Accounting for differences in dieting status: steps in the refinement of a model

Competitiveness as a moderator of the relation between appearance-related factors and disordered eating behaviors

The present study examined competitiveness as a moderator of the relationships between appearance-related factors (i.e., thin-ideal internalization, appearance contingent self-worth) and disordered eating behaviors (i.e., dieting, excessive exercise). Participants were 441 undergraduate females for cross-sectional analyses, with 237 also contributing data longitudinally, 1 year later. Results showed that, in a model including thin-ideal internalization and appearance contingent self-worth and their interactions with competitiveness, thin-ideal internalization (but not appearance contingent self-worth) interacted with competitiveness to identify concurrent levels of both dieting and excessive exercise. Individuals high in both thin-ideal internalization and competitiveness exhibited the highest levels of concurrent dieting and excessive exercise. After controlling for baseline levels of the dependent variables, neither appearance-related factor interacted with competitiveness to predict dieting or excessive exercise. These findings suggest that individuals who are both competitive and accept and strive to achieve the thin ideal may be at risk for disordered eating behaviors.

Emotion regulation styles as longitudinal predictors of compulsive exercise: a twelve month prospective study

Exercise can be used as a mood regulator but, in the eating disorder literature, exercise has sometimes been found to be compulsive, detrimental to physical health, and regarded as one maladaptive strategy used to regulate emotions. This study examined longitudinal associations between emotion regulation styles and this compulsive exercise in 572 adolescents who completed measures of compulsive exercise and emotion regulation. Twelve months later they completed measures of compulsive exercise. Compulsive exercise was predicted by Internal Dysfunctional emotion regulation in girls and boys, even after controlling for initial levels of compulsive exercise. Adolescents displaying compulsivity to exercise may require intervention programmes to alter their emotion regulation strategies.

The relationship between compulsive exercise and emotion regulation in adolescents

OBJECTIVE

Compulsive exercise is suggested to be a strategy to regulate emotions. This suggestion has never been studied in adolescents. Therefore, this study examined the cross-sectional association between emotion regulation and compulsive exercise attitudes in adolescents.

DESIGN

A cross-sectional design was employed for this study.

METHOD

A sample of 1,630 adolescent boys and girls completed self-report measures of compulsive exercise, emotion regulation, and disordered eating attitudes, as part of ongoing research into exercise and eating attitudes in adolescents.

RESULTS

Compulsive exercise was significantly associated with emotion regulation, after controlling for disordered eating attitudes. Among boys, compulsive exercise was associated with internal functional, internal dysfunctional, and external functional emotion regulation strategies. In girls, internal functional and internal dysfunctional emotion regulation strategies predicted compulsive exercise.

CONCLUSIONS

Adolescents' compulsivity towards exercise is positively associated with different emotion regulation strategies. More work is needed to identify whether emotion regulation strategies longitudinally predict compulsive exercise.

Prospectively predicting dietary restraint: the role of interpersonal self-efficacy, weight/shape self-efficacy, and interpersonal stress

OBJECTIVE

This study investigated how the precursors of interpersonal self-efficacy and weight/shape self-efficacy would interact in the face of interpersonal stress to prospectively predict dietary restraint. Three models were explored, each with a different type of interpersonal stress: stress from same sex friendships, opposite sex friendships, or romantic relationships.

METHOD

At Time 1 (T1), participants (N = 406) reported on their typical levels of interpersonal self-efficacy and weight/shape self-efficacy, and recent (past 28 days) dietary restraint. At Time 2 (T2), 11 weeks after T1, participants reported on their recent (past 28 days) levels of dietary restraint at that time. Between T1 and T2, participants completed inventories weekly on the previous week's interpersonal stressors.

RESULTS

Consistent with prediction, low interpersonal self-efficacy and high weight/shape self-efficacy combined with high interpersonal stress (whether from same sex friendships, opposite sex friendships, or romantic relationships) to predict the highest levels of T2 dietary restraint after controlling for T1 levels.

DISCUSSION

These results further link the interpersonal domain with dietary restraint and elucidate characteristics of women particularly apt to increase dietary restraint in response to interpersonal stress.

Predicting the outcome of eating disorders using structural equation modeling

OBJECTIVE

There is a need for models that predict accurately the course of mental disorders.

METHOD

Eating-disordered female inpatients were assessed longitudinally at the beginning of treatment (t1), at the end of treatment (t2), at 2 or 3-year follow-up (t3), and at 6-year follow-up (t4). The sample consisted of 196 women with bulimia nervosa (BN) purging type, 103 women with anorexia nervosa (AN), and 68 women with binge eating disorder (BED; N=367). Confirmatory factor analysis and path analysis were used to predict the women's status at 6-year follow-up.

RESULTS

The results for BN and BED show that the specific eating disorder pathology was influenced mainly by specific eating disorder pathology at earlier time points and not by non-eating-specific (general) psychopathology. Similarly, general psychopathology was influenced mainly by general psychopathology at earlier time points. For AN patients, both categories of psychopathology (eating specific and general) were relevant for the 6-year outcome. The potential impact of 14 factors on the level of pathology was estimated (a) at baseline (at the beginning of treatment), (b) during the course of illness (baseline controlled), and (c) on the 6-year outcome of eating disorders (baseline and course controlled). Although there were many correlations between potential factors and baseline pathology, there was only a limited number of significant correlations with the 6-year outcome. This effect was mediated largely by the level of general psychopathology.

