The Association of Child Abuse and Eating Disorder Symptomatology

Abstract

Using self-report questionnaires, symptoms of eating disorders were examined in relation to child sexual (CSA), physical (CPA), and emotional abuse (CEA), and adult rape among 301 college women. CPA and adult rape were associated with fear of fatness and bulimic behavior. CEA, family cohesion and expressiveness, and adult rape were related to difficulties recognizing emotional states and satiety. Individuals who reported multiple forms of child abuse or who were revictimized exhibited the highest levels of symptoms. Revictimized women were more likely to report clinical levels of symptoms compared with individuals reporting adult rape without child abuse or child abuse without adult rape. Findings support the assumption that negative experiences in addition to CSA, such as adult rape and other forms of child abuse, influence eating pathology, and suggest a cumulative impact of abuse.     

Changes in Television and Magazine Exposure and Eating Disorder Symptomatology

The relationship between girls' media exposure and their development of eating disorder symptomatology was assessed. At Time 1 and Time 2 (16 months later), participants (N = 374; M age = 12.0) completed a questionnaire that assessed eating disorder sympto-matology and television and fashion magazine exposure. Girls were divided into 3 groups: increased, decreased, or no change in eating disorder symptomatology between Times 1 and 2. Girls with increased symptomatology had significantly increased their exposure to fashion magazines but decreased their number of hours of television viewing. Girls with decreased symptomatology had significantly decreased their exposure to both television and fashion magazines.     

A Preliminary Investigation of Body Dissatisfaction and Eating Disorder Symptomatology with Bisexual Individuals

Body dissatisfaction and eating disorder symptomatology were examined in bisexual individuals (n?=?139 women, n?=?37 men) and compared to lesbian/gay (n?=?51 women, n?=?96 men) and heterosexual individuals (n?=?82 women, n?=?34 men) in a U.S. online sample. Age, body mass index (BMI), income, and exercise frequency served as covariates. MANCOVA results showed a significant gender by sexual orientation interaction and significant main effects of gender and sexuality. Univariate tests were used to explore multivariate results. ANCOVA results for body dissatisfaction showed a significant gender by sexual orientation interaction. Post-hoc comparisons revealed higher levels of body dissatisfaction among all groups compared to heterosexual men. ANCOVA results for eating disorder symptomatology showed a significant main effect of sexual orientation. Post-hoc comparisons revealed higher levels of eating disorder symptoms among bisexual compared to heterosexual individuals. For bisexual men, gay community involvement, maladaptive social comparison, drive for muscularity, self-esteem, gender role orientation, and body dissatisfaction were explored as predictors of eating disorder symptomatology while controlling for age, BMI, exercise frequency, and income in a hierarchical regression analysis. The same factors, minus body dissatisfaction, were explored as predictors of body dissatisfaction in bisexual men. For bisexual women, similar factors, with the exception of drive for muscularity, were explored. Drive for muscularity predicted body dissatisfaction and exercise frequency predicted eating disorder symptomatology in bisexual men. BMI and self-esteem predicted body dissatisfaction in bisexual women; gay community involvement and body dissatisfaction predicted eating disorder symptomatology.     

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     

A Comparison of Eating Disorder Symptomatology, Role Concerns, Figure Preference and Social Comparison Between Women Who Have Attended Single Sex and Coeducational Schools

This study sought to examine the effect of high school gender composition on eating disorder symptomatology and attitudes of female Australian university students. We compared female students who had previously attended single sex (n?=?52) or coeducational (n?=?43) high schools on measures of eating disorder symptomatology, role concerns, figure preference and social comparison so as to examine the effect of high school gender composition on these measures. Importantly, the groups compared here were not significantly different in age, body mass index, socioeconomic status, or whether they had previously sought advice about their weight. Contrary to predictions based on previous research, there were no significant differences between the groups on eating disorder symptomatology, role concern, or social comparison measures. However, students who had previously attended single sex schools endorsed significantly thinner figure preferences overall, suggesting that school environment was an important cultural factor in the development of aspiration towards a thin idea. Additionally, both groups perceived their current figure to be larger than the figure they perceived as most attractive. Our findings provide mixed support for the notion that high school gender composition impacted on the eating-related behaviour and attitudes of university students. Methodological differences that may account for the discrepancies between the findings of the current study and those of earlier work are discussed. Further research including longitudinal studies that employ larger sample sizes is required to clarify these findings.     

Psychological Correlates of Anorexic and Bulimic Symptomatology

Few studies examining the relationship between eating disorders and personality have been theoretically derived; thus, findings have been equivocal. From a theoretical and empirical perspective (S. Orbach, 1986; R. L. Rogers & T. A. Petrie, 1997; G. J. Williams et al., 1994), this study investigated the connection between eating disorder symptomatology and several psychological correlates—obsessiveness, dependency, overcontrolled hostility, assertiveness, locus of control, and self‐esteem. Regression analyses indicated that obsessiveness and 2 factors of dependency accounted for 21% of the variance in a measure of anorexic attitudes and behaviors. One factor of dependency and obsessiveness accounted for 20% of the variance in a measure of bulimic symptomatology.     

