Firth
- Division of Psychology and Mental Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom
- Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Mike Trott
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, United Kingdom
- Centre for Public Health, Queen’s University, Belfast, United Kingdom
| | - Arthur Eumann Mesas
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Postgraduate Program in Public Health, Universidade Estadual de Londrina, Londrina, Brazil
| | - Estela Jiménez-López
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
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de Moraes CEF, Appolinário JC, Mourilhe C, de Freitas SR, da Veiga GV. Reliability of the Brazilian version of the questionnaire on eating and weight patterns-5 (QEWP-5). Eat Weight Disord 2021; 26:2463-2470. [PMID: 33479922 DOI: 10.1007/s40519-020-01072-6] [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: 11/12/2019] [Accepted: 11/12/2020] [Indexed: 12/27/2022] Open
Abstract
PURPOSE The Questionnaire on Eating and Weight Patterns-5 (QEWP-5) is a self-report instrument developed to screen individuals for binge eating disorder (BED) and bulimia nervosa (BN) as diagnosed by the DSM-5. This instrument was cross-culturally adapted for the Brazilian Portuguese and well understood by the target sample. The present study aimed to assess the test-retest reliability of the Brazilian version of QEWP-5 in a sample of undergraduate students from Dietitian and Psychology courses. METHODS The Brazilian version of QEWP-5 was administered to a sample of 345 male and female undergraduate students, from dietitian (n = 179) and psychology (n = 166) courses. The instrument was applied twice with a time interval of 2 weeks between the applications. The kappa coefficient was used to assess the temporal stability of the questionnaire in the screening of BED and BN. RESULTS Overall, the kappa coefficient for the screening of BED was .48, and for the screening of BN was .71. In the dietitian course, the temporal stability was .60 (for the assessment of BED) and .80 (for BN). In the psychology course, the kappa values for the assessment of BED and BN were .27 and .60, respectively. All values were statistically significant (p < .001). CONCLUSION In general, the stability of the Brazilian version of QEWP-5 was considered moderate to assess BED and substantial for the screening of BN in undergraduate students. Stratifying by course, the questionnaire had higher stability for the assessment of BED and BN in dietitian students. LEVEL OF EVIDENCE Level V, descriptive study.
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Affiliation(s)
- Carlos Eduardo Ferreira de Moraes
- Josué de Castro Nutrition Institute (INJC), Department of Social and Applied Nutrition (DNSA), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil. .,Psychiatry Institute (IPUB), Group of Obesity and Eating Disorders (GOTA), Federal University of Rio de Janeiro, Avenida Venceslau Brás, 71 fundos, Campus Praia Vermelha, Botafogo, Rio de Janeiro, 22290-140, RJ, Brazil.
| | - José Carlos Appolinário
- Psychiatry Institute (IPUB), Group of Obesity and Eating Disorders (GOTA), Federal University of Rio de Janeiro, Avenida Venceslau Brás, 71 fundos, Campus Praia Vermelha, Botafogo, Rio de Janeiro, 22290-140, RJ, Brazil
| | - Carla Mourilhe
- Josué de Castro Nutrition Institute (INJC), Department of Social and Applied Nutrition (DNSA), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil.,Psychiatry Institute (IPUB), Group of Obesity and Eating Disorders (GOTA), Federal University of Rio de Janeiro, Avenida Venceslau Brás, 71 fundos, Campus Praia Vermelha, Botafogo, Rio de Janeiro, 22290-140, RJ, Brazil
| | - Sílvia Regina de Freitas
- Psychiatry Institute (IPUB), Group of Obesity and Eating Disorders (GOTA), Federal University of Rio de Janeiro, Avenida Venceslau Brás, 71 fundos, Campus Praia Vermelha, Botafogo, Rio de Janeiro, 22290-140, RJ, Brazil.,State Institute of Diabetes e Endocrinology (IEDE), Rio de Janeiro, RJ, Brazil
| | - Glória Valéria da Veiga
- Josué de Castro Nutrition Institute (INJC), Department of Social and Applied Nutrition (DNSA), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
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Pérez Martín PS, Martínez JA, Valecillos AJ, Gainza García L, Galán Berasaluce M, Checa Díaz P. [Early detection and prevalence of risk of eating disorders in Primary Care in Guadalajara city]. Semergen 2021; 47:230-239. [PMID: 33863649 DOI: 10.1016/j.semerg.2021.01.007] [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: 11/02/2020] [Revised: 12/22/2020] [Accepted: 01/01/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To know the percentage of adolescent patients at risk of developing an eating disorder (ED); to identify the prevalence of risk for Anorexia Nervosa, Bulimia Nervosa and Unspecified Eating Disorders (NERD) according to age, sex, health centers, nationality and family data; determine the percentage of young people with subclinical forms and study the feasibility of using tools for the early detection of this pathology in Primary Care. MATERIAL AND METHODS Observational, cross-sectional and multicentre study developed in the five health centers of the city of Guadalajara. Sample of 291 adolescents (124 males and 167 females) obtained through stratified, multi-stage and proportional random sampling according to age, sex and health centers. Sociodemographic, anthropometric and family variables were studied and the EAT-26, SCOFF and EDE-Q6.0 tests were applied in the first round and the EDE-12 interview in the second round. RESULTS The global prevalence of risk of eating disorders was 17.5% (95% CI: 13.7%-19.4%). The variables, having siblings, being single-parent and having obesity were statistically significant. Among the various types of EDs, the NERD were statistically significant with respect to Anorexia and Bulimia. The subscale concern for the silhouette was statistically significant with respect to the others. The SCOFF questionnaire showed a sensitivity of 91.6% and a specificity of 91.0% and the EDE-Q, 99.3% and 91.7% respectively. CONCLUSIONS High percentage of adolescents at risk of developing an eating disorder. The unspecified type of eating disorders and the concern for the silhouette subscale predominate. The SCOFF test proves to be a good screening instrument in Primary Care.
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Affiliation(s)
- P S Pérez Martín
- Medicina de Familia y Comunitaria, Centro de Salud Guzmán el Bueno, Madrid, España.
| | - J A Martínez
- Universidad de Alcalá de Henares, Madrid, España
| | - A J Valecillos
- Medicina de Familia y Comunitaria, Centro de Salud El Balconcillo, Guadalajara, España
| | - L Gainza García
- Medicina de Familia y Comunitaria, Centro de Salud Brihuega, Guadalajara, España
| | - M Galán Berasaluce
- Medicina de Familia y Comunitaria, Centro de Salud Gu-Sur, Guadalajara, España
| | - P Checa Díaz
- Medicina de Familia, Centro de Salud Alcolea del Pinar, Guadalajara, España
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Restrepo JE, Castañeda Quirama T. Risk of Eating Disorders and Use of Social Networks in Female Gym-Goers in the City of Medellín, Colombia. ACTA ACUST UNITED AC 2020; 49:162-169. [PMID: 32888659 DOI: 10.1016/j.rcp.2018.08.003] [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] [Received: 02/26/2018] [Revised: 07/18/2018] [Accepted: 08/30/2018] [Indexed: 10/28/2022]
Abstract
INTRODUCTION There are not many studies on prevalence and factors (use of social networks, for example) associated with eating disorders (ED) in Colombia. These types of studies in regular female gym-goers are of particular interest. METHODS The objective was to analyse the relationship between the risk of EDs and the use of social networks in 337 women between the ages of 15 and 30 who had been regularly going to the gym in the city of Medellín for four months or more. The type of study was quantitative, descriptive and cross-sectional. RESULTS A total of 143 (47.5%) cases with a risk of EDs were identified. Statistically significant associations were found between the risk of eating disorders and some aspects of the use of social networks. DISCUSSION The possible association between ED, the use of social networks and certain personality characteristics and sociocultural beauty stereotypes are discussed. CONCLUSIONS The findings point to an association between the use of social networks as a way to achieve self-image approval, abnormal eating attitudes and body satisfaction. This behaviour, added to other vulnerability factors, may increase the risk for the initiation or maintenance of an ED, particularly in the population using gyms and physical conditioning centres.
