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Bevione F, Martini M, Longo P, Toppino F, Musetti A, Amodeo L, Abbate-Daga G, Panero M. Role of parental educational level as psychosocial factor in a sample of inpatients with anorexia nervosa and bulimia nervosa. Front Psychol 2024; 15:1408695. [PMID: 38827891 PMCID: PMC11140136 DOI: 10.3389/fpsyg.2024.1408695] [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] [Received: 03/28/2024] [Accepted: 05/03/2024] [Indexed: 06/05/2024] Open
Abstract
Introduction Evidence on parental educational level (PEL) as a risk factor for Eating Disorders (EDs) is mixed, and no study has assessed its role in relation to the compliance and outcomes of treatments in EDs. Further, no study differentiated from the educational level of mothers and fathers, nor considered the possible mediation of perfectionism in fostering EDs. Methods A clinical sample of 242 first-ever admitted inpatients with EDs provided information on PEL and completed the following questionnaires: the Eating Disorder Examination Questionnaire (EDE-Q) and the Frost Multidimensional Perfectionism Scale (F-MPS). Clinicians also provided information on the Hamilton Rating Scale for Anxiety (HAM-A) and the Hamilton Rating Scale for Depression (HAM-D) for each participant. Results Individuals with high PEL (whether mothers, fathers, or both parents) showed significantly higher scores on depressive symptoms and lower on parental criticism, were younger, had an earlier age of onset, had fewer years of illness, more were students and employed, and fewer had offspring. Individuals with fathers or both parents with high educational levels suffered more from Anorexia Nervosa rather than Bulimia Nervosa, had a longer length of stay during the current hospitalization, had less dietary restraint, and had higher personal standards. Individuals with mothers with high educational levels showed a lower rate of previous substance or alcohol addiction. Personal standards partially mediated the relationship between higher PEL and lower dietary restraint. Discussion PEL emerged to be a twofold psychosocial risk factor, being associated with higher depressive symptoms and a longer length of stay, but also with a shorter duration of illness and better scholar and working involvement. Higher PEL was related to higher personal standards but not to global perfectionism. Patterns of eating psychopathology emerged based on the high PEL of mothers or fathers.
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Affiliation(s)
- Francesco Bevione
- Eating Disorders Unit, Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy
| | - Matteo Martini
- Eating Disorders Unit, Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy
| | - Paola Longo
- Eating Disorders Unit, Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy
| | - Federica Toppino
- Eating Disorders Unit, Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy
| | - Alessandro Musetti
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Parma, Italy
| | - Laura Amodeo
- Eating Disorders Unit, Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy
| | - Giovanni Abbate-Daga
- Eating Disorders Unit, Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy
| | - Matteo Panero
- Eating Disorders Unit, Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy
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2
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Reynolds TA, Maner JK, Frederick DA, Forney KJ, Garcia JR. A Slim Majority: The Influence of Sex Ratio on Women's Body Dissatisfaction and Weight Loss Motivations. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:3043-3062. [PMID: 37407892 DOI: 10.1007/s10508-023-02644-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 04/05/2023] [Accepted: 06/05/2023] [Indexed: 07/07/2023]
Abstract
The current investigation examined whether women's perceptions of the sex ratio (ratio of women to men) in the local population influence their body dissatisfaction and weight loss motivations. A higher ratio of women to men in a given population signifies a relative abundance of same-sex mating competitors, intensifying female intrasexual competition. Five studies (N = 1,776) tested the hypotheses that women's perceptions of a female-skewed sex ratio would correspond to increased feelings of intrasexual competitiveness and perceptions of unfavorable mating prospects, which would, in turn, be associated with heightened body dissatisfaction and weight loss motivations. Among university and community women (Studies 1and 2), perceptions of a female-skewed sex ratio corresponded to greater intrasexual competitiveness, increased body dissatisfaction, and increased dieting inclinations. Among single women, assessments of a female-skewed sex ratio corresponded to perceptions of unfavorable mating prospects, increased romantic pressure to alter their appearance, and higher body dissatisfaction (Study 3). Studies 4 and 5 experimentally manipulated perceived sex ratio. Women in the female-skewed condition felt less satisfied with their weights and shapes, but only if they believed the manipulation (Study 4). In Study 5, using a within-subjects design, women who evaluated a male-skewed (vs. female-skewed) dating profile array subsequently desired to lose less weight. Findings suggest women's perceptions of their social environments may contribute to body image and dieting motivations.
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Affiliation(s)
- Tania A Reynolds
- Department of Psychology, The University of New Mexico, 2001 Redondo S. Dr., Albuquerque, NM, 87106, USA.
- The Kinsey Institute, Indiana University, Bloomington, IN, USA.
| | - Jon K Maner
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - David A Frederick
- Crean College of Health and Behavioral Sciences, Chapman University, Orange, CA, USA
| | - K Jean Forney
- Psychology Department, Ohio University, Athens, OH, USA
| | - Justin R Garcia
- The Kinsey Institute, Indiana University, Bloomington, IN, USA
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3
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Haynos AF, Koithan E, Hagan KE. Learned industriousness as a translational mechanism in anorexia nervosa. NATURE REVIEWS PSYCHOLOGY 2023; 2:112-126. [PMID: 37693302 PMCID: PMC10485812 DOI: 10.1038/s44159-022-00134-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/25/2022] [Indexed: 09/12/2023]
Abstract
It remains unexplained why some behaviours persist despite being non-hedonic and ostensibly aversive. This phenomenon is especially baffling when such behaviours are taken to excess in the form of psychopathology. Anorexia nervosa is one psychiatric disorder in which effortful behaviours that most people find unpleasant (suchas restrictive eating) are persistently performed. We propose thatthe social psychology theory of learned industriousness providesa novel mechanistic account for such phenomena. This theoryposits that high-effort behaviour can be conditioned to acquire secondary reinforcing properties through repeated pairing with reward. Accordingly, effort sensations become less aversive andmore appetitive, increasing willingness to engage in effortful behaviour. In this Perspective, we review pre-clinical behaviouraland biological data that support learned industriousness, contrast learned industriousness with other models of non-hedonic persistence (such as habit learning), highlight evidence that supports learned industriousness in individuals with anorexia nervosa and consider implications of the model, including translation to other psychiatric presentations.
