Criterion and Incremental Validity of the MMPI-3 Eating Concerns Scale in a University Sample

The purpose of the current study was to evaluate the validity of scores on the Eating Concerns (EAT) scale on the recently released Minnesota Multiphasic Personality Inventory-3 (MMPI-3), which aims to assess for problematic eating behaviours. It was hypothesised that the EAT scale scores would be correlated with binge eating, purging, restrictive eating, weight and body shape concerns. Participants were 396 university students, who completed a series of well-validated eating disorder measures. The EAT scale scores evidenced moderate to large correlations with many symptom dimensions of EDs, including binge eating, purging, restrictive eating and weight and shape concern, thus, supporting the hypotheses and showing evidence for criterion validity. Hierarchical regression analyses also revealed incremental validity for the EAT scale above and beyond other MMPI-3 Specific Problems scale scores. Overall, scores on the new MMPI-3 EAT scale were associated with positive support for validity in a university population and seem promising as a good screening measure for eating pathology.

     

A comparison of eating, exercise, shape, and weight related symptomatology in males with muscle dysmorphia and anorexia nervosa

In the context of the lack of nosological clarity surrounding muscle dysmorphia, this paper aims to compare the symptomatic profile of muscle dysmorphia and anorexia nervosa in males whilst using measures sensitive to indexing male body image concerns. Twenty-one male muscle dysmorphia patients, 24 male anorexia nervosa patients, and 15 male gym-using controls completed the Eating Disorder Examination-Questionnaire, the Muscle Dysmorphia Disorder Inventory, the Compulsive Exercise Test, and a measure of appearance-enhancing substance use. Men with muscle dysmorphia and anorexia nervosa demonstrated widespread symptomatic similarities spanning the domains of disturbed body image, disordered eating, and exercise behaviour, whilst differences were consistent with the opposing physiques pursued in each condition. Furthermore, correlational analyses revealed significant associations between scores on muscle dysmorphia and eating disorder measures. The present findings provide moderate support for the notion that muscle dysmorphia may be nosologically similar to anorexia nervosa.     

The Eating Attitudes Test: validation with DSM-IV eating disorder criteria

The Eating Attitudes Test (EAT; Garner & Garfinkel, 1979) is one of the most widely used self-report eating disorder instruments. Originally developed to diagnose anorexia nervosa, it is often used in nonclinical samples where it has a high false-positive rate, which is likely due to changes in diagnostic criteria. Because the EAT has not been validated with Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association, 1994) criteria, we examined its criterion validity for discriminating between nonclinical women with and without an undifferentiated DSM-IV eating disorder diagnosis. We also examined differences in mean EAT scores among eating-disordered, symptomatic, and asymptomatic participants. Results show that the EAT has an accuracy rate of at least 90% when used to differentially diagnose those with and without eating disorders and that mean EAT scores differed among eating-disordered, symptomatic, and asymptomatic participants.     

Association between self-concept and body weight, gender, and pubertal development among male and female adolescents

This study examined the effects and interactions of gender, pubertal status, and body weight on the self-concept of 462 young adolescent Australian students from two different schools. All students enrolled in Years 7 and 8 completed the Self-Perception Profile for Adolescents, which includes several self-concept subscales and ratings of the importance of each subscale. The self-concept subscales ranked as most important by male and female students were Close Friendship, Scholastic Competence, and Job Competence. Females rated their ability to form close friendships significantly higher and of greater importance than did males. Standard body weight was related to students' Physical Appearance subscale scores, with higher weight students having lower self-concept, and postmenarcheal females having the poorest opinion of their physical appearance. Higher body weight males had lower scores on Athletic Competence, Job Competence, and Behavioral Conduct than did other males. Overweight females and normal weight males considered athletic competence to be more important than did other students. Pubertal status was related to students' scores on Athletic Competence, with postpubertal males who were not overweight scoring highest, and on Physical Appearance, with postmenarcheal females having the lowest opinion of their appearance. The mean self-concept score was significantly related to students' standard body weight, and there was an interaction between gender and puberty, with postpubertal males having the highest and postmenarcheal females the lowest self-concept score. The discrepancy score suggested that females felt they had failed to meet their ideal self-concept significantly more than did males. The results suggest that school programs should be implemented to provide exercise and job skill training suitable for all students, especially those who are overweight. These programs, while taking into account students' pubertal status, should aim to improve self-image without resulting in feelings of failure.     

