1
|
Nasrullah MH, Haider MJ, Arif M, Zahid MN, Iftikhar S, Mahmood S, Akhtar M, Bin Ilyas MA. Eating Disorders and Disordered Eating Behaviors Among Undergraduate Students in Pakistan as Measured by Eating Disorder Examination Questionnaire (EDE-Q). Cureus 2024; 16:e59158. [PMID: 38803725 PMCID: PMC11129612 DOI: 10.7759/cureus.59158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2024] [Indexed: 05/29/2024] Open
Abstract
Objectives Eating disorders (ED) are an emerging public health issue globally, especially in young adults studying at the undergraduate level. This study aims to assess the frequency of eating disorders, their types, and disordered eating behaviors among such students. Moreover, it aims to identify factors like weight concern, shape concern, eating concern, and restraint, along with assessing the shifting trend of BMI impact on eating disorders using a standardized Eating Disorder Examination Questionnaire (EDE-Q). Methods In this cross-sectional study, 400 undergraduate students (aged 18-25) from four public universities participated from July 2022 to November 2023. Data was collected using the Eating Disorder Examination Questionnaire (EDE-Q). The frequency of eating disorders was computed using SPSS version 27. Results Among the participants, 21.75% (n=84) were identified as having a score surpassing the clinical cut-off. This group comprised 5.5% males (n=22) and 16% females (n=64). The highest prevalence among the four subscales was observed in the Shape Concern subscale (10.5%). Objective binge episodes (19.3%) emerged as the most notable disordered eating attitude. Atypical anorexia nervosa accounted for 13.8% of different eating disorders, while disordered eating was noted in 19.5% (n=78) of individuals. Discussion This study offers critical insights into eating disorders among Pakistan undergraduate students, utilizing the EDE-Q 6.0. Disordered eating behaviors, particularly shape concern and objective binge eating, exhibit significant correlations with these disorders. Weight dissatisfaction emerges as a prominent predictor, suggesting societal influence. The study also reveals a moderate correlation between BMI and eating disorders, challenging conventional assumptions. Furthermore, a changing trend in the prevalence of eating disorders is observed among the male population.
Collapse
Affiliation(s)
| | | | - Maria Arif
- Community Medicine, Allama Iqbal Medical College, Lahore, PAK
| | | | - Sana Iftikhar
- Community Health Sciences, Allama Iqbal Medical College, Lahore, PAK
| | - Shahid Mahmood
- Community Medicine, Allama Iqbal Medical College, Lahore, PAK
| | - Mehwish Akhtar
- Community Medicine, Allama Iqbal Medical College, Lahore, PAK
| | | |
Collapse
|
2
|
Ramos-Vera CA, Calizaya-Milla YE, Saintila J. Gender network analysis of the Eating Disorder Examination-Questionnaire (EDE-Q7) in Peruvian adults. NUTR HOSP 2023; 40:778-783. [PMID: 37334823 DOI: 10.20960/nh.04228] [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] [Indexed: 06/21/2023] Open
Abstract
Introduction Background: network assessment of eating disorder (ED)-related symptomatology from a gender perspective is an important topic of study; however, there is limited research in the Latin American context. Objective: this study aimed to explore the patterns of association of the components of the Eating Disorder Examination-Questionnaire (EDE-Q7) according to gender, using two simultaneous network models in 890 Peruvian adults (63.51 % were women; mean age: 26.40). Methods: two graphs considering the gender factor were made using the R package qgrap and the merged LASSO graph. Results: higher network centrality measures were obtained for items related to body image dissatisfaction and overvaluation in women; while in the men's network, the items of food restriction and overestimation of weight were the most central symptoms. Conclusion: both network models were invariant and showed no significant differences in both structure and connections.