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Affiliation(s)
- Ann F. Haynos
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Emily Koithan
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Kelsey E. Hagan
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
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4
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Barakat S, McLean SA, Bryant E, Le A, Marks P, Touyz S, Maguire S. Risk factors for eating disorders: findings from a rapid review. J Eat Disord 2023; 11:8. [PMID: 36650572 PMCID: PMC9847054 DOI: 10.1186/s40337-022-00717-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 12/04/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Risk factors represent a range of complex variables associated with the onset, development, and course of eating disorders. Understanding these risk factors is vital for the refinement of aetiological models, which may inform the development of targeted, evidence-based prevention, early intervention, and treatment programs. This Rapid Review aimed to identify and summarise research studies conducted within the last 12 years, focusing on risk factors associated with eating disorders. METHODS The current review forms part of a series of Rapid Reviews to be published in a special issue in the Journal of Eating Disorders, funded by the Australian Government to inform the development of the National Eating Disorder Research and Translation Strategy 2021-2031. Three databases were searched for studies published between 2009 and 2021, published in English, and comprising high-level evidence studies (meta-analyses, systematic reviews, moderately sized randomised controlled studies, moderately sized controlled-cohort studies, or population studies). Data pertaining to risk factors for eating disorders were synthesised and outlined in the current paper. RESULTS A total of 284 studies were included. The findings were divided into nine main categories: (1) genetics, (2) gastrointestinal microbiota and autoimmune reactions, (3) childhood and early adolescent exposures, (4) personality traits and comorbid mental health conditions, (5) gender, (6) socio-economic status, (7) ethnic minority, (8) body image and social influence, and (9) elite sports. A substantial amount of research exists supporting the role of inherited genetic risk in the development of eating disorders, with biological risk factors, such as the role of gut microbiota in dysregulation of appetite, an area of emerging evidence. Abuse, trauma and childhood obesity are strongly linked to eating disorders, however less conclusive evidence exists regarding developmental factors such as role of in-utero exposure to hormones. Comorbidities between eating disorders and mental health disorders, including personality and mood disorders, have been found to increase the severity of eating disorder symptomatology. Higher education attainment, body image-related factors, and use of appearance-focused social media are also associated with increased risk of eating disorder symptoms. CONCLUSION Eating disorders are associated with multiple risk factors. An extensive amount of research has been conducted in the field; however, further studies are required to assess the causal nature of the risk factors identified in the current review. This will assist in understanding the sequelae of eating disorder development and in turn allow for enhancement of existing interventions and ultimately improved outcomes for individuals.
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Affiliation(s)
- Sarah Barakat
- InsideOut Institute for Eating Disorders, University of Sydney, Sydney Local Health District, Sydney, Australia. .,Faculty of Medicine and Health, Charles Perkins Centre (D17), InsideOut Institute, University of Sydney, Level 2, Sydney, NSW, 2006, Australia.
| | - Siân A McLean
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Emma Bryant
- InsideOut Institute for Eating Disorders, University of Sydney, Sydney Local Health District, Sydney, Australia
| | - Anvi Le
- Healthcare Management Advisors, Melbourne, Australia
| | - Peta Marks
- InsideOut Institute for Eating Disorders, University of Sydney, Sydney Local Health District, Sydney, Australia
| | | | - Stephen Touyz
- InsideOut Institute for Eating Disorders, University of Sydney, Sydney Local Health District, Sydney, Australia
| | - Sarah Maguire
- InsideOut Institute for Eating Disorders, University of Sydney, Sydney Local Health District, Sydney, Australia
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Plummer RS, Alter Z, Lee RM, Gordon AR, Cory H, Brion-Meisels G, Reiner J, Topping K, Kenney EL. "It's Not the Stereotypical 80s Movie Bullying": A Qualitative Study on the High School Environment, Body Image, and Weight Stigma. THE JOURNAL OF SCHOOL HEALTH 2022; 92:1165-1176. [PMID: 35702896 PMCID: PMC10137145 DOI: 10.1111/josh.13203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 03/09/2022] [Accepted: 04/07/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Schools are crucial for preventing negative health outcomes in youth and are an ideal setting to address weight stigma and poor body image. The current study sought to examine and describe the nature of weight stigma and body image in adolescents, ascertain aspects of the school environment that affect body image, and identify recommendations for schools. METHODS We conducted 24 semi-structured interviews with students at 2 high schools in 2020. Qualitative data were analyzed using inductive coding and an immersion/crystallization approach. RESULTS Students did not report weight discrimination or harmful body image messaging from teachers or administrators. Physical education (PE) class and dress codes were 2 instances where covert weight stigma appeared. The most common forms of peer weight stigma reported were weight-based teasing and self-directed appearance critiques. Students recommended that schools eliminate dress codes, diversify PE activities, address body image issues in school, and be cognizant of teasing within friend groups. CONCLUSIONS Weight stigma presents itself in unique ways in high school settings. Schools can play a role in reducing experiences of weight stigma and negative body image. Weight-related teasing within friend groups was common and may not be captured in traditional assessments of bullying. More nuanced survey instruments may be needed.
