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.     

Bulimic symptomatology: the role of adaptive perfectionism, shape and weight concern, and self-esteem

An interactive model implicating high perfectionism, high weight and shape concern, and low self-esteem in the onset and maintenance of bulimic symptoms ( [Bardone et?al., 2000] and [Vohs et?al., 1999] ) has received mixed support. This study aimed to replicate the cross-sectional model in a clinical sample of women with eating disorders, and to investigate whether the model could predict changes in binge eating and purging at the end of treatment. Eating disorder outpatients (n = 353) completed measures of perfectionism, weight/shape concern, self-esteem, and bulimic symptoms at pre-treatment and discharge. Contrary to the hypotheses, the three-way interaction did not predict binge eating or purging cross-sectionally or prospectively as a moderator of psychotherapy outcome. It was concluded that the robustness of the interactive model seems questionable and may be impacted by an inadequate conceptualization of the perfectionism construct.     

Perfectionism, perceived weight status, and self-esteem interact to predict bulimic symptoms: a model of bulimic symptom development

An interactive model of perfectionism, perceived weight status, and self-esteem was tested on 342 female undergraduates to predict bulimic symptoms. Using a longitudinal design, the authors tested the model on data collected at 2 points: the spring of participants' senior year of high school and during participants' first year of college. The authors hypothesized and found that self-esteem moderates the interaction between perfectionism and perceived weight status in predicting bulimic symptoms. Women who are high in perfectionism and who consider themselves overweight exhibit bulimic symptoms only if they have low self-esteem (i.e., if they doubt they can attain their high body standards). High self-esteem women with the same diathesis-stress conditions are less likely to exhibit bulimic symptoms. These findings clarify the role of perfectionism in bulimic symptomatology.     

Racial Identity and Gender as Moderators of the Relationship Between Body Image and Self-esteem for African Americans

This study explored whether multiple dimensions of racial identity and gender moderated the relationship between body dissatisfaction and self-esteem for African American men and women (N?=?425) using an intersectional approach. Centrality (strength of identification with racial group), private regard (positive feelings about racial group), public regard (positive feelings others have about racial group), and gender moderated the relationship between body dissatisfaction and self-esteem for a sample of men (n?=?109) and women (n?=?316) college students from three regions of the United States. Body dissatisfaction was related to lower self-esteem only for those African Americans for whom race was less central to their identities. High private regard and low body dissatisfaction were synergistically associated with higher self-esteem. Similarly, low public regard and high body dissatisfaction were synergistically related to lower self-esteem. There was a positive main effect for assimilation ideology (emphasis on similarities between African Americans and Western society) on self-esteem; however it was not a significant moderator. The relationship between body dissatisfaction and self-esteem was stronger for women than for men. This study extends our knowledge of the ways in which racial attitudes and gender shape how African Americans experience their bodies and are related to self-esteem.     

Somatoform dissociation in eating-disordered patients

This study investigated the role of somatoform dissociation in eating disorders and pathological eating behaviour, relative to the established association of eating pathology with psychological dissociation. The participants were 131 women with DSM-IV diagnoses of anorexic or bulimic disorders and 75 women who had no such disorder. Each woman completed measures of psychological and somatoform dissociation, as well as a measure of bulimic attitudes. The current presence or absence of specific bulimic behaviours was identified during the clinical interview. Levels of both forms of dissociation were higher in the women who had diagnoses of disorders with a bulimic component (bulimia nervosa; anorexia nervosa of the binge/purge subtype) than in the non-clinical or restrictive anorexic women. Somatoform dissociation showed particularly strong links with the presence of bulimic behavioural features (excessive exercise, laxative abuse, diet pill abuse, diuretic abuse) and with bulimic attitudes. The formulation and treatment of cases where there are bulimic features is likely to be enhanced by the assessment of somatoform dissociation.     

Examining a psychosocial interactive model of binge eating and vomiting in women with bulimia nervosa and subthreshold bulimia nervosa

The current study tested a psychosocial interactive model of perfectionism, self-efficacy, and weight/shape concern within a sample of women with clinically significant bulimic symptoms, examining how different dimensions of perfectionism operated in the model. Individuals with bulimia nervosa (full diagnostic criteria or subthreshold) completed measures of bulimic symptoms, multidimensional perfectionism, self-efficacy, and weight/shape concern. Among those who were actively binge eating (n=180), weight/shape concern was associated with binge eating frequency in the context of high perfectionism (either maladaptive or adaptive) and low self-efficacy. Among those who were actively vomiting (n=169), weight/shape concern was associated with vomiting frequency only in the context of high adaptive perfectionism and low self-efficacy. These findings provide support for the value of this psychosocial interactive model among actively binge eating and purging samples and for the importance of considering different dimensions of perfectionism in research and treatment related to bulimia nervosa.     