Collapse
Affiliation(s)
- Cristian Antony Ramos-Vera
- Research Area. Facultad de Ciencias de la Salud. Universidad César Vallejo y Sociedad Peruana de Psicometría
| | | | | |
Collapse
|
3
|
Sahlan RN, Kinkel-Ram SS, Uzoegwu K, Smith A. Fear of COVID-19, insomnia, and eating disorder symptoms among Iranian college students. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2023; 13:100601. [PMID: 37234278 PMCID: PMC10198744 DOI: 10.1016/j.jadr.2023.100601] [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: 12/21/2022] [Revised: 04/10/2023] [Accepted: 05/18/2023] [Indexed: 05/27/2023] Open
Abstract
Objective Eating disorders (EDs), fear of COVID-19, and insomnia have all increased during the COVID-19 pandemic in Western societies. Additionally, fear of COVID-19 and sleep disturbances relate to ED symptoms in Western societies. However, it is unknown whether fear of COVID-19 and insomnia relate to ED symptoms in non-Western countries, such as Iran. Thus, this study examined the relation between fear of COVID-19, insomnia, and ED symptoms among Iranian college students. Specifically, we hypothesized that insomnia and fear of COVID-19 would each uniquely relate to ED symptoms and the interaction between insomnia and fear of COVID-19 would also associate with increased ED symptoms. Method College students (N =1,043) filled out measures assessing fear of COVID-19, insomnia, and ED symptoms. We ran moderation analyses using linear regression for global ED symptoms and negative binomial regressions for binge eating and purging. Results Fear of COVID-19 and insomnia had unique effects on global ED symptoms and binge eating. Insomnia, but not fear of COVID-19, had a unique effect on purging. No significant interaction effect was found. Discussion This study was the first to examine the association between fear of COVID-19 and insomnia on ED symptoms in Iran. Fear of COVID-19 and insomnia should be incorporated into novel assessments and treatments for EDs.
Collapse
Affiliation(s)
- Reza N Sahlan
- Department of Counseling, School, and Educational Psychology, Graduate School of Education, University at Buffalo-SUNY, Buffalo, NY, United States
| | | | - Kelechi Uzoegwu
- Miami University, Department of Psychology, Oxford, Ohio, United States
| | - April Smith
- Auburn University, Department of Psychology, Auburn, AL, United States
| |
Collapse
|
4
|
Gattino S, Czepczor-Bernat K, Fedi A, Brytek-Matera A, Boza M, Lemoine JE, Sahlan RN, Wilson E, De Piccoli N, Rollero C. Self-objectification and its biological, psychological and social predictors: A cross-cultural study in four European countries and Iran. EUROPES JOURNAL OF PSYCHOLOGY 2023; 19:27-47. [PMID: 37063692 PMCID: PMC10103054 DOI: 10.5964/ejop.6075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 12/08/2021] [Indexed: 03/03/2023]
Abstract
Although scholars started investigating self-objectification more than twenty years ago, only a few studies focused on men and even fewer have taken into account the cross-cultural dimension. Our study focused on the antecedents of self-objectification paying attention to the role of biological and sociodemographic variables (gender, BMI), psychological characteristics (self-esteem, perfectionism) together with social and cultural factors (internalization of media standards, influence of family and friends). Self-objectification was operationalized as Body Shame and Body Surveillance. A self-reported questionnaire was administered to 2165 adults living in four European countries (UK, Italy, Poland and Romania) and Iran. Ten regression models were performed (2 per country) to analyse the correlates of self-objectification. Overall, self-objectification emerged as a process affected by factors entrenched in psychological, biological, social and cultural domains, partially different for Body Shame and Body Surveillance. Findings showed the key role of self-esteem as a protective factor against Body Shame across countries. On the other hand, the internalization of media standards emerged as risk factor for both Body Shame and Body Surveillance in the five countries. Taken together, these results underline the complexity of self-objectification and the need to deepen research on this topic among non-Western countries.
