The Role of Self-Objectification in the Experience of Women with Eating Disorders

Objectification theory has linked self-objectification to negative emotional experiences and disordered eating behavior in cultures that sexually objectify the female body. This link has not been empirically tested in a clinical sample of women with eating disorders. In the present effort, 209 women in residential treatment for eating disorders completed self-report measures of self-objectification, body shame, media influence, and drive for thinness on admission to treatment. Results demonstrated that the internalization of appearance ideals from the media predicted self-objectification, whereas using the media as an informational source about appearance and feeling pressured to conform to media ideals did not. Self-objectification partially mediated the relationship between internalized appearance ideals and drive for thinness; internalized appearance ideals continued to be an independent predictor of variance. In accordance with objectification theory, body shame partially mediated the relationship between self-objectification and drive for thinness in women with eating disorders; self-objectification continued to be an independent predictor of variance. These results illustrate the importance of understanding and targeting the experience of self-objectification in women with eating disorders or women at risk for eating disorders.     

Family of Origin and Current Relationship Influences on Codependency

This study investigated codependency in Caucasian individuals within the framework of Bowen's Family Systems Theory. The sample consisted of a group of couples, in which one member of the couple was a recovering alcoholic in an aftercare program, and a group of matched, comparison couples. Participants completed a demographic questionnaire, the Friel Co-dependency Assessment Inventory, and the Personal Authority in the Family System (PAFS) Questionnaire. The findings confirmed that codependency levels were higher in clinical than in comparison couples. Moreover, within the clinical group, there was little difference between alcoholics and their spouses with respect to dysfunction in their families of origin, current families, or their codependency levels. The findings further suggested that the etiology and function of codependency are different in clinical and nonclinical families. In the clinical sample, the family of origin and current relationship characteristics were related to codependency in patterns consistent with previous theory and research. For the nonclinical sample, however, the findings contradicted conventional codependency theory. The findings suggest that, in contrast to clinical populations, codependency in nonclinical populations has some links with favorable characteristics of family functioning.     

CODEPENDENCY, LOSS OF SELF, AND POWER

The feminist critique that codependency and loss of self are related to power was tested in a sample of 122 college women and men in committed relationships. Participants completed two codependency measures, a loss of self scale, and three indices of power: perceived power, use of specific influence strategies, and decision making. Among both women and men, codependency and loss of self were positively related to the use of indirect strategies and negatively related to perceived power, and loss of self was negatively related to use of the direct strategies. Among women alone, codependency was also negatively related to use of direct strategies and loss of self negatively related to decision making. These correlational data provide support for a feminist critique of codependency as related to power; however, gender similarities suggest that the relations between power, loss of self, and codependency hold for college men as well as college women.     

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.     

The relationships among trauma, stress, ethnicity, and binge eating

The present study investigated whether trauma, stress, and discriminatory experiences influenced binge eating among 93 African American and 85 Caucasian women. Trauma and stress were significantly related to binge eating for both groups, although the stress- binge eating relationship was stronger for Caucasian women. Ethnicity did not moderate the relationship between trauma and binge eating, but did moderate the stress-binge eating relationship. Finally, the hypothesis that trauma and stress would influence binge eating through their effects on function of eating was partially supported; the relationship between stress and binge eating was partially mediated by function of eating among Caucasian women. The implications of these findings for our understanding of binge eating are discussed.     

Body figure preferences of men and women: A comparison of two generations

Inspired by the earlier work of Rozin and Fallon (1988), this study investigated some potential determinants of the most recent increase of eating disorders among women in this country. Measures of current, preferred attractive, and acceptable body images for opposite- and same-gender figures, in addition to the thinnest and heaviest figures the subjects found attractive, were obtained from the same generation cohort as these students' parents. While gender differences were found, so were cohort differences. These cohort differences speak to factors relevant to understanding why there has been such an increase in the frequency of eating disorders in Western culture since the late 1960s, especially among adolescent women. Possible implications for treatment of eating disorders are discussed. However, the authors note that further studies are needed to determine if the cohort differences found might reflect a developmental or a definite cohort effect.     

