Interpersonal sensitivity,eating disorder symptoms,and eating/ thinness expectancies

This study examined social-emotional and cognitive factors in relation to eating disorder symptoms in 84 female undergraduates. Sensitivity to criticism and rejection-sensitivity related to each other and to appearance-related sensitivity. Although both interpersonal and appearance sensitivity related to a drive for thinness, appearance sensitivity had the stronger relationship. Interpersonal sensitivity was significantly correlated with expectancies that dieting and thinness lead to overgeneralized self-improvement, but not with eating expectancies. After controlling for body mass index, interpersonal sensitivity, and appearance sensitivity, dieting/thinness expectancies were related to drive for thinness, and expectancies that eating helps to manage negative affect were related to symptoms of bulimia. Findings are discussed in terms of the potential role that interpersonal sensitivity and eating-related expectancies may play in the development and maintenance of eating disorders, as well as intervention approaches. Portion of this paper were presented at the 72^nd Annual Meeting of the Midwestern Psychological Association, Chicago, IL, May 2000.     

Manipulation of thinness and restricting expectancies: further evidence for a causal role of thinness and restricting expectancies in the etiology of eating disorders.

To test the eating disorder expectancy theory contention that expectancies for reinforcement from thinness play a causal role in body dissatisfaction and eating disorder symptoms, the authors manipulated expectancies in 2 studies. Participants were exposed to either a psychoeducational intervention or an experimental manipulation of thinness and restricting expectancies. Study 1 participants were symptomatic college women who attended 3 experimental sessions and 1 follow-up session, each 1 week apart. Study 2 participants were high school girls who received the 3 experimental sessions clustered into 2 meetings; they completed symptom measures at baseline and at follow-up. In both samples, the thinness expectancy manipulation produced greater declines in thinness expectancies and body dissatisfaction than did the psychoeducational intervention. For high school girls, the thinness expectancy manipulation also produced a greater decline in overall eating-disordered attitudes. These results provide further support for the role of expectancies in the etiology of eating-disordered behaviors.     

Perfectionistic self-presentation, body image, and eating disorder symptoms

A specific model for eating disorder symptoms involving perfectionistic self-presentation and two different moderators (i.e., body image evaluation and body image investment) was tested. Participants completed measures of perfectionistic self-presentation, body image dysfunction, and eating disorder symptoms. Findings indicated that all three dimensions of perfectionistic self-presentation were associated with eating disorder symptoms. Results also showed that perfectionistic self-presentation predicted eating disorder symptoms in women who were dissatisfied with their bodies, but that it did not predict eating problems in women who liked their bodies and felt there was little or no discrepancy between their actual and ideal appearances. Body image investment did not moderate the relationship between perfectionistic self-presentation and eating disorder symptoms, suggesting that ego-involvement alone is insufficient to promote eating disturbance in the context of perfectionism. The importance of self-presentation components of perfectionism and specific body image difficulties in predicting eating disorder symptoms are discussed.     

Self-objectification,body image disturbance,and eating disorder symptoms in young Australian children

Self-objectification has been examined extensively in adult populations. Despite theoretical evidence suggesting that children may also be vulnerable to experiencing self-objectification, whether children do self-objectify has not been determined. Accordingly, the present study examined the degree to which children self-objectify. The prevalence of body image and eating disturbances in this population, and the relationship between self-objectification and these disturbances, were also investigated. Results from over 250 boys and girls aged 6–11 years revealed that young girls report levels of self-objectification that are similar to those observed among older girls and women. Self-objectification was also found to be meaningfully related to body image and eating disturbances in children. A significant proportion of children reported body dissatisfaction and a minority engaged in disordered eating behaviours in the four weeks prior to the assessment. These results suggest that children may be at risk of experiencing the negative psychological outcomes associated with self-objectification.     