Collapse
Affiliation(s)
- Silvia Gattino
- Department of Psychology, University of Turin, Turin, Italy
| | | | - Angela Fedi
- Department of Psychology, University of Turin, Turin, Italy
| | | | - Mihaela Boza
- Department of Psychology, Alexandru Ioan Cuza University of Iaşi, Iasi, Romania
| | - Jérémy E. Lemoine
- School of Psychology, University of East London, London, United Kingdom
- ESCP Business School, London, United Kingdom
| | - Reza N. Sahlan
- Department of Clinical Psychology, Iran University of Medical Sciences, Tehran, Iran
| | - Emma Wilson
- ESRC Centre for Society and Mental Health, King’s College London, London, United Kingdom
- Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | | | - Chiara Rollero
- Department of Psychology, University of Turin, Turin, Italy
| |
Collapse
|
5
|
Sahlan RN, Sala M. Eating disorder psychopathology and resilience in Iranian college students: A network analysis. J Clin Psychol 2023; 79:497-513. [PMID: 35975401 DOI: 10.1002/jclp.23428] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 06/13/2022] [Accepted: 07/26/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Eating disorder (ED) psychopathology is common among Iranian college students. Resilience (i.e., the ability to bounce back and adapt in the face of adverse and stressful conditions) has been found to be a protective factor against ED psychopathology in the West. However, no research to date has examined resilience as a protective factor against ED psychopathology in Iran. The current study used network analysis to examine an ED and resilience network in an Iranian sample. METHOD Participants were Iranian college students (N = 478) who completed the Farsi-Eating Disorder Examination-Questionnaire and Farsi-Brief Resilience Scale. We estimated a network of ED symptoms and resilience processes and identified central and bridge symptoms. RESULTS Central ED and resilience nodes were discomfort in seeing one's own body, feeling guilty about eating due to shape/weight, and thinking about shape and weight making it difficult to concentrate. Having a hard time making it through stressful events bridged with binge eating and fear of losing control over eating. CONCLUSION Processes related to managing stress and binge eating appear to maintain the association between ED symptoms and resilience processes.
Collapse
Affiliation(s)
- Reza N Sahlan
- Department of Clinical Psychology, Iran University of Medical Sciences, Tehran, Iran
| | - Margaret Sala
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York, USA
| |
Collapse
|
6
|
İnce B, Yücel B. Reducing eating disorders risk in Turkish female university students using cognitive behavioural theory: A randomized controlled feasibility trial. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03909-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
7
|
Sahlan RN, Keshishian AC, Christian C, Levinson CA. Eating disorder and social anxiety symptoms in Iranian preadolescents: a network analysis. Eat Weight Disord 2022; 27:1855-1867. [PMID: 34787832 DOI: 10.1007/s40519-021-01329-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 10/28/2021] [Indexed: 12/21/2022] Open
Abstract
PURPOSE Network studies of eating disorder (ED) symptoms have identified central and bridge symptoms in Western samples, yet few network models of ED symptoms have been tested in non-Western samples, especially among preadolescents. The current study tested a network model of ED symptoms in Iranian preadolescents (ages 9 to 13), as well as a model of co-occurring social anxiety disorder (SAD) and ED symptoms. METHOD Preadolescent boys (n = 405) and girls (n = 325) completed the Children Eating Attitudes Test-20 and Social Anxiety Scale for Children. We estimated two network models (ED and ED/SAD networks) and identified central and bridge symptoms, as well as tested if these models differed by sex. RESULTS We found that discomfort eating sweets were the most central symptoms in ED networks. Concern over being judged was central in networks including both ED and SAD symptoms. Additionally, concern over being judged was the strongest bridge symptoms. Networks did not differ by sex. CONCLUSION Future research is needed to test if interventions focused on bridge symptoms (i.e., concern over being judged) as primary intervention points target comorbid ED-SAD pathology in preadolescents at risk for ED and SAD. LEVEL OF EVIDENCE Level III; Evidence obtained from well-designed observational study, including case-control design for relevant aspects of the study.
Collapse
Affiliation(s)
- Reza N Sahlan
- Department of Clinical Psychology, Iran University of Medical Sciences, Tehran, Iran
| | - Ani C Keshishian
- Department of Psychological and Brain Sciences, University of Louisville, Life Sciences Building, Louisville, KY, 40292, USA
| | - Caroline Christian
- Department of Psychological and Brain Sciences, University of Louisville, Life Sciences Building, Louisville, KY, 40292, USA
| | - Cheri A Levinson
- Department of Psychological and Brain Sciences, University of Louisville, Life Sciences Building, Louisville, KY, 40292, USA.