Onset of disordered eating attitudes and behaviors in early adolescence: interplay of pubertal status, gender, weight, and age

The interplay of puberty, gender, weight, and age in regard to body image and disordered eating behaviors and attitudes was investigated in a sample of early adolescents. It was found that, after menarche, females had increased personal expectations and were dissatisfied with weight/shape changes. They wanted to reduce their weight and between-meal eating (which was associated with increased feelings of inadequacy, loss of control, and decreased self-esteem). Young postmenarcheal females who were higher achievers and had higher trait anxiety were more likely to have lower weight. Young males at puberty desired to build up their bodies, believing that appearance was important to their sexual appeal. They were also more willing to form close relationships. Postpubertal males felt most in control of their lives, had the highest self-esteem, and were more trusting of their body cues. Overall, high achieving, more anxious postmenarcheal females were at greatest risk for eating disturbances. These results indicate that the interaction of pubertal status and gender must be considered when developing intervention programs.     

Body Image Concerns and Contingent Self-Esteem in Male and Female College Students

Body dissatisfaction in females, and to a lesser extent males, is associated with low self-esteem, depression, and eating disorders. This research examined gender as a moderator of the association between contingent self-esteem and body image concerns, including weight and muscularity. Participants included 359 (59.1% female) heavy drinking first-year U.S. undergraduate students who completed a survey assessing health-related risk behaviors. Hierarchical multiple regression was used to examine relations among gender, contingent self-esteem, and body image. Females reported higher levels of contingent self-esteem and greater concerns about their weight, although males reported a greater drive for muscularity. The relationship between contingent self-esteem and weight concerns was stronger among females, and for males, greater contingent self-esteem was associated with a greater drive for muscularity.     

The role of objective health indicators and neuroticism in perceived health and psychological well-being among patients with chronic heart failure

A total of 119 clinically stable patients with symptomatic congestive heart failure (34 females, 85 males) were recruited from an outpatient hospital practice to explore the role of objective health indicators and neuroticism in subjective health (physical limitations) and psychological well-being. Patients were grouped according to the New York Heart Association functional class criteria (NYHA: indicator of functional status) and proatrial natriuretic factor (proANF), a cardiac hormone that maintains normal fluid balance and vascular resistance. Scores on these two objective indicators of disease severity were generally unrelated to psychological measures, whereas neuroticism scores (EPQ-N) were significantly correlated with indicators of subjective health (perceived disease-related physical limitations) and psychological well-being (depression, general life-satisfaction). Significant interactions between proANF and neuroticism appear due to low physical limitation score among subjects with elevated level of proANF and low scores on neuroticism. High physical limitation was reported by subjects with high level of proANF as well as high scores on neuroticism. Moreover, a marginal significant interaction between NYHA and EPQ-N scores in relation to severity of depression was detected by analyses from two-way ANOVA. Gender differences were due to higher proANF scores in males than females, whereas females scored higher than males on EPQ-N, perceived physical limitation and depression. Results from path analyses supported an indirect effect of neuroticism via perceived physical limitation for males. Possible mechanisms involved in these relations are discussed.     

Effects of parental comments on body dissatisfaction and eating disturbance in young adults: A sociocultural model

This study examined a sociocultural model of the influence of parental comments on body shape and eating concerns among males and females. Questionnaires were completed by 338 undergraduates. Participants reported levels of perceived parental comments, internalization of media ideals, appearance comparison, body dissatisfaction, drive for thinness and bulimia. Results revealed that, regardless of gender, internalization and appearance comparison only partially mediated the relationship between parental comments and the outcome variables. The final model for females explained a larger proportion of the variability in body shape and eating concerns than in males, with positive and negative parental comments directly related to body dissatisfaction and through it to eating outcomes. In males, only negative comments were directly related to body dissatisfaction. These findings highlight the role of parental influences in sociocultural models of the development of body dissatisfaction and eating concerns, and the gender-specific patterns of sociocultural influence.     

