The relationship between eating disorders and personality in physically active women

Anxiety, eating disorders and menstrual disturbances risk in Spanish elite female paddlers

Affiliated athletes are frequently subject to higher levels of anxiety due to the intensity of training, competition and many other factors. This anxiety can cause alterations in their health, both physically and mentally, such as menstrual irregularities, eating disorders, etc. In this work we have analysed the anxiety levels of a population of female affiliated paddlers and the possible consequences for their health. The results showed that a third of the female paddlers analysed have a moderate/high risk of suffering from anxiety; and within this group, the less sporting experience the athlete has, the greater the probability is of suffering from anxiety. Moreover, almost half the total of the female paddlers suffers from menstrual dysfunction before an important competition, with this number rising among high performance athletes, even though three out of every four adjust their training schedule to their menstrual cycle. Less-experienced female athletes, who show higher anxiety levels, also present a greater risk of suffering from eating disorders.

A Brief Review of Personality in Marathon Runners: The Role of Sex, Age and Performance Level

The participation of recreational runners in sport events ranging from 5 km to ultra-endurance races have increased dramatically during the last decades and this phenomenon has attracted scientific interest. Most research has focused on the physiological characteristics of these runners and less in their psychological characteristics. Therefore, the aim of the present study was to review the existing knowledge with regards to the personality of recreational endurance runners and the role of sex, age and performance. It was concluded that limited information was available with regards to the personality of recreational marathon runners. So far, our knowledge on the personality of marathon runners relied on studies conducted a few decades ago, mostly on competitive marathon runners, highlighting the need for original research on recreational runners.

Application of the Transdiagnostic Cognitive-Behavioral Model of Eating Disorders to the Athletic Population

The purpose of this study was twofold: to explore the utility of components related to the transdiagnostic cognitive-behavioral model of eating disorders within an athletic population and to investigate the extent to which the model can be applied across gender, sport type, and performance standard to explain eating psychopathology. Five hundred and eighty-eight (N = 588) male and female British athletes completed a battery of self-report instruments related to eating psychopathology, interpersonal diffculties, perfectionism, self-esteem, and mood. Structural equation modeling revealed that eating psychopathology may arise from an interaction of interpersonal diffculties, low self-esteem, high levels of self-critical perfectionism, and depressive symptoms. Analysis further highlighted that the manner in which eating psychopathology may arise is invariant across athletes’ sport type and performance standard, but not across gender. The current findings suggest that the tested components of the transdiagnostic cognitive-behavioral model are pertinent and useful in explaining eating psychopathology among athletes.

Female athlete triad in monozygotic twins

Female monozygotic twins, both international endurance athletes aged 18 years, presented for a dual energy x-ray absorptiometry (DXA) scan as part of a university clinical trial. Twin 1 had only menstruated twice since menarche; Twin 2 had not yet started menstruating. Both twins acknowledged suffering from disordered eating for approximately 3 years. Both twins presented with low lumbar spine bone mineral density (BMD) and normal total body, total hip, and femoral neck BMD.

DIAGNOSIS

Female athlete triad comprising disordered eating with insufficient energy availability, amenorrhea, and low age-related BMD.

MANAGEMENT

Despite some weight gain and reduction of athletic training and competition over a 5-year period, lumbar BMD remained low in both twins and was complicated by a rapid decline in BMD at the hips. Twin 2 remained amenorrheic. The oral contraceptive pill was not effective in maintaining BMD in the other twin. Contraindicated treatment with bisphosphonates was not tolerated and promptly ceased. This case seminar emphasizes the absence of a clear physician-coordinated multi-disciplinary treatment approach and the complexity in treating all the components of the triad in young athletes.

KEYWORDS

female athlete triad; monozygotic; amenorrhea; bone mineral density.

Contribution of the serotoninergic system to anxious and depressive traits that may be partially responsible for the phenotypical variability of bulimia nervosa

Eating disorders (ED), such as anorexia nervosa (AN) and bulimia nervosa (BN), are complex psychiatric phenotypes influenced by both genetic and environmental factors. We investigated the genetic contribution of four single nucleotide polymorphisms (SNPs) within the serotonin receptor 5HT2C and two sequence variants within the serotonin transporter SLC6A4 to different ED-related psychopathological symptoms in a total sample of 82 ED patients. All patients were diagnosed according to DSM-IV criteria and underwent diagnostic and psychopathological assessments by means of structured clinical interviews and rating scales. We detected significant evidence of association between the -995A/-759T/-697C/Cys23 haplotype of the 5HT2C gene and different anxious and depressive subscales of the SCL90-R instrument, that included Somatization (p = 0.029), Obsessive-Compulsiveness (p = 0.021), Depression (p = 0.032), Anxiety (p = 0.004), Hostility (p = 0.028), Phobic Anxiety (p = 0.029) and Paranoid Ideation (p = 0.008), in BN patients. We also observed a strong association between the 5HTTLPR polymorphism of the SLC6A4 gene and Anxiety in the same group of BN patients (p = 0.004). However, no epistatic effects between the 5HT2C and SLC6A4 genes on the different anxious and depressive subscales were observed. Our preliminary data suggest that the serotoninergic system contributes to the different psychopathological symptoms that may be partially responsible for the phenotypical variability within the bulimic phenotype.

