The self and eating disorders

In our review, we focus on self-related constructs in the context of eating disorders with four aims. First, we examine a variety of self-related constructs that have been theoretically and empirically linked to the development and course of eating disorders. In addition to the more well-researched constructs of self-esteem and self-efficacy, we also report on findings related to selflessness, contingent self-worth, self-objectification, ego-syntonicity, self-concept clarity, self-compassion, social comparison, self-oriented perfectionism/self-criticism, and narcissism. Second, we discuss self-related constructs that may be especially relevant to comorbidities common among those with eating disorders. Third, we review intervention and prevention programs where self-related constructs play a prominent role. Lastly, we share future research directions regarding self-related constructs and eating disorders that we believe will advance a deeper understanding of the role of the self in the eating disorders.     

Reflections on athletes and eating disorders

ObjectivesThe purposes of this paper were to offer reflections, thoughts, and observations on the burgeoning research regarding eating disorders in athletes over the past 25 years, to comment on the findings and clinical implications of the studies contained in this special issue, and to provide suggestions for future research.ResultsDisordered eating and eating disorders are complex, multidimensional, and multiply determined, and can affect the health and performance of athletes in both genders and most sports. Although coaches and teammates can be significant sources of weight and body image pressure, they can also play a positive role in identification and prevention.ConclusionsFurther research is needed in several areas. These include a broader focus that includes athletes believed to be at less risk, most notably males and non-lean sport athletes, and ironically younger athletes, who may be at greatest risk. We also need more research related to treatment of athletes with eating disorders and especially how we might better motivate them for recovery.     

进食障碍影响因素的探讨

神经性厌食症和神经性贪食症是主要的进食障碍症状。进食障碍的影响因素有社会文化因素（例如媒体和同伴的影响）、家庭因素（如困惑和冲突）、消极情绪、低自尊水平和对自身的不满及认知和生物方面的因素等。     

Establishing appropriate symptomatic control groups for the eating disorders

Two symptomatic control groups for the eating disorders were defined using high and low scores on the Dietary Restraint and Disinhibition scales of the Three Factor Eating Questionnaire. Clinical subjects diagnosed with anorexia and bulimia nervosa were compared with these symptomatic control groups using measures of body weight, bulimic symptoms, and anorexic symptoms. In comparison to the high-Restraint/low-Disinhibition group, anorexic subjects scored higher on measures of eating disorder symptoms but not on Restraint and Disinhibition. The high-Restraint/high-Disinhibition group differed from bulimia nervosa subjects on measures of eating disorder symptoms but did not differ on Restraint and Disinhibition. The results suggested that a control group defined by high Restraint and low Disinhibition formed an appropriate control group for anorexia nervosa. For bulimia nervosa, the most appropriate control group was defined by high Restraint and high Disinhibition.     

Interpersonal psychotherapy for eating disorders with co-morbid depression: A pilot study

Objective: Patients with eating disorders (ED) often suffer from co-morbid depression, which may complicate the ED treatment. Previous studies have found that ED interventions seem to have limited capacity to reduce depressive symptoms. Several studies of interpersonal psychotherapy (IPT), have found that when patients have been treated for depression, co-morbid symptoms have diminished. As depression and EDs are commonly co-occurring conditions, this pilot study aimed to examine the effect of an IPT treatment for these conditions, with the focus on the depressive symptoms.

Method: In this multi-centre study, 16 patients with EDs and co-occurring major depression received 16 weeks of depression-focused IPT.

Results: Significant improvements with substantial effect sizes were found for both depression (d = 1.48) and ED (d = .93). Symptom reduction in the two syndromes were strongly correlated (r = .625, p = .004). Patients with a restrictive ED did not improve on either depression or ED symptoms.

Conclusion: These findings point to the usefulness of IPT for concurrent depression and ED with a bingeing/purging symptomatology. Working with negative affect and problem-solving related to current interpersonal problems may alleviate general psychological distress among these patients.     

Effectiveness of parent counselling in eating disorders

ABSTRACT

Eating Disorders (ED) are often severe illnesses entailing a heavy burden for families. Family therapy is recommended for young patients, but only a few studies have investigated therapeutic interventions with families tailored also to adult and longstanding patients. We recruited 87 families with daughters affected by an ED, aiming to assess the effectiveness of eight sessions of parent counselling. The primary outcome was the improvement of parents' coping abilities to achieve more effective support skills. Before treatment, 54% of parents showed poor coping resources whereas 43.7% of the sample improved after parent counselling. Parents with good coping resources responded significantly better to this treatment. Although future research is warranted, these preliminary findings support the effectiveness of parent counselling in ED.     