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Affiliation(s)
- Rachel S. Plummer
- Department of Nutrition, Harvard T. H. Chan School of Public Health, 665 Huntington Ave, Boston, MA, 02115
| | - Zanny Alter
- Harvard Graduate School of Education, 13 Appian Way, Cambridge, MA, 02138
| | - Rebekka M. Lee
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115
| | - Allegra R. Gordon
- Department of Community Health Sciences, Boston University School of Public Health, 715AlbanySt, Boston, MA, 02118; Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, MA; Department of Pediatrics, Harvard Medical School, 300 Longwood Ave, Boston, MA, 02115
| | - Hannah Cory
- Department of Nutrition, Harvard T. H. Chan School of Public Health, 665 Huntington Ave, Boston, MA, 02115
| | | | - Jennifer Reiner
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115
| | - Kimm Topping
- Harvard Graduate School of Education, 13 AppianWay, Cambridge, MA, 02138
| | - Erica L. Kenney
- Department of Nutrition, Harvard T. H. Chan School of Public Health, 665 Huntington Ave, Boston, MA, 02115; Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115
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6
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Reynolds TA. Our Grandmothers' Legacy: Challenges Faced by Female Ancestors Leave Traces in Modern Women's Same-Sex Relationships. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:3225-3256. [PMID: 33398709 DOI: 10.1007/s10508-020-01768-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 06/05/2020] [Accepted: 06/08/2020] [Indexed: 05/15/2023]
Abstract
Investigations of women's same-sex relationships present a paradoxical pattern, with women generally disliking competition, yet also exhibiting signs of intrasexual rivalry. The current article leverages the historical challenges faced by female ancestors to understand modern women's same-sex relationships. Across history, women were largely denied independent access to resources, often depending on male partners' provisioning to support themselves and their children. Same-sex peers thus became women's primary romantic rivals in competing to attract and retain relationships with the limited partners able and willing to invest. Modern women show signs of this competition, disliking and aggressing against those who threaten their romantic prospects, targeting especially physically attractive and sexually uninhibited peers. However, women also rely on one another for aid, information, and support. As most social groups were patrilocal across history, upon marriage, women left their families to reside with their husbands. Female ancestors likely used reciprocal altruism or mutualism to facilitate cooperative relationships with nearby unrelated women. To sustain these mutually beneficial cooperative exchange relationships, women may avoid competitive and status-striving peers, instead preferring kind, humble, and loyal allies. Ancestral women who managed to simultaneously compete for romantic partners while forming cooperative female friendships would have been especially successful. Women may therefore have developed strategies to achieve both competitive and cooperative goals, such as guising their intrasexual competition as prosociality or vulnerability. These historical challenges make sense of the seemingly paradoxical pattern of female aversion to competition, relational aggression, and valuation of loyal friends, offering insight into possible opportunities for intervention.
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Affiliation(s)
- Tania A Reynolds
- Department of Psychology, University of New Mexico, Logan Hall, MSC03-2220, 1 University of New Mexico, Albuquerque, NM, 87131-0001, USA.
- The Kinsey Institute, Indiana University, Bloomington, Bloomington, IN, USA.
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7
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Byrne D, Carthy A. An argument against sex segregation in post-primary schools: examining wellbeing perspectives. PSYCHOLOGY & SEXUALITY 2022. [DOI: 10.1080/19419899.2020.1861072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- David Byrne
- Department of Humanities, TU Dublin – Blanchardstown Campus, Ireland
| | - Aiden Carthy
- Department of Humanities, TU Dublin – Blanchardstown Campus, Ireland
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8
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Risk factors and prevention strategies in eating disorders. NUTR HOSP 2022; 39:16-26. [DOI: 10.20960/nh.04174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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9
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Collins MKR, Lazard AJ. How Narrative Engagement with Young Adult Literature Influences Perceptions of Anorexia Nervosa. HEALTH COMMUNICATION 2021; 36:1646-1655. [PMID: 32615042 DOI: 10.1080/10410236.2020.1785375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Narratives have been shown to alter health beliefs through a process called narrative engagement; however, this process has yet to be empirically investigated for how the increasingly popular young adult (YA) novel format can impact health beliefs about anorexia nervosa among emerging adults. Using an experimental design, we found that the YA format fosters narrative engagement through mechanisms of transportation, which is associated with greater endorsement of accurate social and emotional beliefs about anorexia nervosa. Compared to an informational brochure, the narrative format where the main character was a "supportive peer" (but not experiencing the illness herself) increased self-referencing and was perceived as more relevant among emerging adult participants. Results suggest narratives may be viable tools to communicate about little understood social and emotional aspects of chronic diseases with emerging adults, who are more likely to provide support for sick peers than experience chronic illnesses. Encouraging narrative engagement could facilitate a better understanding of the social and emotional complexity of anorexia nervosa and improve the quality of peer interactions.
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Affiliation(s)
| | - Allison J Lazard
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill
- Lineberger Comprehensive Cancer Center, University of North Carolina
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10
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Herman A, Bajaka A. The role of the intestinal microbiota in eating disorders - bulimia nervosa and binge eating disorder. Psychiatry Res 2021; 300:113923. [PMID: 33857846 DOI: 10.1016/j.psychres.2021.113923] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 04/01/2021] [Indexed: 02/08/2023]
Abstract
Bulimia nervosa (BN) and binge eating disorder (BED) are both eating disorders (EDs) characterised by episodes of overeating in which large amounts of food are consumed in short periods. The aetiology of BN and BED is not fully understood. Psychological and social factors influence the development of BN and BED, but biological factors such as neurohormones that regulate hunger and satiety, or neurotransmitters responsible for mood and anxiety play a significant role in sustaining symptoms. Increasing numbers of studies confirm the relationship between the composition of intestinal microbiota and the regulation of appetite, mood, and body mass. In this manuscript, we will describe the mechanisms by which intestinal dysbiosis can play an important role in the aetiology of binge eating episodes based on current understanding. Understanding the two-way relationship between BN and BED and alterations in the intestinal microbiota suggest the utility of new treatment methods of these disorders aimed at improving the composition of the intestinal microflora.