Non-Suicidal Self-Injury in Pediatric Bipolar Disorder: Clinical Correlates and Impact on Psychosocial Treatment Outcomes

Non-suicidal self-injury (NSSI) in childhood is not well documented, especially among youth with pediatric bipolar disorder (PBD). The current study evaluated prevalence and correlates of NSSI, and its impact on intervention response, in a randomized trial of Child- and Family-Focused Cognitive-Behavioral Therapy (CFF-CBT) versus Treatment As Usual (TAU), adjunctive to pharmacotherapy. This study included 72 children ages 7–13 (58% male) with PBD. NSSI and correlates were assessed at baseline; mood and psychiatric severity were measured longitudinally. NSSI was common: 31% endorsed NSSI behaviors; 10% reported thoughts of NSSI, in the absence of behaviors. Children engaging in NSSI reported higher depression, psychosis, suicidality, and hopelessness; lower self-esteem; and reduced family help-seeking in univariate analyses. In a multivariate logistic regression, high child depression and psychosis, and low family help-seeking, remained significantly associated with baseline NSSI. In mixed-effects regression models, presence of NSSI at baseline did not influence the response of depressive symptoms to treatment. Children who endorsed NSSI experienced steeper response trajectories for psychiatric severity, regardless of treatment group. Youth who denied NSSI showed poorer response to TAU for manic symptoms; mania trajectories in CFF-CBT were similar across youth. Thus, NSSI in PBD is common and associated with impairment. As children might engage in NSSI for different reasons, the function of NSSI should be considered in treatment. Since children without NSSI fared worse in TAU, it may be important to ensure that youth with PBD receive structured, intensive interventions. CFF-CBT was efficacious regardless of NSSI, and thus shows promise for high-risk children with PBD.     

Personality Correlates of Anorexic Symptomatology in Female Undergraduates

In this study, the authors examined personality correlates (obsessiveness, dependency, self-directed hostility, and assertiveness) of anorexic symptomatology in female undergraduates. Regression analyses demonstrated that only obsessiveness and emotional reliance on another person (a measure of dependency) were related to anorexic symptoms, accounting for 19% of the variance. These findings are discussed in relation to S. Orbach's (1985, 1986) and other researchers' concept of the anorexic personality. Implications for therapeutic interventions and directions for future research are provided.     

The Sporting Body: Body Image and Eating Disorder Symptomatology Among Female Athletes from Leanness Focused and Nonleanness Focused Sports

Female athletes experience pressure to conform to social and sporting norms concerning body weight. This study compared general and sporting body dissatisfaction and disordered eating symptomatology among 320 elite, recreational, and noncompetitive female athletes aged 17 to 30 years competing in leanness focused sports and nonleanness focused sports. Participants completed an online questionnaire including demographic questions, the Eating Attitudes Test, and the Figure Rating Scale. Athletes from leanness focused sports reported higher levels of body dissatisfaction and greater disordered eating symptomatology regardless of participation level. Elite athletes reported higher levels of body dissatisfaction and greater disordered eating symptomatology regardless of sport type, and differences between recreational and noncompetitive athletes were not found. More than 60% of elite athletes from leanness focused and nonleanness focused sports reported pressure from coaches concerning body shape. The findings have important implications for identifying risk factors for eating disorders among female athletes, where athletes who compete at elite level and those who compete in leanness focused sports at any level may be at higher risk for developing eating disorders.     

Weighing the Evidence: Social Desirability, Eating Disorder Symptomatology, and Accuracy of Self-reported Body Weight Among Men and Women

Although self-reported measurement of body weight is commonly accepted practice, this method may yield inaccurate estimates varying by respondent gender, body mass index, and eating disorder symptomatology. Given the gendered nature of idealized body weight in the U.S., we examined whether or not these variables and positive impression management are associated with inaccurate weight reporting among undergraduates. College women (n?=?107) and men (n?=?48) from a small liberal arts school in the Northeastern U.S. self-reported height and weight, completed the Eating Disorder Examination Questionnaire, Personality Assessment Inventory-Positive Impression Management scale, and three scales from the Eating Disorder Inventory-3, and were then weighed. Paired t-tests compared self-reported and measured body weight for men and women separately, and respondents were then categorized as under- or over-reporters by gender. Independent samples t-tests were conducted separately for men and women comparing weight under- and over-reporters on BMI, levels of eating disorder symptomatology, and social desirability. Results indicate discrepancies between self-reported and measured body weight were significant. Among those who over-reported weight, men exhibited greater over-reporting than did women. Weight under-reporting was associated with higher BMI, and for women, lower eating disorder symptomatology and higher social desirability scores. There may be inaccuracies in self-reported weight based on positive impression management, BMI, and eating disorder symptomatology, but these appear to differ by gender. Future research should explore the roles of personality, social desirability, and competing pressures for muscularity versus thinness in weight reporting accuracy among men and women.     