A 20-year longitudinal study of body weight, dieting, and eating disorder symptoms

The article describes a 20-year longitudinal study of body weight, dieting, and disordered eating in women and men. Body weight increased significantly over time in both women and men. However, women's weight perception and dieting frequency decreased over time, whereas men's weight perception and dieting frequency increased, and disordered eating declined more in women than in men from late adolescence to midlife. In both women and men, changes in weight perception and dieting frequency were associated with changes in disordered eating. In addition, adult roles such as marriage and parenthood were associated with significant decreases in disordered eating from late adolescence to midlife in women, whereas few associations were observed in men. Despite different developmental trajectories, women demonstrated more weight dissatisfaction, dieting, and disordered eating compared with men across the period of observation.     

Subtyping eating disordered patients along drive for thinness and depression

Subtyping individuals who binge eat by “diet-DT” and “depression” has yielded two valid and clinically useful subtypes that predict eating severity, comorbid psychopathology and outcome. The present study aimed to find four subtypes based on these dimensions and test their validity. Besides, it explored the distribution of eating disorder (ED) diagnoses across subtypes given their known heterogeneity, crossover and binge-eating fluctuation.Cluster analysis grouped 1005 consecutively admitted ED adult women into four subtypes, those previously described “DT” (22%), “DT-depressive” (29%), and “mild DT” (25%) and “depressive-moderate DT” (24%). Overall “mild DT” presented lower and “DT-depressive” greater eating and comorbid psychopathology than the rest, whereas “pure DT” and “depressive-moderate DT” presented no differences on bulimic symptoms but in psychopathology (p < .01). Finally, while BN-P patients were mostly and similarly distributed in the “DT” and “DT-depressive” subtypes than in the other, AN were in the new “mild DT” and “depressive-moderate DT” (p < .01). However, BN-NP, BED and EDNOS were similarly represented across subtypes.Results are discussed with regard to 1) the newly emerged subtypes that may explain cases in which DT prevents or does not predict binge eating; 2) the confluence of DT-depression that signaled greater eating and comorbid pathology, particularly self-control problems; 3) ED-DSM-diagnostic criteria.     

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.     

Interpersonal sensitivity, status, and stereotype accuracy

A classic question in social and organizational psychology is whether low-status persons are more accurate in the perception of their high-status partners than the latter are in their perception of their subordinates. In a series of studies, Snodgrass (1985, 1992) tested this idea. She found that subordinates were more accurate at judging how their bosses viewed them than bosses were at judging how their subordinates viewed them, but that bosses were more accurate at judging how subordinates viewed themselves than subordinates were at judging how bosses viewed themselves. We believe, however, that these results were obscured by stereotype accuracy. Using previously collected data, we found that stereotype accuracy does lead to the pattern previously observed by Snodgrass. We also discovered that when we controlled for stereotype accuracy, subordinates' perceptions were generally more accurate than those of their bosses, which supports Snodgrass's original hypothesis.     

Daily fluctuations in perfectionism dimensions and their relation to eating disorder symptoms

Multidimensional perfectionism has been shown to play an important role in eating disorders (EDs). However, research examining this relation has primarily focused on relatively stable inter-individual differences between persons, thereby failing to examine how these variables are associated within individuals on a daily basis. This study examines how daily fluctuations in Personal Standards (PS) perfectionism and Evaluative Concerns (EC) perfectionism relate to each other and to fluctuations in ED symptoms. Adolescents (N = 275) completed questionnaires each evening during seven consecutive days. Multilevel modeling showed significant day-to-day fluctuations in PS and EC perfectionism, and showed that both dimensions are intertwined in the day. Among females, fluctuations in EC perfectionism co-varied with fluctuations in ED symptoms.     

Self-criticism, low self-esteem, depressive symptoms, and over-evaluation of shape and weight in binge eating disorder patients

Despite the fact that negative self-evaluations are widely considered to be prominent in eating disorders, the role of self-criticism has received little empirical attention. The vast majority of research on the construct of self-criticism has focused on its role as a specific personality vulnerability factor in depression-related phenomena. In this study of 236 patients with binge eating disorder, confirmatory factor analysis supported self-criticism, self-esteem, depressive symptoms, and over-evaluation of shape and weight as distinct, albeit related, constructs. Structural equation modeling demonstrated that the relation between self-criticism and over-evaluation of shape and weight was partly mediated or explained by low self-esteem and depressive symptoms. Continued efforts to understand the role of self-criticism in eating disorders appear warranted.     