Body dissatisfaction,eating disorders,and depression: A developmental perspective

McCarthy (1990) contends that a cultural ideal of thinness (the thin ideal) causes depression and eating disorders to occur more frequently in women than men. She believes eating disorders are a way of coping with depression and hypothesizes that the thin ideal has its greatest impact during puberty when sexual attractiveness becomes important and changes in physical appearance increase the discrepancy between the adolescent girl's actual and ideal body image. The present study used a cross-sectional design of 5th, 8th, and 12th grade males and females (N = 599) to test several predictions from McCarthy's model. As expected, 8th and 12th grade females preferred a thinner than average body shape. They were more dissatisfied with their bodies than males and scored higher on measures of disordered eating. In contrast, before puberty (5th grade) boys were more depressed than their female peers but this pattern was reversed in 8th grade boys and girls. Paralleling changes in depression, disordered eating scores were highest in 8th and 12th grade girls. Both of these findings underscore the role of maturational factors in the onset of eating disorders. Although the sample was ethnically diverse and mainly from middle and low socioeconomic groups, there was a surprisingly high incidence of body dissatisfaction and symptoms of disordered eating. This illustrates the pervasiveness of thinness as a standard of feminine beauty in our society and the damaging effects it can have.     

Predictors for relapse and chronicity in eating disorders: A review of follow-up studies

Abstract: Eating disorders have been known to be intractable. Yet, their long-term consequences have received relatively little attention in the literature. In this paper, the outcome and follow-up studies of anorexia nervosa and bulimia are reviewed and the current knowledge of the predictors and correlates of relapse and chronicity in each disorder is summarized. Based on the problems and limitations of the extant studies, suggestions for future research are offered, especially from a developmental perspective, to understand better the mechanisms underlying long-term prognosis and relapse.     

职场孤独感的前因与后果

职场孤独感是个体在工作场所中体验到的孤独感,包括情感和社交两个维度。在介绍其定义、结构和测量后,根据现有研究总结出职场孤独感的前因与后果。在群体层面上,职场孤独感的前因变量包括组织规模、地位和气氛;结果变量包括团队绩效、领导成员交换和团队成员交换。在个体层面上,职场孤独感的前因变量包括人格特征、职场排斥、工作倦怠、工作过载、经济地位和教育水平等;结果变量包括工作绩效、工作压力感、工作满意度、离职倾向和组织承诺等。     

人际交往能力与生命意义的关系:孤独感和年级的作用

基于存在主义心理学理论,本研究采用人际交往能力问卷、孤独感量表和生命意义量表对福建省三所大学的1476名大一和大二学生进行调查,考察人际交往能力与生命意义的关系,以及孤独感的中介作用和年级的调节作用。结果表明：（1）交往能力和孤独感存在显著的性别差异。男生的交往能力显著高于女生,孤独感显著低于女生;（2）交往能力与孤独感呈显著负相关,与拥有意义和追寻意义均呈显著正相关,而孤独感与它们均呈显著负相关;（3）孤独感在交往能力与拥有生命意义之间的中介作用受到年级的调节。与大二学生相比,大一新生孤独感的中介效应更大。研究结果在一定程度上揭示了交往能力对生命意义的作用过程,为针对性提升大学新生生命意义提供方向指导和实证依据。     

人际交往能力与生命意义的关系:孤独感和年级的作用

基于存在主义心理学理论,本研究采用人际交往能力问卷、孤独感量表和生命意义量表对福建省三所大学的1476名大一和大二学生进行调查,考察人际交往能力与生命意义的关系,以及孤独感的中介作用和年级的调节作用。结果表明：（1）交往能力和孤独感存在显著的性别差异。男生的交往能力显著高于女生,孤独感显著低于女生;（2）交往能力与孤独感呈显著负相关,与拥有意义和追寻意义均呈显著正相关,而孤独感与它们均呈显著负相关;（3）孤独感在交往能力与拥有生命意义之间的中介作用受到年级的调节。与大二学生相比,大一新生孤独感的中介效应更大。研究结果在一定程度上揭示了交往能力对生命意义的作用过程,为针对性提升大学新生生命意义提供方向指导和实证依据。     

An investigation into the psychometric properties of the CORE‐OM in patients with eating disorders

Aim: The current study aimed to explore the psychometric properties of the CORE‐OM (Clinical Outcomes in Routine Evaluation – Outcome Measure) when used in an eating disorder sample. Method: The CORE‐OM was administered at assessment to 360 individuals referred to an eating disorders service. Principal component analysis was conducted to look at the psychometric structure of the CORE‐OM, and psychometric properties were investigated using analyses of reliability and validity. Results: Analyses of the psychometric structure suggested a three‐component solution reflecting negatively worded, positively worded and risk items. The CORE‐OM showed good acceptability, acceptable internal and test‐retest reliabilities, as well as good convergent and known groups validity. Conclusions: The results of the current study support the CORE‐OM as a reliable and valid measure for assessing psychological distress in eating disorders.     

