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Basch M, Lupini F, Ho S, Dagnachew M, Gutierrez-Colina AM, Patterson Kelly K, Shomaker L, Streisand R, Vagadori J, Mackey E. Mindfulness-based group intervention for adolescents with type 1 diabetes: initial findings from a pilot and feasibility randomized controlled trial. J Pediatr Psychol 2024:jsae071. [PMID: 39212647 DOI: 10.1093/jpepsy/jsae071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 08/15/2024] [Accepted: 08/15/2024] [Indexed: 09/04/2024] Open
Abstract
OBJECTIVE To evaluate feasibility/acceptability of a virtual, group mindfulness-based intervention (MBI) adapted for pediatric type 1 diabetes (T1D). METHODS This two-way controlled trial randomized adolescents 1:1 to MBI (n = 20) or health education (HE; n = 22) groups lasting 6-7 weeks. Eligibility included 12-17 years, T1D ≥ 1 year, and elevated scores on PROMIS depression or anxiety measures. Recruitment, retention, and session attendance were tracked to measure feasibility. Acceptability was measured via youth-reported post-session surveys. Adolescents completed depression, anxiety, and diabetes-specific surveys at baseline, immediately post-program, and 3 months post-program completion. HbA1c values approximating these timeframes were obtained from chart review. RESULTS 55% of screened participants were eligible to participate, and 100% of eligible youth enrolled. There was 93% study retention and 96% session attendance rates. Survey data were 100% complete at baseline, and 93% complete at post-program and 3-month follow-ups; 83% and 78% of MBI participants rated sessions as at least somewhat enjoyable and helpful, respectively, and 91% and 82% of HE participants rated sessions as at least somewhat enjoyable and helpful, respectively. Mean scores showed declines in depression, anxiety, disordered eating, diabetes distress, and HbA1c in both groups across time, with trends toward potential greater reductions in depression and HbA1c in MBI. CONCLUSIONS This pilot provides preliminary evidence that virtual MBI and HE groups adapted for adolescents with T1D are feasible to deliver and acceptable, with potential improvement in psychosocial, behavioral, and diabetes-specific outcomes. Whether MBI is more effective for targeting negative affect and glycemic control in the context of adolescent T1D requires testing in a full-scale efficacy trial.
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Affiliation(s)
- Molly Basch
- Center for Translational Research, Children's National Hospital, Washington, DC, United States
- Psychiatry & Behavioral Sciences, The George Washington University School of Medicine, Washington, DC, United States
| | - Francesca Lupini
- Center for Translational Research, Children's National Hospital, Washington, DC, United States
| | - Sally Ho
- Center for Translational Research, Children's National Hospital, Washington, DC, United States
| | - Mesgana Dagnachew
- Center for Translational Research, Children's National Hospital, Washington, DC, United States
| | - Ana M Gutierrez-Colina
- Human Development & Family Studies, Colorado State University, Fort Collins, CO, United States
- Pediatric Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Katherine Patterson Kelly
- Nursing Science, Professional Practice, & Quality, Children's National Hospital, Washington, DC, United States
- Pediatrics, The George Washington University School of Medicine, Washington, DC, United States
| | - Lauren Shomaker
- Human Development & Family Studies, Colorado State University, Fort Collins, CO, United States
- Pediatric Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
- Pediatric Endocrinology, Children's Hospital Colorado, Aurora, CO, United States
| | - Randi Streisand
- Center for Translational Research, Children's National Hospital, Washington, DC, United States
- Psychiatry & Behavioral Sciences, The George Washington University School of Medicine, Washington, DC, United States
| | - Jack Vagadori
- Center for Translational Research, Children's National Hospital, Washington, DC, United States
| | - Eleanor Mackey
- Center for Translational Research, Children's National Hospital, Washington, DC, United States
- Psychiatry & Behavioral Sciences, The George Washington University School of Medicine, Washington, DC, United States
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Croci MS, Brañas MJAA, Javaras KN, Dechant E, Jurist J, Steigerwald G, Choi-Kain LW. General Psychiatric Management for Adolescents With Borderline Personality Disorder and Eating Disorders. Am J Psychother 2024:appipsychotherapy20230045. [PMID: 39083007 DOI: 10.1176/appi.psychotherapy.20230045] [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: 08/09/2024]
Abstract
Borderline personality disorder and eating disorders frequently co-occur among youths. These disorders emerge in adolescence, during the critical developmental period of building an independent sense of self and the capacity to relate to one's community. Because of core differences in the development and psychopathology of borderline personality disorder and eating disorders, adjustments are required when treating these disorders when they co-occur. Few established treatment approaches can address these disorders simultaneously. Evidence-based psychotherapies for borderline personality disorder, such as dialectical behavior therapy and mentalization-based treatment, have been adapted to accommodate the shared vulnerabilities and features of the two disorders. However, these approaches are specialized, intensive, and lengthy and are therefore poorly suited to implementation in general psychiatric or primary health care, where most frontline mental health care is provided. Generalist approaches can fill this public health gap, guiding nonspecialists in structuring informed clinical management for these impairing and sometimes fatal disorders. In this overview, the authors describe the adjustment of good (or general) psychiatric management (GPM) for adolescents with borderline personality disorder to incorporate the prevailing best practices for eating disorder treatment. The adjusted treatment relies on interventions most clinicians already use (diagnostic disclosure, psychoeducation, focusing on life outside treatment, managing patients' self-destructive behaviors, and conservative psychopharmacology with active management of comorbid conditions). Limitations of the adjusted treatment, as well as guidelines for referring patients to specialized and general medical treatments and for returning them to primary generalist psychiatric care, are discussed.
