Effectiveness of an Internet-based program for reducing risk factors for eating disorders.

This study evaluated an Internet-delivered computer-assisted health education (CAHE) program designed to improve body satisfaction and reduce weight/shape concerns—concerns that have been shown to be risk factors for the development of eating disorders in young women. Participants were 60 women at a public university randomly assigned to either an intervention or control condition. Intervention participants completed the CAHE program Student Bodies. Measures of body image and disordered eating attitudes were assessed at baseline, postintervention, and 3-month follow-up. At follow-up, intervention participants, compared with controls, reported a significant improvement in body image and a decrease in drive for thinness. This program provides evidence for the feasibility and effectiveness of providing health education by means of the Internet. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A prospective study of pediatric loss of control eating and psychological outcomes.

Loss of control (LOC) eating in youth is associated cross-sectionally with eating-related and psychosocial distress and is predictive of excessive weight gain. However, few longitudinal studies have examined the psychological impact and persistence of pediatric LOC eating. We administered the Eating Disorder Examination and self-reported measures of depressive and anxiety symptoms to 195 boys and girls (mean age = 10.4 years, SD = 1.5) at baseline and again 4.7 years (SD = 1.2) later to 118 of these youth. Missing data were imputed. Baseline report of LOC was associated with the development of partial- or full-syndrome binge eating disorder (p = .03), even after accounting for the contribution of sex, race, baseline characteristics (age, disordered eating attitudes, and mood symptoms), body mass index growth between baseline and follow-up, and years in study. Half (52.2%; 95% CI [1.15, 6.22]) of children who endorsed experiencing LOC at baseline reported persistence of LOC at follow-up (p = .02). Compared with children who never reported LOC eating or reported LOC only at baseline, those with persistent LOC experienced significantly greater increases in disordered eating attitudes (ps p = .027) over time. These data suggest that LOC eating in children is a problematic behavior that frequently persists into adolescence and that persistent LOC eating is associated with worsening of emotional distress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A 10-year longitudinal study of body weight, dieting, and eating disorder symptoms.

This article describes a 10-year longitudinal study of eating attitudes and behaviors. A sample of 509 women and 206 men completed a detailed survey in 1982 while they were in college. The authors contacted participants 10 years later and administered a 2nd questionnaire to assess stability and change in eating behaviors that occurred during the transition to early adulthood. Women in the study had substantial declines in disordered eating behavior as well as increased body satisfaction. However, body dissatisfaction and desires to lose weight remained at relatively high levels. Men, who rarely dieted or had eating problems in college, were prone to weight gain following college, and many of them reported increased dieting or disordered eating. The authors conclude that disordered eating generally tends to decline during the transition to early adulthood. However, body dissatisfaction remains a problem for a substantial segment of the adult population. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Disordered eating and unhealthy weight reduction practices among adolescent females

BACKGROUND: Dissatisfaction with body weight and the use of unhealthy weight reduction practices have been reported among adolescent females. There is a need for methodologically rigorous studies using large representative samples of adolescent females to accurately assess the prevalence of these behaviors and attitudes. METHODS: Eight hundred sixty-nine Australian school girls ages 14-16 years were administered a self-report questionnaire to determine the prevalence of disordered eating behaviors, unhealthy dieting practices, and distorted body image. Anthropometric (height and weight) data were collected on each of these adolescent females. RESULTS: The prevalences of disordered eating, unhealthy dieting, and distorted body image were 33, 57, and 12%, respectively. Over one-third (36%) of the total sample had used at least one "extreme" dieting method in the past month, i.e., "crash" dieting, fasting, slimming tablets, diuretics, laxatives, and/or cigarettes to lose weight. Of the total sample, 77% wanted to lose weight and 51% had tried to lose weight in the past month. Motivating factors for disordered eating and unhealthy dieting behaviors were peer pressure, media pressure, and the perception that extreme dieting strategies were harmless. CONCLUSION: The prevalence of disordered eating and dieting behaviors among adolescent females shown by this study suggests the need for preventive programs encouraging appropriate eating and dieting behaviors.     

Age differences in genetic and environmental influences on eating attitudes and behaviors in preadolescent and adolescent female twins.

A sample of 680 11- and 602 17-year-old female twins was used to examine (a) age differences in genetic and environmental influences on disordered eating attitudes and behaviors and (b) associations between body mass index (BMI) and eating attitudes and behaviors. Univariate, biometrical model-fitting analyses indicated that 11-year-old twins exhibited less genetic and greater shared environmental influence on eating attitudes and behaviors than 17-year-old twins. Bivariate model-fitting analyses indicated that the relationship between BMI and eating attitudes was mediated primarily by common shared environmental influences in 11-year-old twins and common genetic influences in 17-year-old twins. Nonetheless, the majority of genetic influences on eating attitudes and behaviors in older twins were due to genetic effects that are independent of those operating in BMI. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Do adherence variables predict outcome in an online program for the prevention of eating disorders?

