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Barnhart WR, Cui T, Zhang H, Cui S, Zhao Y, Lu Y, He J. Examining an integrated sociocultural and objectification model of thinness- and muscularity-oriented disordered eating in Chinese older men and women. Int J Eat Disord 2023; 56:1875-1886. [PMID: 37386889 DOI: 10.1002/eat.24017] [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: 01/07/2023] [Revised: 06/19/2023] [Accepted: 06/19/2023] [Indexed: 07/01/2023]
Abstract
OBJECTIVE We tested an integrated model of three prominent theories of disordered eating (tripartite influence theory, objectification theory, and social comparison theory) in a sample of older Chinese men and women. METHOD Chinese older men (n = 270) and women (n = 160) completed questionnaires assessing the tripartite influence, objectification, and social comparison theories and thinness- and muscularity-oriented disordered eating. Two structural equation models were tested in Chinese older men and women. RESULTS The integrated model showed good model fit and described meaningful variance in thinness- and muscularity-oriented disordered eating in Chinese older men and women. Higher appearance pressures were uniquely related to higher muscularity-oriented disordered eating in men. Across both gender groups, higher thinness internalization was uniquely related to higher thinness- and muscularity-oriented disordered eating, and in women only, higher muscularity internalization was uniquely related to lower thinness-oriented disordered eating. In men, higher upward and downward body image comparisons were uniquely related to higher and lower, respectively, muscularity-oriented disordered eating. In women, higher upward body image comparisons were only uniquely related to higher muscularity-oriented disordered eating while higher downward body image comparisons were uniquely related to both outcomes. Higher body shame was uniquely related to higher thinness-oriented disordered eating across both groups and in men alone, higher body shame was also uniquely related to higher muscularity-oriented disordered eating. DISCUSSION Findings, which tested the integration of tripartite influence, objectification, and social comparison theories, inform the prevention and treatment of disordered eating in Chinese older populations. PUBLIC SIGNIFICANCE The present study is the first to describe theories of disordered eating (tripartite influence, objectification, and social comparison) in Chinese older adults. Findings suggested good model fit and the integrated models described meaningful variance in thinness- and muscularity-oriented disordered eating in Chinese older women and men. Findings extend existing theories of disordered eating and, pending further study, may inform theory-driven prevention and treatment approaches in Chinese older adults.
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Affiliation(s)
- Wesley R Barnhart
- Department of Psychology, Bowling Green State University, Bowling Green, Ohio, USA
| | - Tianxiang Cui
- Department of Psychology, University of Macau, Macau, China
| | - Hengyue Zhang
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, China
| | - Shuqi Cui
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, China
| | - Yiqing Zhao
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, China
| | - Yining Lu
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, China
| | - Jinbo He
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, China
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Lengvenyte A, Strumila R, Maimoun L, Seneque M, Olié E, Lefebvre P, Renard E, Courtet P, Guillaume S. A specific association between laxative misuse and suicidal behaviours in patients with anorexia nervosa and bulimia nervosa. Eat Weight Disord 2022; 27:307-315. [PMID: 33797033 DOI: 10.1007/s40519-021-01180-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 03/22/2021] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE Eating disorders (ED) are associated with an in increased risk of suicidal behaviours. Laxative abuse might alter the gut-brain axis signaling, that might be implicated in the pathophysiology of suicide. This study aims to determine the association between laxative misuse and suicide attempt (SA) and suicidal ideation (SI) in patients with ED. METHODS 277 patients with ED were recruited from an Eating Disorder Unit of Lapeyronie Academic Hospital, Montpellier, France. Sociodemographic and clinical data were collected. Chi-square and t test were used, with Bonferroni corrections where required. Multiple regression models assessed the relationships between laxative misuse, SA, and SI. RESULTS 62 (22.4%) patients reported lifetime laxative misuse. They were more likely to have a history of SA than non-misusers [43.83 vs 19.9%, p < 0.001, odds ratio (OR) 3.68]. In the multivariate model, adjusted for other confounders, lifetime laxative misuse remained associated with SA (adjusted OR 3.79, p = 0.041). In past 28 days, patients with SA history reported misusing laxatives for more days than patients without SA history (6 vs 1.5 days, p = 0.01, adjusted for vomiting and ED severity). Laxative use days during past 28 days was associated with current SI, adjusted for vomiting in the same period (p = 0.017). CONCLUSIONS Current and lifetime laxative misuse were associated with SA history and current SI in patients with ED, at least in part independently of other suicide-related factors. LEVEL OF EVIDENCE Level III cohort, cross-sectional study.