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Affiliation(s)
- Marcos S Croci
- Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, and National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil (Croci, Brañas); Division of Women's Mental Health (Javaras), Klarman Eating Disorders Center (Dechant), and Gunderson Personality Disorders Institute (Jurist, Steigerwald, Choi-Kain), McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston (Javaras, Dechant, Choi-Kain); Department of Psychology, Harvard University, Cambridge, Massachusetts (Steigerwald)
| | - Marcelo J A A Brañas
- Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, and National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil (Croci, Brañas); Division of Women's Mental Health (Javaras), Klarman Eating Disorders Center (Dechant), and Gunderson Personality Disorders Institute (Jurist, Steigerwald, Choi-Kain), McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston (Javaras, Dechant, Choi-Kain); Department of Psychology, Harvard University, Cambridge, Massachusetts (Steigerwald)
| | - Kristin N Javaras
- Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, and National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil (Croci, Brañas); Division of Women's Mental Health (Javaras), Klarman Eating Disorders Center (Dechant), and Gunderson Personality Disorders Institute (Jurist, Steigerwald, Choi-Kain), McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston (Javaras, Dechant, Choi-Kain); Department of Psychology, Harvard University, Cambridge, Massachusetts (Steigerwald)
| | - Esther Dechant
- Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, and National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil (Croci, Brañas); Division of Women's Mental Health (Javaras), Klarman Eating Disorders Center (Dechant), and Gunderson Personality Disorders Institute (Jurist, Steigerwald, Choi-Kain), McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston (Javaras, Dechant, Choi-Kain); Department of Psychology, Harvard University, Cambridge, Massachusetts (Steigerwald)
| | - Julia Jurist
- Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, and National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil (Croci, Brañas); Division of Women's Mental Health (Javaras), Klarman Eating Disorders Center (Dechant), and Gunderson Personality Disorders Institute (Jurist, Steigerwald, Choi-Kain), McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston (Javaras, Dechant, Choi-Kain); Department of Psychology, Harvard University, Cambridge, Massachusetts (Steigerwald)
| | - Georgia Steigerwald
- Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, and National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil (Croci, Brañas); Division of Women's Mental Health (Javaras), Klarman Eating Disorders Center (Dechant), and Gunderson Personality Disorders Institute (Jurist, Steigerwald, Choi-Kain), McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston (Javaras, Dechant, Choi-Kain); Department of Psychology, Harvard University, Cambridge, Massachusetts (Steigerwald)
| | - Lois W Choi-Kain
- Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, and National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil (Croci, Brañas); Division of Women's Mental Health (Javaras), Klarman Eating Disorders Center (Dechant), and Gunderson Personality Disorders Institute (Jurist, Steigerwald, Choi-Kain), McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston (Javaras, Dechant, Choi-Kain); Department of Psychology, Harvard University, Cambridge, Massachusetts (Steigerwald)
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Paraskeva N, Haywood S, Hasan F, Nicholls D, Toledano MB, Diedrichs PC. An exploration of having social media influencers deliver a first-line digital intervention to improve body image among adolescent girls: A qualitative study. Body Image 2024; 51:101753. [PMID: 38901182 DOI: 10.1016/j.bodyim.2024.101753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 06/03/2024] [Accepted: 06/04/2024] [Indexed: 06/22/2024]
Abstract
Social media influencers are popular among adolescents and could offer a unique way to reach young people at scale with body image interventions. This study explored girls' and influencers' views on having influencers deliver body image interventions through vlogs (video blogs) and to gain insight into their preferred format, content, and views on factors that encourage engagement with vlogs. Twenty-one UK based participants were recruited. Three online focus groups were conducted with adolescent girls (n = 16) aged 14-18 years and one with influencers (n = 5) aged 24-33 years, who had a collective following of over 1.5 million subscribers across social media platforms. Data were analysed using reflexive thematic analysis and four themes were generated: Choosing an influencer whose messages and core values are aligned with the topic of body image; the importance of influencer authenticity and personal experience; collaborating on content creation with mental health professionals; and the need for long-form (i.e., 10-20 min) content to address serious topics. Findings suggest having influencers deliver body image interventions to young people could be a useful approach. Results highlight the need to engage with end users from the outset of intervention development to increase the likelihood of intervention effectiveness and engagement.
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Affiliation(s)
- Nicole Paraskeva
- Centre for Appearance Research, University of the West of England, Bristol, UK.
| | - Sharon Haywood
- Centre for Appearance Research, University of the West of England, Bristol, UK
| | - Farheen Hasan
- Centre for Appearance Research, University of the West of England, Bristol, UK
| | - Dasha Nicholls
- Division of Psychiatry, Department of Brain Sciences, Imperial College London, UK
| | - Mireille B Toledano
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK; MRC Centre for Environment and Health, Imperial College London, UK; Mohn Centre for Children's Health and Wellbeing, Imperial College London, UK
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Makowski C, Westwater ML, Rhee KE, Zou J, Bischoff-Grethe A, Wierenga CE. Sociodemographic correlates of parent and youth-reported eating disorder symptoms in the Adolescent Brain Cognitive Development Study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2023.12.18.23300155. [PMID: 38196622 PMCID: PMC10775341 DOI: 10.1101/2023.12.18.23300155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
Purpose Eating Disorders (EDs) often start in adolescence, though ED-related concerns in diverse youth samples remain understudied. We leveraged data from the Adolescent Brain Cognitive Development (ABCD) Study to identify the prevalence of parent- and youth-reported ED symptoms and their sociodemographic characteristics. Methods Data were drawn from baseline (ages 9-11 years, n=11,868) and 2-year follow-up (ages 11-14 years; n=10,908) from the ABCD Study. A tetrachoric factor analysis summarized clusters of ED symptoms, which were compared between parent and youth reports and across sociodemographic variables. Results Three factors emerged reflecting "weight distress", "weight control", and "binge eating" (prevalence range: 1.5-7.3%). Symptoms loaded onto similar factors between reporters. Rates of symptom endorsement were similar between sexes, with disproportionately higher endorsement rates for youth who self-identified as sexual minority, Hispanic, Black, or Mixed race participants, and those from a disadvantaged socioeconomic background, compared to the reference ABCD sample. Youth and parent reports at 2-year showed ~12% overlap. Conclusions ED-related concerns among historically understudied racial and sexual minority groups call for greater attention to the detection and treatment of these symptoms in these groups. Applying a transdiagnostic approach to ED symptoms can inform effective detection and intervention efforts.
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Affiliation(s)
| | - Margaret L Westwater
- Department of Psychiatry, University of Oxford
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine
| | - Kyung E Rhee
- Department of Pediatrics, University of California San Diego
| | - Jingjing Zou
- Department of Biostatistics, University of California San Diego
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Ryan L, Quigley F, Birney S, Crotty M, Conlan O, Walsh JC. 'Beyond the Scale': A Qualitative Exploration of the Impact of Weight Stigma Experienced by Patients With Obesity in General Practice. Health Expect 2024; 27:e14098. [PMID: 38859797 PMCID: PMC11165259 DOI: 10.1111/hex.14098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 05/16/2024] [Accepted: 05/21/2024] [Indexed: 06/12/2024] Open
Abstract
OBJECTIVE Obesity is a complex, chronic, relapsing disease that requires an individualised approach to treatment. However, weight stigma (WS) experienced in healthcare settings poses a significant barrier to achieving person-centred care for obesity. Understanding the experiences of people living with obesity (PwO) can inform interventions to reduce WS and optimise patient outcomes. This study explores how patients with obesity perceive WS in general practice settings; its impact on their psychological well-being and health behaviours, and the patients suggestions for mitigating it. METHODS In-depth semistructured interviews were conducted with 11 PwO who had experienced WS in general practice settings in Ireland. The interviews were conducted online via Zoom between May and August 2023; interviews lasted between 31 and 63 min (M = 34.36 min). Interviews were audio-recorded, transcribed verbatim and analysed using inductive reflexive thematic analysis. RESULTS Three overarching themes specific to participants' experience of WS in general practice were generated: (1) shame, blame and 'failure'; (2) eat less, move more-the go-to treatment; (3) worthiness tied to compliance. A fourth theme: (4) the desire for a considered approach, outlines the participants' suggestions for reducing WS by improving the quality of patient-provider interactions in general practice. CONCLUSION The findings call for a paradigm shift in the management of obesity in general practice: emphasising training for GPs in weight-sensitive communication and promoting respectful, collaborative, and individualised care to reduce WS and improve outcomes for people with obesity. PATIENT OR PUBLIC CONTRIBUTION PPI collaborators played an active and equal role in shaping the research, contributing to the development of the research questions, refining the interview schedule, identifying key themes in the data, and granting final approval to the submitted and published version of the study.