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Affiliation(s)
- Anna Herman
- Department of Child Psychiatry, Medical University of Warsaw, 61 Żwirki i Wigury St., 02-091 Warsaw, Poland.
| | - Armand Bajaka
- Department of Child Psychiatry, Medical University of Warsaw, 61 Żwirki i Wigury St., 02-091 Warsaw, Poland
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11
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Schilder CMT, Sternheim LC, Aarts E, van Elburg AA, Danner UN. Relationships between educational achievement, intelligence, and perfectionism in adolescents with eating disorders. Int J Eat Disord 2021; 54:794-801. [PMID: 33554341 DOI: 10.1002/eat.23482] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 01/22/2021] [Accepted: 01/23/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVE High performance at school is associated with the risk of eating disorders (EDs), and perfectionism is proposed as an explanatory factor for this association. This study aims to evaluate (a) potential discrepancies between the measured IQ of adolescents with EDs and the IQ that is expected given their educational track, and (b) to what extent perfectionism was associated with educational achievement independent from IQ. METHOD WISC-III Verbal IQ, Performance IQ, and Full Scale IQ of 386 adolescent ED patients were compared with population norms for their educational track, using one-sample t tests. The association between self-oriented perfectionism (Eating Disorder Inventory-2) and educational achievement, adjusted for IQ, was determined with sequential ordinal regression analyses. RESULTS Over 50% of the patients received pre-university education, the most complex educational track. For patients receiving education in the second most complex track, IQ-scores were lower than normative data for that track. For patients receiving pre-university education, the verbal IQ was lower than the norm for that track. Self-oriented perfectionism was associated with educational achievement independent from intelligence. DISCUSSION This study suggests that high educational achievement is common in adolescents with EDs. Particularly for patients who receive education in the most complex tracks the demands at school may be higher than they can handle, based on their IQ. Self-oriented perfectionism contributed to educational achievement independent from IQ. Our results indicate that treatment for EDs should include awareness for the possibility of a too high target level of patients at school and perfectionism.
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Affiliation(s)
| | - Lot C Sternheim
- Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands
| | - Emmeke Aarts
- Department of Methodology and Statistics, Utrecht University, Utrecht, The Netherlands
| | - Annemarie A van Elburg
- Altrecht Eating Disorders Rintveld, Zeist, The Netherlands.,Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands
| | - Unna N Danner
- Altrecht Eating Disorders Rintveld, Zeist, The Netherlands.,Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands
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Effect of the Flipped Classroom and Gamification Methods in the Development of a Didactic Unit on Healthy Habits and Diet in Primary Education. Nutrients 2020; 12:nu12082210. [PMID: 32722228 PMCID: PMC7468774 DOI: 10.3390/nu12082210] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 07/22/2020] [Accepted: 07/23/2020] [Indexed: 12/21/2022] Open
Abstract
Currently, there are several methodological models that have broken into different disciplines of knowledge with the aim of making the teaching/learning process more dynamic, active and participatory for students. This is the case of Flipped Classroom, which is based on a mixed approach between e-learning and face-to-face teaching, as well as gamification, which bases its didactic principles on the recreational components of the games. Within this context, the aim of this research is to observe what effect the application of Flipped Classroom and gamification has in the development of motivation, autonomy and self-regulation towards learning through a didactic unit on healthy habits and diet in 202 students of 6th grade of Primary School from four different schools (public and state-subsidized) in the city of Granada (Spain). For this purpose, a methodological design was used with pre-test and post-test to check the effects of the experience on the students. The findings obtained showed that the application of these methods promoted an increase in students' motivation, as well as in their autonomy and self-regulation when facing the contents of the subject. For this reason, it is advocated that there is a need to continue promoting a quality and innovative educational practice according to the figure of the student today.
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Cavalcanti AL, Andrade NM, Brandt LMT, Freitas Fernandes LH, Toscano RL, Auad SM, Buldur B, Cavalcanti AFC. Risk Behaviors for Eating Disorders Among Brazilian Female Adolescents. Open Dent J 2020. [DOI: 10.2174/1874210602014010007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Eating disorders are complex conditions that cause serious emotional and physical problems.
Aim:
The aim of the study was to evaluate the behavioral risk for eating disorders in Brazilian female adolescents and their association with dental caries and erosion.
Materials and Methods:
This cross-sectional study included 200 students from public and private schools aged 15-18 years divided into two groups according to behavioral risk: Group 1 - adolescents without risk and Group 2 - adolescents at risk / disorder situation. Sociodemographic information (age and type of school), use of dental services, eating habits, and Body Mass Index (BMI) was obtained. The Bulimic Investigatory Test of Edinburgh (BITE) was used to identify behavioral risk. Caries experience was assessed using the DMFT index, while dental erosion was evaluated using the O'Sullivan index. Data were analyzed using descriptive and inferential statistics, with a significance level of 5%.
Results:
The highest overweight and obesity percentages were verified among adolescents at risk / disorder, respectively, 33% and 16%. There was a statistically significant association between behavioral risk and variables standard dietary pattern (p<0.001), strict diet (p<0.001), fasting for 24 hours (p<0.001), self-induced vomiting (p<0.001), and BMI (p<0.001). There was also a statistically significant difference between behavioral risk and the presence of dental caries (p<0.05) and erosion (p<0.001).
Conclusion:
Behavioral risk for eating disorders in female adolescents was associated with standard dietary patterns, strict diet and, self-induced vomiting. Adolescents at risk / eating disorders for bulimia were related to dental caries and erosion.