Unlike traditional interventions, Internet interventions allow for objective tracking and examination of the usage of program components. Student Bodies (SB), an online eating disorder (ED) prevention program, significantly reduced ED attitudes/behaviors in college-aged women with high body image concerns, and reduced the development of EDs in some higher risk subgroups. The authors investigated how adherence measures were associated with ED attitudes and behaviors after treatment. Female SB participants (n = 209) completed the Eating Disorders Examination-Questionnaire (EDE-Q; C. G. Fairburn & S. J. Beglin, 1994) at baseline, posttreatment, and 1-year follow-up. Total weeks participation and frequency of utilizing the online Web pages/journals predicted pre- to posttreatment changes in EDE-Q Restraint but not in other ED symptoms. In participants with some compensatory behaviors, discussion board and booster session use were associated with increased weight/shape concerns during follow-up. In overweight participants, higher online Web page/journal use was related to decreased EDE-Q Eating Concern scores during follow-up. This is the first study to investigate the relationship between adherence to specific program components and outcome in a successful Internet-based intervention. Results can be used to inform future development and tailoring of prevention interventions to maximize effectiveness and facilitate dissemination. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Group cognitive-behavioral therapy and group interpersonal psychotherapy for the nonpurging bulimic individual: A controlled comparison.

Evaluated the effectiveness of group cognitive-behavioral treatment (CBT) and group interpersonal psychotherapy (IPT) for binge eating. 56 women with nonpurging bulimia were randomly assigned to 1 of 3 groups: CBT, IPT, or a wait-list control (WLC). Treatment was administered in small groups that met for 16 weekly sessions. At posttreatment, both group CBT and group IPT treatment conditions showed significant improvement in reducing binge eating, whereas the WLC condition did not. Binge eating remained significantly below baseline levels for both treatment conditions at 6-mo and 1-yr follow-ups. These data support the central role of both eating behavior and interpersonal factors in the understanding and treatment of bulimia. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adolescent male athletes: body image, diet, and exercise

The purpose of this study was to investigate and compare body image concerns, attitudes toward eating/weight control, and reasons for exercising between two groups of adolescent male athletes--football players (N = 44) and cross-country runners (N = 30). Subjects responded to surveys covering eating attitudes, weight concerns, physical traits, perceived and ideal body shape/size, and reasons for exercising. Significant differences were noted: Football players reported a more positive body image; cross-country runners indicated a greater degree of body dissatisfaction, more disordered eating patterns, and a greater degree of concern for weight control which identified this group as one in need of increased health education.     

Mind over matter: Internalization of the thinness norm as a moderator of responsiveness to norm misperception education in college women.

The authors examine the effectiveness of norm misperception education in decreasing disordered eating. One hundred seven Ist-year college women completed questionnaires assessing their own and others' actual and ideal body size as well as their own disordered eating and were then randomly assigned to read either a norm misperception or a control brochure. Participants completed questionnaires immediately after reading the brochures and again 3 months later. Although there were no main effects of brochure condition at the follow-up, participants who primarily compared themselves with other college women and who read the norm misperception brochure had higher actual and ideal weight as well as less frequent disordered eating. The discussion focuses on the theoretical and applied implications of these findings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An Interactive Psychoeducational Intervention for Women at Risk of Developing an Eating Disorder.

This study evaluated a synchronous Internet-delivered intervention (chat room) for improving eating habits and body image in college-age women at risk for developing an eating disorder. Sixty at-risk women (mean age = 18.9, SD = 2.4; 65.0% Caucasian, 19% Latino/Hispanic, 8% Asian/Pacific Islander, 3% African American, 5% other; mean body mass index = 25.6, SD = 5.7) were randomly assigned to intervention (n = 30) or control (n = 30) groups. Once a week for 8 weeks, participants used a private chat room for a 1-hr moderated discussion focused on improving body image and eating behaviors. Additional treatment components included psychoeducation, asynchronous support, homework, and summaries. Assessments were conducted at baseline, posttreatment, and 10 weeks after posttreatment. Participants indicated high satisfaction with the intervention mode. Intervention participants significantly reduced eating pathology and improved self-esteem over controls at follow-up. These findings suggest that synchronous, Internet-delivered programs are efficacious and have potential to reduce problematic attitudes and behaviors that may lead to eating disorders among college-age women. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Puberty and the genetic diathesis of disordered eating attitudes and behaviors.

