Prevention programme for eating disturbances in adolescents. Is their effect on body image maintained at 30 months later?

We assessed changes in the body image of Spanish adolescents who participated in a programme aimed at preventing disordered eating, with a 30-month follow-up. 254 girls and 189 boys aged 12–14 were assigned to a control group (n = 201) or one of two possible experimental conditions: media literacy programme (ML, n = 143) and media literacy plus nutrition awareness programme (ML + NUT, n = 99). Body image was assessed with the Body Image Questionnaire (Qüestionari d’Imatge Corporal; QÜIC). Pre-test, post-test, 7- and 30-month follow-up measurements were taken. Linear model analyses were carried out with a 2 × 3 × 3 ANOVA (sex × group × phase), adjusted by the baseline level. At 30-month follow-up, ML and ML + NUT participants showed fewer body problems and more body satisfaction than the control group. There is a need for prevention programmes addressing eating and body image disturbances that involve both boys and girls.     

Comparison of single- and double-stage designs in the prevalence estimation of eating disorders in community samples

The aim of this research was to compare two different case-identification designs: (a) a one-stage anonymous design using the Eating Disorders Examination-Questionnaire (EDE-Q; Fairburn & Beglin, 1994) as diagnostic instrument and (b) a two-stage-non-anonymous design using the Eating Attitudes Test (EAT; Garner & Garfinkel, 1979) and the EDE-Q as screening instruments and the clinical interview Eating Disorders Examination (EDE; Fairbumrn & Cooper, 1993) as diagnostic instrument, in the estimation of eating disorders prevalence in community samples. Both epidemiological designs were compared in: eating disorders prevalence, population at risk, and weekly frequency of associated symptomatology (binge eating episodes, self-vomiting) within a sample of 559 scholars (14 to 18 year-old males and females) studying in the region of Madrid. Eating disorders prevalence estimation using single-stage design was 6.2%, and 3% using the two-stage design; however, these differences were not significant (p = .067). No significant differences between the two procedures were found either in population at risk or in weekly frequency of reported self-vomiting. Reported binge eating episodes were higher in the one-stage design. The use of a two-stage procedure with clinical interview (vs. questionnaire) leads to a better understanding of the items (specially the most ambiguous ones) and thus, to a more accurate prevalence estimation.     

McEwen-Induced Modulation of Endocrine History: A Partial Review

In endless facets of physiology, there are points of homeostatic balance, such that too much or too litttle of something can both be deleterious (i.e., an "inverse U" pattern). This is particularly true when considering glucocorticoids (GCs), the adrenals steroid secreted during stress. In the first part of this paper, I review a number of realms in which a paucity and an excess of GCs are both damaging. Some findings are classical (for example, concerning GC effects upon body weight), while some are quite recent and have considerable implications for both physiology and pathophysiology (for example, inverse U's of GC actions in the realm of immunity and neuronal survival). The second part of the review considers the far thornier issue of how such inverse U's of GC actions are generated on a cellular and molecular level. One solution that has evolved, primarily in the hippocampus within the nervous system, involves the presence of two different types of receptors for GCs within the same cells; so long as the two receptors have very different affinities and mediate opposing effects on some cellular endpoint, an inverse U will emerge. The second solution, found in a number of peripheral tissues, involves GCs having opposing effects on the amount of some signal being generated (e.g., an immune cytokine) and the sensitivity of target tissues to that signal; under conditions that appear to be physiologically relevant, inverse U's emerge from this pattern as well. The final section of this review considers the enormous role played by Bruce McEwen in the emergence of this literature. I suggest that while much of this obviously has to do with the facts that have come from his group, another substantial contribution is from his steadying and supportive personality, the veritable embodiment of homeostatic balance.     

