EVALUATION OF A STRUCTURAL MODEL OF OBJECTIFICATION THEORY AND EATING DISORDER SYMPTOMATOLOGY AMONG EUROPEAN AMERICAN AND AFRICAN AMERICAN UNDERGRADUATE WOMEN

This study evaluated a structural equation model of objectification theory among European American (EA;  n  = 408) and African American women (AA;  n  = 233). Modeling results indicated a particularly strong association between thin-ideal internalization/body monitoring and eating disorder symptoms, with weaker relationships among body dissatisfaction, depression, anxiety, and eating disorder symptoms. The measurement model was not equivalent for EAs and AAs; however, the structural model was invariant, suggesting that the relationships among these variables may be similar for both groups. Thus, objectification theory does appear to be applicable to AA women, although specification of relevant constructs and refinement of assessment instruments is warranted.     

Associations between depression, distress tolerance, delay discounting, and alcohol-related problems in European American and African American college students

Although levels of heavy drinking and alcohol-related problems are high in college students, there is significant variability in the number and type of problems experienced, even among students who drink heavily. African American students drink less and experience fewer alcohol-related problems than European American students, but are still at risk, and little research has investigated the potentially unique patterns and predictors of problems among these students. Depression, distress tolerance, and delay discounting have been implicated in adult substance abuse and may be important predictors of alcohol problem severity among college students. We examined the relationship between these variables and alcohol-related problems among African American and European American students (N = 206; 53% female; 68% European American; 28% African American) who reported recent heavy drinking. In regression models that controlled for drinking level, depression, distress tolerance, and delay discounting were associated with alcohol problems among African American students, but only depression was associated with alcohol problems among European American students. These results suggest that negative affect is a key risk factor for alcohol problems among college student drinkers. For African American students, the inability to tolerate negative emotions and to organize their behavior around future outcomes may also be especially relevant risk factors.     

ACCULTURATION AND EATING DISORDERS IN A MEXICAN AMERICAN COMMUNITY SAMPLE

Our purpose was to investigate acculturation and eating disorders by examining the role of ethnic identity and by utilizing a bidimensional perspective toward two cultures. We predicted that orientation toward European American culture and lower ethnic identity would be positively associated with eating disorders. Participants were 188 Mexican American women recruited from the community (79 with eating disorders and 109 control women). The Structured Clinical Interview for DSM-IV-TR and Eating Disorder Examination were used to establish diagnoses. The Acculturation Rating Scale for Mexican Americans–II and the Multigroup Ethnic Identity Measure assessed Anglo orientation, Mexican orientation, and ethnic identity. Orientation toward Anglo American culture was significantly associated with eating disorders, whereas orientation toward Mexican culture and strength of ethnic identity were not associated with eating disorder status. Findings point to the role of Anglo cultural orientation in the development of eating disorders and underscore the need for future research to utilize bidimensional models.     

Relationship Between Alexithymia and Social Anxiety in Female Outpatients with Dermatological Disorder Presenting for Psychiatric Consultation

The aim of this study was to evaluate the relationship between alexithymia and social anxiety symptoms in female outpatients with dermatological disorder. Fifty consecutive patients sent to a psychiatry outpatient clinic for consultation from a dermatology outpatient clinic were included in the study. Social anxiety symptoms showed significant correlations with depression, trait anxiety, alexithymia and global psychiatric symptom severity. A multivariate analysis of covariance demonstrated that subscales of the Liebowitz Social Anxiety Scale (LSAS) were related to alexithymia and trait anxiety. The “difficulty in describing feelings” (DDF) dimension of alexithymia and trait anxiety appear to be important factors in this relationship between social anxiety and alexithymia. Results of this study suggest that patients with dermatological disorder may benefit from both treatment of social anxiety symptoms and learning how to regulate their affects and emotional expression.     

TO BE FEMALE, MIDDLE CLASS, ANXIOUS, AND BLACK

Women of color theorists have suggested that the double minority status of gender and ethnicity places African American women at higher risk for anxiety. However, little information is available about anxiety disorders among African American women. The existing literature subsumes Black women under the general category of African Americans and focuses on low-income samples. In this study, we examine the manifestation of panic disorder in a sample of 15 predominantly middle-class African American women. We then compare these women to a group of 35 predominantly middle-class African American women without panic disorder on several factors, including presence of isolated sleep paralysis, presence of other anxiety disorders, help-seeking behavior, and victimization. Results indicate that African American women with panic disorder experienced isolated sleep paralysis, and that both groups had high levels of sexual victimization. Help-seeking among women with panic and other anxiety disorders was limited to relationship difficulties, sexual assault, and bereavement.     