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Risk of eating disorder in Colombian women who go to the gym. INTERACCIONES: REVISTA DE AVANCES EN PSICOLOGÍA 2020. [DOI: 10.24016/2020.v6n2.161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: Mental health in gyms has not been a topic of study in Colombia. Social stereotypes of beauty and dissatisfaction with body image make women a population prone to excessive exercise. This research analyzes the risk of eating disorder in women who attend gyms (comparing ages), its relationship with the frequency of physical exercise and the use of diet to improve physical appearance. Methods: 519 women with ages between 15 and 50 years participated. The EAT-26 Eating Attitude Test was used, a standardized procedure to estimate the frequency of physical exercise and a brief socio-demographic survey. Results: The percentages of women with risk (46.8%) of TBI and without risk (53.2%) are similar, the factor scores and the total of the EAT-26 only show significant differences in the age range 15 -19 and 20-24, no significant correlations were found between the factors and the total score of the EAT-26 and the measure of the frequency of physical exercise, and there is an association between the risk of eating disorders and diet to improve the physical image. Conclusion: The percentage of women at risk for eating disorders is higher than those reported for high school students, university students, and athletes. A very high percentage of gym users would be compromising their mental health in some way, considering the frequency values of physical exercise.
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Kutz AM, Marsh AG, Gunderson CG, Maguen S, Masheb RM. Eating Disorder Screening: a Systematic Review and Meta-analysis of Diagnostic Test Characteristics of the SCOFF. J Gen Intern Med 2020; 35:885-893. [PMID: 31705473 PMCID: PMC7080881 DOI: 10.1007/s11606-019-05478-6] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 10/07/2019] [Indexed: 02/01/2023]
Abstract
BACKGROUND Eating disorders affect upwards of 30 million people worldwide and often go undertreated and underdiagnosed. The purpose of this systematic review and meta-analysis was to evaluate the diagnostic accuracy of the Sick, Control, One, Fat and Food (SCOFF) questionnaire for DSM-5 eating disorders in the general population. METHOD The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) were followed. A PubMed search was conducted among peer-reviewed articles. Information regarding validation of the SCOFF was required for inclusion. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. RESULTS The final analysis included 25 studies. The validity of the SCOFF was high across samples with a pooled sensitivity of 0.86 (95% CI, 0.78-0.91) and specificity of 0.83 (95% CI, 0.77-0.88). Subgroup analyses were conducted to examine the impact of methodology, study quality, and clinical characteristics on diagnostic accuracy. Studies with the highest sensitivity tended to be case-control studies of young women with anorexia nervosa (AN) and bulimia nervosa (BN). Studies which included more men, included those diagnosed with binge eating disorder, and recruited from large community samples tended to have lower sensitivity. Few studies reported on BMI and race/ethnicity; thus, subgroups for these factors could not be examined. No studies used reference standards which assessed all DSM-5 eating disorders. CONCLUSION This meta-analysis of 25 validation studies demonstrates that the SCOFF is a simple and useful screening tool for young women at risk for AN and BN. However, there is not enough evidence to support utilizing the SCOFF for screening for the range of DSM-5 eating disorders in primary care and community-based settings. Further examination of the validity of the SCOFF or development of a new screening tool, or multiple tools, to screen for the range of DSM-5 eating disorders heterogenous populations is warranted. TRIAL REGISTRATION This study is registered online with PROSPERO (CRD42018089906).
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Affiliation(s)
- Amanda M Kutz
- VA Salt Lake City Health Care System, Salt Lake City, UT, USA.
| | | | - Craig G Gunderson
- VA Connecticut Healthcare System, West Haven, CT, USA
- Department of Internal Medicine, Section of General Internal Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Shira Maguen
- San Francisco VA Healthcare System, San Francisco, CA, USA
- Department of Psychiatry, University of California San Francisco, School of Medicine, San Francisco, CA, USA
| | - Robin M Masheb
- VA Connecticut Healthcare System, West Haven, CT, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
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Lichtenstein MB, Hemmingsen SD, Støving RK. Identification of eating disorder symptoms in Danish adolescents with the SCOFF questionnaire. Nord J Psychiatry 2017; 71:340-347. [PMID: 28290749 DOI: 10.1080/08039488.2017.1300322] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Eating disorders often develop in adolescence and, therefore, instruments are needed that are useful to detect risk behaviour in young people. The SCOFF is a 5-item screening instrument, named SCOFF as an acronym of keywords from the questions. It has been used widely in adult samples, but studies that evaluate the scale in adolescents are missing. AIMS The aim of this study was to test the psychometric properties of the SCOFF in adolescents aged 11-20 years and for the first time validate the questionnaire in Danish. METHODS A total of 184 adolescents completed the Danish version of the SCOFF and sub-scales from the Eating Disorder Inventory (EDI-3). The sample consisted of 87 patients (mean age = 16) from a specialized eating disorder department in the Region of Southern Denmark and 97 healthy adolescents (mean age = 17) from Danish primary and high schools. RESULTS It was found that the reliability of the SCOFF was acceptable, and that cut-off 2 is useful to detect those with potential eating disorder pathology. Item 3 (weight loss) correlated poorly with EDI-3 sub-scales and might be reformulated by addressing the intentionality behind weight loss (due to unhappiness with body) rather than a specific amount of weight loss (1 stone), because this could have somatic reasons. CONCLUSIONS The SCOFF is a very easily applicable questionnaire, which may fulfil the necessary psychometric properties for detection of ED symptoms in Danish adolescents. Before general screening can be recommended, conditions regarding benefits and potential adverse effects still remain to be addressed.