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Rantala MJ, Luoto S, Krama T, Krams I. Eating Disorders: An Evolutionary Psychoneuroimmunological Approach. Front Psychol 2019; 10:2200. [PMID: 31749720 PMCID: PMC6842941 DOI: 10.3389/fpsyg.2019.02200] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 09/12/2019] [Indexed: 12/18/2022] Open
Abstract
Eating disorders are evolutionarily novel conditions. They lead to some of the highest mortality rates of all psychiatric disorders. Several evolutionary hypotheses have been proposed for eating disorders, but only the intrasexual competition hypothesis is extensively supported by evidence. We present the mismatch hypothesis as a necessary extension to the current theoretical framework of eating disorders. This hypothesis explains the evolutionarily novel adaptive metaproblem that has arisen when mating motives conflict with the large-scale and easy availability of hyper-rewarding but obesogenic foods. This situation is exacerbated particularly in those contemporary environments that are characterized by sedentary lifestyles, ever-present junk foods, caloric surplus and the ubiquity of social comparisons that take place via social media. Our psychoneuroimmunological model connects ultimate-level causation with proximate mechanisms by showing how the adaptive metaproblem between mating motives and food rewards leads to chronic stress and, further, to disordered eating. Chronic stress causes neuroinflammation, which increases susceptibility to OCD-like behaviors that typically co-occur with eating disorders. Chronic stress upregulates the serotonergic system and causes dysphoric mood in anorexia nervosa patients. Dieting, however, reduces serotonin levels and dysphoric mood, leading to a vicious serotonergic-homeostatic stress/starvation cycle whereby cortisol and neuroinflammation increase through stringent dieting. Our psychoneuroimmunological model indicates that between-individual and within-individual variation in eating disorders partially arises from (co)variation in gut microbiota and stress responsivity, which influence neuroinflammation and the serotonergic system. We review the advances that have been made in recent years in understanding how to best treat eating disorders, outlining directions for future clinical research. Current evidence indicates that eating disorder treatments should aim to reduce the chronic stress, neuroinflammation, stress responsivity and gut dysbiosis that fuel the disorders. Connecting ultimate causes with proximate mechanisms and treating biopsychosocial causes rather than manifest symptoms is expected to bring more effective and sophisticated long-term interventions for the millions of people who suffer from eating disorders.
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Affiliation(s)
| | - Severi Luoto
- English, Drama and Writing Studies, University of Auckland, Auckland, New Zealand.,School of Psychology, University of Auckland, Auckland, New Zealand
| | - Tatjana Krama
- Department of Biotechnology, Daugavpils University, Daugavpils, Latvia
| | - Indrikis Krams
- Department of Biotechnology, Daugavpils University, Daugavpils, Latvia.,Institute of Ecology and Earth Sciences, University of Tartu, Tartu, Estonia
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Wood S, Marchant A, Allsopp M, Wilkinson K, Bethel J, Jones H, John A. Epidemiology of eating disorders in primary care in children and young people: a Clinical Practice Research Datalink study in England. BMJ Open 2019; 9:e026691. [PMID: 31378721 PMCID: PMC6688704 DOI: 10.1136/bmjopen-2018-026691] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Examination of current temporal trends and clinical management patterns of eating disorders (ED) in primary care is lacking. We aimed to calculate annual incidence rates of EDs in primary care by age, sex and deprivation. We also explored the care received through referrals, psychotropic prescriptions and associated secondary care service use. PARTICIPANTS AND SETTINGS A retrospective electronic cohort study was conducted using the Clinical Practice Research Datalink in those aged 11-24 years between 2004 and 2014 in England (n=1 135 038). RESULTS A total of 4775 individuals with a first ever recorded ED diagnosis were identified. The crude incidence rate was 100.1 per 100 000 person years at risk (95% CI 97.2 to 102.9). Incidence rates were highest in females (189.3 per 100 000 person years, 95% CI 183.7 to 195.0, n=4336), 16-20 years of age (141.0 per 100 000 person years, 95% CI 135.4 to 146.9, n=2348) and individuals from the least deprived areas (115.8 per 100 000 person years (95% CI 109.3 to 122.5, n=1203). Incidence rates decreased across the study period (incidence rate ratio (IRR) 0.6, 95% CI 0.5 to 0.8), particularly for individuals with bulimia nervosa (IRR 0.5, 95% CI 0.3 to 0.7) and from the most deprived areas (IRR 0.5, 95% CI 0.4 to 0.7). A total of 17.4% (95% CI 16.3 to 18.5, n=831) of first ever recorded ED cases were referred from primary to secondary care. 27.1% (95% CI 25.9 to 28.4, n=1294) of individuals had an inpatient admission 6 months before or 12 months after an incident ED diagnosis and 53.4% (95% CI 52.0 to 54.9, n=2550) had an outpatient attendance. Antidepressants were the most commonly prescribed psychotropic medication. CONCLUSIONS New ED presentations in primary care are reducing. Understanding the cause of this decrease (coding behaviours, changes in help-seeking or a genuine reduction in new cases) is important to plan services, allocate resources and deliver effective care.
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Affiliation(s)
- Sophie Wood
- Population Psychiatry, Suicide and Informatics, Swansea University Medical School, Swansea, UK
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK
| | - Amanda Marchant
- Population Psychiatry, Suicide and Informatics, Swansea University Medical School, Swansea, UK
| | - Mark Allsopp
- Child and Adolescent Psychiatry, Berkshire Healthcare NHS Foundation Trust, England, UK
- NCEPOD, London, UK
| | | | - Jackie Bethel
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK
| | - Hywel Jones
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK
| | - Ann John
- Population Psychiatry, Suicide and Informatics, Swansea University Medical School, Swansea, UK
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16
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Bouguettaya A, Moulding R, King RM, Harrold G. The relationships between socially prescribed perfectionism, in-group affect, negative urgency, and disordered eating in women. Scand J Psychol 2019; 60:369-376. [PMID: 31006891 DOI: 10.1111/sjop.12539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 03/13/2019] [Indexed: 01/03/2023]
Abstract
Socially prescribed perfectionism (SPP) is often considered as a key risk factor for disordered eating (DE). However, current conceptualizations of SPP largely assume that this perfectionism pressure is non-specific (i.e., a global pressure), despite research indicating that for females experiencing DE, female-dominated groups impose this pressure (as a perceived norm). Furthermore, this relationship may be mediated by a negative reaction to this pressure, in the form of impulsivity (or negative urgency). To date, no research has investigated whether the relationship between SPP and DE is mediated by negative urgency, nor has there been research clarifying how in-group identification relates to DE, independent of SPP and negative urgency. To address these gaps, we assessed these variables in 147 female dieters (Mage = 25.12 years, SD = 3.08) using a cross-sectional design. Consistent with our hypotheses, negative urgency fully mediated the link between female-based SPP and disordered eating, while female-based in-group affect (identification) was predictive of disordered eating (although the latter relationship was not sustained in a multiple regression model). These findings suggest that the SPP from other women may relate to DE through increasing negative urgency, and that the link between in-group (female) affect and DE may be better explained by SPP's link to DE.