Eating Disorders Among Urban and Rural African American and European American Women

Abstract

It is alleged that eating disorders are nonexistent in African American women and that eating disorder symptomatology occurs predominantly among White middle class women (Kumanyika, Wilson, & Guilford-Davenport, 1993; Smolak & Striegel-Moore, 2001). This research attempted to identify differences in eating disorder symptomatology in African American and White American women. An eating disorder is a disability because it can damage the person physically, emotionally and socially. It can be undetected for years and society may reinforce the hidden disorder by being complimentary regarding the thin appearance of the person. The Eating Disorder Inventory (EDI) was used to measure psychological traits and symptom clusters associated with the understanding and treatment of eating disorders (Garner, 1990). Measures of self-esteem, depression and coping were also examined. Findings indicated differences between African American and White women on the Ineffectiveness scale of the EDI, differences between the urban/rural women on Ineffectiveness and Perfectionism, and differences in coping strategies and education among this sample group of women. Successful treatment usually involves psychotherapy and/or medication for depression.     

Additive impact of childhood emotional,physical, and sexual abuse on suicide attempts among low-income African American women

This study examines the association between exposures to multiple forms of childhood abuse (emotional, physical, sexual) and adult suicidal behavior in a sample of low-income, African American women. We hypothesized a linear relation between childhood abuse and risk for making a suicide attempt, such that the more forms of childhood abuse to which a woman was exposed, the greater her risk would be to make a suicide attempt. Logistic regression analyses revealed that, compared to women who did not report any experiences of childhood abuse, women who experienced one, two, or three forms of abuse were 1.83, 2.29, or 7.75 times more likely to attempt suicide, respectively (all statistically significant). Furthermore, compared to women who reported one or two types of abuse, women who reported all three types of abuse were statistically more likely to attempt suicide. These findings have implications for clinicians working with African American women who report either childhood abuse or exhibit suicidal behavior.     

Comparison of bulimics, obese binge eaters, social phobics, and individuals with panic disorder on comorbidity across DSM-III-R anxiety disorders.

Eighty-two women, presenting as normal-weight bulimics, obese binge eaters, social phobics, and individuals with panic disorder, were compared on anxiety, depression, and substance abuse. All were administered the Anxiety Disorder Interview Schedule-Revised and completed the Michigan Alcohol Screening Test, Drug Abuse Screening Test, and Self-Consciousness Scale. A striking proportion of eating disorder subjects were comorbid for one or more anxiety disorders, the most frequent diagnoses being generalized anxiety disorder and social phobia. The results suggest that the place of anxiety in bulimia nervosa goes beyond that discussed within the context of the anxiety reduction model. Conflicting comorbidity findings among this and prior investigations are noted, however, and discussed in terms of the issue of differential diagnosis between eating and anxiety disorders.     

Developmental trajectories of co-occurring depressive, eating, antisocial, and substance abuse problems in female adolescents

Growth trajectories of co-occurring symptomatology were examined in a community sample of 493 female adolescents who were followed annually from early to late adolescence. On average, depression, eating disorder, and substance abuse symptoms increased over time, whereas antisocial behavior decreased. Increases in each symptom domain were associated with relative increases in all other domains. Initial depressive and antisocial behavior symptoms predicted future increases in the other; substance abuse and antisocial behavior symptoms also showed prospective reciprocal relations. Initial depression predicted increases in eating disorder and substance abuse symptoms. Initial eating disorder symptoms predicted increases in substance abuse problems. Finally, the results suggest that the developmental covariation between depressive and eating disorder symptoms and between antisocial behavior and substance abuse symptoms was accounted for by distinct but related 2nd-order growth parameters.     

Emotional Self-Awareness,Eating Disorders,and Racial Identity Attitudes in African American Women

Certain racial identity attitudes may involve diminished internal emotional awareness, features of a syndrome known as “alexithymia,” which has been observed in survivors of extreme trauma. This study found that levels of alexithymia, but not eating disorders, were related to attitudes characteristic of early stages of racial identity development among African American women.     