Exploring gender differences in body image,eating pathology,and sexual harassment

This study examines the relationship between body image (weight/shape concerns), eating pathology, and sexual harassment among men and women (N = 2446). Hierarchical regressions controlling for depression revealed main effects of gender such that women reported greater weight/shape concerns, eating pathology, dietary restraint, eating concerns, and binge eating compared to men. Main effects for sexual harassment indicated that as harassment increased, participants reported increased weight/shape concerns, eating pathology, dietary restraint, eating concerns, binge eating, and compensatory behaviors. There were small but significant interactions between gender and harassment for eating pathology total score (which included each of the domains listed above), weight/shape concerns, dietary restraint, and eating concerns such that the relationship between increased harassment and increased pathology was stronger for women compared to men. The largest interaction was found for compensatory behaviors, such that while women and men's scores both increased as harassment increased, the relationship was stronger for men.     

Anorexic eating attitudes and behaviors of male and female college students

This study examined gender differences in eating attitudes and behaviors in a sample of 471 undergraduate college students. The prevalence of symptomatology indicative of anorexia was determined using the Eating Attitudes Test (EAT-26). In addition, the family climate, parent-child dynamics, and self-concept of students with and without maladaptive eating attitudes and behaviors were compared, and the relationship between eating attitudes/behaviors and current psychological distress was examined. Anorexic symptomatology was found for 20% of the females and 10% of the males. In general, students without symptomatic attitudes and behaviors had a more positive self-concept and reported less psychological distress than did those with eating disturbances. The findings suggest that eating problems may be more prevalent among males than previously estimated.     

Actual differences and stereotypical perceptions in body image and eating disturbance: A comparison of male and female heterosexual and homosexual samples

In the present study, 32 homosexual males (HMM), 32 homosexual females (HMF), 32 heterosexual males (HTM), and 32 heterosexual females (HTF) completed measures of body image disturbance and concerns with weight and dieting from five different perspectives: self, and typical homosexual male, heterosexual male, heterosexual female, and homosexual female. Participants were primarily Caucasian. Results indicated that, in general, HMMs and HTFs showed greater actual concerns with appearance, weight, and dieting, and were perceived to possess greater body image disturbance and dieting concerns compared to HTMs and HMFs. Subjects also held various stereotypic misperceptions about certain target groups such that HTFs and HMMs were predicted to possess greater body image disturbance and be more concerned with weight and dieting than was actually true. In addition, subjects made accurate predictions about HTMs overall, but were inconsistent in their predictions of HMFs on these measures. Results are discussed in terms of possible variation in the degree of importance these attributes may have for members of these four populations and how such differences may lead to an increased risk for developing eating disorders among heterosexual females and homosexual males.     

Eating disordered adolescent males

The purpose of this study was to describe a sample of 40 eating disordered adolescent males in order to complete a series of follow-up studies on adolescent females who were seen for evaluation and treatment at Boston Children's Hospital Outpatient Eating Disorders Clinic between 1981 and 1991. The sample was drawn from all males seen at the clinic (between 1981 and 1995) who were eligible for inclusion because of a diagnosis of anorexia nervosa, bulimia nervosa, or eating disorder-not otherwise specified. Data were collected via retrospective chart review and three self-administered quantitative scales. Although the response rate to the mailed follow-up questionnaires was low, comparisons with the three studies on females were consistent with those of other investigations, suggesting that the course and outcome of these illnesses are remarkably similar for males and females. The findings support the idea that clinicians, coaches, peers, and family members should encourage young men to share concerns about body image and weight at an earlier, less severe juncture, with assurance that these issues are common to both sexes.     

Parent, peer, and media influences on body image and strategies to both increase and decrease body size among adolescent boys and girls

This study investigated the nature of body image and body change strategies, as well as the sociocultural influences on these variables, among a group of 1,266 adolescents (622 males, 644 females). In particular, it investigated weight gain and increased muscle, as well as weight loss. It was found that females were less satisfied with their bodies and were more likely to adopt strategies to lose weight, whereas males were more likely to adopt strategies to increase weight and muscle tone. Respondents with higher body mass index (BMI) evidenced greater body dissatisfaction and more weight loss strategies, but there were no differences between BMI groups in weight gain or strategies to increase muscles. Weight gain and strategies to increase muscles were more likely to be undertaken by older adolescents, but there were no grade level differences in weight loss. Media influences to alter weight, as well as feedback from mother, father, and both male and female peers, were greater for females. There were few grade level or BMI differences in regard to any of the sociocultural influences. The importance of these findings in terms of providing a better understanding of factors which may lead to a disturbed body image and body change disorders, particularly among adolescent boys, is discussed.     