A MEDIATIONAL MODEL RELATING SOCIOTROPY, AMBIVALENCE OVER EMOTIONAL EXPRESSION, AND DISORDERED EATING

Two factors that have been found to predict eating disorders are sociotropy or dependent personality style and ambivalence over emotional expression, but there has been little consideration of the relationship between them and how this relationship may contribute to an understanding of eating disorders. A mediational model is proposed in which high sociotropy leads to greater ambivalence over expressing emotions, which in turn increases vulnerability to eating disorders. Consistent with predictions, among 115 college women, a high level of sociotropy was associated with a high level of ambivalence over emotional expression, which in turn was associated with increased disordered eating. Furthermore, ambivalence over emotional expression significantly mediated the effect of sociotropy on disordered eating, even when controlling for depression level. Findings are considered within a developmental framework, and treatment implications are discussed.     

THE RELATIONSHIP BETWEEN FEMININE GENDER ROLE STRESS, BODY IMAGE, AND EATING DISORDERS

The Feminine Gender Role Stress (FGRS) scale was used in two studies to determine whether eating disorders could be linked to the cognitive tendency among women to appraise specific situations as highly stressful because of rigid adherence to the traditional feminine gender role. Study 1 showed the FGRS scale could distinguish eating disorders from other psychiatric disorders in an inpatient setting and from normal college women. This suggests that women who have eating disorders report higher than usual levels of stress as a result of rigid adherence to the traditional feminine gender role. Study 2 looked at cardiovascular reactivity to a "feminine" (i.e., body image threat) and a control stressor and determined the FGRS scale could predict which women are threatened by feminine stressors. Results from these studies suggest feminine gender role stress may be the missing link between cultural values of femininity and vulnerability for eating disorders.     

Evidence of codependency in women with an alcoholic parent: helping out Mr. Wrong

A conceptualization of codependency and its development, which is based largely on the writings of Karen Horney, is presented. It is proposed that having learned to obtain approval and self-esteem by conforming to the demands of an exploitive person, women with alcoholic parents will continue to seek opportunities to help such people. On the basis of this analysis, it was hypothesized that women with alcoholic parents would be more helpful to an experimenter portrayed as exploitive than to one portrayed as nurturant; women with nonalcoholic parents were expected to exhibit the opposite pattern. The results strongly supported the existence of codependent behavior in the women with alcoholic parents. The implication of these findings and directions for future research were briefly discussed.     

Relationships between eating disorder characteristics and love and sex attitudes

The current study explored theories proposing relationship difficulties in women with eating disorder characteristics. Results for the sample of 232 women (82% White-non-Hispanic, 12% White-Hispanic, 4% Black, 2% Oriental and other) indicated that eating disorder characteristics were most consistently positively related to a possessive and game-playing approach to love, and most consistently negatively related to a passionate and companionate love approach. In addition, eating disorder characteristics were positively related to casual and instrumental sexual attitudes, and negatively related to idealistic sexual attitudes. Women who were more endorsing of eating disorders were also lower in sexual self-esteem. Women who were dissatisfied with themselves physically, differed from satisfied women on several measures. Interpersonal features appear to be related to eating disorder characteristics in various ways.     

From one extreme to the other: Negative evaluation anxiety and disordered eating as candidates for the extreme female brain

Simon Baron-Cohen pioneered the idea that different brain types evolved to process information in gender specific ways. Here we expand this approach to looking at eating disorders as a byproduct of the extreme female brain. The incidence of eating disorders is higher among females, and recent findings show that hormones may play a role in eating disorders. We present new evidence from four studies that both an empathizing bias and hyper-mentalizing (as measures of the extreme female brain; EFB) are related to disordered eating and negative evaluation anxiety in women. We also advance the novel hypothesis that concerns about animal welfare (a unique expression of the EFB) may account for the relationship between vegetarianism and eating disorders.     

Testing a model of codependency for college students in Taiwan based on Bowen's concept of differentiation

The purpose of this study was to test a model of codependency based on Bowen's concept of differentiation for college students in Taiwan. The relations between family‐of‐origin dysfunction, differentiation of self, codependency traits and related symptoms including low self‐esteem, relationship distress and psychological adjustment problems were examined. Data were collected from 567 college students from 2 large, urban universities in northern Taiwan. Results indicated a significantly negative relationship between levels of codependency and self‐differentiation and that self‐differentiation partially mediated the relationship between family‐of‐origin dysfunction and codependency. The implications of these findings for counselling Taiwanese college students who experience codependency traits and related symptoms as well as suggestions for future research are discussed.     