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Affiliation(s)
- Mia Beck Lichtenstein
- a Centre for Telepsychiatry, Odense, Region of Southern Denmark, Department of Psychology , University of Southern Denmark , Denmark
| | - Simone Daugaard Hemmingsen
- b Nutrition Clinic, Centre for Eating Disorders, Odense University Hospital, Psychiatric Services in the Region of Southern Denmark, Research Unit of Medical Endocrinology, Department of Clinical Research , University of Southern Denmark , Denmark
| | - René Klinkby Støving
- c Nutrition Clinic, Centre for Eating Disorders, Odense University Hospital, Psychiatric Services in the Region of Southern Denmark, Research Unit of Medical Endocrinology, Department of Clinical Research , University of Southern Denmark , Denmark
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Sanchez-Armass O, Raffaelli M, Andrade FCD, Wiley AR, Noyola ANM, Arguelles AC, Aradillas-Garcia C. Validation of the SCOFF questionnaire for screening of eating disorders among Mexican university students. Eat Weight Disord 2017; 22:153-160. [PMID: 26928282 DOI: 10.1007/s40519-016-0259-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 02/05/2016] [Indexed: 10/22/2022] Open
Abstract
PURPOSE To evaluate the criterion validity and diagnostic utility of the SCOFF, a brief eating disorder (ED) screening instrument, in a Mexican sample. METHODS The study was conducted in two phases in 2012. Phase I involved the administration of self-report measures [the SCOFF and the Eating Disorder Inventory-2, (EDI-2)] to 1057 students aged 17-56 years (M age = 21.0, SD = 3.4; 67 % female) from three colleges at the Universidad Autónoma de San Luis Potosí, Mexico. In Phase II, a random subsample of these students (n = 104) participated in the eating disorder examination, a structured interview that yields ED diagnoses. Analyses were conducted to evaluate the SCOFF's criterion validity by examining (a) correlations between scores on the SCOFF and the EDI-2 and (b) the SCOFF's ability to differentiate diagnosed ED cases and non-cases. RESULTS EDI-2 subscales showed high correlations with the SCOFF scores proving initial evidence of criterion validity. A score of two points on the SCOFF optimized the sensitivity (78 %) and specificity (84 %). With this cutoff, the SCOFF correctly classified over half the cases (PPV = 58 %) and screened out the majority of non-cases (NPV = 93 %) providing further evidence of criterion validity. Analyses were repeated separately for men and women, yielding gender-specific information on the SCOFF's performance. CONCLUSIONS Taken as a whole, results indicated that the SCOFF can be a useful tool for identifying Mexican university students who are at risk of eating disorders.
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Affiliation(s)
- Omar Sanchez-Armass
- School of Psychology, Universidad Autónoma de San Luis Potosí, Carretera Central Km. 424.5, 78494, San Luis Potosí, Mexico.
| | - Marcela Raffaelli
- Department of Human Development and Family Studies, University of Illinois at Urbana-Champaign, 2003 Doris Kelley Christopher Hall, Urbana, IL, 61801, USA
| | - Flavia Cristina Drumond Andrade
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 2011 Huff Hall, 1206 S. Fourth St., Champaign, IL, 6182, USA
| | - Angela R Wiley
- Department of Human Development and Family Studies, University of Illinois at Urbana-Champaign, 2003 Doris Kelley Christopher Hall, Urbana, IL, 61801, USA
| | - Aida Nacielli Morales Noyola
- School of Psychology, Universidad Autónoma de San Luis Potosí, Carretera Central Km. 424.5, 78494, San Luis Potosí, Mexico
| | - Alejandra Cepeda Arguelles
- School of Psychology, Universidad Autónoma de San Luis Potosí, Carretera Central Km. 424.5, 78494, San Luis Potosí, Mexico
| | - Celia Aradillas-Garcia
- School of Medicine, Universidad Autónoma de San Luis Potosí, Avenida Venustiano Carranza No 2405., Col. Los filtros, 7821, San Luis Potosí, Mexico
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Abstract
PURPOSE OF REVIEW Eating disorders are currently not considered to be limited to Western culture. We systematically reviewed the existing literature on the prevalence of eating disorders in Latin America. RECENT FINDINGS Of 1583 records screened, 17 studies from Argentina, Brazil, Chile, Colombia, Mexico, and Venezuela were included in the analysis. Most studies reported point-prevalence rates and only three studies provided lifetime and 12-month prevalence rates. We found a mean point-prevalence rate of 0.1% for anorexia nervosa, 1.16% for bulimia nervosa, and 3.53% for binge-eating disorder (BED) in the general population. Heterogeneity for bulimia nervosa and BED was large. This meta-analysis indicates that the prevalence of anorexia nervosa seems to be lower, whereas the prevalence of bulimia nervosa and especially of BED seems to be higher in Latin America than in Western countries. SUMMARY Our findings show that eating disorders are common mental disorders in Latin America. However, some facets of Latin American culture might be protective for the development of anorexia nervosa and increase the risk for bulimia nervosa and BED. Further studies investigating the epidemiology of eating disorders and their relation to culture in Latin America are needed. VIDEO ABSTRACT SPANISH ABSTRACT.
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Gutiérrez T, Espinoza P, Penelo E, Mora M, González ML, Rosés R, Raich RM. Association of biological, psychological and lifestyle risk factors for eating disturbances in adolescents. J Health Psychol 2016; 20:839-49. [PMID: 26032800 DOI: 10.1177/1359105315577302] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
We aimed to assess the association of several risk factors for eating disturbances in adolescents. Participants were 448 girls and boys aged 12-15 years. Being female, higher body mass index, internalisation of standard of appearance, perfectionism, body dissatisfaction, number of lifetime addictive behaviours and lower self-esteem were associated with higher eating disturbance scores, whereas frequency of sedentary behaviours and physical activity were not (R(2) ⩾ 41%). Findings suggest the need to guide prevention efforts towards the broad spectrum of individual potentially modifiable factors. A non-specific comprehensive perspective may be adequate to prevent problems related to weight, body image and drug use.
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Affiliation(s)
- Teresa Gutiérrez
- Unitat d'Avaluació i Intervenció en Imatge Corporal, Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Spain
| | - Paola Espinoza
- Unitat d'Avaluació i Intervenció en Imatge Corporal, Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Spain
| | - Eva Penelo
- Laboratori d'Estadística Aplicada, Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Spain
| | - Marisol Mora
- Unitat d'Avaluació i Intervenció en Imatge Corporal, Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Spain
| | - Marcela L González
- Unitat d'Avaluació i Intervenció en Imatge Corporal, Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Spain
| | - Rocío Rosés
- Unitat d'Avaluació i Intervenció en Imatge Corporal, Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Spain
| | - Rosa M Raich
- Unitat d'Avaluació i Intervenció en Imatge Corporal, Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Spain
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Zakhem E, El Hage R, Pezé T, Hurdiel R, Zunquin G, Theunynck D. [Factors associated with eating disorders in students of the University of Littoral Côte d'Opale]. Rev Epidemiol Sante Publique 2015; 63:259-65. [PMID: 26143089 DOI: 10.1016/j.respe.2015.04.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Revised: 02/16/2015] [Accepted: 04/08/2015] [Indexed: 10/23/2022] Open
Abstract
AIMS Our study aimed to observe the rate of eating disorders in first year public health students (allied medical and sports) of the University of the Littoral Opal Coast (ULCO) using the SCOFF-F (Sick, Control, One, stone, Fat, Food; French version) questionnaire and to compare morphological characteristics, level of physical condition, level of physical activity and sleep quality. METHODS Overall 642 subjects (459 women and 183 men) aged 22years (20.9±4.9years) participated in this study (Universanté-CEMHaVi). Weight, height, and fat mass were measured, and waist-to-hip ratio and body mass index (BMI) were calculated. The level of physical condition was evaluated using several physical tests: Leger and Boucher (20m) and shuttle run (4×10m), Sargent-test and handgrip strength. The SCOFF-F questionnaire followed by a clinical maintenance conducted by a professional was used to detect eating disorders. Several other questionnaires were used to evaluate the physical activity level; General Practice Assessment Questionnaire (GPAQ) and wellness. Sleep quality index was evaluated using Pittsburgh Sleep Quality Index (PSQI). RESULTS SCOFF-F was positive in 24.2% of women and 10.2% of men. In women, there were no significant differences between those who had a positive SCOFF-F screening and those who had a negative SCOFF-F screening regarding age, height, waist-to-hip ratio, level of physical condition measured and level of physical activity evaluated. However, significant differences were found between women who had a positive SCOFF-F screening and women who had a negative SCOFF-F screening regarding sleep quality, well-being score, BMI and fat mass. In men, significant differences were found between those who had a positive SCOFF-F screening and those who had a negative SCOFF-F screening regarding BMI and fat mass. CONCLUSION This study suggests that in both sexes, having a positive SCOFF-F screening is associated with higher BMI. In women, the increase in BMI and the perturbations in sleep quality and well-being score may indicate bulimia nervosa. The definition of a panel of possible factors associated with eating disorders can help in screening and early detection of eating disorders.