Impact of a school-based disordered eating prevention program in adolescent girls: general and specific effects depending on adherence to the interactive activities

This study assessed the impact of a school-based program aimed at preventing disordered eating. The program was based on the media-literacy approach and has interactive format. The program was assessed under strong methodological conditions. Seven schools with 263 Spanish adolescent girls in the area of Barcelona, were randomly assigned to either the complete prevention program condition, the partial program condition or the non-treatment control condition, and assessed at pre, post and 6-month follow-up. The program was effective in generating positive changes at follow-up. The effects sizes (ES(d) = 0.29 to ES(d) = 0.38) were greater, on average, than that obtained up to now in selective-universal programs, and similar or greater than that achieved by targeted prevention programs. The results indicate a greater and relevant effect size of the intervention in those participants who completed the inter-session interactive activities (ES(d) = 0.29 to ES(d) = 0.45) although the differences were not significant. These results suggest the importance of monitoring adherence to the activities in all programs defined as "interactive". The implications and limitations of this study are discussed.     

Autonomic concomitants of discriminative avoidance and punishment training in the monkey

TwoCebus albifrons monkeys were trained to press a back-lighted panel to postpone a brief electric shock to the tail using a Sidman avoidance schedule (SS = 40 sec, RS = 40 sec). After 25 training sessions, a discriminative schedule was introduced, with the Sidman avoidance continuing in the presence of one discriminative stimulus and punishment introduced in the presence of the other. The discriminative stimuli were colors on the panel. Discriminative training also involved 25 sessions, each with a random sequence of 6 avoidance and 6 punishment segments, with 30 sec intervals between the segments. Plantar skin conductance and heart rate were recorded along with the panel-pressing behavior. The two monkeys adjusted to the discriminative schedule quite differently from one another. One animal responded at a high level and avoided very well (during avoidance) but was punished frequently (during punishment). The other animal responded less frequently and received many shocks during avoidance but almost none during punishment. The animal that showed less ability to inhibit responding (and received about four times as many shocks overall) appeared to have discriminated better temporally in spacing its responses during avoidance training. The monkey whose panel-pressing behavior resulted in more shocks also tended to show a higher tonic level of autonomic arousal. However, within-animal differences in shock frequency (between avoidance and punishment) were not similarly related to autonomie arousal. The animal that received fewer shocks overall (but more during avoidance) showed greater arousal during punishment. The animal that received more shocks overall (but fewer during avoidance) showed no arousal differences between avoidance and punishment.     

Screening for Eating Disorders in Undergraduate Women: Norms and Validity of the Spanish Version of the Eating Disorder Examination Questionnaire (EDE-Q)

The purpose of this investigation was to examine the internal consistency reliability and the convergent validity of the Spanish version of the Eating Disorder Examination Questionnaire (EDE-Q) and to provide EDE-Q norms for Spanish undergraduate women. Seven hundred eight college women, aged 18–30 years, volunteered to complete the EDE-Q, BSQ and EDI-2. Satisfactory internal consistency for the four subscales and the global score of the EDE-Q was obtained (Cronbach’s α ≥ .81). The EDI-2 Drive for Thinness and Body Dissatisfaction subscales and the BSQ global factor score correlated highly and positively with the corresponding EDE-Q subscales (r ≥ .72). Average scores, standard deviations and percentile ranks for the raw EDE-Q subscales and data on the occurrence of binge eating and compensatory behaviors are presented. Most of these values were lower than those found in other non-European developed countries. Results support the satisfactory internal consistency and convergent validity of the Spanish version of the EDE-Q. Lower scores in EDE-Q subscales suggest the need to study a lower cut-off point for clinical significance in Spanish college women. These data will help clinicians and researchers to interpret the EDE-Q scores of college women in Spain.     

Developmental and sex-related differences in preschoolers' affective decision making

This study investigated developmental and sex-related differences in affective decision making, using a two-deck version of Children's Gambling Task administered to 3- and 4-year-old children. The main findings were that 4-year-old children displayed better decision-making performance than 3-year-olds. This effect was independent of developmental changes in inductive reasoning, language, and working memory. There were also sex differences in decision-making performance, which were apparent only in 3-year-old children and favored girls. Moreover, age predicted awareness of task and the correlation between the latter and decision-making performance was significant, but only in 4-year-old children. This study thus indicates that there is a remarkable developmental leap in affective decision making, whose effects are apparent around the age of 4, which according to our results, also marks the age when the correlation of declarative knowledge and decision-making performance becomes significant.     