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Affiliation(s)
- Leona Ryan
- School of PsychologyUniversity of GalwayGalwayIreland
| | - Fiona Quigley
- School of Communication and MediaUlster UniversityBelfastNorthern Ireland
| | - Susie Birney
- Irish Coalition for People Living with Obesity (ICPO)DublinIreland
| | | | - Owen Conlan
- School of Computer Science and StatisticsTrinity College DublinDublinIreland
| | - Jane C. Walsh
- School of PsychologyUniversity of GalwayGalwayIreland
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Hochgraf AK, Berge JM, Lanza ST. Age-varying associations between attempts to change weight and suicidal ideation among adolescents in the United States. Prev Med 2024; 182:107946. [PMID: 38574970 PMCID: PMC11084873 DOI: 10.1016/j.ypmed.2024.107946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 03/20/2024] [Accepted: 04/01/2024] [Indexed: 04/06/2024]
Abstract
PURPOSE The goal of this study was to inform theory and suicide prevention efforts by examining how the link between attempts to change weight and suicidal ideation varies across adolescence, when it is strongest, and whether there are sex differences. METHODS Data were from 13,518 youth ages 14-18 years who participated in the 2019 Youth Risk Behavior Survey, a nationally representative study of U.S. high school students. Time-varying effect modeling was used to estimate associations between attempts to change weight and suicidal ideation as continuous functions of age and to test sex differences in these links. RESULTS The link between attempts to lose weight and suicidal ideation was positive and significant between ages 14.0-17.3 years, with the strongest association at age 15.0 (OR = 2.07). There were no sex differences in this age-varying association. The association between attempts to gain weight and suicidal ideation was positive and age-varying for girls, with the strongest association at age 17.2 years (OR = 2.79). This association was not significant for boys at any age. CONCLUSIONS Girls and boys who are trying to lose weight and girls who are trying to gain weight may be at elevated risk for suicidal ideation between ages 14 and 18 years. Findings illuminate patterns of association during adolescence and have implications for suicide prevention.
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Affiliation(s)
- Anna K Hochgraf
- Division of Epidemiology and Community Health, School of Public Health, The University of Minnesota, Minneapolis, MN, USA.
| | - Jerica M Berge
- Department of Family Medicine and Community Health, Medical School, The University of Minnesota, Minneapolis, MN, USA
| | - Stephanie T Lanza
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, USA
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Ghazzawi HA, Nimer LS, Haddad AJ, Alhaj OA, Amawi AT, Pandi-Perumal SR, Trabelsi K, Seeman MV, Jahrami H. A systematic review, meta-analysis, and meta-regression of the prevalence of self-reported disordered eating and associated factors among athletes worldwide. J Eat Disord 2024; 12:24. [PMID: 38326925 PMCID: PMC10851573 DOI: 10.1186/s40337-024-00982-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 01/31/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND The purpose of this meta-analysis was to provide a pooled prevalence estimate of self-reported disordered eating (SRDE) in athletes based on the available literature, and to identify risk factors for their occurrence. METHODS Across ten academic databases, an electronic search was conducted from inception to 7th January 2024. The proportion of athletes scoring at or above predetermined cutoffs on validated self-reporting screening measures was used to identify disordered eating (DE). Subgroup analysis per country, per culture, and per research measure were also conducted. Age, body mass index (BMI), and sex were considered as associated/correlated factors. RESULTS The mean prevalence of SRDE among 70,957 athletes in 177 studies (132 publications) was 19.23% (17.04%; 21.62%), I2 = 97.4%, τ2 = 0.8990, Cochran's Q p value = 0. Australia had the highest percentage of SRDE athletes with a mean of 57.1% (36.0%-75.8%), while Iceland had the lowest, with a mean of 4.9% (1.2%-17.7%). The SRDE prevalence in Eastern countries was higher than in Western countries with 29.1% versus 18.5%. Anaerobic sports had almost double the prevalence of SRDE 37.9% (27.0%-50.2%) compared to aerobic sports 19.6% (15.2%-25%). Gymnastics sports had the highest SRDE prevalence rate, with 41.5% (30.4%-53.6%) while outdoor sports showed the lowest at 15.4% (11.6%-20.2%). Among various tools used to assess SRDE, the three-factor eating questionnaire yielded the highest SRDE rate 73.0% (60.1%-82.8%). Meta-regression analyses showed that female sex, older age, and higher BMI (all p < 0.01) are associated with higher prevalence rates of SRDE. CONCLUSION The outcome of this review suggests that factors specific to the sport affect eating behaviors throughout an athlete's life. As a result, one in five athletes run the risk of developing an eating disorder. Culture-specific and sport-specific diagnostic tools need to be developed and increased attention paid to nutritional deficiencies in athletes.
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Affiliation(s)
- Hadeel A Ghazzawi
- Department of Nutrition and Food Technology, School of Agriculture, The University of Jordan, Amman, Jordan
| | - Lana S Nimer
- Department of Nutrition and Food Technology, School of Agriculture, The University of Jordan, Amman, Jordan
| | - Areen Jamal Haddad
- Department of Nutrition and Food Technology, School of Agriculture, The University of Jordan, Amman, Jordan
| | - Omar A Alhaj
- Department of Nutrition, Faculty of Pharmacy and Medical Sciences, University of Petra, Amman, Jordan
| | - Adam T Amawi
- Department of Exercise Science and Kinesiology, School of Sport Science, The University of Jordan, Amman, Jordan
| | - Seithikurippu R Pandi-Perumal
- Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
- Division of Research and Development, Lovely Professional University, Phagwara, Punjab, 144411, India
| | - Khaled Trabelsi
- High Institute of Sport and Physical Education of Sfax, University of Sfax, 3000, Sfax, Tunisia
- Research Laboratory: Education, Motricity, Sport and Health, University of Sfax, EM2S, LR19JS013000, Sfax, Tunisia
| | - Mary V Seeman
- Department of Psychiatry, University of Toronto, Toronto, ON, M5S 1A8, Canada
| | - Haitham Jahrami
- Ministry of Health, Manama, Bahrain.
- Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain.
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Desrivières S, Zhang Z, Robinson L, Whelan R, Jollans L, Wang Z, Nees F, Chu C, Bobou M, Du D, Cristea I, Banaschewski T, Barker G, Bokde A, Grigis A, Garavan H, Heinz A, Bruhl R, Martinot JL, Martinot MLP, Artiges E, Orfanos DP, Poustka L, Hohmann S, Millenet S, Fröhner J, Smolka M, Vaidya N, Walter H, Winterer J, Broulidakis M, van Noort B, Stringaris A, Penttilä J, Grimmer Y, Insensee C, Becker A, Zhang Y, King S, Sinclair J, Schumann G, Schmidt U. Machine learning models for diagnosis and risk prediction in eating disorders, depression, and alcohol use disorder. RESEARCH SQUARE 2024:rs.3.rs-3777784. [PMID: 38352452 PMCID: PMC10862965 DOI: 10.21203/rs.3.rs-3777784/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
This study uses machine learning models to uncover diagnostic and risk prediction markers for eating disorders (EDs), major depressive disorder (MDD), and alcohol use disorder (AUD). Utilizing case-control samples (ages 18-25 years) and a longitudinal population-based sample (n=1,851), the models, incorporating diverse data domains, achieved high accuracy in classifying EDs, MDD, and AUD from healthy controls. The area under the receiver operating characteristic curves (AUC-ROC [95% CI]) reached 0.92 [0.86-0.97] for AN and 0.91 [0.85-0.96] for BN, without relying on body mass index as a predictor. The classification accuracies for MDD (0.91 [0.88-0.94]) and AUD (0.80 [0.74-0.85]) were also high. Each data domain emerged as accurate classifiers individually, with personality distinguishing AN, BN, and their controls with AUC-ROCs ranging from 0.77 to 0.89. The models demonstrated high transdiagnostic potential, as those trained for EDs were also accurate in classifying AUD and MDD from healthy controls, and vice versa (AUC-ROCs, 0.75-0.93). Shared predictors, such as neuroticism, hopelessness, and symptoms of attention-deficit/hyperactivity disorder, were identified as reliable classifiers. For risk prediction in the longitudinal population sample, the models exhibited moderate performance (AUC-ROCs, 0.64-0.71), highlighting the potential of combining multi-domain data for precise diagnostic and risk prediction applications in psychiatry.