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Affiliation(s)
- E Zakhem
- Département d'éducation physique, faculté des lettres et des sciences humaines, université de Balamand, El-Koura, P.O. Box 100, Tripoli, Liban; URePSSS-EA 4488_E1 ULCO, COMUE Lille Nord-de-France, 59383 Dunkerque cedex 01, France
| | - R El Hage
- Département d'éducation physique, faculté des lettres et des sciences humaines, université de Balamand, El-Koura, P.O. Box 100, Tripoli, Liban.
| | - T Pezé
- URePSSS-EA 4488_E1 ULCO, COMUE Lille Nord-de-France, 59383 Dunkerque cedex 01, France
| | - R Hurdiel
- URePSSS-EA 4488_E1 ULCO, COMUE Lille Nord-de-France, 59383 Dunkerque cedex 01, France
| | - G Zunquin
- URePSSS-EA 4488_E1 ULCO, COMUE Lille Nord-de-France, 59383 Dunkerque cedex 01, France
| | - D Theunynck
- URePSSS-EA 4488_E1 ULCO, COMUE Lille Nord-de-France, 59383 Dunkerque cedex 01, France
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Pustivšek S, Hadžić V, Dervišević E. Risk Factors for Eating Disorders among Male Adolescent Athletes. Zdr Varst 2015; 54:58-65. [PMID: 27646623 PMCID: PMC4820150 DOI: 10.1515/sjph-2015-0008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2014] [Accepted: 11/24/2014] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Eating disorders (ED) are an important and increasing problem in adolescents. The objective of this study was to examine the risk factors and the prevalence of risk for ED among male adolescent elite athletes and nonathletic controls. Differences between male athletes competing in aerobic, anaerobic and aerobic-anaerobic sports were examined as well. METHODS This was a cross-sectional epidemiological study. A cross-sectional questionnaire survey and anthropometric measurements were conducted on 351 adolescents (athletes n = 228; controls n = 123). All participants were aged 15-17 at the time of measuring. Risk for ED was determined using a SCOFF questionnaire. RESULTS The overall prevalence of the risk for ED in male adolescents was 24.8%, with no significant differences among athletes and controls or different subgroups of athletes (p>0.05), although the highest prevalence (37.2%) was registered in aerobic subgroup of athletes. Higher number of attempts to lose weight was associated with increased risk of ED in each group (athletes and controls). Other predictors referred to lack of breakfast and body composition in aerobic subgroup of athletes and number of meals and training frequency in anaerobic subgroup. The most common reasons for dieting were improvement of sport results (19.6-44.2%) and better self-esteem (41.5%) in athletes and controls respectively. CONCLUSIONS Participation in the competitive sport itself is not associated with the increased risk for ED. It seems that risk factors for ED for adolescent athletes competing in aerobic and anaerobic sports represent a subject that deserves consideration and further investigation in the future.
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Affiliation(s)
- Suzana Pustivšek
- University of Ljubljana, Faculty of Sport, Gortanova 22, 1000 Ljubljana, Slovenia
| | - Vedran Hadžić
- University of Ljubljana, Faculty of Sport, Gortanova 22, 1000 Ljubljana, Slovenia
| | - Edvin Dervišević
- University of Ljubljana, Faculty of Sport, Gortanova 22, 1000 Ljubljana, Slovenia
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17
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Veses AM, Gómez-Martínez S, de Heredia FP, Esteban-Cornejo I, Castillo R, Estecha S, García-Fuentes M, Veiga OL, Calle ME, Marcos A. Cognition and the risk of eating disorders in Spanish adolescents: the AVENA and AFINOS studies. Eur J Pediatr 2015; 174:229-36. [PMID: 25074843 DOI: 10.1007/s00431-014-2386-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Revised: 07/17/2014] [Accepted: 07/21/2014] [Indexed: 11/28/2022]
Abstract
UNLABELLED Eating disorders (ED) can arise from a combination of biological and psychological factors. Some studies suggest that intellectual factors might be important in the development of ED, although the evidence is still scarce. The aim of this study was to examine the association between cognition measurements (cognitive performance and academic achievement) and the risk of developing ED in adolescents considering their weight status. The sample consisted of 3,307 adolescents (1,756 girls), aged 13-18.5 years, who participated in the AVENA (n = 1,430; 783 girls) and AFINOS (n = 1,877; 973 girls) studies. Cognitive performance was measured by the TEA test in the AVENA study, and academic achievement was self-reported in the AFINOS study. ED risk was evaluated in both studies by using the SCOFF questionnaire. Body mass index was calculated to classify adolescents as non-overweight or overweight (including obesity). Overweight adolescents showed a higher risk of developing ED than non-overweight ones in both studies. In the AVENA study, overweight boys with low performance in reasoning ability showed increased risk of ED (p = 0.05). In the AFINOS study, overweight boys with low academic performance in physical education and non-overweight girls with low academic achievement in all the areas analyzed showed higher risk of ED than their peers (all p < 0.05). CONCLUSION No association between cognitive performance and ED risk was found in adolescents, while academic achievement was associated with ED risk, especially in non-overweight girls. The non-cognitive traits that accompany academic achievement could influence the likelihood of developing ED in these girls.
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Affiliation(s)
- A M Veses
- Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science and Technology and Nutrition, Spanish National Research Council (CSIC), Madrid, Spain,
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18
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Rueda-Jaimes GE, López PAC, Flórez SM, Martínez-Villalba AMR. [Validity and Reliability of Two Silhouette Scales to Asses the Body Image in Adolescent Students]. ACTA ACUST UNITED AC 2014; 41:101-10. [PMID: 26573472 DOI: 10.1016/s0034-7450(14)60071-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2011] [Accepted: 11/18/2011] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To determine the validity and reliability of the 13-figure images scale (13-CS) and Standard Figural Stimuli (SFS) for the evaluation of body images in adolescent students from Bucaramanga. METHODS A probabilistic sample with 189 students was evaluated with the two scales. Two weeks later, the valuation together with the size, weight, percentage of body fat, SCOFF questionnaire and Rosenberg self-esteem valuation was repeated. RESULTS The average age was 14.1 years; 62.7% were women. The correlation of the 13-CS and SFS with body fat index, weight and body fat percentage was 0.61, 0.74, 0.40 and 0.72, 0.55, 0.45 respectively. The correlation of dissatisfaction with body image according to the SCOFF and the Rosenberg scales was 0.43 and 0.26 with the 13-CS; 0.50 and -0.23 with the SFS. The reproducibility shows that perceived and ideal figure was 0.93 and 0.90 with the 13-CS; and 0.85 and 0.78 with the SFS. CONCLUSION the concurrent validity of both scales was good. The reproducibility of the 13-CS was excellent while the SFS was good.