Effects of body mass and body image on exercise motives in adolescence

Objective. The objective was to examine age and gender differences in the effects of body mass and body image on exercise motives in adolescents. It was specifically predicted that weight management motive would be explained by body mass index in males, and by body size discrepancy in females, but this pattern would be less pronounced in younger than in older adolescents.Design. The design was a cross-sectional comparative study.Method. Participants comprised younger (11–13 years) and older (17–19 years) males and females (N=180). They completed measures of exercise participation, exercise motives, and perceived and ideal body size. Height and weight were also measured. Hierarchical regression analyses were conducted, separately for younger males, younger females, older males and older females. In each analysis, the dependent variable was an exercise motive, and the independent variables were, in order of entry, exercise level, body mass index, perceived body size, and ideal body size.Results. Weight management motive was positively predicted by body mass index in older males, and by perceived and ideal body size in older females. Other, more intrinsic, motives were negatively predicted by body mass index or perceived body size in older males or females. Such relationships were not significant in younger adolescents.Conclusion. Effects of body mass and body image on exercise motives emerge in adolescence, with gender differences. Such effects may influence exercise adherence and should be taken into account in exercise promotion programmes.     

Eating Attitudes and Dieting Behavior Among Religious Subgroups of Israeli-Arab Adolescent Females

Objectives The aim of the study was to compare the eating attitudes and behaviors, including weight concerns and dieting behavior, among three religious subgroups (Moslems, Druze, and Christians) and three age subgroups (12–13, 14–15, and 16–18 years old) of Israeli-Arab adolescent females. Methods The sample consisted of 1141 Israeli-Arab adolescent females, including 926 (81.2%) Moslem, 128 (11.2%) Christian, and 87 (7.6%) Druze schoolgirls in the seventh to twelfth grades. Participants were assessed using the EAT–26 questionnaire. Results The results showed that 75% of the students had a negative EAT-26 score (>20) and that 25% of the students had a positive EAT-26 score (<20). No significant differences were found in total scores, subscale scores, or scores above 20 between the age subgroups or the religious subgroups. The results demonstrated a high prevalence of disturbed eating attitudes and behaviors among Israeli-Arab adolescent schoolgirls. Discussion Higher prevalence of disturbed eating attitudes found among Israeli-Arab schoolgirls as compared to their Jewish counterparts. Although our sample is a communal based, there still remains an open question as to why the desired “slenderness culture” evident in the results is not reflected in the number of ED clinic referrals, among clinical population. These discrepancies were discussed in light of ethnicity-specific factors that may influence the perceived severity of eating disorders and the receptiveness of primary practitioners to address them.     

Adjunctive mirror exposure for eating disorders: A randomized controlled pilot study

Mirror exposure therapy has proven efficacious in improving body image among individuals with shape/weight concerns and eating disorders. No randomized controlled trials have examined the effect of mirror exposure in a healthy-weight clinical sample of eating disordered individuals. The purpose of the current study was to test the efficacy of a five-session acceptance based mirror exposure therapy (A-MET) versus a non directive body image therapy (ND) control as an adjunctive treatment to outpatient eating disorder treatment. Thirty-three males and females aged 14–65 with a body mass index of 18.5–29.9 were randomized to five sessions of A-MET or ND with a 1-month follow-up. Results indicated large to moderate effect size differences for efficacy of A-MET across measures of body checking, body image dissatisfaction, and eating disorder symptoms (d = ?0.38 to ?1.61) at end of treatment and follow-up. Baseline measures of social comparison and history of appearance-related teasing were predictive of treatment response. There were also differential effects of treatment on participants' perceived homework quality, but no differences in therapeutic alliance. Results suggest that A-MET is a promising adjunctive treatment for residual body image disturbance among normal and overweight individuals undergoing treatment for an eating disorder. Future research and clinical implications are discussed.     