Twin studies from the Minnesota Twin Family Study (MTFS) suggest negligible genetic effects on eating pathology before puberty but increased genetic effects during puberty. However, an independent study found no pubertal differences in genetic and environmental effects (R. Rowe, A. Pickles, E. Simonoff, C. M. Bulik, & J. L. Silberg, 2002). Discrepant results may be due to methodological differences. The MTFS studies divided twins at mid-puberty, whereas R. Rowe et al. (2002) divided twins based on menarche alone. In the present study, the authors aimed to reconcile discrepant findings by examining differences in etiologic effects for disordered eating attitudes and behaviors (i.e., levels of weight preoccupation, body dissatisfaction, binge eating, compensatory behaviors) using both classification methods in a new sample of 656 female twins. Using the MTFS method (i.e., K. L. Klump, M. McGue, & W. G. Iacono, 2003), the authors observed nominal genetic effects in prepubertal twins but significant genetic effects in pubertal and young adult twins. Conversely, genetic effects were moderate and equal in all groups using the R. Rowe et al. (2002) method. Findings highlight the potentially important role of puberty in the genetic diathesis of disordered eating attitudes and behaviors and the need to use early indicators of pubertal status in studies of developmental effects. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparative effectiveness of social problem-solving therapy and reminiscence therapy as treatments for depression in older adults.

Compared the effects of 2 psychotherapies based on divergent conceptualizations of depression in later life. 75 older adults diagnosed with major depressive disorder were assigned randomly to problem-solving therapy (PST), reminiscence therapy (RT), or a waiting-list control (WLC) condition. Participants in PST and RT were provided with 12 weekly sessions of group treatment. Dependent measures, taken at baseline, posttreatment, and 3-mo follow-up, included self-report and observer-based assessments of depressive symptomatology. At posttreatment, both the PST and the RT conditions produced significant reductions in depressive symptoms, compared with the WLC group, and PST Ss experienced significantly less depression than RT Ss. Moreover, a significantly greater proportion of Ss in PST vs RT demonstrated sufficient positive change to warrant classification of their depression as improved or in remission at the posttreatment and follow-up evaluations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Imaging of hamate bone fractures in conventional X-rays and high-resolution computed tomography. An in vitro study

BACKGROUND: To explore the impact of a prevention program on the eating and body attitudes of a sample of adolescent schoolgirls. METHODS: The program involved lessons and group discussions of general adolescent problems and eating disorders. A total of 254 16-year-old schoolgirls were evaluated, of whom 154 participated in the program and a further 154 subjects formed the control group. Variations in weight, Eating Attitudes Test and Eating Disorders Inventory at a 1-year follow-up were compared for the two groups. RESULTS: Among high-risk subjects, no significant differences were found between the prevention and the control group. The preventive program appeared to reduce significantly body dissatisfaction and to decrease the risk of bulimic attitudes in low-risk subjects. CONCLUSIONS: Providing schoolgirls with the correct information about eating disorders did not encourage unhealthy attitudes to eating and weight regulation practices. However, for high-risk subjects more intensive and specific intervention may be required, for which further research is needed.     

Mothers, daughters, and disordered eating.

Examined features of 77 mothers' attitudes and behavior that relate to disordered eating among their adolescent daughters. Mothers whose daughters reported a level of disordered eating comparable with clinical samples of bulimic patients were compared with mothers whose daughters reported a low level of eating disturbances. As hypothesized, mothers of daughters with disordered eating were more dissatisfied with the general functioning of the family system. Also, mothers whose daughters were eating disordered were themselves more eating disordered and differed in their dieting history compared with mothers of the girls who were not eating disordered. Furthermore, mothers of girls with disordered eating thought their daughters should lose more weight than mothers of girls who were not eating disordered. They also thought that their daughters were less attractive than the girls judged themselves. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of tooth loss on the anatomy of the maxilla]

OBJECTIVES: To compare prevalence rates of weight-control behaviors among adolescents with and without chronic illness and to explore the role of familial and other social factors on associations between disordered eating and chronic illness. DESIGN AND SETTING: Survey conducted in public schools in Connecticut. PARTICIPANTS: A representative statewide population-based sample of 9343 7th-, 9th-, and 11th-grade public school students, of whom 1021 reported a chronic illness. MAIN OUTCOME MEASURES: Disordered eating (vomiting, diet pills, and laxatives), dieting, and exercise for weight control; chronic illness status; family structure, family communication, parental caring, parental monitoring, parental expectations, peer support, and sexual and physical abuse. RESULTS: Adolescents with chronic illness were at greater risk for disordered eating than youth without chronic illness, after controlling for sociodemographic variables (girls: odds ratio, 1.59 [95% confidence interval, 1.19-2.14]; boys: odds ratio, 2.22 [95% confidence interval, 1.49-3.32]). Adolescents with chronic illness were less likely to come from 2-parent families; reported lower levels of family communication, parental caring, and parental expectations; and reported more sexual and physical abuse than youth without chronic illness. Male adolescents with chronic illness were more likely to report low peer support and low parental monitoring. Most of these familial-social factors were also associated with an increased prevalence of disordered eating. After familial-social factors were controlled for, however, associations between disordered eating and chronic illness remained statistically significant. CONCLUSIONS: Adolescents with chronic illness are at greater risk for disordered eating behaviors than youth without chronic illness. Factors other than the familial-social factors assessed in this study may be contributing to this increased risk. In the clinical setting, youth with chronic illness need to be screened for disordered eating and familial and other social concerns.     