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Mohapatra D, Pemde HK, Kataria D. Disordered eating behaviors, body dissatisfaction and their determinants in Indian adolescents: A cross-sectional observational study. Indian J Psychiatry 2024; 66:165-170. [PMID: 38523766 PMCID: PMC10956595 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_717_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 12/30/2023] [Accepted: 01/15/2024] [Indexed: 03/26/2024] Open
Abstract
Objective Although the prevalence of disordered eating is maximum in high-income countries, the most significant rise occurred in East Asia and South Asia over the last three decades. Body dissatisfaction and disordered eating behaviors (DEBs) are more common than full-blown eating disorders. The cognitive distortion leading to these manifestations mainly occurs during adolescence and early adulthood. In this study, we assess the burden of DEBs in a cohort of Indian adolescents and determine their correlation with body dissatisfaction, calorie intake, and clinicosocial determinants. Methods The study was conducted from November 2016 to November 2020 and enrolled 180 adolescents of 10-18 years attending the outpatient department of a tertiary-care hospital. Subjects were screened for DEBs, using a 15-item Screening Questionnaire for Eating Distress Syndromes, and for body dissatisfaction, using Photographic-Figure-Rating-Scale. Clinicosocial interviews, dietary and anthropometric evaluation, and psychiatric screening using a Mini-International Neuropsychiatric Interview (MINI-KIDS screen) were conducted. Results DEB was present in 17.2% of adolescents, while 81.1% had body dissatisfaction and 32.2% had some psychiatric symptoms. The prevalence of DEBs in females was much higher than in males (OR = 7.89, 95%CI: 2.25-27.75, P = 0.001). More males (84.1%) reported body dissatisfaction than females (76.7%) [χ² =9.2, P = 0.010]. However, while females wished to lose weight, males desired weight gain, as measured by body dissatisfaction score (t = 2.9, P = 0.004). Apart from sex, other factors found significant in predicting DEBs in multivariate analysis were education, body dissatisfaction, BMI, and the number of siblings. Conclusion We conclude that, unlike overt eating disorders, DEBs are common in Indian adolescents. The development of DEBs is influenced by gender, education, body dissatisfaction, BMI, and the number of siblings.
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Beckers D, Burk WJ, Larsen JK, Cillessen AHN. The bidirectional associations between self-esteem and problematic eating behaviors in adolescents. Int J Eat Disord 2024; 57:104-115. [PMID: 37902407 DOI: 10.1002/eat.24083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 10/11/2023] [Accepted: 10/11/2023] [Indexed: 10/31/2023]
Abstract
OBJECTIVE Theories propose that low self-esteem and problematic eating behaviors (PEBs) negatively impact each other. While previous studies suggested bidirectional associations between self-esteem and PEBs, they did not separate within-person from between-person associations. Therefore, this prospective study investigated the within-person bidirectional associations between self-esteem and four PEBs in adolescence, while accounting for between-person differences. METHOD We used two independent longitudinal samples of Dutch adolescents, each including three annually collected waves of data. Sample 1 consisted of 1856 adolescents (Baseline: 50.4% males; Mage = 13.79 years, SDage = 0.72), with measures of self-esteem, emotional eating, restrained eating, and loss of control (LOC) while overeating. Sample 2 consisted of 555 adolescents (Baseline: 49.7% males; Mage = 13.13 years, SDage = 0.68), with measures of self-esteem and LOC eating. The data were analyzed using random intercept cross-lagged panel models (CLPMs). RESULTS Within persons, lower self-esteem was associated with higher emotional and restrained eating (both Sample 1) one year later, and vice versa. Self-esteem did not predict, nor was predicted by, LOC while overeating (Sample 1) or LOC eating (Sample 2). Between persons, self-esteem was negatively correlated with all PEBs (Samples 1 and 2). DISCUSSION We found within-person bidirectional associations between low self-esteem and emotional and restrained eating (but not LOC while overeating/LOC eating), and between-person correlations between low self-esteem and all PEBs. These results have theoretical and practical implications. Within-person processes clarify underlying mechanisms that explain the occurrence of PEBs; between-person associations are important to identify adolescents at risk of PEBs. PUBLIC SIGNIFICANCE While theories indicate that low self-esteem and PEBs are inversely associated within individuals, empirical studies have not disentangled within-person processes from between-person differences. This study addressed this disparity, finding that lower self-esteem was bidirectionally associated with higher emotional and restrained eating (but not LOC eating) within persons. These findings suggest that enhancing self-esteem is a viable option for prevention and intervention.
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Affiliation(s)
- Desi Beckers
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - William J Burk
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Junilla K Larsen
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
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11
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Cheng CM, Chu J, Ganson KT, Trompeter N, Testa A, Jackson DB, He J, Glidden DV, Baker FC, Nagata JM. Cyberbullying and eating disorder symptoms in US early adolescents. Int J Eat Disord 2023; 56:2336-2342. [PMID: 37671456 PMCID: PMC10842483 DOI: 10.1002/eat.24034] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 07/06/2023] [Accepted: 07/21/2023] [Indexed: 09/07/2023]
Abstract
OBJECTIVE The objective of this study was to determine the association between cyberbullying and eating disorder symptoms in a national sample of 10-14-year-old early adolescents. METHOD We analyzed cross-sectional data from the Adolescent Brain Cognitive Development (ABCD) Study (Year 2, 2018-2020, N = 10,258/11,875, 49% female, 46% non-White). Data were collected using multi-stage probability sampling. Modified Poisson regression analyses examined the association between cyberbullying and self-reported eating disorder symptoms based on the Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS-5). RESULTS Cyberbullying victimization was associated with worry about weight gain (prevalence ratio [PR] 2.41, 95% confidence interval [CI] 1.48-3.91), self-worth tied to weight (PR 2.08, 95% CI 1.33-3.26), inappropriate compensatory behavior to prevent weight gain (PR 1.95, 95% CI 1.57-2.42), binge eating (PR 1.95, 95% CI 1.59-2.39), and distress with binge eating (PR 2.64, 95% CI 1.94-3.59), in models adjusting for potential confounders. Cyberbullying perpetration was associated with worry about weight gain (PR 3.52, 95% CI 1.19-10.37), self-worth tied to weight (PR 5.59, 95% CI 2.56-12.20), binge eating (PR 2.36, 95% CI 1.44-3.87), and distress with binge eating (PR 2.84, 95% CI 1.47-5.49). DISCUSSION Cyberbullying victimization and perpetration in early adolescence are associated with eating disorder symptoms. Clinicians may consider assessing for cyberbullying and eating disorder symptoms in early adolescence and provide anticipatory guidance. PUBLIC SIGNIFICANCE STATEMENT Eating disorders often onset in adolescence and have among the highest mortality rates of any psychiatric disorder. In addition, cyberbullying has increased in prevalence among adolescents and significantly impacts mental health. In a national study of early adolescents, we found that cyberbullying victimization and perpetration are associated with eating disorder symptoms. Screening for and providing anticipatory guidance on cyberbullying and eating disorder symptoms in early adolescents may be warranted.