The interaction of perfectionism, perceived weight status, and self-esteem to predict bulimic symptoms: the role of 'benign' perfectionism

The present study sought to replicate an interactive model of global perfectionism, perceived weight status, and self-esteem in predicting bulimic symptom development in a sample of young women [Bardone-Cone, et al. (2006). Predicting bulimic symptoms: An interactive model of self-efficacy, perfectionism, and perceived weight status. Behaviour Research and Therapy, 44, 27-42; Vohs, K. D., et al. (1999). Perfectionism, perceived weight status, and self-esteem interact to predict bulimic symptoms: A model of bulimic symptom development. Journal of Abnormal Psychology, 108, 695-700; Vohs, K. D., et al. (2001). Perfectionism, body dissatisfaction, and self-esteem: An interactive model of bulimic symptom development. Journal of Social and Clinical Psychology, 20, 476-497]. The aim was to investigate the role of 'problematic' and 'benign' perfectionism within this model, using data from 95 female university students over a 3-month period. Contrary to hypotheses, multivariate analyses revealed a significant three-way interaction only between 'benign' perfectionism, perceived weight status and self-esteem in predicting change in bulimic symptoms over a 3-month period. The predictive effect of the interaction between 'benign' perfectionism and perceived weight status on bulimic symptoms was strongest for women with high self-esteem, for whom feeling overweight and having perfectionistic attitudes preceded increased bulimic symptoms. These findings suggest that high self-esteem is insufficient to protect against the development of bulimic symptoms when both the perception of oneself as being overweight, and high levels of perfectionistic standards, are present. It would appear that the role of perfectionism within the context of disordered eating is complex.     

Emotional Stroop via Internet among individuals with eating disorders

The present study investigated whether Stroop interference in eating disordered individuals for food - and body-related words, as repeatedly found previously using standard emotional Stroop tasks, would also be demonstrated when using an Internet based emotional Stroop task. Participants were anorexic women (n= 13), bulimic women (n= 20), non-clinically eating disordered women nevertheless over-concerned about eating and body appearance (n= 27) and normal control women (n= 31). Bulimic individuals showed Stroop interference for body-related words whereas anorexic individuals showed Stroop interference for food-related words. The present results thus suggest that administration of the emotional Stroop task is possible via the Internet. Furthermore, it is possible that the time consuming response delivery, relative to previous studies, could lead to Stroop interference only for the most emotionally significant information, in turn, differentiating between the core concerns of anorexic and bulimic individuals.     

An Examination of Psychosocial Correlates of Disordered Eating among Undergraduate Women

Multivariate analyses were used to compare key eating behavior, cognitive, affective, and body variables to determine the similarities and differences between eating-disordered, symptomatic, and asymptomatic female undergraduates. On the eating behavior (i.e., bulimic symptoms, concern for dieting, weight fluctuation), and some of the cognitive (i.e., impression management, approval by others, dichotomous thinking, self-control, rigid weight regulation, weight and approval) and body (i.e., concern with body shape, satisfaction with face) variables, the eating-disorder group reported the most severe symptoms, followed linearly by the symptomatic and asymptomatic groups. On the affective (i.e., sad, anxious, guilty, shameful, stressed, happy, confident, overall self-esteem) and the remaining cognitive (i.e., vulnerability, catastrophizing) and body (i.e., importance of being physically fit and being attractive, satisfaction with body) variables, the symptomatic and eating-disorder groups did not differ from one another but had higher levels of distress than did the asymptomatic women. These findings suggest that (1) counselors need to be aware that a large percentage of female undergraduates are nondiagnosable yet experience eating-disorder symptoms, and (2) these symptomatic women are experiencing high levels of distress, particularly in the areas of affect and body image.A version of this article was presented at the 110th Annual Convention of the American Psychological Association, Chicago, IL, August, 2002     

Sex, body-esteem and self-esteem

This study investigated the relationship between body-esteem and self-esteem among 215 young men and women (ages 18 to 25 years). It was expected that concern with weight and shape would be strongly associated with women's self-esteem, while men's self-esteem would be more closely linked to concerns about their fitness. Multiple regression analyses indicated that perceived attractiveness and the salience of weight and shape were significant predictors of self-esteem among women. Among men, the significant predictors of self-esteem were perceived attractiveness, body disparagement, and perceived strength and fitness.     