Adherence to the Super Woman ideal and eating disorder symptoms among college women

The degree to which three components of the Super Woman construct of femininity [C. Steiner-Adair (1986) “The Body Politic: Normal Female Adolescent Development and the Development of Eating Disorders” Journal of the American Academy of Psychoanalysis, Vol. 14, pp. 95–114], valuing physical appearance, striving for success in multiple roles, and insecure parental attachment, are related to eating disorder symptoms was examined for a sample of 156 college women (84% white, 6% African American, 6% Asian, 3% Latina, 1% another race). Canonical analysis yielded three significant roots, suggesting a complex relationship between components of the Super Woman model and eating disorder symptoms. The first root supports the hypothesized relationship between the three components of the Super Woman model and eating disorder symptoms. The second root suggests that striving for success, when accompanied by a context of secure parental attachment, is positively associated with measures of social competence. The third root highlights the contribution of an emphasis on physical appearance to weight concern, dieting, and bulimic behavior.     

Physical appearance perfectionism explains variance in eating disorder symptoms above general perfectionism

Physical appearance perfectionism is a domain-specific form of perfectionism comprising two components: hope for perfection and worry about imperfection (Yang & Stoeber, 2012). Previous studies found that physical appearance perfectionism is related to eating disorder symptoms, particularly the worry about imperfection component, but did not address the question of whether physical appearance perfectionism explains variance in eating disorder symptoms above general perfectionism. The present study investigated the question examining 559 female university students. Physical appearance perfectionism explained an additional 9–17% of variance in eating disorder symptoms above the 11–20% variance explained by general perfectionism. The findings suggest that physical appearance perfectionism plays an important role in disordered eating beyond general perfectionism.     

Eating-related Intrusive Thoughts Inventory: exploring the dimensionality of eating disorder symptoms

The aims of this study were, first, to examine the structure and validity of the Eating-related Intrusive Thoughts Inventory (INPIAS), a self-report questionnaire designed to assess eating disorders related to intrusive thoughts (EDITs), and second, to explore the existence of a continuum ranging from normal to abnormal thought intrusions related to eating, weight, and shape. Participants were 574 (408 women) nonclinical community individuals. Analyses revealed that EDITs can be clustered into three sets: appearance-dieting, need to exercise, and thoughts-impulses related to eating disorders. EDITs' consequences showed a two-factor structure: emotional consequences/personal meaning and thought-action fusion responsibility; and four factors of strategies: "anxiety," suppression, obsessive-compulsive rituals, and distraction. The sample was then divided according to reported restrained eating. The High dietary restraint group reported a higher frequency of EDITs, whereas differences in the other factors were mediated by depression, anxiety, and obsessionality. The results suggest that eating disorder-related cognitions are experienced by nonclinical individuals, and distributed on a continuum.     

Perceived acceptability of anorexia and bulimia in women with and without eating disorder symptoms

Perceptions of the acceptability of eating‐disordered behaviour were examined in young adult women with (n = 44) and without (n = 268) eating disorder symptoms. All participants viewed vignettes of anorexia nervosa (AN) and bulimia nervosa (BN) and responded to the same series of questions—addressing different possible ways in which the conditions described might be seen to be acceptable—in relation to each vignette. Participants with eating disorder symptoms perceived eating‐disordered behaviour to be more acceptable than asymptomatic participants, and this was the case for both AN and BN vignettes and for a range of different items. Differences on items tapping the perception that it ‘might not be too bad’ to have an eating disorder and that an eating disorder is ‘nothing to be concerned about’ were particularly pronounced. The findings could not be accounted for by between‐group differences in body weight. The findings indicate the ambivalence towards eating‐disordered behaviour that exists among a subgroup of young women in the community and the clear association between such ambivalence and actual eating disorder symptoms. The perceived acceptability of eating‐disordered behaviour may need to be addressed in prevention and early‐intervention programs for eating disorders.     