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Affiliation(s)
- Chloe M. Cheng
- Department of Pediatrics, University of California, San Francisco, 550 16 Street, 4 Floor, Box 0503, San Francisco, CA, 94143, USA
| | - Jonathan Chu
- Department of Pediatrics, University of California, San Francisco, 550 16 Street, 4 Floor, Box 0503, San Francisco, CA, 94143, USA
| | - Kyle T. Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Toronto, Ontario, M5S 1V4, Canada
| | - Nora Trompeter
- Institute for Child Health, University College London, United Kingdom, 30 Guilford St, London WC1N 1EH, UK
| | - Alexander Testa
- Department of Management, Policy and Community Health, University of Texas Health Science Center at Houston, 7000 Fannin Street, Houston, TX, 77030, USA
| | - Dylan B. Jackson
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, 615 N Wolfe Street, Baltimore, MD, 21205, USA
| | - Jinbo He
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen 518172, Guangdong, China
| | - David V. Glidden
- Department of Epidemiology and Biostatistics, University of California, San Francisco, 550 16 Street, 2 Floor, San Francisco, California, 94158, USA
| | - Fiona C. Baker
- Center for Health Sciences, SRI International, 333 Ravenswood Ave, Menlo Park, CA 94025, USA
- School of Physiology, University of the Witwatersrand, 1 Jan Smuts Ave, Braamfontein, Johannesburg, 2000, South Africa
| | - Jason M. Nagata
- Department of Pediatrics, University of California, San Francisco, 550 16 Street, 4 Floor, Box 0503, San Francisco, CA, 94143, USA
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12
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Dufour R, Breton É, Morin AJS, Côté SM, Dubois L, Vitaro F, Boivin M, Tremblay RE, Booij L. Childhood hyperactivity, eating behaviours, and executive functions: Their association with the development of eating-disorder symptoms in adolescence. J Eat Disord 2023; 11:183. [PMID: 37833803 PMCID: PMC10571422 DOI: 10.1186/s40337-023-00902-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 09/27/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Cross-sectional studies have shown that hyperactivity and impaired executive functioning are associated with symptoms of eating disorders in adolescence and adulthood. Whether hyperactivity and executive functions in early life can prospectively predict the emergence of eating disorder symptoms in adolescence remains unknown. The present study relies on a longitudinal design to investigate how hyperactivity at age 3, eating behaviours at age 3.5 and cognition at ages 3-6 were associated with the development of eating-disorder symptoms from 12 to 20 years old. METHODS Using archival data collected since 1997 from the Quebec Longitudinal Study of Child Development cohort (N = 2, 223), we used Latent Curve Models to analyse predictors of youth's trajectories of eating-disorder symptoms at four timepoints. RESULTS A quadratic (curvilinear) trajectory of eating-disorder symptoms was found to be most representative of the data. Higher hyperactivity at age 3 was associated with higher levels of eating-disorder symptoms at age 12, and this association was partially mediated by higher levels of overeating and cognitive inflexibility in childhood. Cognitive inflexibility in childhood also mediated the association between hyperactivity at age 3 and increases in eating-disorder symptoms during adolescence. Furthermore, working memory was indirectly related to eating-disorder symptoms via the mediational role of cognitive flexibility. CONCLUSIONS Hyperactivity, overeating, cognitive inflexibility, and working memory early in life might precede the onset of eating-disorder symptoms in adolescence. Early behavioural and cognitive screening may help to identify children who are most at risk for eating disorders. This, in turn, could guide preventive interventions.
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Affiliation(s)
- Rachel Dufour
- Sainte-Justine Hospital Research Centre, Montreal, Canada
- Department of Psychology, Concordia University, Montreal, Canada
- Research centre, Douglas Mental Health University Institute, Montreal, Canada
- Eating Disorders Continuum, Douglas Mental Health University Institute, Montreal West Island Integrated University Health and Social Service Centre, 6603-05 LaSalle Blvd, Montreal, QC, H4H 1R3, Canada
| | - Édith Breton
- Sainte-Justine Hospital Research Centre, Montreal, Canada
- Department of Psychiatry and Addictology, Université de Montréal, Montreal, Canada
| | | | - Sylvana M Côté
- Sainte-Justine Hospital Research Centre, Montreal, Canada
- School of Public Health, Université de Montréal, Montreal, Canada
| | - Lise Dubois
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Frank Vitaro
- Sainte-Justine Hospital Research Centre, Montreal, Canada
- School of Psychoeducation, Université de Montréal, Montreal, Canada
| | - Michel Boivin
- Department of Psychology, Université Laval, Québec City, QC, Canada
| | - Richard E Tremblay
- Sainte-Justine Hospital Research Centre, Montreal, Canada
- Department of Psychology and Pediatrics, Université de Montréal, Montreal, Canada
| | - Linda Booij
- Sainte-Justine Hospital Research Centre, Montreal, Canada.
- Department of Psychology, Concordia University, Montreal, Canada.
- Department of Psychiatry and Addictology, Université de Montréal, Montreal, Canada.
- Department of Psychiatry, McGill University, Montreal, Canada.
- Research centre, Douglas Mental Health University Institute, Montreal, Canada.
- Eating Disorders Continuum, Douglas Mental Health University Institute, Montreal West Island Integrated University Health and Social Service Centre, 6603-05 LaSalle Blvd, Montreal, QC, H4H 1R3, Canada.
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Chen J, Liu K, Zhang J, Liu S, Wang Y, Cao R, Peng X, Han M, Han H, Yao R, Fu L. Parental Pressure on Child Body Image, BMI, Body Image Dissatisfaction Associated with Eating Disorders in School-Age Children in China: A Path Analysis. Psychol Res Behav Manag 2023; 16:3247-3258. [PMID: 37609642 PMCID: PMC10440685 DOI: 10.2147/prbm.s418535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 08/05/2023] [Indexed: 08/24/2023] Open
Abstract
Background Children's eating behaviors, body shape and body image cognition may be more susceptible to the influence of their parents, but these influences may be weakened with age. There may be different association pathways between parental pressure on children's body image (PPCBI), body mass index (BMI), body image dissatisfaction (BID) and eating disorders (EDs) among children and adolescents at different developmental stages. Methods The stratified cluster sampling method (Stratified by grade, and took the classes as clusters) was used to select 486 students aged 8-15 years in two 9-year schools. Children's body height, weight, testicular volume and breast development were measured. PPCBI, BID, and EDs were investigated using the Appearance-related Social Stress Questionnaire, Body Size Questionnaire (BID-14), and EDI-1 scale, respectively. Results The boys before puberty initiation had significantly higher EDs score (182.3±50.8) than girls before puberty initiation (164.1±58.1) (P<0.05). There were significant association pathways of PPCBI→BMI→BID→EDs and PPCBI→BID→EDs in boys before puberty initiation (β=0.035, P<0.01; β=0.059, P<0.01), in boys after puberty initiation (β=0.032, P<0.01; β=0.175, P<0.001), and in girls after puberty initiation (β=0.026, P<0.01; β=0.172, P<0.001). There was a positive association pathway of PPCBI→EDs in boys before puberty initiation (β=0.30, P<0.001) and PPCBI→BID→EDs in girls before puberty initiation (β=0.176, P<0.01). Conclusion Parental pressure on children's body image may positively associate with children's eating disorders through BMI and body image dissatisfaction in boys and girls after puberty initiation and directly associate with eating disorders in boys before puberty initiation; however, it may indirectly associate with eating disorders only through BID in girls before puberty initiation.
