[Validation of an eating attitude scale in a French-speaking Quebec population]

Weight-control behaviour and weight-concerns in young elite athletes - a systematic review

Weight-control behaviour is commonly observed in a wide range of elite sports, especially leanness sports, where control over body weight is crucial for high peak performance. Nonetheless, there is only a fine line between purely functional behaviour and clinically relevant eating disorders. Especially the rapid form of weight manipulation seems to foster later eating disorders. So far, most studies have focussed on adult athletes and concentrated on manifest eating disorders. In contrast, our review concentrates on young athletes and weight-control behaviour as a risk factor for eating disorders. An electronic search according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) Statement was performed using Pubmed, PsychInfo and Spolit. The following search terms were used: weight-control, weight-control behaviour, weight gain, weight loss, pathogenic weight-control behaviour and weight-concerns, each of them combined with elite athlete, young elite athlete, adolescent elite athlete and elite sports. Overall, data are inconsistent. In general, athletes do not seem to be at a higher risk for pathogenic weight concerns and weight-control behaviour. It does seem to be more prevalent in leanness sports, though. There is evidence for pathogenic weight-control behaviour in both genders; male athletes mostly trying to gain weight whereas females emphasise weight reduction. There is not enough data to make predictions about connections with age of onset. Young elite athletes do show weight-control behaviour with varying degrees of frequency and severity. In particular, leanness sports seem to be a risk factor for weight manipulation. Further research is needed for more details and possible connections.

Prognostic value of early therapeutic alliance in weight recovery: a prospective cohort of 108 adolescents with anorexia nervosa

PURPOSE

To determine whether patients' perception of early therapeutic alliance (TA) could predict time to achieve a target weight among adolescents undergoing treatment for anorexia nervosa.

METHOD

TA was assessed in a prospective cohort recruited from both inpatient and outpatient settings by self-administered and validated questionnaires. Kaplan-Meier survival curves were compared by log rank test, and Cox regression was used to test whether patients' perception of early TA predicted time to achieve a target weight.

RESULTS

In total, 108 patients were included, and 79.6% achieved a target weight. Better patient perception of early TA increased the hazard ratio (HR) of achieving a target weight (HR = 2.7, 95% confidence interval: 1.7-4.4, p < .001) such as being in the inpatient setting by 6.7. Being very severely underweight at admission decreased the HR of achieving the target weight.

CONCLUSION

Patients' perception of early TA is a good predictor of achieving a target weight. Because TA is a modifiable construct, it could be a target for intervention.

Body image distortion change during inpatient treatment of adolescent girls with restrictive anorexia nervosa

Body image distortion is one core symptom of anorexia nervosa. However, little is known concerning its fluctuation over time. This paper pursues two objectives: (1) to assess body image distortion change during inpatient treatment of adolescent girls with restrictive anorexia nervosa (n=10), and (2) to identify associations between this change and the change observed to other measures of eating and weight-related disorders. A Quantification of Body Image Distortion computerized tool (Q-BID) and paper-and-pencil questionnaires were used at both beginning and end of inpatient treatment. Pearson correlations and linear regression analyses were conducted to identify associations between body image distortion change and the change observed to other measures of eating and weight-related disorders. The results indicate that all adolescents experienced a body image distortion change. This change corresponds to a body image distortion decrease for 70% of them. The body image distortion change measure was highly correlated with the change observed in the score to the Eating Attitude Test (EAT-26) and to the Eating Disorder Examination Questionnaire (EDEQ-4) during the inpatient treatment. These two measures of change indeed explained 88.4% of the body image distortion change variance in the multivariate model. We concluded that the Q-BID is an interesting tool for the assessment of body image distortion change. More research is needed concerning the correlates of this outcome in order to elaborate appropriate interventions for both clinical and community settings.

The effects of social relationships and acceptance on disturbed eating attitudes in elite adolescent female athletes: the mediating role of physical self-perceptions

OBJECTIVE

The purpose of the study was to examine the effects of social relationships (i.e., coach, friends, and parents) and acceptance (i.e., peers) on disturbed eating attitudes (DEAs) in elite adolescent female athletes, through the mediating role of physical self-perception (i.e., perceived physical appearance and perceived physical ability).

METHOD

The sample comprised 227 elite adolescent female athletes (M(age) = 15.75; SD(age) = 3.00) engaged in various esthetic sports. The data was analyzed using structural equation modeling method and mediation analysis.

RESULTS

They showed that peer acceptance and quality of parent-athlete relationships have a significant negative influence on DEA in elite adolescent female athletes. Moreover, the quality of relationship with the coach and sport friend has a significant positive influence on DEA in female athletes through the mediating role of perceived physical ability.

DISCUSSION

The quality of relationship with parents and peer acceptance would be a protective factor regarding DEA, whereas the quality of relationships with coach and friend in sport would be risk factors for the development of DEA in adolescent female athletes through the mediating role of perceived physical ability. Recommendations for future use of, and research on, activities are outlined. The effects of social relationships and acceptance on DEA in elite adolescent female athletes: the mediating role of physical self-perceptions.

The body image avoidance questionnaire: assessment of its construct validity in a community sample of French adolescents

BACKGROUND

Among the few instruments used to measure the behavioral component of body image disturbances, the Body Image Avoidance Questionnaire (BIAQ) is the most widely used. Despite the wide utilization of this instrument, it is currently unknown whether it is appropriate for male and female adolescents from middle and junior high schools.

PURPOSE

The main objective of the present series of studies was to test the construct validity of the BIAQ in a community sample of French adolescents.