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Affiliation(s)
- Germán Eduardo Rueda-Jaimes
- Médico, profesor asociado de la Facultad de Ciencias de la Salud y director del Grupo de Neuropsiquiatría, de la Universidad Autónoma de Bucaramanga, Bucaramanga, Colombia.
| | - Paul Anthony Camacho López
- MSc. Investigador invitado. Grupo de Neuropsiquiatría de la Universidad Autónoma de Bucaramanga, Bucaramanga, Colombia
| | - Silvia Milena Flórez
- Médica, egresada de la Universidad Autónoma de Bucaramanga, Bucaramanga, Colombia
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Castro-Piñero J, Carbonell-Baeza A, Martinez-Gomez D, Gómez-Martínez S, Cabanas-Sánchez V, Santiago C, Veses AM, Bandrés F, Gonzalez-Galo A, Gomez-Gallego F, Veiga OL, Ruiz JR, Marcos A. Follow-up in healthy schoolchildren and in adolescents with Down syndrome: psycho-environmental and genetic determinants of physical activity and its impact on fitness, cardiovascular diseases, inflammatory biomarkers and mental health; the UP&DOWN study. BMC Public Health 2014; 14:400. [PMID: 24761982 PMCID: PMC4012062 DOI: 10.1186/1471-2458-14-400] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Accepted: 04/14/2014] [Indexed: 12/25/2022] Open
Abstract
Background An objective diagnosis of sedentary behaviour as well as of the physical activity and fitness levels in youth and to better understand how lifestyle is associated with cardiovascular disease risk factors and other phenotypes is of clinical and public health interest, and might be informative for developing intervention studies focused on the promotion of physical activity in these population. The aim of this methodological paper is to describe the design and assessment in the UP&DOWN study. Methods/Design The UP&DOWN study is a multi-center follow-up design where 2225 Spanish primary and secondary schoolchildren from Cadiz and Madrid, respectively, as well as 110 Spanish adolescents with Down syndrome from Madrid and Toledo were recruited to be assessed. Nine main measurement categories are assessed: i) socio-demographic and early determinants; ii) environmental determinants; iii) physical activity and sedentary behaviour; iv) health-related fitness; v) blood pressure and resting heart rate; vi) mental health; vii) dietary patterns; viii) blood samples; and ix) genetic analysis. During the 3-yr follow-up study, socio-demographic and early determinants, and genetic analysis are only assessed in the first year. Blood sampling is assessed in the first year and the third year (2nd follow-up), and all the other measurements are assessed every year. Discussion The findings of the UP&DOWN study may help the Health Information Systems and policy makers to identify the target population for primary prevention and health promotion policies, and to develop and test preventive strategies. Moreover, these data will allow following the trends at population level, as well as to modify/adapt/create new evidence-based physical activity guidelines at national level. The findings will also serve as a scientific platform for interventional studies.
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Affiliation(s)
- José Castro-Piñero
- Department of Physical Education, School of Education, University of Cádiz, Puerto Real, Spain.
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Cogollo Z, Gómez-Bustamante EM. Health risk behavior pattern among students from Cartagena, Colombia: prevalence and associated variables. Rev Esc Enferm USP 2013; 47:830-5. [PMID: 24310679 DOI: 10.1590/s0080-623420130000400009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2012] [Accepted: 09/10/2012] [Indexed: 11/21/2022] Open
Abstract
The aim of the study was to determine the prevalence and variables associated with the pattern of risky health behavior (PRHB) among adolescent students in Cartagena, Colombia. A cross-sectional study was designed to investigate PRHB in a random cluster sample of students from middle and high schools. The associations were adjusted by logistic regression. A total of 2,625 students participated in this research, with ages from 10 to 20 years, mean=13.8 years (SD=2.0), and 54.3% were women. A total of 332 students reported PRHB (12.7%, 95%CI 11.4-14.0). Age over 15 years (OR=2.19, 95%CI 1.72-2.79), not being heterosexual (OR=1.98, 95%CI 1.36-2.87), poor/mediocre academic performance (OR=1.87, 95%CI 1.47-2.38), family dysfunction (OR=1.78, 95%CI 1.40-2.28) and male gender (OR=1.58, 95%CI 1.24-2.01) were associated with PRHB. One in every eight students presented a PRHB. It is important to pay greater attention to students who are over 15 years of age, male, not heterosexual, with a poor/mediocre academic performance and a dysfunctional family.
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Affiliation(s)
- Zuleima Cogollo
- Research Group on Community Health, Nursing School, University of Cartagena, Cartagena, Colombia,
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A Meta-Analysis of the Diagnostic Accuracy of the SCOFF. SPANISH JOURNAL OF PSYCHOLOGY 2013; 16:E92. [DOI: 10.1017/sjp.2013.92] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractA meta-analysis was conducted to reach a pooled estimate of the diagnostic accuracy of the SCOFF. The 15 selected studies represented a total of 882 cases and 4350 controls. The main criterion for inclusion was that the primary study had provided diagnostic classification with both a diagnostic reference and with the SCOFF (with five items and a cut-off point of two). The pooled estimates were .80 (sensitivity) and .93 (specificity). The moderator variables gender and type of measure for the diagnostic reference (interview versus psychometric tests) account for part of the observed variability. For diagnostic references based on interviews the estimate of the efficacy improves significantly. For the studies that match this criterion the sensitivity is .882 and the specificity .925 (diagnostic odds ratio, 92.19). The main conclusion was that the five questions of the SCOFF constitute a very useful screening tool, in several languages; it is highly recommended for screening purposes.
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Giel KE, Zipfel S, Schweizer R, Braun R, Ranke MB, Binder G, Ehehalt S. Eating disorder pathology in adolescents participating in a lifestyle intervention for obesity: associations with weight change, general psychopathology and health-related quality of life. Obes Facts 2013; 6:307-16. [PMID: 23941969 PMCID: PMC5644671 DOI: 10.1159/000354534] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Accepted: 03/13/2013] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The aim of this study was to identify the prevalence of eating disorder symptoms in obese adolescents participating in a lifestyle intervention for weight loss and to investigate possible relationships with weight change, general psychopathology, and health-related quality of life (HRQOL). METHOD At the beginning and after completion of a 6-month lifestyle intervention, 41 participants (20 females; age: 13.7 ± 1.4 years) reported on core symptoms of eating disorders (SCOFF), self-esteem (Rosenberg Self-Esteem Scale, RSES), and HRQOL (Questionnaire for Measuring Health-Related Quality of Life in Children and Adolescents, KINDL), while parents filled in a questionnaire assessing their children's internalizing and externalizing behavioral problems (Child Behavior Checklist, CBCL). RESULTS Compared to age-matched normative samples, patients showed increased behavior problems and an impaired HRQOL. 43% of the patients were screened positive for an eating disorder pathology, and this subgroup showed an increased psychopathological burden compared to patients that were screened negative. The lifestyle intervention resulted in a significant weight loss which was unaffected by the presence of an eating disorder pathology. The screening rate for eating disorders remained stable after the intervention. CONCLUSION The large overlap, mutual interaction, and high burden of eating and weight problems in children and adolescents underpin the need for an integrated view in both prevention and treatment approaches in pediatric obesity.
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Affiliation(s)
- Katrin E Giel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany.