Perception of parental acceptance in women with binge eating disorder

The authors contribute to the validating literature for binge eating disorder (BED) by examining perceptions of parents and satisfaction with life among obese women with and without BED. Participants were female patients, recruited through a private medical clinic, who were assigned to groups on the basis of body mass index (BMI) and scores on the Questionnaire on Eating and Weight Patterns (QEWP; R. L. Spitzer et al., 1992). Groups consisted of (a) obese women with BED (n = 32), (b) obese women who had no eating disorders (n = 51), and (c) nonobese women with no eating disorders (n = 30). All participants completed the Parental Acceptance/Rejection Questionnaire (PARQ; R. P. Rohner, 1986), the Satisfaction with Life Scale (SWLS; J. Fischer & K. Corcoran, 1994), and the Beck Depression Inventory (BDI; A. T. Beck & R. A. Steer, 1987). Obese women with BED perceived their fathers as more rejecting than did women in the other groups. Moreover, obese women with BED perceived their fathers as significantly more rejecting than their mothers. The BED group indicated lower satisfaction with life and higher levels of depression than the groups without eating disorders. These findings further validate the diagnostic category of BED. Obese women with BED appear to be a distinct subgroup of the obese population. The results indicate a need for further assessment of the father-daughter relationship in connection to BED and other eating disorders.     

Body Covering and Body Image: A Comparison of Veiled and Unveiled Muslim Women,Christian Women,and Atheist Women Regarding Body Checking,Body Dissatisfaction,and Eating Disorder Symptoms

Although Islam is the fastest growing religion worldwide, only few studies have investigated body image in Muslim women, and no study has investigated body checking. Therefore, the present study examined whether body image, body checking, and disordered eating differ between veiled and unveiled Muslim women, Christian women, and atheist women. While the groups did not differ regarding body dissatisfaction, unveiled Muslim women reported more checking than veiled Muslim and Christian women, and higher bulimia scores than Christian. Thus, prevention against eating disorders should integrate all women, irrespective of religious affiliation or veiling, with a particular focus on unveiled Muslim women.     

Female Adolescents with Eating Disorders,Parental Psychopathological Risk and Family Functioning

Epidemiological studies on adolescents with eating disorders demonstrate a high prevalence of disordered eating behaviors, with a higher prevalence of eating disorders among girls. Several studies have recently demonstrated an association between female adolescents’ eating disorders, parental psychopathological risk, and an impaired family functioning with poor quality of the relationships among family members. On the basis of these premises, we conducted a cross-sectional study initially recruiting 243 families of female adolescents affected by anorexia nervosa (Group A), bulimia nervosa (Group B), and binge eating disorder (Group C) (average age 14–17) to assess their psychological profile (SCL90-R), specific representations of their family functioning (FACES-IV), and the possible effect of adolescents’ psychological profiles and parents’ psychopathological risk on family functioning. Our results indicate that adolescents and parents in Groups A, B, and C show an unequivocal psychopathological profile; in particular, adolescents with anorexia present the most severe psychopathological risk. Further, our results show that adolescents and their parents differ in their perception of their family functioning. More specifically, adolescents with anorexia perceive their family as highly disengaged, poorly interwoven, and rigid, in addition cohesion and communication qualities are perceived as low. Interestingly, parental psychopathological risk predicts adolescents’ specific perception of their family functioning. These findings may guide clinical interventions as they suggest that distinct maternal psychopathological symptoms can be associated with a variety of clinical configurations in their offspring, whereas paternal psychopathological risk may be present in adolescents suffering from all forms of eating disorders.     