Risk factors for clinically significant importance of shape and weight in adolescent girls.

The objective of the current study was to conduct a longitudinal study of adolescent girls to determine how temperament, attitudes toward shape and weight, life events, and family factors might contribute to the growth of clinically significant importance of shape and weight, assessed using the Eating Disorder Examination (EDE). Time 1 data were available from 699 female twins (M age = 13.96 years) and 595 parents, and approximately 1.15 years later (Time 2) the twins completed the EDE again (M age = 15.10 years). Twins were treated as singletons in the analyses. Time 1 importance of shape and weight was a significant predictor of Time 2 lifetime disordered eating behaviors. Seven Time 1 variables were significant univariate predictors of Time 2 importance of shape and weight. In multivariate analyses, fathers’ sensitivity to reward was the only significant predictor of growth of Time 2 importance of shape and weight. Some support was found for established risk factors of disordered eating risk, while the multivariate analyses highlight the importance of developing conceptualizations of eating disorder etiology beyond the individual level. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Disordered eating, weight dissatisfaction and dieting in relation to unwanted childhood sexual experiences in a community sample

A study was conducted to examine the relationships among eating pathology, weight dissatisfaction and dieting, and unwanted sexual experiences in childhood. An unselected community sample of 201 young and 268 middle-aged women were administered questionnaires assessing eating behaviors and attitudes, and past and current sexual abuse. Results showed differential relationships among these factors for the two age cohorts: for young women, past sexual abuse predicted weight dissatisfaction, but not dieting or disordered eating behaviors, whereas for middle-aged women, past abuse was predictive of disordered eating, but not dieting or weight dissatisfaction. Current physical or sexual abuse was also found to be predictive of disordered eating for the young women. These findings underscore the complexity of the relationships among unwanted sexual experiences and eating and weight pathology, and suggest that the timing of sexual abuse, and the age of the woman, are important mediating factors.     

Interactive effects of menarcheal status and dating on dieting and disordered eating among adolescent girls.

The effects of menarcheal status and opposite-sex socializing (mixed-sex social activity, dating, and noncoital sexual involvement with boyfriends) on dieting and disordered eating among early adolescent girls are examined. In all, 89 12- and 13-year-old girls reported their menarcheal status, dieting behaviors and attitudes, and involvement in dating and other heterosocial activities. Girls who are more involved in mixed-sex social activities are more likely to exhibit disordered eating tendencies, and this effect is stronger among girls who have experienced menarche. Also, girls who are dating and are more physically involved with boyfriends are more likely to report dieting and disordered eating than are their peers. An interaction between dating and menarcheal status was observed in the prediction of dieting and disordered eating, with dating more strongly linked to dieting and disordered eating among girls who have recently experienced menarche. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sexual abuse and bulimia: response to inpatient treatment and preliminary outcome

The purpose of this study was to explore the clinical impact of child sex abuse on bulimic patients. Specifically, differences in treatment response and preliminary treatment outcome between hospitalized bulimic patients with and without a reported history of sexual abuse were examined. The patients were evaluated for past history of alleged sexual abuse by investigator-based interview and ratings of severity of sexual abuse were made. Assessments of mood, eating disordered-related attitudes, and eating behaviors were conducted at the start of treatment, weekly during treatment, and three months post discharge. Sixty-one per cent (45) of the 74 patients enrolled in the study reported a history of child sexual abuse. The majority of such events constituted serious and very serious abuse by this study's criteria. The abused subjects exhibited higher levels of depression, anxiety, and eating disordered attitudes at each assessment point relative to nonabused subjects. In addition, abused subjects were more likely to be re-hospitalized in the 3 month post-discharge period. Significant differences in the extent of actual bulimic behaviors were not detected. Both the abused and nonabused bulimic patients demonstrated significant reductions in psychiatric symptomatology from pretreatment to posttreatment, and from posttreatment to follow-up. Contrary to prediction, differences in symptomatology between the very serious, serious, and least serious abused groups were not detected. Results suggest that bulimic patients with reported histories of sexual abuse can be effectively engaged in a conventional eating disorder treatment program, but that such abuse may place patients at a disadvantage owing to higher levels of pretreatment symptom severity. Findings suggest that extended and/or more specific intervention may be warranted for the abused bulimic patient.     

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. (PsycINFO Database Record (c) 2010 APA, all rights reserved)