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Affiliation(s)
| | | | - Ross M King
- Faculty of Health, Deakin University, Australia
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17
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Abstract
Most theories emphasize the role of sociocultural factors in the etiology of eating disorders (EDs). This article uses a broad search strategy to identify current etiologic studies. Women with an ED outnumber men in each diagnosis, but gender differences vary by diagnosis. Men were underrepresented in study samples, and information about variable risk factors in men is sparse. Findings suggest transdiagnostic risk factors and disorder-specific risk factors. Extracting data from population-based registers represents a major advance. Novel analytic approaches suggest complex pathways to ED. Although used in several studies, reliance on a transdiagnostic ED category (vs diagnosis-specific groupings) is premature.
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Affiliation(s)
- Ruth Striegel Weissman
- Department of Psychology, Wesleyan University, 207 High Street, Middletown, CT 06359, USA.
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18
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Life Satisfaction, Interpersonal Relationships, and Learning Influence Withdrawal from School: A Study among Junior High School Students in Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15102309. [PMID: 30347810 PMCID: PMC6210206 DOI: 10.3390/ijerph15102309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 10/16/2018] [Accepted: 10/18/2018] [Indexed: 12/02/2022]
Abstract
School absenteeism, particularly among junior high school students, has increased annually in Japan. This study demonstrates the relationship between subjective adjustment to school life and students’ absenteeism. Data were collected from 17,378 junior high school students in Japan. A longitudinal design was used for the study. Teachers were asked to distribute the Adaptation Scale for School Environments on Six Spheres (ASSESS) questionnaire to junior high school students and ask the students to fill out the questionnaire at the beginning of the 2014 academic year in April 2014, and the relationship between their subjective adjustment and absenteeism as measured by the total number of absent days during the 2014 academic year was evaluated by logistic regression and a survival analysis model. Low life satisfaction was associated with absences. The corresponding odds ratio (OR) was higher for seventh graders (OR 3.29, confidence interval (CI): 2.41–4.48, hazard ratio (HR) 5.57, CI: 3.51–8.84) than for students in other grades. Interpersonal relationships were significantly related to absenteeism for seventh and eighth graders in the group with scores less than 39 points. Lower adjustment to learning seemed to be related to absenteeism for seventh and eighth graders. For effective interventions, a well-designed study that uses detailed information regarding life-related covariates is necessary.
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Kim Y, Austin SB, Subramanian SV, Thomas JJ, Eddy KT, Franko DL, Rodgers RF, Kawachi I. Risk factors for disordered weight control behaviors among Korean adolescents: Multilevel analysis of the Korea Youth Risk Behavior Survey. Int J Eat Disord 2018; 51:124-138. [PMID: 29341246 DOI: 10.1002/eat.22820] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 12/17/2017] [Accepted: 12/18/2017] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To investigate the prevalence and risk factors for disordered weight control behaviors (DWCB) in South Korean adolescents at multiple levels, including individual, family, school, and geographic area. METHOD We drew participants from the 11th Korea Youth Risk Behavior Web-based Survey, conducted in 2015, with 65,529 adolescents (31,687 girls, 33,842 boys) aged 12-18 years. DWCB was defined as engaging in any of the following behaviors for weight control over the past month: fasting, one-food diet (eating only one food over an extended period of time for weight control), vomiting, and taking laxatives/diuretics/unprescribed diet pills. Sex-stratified four-level multilevel logistic models examined potential predictors of DWCB, including age, body-mass index, puberty, perceived household economic status, parental education, living structure, school type and sex-composition, percentage of students participating in school nutrition programs, and urbanicity. RESULTS Overall, 6.2% of Korean adolescents (8.9% of girls, 3.7% of boys) exhibited any DWCB. We found significant between-school variation among girls and boys and between-classroom variation among girls. Older age, overweight/obesity, pubertal maturity, high household economic status (vs. mid-range economic status), and vocational schooling (vs. general) were positively associated with DWCB among girls and boys. Low household economic status (vs. mid-range economic status), higher parental education, and coeducational schooling (vs. single-sex) were positively associated with DWCB among girls only. DISCUSSION The findings suggest that DWCB are prevalent among Korean adolescents across age, sex, and socioeconomic status. Social contextual factors including school and familial environmental factors, as well as individual characteristics, should be considered when developing effective prevention strategies.
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Affiliation(s)
- Yongjoo Kim
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - S Bryn Austin
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.,Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - S V Subramanian
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Jennifer J Thomas
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Kamryn T Eddy
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Debra L Franko
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts.,Bouvé College of Health Sciences, Department of Applied Psychology, Northeastern University, Boston, Massachusetts
| | - Rachel F Rodgers
- Bouvé College of Health Sciences, Department of Applied Psychology, Northeastern University, Boston, Massachusetts
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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20
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María Pérez-Sánchez C, Nicolás Torres D, Hernández Morante JJ. Altered Eating Attitudes in Nursing Home Residents and Its Relationship with their Cognitive and Nutritional Status. J Nutr Health Aging 2018; 22:869-875. [PMID: 30080233 DOI: 10.1007/s12603-018-1056-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND although eating disorders are usually linked to young adolescents, these mental disorders can also appear in the elderly, especially in those living in nursing homes, which might be associated or not with the cognitive decline; however, there are few data regarding elderly subjects. OBJECTIVES the objective of the present work was to evaluate the presence of abnormal eating attitudes in nursing home residents and its relation with several cognitive, nutritional and psychological factors that could be influencing their nutritional state. DESIGN AND SETTING a observational experimental study was carried out at several nursing homes of Murcia, Spain. SUBJECTS 139 nursing home residents. METHODS EAT-26 test was used to screen classic eating disorders (anorexia and bulimia). Blandford's scale was employed to determine aversive eating attitudes. Moreover, subjective appetite sensations, body image perception, nutritional (MNA and diet composition) and biochemical data were also evaluated. RESULTS 33% of the subjects had malnutrition. No subject showed symptoms of anorexia or bulimia; however, subjects with cognitive decline frequently showed aversive feeding behaviours (21.6%). Albumin values were significantly lower in subjects with cognitive impairment. CONCLUSIONS our data showed a clear relation between cognitive impairment and altered eating attitudes, which was reflected by both biochemical (albumin) and nutritional parameters, while no classic eating disorder was observed in residents with normal cognitive-status. These data confirm the need to strengthen our efforts towards maintaining the nutritional status of the subjects with cognitive impairment.