Adolescent attitudes toward body image and anorexic behavior

This study explored the relationship between anorexic behavior and selected dimensions of body image. Anorexic behavior was assessed by two scales, the Eating Attitudes Test (EAT 26) (Garner, Olmstead, Bohr, & Garfinkel, 1982) and the Eating Disorders Inventory (EDI) (Garner, Olmstead, & Polivy, 1983). Predictor variables, selected dimensions of body image, physical attractiveness, self-esteem, and physical effectiveness, were measured by scales adapted by Lerner and Karabenick (1974) and Lerner, Orlos, and Knapp (1976). Multiple regression techniques were used to determine how much of the tendency toward anorexic behavior can be predicted by selected dimensions of body image. The major focus of the analysis was to explore the contributions of each of the dimensions of body image to predicting tendencies toward anorexic behavior in adolescents. The research sample consisted of 169 high school students, aged 15 to 18, who were enrolled in health, physical education, or psychology classes in the spring of 1983. Results indicated that the dimension of self-esteem was the major factor in the prediction of anorexic behaviors as measured by the Eating Disorders Inventory.     

Anorexic and bulimic states of mind in the psycho-analytic treatment of anorexic/bulimic patients and psychotic patients

SUMMARY

This paper discusses the relationship of bulimic and anorexic states of mind, and their interchangeability as manifested in the transference. The anorexic making bulimic-like greedy demands upon his/her objects. The bulimic showing all the qualities manifestly presented by the anorexic, an appetiteless approach to possibilities and peculiar searches in a non-specific fashion for satisfaction. Clinical material for discussion is presented from the analysis of three patients — one of whom was psychotic.

The paper attempts to show how in the transference in the true anorexic and bulimic, attacks are directed towards the awareness of the meaningful and intended specificity and function of all objects, so that any specific function can be mis-directed or nullified by the patient. The paper shows how some of these characteristics can appear as well in the treatment of borderline cases and affect the countertransference of the therapist.     

Separating the Effects of Gender and Weight-Loss Desire on Body Satisfaction and Disordered Eating Behavior

The purpose of this study was to separate the effects of gender from those of desired weight loss on body satisfaction and eating disordered behavior. Therefore, we explored gender differences in a sample (N = 191) of men and women who wanted to lose weight. We expected that controlling for desire to lose weight would minimize gender differences; this was supported for (a) overall body dissatisfaction, and (b) degree of concern about, effect of, and importance of weight and appearance. Nevertheless, women reported (a) less satisfaction with several body parts, (b) stronger relations between body satisfaction and self-esteem, and (c) use of more weight-loss strategies. Exploratory analyses also were conducted to examine within-group differences among men. Implications are discussed.     

Romantic partners and body image disturbance: Further evidence for the role of perceived—actual disparities

In this study, female and male college dyads (primarily Caucasian) involved in a “romantic relationship” used schematic figures to rate their conceptions of body size on a variety of rating protocols, including actual self, ideal self, ideal opposite gender, perceived partner's ideal opposite gender, perceived partner's rating of self, and rating of partner's body size. Based on the reflected-appraisal literature and previous body image research on perceived—actual disparities in body size ratings, five discrepancy indices were created and related to dispositional levels of body image disturbance, eating dysfunction, and general psychological function (self-esteem, depression). The results clearly indicated gender differences in the particular predictor associated with all measures of disturbance. For females, the discrepancy between the Self rating and the Perceived Partner's Ideal Other Gender rating accounted for almost all of the variance associated with clinical indices of disturbance. For males, the discrepancy between the Self rating and the Actual Partner's Ideal Other Gender rating was the only important predictor to emerge in regression analyses. The findings are interpreted in light of recent research on actual/perceived differences in body size ratings.     

Body Dissatisfaction and Eating Disorder Symptomatology: A Latent Structural Equation Modeling Analysis of Moderating Variables in 18-to-28-Year-Old Males

ABSTRACT. Although body dissatisfaction is recognized as the strongest risk factor for eating disturbances, a majority of young males are body dissatisfied, but do not concomitantly report severe levels of eating disorder symptomatology. The present investigation was designed to examine five theoretically relevant variables (i.e., body checking, emotional dysregulation, perfectionism, insecure-anxious attachment, and self-esteem) as potential moderators of the relationship between body dissatisfaction and two critical components of male eating disorder symptomatology: drive for muscularity and bulimic behaviors. Data collected from 551 Italian males between 18 and 28 years old were analyzed using latent structural equation modeling. The authors found that emotional dysregulation, body checking, insecure-anxious attachment and perfectionism intensified the relationship between body dissatisfaction and each criterion variable representing male eating disorder symptomatology; the interactions accounted respectively for an additional 2%, 7%, 4% and 5% of variance in drive for muscularity and for an additional 6%, 4%, 5%, and 2% of the variance in bulimic behaviors. By contrast self-esteem weakened this relationship and the interactions accounted for an additional 3% of the variance in both drive for muscularity and bulimic behaviors. Implications of these findings for prevention and treatment of male eating disturbances are discussed.     