DISCUSSION

The models for outcome prediction based on structural equation modeling techniques were very similar for BN and BED. For both BN and BED, there were almost entirely separate predictions for the specific eating disorder on the one hand and non-eating-related (general) psychopathology on the other hand. This was true to a lesser degree for AN.

CONCLUSIONS

The use of refined path analytic methods in follow-up studies on larger general populations will be helpful to increase our understanding of the course of illness of psychiatric disorders.

Correlates of unhealthy weight-control behaviors among adolescents: implications for prevention programs

This study aimed to identify correlates of unhealthy weight-control behaviors in adolescents to guide the development of programs aimed at the primary prevention of disordered eating. A model explaining unhealthy weight-control behaviors was tested among 4,746 adolescents using structural equation modeling. Models fit the data well and explained 76% of the variance in unhealthy weight-control behaviors among girls and 63% among boys. Weight-body concerns were a strong correlate of unhealthy weight-control behaviors in both girls and boys. Models also emphasized the importance of weight-specific social norms within the adolescent's proximal environment. Findings suggest the importance of addressing weight-body concerns within prevention programs and extending interventions beyond classroom settings to ensure changes in weight-related norms among peer groups and family members.

Coping style and disturbed eating attitudes in adolescent girls

OBJECTIVE

The main goal of this work was to explore the relationship between coping styles and predisposition to eating disorders in a sample of adolescent girls.

METHOD

The sample comprised 186 females (mean age 15.91 years) and the questionnaires used were the Eating Disorders Inventory-2 (EDI-2) and the Adolescent Coping Scale (ACS).

RESULTS

The regression analyses indicated that the coping strategy most closely linked to the predisposition to develop an eating disorder was intropunitive avoidance, which explained the following percentage of variance: 29% of the total EDI-2 score, 23% of the personal factor, 28% of the social factor, and 4% of the bodily factor. On the other hand, the scale of intropunitive avoidance dimension with the most explanatory power was the tension reduction, which reflects emotional reactions to problems such as crying, shouting, or taking drugs.

DISCUSSION

A cultural hypothesis is presented in an attempt to account for the low percentage of variance of bodily factor explained by intropunitive avoidance and emphasis is placed on the need for prevention programs for adolescents, particularly those at risk.

Empirical support for a model of dieting: findings from structural equations modeling

OBJECTIVE

This paper presents the results of an evaluation of a model of dieting (Huon, G.F., & Strong, K.G., International Journal of Eating Disorders, 23, 361-370, 1998). It represents the culmination of a large-scale time-extended study of dieting among adolescent girls.

METHODS

Data were collected from approximately 1,000 girls. A battery of questionnaires assessed dieting status, social influence, vulnerability (conformity) disposition, protective social skills, and aspects of the familial context as core components of the model.

RESULTS

When the data were subjected to analyses within structural equations modeling, all specific hypotheses within the model found strong support. Moreover, multiple indices revealed that the model had a very good fit with the data and accounted for 89% of the variance in commitment to dieting.

CONCLUSION

This study provides strong support for the validity of Huon and Strong's model of dieting among Australian girls. Its generality among girls in other cultures remains to be established.

Relationships between objective physical characteristics and the use of weight control methods in adolescence: a mediating role for eating attitudes?

This study of non-clinical adolescent males and females examined associations of objectively measured physical characteristics with greater use of methods of weight control and considered whether the relationships between these variables might be explained by a mediating effect of a subjective characteristic--unhealthy eating attitudes. Non-clinical male and female adolescents completed measures of weight control and eating attitudes, and their physical characteristics were measured using a range of standardized anthropometry techniques. Regression analyses were used to test the role of eating attitudes as mediators in the relationship between physical characteristics and the use of weight control methods. The data were compatible with a partial mediator model, where physical characteristics influence eating attitudes, and those where attitudes drive the use of methods to control weight. However, not all of the relationship was explained by this mediator. In addition, there were different patterns of association for men and women, consistent with different patterns of bodily focus between the genders. These findings stress the importance of understanding objective physical characteristics as well as subjective eating attitudes to find out why people use different levels of weight control behaviours. Limitations, further research and potential implications for clinical and preventative programmes are discussed.

Pathways to serious dieting: significant insights from discontinuity

OBJECTIVES

This paper outlines a strategy for systematically examining the discontinuity in pathways to serious dieting.

METHOD

Eight hundred and twenty-three adolescent females were recruited from six high schools in metropolitan Sydney, Australia. They completed a battery of measures that assessed perceived social influences to diet, predisposition to conformity, protective skills, aspects of positive familial context, and dieting-related attitudes and status. Testing took place over two occasions approximately 10 months apart.

RESULTS

Family context, protective skills, and a predisposition to conformity were found to differentiate the vulnerable girls who reported high levels of social influence from those who did not. However, those variables did not differentiate those with high social influence who seriously diet from nondieters. Body mass index, drive for thinness, and body dissatisfaction differentiated all of the comparison groups tested. Age did not consistently differentiate these groups.

DISCUSSION

The findings can tell us what seems to protect girls who appear susceptible to social influences from becoming serious dieters.