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Affiliation(s)
- C María Pérez-Sánchez
- Dr. Juan José Hernández Morante, Catholic University of Murcia, Campus de Guadalupe, 30107 Guadalupe, Murcia. Spain, E-mail:
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21
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Do disordered eating behaviours in girls vary by school characteristics? A UK cohort study. Eur Child Adolesc Psychiatry 2018; 27:1473-1481. [PMID: 29546694 PMCID: PMC6447693 DOI: 10.1007/s00787-018-1133-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 02/23/2018] [Indexed: 10/31/2022]
Abstract
Previous research on eating disorders, disordered eating behaviours, and whether their prevalence varies across schools, has produced inconsistent results. Our previous work using Swedish record-linkage data found that rates of diagnosed eating disorders vary between schools, with higher proportions of girls and higher proportions of highly educated parents within a school being associated with greater numbers of diagnosed eating disorders. We aimed to extend these findings to a UK population-based sample and hypothesised that a similar association would be evident when studying disordered eating behaviours. We used data from the Avon Longitudinal Study of Parents and Children to test the hypothesis that prevalence of self- and parent-reported disordered eating behaviours (binge eating, purging, fasting, restrictive eating, and fear of weight gain), and body dissatisfaction cluster by school. We had complete data on body dissatisfaction, school attended, and other possible risk factors for 2146 girls in 263 schools at age 14 and on disordered eating behaviours for 1769 girls in 273 schools at age 16. We used multilevel logistic regression modelling to assess whether prevalence varied between and within schools, and logistic regression to investigate the association between specific school characteristics and prevalence of disordered eating behaviours and body dissatisfaction. At age 14, there was no evidence for body dissatisfaction clustering by school, or for specific school characteristics being associated with body dissatisfaction. At age 16, there was no evidence for clustering, but higher rates of disordered eating behaviours were associated with attending all-girl schools and lower levels with attending schools with higher academic results. We found no evidence for clustering of disordered eating behaviours in individual schools, possibly because of the small cluster sizes. However, we found evidence for higher levels of disordered eating behaviours in 16 years in all-girl schools, and in schools with lower academic performance.
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22
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Bühren K, Herpertz-Dahlmann B, Dempfle A, Becker K, Egberts KM, Ehrlich S, Fleischhaker C, von Gontard A, Hahn F, Jaite C, Kaess M, Legenbauer T, Renner TJ, Schrötter E, Schulze U, Sinzig J, Antony G, Hebebrand J, Föcker M. First Sociodemographic, Pretreatment and Clinical Data from a German Web-Based Registry for Child and Adolescent Anorexia Nervosa. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2017; 45:393-400. [DOI: 10.1024/1422-4917/a000544] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Abstract. Objective: The first web-based registry for childhood and adolescent anorexia nervosa (AN) in Germany was established to systematically collect demographic and clinical data. These data as well as information on how young individuals with AN can find access to healthcare services are presented. Method: Patients´ data from child and adolescent psychiatry departments of 12 university hospitals and two major nonuniversity hospitals in Germany were collected between January 2015 and December 2016. All patients met the ICD-10 diagnostic criteria for (atypical) AN. Sociodemographic data, type and amount of healthcare utilization before admission, and clinical data at admission and discharge were compiled. Results: 258 patients with a mean age of 14.7 years and a mean BMI at admission of 15.3 kg/m2 were included. The parents and patients had a higher educational level than the general German population. More than 80 % of the patients reported having utilized healthcare before hospitalization. The mean duration of outpatient treatment before hospitalization was 7 months. Conclusions: There seem to be major barriers to specialist treatment for young patients with AN in Germany, which should be analyzed in future studies.