| |
Collapse
|
8
|
Bazzazian S, Ozgoli G, Kariman N, Nasiri M, Mokhtaryan-Gilani T, Hajiesmaello M. The translation and psychometric assessment of the SCOFF eating disorder screening questionnaire: the Persian version. J Eat Disord 2022; 10:38. [PMID: 35296362 PMCID: PMC8925224 DOI: 10.1186/s40337-022-00564-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 03/03/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Eating Disorders (EDs) are defined by abnormal eating habits. The SCOFF (Sick-Control-One stone-Fat-Food) is a simple screening questionnaire for EDs. This study was conducted to translate and evaluate the psychometric properties of the SCOFF questionnaire in Iranian university students. METHODS A total of 310 Iranian students of the Shahid Beheshti University of Medical Sciences completed a test battery of questionnaires including the well-known screener of eating disorder symptoms, the SCOFF. All measures were presented to the participants in Persian. The 5-item SCOFF questionnaire was translated to Persian using the forward-backward method. The face, content, criterion, and construct validity of the Persian version of the SCOFF were assessed. The validity and reliability of the Persian version of the SCOFF was assessed and factor analysis was conducted. RESULTS All five items of the translated questionnaire were approved after face validity. Content validity ratio was 0.73 (range 0.66-0.83) and content validity index was 0.96 (range 0.91-1), so all items were approved. Exploratory factor analysis revealed a 2-factor structure, which explained 52.47% of the variance. Confirmatory factor analysis showed a very good goodness-of-fit for the 2-factor model. 2-factor and 1-factor models indicate a very good goodness-of-fit in females and adequate goodness-of-fit in males. Criterion validity showed an acceptable correlation between the SCOFF and the EDE-Q. Reliability was acceptable based on the stability [ICC = 0.905(95% CI .760-.962 p < 0.001)] and the internal consistency (KR20 = 0.4). CONCLUSION Appropriate psychometric properties of the 5-item Persian version of the SCOFF (both models) were confirmed, suggesting its use as a valid questionnaire in EDs screening.
Collapse
Affiliation(s)
- Shahin Bazzazian
- Student Research Committee, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Giti Ozgoli
- Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Nourossadat Kariman
- Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Malihe Nasiri
- Department of Basic Sciences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, IR, Iran
| | - Tahereh Mokhtaryan-Gilani
- Student Research Committee, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | |
Collapse
|
9
|
Sahlan RN, Saunders JF, Perez M, Blomquist KK, Fitzsimmons-Craft EE, Bodell LP. The validation of a Farsi version of the Clinical Impairment Assessment (F-CIA) among Iranian adolescent boys and girls. Eat Weight Disord 2022; 27:665-674. [PMID: 33970468 DOI: 10.1007/s40519-021-01204-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 04/26/2021] [Indexed: 01/01/2023] Open
Abstract
PURPOSE Although some studies have been conducted to examine general psychosocial impairment in Iran, there is no research to date on clinical impairment secondary to disordered eating in Iranian adolescents. The purpose of this study was to evaluate the Farsi version of the Clinical Impairment Assessment (F-CIA) among Iranian adolescents. METHODS A total of 1112 adolescents (ageM [SD] = 15.55 [1.59], body mass index [zBMI] M [SD] = - 0.00 [1.0]; 54.6% girls) were recruited from four cities (Tehran [Capital], Tabriz [North-Western], Kurdistan [West], and Rasht [North]) in Iran. After translation and back-translation procedures, the F-CIA, Eating Disorder Examination Questionnaire (EDE-Q), and Beck Depression Inventory-Second Edition (BDI-II) were administered to adolescents. We used confirmatory factor analysis (CFA), measurement invariance, independent samples t tests, Pearson correlation, chi-square tests, and internal consistency to test validity and reliability. RESULTS CFA indicated that F-CIA demonstrated good fit to the data and supported a three-factor model. The scale was invariant across gender and zBMI. The F-CIA had good internal consistency (αs = 0.76-0.93) and positive associations (rs = 0.13-0.62; p < 0.001) with zBMI, disordered eating symptoms, and binge/purge symptoms. We found no gender differences across mean scores on the F-CIA, but adolescents with higher zBMI reported higher scores on the F-CIA relative to those with lower zBMIs. Finally, adolescents scoring above CIA cutoffs reported higher zBMI, disordered eating outcomes, and depression. CONCLUSION Findings suggested that the F-CIA is a reliable and valid measure of clinical eating disorder-related impairment in Iranian adolescents. LEVEL OF EVIDENCE III; Evidence obtained from well-designed observational study, including case-control design for relevant aspects of the study.