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Affiliation(s)
- Aiste Lengvenyte
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, 371 Av. du Doyen Gaston Giraud, 34090, Montpellier, France
- Department of Urgent and Post Urgent Psychiatry, CHU Montpellier, 371 Av. du Doyen Gaston Giraud, 34090, Montpellier, France
- Faculty of Medicine, Institute of Clinical Medicine, Psychiatric Clinic, Vilnius University, Vilnius, Lithuania
| | - Robertas Strumila
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, 371 Av. du Doyen Gaston Giraud, 34090, Montpellier, France.
- Department of Urgent and Post Urgent Psychiatry, CHU Montpellier, 371 Av. du Doyen Gaston Giraud, 34090, Montpellier, France.
- Faculty of Medicine, Institute of Clinical Medicine, Psychiatric Clinic, Vilnius University, Vilnius, Lithuania.
| | - Laurent Maimoun
- PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France
- Département de Médecine Nucléaire, Hôpital Lapeyronie, Centre Hospitalier Régional Universitaire (CHRU) Montpellier, 34295, Montpellier, France
| | - Maude Seneque
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, 371 Av. du Doyen Gaston Giraud, 34090, Montpellier, France
- Department of Urgent and Post Urgent Psychiatry, CHU Montpellier, 371 Av. du Doyen Gaston Giraud, 34090, Montpellier, France
| | - Emilie Olié
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, 371 Av. du Doyen Gaston Giraud, 34090, Montpellier, France
- Department of Urgent and Post Urgent Psychiatry, CHU Montpellier, 371 Av. du Doyen Gaston Giraud, 34090, Montpellier, France
| | - Patrick Lefebvre
- Department of Endocrinology, Diabetes, and Nutrition, CHRU Montpellier, Montpellier, France
| | - Eric Renard
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, 371 Av. du Doyen Gaston Giraud, 34090, Montpellier, France
- UMR CNRS 5203, INSERM U1191, Institute of Functional Genomics, University of Montpellier, Montpellier, France
| | - Philippe Courtet
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, 371 Av. du Doyen Gaston Giraud, 34090, Montpellier, France
- Department of Urgent and Post Urgent Psychiatry, CHU Montpellier, 371 Av. du Doyen Gaston Giraud, 34090, Montpellier, France
| | - Sebastien Guillaume
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, 371 Av. du Doyen Gaston Giraud, 34090, Montpellier, France
- Department of Urgent and Post Urgent Psychiatry, CHU Montpellier, 371 Av. du Doyen Gaston Giraud, 34090, Montpellier, France
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Lie SØ, Bulik CM, Andreassen OA, Rø Ø, Bang L. Stressful life events among individuals with a history of eating disorders: a case-control comparison. BMC Psychiatry 2021; 21:501. [PMID: 34645394 PMCID: PMC8513319 DOI: 10.1186/s12888-021-03499-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 09/24/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Experiencing stressful life events (SLEs) can negatively impact mental health and increase risk for psychiatric disorders including eating disorders (EDs). Previous research has shown that childhood sexual abuse is associated with some EDs, but less is known about the association between other non-sexual SLEs and EDs. METHOD A case-control study of individuals with (n = 495, age mean ± SD = 29.1 ± 9.8 years) and without (n = 395, age = 30.2 ± 11.7) self-reported lifetime history of EDs was conducted to compare history of self-reported SLEs. Participants reported history of sexual (e.g., rape, other sexual assault) and non-sexual (e.g., emotional abuse, assault, bereavement) life events using an adaptation of the Stressful Life Events Screening Questionnaire. Individuals with EDs were divided into ED subtypes along the restricting - binge eating/purging spectrum to examine subtype differences. Logistic regressions were conducted for each SLE and ED subtype to obtain odds ratios (ORs). We report