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Campo-Arias A, Villamil-Vargas M. Riesgo de trastorno del comportamiento alimentario (TCA) en estudiantes de medicina en Colombia*. ACTA ACUST UNITED AC 2012; 41:328-39. [DOI: 10.1016/s0034-7450(14)60008-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Accepted: 04/29/2012] [Indexed: 11/28/2022]
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Hautala L, Helenius H, Karukivi M, Maunula AM, Nieminen J, Aromaa M, Liuksila PR, Räihä H, Välimäki M, Saarijärvi S. The role of gender, affectivity and parenting in the course of disordered eating: a 4-year prospective case-control study among adolescents. Int J Nurs Stud 2011; 48:959-72. [PMID: 21349520 DOI: 10.1016/j.ijnurstu.2011.01.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2010] [Revised: 01/12/2011] [Accepted: 01/28/2011] [Indexed: 10/18/2022]
Abstract
BACKGROUND Prolonged eating disturbances increase the risk for a full-blown eating disorder and lifelong health impairment. Screening will improve early detection of eating pathology, but the major question still remains: who will benefit from early treatment and who needs little or no intervention. To answer this question, information about the factors that predict the course of disordered eating is valuable. OBJECTIVES To investigate the course of eating disturbance from middle to late adolescence, to test certain individual and parental factors potentially explaining the differences in the course of eating disturbance, and to estimate the predictive power of these factors in terms of the recurrence of eating disturbance and the onset of new presentations of eating pathology after mid-adolescence. DESIGN A four-year follow-up study with a case-control design. SETTINGS School health care and community settings in south-western Finland. PARTICIPANTS Students who had reported eating disturbance at baseline (n=208, response rate 69%) and a group of non-symptomatic controls (n=514, response rate 81%) were enrolled and matched by school, grade, and gender. METHODS At baseline assessment, mid-adolescent students (mean age 14.9 years) self-administered the SCOFF eating disorder questionnaire as part of their regular health examination. Background information, including self-reported mood questionnaire RBDI, was obtained from the students' health care records. Four years later, the participants (mean age 19.0 years) responded to the questionnaire by mail. Logistic regression analyses were used to assess the recurrence and onset of eating disturbance and the associated factors. RESULTS Altogether 52% of girls and 17% of boys who reported eating disorder symptoms in the baseline assessment remained symptomatic at follow-up. Depressiveness--even transient--in mid-adolescence predicted recurrence of eating disturbance in late adolescence. Prolonged dissatisfaction with appearance predicted the onset of eating disturbance in previously symptom-free girls. In general, experience of average parenting was good enough for the girls in terms of recovering from eating disturbance and avoiding the onset of eating problems after mid-adolescence. CONCLUSIONS Adolescent girls who report both eating disturbance and negative affectivity may benefit from extra support. The beneficial role that parents may have in helping these girls must not be forgotten.
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Affiliation(s)
- Lea Hautala
- Clinic of Adolescent Psychiatry, University of Turku, Finland.
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Garcia FD, Grigioni S, Allais E, Houy-Durand E, Thibaut F, Déchelotte P. Detection of eating disorders in patients: validity and reliability of the French version of the SCOFF questionnaire. Clin Nutr 2010; 30:178-81. [PMID: 20971536 DOI: 10.1016/j.clnu.2010.09.007] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2010] [Revised: 09/15/2010] [Accepted: 09/20/2010] [Indexed: 11/18/2022]
Abstract
BACKGROUND & AIMS Although eating disorders prevalence is increasing, they are often under diagnosed in cases of unspecific signs of malnutrition. Screening scales may allow earlier diagnosis and nutritional intervention. This study aimed to evaluate the validity of the French version (SCOFF-F) of the SCOFF questionnaire for the detection of eating disorders among a female patient population referred to a clinical nutrition unit. METHODS After answering the 5 dichotomous questions of the paper version of SCOFF-F, patients were evaluated by one eating disorders specialist blinded to questionnaire results, using the MINI and Diagnosis and Statistical Manual for Mental diseases (DSM-IV) criteria as a gold standard. RESULTS Patients with anorexia nervosa (n = 67) and with bulimia nervosa (n = 45) were assessed. Age-matched healthy female students (n = 114) served as control group. At a cut-off of two positive responses, the sensibility, specificity and the area under the curve of SCOFF-F were 94.6%, 94.7% and 97.9% respectively. Cohen's kappa coefficient between SCOFF-F and MINI results was 89%. CONCLUSIONS The results of this study confirm the reliability of SCOFF-F as a screening and diagnostic-facilitating test for eating disorders in a French-speaking female patient population. SCOFF-F should help professionals in clinical nutrition to achieve earlier diagnosis and care of eating disorder patients.
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Affiliation(s)
- Frederico Duarte Garcia
- Nutrition Unit and EA 4311, Biomedical Research Institute & IFR23, University Hospital of Rouen, 76031 Rouen, Cedex, France.
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Ortíz SP, Caro JM, Mesa CLD. Factores de riesgo de los trastornos de la conducta alimentaria en jóvenes escolarizados en Cundinamarca (Colombia)*. ACTA ACUST UNITED AC 2010. [DOI: 10.1016/s0034-7450(14)60253-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Karukivi M, Hautala L, Korpelainen J, Haapasalo-Pesu KM, Liuksila PR, Joukamaa M, Saarijarvi S. Alexithymia and eating disorder symptoms in adolescents. Eat Disord 2010; 18:226-38. [PMID: 20419527 DOI: 10.1080/10640261003719518] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
An increasing amount of evidence indicates an association between alexithymia and eating disorder symptoms. This possible association was evaluated in a non-clinical sample of late adolescents. Seven hundred and twenty nine adolescents completed the questionnaire and formed the final sample. Alexithymia was measured using the 20-item Toronto Alexithymia Scale and eating disorder symptoms were assessed using the SCOFF questionnaire. The rate of alexithymia was 8.2%, without any gender difference. The mean SCOFF scores differed significantly between alexithymic and non-alexithymic subjects, and the share of SCOFF positive subjects was significantly higher among alexithymics. The results suggest that eating disorder symptoms are more common in alexithymic adolescents.
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Affiliation(s)
- Max Karukivi
- Unit of Adolescent Psychiatry, University of Turku, Turku, Finland
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Veiga OL, Gómez-Martínez S, Martínez-Gómez D, Villagra A, Calle ME, Marcos A. Physical activity as a preventive measure against overweight, obesity, infections, allergies and cardiovascular disease risk factors in adolescents: AFINOS Study protocol. BMC Public Health 2009; 9:475. [PMID: 20021690 PMCID: PMC2813851 DOI: 10.1186/1471-2458-9-475] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2009] [Accepted: 12/19/2009] [Indexed: 01/24/2023] Open
Abstract
Background Prior studies addressing the impacts of regular physical activity or sedentary habits on the immune system have been conducted in adults and laboratory settings. Thus, it is practically unknown how a healthy active lifestyle could affect low-grade inflammation processes, infections or allergies in young persons. The AFINOS Study was designed to determine the relationship between the regular physical activity levels of adolescents and overweight, infection, and allergies along with the presence of metabolic and immunological biomarkers of a deteriorated health status. A further objective of the AFINOS Study is to assess the health status and lifestyle habits of an adolescent population in an effort to identify any protective factors that could be used as preventive measures, since many chronic diseases and their associated co-morbidities often persist from adolescence into adulthood. Methods/Design This study was conducted as three separate sub-studies in three different populations as follows: (a) Study 1 was performed on a population sample of adolescents; (b) Study 2 on the adolescents' parents; and (c) Study 3 on a subset of the adolescents from Study 1. Study 1 assessed health and lifestyle indicators through a questionnaire administered to a representative sample of adolescents from the Madrid Region (n = 2400) aged 13 to 16 years. In Study 2, the parents of the teenagers participating in Study 1 were required to fill out a questionnaire. Finally in Study 3, body composition, physical activity, health-related physical fitness, and blood measurements were determined in a subset (n = 200) of the individuals included in Study 1. Discussion This paper describes the rationale, design, and methodologies used in the AFINOS Study. This multidisciplinary, multicenter study seeks to evaluate several aspects of existing relationships between routine physical activity/sedentary behaviour and several health status markers, specifically those related to the immune system. The results of this cross-sectional study will serve for comparisons with the available data obtained in laboratory settings and in adults. In addition, knowledge regarding the health status and lifestyle habits of Spanish adolescents and their parents will be useful for designing preventive measures.