Collapse
Affiliation(s)
- Reza N Sahlan
- Department of Clinical Psychology, Iran University of Medical Sciences, Tehran, Iran
| | - Jessica F Saunders
- Department of Psychological Science, Georgia College and State University, Milledgeville, GA, USA
| | - Marisol Perez
- Department of Psychology, Arizona State University, Tempe, AZ, USA
| | | | | | - Lindsay P Bodell
- Department of Psychology, University of Western Ontario, 361 Windermere Road, London, ON, N6A 3K7, Canada.
| |
Collapse
|
10
|
Binge eating among young adults: association with sociodemographic factors, nutritional intake, dietary n-6: n-3 ratio and impulsivity. Br J Nutr 2021; 126:1431-1440. [PMID: 33441196 DOI: 10.1017/s0007114521000118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Binge eating behaviour (BE) is the major symptom of binge eating disorder (BED). This study aimed to compare the nutritional intake in the presence or absence of BE, with a particular focus on dietary n-6:n-3 ratio, to assess the association between BE and impulsivity and the mediating effect of BMI on this association. A total of 450 university students (age 18-28 years) participated. The self-administered questionnaires were a semi-quantitative FFQ and the UPPS-P Impulsive Behavior Scale and the binge eating scale. The average BE score was 11·6 (se 7·388), and 20 % of the total participants scored above the cut-off of 17, thus presenting BE with 95 % CI of 16·3, 23·7 %. Our study revealed that greater BMI, higher total energy intake, greater negative urgency and positive urgency scores were significantly associated with BE. Participants with high value of dietary n-6:n-3 ratio were 1·335 more at risk to present a BE compared with those with a lower value of this ratio (P = 0·017). The relationship between BE score and UPPS domains score was not mediated by the BMI. This is the first study reporting a link between high dietary n-6:n-3 ratio and BE as well as the fact that BE was linked to both, negative and positive urgencies, and that the association between BE and impulsivity was not mediated by BMI. These findings can help to deal more efficiently with people suffering from BE, a symptom that can precede the development of BED.
Collapse
|
11
|
Abstract
PURPOSE OF REVIEW This review scoped recent (2019-2020) literature investigating the association between urbanization and eating disorders, and the putative role of urbanization as a direct or indirect risk factor. RECENT FINDINGS There are few epidemiological studies which investigated adequately direct or indirect association between urban domicile and eating disorders. Findings suggest that urbanization is a complex phenomenon and its effects on eating behaviour are indirect, for example, because of other important social and environmental features, such as the amount of 'green' space, 'Western' thin idealization, and poverty. The review also supports others indicating an increase of eating disorders in Africa and Asia. The majority of research includes only adolescent and young woman. SUMMARY It does not seem likely that metropolitan dwelling in itself is a major risk factor for developing an eating disorder. However, when accompanied by other sociodemographic effects, there may well be an increase in eating disorder risk. There are opportunities for planners to design cities to be supportive of peoples' eating and mental health in general. More research investigating moderating and mediating effects on the associations between urban dwelling and eating disorder is needed as well as studies of more sexually and age diverse populations.
Collapse
|
12
|
Sahlan RN, Saunders JF, Perez M, Blomquist KK, Fitzsimmons-Craft EE, Bodell LP. The validation of a Farsi version of the Loss of Control over Eating Scale (F-LOCES) among Iranian adolescent boys and girls. Eat Behav 2021; 41:101502. [PMID: 33812127 DOI: 10.1016/j.eatbeh.2021.101502] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 03/22/2021] [Accepted: 03/25/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Few studies have been conducted on disordered eating in Iran, with limited research on loss of control (LOC) eating in adolescents. The purpose of the current study was to evaluate the validation of a Farsi version of the Loss of Control over Eating Scale (F-LOCES) among Iranian adolescents. METHOD Participants were 504 boys (Age mean = 15.35; Body Mass Index [zBMI] mean = 0.01) and 607 girls (Age mean = 15.71; zBMI mean = -0.01) who completed a battery of questionnaires including the F-LOCES. RESULTS Confirmatory Factor Analysis (CFA) and bi-factor model indicated that the F-LOCES had good fit to the data and supported a three-factor model. Additionally, the scale was invariant across all the groups. Girls had higher scores than boys on the behavioral subscale. Additionally, individuals with elevated eating pathology and zBMI endorsed higher LOC eating. As expected, the F-LOCES scores were positively associated with zBMI, disordered eating symptoms, and depression, and negatively associated with self-esteem. DISCUSSION Findings suggest that the F-LOCES is a reliable and valid measure of LOC eating in Iranian adolescents. The availability of the F-LOCES will enable researchers to examine the developmental trajectories, predictors, and outcomes of LOC eating.