p-values corrected for multiple comparisons. RESULTS Exposure to any SLE was significantly more common in individuals with EDs than in controls (OR = 2.47, p < .001). Specifically, rape, other sexual assault, and emotional abuse were significantly more common among individuals with a history of binge-eating/purging ED subtypes (ORs = 2.15-3.58, p's < .01) compared with controls. Furthermore, history of life-threatening disease and loss of a close relative/partner/friend were associated with some ED subtypes. The association between SLEs and EDs was stronger for individuals who had experienced multiple SLEs. CONCLUSION By investigating a range of different SLEs, we showed that both sexual and non-sexual SLEs were more common in individuals with a history of EDs (binge-eating/purging subtypes) than controls. Results highlight the importance of assessing a variety of past SLEs in risk assessment for different EDs.
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Affiliation(s)
- Selma Ø. Lie
- grid.55325.340000 0004 0389 8485Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway ,grid.5510.10000 0004 1936 8921Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Cynthia M. Bulik
- grid.4714.60000 0004 1937 0626Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden ,grid.10698.360000000122483208Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC USA ,grid.10698.360000000122483208Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - Ole A. Andreassen
- grid.5510.10000 0004 1936 8921NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway ,grid.55325.340000 0004 0389 8485Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Øyvind Rø
- grid.55325.340000 0004 0389 8485Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway ,grid.5510.10000 0004 1936 8921Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Lasse Bang
- grid.55325.340000 0004 0389 8485Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway ,grid.418193.60000 0001 1541 4204Norwegian Institute of Public Health, Oslo, Norway
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Hayes S, Linardon J, Kim C, Mitchison D. Understanding the relationship between sexual harassment and eating disorder psychopathology: A systematic review and meta-analysis. Int J Eat Disord 2021; 54:673-689. [PMID: 33751633 DOI: 10.1002/eat.23499] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 02/14/2021] [Accepted: 02/15/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The experience of sexual harassment (SH) may exacerbate the drive toward an ideal and often unattainable physical appearance, creating the foundation of unhealthy eating, and greater shape and weight concerns. This systematic review aimed to synthesize evidence on the relationship between SH and eating disorder psychopathology, as well as mediating and moderating factors that contribute to this relationship. METHOD Six key databases were searched from inception to August 2020; including CINAHL, PsycInfo, PubMed, Medline, Scopus, and Web of Science. RESULTS Overall, 15 studies meeting inclusion criteria were found, with 14 reporting a statistically significant relationship between SH and eating disorder psychopathology. A meta-analysis with 12 cross-sectional studies confirmed a small but significant effect for this concurrent association. Moderators of this relationship included gender, posttraumatic stress, and anxiety. No studies in this review conducted true mediation. DISCUSSION Conclusions about causal and mediating relationship between SH and eating disorder psychopathology are constrained by the preponderance of cross-sectional design (14 of the 15 studies). Therefore, it is recommended that future studies focus on the use of longitudinal design, and also on adolescent populations, where first experiences of SH are usually reported, and which is also the peak age of onset for eating disorders.