Gender-Related Self-Discrepancies and Bulimic Eating Behavior

The purpose of this study was to explore a hypothetical link between the development of bulimic eating behavior and the suppression of masculine traits in adolescence. Discrepancies between the actual and the ideal self were examined as precursors of negative self-evaluation and binge–purge behavior. Using the Bem Sex-Role Inventory (Bem, 1974), 821 German students between the ages of 13 and 20 were questioned anonymously. Data were analyzed with structural equation modeling. For girls in contrast to boys, the discrepancy between how much adolescents believed that they possess masculine traits (actual self) and how much they would like to (ideal self) was significantly greater at older ages. For both sexes, gender-related self-discrepancies were related to bulimic symptoms indirectly, via self-esteem and dieting.     

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.     

A MEDIATIONAL MODEL LINKING SELF-OBJECTIFICATION, BODY SHAME, AND DISORDERED EATING

This study tests a mediational model of disordered eating derived from objectification theory (Fredrickson & Roberts, 1997). The model proposes that the emotion of body shame mediates the relationship between self-objectification and disordered eating. Two samples of undergraduate women ( n = 93, n = 111) completed self-report questionnaires assessing self-objectification, body shame, anorexic and bulimic symptoms, and dietary restraint. Findings in both samples supported the mediational model. Additionally, a direct relationship between self-objectification and disordered eating was also observed. Implications and future research directions are discussed.     

A study of temperament and personality in anorexia and bulimia nervosa

Although temperament and personality traits could influence the development and course of eating disorders, only a few studies examined the similarities and differences in personality between anorexia and bulimia nervosa. We compared 72 patients with DSM-IV eating disorders and 30 healthy controls. Dimensions of personality and personality disorders were evaluated with the Eysenck's EPQ, Cloninger's TCI, and the SCID-II questionnaires. The rates of impulsivity and clinical features were evaluated using specific rating scales. A comorbid personality disorder was found in 61.8% of patients with eating disorder. Avoidant personality disorder appeared was relatively common in anorexia nervosa restricting type; borderline personality disorder was most frequent in bulimia nervosa and the binge eating-purging type of anorexia nervosa. From a dimensional perspective, anorexic patients presented high scores in the dimension of persistence. Higher harm avoidance and impulsivity was found in bulimic patients. The overall eating disorders group presented high scores in neuroticism and low scores in self-directedness. Eating disorder patients have heterogeneous features of temperament and personality traits. Cluster C personality disorders seem more common in anorexia nervosa restricting type and impulsive personality features are associated with bulimic symptoms. Impulsivity seems to be a key aspect of temperament of bulimic patients, whereas anorexic symptoms are linked to persistent temperament traits.     

Measurement of body size and shape perception in eating‐disordered and control observers using body‐shape software

A disturbance in the perception of personal body size and shape is a key feature of both anorexia and bulimia nervosa, but it has proved difficult to quantify. Previous attempts have used methods like the distorting video technique (DVT), which alters an image by stretching the figure in either the X‐ or Y‐axis. This is a poor representation of the way fat is added to or lost from the body, and the pattern of distortion provides a host of cues to the degree to which the image has been altered. To overcome these problems we have used a specially designed software system that uses biometric data based on real body shapes, instead of simply stretching or compressing images of bodies. This technique also allows individual body parts to be altered separately, so we can determine whether a specific body part is overestimated relative to others. We can also calculate the apparent body mass index (BMI) of our modified pictures, using the perimeter‐area ratio (PAR). This allows us to compare an observer's actual BMI with that calculated for their estimated and ideal bodies. We tested 30 anorexic, 30 bulimic and 137 control observers. Our results show that all three observer groups tend to overestimate their body size, but not significantly so. Both the control and bulimic observers prefer an ideal body with a BMI of 20, which is at the lower end of the ‘normal’ BMI range. However, the anorexics ideal BMI is 15, which is on the border between the emaciated and underweight BMI categories.