Comparison of personality risk factors in bulimia nervosa and pathological gambling

OBJECTIVE

The objective of the study was to assess the predictive value of personality profiles to classify individuals with bulimia nervosa (BN), pathological gambling (PG), and a nonpsychiatric comparison group while controlling for sex.

METHODS

The sample comprised 270 BN (241 women, 29 men), 429 PG (42 women, 387 men), and 96 comparison (nonpsychiatric) subjects (35 women, 61 men). All patients were consecutively admitted to our Psychiatry Department and were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria. We administered the Temperament and Character Inventory-Revised as well as other clinical indices. Multinomial and binary logistic regression models adjusted for age and stratified by sex were used to assess the predictive value of personality in relation to group status.

RESULTS

In comparison to controls, high Novelty Seeking (P < .001) was specifically associated with a diagnosis of PG. Independently of sex, low Self-Directedness was associated with both BN (P < .001) and PG (P < .001). Some sex-specific differences were also observed; namely, women with BN and PG displayed higher Harm Avoidance and Cooperativeness than control women, whereas men with PG reported higher Reward Dependence and Persistence than control men.

CONCLUSIONS

Our results suggested that, whereas there are some shared personality traits between BN and PG when compared with healthy controls, there are also some sex- and diagnostic-specific personality traits that weigh against the consideration of BN as an impulse control disorder.

Gender, eating behavior, and personality characteristics in physically active students

The aim of this paper was to examine associations between personality traits, eating disorder (ED) behavior, exercise, and gender. The participants (n=1482: 905 women and 577 men) were students from four universities in Norway. The subjects filled out a compound questionnaire including demographics, weekly hours of exercise, type of sport, Karolinska Scales of Personality (KSP), and the Eating Disorder Inventory (EDI). Because of the data collection procedure, it is difficult to provide a clear-cut response rate in this study. The results showed that the risk ratio for women who scored 40 or higher on the EDI was three times higher compared with men. ED behavior did not seem to be associated with high weekly hours of physical activity in general. There were significant gender differences in personality traits. However, women and men with high scores on the EDI showed no differences on the KSP scales, except on "detachment" and "indirect aggression". The most important predictors for weekly hours of physical activity were the EDI scales "drive for thinness" and "body dissatisfaction", and the personality variables "extraversion" and "neuroticism". The factors that contributed most to the differences between students who scored 40 or higher on the EDI and those who scored below 40 on the EDI were neuroticism, BMI, gender, and age.

Eating disorder behavior in physically active Norwegian women

Competitive female athletes may have higher risk of eating disorders (ED) than recreational athletes, in part because low body fat may be advantageous in sports. However, women who participate in sports or physical activities might also do this for weight reduction, altering body shape, and for other food related reasons. This study was conducted to evaluate the association between hours of leisure time physical activity (PA) and prevalence of ED, and whether the association between the Eating Disorders Inventory (EDI) scales and ED, as classified by the Survey of Eating Disorders (SED), was the same among women with high vs. low physical activity levels. The community-based study sample consisted of 898 female students aged 18-50 years. Subjects filled out the EDI, the SED, and a questionnaire concerning physical activity and demographic data. Physical activity was not associated with increased risk of having a SED-defined diagnosis of an ED or of having an EDI score greater than 40, which is sometimes used to define women at risk for having an eating disorder. Women with a SED-defined ED had higher scores on all subscales of the EDI, but did not differ with respect to age, BMI or hours of weekly activity. The strongest predictors of having a SED-defined ED were body mass index (BMI), two EDI scales, drive of thinness and Bulimia Nervosa, with no differences between the two PA groups. Among women with a SED-defined ED, those with more than 5 h weekly PA did not differ from others with respect to scoring on the EDI or BMI. Results suggest that hours of physical activity may not increase risk of developing ED. Effective interventions are needed to help the growing numbers of persons with body-image and eating difficulties. For some, moderate physical training might be helpful.