Abstract
ObjectivesTo distinguish between ethnic differences among segregated schoolgirls and restrictive anorexia nervosa using a simple culture-fair test of body image (BI) figure drawings.MethodsSeveral responses to BI figure drawings by 178 adolescent schoolgirls from three ethnically distinct and segregated schools and communities in Israel, Jewish secular (JS), Jewish Haredi (H), and Christian Arab (C), and a group of 14 severely restricting anorexic girls (AN). BI evaluations were analyzed by MANCOVA, followed by paired or Student-t tests for comparisons between responses and groups respectively. Pearson r served for correlations and the Fisher Z for differences between slopes.ResultsDespite the total ethnic segregation among the schoolgirls, there are commonalities; all prefer a thinner ideal BI, and are similarly dissatisfied with their BI. However, ethnic differences also emerge: C underestimate their BI and how others view them, and H true and Ideal BI evaluations correlate, unlike the other groups. Despite this variability, and in stark contrast, the anorexic girls show a gross misperception of their BI, even in comparison to girls equated for BMI.DiscussionThe findings show that figure drawings evaluation of BI is a simple and robust instrument dissociating clinical and ethnic responses. Clinicians may consider body figure drawings as a simple, supportive, diagnostic for first-line recognition for risk of AN in adolescent girls.
Highlights
Eating disorders (ED) are among the most common psychiatric disorders in young women
Univariate analysis with BMI% and age covariates for dissatisfaction shows a group effect, F (3187) = 2.9, p < 0.05, partial eta squared (PES) = 0.045, due to anorexia nervosa (AN) more dissatisfied than schoolgirls, whereas it does not differ among schoolgirls
In comparing 3 groups of schoolgirls we find that despite substantive ethnic differences, body image (BI) evaluations are similar: Ideal shape is thinner than true BMI%, and dissatisfaction significant
Summary
Eating disorders (ED) are among the most common psychiatric disorders in young women. “the presentation of eating disorders is often cryptic—for example, via physical symptoms in primary care. In multi-ethnic communities it is often helpful to distinguish between cultural norms and potential diagnostic features, because cultural factors influence body weight norms, weight control, obesity, and body image (BI), body image dissatisfaction, and may both obscure or increase vulnerability for ED [6,7,8,9,10,11,12,13,14,15,16,17,18]. At the same time in anorexia nervosa (AN), BI dissatisfaction is an essential diagnostic and together with the drive for thinness is extreme and underlies and perpetuates the psychopathology [8, 15, 19, 20]
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