Collapse
Affiliation(s)
- Reza N Sahlan
- Department of Clinical Psychology, Iran University of Medical Sciences, Tehran, Iran
| | - Jessica F Saunders
- Department of Psychological Science, Georgia College and State University, Milledgeville, GA, USA
| | - Marisol Perez
- Department of Psychology, Arizona State University, Tempe, AZ, USA
| | | | | | - Lindsay P Bodell
- Department of Psychology, University of Western Ontario, London, Ontario, Canada.
| |
Collapse
|
13
|
Sahlan RN, Williams BM, Forrest LN, Saunders JF, Fitzsimmons-Craft EE, Levinson CA. Disordered eating, self-esteem, and depression symptoms in Iranian adolescents and young adults: A network analysis. Int J Eat Disord 2021; 54:132-147. [PMID: 32865853 PMCID: PMC8159574 DOI: 10.1002/eat.23365] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 07/30/2020] [Accepted: 07/30/2020] [Indexed: 12/23/2022]
Abstract
OBJECTIVE The network theory of psychopathology examines networks of interconnections across symptoms. Several network studies of disordered eating have identified central and bridge symptoms in Western samples, yet network models of disordered eating have not been tested in non-Western samples. The current study tested a network model of disordered eating in Iranian adolescents and college students, as well as models of co-occurring depression and self-esteem. METHOD Participants were Iranian college students (n= 637) and adolescents (n = 1,111) who completed the Eating Disorder Examination-Questionnaire (EDE-Q), Rosenberg Self-Esteem Scale (RSES) and Beck Depression Inventory, Second Edition (BDI-II). We computed six Glasso networks and identified central and bridge symptoms. RESULTS Central disordered eating nodes in most models were a desire to lose weight and discomfort when seeing one's own body. Central self-esteem and depression nodes were feeling useless and self-dislike, respectively. Feeling like a failure was the most common bridge symptom between disordered eating and depression symptoms. With exception of a few differences in some edges, networks did not significantly differ in structure. DISCUSSION Desire to lose weight was the most central node in the networks, which is consistent with sociocultural theories of disordered eating development, as well as prior network models from Western-culture samples. Feeling like a failure was the most central bridge symptom between depression and disordered eating, suggesting that very low self-esteem may be a shared correlate or risk factor for disordered eating and depression in Iranian adolescents and young adults.
Collapse
Affiliation(s)
- Reza N. Sahlan
- Department of Clinical Psychology, Iran University of Medical Sciences, Tehran, Iran
| | - Brenna M. Williams
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky, USA
| | | | | | | | - Cheri A. Levinson
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky, USA
| |
Collapse
|
14
|
Rasouli A, Mohiti S, Javadi M, Panjeshahin A, Kazemi M, Shiri-Shahsavar MR. The effect of daily fast food consumption, family size, weight-caused stress, and sleep quality on eating disorder risk in teenagers. Sleep Breath 2021; 25:1527-1533. [PMID: 33411190 DOI: 10.1007/s11325-020-02189-9] [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: 07/10/2020] [Revised: 08/29/2020] [Accepted: 09/12/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE Eating disorder (ED) is a common complication with disturbance of eating or eating-related behaviors that lead to physical and psychosocial disorders. The purpose of this study was to evaluate the association between eating disorders and daily fast food consumption, family size, weight-caused stress, and sleep quality in teenagers in Zanjan, Iran. METHODS Adolescent girl students aged 12-15 years (n = 370), selected in a cross-sectional study, completed the Eating Attitude Test-26 and Pittsburgh Sleep Quality Index questionnaires. The cluster random sampling method was used. Statistical analysis was performed using R software version 3.6.3. Logistic regression modeling was used for investigating the relationship between factors and odds of EDs. A p value of less than 0.05 was considered significant. RESULTS A significant relationship was found between family size (OR = 0.77, p = 0.049), fast food-daily consumption (OR = 5.42, p = 0.043), weight-caused stress (OR = 12.47, p < 0.001), and poor sleep quality (OR = 1.70, p = 0.024) and odds of eating disorder among teenage girls. CONCLUSION A significant positive association was found between a low number of family members, daily fast food consumption, stress status, poor sleep quality and odds of EDs. However more longitudinal studies are required to confirm the results.