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Affiliation(s)
- Jiaoyan Chen
- Department of Child and Adolescent Health, School of Public Health, Bengbu Medical College, Bengbu, Anhui, 233030, People’s Republic of China
| | - Keke Liu
- Department of Child and Adolescent Health, School of Public Health, Bengbu Medical College, Bengbu, Anhui, 233030, People’s Republic of China
| | - Juan Zhang
- Department of Child and Adolescent Health, School of Public Health, Bengbu Medical College, Bengbu, Anhui, 233030, People’s Republic of China
| | - Songhui Liu
- Department of Child and Adolescent Health, School of Public Health, Bengbu Medical College, Bengbu, Anhui, 233030, People’s Republic of China
| | - Yuanyuan Wang
- Department of Child and Adolescent Health, School of Public Health, Bengbu Medical College, Bengbu, Anhui, 233030, People’s Republic of China
| | - Ruiyao Cao
- Department of Child and Adolescent Health, School of Public Health, Bengbu Medical College, Bengbu, Anhui, 233030, People’s Republic of China
| | - Xingwang Peng
- Department of Child and Adolescent Health, School of Public Health, Bengbu Medical College, Bengbu, Anhui, 233030, People’s Republic of China
| | - Mei Han
- Department of Child and Adolescent Health, School of Public Health, Bengbu Medical College, Bengbu, Anhui, 233030, People’s Republic of China
| | - Hui Han
- Department of Child and Adolescent Health, School of Public Health, Bengbu Medical College, Bengbu, Anhui, 233030, People’s Republic of China
| | - Rongying Yao
- Department of Child and Adolescent Health, School of Public Health, Bengbu Medical College, Bengbu, Anhui, 233030, People’s Republic of China
| | - Lianguo Fu
- Department of Child and Adolescent Health, School of Public Health, Bengbu Medical College, Bengbu, Anhui, 233030, People’s Republic of China
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14
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Ghazzawi HA, Nimer LS, Sweidan DH, Alhaj OA, Abulawi D, Amawi AT, Levine MP, Jahrami H. The global prevalence of screen-based disordered eating and associated risk factors among high school students: systematic review, meta-analysis, and meta-regression. J Eat Disord 2023; 11:128. [PMID: 37537604 PMCID: PMC10398929 DOI: 10.1186/s40337-023-00849-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 07/24/2023] [Indexed: 08/05/2023] Open
Abstract
OBJECTIVE Estimate the prevalence, and associated risk factors, of high school students who are considered at risk for an eating disorder based on screening measures. METHODS An electronic search of nine databases was completed from their inception until 1st September 2022. A random-effects meta-analysis was conducted, and confounder (moderator) analyses and meta-regressions examined whether the overall prevalence estimate for of screen-based disordered eating (SBDE) was moderated by student age, BMI, or gender, as well as culture and type of SBDE assessment. RESULTS The mean estimate of the prevalence of SBDE among high school students (K = 42 (66 datapoints), N = 56282] in the sample of 25 countries was 13% ([95% CI] = 10.0-16.8%, I2 = 99.0%, Cochran's Q p = 0.001). This effect was not moderated by features of the samples such as gender, BMI, or age. Among cultures, non-Western countries had a higher prevalence of SBDE prevalence than Western countries, but the difference was not significant. There was considerable variability in the prevalence estimates as a function of the assessment measure, but no meaningful pattern emerged. CONCLUSION The estimated figure of 1 in 8 high school students with SBDE-unmoderated by gender and BMI-stands out as a problem in need of attention from public health officials, psychologists, psychiatrists, pediatricians, parents, and educators. There is a great need for innovative, integrated policy and program development all along the spectrum of health promotion and universal, selective, and indicated prevention. Further research is also needed to validate and refine this estimate by (a) conducting basic research on the accuracy of eating disorder screening measurements in samples ages 14 through 17; (b) examining representative samples in more countries in general and Latin American countries in particular; (c) clarifying the relationships between SBDE and age throughout the different phases of late childhood, adolescence, and emerging adulthood; and (d) investigating whether there are meaningful forms of disordered eating and whether these are associated with variables such as gender, ethnicity, and BMI.
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Affiliation(s)
- Hadeel A. Ghazzawi
- Department Nutrition and Food Technology, School of Agriculture, The University of Jordan, P.O. Box 11942, Amman, Jordan
| | - Lana S. Nimer
- Department Nutrition and Food Technology, School of Agriculture, The University of Jordan, P.O. Box 11942, Amman, Jordan
| | - Dima H. Sweidan
- Department of Nutrition, Faculty of Pharmacy and Medical Sciences, University of Petra, Amman, Jordan
| | - Omar A. Alhaj
- Department of Nutrition, Faculty of Pharmacy and Medical Sciences, University of Petra, Amman, Jordan
| | - Duha Abulawi
- Department Nutrition and Food Technology, School of Agriculture, The University of Jordan, P.O. Box 11942, Amman, Jordan
| | - Adam T. Amawi
- Department of Physical and Health Education, Faculty of Educational Sciences, Al-Ahliyya Amman University, As-Salt, 19328 Jordan
| | | | - Haitham Jahrami
- Goverment Hospitals, Manama, Bahrain
- Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
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15
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Meshkova TA, Mitina OV, Aleksandrova RV. Risk factors of disordered eating in adolescent girls from a community sample: a multidimensional approach. CONSORTIUM PSYCHIATRICUM 2023; 4:21-39. [PMID: 38250642 PMCID: PMC10795956 DOI: 10.17816/cp6132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 06/26/2023] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND Eating disorders (ED) are severe, chronic, and complex in nature mental illnesses that are difficult to treat. One of the ways to stave off EDs is by screening among adolescents to preempt the development of clinical forms of ED in risk groups. AIM 1) to investigate the prevalence of ED risk among adolescent girls and compare subgroups at high and low risk of ED; 2) to investigate using a multidimensional approach those variables that can interact with temperament and character traits to predict ED symptomatology. METHODS The cross-sectional observational self-report study of a community sample of adolescent girls 1217 years old (n=298; M=14.771.13) was carried out in the city of Ryazan, Russia. The Russian versions of Eating Attitudes Test and Cloningers Temperament and Character Inventory-Revised were used. In addition, an original questionnaire (Risk Factors of Eating Disorders) was developed. Regression models (to test for significant moderation) and path analysis (to test for significant mediations) were used. RESULTS Girls at risk of developing EDs are characterized by a heightened level of concern about weight and dissatisfaction with their body, tend to suffer from low self-directedness, higher novelty seeking and tendency to higher harm avoidance, display high alexithymia, experience self-distrust, negative emotionality and are dissatisfied with family relationships. They also suffer from low self-esteem and tend to be perfectionism and engage in risk behavior. Significant moderating effects were uncovered between the following ED risk factors: (1) self-distrust/risk behavior and BMI; (2) alexithymia/negative emotionality/self-esteem and cooperativeness; and (3) negative emotionality/risk behavior and self-transcendence. Family relationship dissatisfaction mediates the association between self-directedness/cooperativeness/self-transcendence and disordered eating. CONCLUSION There are various mutual influences between the numerous ED risk and prevention factors, which all together determine the paths between the predictors and final outcome.