Drive for thinness, affect regulation and physical activity in eating disorders: a daily life study

Using Ecological Momentary Assessment, the within patient associations between drive for thinness, emotional states, momentary urge to be physically active and physical activity were studied in 32 inpatients with an eating disorder. Participants received an electronic device and had to indicate at nine random times a day during 1 week their momentary drive for thinness, positive and negative emotional states and their urge to be physically active and physical activity. Multilevel analyses indicated that patients with higher mean levels for urge to be physically active were characterized by lower body mass index (BMI) and chronically negative affect whereas patients with higher mean levels for physical activity were characterized by lower BMI and higher dispositions for drive for thinness. In addition, within patient relations between drive for thinness and urge to be physically active were moderated by BMI and chronically negative affect whereas within patient relations between drive for thinness and physical activity were moderated by BMI. Finally, also positive emotional states were significantly associated with physical activity within patients. By using a daily process design, characteristics of physical activity were revealed that have not been identified with assessment methods that have a lower time resolution.     

An empirical typology of perfectionism in early-to-mid adolescents and its relation with eating disorder symptoms

Although the association between perfectionism and eating disorder (ED) symptoms is well-established, debate remains about the relative contribution of two central dimensions of perfectionism, that is, Personal Standards (PS) perfectionism and Evaluative Concerns (EC) perfectionism, in the prediction of ED symptoms. This study used cluster analysis to establish naturally occurring combinations of PS and EC perfectionism in early-to-mid adolescents (N = 656; M age = 13.9 years). Evidence was obtained for four perfectionism profiles: (1) maladaptive perfectionism (high PS and high EC), (2) pure evaluative concerns perfectionism (high EC only), (3) adaptive perfectionism (high PS, low EC), and (4) non-perfectionism (low on both PS and EC). A comparison of participants in these four clusters in terms of ED symptoms suggests that a combination of high personal standards and evaluative concerns (rather than the presence of one of these two dimensions alone) is most strongly related to ED symptoms.     

Perfectionism in depression, obsessive-compulsive disorder and eating disorders

High levels of perfectionism have been observed in major depression, anxiety disorders and eating disorders. Though few studies have compared levels of perfectionism across these disorders, there is reason to believe that different dimensions of perfectionism may be involved in eating disorders than in depression or anxiety [Bardone-Cone, A. M. et al. (2007). Perfectionism and eating disorders: Current status and future directions. Clinical Psychology Review, 27, 84-405]. The present study compared patients with major depression, obsessive-compulsive disorder, and eating disorders on dimensions of perfectionism. Concern over Mistakes was elevated in each of the patient groups while Pure Personal Standards was only elevated in the eating disorder sample. Doubts about Actions was elevated in both patients with obsessive-compulsive disorder and eating disorders, but not in depressed patients. Analyses of covariance indicated that Concern over Mistakes accounted for most of the variance in the relationship of perfectionism to these forms of psychopathology.     

Heart-beat perception, panic/somatic symptoms and anxiety sensitivity in children

There is considerable evidence implicating heart-beat perception (HBP) accuracy and anxiety sensitivity (AS) in the development of panic in adults. However, to date there have been no studies exploring the association between HBP, AS and childhood panic/somatic symptoms. Seventy-nine children aged 8 to 11 years completed a mental tracking paradigm (Psychophysiology 18 (1981) 483) to assess HBP, the Children's Anxiety Sensitivity Index (J Clin Chil Psychol 20 (1991) 162) and the Screen for Childhood Anxiety Related Emotional Disorders (J Am Acad Child Adoles Psych 38 (1999) 1230). Those with good HBP (n = 7, 9%) had significantly higher panic/somatic symptoms (t = -1.71, P < 0.05), and AS (t = -2.16, P < 0.02) than those with poor HBP. There were no effects of age, sex or BMI on HBP. Those with high levels of panic/somatic symptoms were seven times more likely to have good HBP and had AS scores 1 S.D. higher than the remainder of the sample. Multivariate analyses revealed that these two phenotypes had independent associations with high panic/somatic symptoms. These results extend the literature on HBP and panic and suggest that in children, as in adults, increased panic/somatic symptoms are associated with enhanced ability to perceive internal physiological cues, and fear of such sensations.