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.     

Boundary Disturbances and Eating Disorder Symptoms

Female graduate students in counseling and clinical psychology retrospectively rated maternal and paternal boundaries in their families of origin. Subscales of the Eating Disorders Inventory-3 were used to assess disordered eating, including drive for thinness, body dissatisfaction, bulimia symptoms, and overall risk. Results indicated that maternal enmeshment and maternal psychological control were related to disordered eating. Further, daughters who reported that their mothers shielded them from parents’ conflict and adult concerns were less likely to report drive for thinness or bulimic tendencies. With respect to paternal boundary problems, paternal infantilization (overprotection) was significantly related to daughters’ drive for thinness.     

Childhood Predictors of Adulthood Antisocial Personality Disorder Symptomatology

The present study aimed to examine relationships between antisocial personality disorder (APD) symptoms in adulthood and retrospective reports of childhood maltreatment, parental bonding, and teasing, and while controlling for symptoms of depression and anxiety. Four hundred eleven non‐clinical participants (99 males, 312 females), aged 18–65 years, recruited from an Australian university and the general public, completed the questionnaire package. Findings indicated significant associations between childhood maltreatment, parental bonding, teasing, depression, and anxiety, and levels of APD symptomatology. Hierarchical regression analysis revealed that physical abuse, physical neglect, teasing, and level of father care made the largest unique contributions to the prediction of APD scores after statistically controlling for comorbid depression and anxiety. Analysis of variance revealed higher levels of APD symptoms were reported by males and younger participants. This research contributes importantly to our understanding of factors influencing APD symptomatology, with clinical and early intervention implications.     

Psychosocial Correlates of Suicidal Ideation in Adolescent Psychiatric Inpatients

The Beck Scale for Suicide Ideation (BSI) was administered to 121 inpatients between 12 and 17 years old who were diagnosed with mixed psychiatric disorders. Twelve background and clinical characteristics, previously found to be associated with adolescent suicidal ideation, were entered into a multiple regression to estimate the BSI scores, along with the Beck Anxiety Inventory, the revised Beck Depression Inventory (BDI), the Beck Hopelessness Scale (BHS), and the Youth Self-Report. The BHS and the BDI were the only two variables that contributed unique variance to the explanation of the BSI scores.     

Discrimination and Eating Disorder Psychopathology: A Meta-Analysis

Eating disorders occur in diverse populations, and discrimination may be a specific factor that is related to higher eating disorder psychopathology among marginalized individuals. To evaluate the current evidence on this topic, a meta-analysis was used to quantitatively synthesize the literature on discrimination and eating disorder psychopathology across a heterogeneous range of studies. Searches were conducted in peer-reviewed journals and accessible unpublished dissertations of all years through January 2020. Studies were coded by two authors using a tailored coding form, and zero-order bivariate correlations were used as effect size measures. There were 55 cross-sectional studies extracted for inclusion in the meta-analysis. Results showed a small-to-medium association between discrimination and eating disorder psychopathology that was consistent across domains. Effect sizes were typically higher for weight discrimination. For binge eating and general eating disorder pathology, effects were smaller in studies that had larger proportions of women, and for binge eating only, effects were higher in college samples. These findings could suggest that discrimination represents a contributory factor related to eating disorder psychopathology across types of discrimination and eating disorder psychopathology. Implications are discussed for future research on discrimination and psychopathology including possible mechanisms.     

Psychosocial Correlates of Medical Mistrust Among African American Men

The current study proposed and tested a conceptual model of medical mistrust in a sample of African American men (N = 216) recruited primarily from barbershops in the Midwest and Southeast regions of the United States. Potential psychosocial correlates were grouped into background factors, masculine role identity/socialization factors, recent healthcare experiences, recent socioenvironmental experiences (e.g., discrimination), and healthcare system outcome expectations (e.g., perceived racism in healthcare). Direct and mediated relationships were assessed. Results from the hierarchical regression analyses suggest that perceived racism in healthcare was the most powerful correlate of medical mistrust even after controlling for other factors. Direct effects were found for age, masculine role identity, recent patient–physician interaction quality, and discrimination experiences. Also, perceived racism in healthcare mediated the relationship between discrimination experiences and medical mistrust. These findings suggest that African American men’s mistrust of healthcare organizations is related to personal characteristics, previous negative social/healthcare experiences, and expectations of disparate treatment on the basis of race. These findings also imply that aspects of masculine role identity shape the tone of patient–physician interactions in ways that impede trust building processes.