Collapse
Affiliation(s)
- Ahmadreza Rasouli
- Department of Nutrition, School of Health, Qazvin University of Medical Sciences, Qazvin, Iran.,Student Research Committee, School of Health, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Sara Mohiti
- Department of Nutrition, School of Health, Qazvin University of Medical Sciences, Qazvin, Iran.,Student Research Committee, School of Health, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Maryam Javadi
- Department of Nutrition, School of Health, Qazvin University of Medical Sciences, Qazvin, Iran.,Children Growth Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Asieh Panjeshahin
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Morteza Kazemi
- Department of Biostatistics and Epidemiology, School of Health Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Mohammad Reza Shiri-Shahsavar
- Department of Nutrition, School of Health, Qazvin University of Medical Sciences, Qazvin, Iran. .,Children Growth Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
| |
Collapse
|
15
|
Sahlan RN, Saunders JF, Fitzsimmons-Craft EE. Body-, eating-, and exercise-related social comparison behavior and disordered eating in college women in the U.S. and Iran: A cross-cultural comparison. Eat Behav 2021; 40:101451. [PMID: 33246301 PMCID: PMC7978496 DOI: 10.1016/j.eatbeh.2020.101451] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 11/10/2020] [Accepted: 11/15/2020] [Indexed: 12/26/2022]
Abstract
Wearing of the hijab is associated with lower eating disorder (ED) attitudes and behaviors in women. However, this potential buffering role of the hijab has been questioned in countries, such as Iran, where its wearing is compulsory. Further, cross-cultural comparisons between disordered eating behaviors and correlates in Iranian and U.S. women are lacking. This study examines social-cognitive correlates of disordered eating in U.S. and Iranian women, comparing rates of ED- related social comparison and eating pathology. College women in the U.S. (n = 180) and Iran (n = 384) completed the Body, Eating, and Exercise Comparison Orientation Measure (BEECOM) and the Eating Disorder Examination-Questionnaire (EDE-Q) in one session. One-way analyses of covariance and partial correlations were used to test the mean differences and inter-correlations between the variables among U.S. and Iranian women. U.S. women endorsed higher BEECOM scores and higher levels of overvaluation of weight and shape and dietary restraint compared to Iranians. Most BEECOM subscales and disordered eating symptoms were inter-correlated in each culture. The tendency to engage in exercise comparison was not significantly correlated with excessive exercise for U.S. women. Correlations between variables were stronger for U.S. women compared to Iranian women. While the ED-related social comparison levels were higher for U.S. women, the typical Western patterns of social comparison and disordered eating extend to Iranian women. Eating disorder-related social comparison is a recommended clinical target in both Eastern and Western cultures.
Collapse
Affiliation(s)
- Reza N. Sahlan
- Department of Clinical Psychology, Iran University of Medical Sciences, Tehran, Iran
| | - Jessica F. Saunders
- Department of Psychological Science, Georgia College and State University, Milledgeville, GA, USA
| | | |
Collapse
|
16
|
Sahlan RN, Saunders JF, Mond JM, Fitzsimmons-Craft EE. Eating disorder symptoms among adolescent boys and girls in Iran. Int J Eat Disord 2021; 54:19-23. [PMID: 33270255 PMCID: PMC8006449 DOI: 10.1002/eat.23420] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 11/04/2020] [Accepted: 11/06/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Few studies of eating disorder (ED) symptoms among young people in Iran have been conducted. This cross-sectional study examined ED symptoms, assessed by the Eating Disorder Examination Questionnaire (EDE-Q). METHOD Adolescent boys (n = 498) and girls (n = 607) aged 12-19 years, recruited from schools in four different regions of Iran, completed a survey that included the EDE-Q. ED symptoms, namely, EDE-Q global scores and the occurrence of specific ED behaviors, were compared between boys and girls. RESULTS Girls had higher global scores and were more likely to report regular extreme dietary restriction than boys (16.6 vs. 12.0%). The effect sizes for these differences were small. The regular occurrence of other behaviors (girls vs. boys-binge eating: 21.1 vs. 18.8%; self-induced vomiting: 3.3 vs. 5.4%; laxative misuse: 6.1 vs. 7.6%; excessive exercise: 5.3 vs. 4.4%) did not significantly differ by gender. Twelve percent of boys and 12.9% of girls met criteria for an operational definition of "probable ED case." CONCLUSION ED symptoms appear to be relatively common among Iranian adolescent boys and girls. Programs designed to reduce the occurrence and adverse impact of these symptoms may therefore be increasingly important.