APPEARANCE SELF-ATTITUDES OF AFRICAN AMERICAN AND EUROPEAN AMERICAN WOMEN: MEDIA COMPARISONS AND INTERNALIZATION OF BEAUTY IDEALS

African American (AA) women have reported less body image disturbance than European American (EA) women, but questions remain about the nature and extent of this difference. This study examined differences in the body image of 80 AA women and 89 EA women with an improved methodology that controlled for body size, distinguished between satisfaction with and importance of body features, and included nonweight (e.g., hair texture, skin color) as well as weight-related features. Results provide evidence that, in contrast to AA women, EA women (a) were more dissatisfied with both weight and specific appearance features, (b) compared themselves more often to media beauty figures and internalized Western beauty standards more, and (c) showed a significant relation between media comparisons and body dissatisfaction. Internalization of Western beauty ideals was related to body dissatisfaction in both groups of women.     

Sexual Abuse and Eating Disorders: A Test of a Conceptual Model

To provide a better conceptual understanding and to stimulate further research, A. Kearney-Cooke and R. H. Striegel-Moore (1994) proposed several theoretical models concerning the relationship between sexual abuse and eating disorders. In this study, we tested the model that hypothesized an indirect relationship between sexual abuse and eating disorders, with the effects of sexual abuse being mediated through bodily shame and body disparagement. Three hundred thirty female undergraduates from a large southwestern public university participated. The women represented the social class of the university, which is predominantly middle to upper-middle class. Race/ethnicity of the participants was 69.8% Caucasian, 15.9% African American, 5.8% Latino/Mexican American, 4.9% Asian American, and 0.9% Native American; the remainder did not indicate their race/ethnicity. Of the total sample, 60% reported having been sexually abused at some point in their lives; 21% had experienced abuse prior to age 14. Almost 8% were categorized as having a diagnosable eating disorder, whereas another 72.7% were symptomatic. To test the hypothesized model, structural equation modeling with LISREL 8.3 (K. G. Joreskog & G. Sorbom, 1999) was used. Results indicated that the model fit the data well and the hypothesized relationships among the variables were in the expected directions. Sexual abuse predicted higher levels of bodily shame that, in turn, predicted increases in body disparagement. As expected, only body disparagement directly predicted eating disorder symptoms. Directions for future research are discussed.     

Ethnic identity,thin-ideal internalization,and eating pathology in ethnically diverse college women

Although much research suggests that ethnic identity is positively correlated with psychological health for ethnic minority women, research examining ethnic identity's relationships to thin-ideal internalization, weight concerns, and eating concerns is sparse. Consequently, this study examined these relationships in European American, African American, Latina, and Asian American college women (N = 816). As expected, univariate analyses of variance indicated that European American women scored lowest on ethnic identity and highest on eating and weight concerns, whereas African American women scored lowest on thin-ideal internalization. Hierarchical regression analyses indicated that ethnic identity was negatively associated with eating and weight concerns, while body mass index and thin-ideal internalization were positively associated. Ethnic identity moderated the relationship between thin-ideal internalization and eating concerns such that the relationship was stronger for participants with lower ethnic identity. These results suggest ethnic identity may be a direct or interactive protective factor against eating concerns in ethnically diverse college women.     

The relationship between self‐harm and alexithymia

This paper presents a systematic review of the literature concerning the relationship between alexithymia and self‐harm. Fifteen studies were selected following a systematic search of relevant databases. Results indicate significantly higher levels of alexithymia in women who self‐harm compared with women who do not self‐harm. Studies of men were less conclusive and require further investigation. A subsample of the studies found that childhood abuse and bullying were more likely to be associated with self‐harm if alexithymia was present as a mediator. Other studies found that depression mediated between alexithymia and self‐harm. The results indicate that the poor emotional cognition and expression associated with alexithymia may increase vulnerability to self‐harm, particularly in women.     