Assessment of Problematic Situations and Coping Strategies in Women with Eating Disorders: Initial Validation of a Situation-Specific Problem Inventory

The current study examined the psychometric properties of the Anorexia and Bulimia Problem Inventory (ABPI; Eason, 1983) in women with and without diagnosed eating disorders. The ABPI was initially constructed in accordance with the Behavior-Analytic model of instrument development (Goldfried & D'Zurilla, 1969). In this investigation, the ABPI was refined to consist of 38 audiotaped problematic situations, including those related to eating and weight, academic, family, and interpersonal relationship issues, and scoring criteria to rate the effectiveness of responses. Convergent and discriminant validity were established between ABPI-R scores and the Eating Disorder Inventory (EDI; Garner, Olmsted, & Polivy, 1983) scales. As evidence of disciminative validity women with eating disorders received less ratings indicating less effective problem-solving on the ABPI-R scales than women without eating disorders. A significant increase in effective coping as measured by the ABPI-R was found for women following an 8-week outpatient eating disorders treatment program. Potential uses of this measure in research and clinical practice are discussed.     

The Relationships Between Codependency and Femininity and Masculinity

Feminist writers critical of the codependency model have argued that codependency refers to an overly strong conformity to the traditional feminine role. Canonical correlation analysis using data from 192 first-year university students found a moderate association between codependency and gender-role identification. The specific nature of this association varied with different aspects of codependency. External focus (approval seeking) was associated with high scores on the negative aspects of femininity and low scores on positive aspects of masculinity. Self-sacrificing was associated with high positive femininity and low negative masculinity. Women scored higher than men on one aspect of codependency: external focus. Although the data are broadly consistent with a feminist critique of codependency, the relationship between codependency and gender-role identification appears to be more complex than previously suggested.     

The Eating Disorders Continuum,Self‐Esteem,and Perfectionism

Among 261 undergraduate women, increased severity of eating disorders along a continuum was associated with decreased self‐esteem, increased perfectionism, and increased scores on 7 subscales of the Eating Disorders Inventory‐2. Women with eating disorders differed from both symptomatic women and asymptomatic women on all variables, whereas symptomatic women differed from asymptomatic women only on self‐esteem, perfectionism, ineffectiveness, body dissatisfaction, and interoceptive awareness. Discriminant analysis correctly classified 45.2% of the women with eating disorders and 59% of the overall sample.     

A MEDIATIONAL MODEL OF AUTONOMY, SELF-ESTEEM, AND EATING DISORDERED ATTITUDES AND BEHAVIORS

This study expands upon existing literature by examining how the relationship between autonomy deficits and low self-esteem may create a psychological environment conducive to the development of eating disordered behaviors. Findings supported a mediational model to account for eating disordered behaviors in 71 college women. In this model, lack of autonomy was related to decreased global self-esteem, which in turn was associated with bulimia, body dissatisfaction, and drive for thinness. Although only tentative and cross-sectional in nature, this study is of particular importance because it links autonomy and self-esteem in a coherent model predictive of eating disordered behaviors in college women. Developmental aspects of eating disorders and treatment implications are discussed.     

Interventions to Empower Adults with Eating Disorders and Their Partners around the Transition to Parenthood

The transition to parenthood is perceived as a stressful life event, when parents experience an immense change of their psychological focus and a reorientation of roles and responsibilities in the family system. This process may be even more challenging in the presence of a parental eating disorder history. This paper reviews the impact of parental eating disorders on the parents, the couple relationship, and their child during the perinatal period. A parental eating disorder is associated with more negative expectations of parental efficacy as well as specific difficulties in couple communication over the child’s feeding, shape, and weight. Providers who better understand the effects of an eating disorder on parental functioning can more effectively intervene early on. We also present couple- or parent-based, empirically supported interventions for adults with eating disorders and their partners in the prenatal and postnatal periods: Uniting Couples in the treatment of Anorexia Nervosa (UCAN) and Uniting couples In the Treatment of Eating disorders (UNITE) both enhance recovery from the eating disorder through a couple-based intervention; the Maudsley Model of Treatment for Adults with Anorexia Nervosa (MANTRA) incorporates the support of partners, when appropriate; Parent-Based Prevention (PBP) focuses on improving parental functioning and reducing risk of negative parental and child outcomes. Finally, we discuss the clinical implications of addressing parental eating disorders and encourage more research on these families.