Disordered eating behaviors and body image in a longitudinal pilot study of adolescent girls: What happens 2 years later?

We assessed the prospective association of risk factors for eating and body image disturbances after a 2-year follow-up in a community sample of Spanish adolescent girls. The participants included 128 Spanish girls aged 12–14, who took part in a 28-month prospective study. Aspects assessed were eating attitudes (Eating Attitudes Test), influence of the body shape model (questionnaire on influences of the aesthetic body shape model), extreme weight-control behaviors (Eating Disorder Examination-Questionnaire), body image (Body Image Questionnaire) and Body Mass Index (BMI). BMI, extreme weight-control behaviors and body image problems emerged as potential predictors of an increase in eating disturbances. An increased influence of the thinness model was significantly associated with reduced body satisfaction and body image problems. Preventive programs are needed to contribute reducing the impact of sociocultural influences with regard to thinness, the use of extreme weight-control behaviors and overweight in adolescents.     

Validation of eating disorder examination questionnaire (EDE-Q)--Spanish version--for screening eating disorders

This research examines the internal consistency, convergent validity, and sensitivity, specificity, and positive and negative predictive value of the Spanish version of the Eating Disorder Examination-Self-Report Questionnaire (S-EDE-Q), as a screening questionnaire for eating disorders (ED) in a community sample. Participants were 1543 male and female Spanish-speaking students (age range: 12-21 years), who volunteered to complete the S-EDE-Q and the EAT-40. The Spanish version of the Eating Disorders Examination (S-EDE) interview, 12th edition, was administered to 602 of the students. Acceptable internal consistency for the four subscales of the S-EDE-Q was obtained (alpha > or = .74). Corrected point-biserial correlation performed with the 22 items included in the S-EDE-Q subscales showed acceptable values for all the items. The EAT-40 Dieting subscale correlated highly and positively with the four S-EDE-Q subscales (r > or = .70). Acceptable results in sensitivity, specificity, and positive and negative predictive value when compared with the EDE were found. Correlation between S-EDE and S-EDE-Q diagnoses was positive and significant. Overall, results support the psychometric adequacy of the S-EDE-Q as a screening questionnaire for ED in community samples.     

Stress, Glucocorticoids, and Damage to the Nervous System: The Current State of Confusion

An extensive literature demonstrates that glucocorticoids (GCs), the adrenal steroids secreted during stress, can have a broad range of deleterious effects in the brain. The actions occur predominately, but not exclusively, in the hippocampus, a structure rich in corticosteroid receptors and particularly sensitive to GCs. The first half of this review considers three types of GC effects: a) GC-induced atrophy, in which a few weeks' exposure to high GC concentrations or to stress causes reversible atrophy of dendritic processes in the hippocampus; b) GC neurotoxicity where, over the course of months, GC exposure kills hippocampal neurons; c) GC neuroendangerment, in which elevated GC concentrations at the time of a neurological insult such as a stroke or seizure impairs the ability of neurons to survive the insult. The second half considers the rather confusing literature as to the possible mechanisms underlying these deleterious GC actions. Five broad themes are discerned: a) that GCs induce a metabolic vulnerability in neurons due to inhibition of glucose uptake; b) that GCs exacerbate various steps in a damaging cascade of glutamate excess, calcium mobilization and oxygen radical generation. In a review a number of years ago, I concluded that these two components accounted for the deleterious GC effects. Specifically, the energetic vulnerability induced by GCs left neurons metabolically compromised, and less able to carry out the costly task of containing glutamate, calcium and oxygen radicals. More recent work has shown this conclusion to be simplistic, and GC actions are shown to probably involve at least three additional components: c) that GCs impair a variety of neuronal defenses against neurologic insults; d) that GCs disrupt the mobilization of neurotrophins; e) that GCs have a variety of electrophysiological effects which can damage neurons. The relevance of each of those mechanisms to GC-induced atrophy, neurotoxicity and neuroendangerment is considered, as are the likely interactions among them.