情绪对饮食行为的影响

人类的饮食行为受到诸多因素的影响, 包括生理因素、心理因素及社会文化因素等, 其中情绪对饮食行为的影响日益受到研究者的重视, 这种影响一般表现为摄入量的多少和食物(热量)的选择。通过探讨不同情绪下临床和非临床个体食物摄入量的表现, 总结发现消极情绪导致个体暴饮暴食的可能更大。积极情绪影响下的饮食行为的研究结果则存在分歧: 生理角度解释为积极情绪能够促进个体的享乐机制, 导致进食行为增加; 而自我控制理论则认为积极情绪增加了个人资源以抵制美食诱惑。此外, 进一步探讨了情绪影响下饮食行为的神经生理机制。未来在饮食相关的临床研究和治疗上, 需要对情绪影响下的饮食行为有更深入的神经机制方面的探究。     

孤独感对人际目标追求的影响：目标实现可能性的作用

采用两个研究和内部元分析考察了孤独感对人际目标追求的影响以及目标实现可能性的作用。研究1采用问卷测量人际目标实现可能性以及特定一天中的孤独感和人际目标投入,发现孤独感与人际目标投入呈负相关,目标实现可能性调节了二者间的关系;研究2操纵人际联结体验,发现孤独组投入意愿最低,策略数更多,策略字数最少,目标实现可能性调节了人际联结体验和投入意愿的关系。研究表明,孤独感会降低人际目标投入,目标实现可能性调节了二者间的关系;孤独者不是缺乏人际投入策略,而是不愿意投入人际目标。     

Loneliness,eating, and body mass index in parent–adolescent dyads from the Family Life,Activity, Sun,Health, and Eating study

Loneliness is a salient risk factor for obesity, emotional eating, and poor diet. Because adolescents and parents are embedded within a family unit, their experiences of loneliness may be associated with both their own and one another's behaviors. To examine the extent to which parent and child loneliness predict body mass index (BMI) and eating in parents and adolescents, an actor–partner interdependence model of loneliness, eating, and BMI in adolescent–parent dyads was analyzed. There were actor effects among adolescents such that greater loneliness was positively associated with emotional eating and BMI‐z, and there was an actor effect among parents such that higher loneliness was positively related to emotional eating. There was a partner effect among adolescents such that greater parental loneliness was positively associated with adolescent emotional eating, and there was a partner effect among parents such that higher adolescent loneliness was positively associated with parental emotional eating. There were several actor–partner effects for loneliness and junk food in dyads with boys. Findings highlight the importance of dyadic models of loneliness in adolescent–parent dyads.     

Loneliness among school-aged children and their parents

The aim of this study was to examine the existence of the intergenerational transmission of loneliness between parents and children, including an examination of its stability and of gender differences. The study consisted of an evaluation of loneliness in mothers ( n = 834), fathers ( n = 661) and their 10-year-old children ( n = 981). Parent's self-reported loneliness was measured once, and their children's social and emotional loneliness were assessed at three time-points. The stability analysis indicated average stability in children's loneliness, especially their social loneliness. Boys were found to experience more emotional loneliness than girls. Structural equation modeling indicated no direct relationship between mothers'/fathers' loneliness and their children's loneliness. However, mothers' and fathers' loneliness reduced their daughters' peer-evaluated cooperating skills, which consequently predicted higher levels of both social and emotional loneliness.     

Confirmatory factor analysis of eating disorder symptoms in college women

Recent studies have found that the eating disorders can best be conceptualized as multidimensional. Four factors have consistently emerged from factor analytic studies of eating disorder symptoms: dietary restraint, bulimic behaviors, neurotic personality characteristics, and body image/body dysphoria. Confirmatory factor analysis was utilized to determine if this four-factor structure of eating disorder symptoms would be found in a sample of college women. Principal components analysis extracted four factors which were supported with a confirmatory factor analysis procedure. These four factors were negative affect and body dysphoria, bulimic behaviors, restrictive eating, and body image. The negative affect and body dysphoria factor was positively correlated with the other factors (i.e., bulimic behaviors, restrictive eating, and body image). This factor structure was similar to the factor structure found in samples of patients with bulimia and anorexia nervosa, except that the factors were more highly intercorrelated in the nonclinical sample. Results suggest that the measures of eating disorder symptoms used in this investigation are measuring the same multidimensional constructs in clinical and nonclinical subjects.This paper is partially based upon the master's thesis of the first author.     

Personality disorder cognitions in the eating disorders

The eating disorders are frequently found to be comorbid with Axis II cluster B and C personality disorders. It is important to identify the personality-level cognitions that typify these disorders. This study of a clinical group examines the personality disorder cognitions in the eating disorders. The cognitions that were most relevant to the eating disorder pathology were those relating to avoidant and obsessive-compulsive personality disorder. Other personality disorder cognitions were associated with comorbid psychopathology in largely clinically meaningful ways. These findings extend our understanding of the comorbidity of eating disorders and personality pathology, suggesting that some cases need to be assessed and formulated with such cognitions in mind. Treatment strategies are required that address both the eating and the personality pathology, while considering the impact of these cognitions on the therapeutic relationship.