Body esteem, eating attitudes, and gender-role orientation in three age groups of children

The purpose of this study was to assess body esteem, eating attitudes, and gender-role orientation in three age groups (first, third, and fifth graders). The first graders were interviewed individually; the third and fifth graders completed a questionnaire in a group setting in which the questions were read aloud to set a pace and help those who may have had difficulty reading. All children completed the Children’s Sex Stereotypes Measure, the children’s version of the Eating Attitudes Test, and the Body Esteem Scale. It was hypothesized that children as young as six or seven do understand the connection between eating and body weight, that a proportion of children do experience eating and weight concerns, and that feminine children are most likely to experience such concerns. The results demonstrated that children, as early as first grade, were indeed engaging in eating disordered behaviors and expressing dieting and weight concerns. The children appeared to understand the connection between eating and weight, and body esteem was found to be significantly lower in the fifth than the third graders. However, feminine children were not more likely to exhibit eating disordered behaviors. An earlier version of this article was presented at the 1993 meeting of the Eastern Psychological Association in Arlington, VA.     

Expanding understandings of the body,food and exercise relationship in distance runners: A narrative approach

ObjectivesAdditional forms of theorizing and methodologies are warranted to expand understandings of the body, food and exercise relationship in physically active individuals.DesignA narrative approach grounded in social constructionism was used to explore the meaning-making process around this relationship in male and female distance runners.MethodNarratives around the body, food and exercise were elicited from nine recreational male and female distance runners (n = 5 males, 4 females). The sociocultural construction of meaning was explored through a thematic and dialogic/performance analysis of 17 in-depth interviews (2 interviews per person, with one exception) (see Riessman, 2008).ResultsFindings indicated that male and female runners drew upon one of two running narratives – ‘just do it’ and ‘just do it better’ – in constructing meanings around the body, food and exercise. Meanings shifted based upon the gendered narratives and cultural discourses. The specific narratives and meanings within them had implications for the runners' experiences and behaviors around their bodies, food and exercise in empowering/healthy and/or disempowering/unhealthy ways.ConclusionsThis study highlights the complexity of the body, food and exercise relationship in male and female distance runners, demonstrating that athletes' eating and exercising practices are socially and culturally formed in and through particular narratives and cultural discourse. These findings also add to the genre of cultural sport psychology research and a growing body of qualitative literature on disordered eating in the physical activity realm.     

Eating attitudes and their psychological correlates among Turkish adolescents

This study examined the eating attitudes and psychological characteristics of Turkish late adolescents. Seven hundred eighty-three university students were administered the Eating Attitudes Test, Rosenberg Self-Esteem Scale, State-Trait Anxiety Inventory, and Social Physique Anxiety Scale. More than one in ten (9.2% of the males and 13.1% of the females) had abnormal eating attitude scores. Chi-square analysis revealed that there were no significant differences in the prevalance of abnormal eating behaviors based on gender. Analysis of covariance indicated that participants who had disturbed eating attitudes had lower self-esteem, higher social physique anxiety, and higher trait anxiety than those who had normal eating attitudes. It was concluded that the prevalence of disturbed eating attitudes was high among these Turkish late adolescents, and that disturbed eating attitudes were related to several psychological characteristics.     

Behavioral and psychological traits of weight-conscious teenagers: a comparison of eating-disordered patients and high- and low-risk groups

The present study was designed to test the clinical hunch that members of high-risk groups, such as athletes, have psychological traits similar to persons with eating disorders. Three groups of adolescent females (eating-disordered, athletes, and students) were studied to determine their menstrual, dieting, and exercise patterns and their self-images. Although the three groups fell on a continuum of anorexic-like behaviors, their self-images were not on a similar continuum. Eating-disordered females had the poorest self-images while athletes were the best adjusted of all three groups. Eating-disordered subjects exhibited extremely low scores on emotional tone and social relationships, suggesting that these dimensions of self-image may be characteristic which clearly distinguish the eating-disordered from so-called high-risk persons.