Weight-Related Abuse: Impact of Perpetrator-Victim Relationship on Binge Eating and Internalizing Symptoms

Disordered eating and weight problems are associated with experiencing childhood abuse. While weight-related abuse (WRA; teasing and verbal abuse specific to one’s weight) uniquely predicts disordered eating and mood problems in adulthood, the link between WRA and adult outcomes is largely unexplored. Relationships between perpetrators and victims (e.g., family member vs. stranger) have demonstrated an impact on outcomes in research on sexual abuse, and may elucidate important aspects of the relationship between psychopathology and abuse. Thus, we investigated the effect of the perpetrator’s relationship to the victim on disordered eating symptoms in a population of young adults (N = 371) oversampled for current overweight and obesity. Parent perpetration of WRA was the strongest predictor of both depression and abuse-related emotional impact ratings. In contrast, friend and classmate perpetration of WRA were the sole predictors of binge eating and anxiety symptoms, respectively. Results highlight the importance of investigating the impact of multiple types of perpetrators of WRA, as well as the need to examine family and other close relationships in the treatment of disordered eating and internalizing symptoms.     

Breathing Characteristics and Symptoms of Psychological Distress: An Exploratory Study

In this exploratory study of the relationship between characteristics of breathing and 3 common psychological issues (i.e., symptoms of anxiety, alexithymia, and depression), 79 college‐age adults were examined using self‐report, rater observation, and physiological measures. Results indicated significant positive relationships between dysfunctional breath characteristics and symptoms of both anxiety and alexithymia. A significant positive correlation was found between self‐reported symptoms of dysfunctional breathing and symptoms of depression, but no significant relationships existed between symptoms of depression and either rater‐observed breath characteristics or physiological measures.     

DISORDERED EATING AND PERCEPTIONS OF CHILDHOOD ABUSE AMONG WOMEN IN A PRIMARY CARE SETTING

Research has demonstrated links between sexual abuse and disordered eating among women in college student and mental health samples. Little is known about such relationships among women from other samples or the relationship between other forms of childhood abuse as well as disordered eating (vomiting, starvation, laxative abuse). Prevalence of disordered eating was significantly higher among women who indicated a perceived childhood history of sexual, physical, or emotional abuse or who had personally witnessed violence.     

ACCULTURATION, BODY IMAGE, SELF-ESTEEM, AND EATING-DISORDER SYMPTOMATOLOGY IN ADOLESCENT MEXICAN AMERICAN WOMEN

In this article the relationship among acculturation, body image, self-esteem, and eating disorder symptomatology in 120 Mexican American adolescent women was investigated. Surprisingly, acculturation levels were not related to anorexic or bulimic symptomatology, self-esteem, body dissatisfaction or thinness of ideal and attractive figures. Lower levels of self-esteem predicted higher levels of anorexic and bulimic symptomatology. Body mass was positively related to bulimic scores. In contrast to Lester and Petrie (1995), body dissatisfaction was significantly related to eating-disorder symptomatology. The high levels of disordered eating attitudes and behaviors found in this study suggest that rather than exclusively being an Anglo, middle-to upper-class phenomenon, eating-disordered behavior also exists within lower socioeconomic status Mexican American adolescent women.     

Relation of early menarche to depression, eating disorders, substance abuse, and comorbid psychopathology among adolescent girls

This prospective study tested whether early menarche partially accounts for the increases in depression, eating pathology, substance abuse, and comorbid psychopathology that occur among adolescent girls, with structured interview data from a community sample (N = 496). Early menarche (prior to 11.6 years) was associated with elevated depression, substance abuse, and "any" disorder but did not confer increased risk for anorexia nervosa, bulimia nervosa, or binge eating disorder. Although there was significant comorbidity across all three classes of pathology, early menarche was associated only with comorbid depression and substance abuse. Results provide partial support for the assertion that early menarche is a general risk factor for psychopathology among adolescent girls but suggest that this risk may not apply to certain disorders and that the effects are modest in size.     

Eating disorders: relations with inconsistent discipline,anxiety, and drinking among college women

Since as many as 20% of all college women report symptoms of eating disorders, the present study examined the relationship between self-reported eating disorder symptoms. anxiety, drinking, and retrospective reports of inconsistent parenting during childhood. 101 college women, 85% Euro-Americans of mean age 19 yr., completed an anonymous survey including questions from the Eating Disorder Index-1, the Retrospective Family Unpredictability Scale, the Trait Anxiety Scale, and measures of drinking in the previous month. Eating disorder symptoms correlated with self-reported drinking quantity, anxiety, and retrospective ratings of inconsistent discipline. This appears to be the first time eating disorder symptoms have been associated with inconsistent discipline. Implications for etiology and treatment of eating disorders are discussed.