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Affiliation(s)
- Katharina Bühren
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, RWTH Aachen, Germany
| | - Beate Herpertz-Dahlmann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, RWTH Aachen, Germany
| | - Astrid Dempfle
- Institute of Medical Informatics and Statistics, Kiel University, Germany
| | - Katja Becker
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Philipps University Marburg and University Hospital Marburg, Germany
| | - Karin M. Egberts
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Germany
| | - Stefan Ehrlich
- Department of Child and Adolescent Psychiatry & Division of Psychological & Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technical University Dresden, Germany
| | - Christian Fleischhaker
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Freiburg, Germany
| | - Alexander von Gontard
- Department of Child and Adolescent Psychiatry, Saarland University Hospital, Homburg, Germany
| | - Freia Hahn
- Department of Child an Adolescent Psychiatry, Psychosomatics and Psychotherapy, LVR – Hospital Viersen, Germany
| | - Charlotte Jaite
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Berlin, Germany
| | - Michael Kaess
- Clinic of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University Hospital Heidelberg, Germany
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Tanja Legenbauer
- LWL University Hospital Hamm for Child and Adolescent Psychiatry, Ruhr University Bochum, Germany
| | - Tobias J. Renner
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Tübingen, Germany
| | - Ellen Schrötter
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technical University Dresden, Germany
| | - Ulrike Schulze
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital, University of Ulm, Germany
| | - Judith Sinzig
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, LVR-Klinik Bonn, Germany
| | - Gisela Antony
- Central Information Office KKNMS, Philipps University Marburg, Germany
| | - Johannes Hebebrand
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Hospital Essen, University of Duisburg-Essen, Germany
| | - Manuel Föcker
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Hospital Essen, University of Duisburg-Essen, Germany
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23
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Forrest LN, Smith AR, Swanson SA. Characteristics of seeking treatment among U.S. adolescents with eating disorders. Int J Eat Disord 2017; 50:826-833. [PMID: 28323350 DOI: 10.1002/eat.22702] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 02/20/2017] [Accepted: 02/26/2017] [Indexed: 01/03/2023]
Abstract
OBJECTIVE The majority of persons with eating disorders (EDs) do not seek ED treatment, yet little is known about treatment-seeking barriers or facilitators. The aim of the study is to describe the characteristics associated with seeking ED treatment among U.S. adolescents with EDs. METHOD Data from a nationally representative cross-sectional study of U.S. adolescents ages 13-18 years were used for these analyses. Specifically, adolescents who met criteria for lifetime EDs (N = 281) were included. Sociodemographic information, characteristics of EDs, psychiatric comorbidities, and other mental health service use were assessed via interview. RESULTS Only 20% of adolescents sought ED treatment. Females were 2.2 (95% CI 0.8, 6.4) times more likely to seek treatment than males (19.9% vs. 8.9%). Adolescents who met criteria for anorexia nervosa or bulimia nervosa were 2.4 (95% CI 0.9, 6.3) and 1.9 (95% CI 1.0, 3.8) times more likely to seek treatment than adolescents who met criteria for binge-eating disorder (27.5% and 22.3% vs. 11.6%). Specific ED behaviors (restriction and purging), ED-related impairment, and any mental health service use were also associated with adolescent treatment seeking. DISCUSSION Adolescent treatment seeking was infrequent overall, with individuals with counter-stereotypic ED presentations least likely to have sought treatment. Adolescent treatment seeking could be promoted through increasing awareness among the public and healthcare professionals that EDs affect a heterogeneous group of people. More generally, research involving both treatment-seeking and non-treatment-seeking individuals holds great potential to refine the field's knowledge of ED etiology, prevalence, treatment, and prevention.
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Affiliation(s)
| | - April R Smith
- Department of Psychology, Miami University, Oxford, Ohio
| | - Sonja A Swanson
- Erasmus MC, Rotterdam, The Netherlands.,Harvard T. H. Chan School of Public Health, Boston, Massachusetts
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Epidemiology of eating disorders in Europe: prevalence, incidence, comorbidity, course, consequences, and risk factors. Curr Opin Psychiatry 2016; 29:340-5. [PMID: 27662598 DOI: 10.1097/yco.0000000000000278] [Citation(s) in RCA: 417] [Impact Index Per Article: 52.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
PURPOSE OF REVIEW Eating disorders - anorexia nervosa, bulimia nervosa, and binge eating disorder - affect numerous Europeans. This narrative review summarizes European studies on their prevalence, incidence, comorbidity, course, consequences, and risk factors published in 2015 and the first half of 2016. RECENT FINDINGS Anorexia nervosa is reported by <1-4%, bulimia nervosa <1-2%, binge eating disorder <1-4%, and subthreshold eating disorders by 2-3% of women in Europe. Of men, 0.3-0.7% report eating disorders. Incidences of anorexia appear stable, whereas bulimia may be declining. Although the numbers of individuals receiving treatment have increased, only about one-third is detected by healthcare. Over 70% of individuals with eating disorders report comorbid disorders: anxiety disorders (>50%), mood disorders (>40%), self-harm (>20%), and substance use (>10%) are common. The long-term course of anorexia nervosa is favorable for most, but a substantial minority of eating disorder patients experience longstanding symptoms and somatic problems. The risk of suicide is elevated. Parental psychiatric disorders, prenatal maternal stress, various family factors, childhood overweight, and body dissatisfaction in adolescence increase the risk of eating disorders. SUMMARY Eating disorders are relatively common disorders that are often overlooked, although they are associated with high comorbidity and serious health consequences.
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Chang CT, Garg P, Giddon DB. Boarding school influence on self-reported concern for perceived body and face morphology in Taiwan. Asian J Psychiatr 2016; 22:96-101. [PMID: 27520907 DOI: 10.1016/j.ajp.2016.05.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 05/07/2016] [Accepted: 05/14/2016] [Indexed: 10/21/2022]
Abstract
To determine the influence of boarding school on self-perceived body and facial morphology, the Body Shape Questionnaire (BSQ) and exploratory questions about the orofacial area (OFA) were administered to female boarding (B) and nonboarding (NB) students at two Catholic schools in Taiwan. The mean total BSQ scores of Bs were significantly higher than NBs, with both being significantly higher than the published normative score but lower than probable bulimics with no significant B vs. NB difference in mean total OFA scores. Because the Bs were significantly taller and reported more orthodontic treatment than NBs, the possible confounding by the higher economic status of the Bs was minimized by finding similar significantly higher BSQ scores for the small number of Bs (5%) than the remaining NBs (95%) in the documented lower socio-economic school. In summary, the experience of boarding in religion-dominated schools significantly increases body image concerns of adolescent females.
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Affiliation(s)
- Chieh Ting Chang
- University of Texas School of Dentistry at Houston, United States
| | - Prerna Garg
- Boston University Henry M. Goldman School of Dental Medicine, United States
| | - Donald B Giddon
- Harvard University, School of Dental Medicine, 188 Longwood Ave., Boston, MA 02115, United States.
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26
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Swanson SA, Field AE. Commentary: Considerations for the use of registry data to study adolescent eating disorders. Int J Epidemiol 2016; 45:488-90. [DOI: 10.1093/ije/dyw084] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2016] [Indexed: 11/14/2022] Open
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27
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Ferrie JE. Accomplishments, malfeasances, misfeasances and nonfeasances. Int J Epidemiol 2016. [DOI: 10.1093/ije/dyw068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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