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Affiliation(s)
- Oscar L Veiga
- Department of Physical Education, Sport and Human Movement, Faculty of Teacher Training and Education, Universidad Autónoma de Madrid, Campus de Canto Blanco. Ctra de Colmenar Km 11. E-28049, Madrid, Spain.
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Uncovering hidden eating disorders using the SCOFF questionnaire: Cross-sectional survey of adolescents and comparison with nurse assessments. Int J Nurs Stud 2009; 46:1439-47. [DOI: 10.1016/j.ijnurstu.2009.04.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2009] [Revised: 04/08/2009] [Accepted: 04/20/2009] [Indexed: 11/21/2022]
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Currin L, Schmidt U. A critical analysis of the utility of an early intervention approach in the eating disorders. J Ment Health 2009. [DOI: 10.1080/09638230500347939] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Lähteenmäki S, Aalto-Setälä T, Suokas JT, Saarni SE, Perälä J, Saarni SI, Aro H, Lönnqvist J, Suvisaari JM. Validation of the Finnish version of the SCOFF questionnaire among young adults aged 20 to 35 years. BMC Psychiatry 2009; 9:5. [PMID: 19200401 PMCID: PMC2656502 DOI: 10.1186/1471-244x-9-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2008] [Accepted: 02/08/2009] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We tested the validity of the SCOFF, a five-question screening instrument for eating disorders, in a general population sample. METHODS A random sample of 1863 Finnish young adults was approached with a questionnaire that contained several screens for mental health interview, including the SCOFF. The questionnaire was returned by 1316 persons. All screen positives and a random sample of screen negatives were invited to SCID interview. Altogether 541 subjects participated in the SCID interview and had filled in the SCOFF questionnaire. We investigated the validity of the SCOFF in detecting current eating disorders by calculating sensitivity, specificity, and positive and negative predictive values (PPV and NPV) for different cut-off scores. We also performed a ROC analysis based on these 541 persons, of whom nine had current eating disorder. RESULTS The threshold of two positive answers presented the best ability to detect eating disorders, with a sensitivity of 77.8%, a specificity of 87.6%, a PPV of 9.7%, and a NPV of 99.6%. None of the subjects with current eating disorder scored zero points in the SCOFF. CONCLUSION Due to its low PPV, there are limitations in using the SCOFF as a screening instrument in unselected population samples. However, it might be used for ruling out the possibility of eating disorders.
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Affiliation(s)
- Sini Lähteenmäki
- Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland.
| | - Terhi Aalto-Setälä
- Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland,Helsinki University Central Hospital, Hospital for Children and Adolescents, Department of Adolescent Psychiatry, Helsinki, Finland
| | - Jaana T Suokas
- Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland,Helsinki University Central Hospital, Department of Psychiatry, Helsinki, Finland
| | - Suoma E Saarni
- Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland,Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Jonna Perälä
- Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland
| | - Samuli I Saarni
- Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland
| | - Hillevi Aro
- Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland
| | - Jouko Lönnqvist
- Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland,Helsinki University Central Hospital, Department of Psychiatry, Helsinki, Finland,Department of Psychiatry, University of Helsinki, Helsinki, Finland
| | - Jaana M Suvisaari
- Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland,Department of Social Psychiatry, Tampere School of Public Health, University of Tampere, Tampere, Finland
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Ravens-Sieberer U, Kurth BM. The mental health module (BELLA study) within the German Health Interview and Examination Survey of Children and Adolescents (KiGGS): study design and methods. Eur Child Adolesc Psychiatry 2008; 17 Suppl 1:10-21. [PMID: 19132300 DOI: 10.1007/s00787-008-1002-3] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The BELLA study on mental health and well-being in children and adolescents is the mental health module of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). The cross-sectional KiGGS survey collected comprehensive data on the health status of 17,641 children and adolescents, aged 0-17 years, living in Germany. The survey included physical examinations and tests, questionnaires filled in by parents and equivalent questionnaires for children aged 11 years or older. A computer-assisted personal interview was conducted by study physicians, and various laboratory tests, e.g. on blood and urine samples, were performed. The longitudinal BELLA study collected initial cross-sectional data from a representative KiGGS sub-sample of families with children aged 7-17 years. Of the 4,199 randomly selected families invited to participate in the BELLA study, 2,863 took part. A total of 48.5% of the participating children and adolescents were girls, 51.5% were boys. Within the BELLA study, trained interviewers conducted standardised telephone interviews with one parent and also the child, if it was at least 11 years old. Afterwards the families received additional questionnaires. The interviews and questionnaires included various standardised and ICD-10-oriented instruments examining overall mental health problems and associated burden, depression, anxiety, attention deficit-/hyperactivity and conduct disorders. Furthermore they covered a broad spectrum of aspects related to mental health and well-being, such as risk and protective factors and health-related quality of life. An analysis of the non-responders showed that the families who agreed to participate form a representative sample with respect to the German population. The sample deviated only slightly from the KiGGS sample structure regarding socioeconomic status and regarding parent-reported mental health problems. No such difference was observed for the children's self-reported mental health. A weighting procedure was applied to correct for deviations from the sociodemographic and socioeconomic structure of the target population.
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Affiliation(s)
- Ulrike Ravens-Sieberer
- Department of Psychosomatics in Children and Adolescents, Center for Obstetrics and Paediatrics, University Clinic Hamburg-Eppendorf, Martinistrasse 52, W29, 20246, Hamburg, Germany.
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Herpertz-Dahlmann B, Wille N, Hölling H, Vloet TD, Ravens-Sieberer U. Disordered eating behaviour and attitudes, associated psychopathology and health-related quality of life: results of the BELLA study. Eur Child Adolesc Psychiatry 2008; 17 Suppl 1:82-91. [PMID: 19132307 DOI: 10.1007/s00787-008-1009-9] [Citation(s) in RCA: 100] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To identify disordered eating behaviour and attitudes in a large representative population in order to determine the relationship with body weight status, and to assess associated psychopathology and health-related quality of life. METHODS A total of 11-17 year-old adolescents (n=1,895) were randomly selected from the national representative sample of 17,641 families participating in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Weight and height were assessed by trained staff. Mental health problems and health-related quality of life were examined by means of a telephone interview and different questionnaires. Eating disordered behaviour and attitudes were identified by the SCOFF, an instrument consisting of five questions originally developed to screen for eating disorders in clinical settings. RESULTS About one third of the girls and 15% of the boys reported disordered eating behaviour and attitudes, which were most prevalent in overweight youth. There was a significant association between the presence of disordered eating behaviour and psychopathology, which was comprised of internalising and externalising behavioural problems. In addition, adolescents with disordered eating behaviour reported reduced quality of life. CONCLUSION The high prevalence of disordered eating in the general population of Germany is of great concern. Health professionals should not only be aware of disordered eating in underweight adolescents, but in all youth, especially overweight individuals. Disordered eating behaviour is associated with a wide range of psychopathological and psychosocial concerns. Thus, youngsters engaging in disordered eating behaviour should also be explored for other serious mental or social problems.