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Affiliation(s)
- Samantha Hayes
- School of Psychology, Western Sydney University, Sydney, New South Wales, Australia
| | - Jake Linardon
- School of Psychology, Deakin University, Burwood, Victoria, Australia
| | - Christina Kim
- School of Medicine, Western Sydney University, Sydney, New South Wales, Australia
| | - Deborah Mitchison
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, New South Wales, Australia.,Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
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The relationship between eating disorder psychopathology and sexuality: etiological factors and implications for treatment. Curr Opin Psychiatry 2020; 33:554-561. [PMID: 32858598 DOI: 10.1097/yco.0000000000000646] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE OF REVIEW There is a remarkable overlap between eating disorders and sexual problems, both in terms of sexual dysfunctions and risky sexual behaviors. This systematic review of the recent literature aimed at clarifying the nature of this relationship in terms of psychopathological meaning. RECENT FINDINGS Body image disturbance, and particularly body dissatisfaction and embodiment disorder, emerged as shared psychopathological dimensions between eating disorder symptoms and sexual dysfunctions. Interpersonal difficulties, a disturbed intimacy and insecure attachment style, but not a history of sexual abuse per se, resulted to play a pivotal role in the interconnection between eating disorder psychopathology and sexual dysfunctions. On the other hand, several studies confirmed the association between eating disorder symptoms and risky sexual behaviors, which has been explained in terms of several common psychopathological dimensions, including impulsivity and addiction. SUMMARY Sexuality is deeply interconnected with eating disorder psychopathology, and it should be considered a fundamental aspect in managing these disorders. An accurate assessment of sexual function might allow to characterize etiological information (e.g., sexual abuse) and maintaining factors (embodiment disorder and emotion dysregulation). Accordingly, the recovery of a good sexuality should be considered a crucial signal of recovery.
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Bastiani F, Romito P, Saurel-Cubizolles MJ. Mental distress and sexual harassment in Italian university students. Arch Womens Ment Health 2019; 22:229-236. [PMID: 29982947 DOI: 10.1007/s00737-018-0886-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 06/25/2018] [Indexed: 11/27/2022]
Abstract
Only a few studies have analyzed the association between sexual harassment (SH) and mental health controlling for other types of violence. The aim of this study was to describe SH among male and female university students and analyze the association between harassment and mental distress controlling for sexual violence. An observational survey was conducted at Trieste University (Italy). Students answered an anonymous questionnaire about harassment that included three domains-sexual harassment, gender harassment, cyber harassment-and three psychological health indicators. The global harassment index was computed, with three levels: 0, no harassment; level 1, harassment in at least one of the three domains; and level 2, harassment in two or three domains. The symptoms of mental distress were measured by the 12-item General Health Questionnaire (GHQ) for depressive symptoms; a question about panic symptoms; and a question about general health. The sample included 759 students (412 women; 18 to 29 years old). After adjustment for age, birth country, couple relationship, employment status, mother's education, and previous sexual violence, the risk of mental distress was increased with harassment exposure. Men were affected in perceived health and depressive symptoms (GHQ score ≥ 6); women were affected in panic symptoms. Harassment has a strong negative impact on the mental health of victims; in some cases, men may be more affected than women. Clinicians should be aware of the negative impact of SH also on men.
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Affiliation(s)
- Federica Bastiani
- Department of Life Sciences-Psychology Unit, University of Trieste, Via Weiss, 2, 34128, Trieste, Italy.