Collapse
Affiliation(s)
- Reza N. Sahlan
- Department of Clinical Psychology, Iran University of Medical Sciences, Tehran, Iran
| | - Jessica F. Saunders
- Department of Psychological Science, Georgia College and State University, Milledgeville, GA, USA
| | - Jonathan M. Mond
- Center of Rural Health, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia,School of Medicine, Western Sydney University, Campbelltown, Australia
| | | |
Collapse
|
17
|
Validation of a Farsi version of the Sociocultural Attitudes Towards Appearance Questionnaire-4 (F-SATAQ-4) in Iranian men and women. Eat Behav 2020; 39:101438. [PMID: 33130367 DOI: 10.1016/j.eatbeh.2020.101438] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 09/11/2020] [Accepted: 10/01/2020] [Indexed: 11/21/2022]
Abstract
Understanding sociocultural factors (i.e., thin-ideal internalization and pressures for thinness) is a key step in managing disordered eating risk. Although sociocultural factors may vary across cultures and nations, studies on populations outside of Europe and North America are sparse, and psychometric data are often lacking. The purpose of this study was to validate a Farsi version of the Sociocultural Attitudes Towards Appearance Questionnaire-4 (F-SATAQ-4) in Iranian college students. Participants (age 18-30) were recruited from Iranian universities, resulting in two separate convenience samples for Study 1 (n = 328 men, n = 342 women) and Study 2 (n = 336 men, n = 331 women). In Study 1, which followed back-translation procedure, exploratory factor analyses supported a 5-factor structure of the F-SATAQ-4 for men and women (i.e., thin-ideal internalization, athletic-ideal internalization, family pressure, media pressure, and peers pressure). In Study 2, confirmatory factor analyses confirmed the same structure for men and women. The F-SATAQ-4 subscales scores demonstrated excellent reliability, internal consistency, and weak convergent validity for men and women, as evidenced by significant Pearson's correlations with shape/weight concerns (EDE-Q), appearance evaluation (MBSRQ-AE), social comparison (PACS-R), perceived pressures for thinness (PSPS), BMI, as well as a partial discriminant validity with self-esteem (RSES) in women. Women scored higher on thin-ideal internalization, while men scored higher on athletic-ideal internalization. Participants with higher weights had higher scores on thin-ideal internalization and on family and peers pressures. The Farsi SATAQ-4 is a useful measure of internalization and pressures for thinness among Iranian college men and women.
Collapse
|
18
|
Sahlan RN, Saunders JF, Fitzsimmons-Craft EE, Taravatrooy F. The validity and reliability of the Farsi version of the Body, Eating, and Exercise Comparison Orientation Measure (F-BEECOM) among Iranian male and female students. Body Image 2020; 34:72-84. [PMID: 32531756 PMCID: PMC8015361 DOI: 10.1016/j.bodyim.2020.05.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 05/09/2020] [Accepted: 05/09/2020] [Indexed: 11/21/2022]
Abstract
Body-, eating-, and exercise-related social comparison tendencies are implicated in body dissatisfaction and disordered eating among Western women. To date, no published study examines eating- and exercise-related comparisons in a male or non-Western sample. The current series of studies fills these gaps in the literature by translating and validating the existing measure of these comparisons (the 18-item Body, Eating, and Exercise Comparison Orientation Measure [BEECOM]) in samples of Iranian men and women. In Studies 1 and 2, female (n = 284) and male (n = 302) participants completed the translated Farsi BEECOM. Scores were analyzed by exploratory factor analyses (EFA) revealing two different three factor, 15-item scale structures for men and women. In Studies 3 and 4, participants (female n = 384; male n = 253) completed measures of social comparison and psychological functioning in one session. These data were analyzed using confirmatory factor analyses (CFA) and Pearson correlations. Each CFA yielded adequately fitting models. Results support the use of two different 15-item Farsi BEECOM measures with women and men and highlight unique gender differences in social comparison tendencies. The resulting F-BEECOM demonstrates strong psychometric properties and will be a useful research tool in Iranian women and men.
Collapse
Affiliation(s)
- Reza N Sahlan
- Department of Clinical Psychology, Iran University of Medical Sciences, Tehran, Iran
| | | | | | - Fatemeh Taravatrooy
- Department of Psychology, Shiraz Branch, Islamic Azad University, Shiraz, Iran
| |
Collapse
|