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Affiliation(s)
- Beate Herpertz-Dahlmann
- Department of Child and Adolescent Psychiatry, University Hospital Aachen, Technical University, 52074, Aachen, Germany.
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Hautala LA, Junnila J, Helenius H, Väänänen AM, Liuksila PR, Räihä H, Välimäki M, Saarijärvi S. Towards understanding gender differences in disordered eating among adolescents. J Clin Nurs 2008; 17:1803-13. [DOI: 10.1111/j.1365-2702.2007.02143.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Kaluski DN, Natamba BK, Goldsmith R, Shimony T, Berry EM. Determinants of disordered eating behaviors among Israeli adolescent girls. Eat Disord 2008; 16:146-59. [PMID: 18307114 DOI: 10.1080/10640260801887303] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Eating behaviors were assessed by a modified SCOFF questionnaire in a National representative cross-sectional study among 2978 Israeli schoolgirls. The mean age was 14.7. Thirty percent met the criteria for disordered eating. Being Jewish or underweight reduced the odds for disordered eating. The following increased the risk: dieting, early onset of menarche, being overweight or obese, and suffering from constipation. School socio-economic status, physical activity, and smoking status were not contributory. These results help identify possible interventions to prevent the development of disordered eating behaviors.
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Muro-Sans P, Amador-Campos JA, Morgan JF. The SCOFF-c: psychometric properties of the Catalan version in a Spanish adolescent sample. J Psychosom Res 2008; 64:81-6. [PMID: 18158003 DOI: 10.1016/j.jpsychores.2007.06.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2006] [Revised: 05/22/2007] [Accepted: 06/07/2007] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The objective of this study is to validate the Catalan version of the SCOFF questionnaire with a community sample of adolescents. METHOD This study used a community sample of 954 participants (475 girls and 479 boys; aged between 10.9 and 17.3 years and from the city of Barcelona) and a risk group of 78 participants (35 men and 43 women; derived from the community sample) that have exceeded > or =95 percentile in at least two of the three scales of the Eating Disorders Inventory-2 (EDI-2): Drive for Thinness, Bulimia, and Body Dissatisfaction. RESULTS There were significant differences in total SCOFF scores across gender and school grades. The SCOFF best cutoff point was 2 (sensitivity=73.08%; specificity=77.74%). Concurrent validity with the EDI-2 varied between low and moderate. The reliability of the SCOFF questionnaire was moderate. Exploratory factor analysis of the SCOFF questionnaire showed a two-factor structure for the total sample and for girls, and one factor for boys. CONCLUSION The best cutoff point for this community sample is 2. The data suggest that the SCOFF questionnaire could be a useful screening questionnaire to enable the detection of groups possibly at risk for eating disorders among adolescent Spanish community samples.
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Affiliation(s)
- Pilar Muro-Sans
- Departament de Personalitat, Avaluació i Tractament Psicològic, Facultat de Psicologia, Universitat de Barcelona, Barcelona, Spain
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González-Juárez C, Pérez-Pérez E, Martín Cabrera B, Mitja Pau I, Roy de Pablo R, Vázquez de la Torre Escalera P. [Detection of adolescents at risk of suffering eating disorders]. Aten Primaria 2007; 39:189-94. [PMID: 17428423 PMCID: PMC7664523 DOI: 10.1157/13100842] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2006] [Accepted: 10/18/2006] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES To analyse which risk factors are related to eating disorders and to identify useful questions for their early detection in primary care. DESIGN Observational, cross-sectional study. SETTING Six secondary schools in Leganés, Madrid, Spain. PARTICIPANTS Adolescents aged between 12 and 18 years old attending secondary school. MAIN MEASUREMENTS Risk of suffering an eating disorder (Eating Attitudes Test-26) and questions about weight, height, family, attitudes towards body image, use of health services for eating disorders, and mental illness history. RESULTS An 8.8% of the adolescents were at risk of developing an eating disorder (4.6% male; 11.8% female). Age in males (OR=0.76) and 24-hour fasting to lose weight (OR for males =7.44; OR for females =3.09) were associated with the risk of eating disorders. Early menarche (OR=1.69), having dieted for social or environmental reasons, and self-induced vomiting (OR=5.71) were associated with eating disorders in women. The specificity and negative predictive value of asking about self-induced vomiting and 24-hour fasting in order to detect an eating disorder were around 95%. CONCLUSIONS Age is a protective factor for eating disorders, especially in males. In women, early menarche is a risk factor. Asking about self-induced vomiting and 24-hour fasting enables eating disorders in women to be ruled out.
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Cook SJ, MacPherson K, Langille DB. Far from ideal: weight perception, weight control, and associated risky behaviour of adolescent girls in Nova Scotia. CANADIAN FAMILY PHYSICIAN MEDECIN DE FAMILLE CANADIEN 2007; 53:678-84. [PMID: 17872719 PMCID: PMC1952598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
OBJECTIVE To examine the prevalence of weight-related concerns, unhealthy weight-control behaviour, and associated risky behaviour among adolescent girls, and to ascertain whether these girls had discussed a healthy weight with their physicians. DESIGN Anonymous, self-report, cross-sectional survey. SETTING Four high schools in rural Nova Scotia. PARTICIPANTS Adolescent girls in grades 10 to 12. MAIN OUTCOME MEASURES Weight perception, prevalence of weight-control behaviour, associations between weight perception and risky behaviour, associations between disordered eating behaviour and other risky behaviour. RESULTS Overall response rate was 76%. Half the 1133 participants saw themselves as not being the "right" weight; 60% were trying to lose weight. During the past 30 days, 16% of the girls were attempting to control or lose weight and had engaged in disordered eating behaviour. In univariate analysis, perception of being either overweight or underweight was significantly associated with suicidal thoughts, suicide planning, and risk of depression. In multivariate analysis, positive associations were found between disordered eating behaviour and suicidal thoughts (odds ratio [OR] 4.2, 95% confidence interval [CI] 2.6 to 6.7), suicide planning (OR 2.9, 95% CI 1.7 to 4.7), suicide attempts (OR 3.4, 95% CI 1.8 to 6.6), and ever having had vaginal intercourse (OR 1.6, 95% CI 1.1 to 2.5). Only 22% of respondents had spoken with a doctor about a healthy weight. CONCLUSION Weight concerns are prevalent among adolescent girls in Nova Scotia. Many of them, especially those who see themselves as overweight or underweight, engage in unhealthy weight-control methods. Perceived underweight and overweight and disordered eating behaviour have strong associations with depression and self-harming behaviour. Few participants had discussed a healthy weight with a physician. Health professionals should be aware of the associations between weight perception and disordered eating behaviour and other risky behaviour.
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