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Affiliation(s)
| | | | - Roza V. Aleksandrova
- Research Educational Center of Applied Psychology and Psychological Services of S. Yesenin Ryazan State University
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16
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Breton É, Côté SM, Dubois L, Vitaro F, Boivin M, Tremblay RE, Booij L. Childhood Overeating and Disordered Eating From Early Adolescence to Young Adulthood: A Longitudinal Study on the Mediating Role of BMI, Victimization and Desire for Thinness. J Youth Adolesc 2023:10.1007/s10964-023-01796-5. [PMID: 37270466 DOI: 10.1007/s10964-023-01796-5] [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: 02/23/2023] [Accepted: 05/21/2023] [Indexed: 06/05/2023]
Abstract
Eating disorders have early origins, and there could be a continuum between childhood eating behaviors, such as overeating, and long-term disordered eating, but this remains to be shown. BMI, desire for thinness and peer victimization could influence this continuum, but their interactions are unknown. To fill this gap, the study used data from the Quebec Longitudinal Study of Child Development (N = 1511; 52% girls), in which 30.9% of youth presented a trajectory associated with high disordered eating from 12 to 20 years. The results support an indirect association between overeating at age 5 and disordered eating trajectories, with different mediation processes observed between boys and girls. The findings underscore the importance of promoting healthy body images and eating behaviors among youths.
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Affiliation(s)
- Édith Breton
- Sainte-Justine Hospital Research Centre, Montreal, Canada
- Department of Psychiatry and Addictology, University of Montreal, Montreal, Canada
| | - Sylvana M Côté
- Sainte-Justine Hospital Research Centre, Montreal, Canada
- School of Public Health, University of Montreal, Montreal, Canada
| | - Lise Dubois
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Frank Vitaro
- Sainte-Justine Hospital Research Centre, Montreal, Canada
- School of Psychoeducation, University of Montreal, Montreal, Canada
| | - Michel Boivin
- Department of Psychology, University Laval, Quebec, Canada
| | - Richard E Tremblay
- Sainte-Justine Hospital Research Centre, Montreal, Canada
- Department of Psychology and Pediatrics, University of Montreal, Montreal, Canada
| | - Linda Booij
- Sainte-Justine Hospital Research Centre, Montreal, Canada.
- Department of Psychiatry and Addictology, University of Montreal, Montreal, Canada.
- Department of Psychology, Concordia University, Montreal, Canada.
- Department of Psychiatry, McGill University, Montreal, Canada.
- Research centre, Douglas Mental Health University Institute, Montreal, Canada.
- Eating Disorders Continuum, Douglas Mental Health University Institute, Montreal, Canada.
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17
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Auger N, Steiger H, Luu TM, Chadi N, Low N, Bilodeau-Bertrand M, Healy-Profitós J, Ayoub A, Brousseau É, Israël M. Shifting age of child eating disorder hospitalizations during the Covid-19 pandemic. J Child Psychol Psychiatry 2023. [PMID: 37012056 DOI: 10.1111/jcpp.13800] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/03/2023] [Indexed: 04/05/2023]
Abstract
BACKGROUND We studied the effect of the Covid-19 pandemic on child eating disorder hospitalizations in Quebec, Canada. Quebec had one of the strictest lockdown measures targeting young people in North America. METHODS We analyzed eating disorder hospitalizations in children aged 10-19 years before and during the pandemic. We used interrupted time series regression to assess trends in the monthly number of hospitalizations for anorexia nervosa, bulimia nervosa, and other eating disorders before the pandemic (April 2006 to February 2020), and during the first (March to August 2020) and second waves (September 2020 to March 2021). We determined the types of eating disorders requiring hospital treatment and identified the age, sex and socioeconomic subgroups that were most affected. RESULTS Hospitalization rates for eating disorders increased during the first (6.5 per 10,000) and second waves (12.8 per 10,000) compared with the period before the pandemic (5.8 per 10,000). The increase occurred for anorexia nervosa as well as other types of eating disorders. The number of girls and boys aged 10-14 years admitted for eating disorders increased during wave 1. Wave 2 triggered an increase in eating disorder admissions among girls aged 15-19 years. Hospitalization rates increased earlier for advantaged than disadvantaged youth. CONCLUSIONS The Covid-19 pandemic affected hospitalizations for anorexia nervosa as well as other eating disorders, beginning with girls aged 10-14 years during wave 1, followed by girls aged 15-19 years during wave 2. Boys aged 10-14 years were also affected, as well as both advantaged and disadvantaged youth.
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Affiliation(s)
- Nathalie Auger
- University of Montreal Hospital Research Centre, Montreal, QC, Canada
- Institut national de santé publique du Québec, Montreal, QC, Canada
- Department of Social and Preventive Medicine, University of Montreal, Montreal, QC, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada
| | - Howard Steiger
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Thuy Mai Luu
- Department of Pediatrics, Sainte-Justine Hospital, Montreal, QC, Canada
| | - Nicholas Chadi
- Department of Pediatrics, Sainte-Justine Hospital, Montreal, QC, Canada
| | - Nancy Low
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Marianne Bilodeau-Bertrand
- University of Montreal Hospital Research Centre, Montreal, QC, Canada
- Institut national de santé publique du Québec, Montreal, QC, Canada
| | - Jessica Healy-Profitós
- University of Montreal Hospital Research Centre, Montreal, QC, Canada
- Institut national de santé publique du Québec, Montreal, QC, Canada
| | - Aimina Ayoub
- University of Montreal Hospital Research Centre, Montreal, QC, Canada
- Institut national de santé publique du Québec, Montreal, QC, Canada
| | - Émilie Brousseau
- University of Montreal Hospital Research Centre, Montreal, QC, Canada
- Institut national de santé publique du Québec, Montreal, QC, Canada
| | - Mimi Israël
- Department of Psychiatry, McGill University, Montreal, QC, Canada
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López-Gil JF, García-Hermoso A, Smith L, Firth J, Trott M, Mesas AE, Jiménez-López E, Gutiérrez-Espinoza H, Tárraga-López PJ, Victoria-Montesinos D. Global Proportion of Disordered Eating in Children and Adolescents: A Systematic Review and Meta-analysis. JAMA Pediatr 2023; 177:363-372. [PMID: 36806880 PMCID: PMC9941974 DOI: 10.1001/jamapediatrics.2022.5848] [Citation(s) in RCA: 38] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 11/30/2022] [Indexed: 02/22/2023]
Abstract
Importance The 5-item Sick, Control, One, Fat, Food (SCOFF) questionnaire is the most widely used screening measure for eating disorders. However, no previous systematic review and meta-analysis determined the proportion of disordered eating among children and adolescents. Objective To establish the proportion among children and adolescents of disordered eating as assessed with the SCOFF tool. Data Sources Four databases were systematically searched (PubMed, Scopus, Web of Science, and the Cochrane Library) with date limits from January 1999 to November 2022. Study Selection Studies were required to meet the following criteria: (1) participants: studies of community samples of children and adolescents aged 6 to 18 years and (2) outcome: disordered eating assessed by the SCOFF questionnaire. The exclusion criteria included (1) studies conducted with young people who had a diagnosis of physical or mental disorders; (2) studies that were published before 1999 because the SCOFF questionnaire was designed in that year; (3) studies in which data were collected during COVID-19 because they could introduce selection bias; (4) studies based on data from the same surveys/studies to avoid duplication; and (5) systematic reviews and/or meta-analyses and qualitative and case studies. Data Extraction and Synthesis A systematic review and meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline. Main Outcomes and Measures Proportion of disordered eating among children and adolescents assessed with the SCOFF tool. Results Thirty-two studies, including 63 181 participants, from 16 countries were included in this systematic review and meta-analysis. The overall proportion of children and adolescents with disordered eating was 22.36% (95% CI, 18.84%-26.09%; P < .001; n = 63 181) (I2 = 98.58%). Girls were significantly more likely to report disordered eating (30.03%; 95% CI, 25.61%-34.65%; n = 27 548) than boys (16.98%; 95% CI, 13.46%-20.81%; n = 26 170) (P < .001). Disordered eating became more elevated with increasing age (B, 0.03; 95% CI, 0-0.06; P = .049) and body mass index (B, 0.03; 95% CI, 0.01-0.05; P < .001). Conclusions and Relevance In this systematic review and meta-analysis, the available evidence from 32 studies comprising large samples from 16 countries showed that 22% of children and adolescents showed disordered eating according to the SCOFF tool. Proportion of disordered eating was further elevated among girls, as well as with increasing age and body mass index. These high figures are concerning from a public health perspective and highlight the need to implement strategies for preventing eating disorders.