| | - Patrizia Romito
- Department of Life Sciences-Psychology Unit, University of Trieste, Via Weiss, 2, 34128, Trieste, Italy
| | - Marie-Josephe Saurel-Cubizolles
- INSERM UMR 1153-Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé) Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in pregnancy, Paris Descartes University, Hôpital Tenon, 4, rue de la Chine, 75970, Paris Cedex 20, France
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Romito P, Cedolin C, Bastiani F, Beltramini L, Saurel-Cubizolles MJ. Sexual harassment and menstrual disorders among Italian university women: A cross-sectional observational study. Scand J Public Health 2017; 45:528-535. [PMID: 28566013 DOI: 10.1177/1403494817705559] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIMS Menstrual disorders and sexual harassment are common among young women and interfere with their life and activities. We aimed to describe the association of sexual harassment and menstrual disorders among female university students. METHODS This cross-sectional, observational study examined the association between sexual harassment and menstrual disorders in a sample of 349 university students in Italy. Students answered an anonymous self-administered questionnaire. Descriptive bivariate analyses and logistic regression analyses were performed. Main outcome measures were associations between levels of exposure to sexual harassment (none, levels 1 and 2) and five menstrual disorders (premenstrual symptoms, heavy bleeding, pain, irregular cycles, and amenorrhea). RESULTS Among the women interviewed (mean age 20.4 ± 1.45 years), 146 (41.8%) had experienced sexual harassment in the previous 12 months: 91 (26.1%) level 1 and 55 (15.7%) level 2. The frequency of premenstrual symptoms was 31.9% ( n=110); heavy bleeding, 35.3% ( n=124); pain, 51.4% ( n=181); irregular cycles, 55.5% ( n=195); and amenorrhea, 6.7% ( n=23). After adjustment for age, place of birth, being in a couple relationship and receiving hormone therapy, the frequency of menstrual disorders, except for amenorrhea, was increased with sexual harassment, with a regular gradient from no harassment to level 2 harassment. Introducing factors of depression, specific gynaecological problems and lifetime sexual violence did not change the results. For instance, the adjusted odds ratios of premenstrual symptoms were 2.10 [1.19-3.68] for women with level 1 harassment and 3.58 [1.83-7.03] for women with level 2 compared with women without harassment exposure. CONCLUSIONS Sexual harassment is related to the prevalence of menstrual disorders. Healthcare providers should encourage dialogue with patients and address the issue of sexual violence or harassment.
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Affiliation(s)
- P Romito
- 1 Department of Life Sciences - Psychology Unit, University of Trieste, Trieste, Italy
| | - C Cedolin
- 1 Department of Life Sciences - Psychology Unit, University of Trieste, Trieste, Italy
| | - F Bastiani
- 1 Department of Life Sciences - Psychology Unit, University of Trieste, Trieste, Italy
| | - L Beltramini
- 1 Department of Life Sciences - Psychology Unit, University of Trieste, Trieste, Italy
| | - M J Saurel-Cubizolles
- 2 INSERM UMR 1153 - Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Center for Epidemiology and Statistics, Sorbonne Paris Cité, DHU Risks in pregnancy, Paris Descartes University, Hôpital Tenon, Paris, France
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Body dissatisfaction, excessive exercise, and weight change strategies used by first-year undergraduate students: comparing health and physical education and other education students. J Eat Disord 2017; 5:10. [PMID: 28392918 PMCID: PMC5376693 DOI: 10.1186/s40337-016-0133-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 12/18/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Health and Physical Education (HPE) teachers are known to be under social-, personal-, and employment-related pressure to be and appear physically fit, and to use dangerous dieting and weight control practices. This is problematic due to the influence this may have on their own health and the potential to model these attitudes and behaviours to their future students. METHODS In this paper, we compare the body image, dieting, disordered eating, and exercise behaviours of first year, HPE, and non-HPE, teacher education students. Participants were 596 first-year university student pre-service teachers (n = 249 HPE and n = 347 non-HPE) from three universities in Australia who completed self-report questionnaires. Analysis of covariance and logistic regression analyses were used to determine differences in attitudes and behaviours between these two groups for males and females separately. RESULTS We found that male HPE participants had significantly higher levels of drive for muscularity and obligatory exercise, and were more likely to be classified as having an exercise disorder, dieting, and using steroids than non-HPE students were. Female HPE students were more likely to engage in self-reported excessive exercise, to have higher scores on the Obligatory Exercise Questionnaire, and be classified as having an exercise disorder. CONCLUSION These findings are important as they confirm the presence of dieting and disordered eating attitudes and behaviours among all teacher education students, and highlight male HPE teachers as a potentially vulnerable group. These results may inform the implementation of intervention programs for teacher education students to ensure their personal wellbeing and professional capacity in promoting positive body image, nutrition, and physical activity among young people.
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