METHOD

The content, factor, and convergent validity of the BIAQ were verified in the context of four independent studies conducted on a total sample of 945 adolescents.

RESULTS

The first study showed that the content and formulation of the French BIAQ items were adequate for children and adolescents. The following three studies provided support for the factor validity, measurement invariance (across sex), reliability, and convergent validity of the French BIAQ. Regarding the measurement invariance tests, the results revealed that the models were invariant up to the levels of the latent means structures. Post hoc probing of these differences showed a significant higher latent mean score of the global BIAQ scale in females (in samples 2 and 3).

DISCUSSION

The present results provide preliminary evidence regarding the construct validity of the BIAQ in a community sample of French adolescents.

Disordered eating attitudes and behaviours in the high-school students of a rural Canadian community

BACKGROUND

Most surveys of disordered eating attitudes in teenagers target females in urban areas. To help plan the distribution of treatment resources for eating disorders in British Columbia we studied male and female students in all of the high schools of a rural community.

METHODS

Three hundred and ninety-six of the 2,589 students attending the four high schools within the rural community completed the EAT-26 and a demographic questionnaire.

RESULTS

Three hundred and eighty-one of the 396 students (96%) satisfactorily completed and returned the survey. Their ages ranged from 12 to 19 years with a mean of 15.2 years (SD=1.5 years). Fifty-nine percent of participants were female. On average, males wanted to be 6.2 kg (SD=1.2 kg) heavier and females wanted to be 2.8 kg (SD=6.5 kg) lighter and 8.3 percent of males and 17.3 percent of females scored twenty or above on the EAT-26.

INTERPRETATION

The prevalence of disordered eating attitudes and behaviours in this rural setting was similar to that reported in urban communities in Canada. Disordered eating attitudes and behaviours were common in males. We conclude that there is need for treatment resources for males and that the need for treatment is as great in rural as urban communities.

The Eating Attitudes Test: validation with DSM-IV eating disorder criteria

The Eating Attitudes Test (EAT; Garner & Garfinkel, 1979) is one of the most widely used self-report eating disorder instruments. Originally developed to diagnose anorexia nervosa, it is often used in nonclinical samples where it has a high false-positive rate, which is likely due to changes in diagnostic criteria. Because the EAT has not been validated with Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association, 1994) criteria, we examined its criterion validity for discriminating between nonclinical women with and without an undifferentiated DSM-IV eating disorder diagnosis. We also examined differences in mean EAT scores among eating-disordered, symptomatic, and asymptomatic participants. Results show that the EAT has an accuracy rate of at least 90% when used to differentially diagnose those with and without eating disorders and that mean EAT scores differed among eating-disordered, symptomatic, and asymptomatic participants.

Intraethnic comparison of eating attitudes in native Koreans and Korean Americans using a Korean translation of the eating attitudes test

Although Asian samples have been studied using the Eating Attitudes Test (EAT-26), the literature lacks data on Korean samples. Furthermore, although cross-cultural studies of eating disorders have been done, intraethnic studies are lacking. This study concerns an intraethnic Korean comparison of eating attitudes. The EAT-26 was translated into Korean and validated by back-translation and by a preliminary study on 32 bilingual (Korean and English-speaking) Korean women. The validated Korean translation was completed by a sample of 195 native South Koreans (NKs) and the original version by a sample of 39 Korean Americans (KAs). EAT-26 scores seemed to indicate that the NKs had more disordered eating attitudes. Furthermore, the KAs appear to be a low-risk sample for eating disorders. Implications for further research are discussed.

Axis II comorbidity and developmental adversity in bulimia nervosa

Using data from 61 bulimic patients, we evaluated associations among axis II disturbances, psychopathological traits, eating symptoms, and adverse developmental experiences (e.g., childhood sexual and physical abuse). Findings showed likelihood of childhood abuse to increase markedly in function of comorbid personality pathology. In addition, comorbid borderline personality disorder was found to be a better predictor of object-relations disturbances, primitive defenses, and hostility than developmental adversity was. Although marked trait disturbances were strongly associated with borderline personality disorder (more than with severity of childhood adversity), the converse seemed true of severity of bulimic symptoms (i.e., comorbid personality disorder had no predictive effects, whereas developmental variables had inconsistent effects). Bulimic and general psychopathological symptoms, thus, seemed to have intriguingly independent determinants. We interpret these findings as showing that the observed association between developmental adversity and bulimic syndromes may, in large part, be attributable to comorbid personality pathology.

Controlled study of eating concerns and psychopathological traits in relatives of eating-disordered probands: do familial traits exist?

To examine the extent to which first-degree relatives of eating-disordered (ED) probands endorse maladaptive eating attitudes and personality/affective traits, we compared self-reported eating concerns (Restraint, Emotional Eating, Body Dissatisfaction, and maladaptive eating attitudes) and psychopathological traits (Affective Instability, Anxiousness, Compulsivity, and Narcissism) across groups of restricter (n = 19), binger (n = 56), psychiatric control (PC, n = 38), normal dieter (ND, n = 29), and nondieter control (NC, n = 28) probands, and then across participating nuclear family members. Results among probands were as anticipated: ED probands showed expected elevations in both areas, and predicted restricter/binger differences were obtained. However, corresponding differences were not obtained on measures of mothers', fathers', or siblings' eating concerns and traits. Our findings corroborate the notion that EDs represent a convergence of eating, affective, and personality disturbances, but not that such a clustering of features exists as a familial trait. We discuss normal trait and attitudinal variations observed in ED probands' relatives in light of findings showing EDs and other psychiatric syndromes to aggregate within families.