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Affiliation(s)
- José Francisco López-Gil
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Antonio García-Hermoso
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Navarra, Spain
| | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, United Kingdom
| | - Joseph Firth
- Division of Psychology and Mental Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom
- Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Mike Trott
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, United Kingdom
- Centre for Public Health, Queen’s University, Belfast, United Kingdom
| | - Arthur Eumann Mesas
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Postgraduate Program in Public Health, Universidade Estadual de Londrina, Londrina, Brazil
| | - Estela Jiménez-López
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
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19
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Loose T, Geoffroy MC, Orri M, Chadi N, Scardera S, Booij L, Breton E, Tremblay R, Boivin M, Coté S. Pathways of association between disordered eating in adolescence and mental health outcomes in young adulthood during the COVID-19 pandemic. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2023; 114:22-32. [PMID: 36482144 PMCID: PMC9734974 DOI: 10.17269/s41997-022-00715-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 10/21/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVES The COVID-19 pandemic has been associated with increased mental health problems. We investigated (1) associations between disordered eating in adolescence and mental health problems after one year of the pandemic and (2) the mechanisms explaining associations. METHOD We analyzed data from a population-based birth cohort in Quebec, Canada (557 males and 759 females). High and low levels of disordered eating symptom trajectories were previously estimated (age 12, 15, 17, and 20 years). Anxiety, depression, non-suicidal self-injury, and suicidal ideation were assessed at 23 years (March-June 2021). Putative mediators included loneliness and social media use (age 22 years, July-August 2020). Analyses controlled for mental health and socio-economic status at age 10-12 years and were conducted for males and females separately. RESULTS Females in the high-level disordered eating symptom trajectory were at increased risk for non-suicidal self-injury (OR 1.60; 95% CI 1.02-2.52) and suicidal ideation (2.16; 1.31-3.57), whereas males were at increased risk for severe anxiety (2.49; CI 1.11-5.58). Males and females in the high-level trajectory were more likely to report severe depression (2.26; 1.14-5.92 and 2.15, 1.36-3.38 respectively). Among females, associations were partially explained (17-35%) by loneliness during the first 4 months of the pandemic. CONCLUSION Young adults who experienced disordered eating as adolescents were at increased risk of mental health problems during the pandemic. Loneliness partially mediated the effect, suggesting that pandemic mitigation resulting in increased social isolation may have exacerbated mental health problems among women with a history of disordered eating.
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Affiliation(s)
- Tianna Loose
- Department of Social and Preventive Medicine, Université de Montréal School of Public Health, Montreal, QC Canada
- Sainte-Justine University Hospital Research Centre, Montreal, QC Canada
| | - Marie Claude Geoffroy
- Department of Educational and Counselling Psychology, McGill University, Montreal, QC Canada
- Douglas Research Centre and Department of Psychiatry, McGill University, Montreal, QC Canada
| | - Massimiliano Orri
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal, QC Canada
| | - Nicholas Chadi
- Sainte-Justine University Hospital Research Centre, Montreal, QC Canada
- Department of Pediatrics, University of Montreal, Montreal, QC Canada
| | - Sara Scardera
- Department of Educational and Counselling Psychology, McGill University, Montreal, QC Canada
| | - Linda Booij
- Sainte-Justine University Hospital Research Centre, Montreal, QC Canada
- Department of Psychology, Concordia University, Montreal, QC Canada
- Department of Psychiatry, McGill University, Montreal, QC Canada
| | - Edith Breton
- Sainte-Justine University Hospital Research Centre, Montreal, QC Canada
- Department of Psychiatry and Addictology, University of Montreal, Montreal, QC Canada
| | - Richard Tremblay
- Department of Pediatrics and School of Psychology, Université de Montréal, Montreal, QC Canada
| | - Michel Boivin
- School of Psychology, Université Laval, Québec City, QC Canada
| | - Sylvana Coté
- Department of Social and Preventive Medicine, Université de Montréal School of Public Health, Montreal, QC Canada
- Sainte-Justine University Hospital Research Centre, Montreal, QC Canada
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20
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Marshall TE, Thomas KS, Weinstein N, Vanderwert RE. Disordered eating behaviours and basic psychological need satisfaction: the mediating role of anxiety symptoms in preadolescents. J Child Adolesc Ment Health 2022; 34:42-52. [PMID: 38504657 DOI: 10.2989/17280583.2023.2277763] [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: 03/21/2024]
Abstract
Objective: According to self-determination theory, satisfied basic psychological needs can be a protective factor for psychopathology, including eating disorders and anxiety symptomatology. However, most research has focused on adolescent and adult populations, with less work examining perceived basic psychological need satisfaction from parents in younger samples who report anxiety and disordered eating. This cross-sectional study aimed to investigate whether basic psychological need satisfaction from parents was associated with disordered eating in preadolescents and whether anxiety mediated this relation.Method: A total of 211 preadolescents were recruited from primary schools across south Wales (mean age = 10.27 years, age range = 9-11 years; 49.3% female). Children completed self-report questionnaires on their basic psychological need satisfaction when with parents, as well as disordered eating and anxiety symptoms.Results: It was found that higher needs satisfaction was associated with lower disordered eating and anxiety, with stronger relations found in girls compared with boys. Furthermore, anxiety was found to mediate this relationship.Conclusions: Results suggest that basic psychological needs satisfaction may play an important role in the early emergence of co-occurring disordered eating and anxiety symptoms in boys and girls. The importance of considering anxiety symptoms in future work investigating needs satisfaction in the context of disordered eating and eating disorders is discussed.
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Affiliation(s)
| | - Kai S Thomas
- School of Psychology, Cardiff University, UK
- Cardiff University Centre for Human Developmental Science, Cardiff University, UK
| | - Netta Weinstein
- School of Psychology, Cardiff University, UK
- School of Psychology and Clinical Language Sciences, University of Reading, UK
| | - Ross E Vanderwert
- School of Psychology, Cardiff University, UK
- Cardiff University Centre for Human Developmental Science, Cardiff University, UK
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