Dysfunctional Eating Attitudes Research Articles

Turkish Adaptation and Psychometric Properties of Acceptance and Action Questionnaire for Weight-Related Difficulties-Revised

The aim of this study was to adapt the revised Acceptance and Action Questionnaire for Weight-Related Difficulties-Revised (AAQW-R) into Turkish language and examine its psychometric properties in a nonoverweight sample. This cross-sectional study included predominantly female individuals (83.2%), and mean age of the sample was 21.5. Final sample size included 161 university students. AAQW-R was translated into Turkish and translated back into English. Internal consistency levels for the total AAQW-R score and its subscales (i.e., food as control, weight as barrier to living, and weight stigma) were obtained for reliability. Measures of general experiential avoidance (AAQ-II), body anxiety (SPAS), dysfunctional eating attitudes (EAT-26), anxiety symptoms (GAD-7) and subjective happiness (SHS) were examined for convergent and divergent validity. Confirmatory factor analysis was conducted to examine the factor structure of the scale. The three-factor structure model was a good fit to the data (χ2 [N = 161] = 81.27, p < .001, RMSEA = .098, 90% CI [.072, .124]). The Turkish version of AAQW-R and the subscales indicated a good level of internal consistency (α value ranging between .70 and .87). AAQW-R was found positively correlated with general experiential avoidance, dysfunctional eating attitudes and anxiety symptoms, indicating support for convergent validity. No relationship between AAQW-R and subjective happiness demonstrated evidence for divergent validity. Overall, the Turkish version of AAQW-R is valid and reliable tool to measure weight-related experiential avoidance in nonoverweight sample.

Exploring the impact of the COVID-19 pandemic on perceptual disturbances and dysfunctional eating attitudes and behaviors: A review of the literature.

From the outbreak of the novel coronavirus 2019 (COVID-19) a new physical and social distancing environment has changed our lives and, more particularly, the way of perceiving oneself, as well as eating attitudes and behaviors. An increasing number of studies have highlighted a risky scenario in terms of negative perceptions of one's body as well as disordered eating and eating disorder patterns in both clinical and general population. With regard to this postulate, this literature review posits two main concepts-perceptual disturbances and dysfunctional eating attitudes and behaviors-in the general and (sub-)clinical populations, to provide an understanding of these phenomena during the COVID-19 pandemic. The main objective of this article is to provide a comprehensive and critical review of published scientific literature about perceptual disturbances (i.e., negative body image, body image disturbances, low body esteem) and dysfunctional eating attitudes and behaviors, including disordered eating (e.g., restrictive eating, binge-eating episodes, overeating, emotional eating) and eating disorders features in community (i.e., general population) and clinical and sub-clinical samples worldwide during the COVID-19 pandemic. The PubMed, ScienceDirect, Ebsco, and Google Scholar databases were searched. The initial search produced 42 references. Scientific publications from March 2020 to April 2022 were included, and among the works compiled, only published research articles have been retained. Purely theoretical papers were also excluded. The final selection consisted of 21 studies, covering both community, clinical (i.e., eating disorder population), and sub-clinical samples. The details of the results are discussed taking into consideration the potential impact of changes in the way we perceive ourselves and interact with others (e.g., the popularity of videoconferencing and the over-use of social network sites due to social isolation) as well as changes in eating attitudes and behaviors, physical activity and exercise (e.g., as an emotional response to the insecurity generated by the pandemic context), in community and (sub-)clinical samples. The discussion sheds light on two outcomes: (1) a summary of findings with methodological considerations; (2) an intervention continuum to deal with the consequences of the COVID-19 pandemic; (3) and a final conclusion.

Eating Behaviors, Lifestyle, and Ischemic Stroke: A Lebanese Case-Control Study.

Stroke is the second leading cause of death and the third leading cause of disability on a global scale. Most clinicians tend to underestimate the importance of diet and inadequate or dysfunctional eating attitudes in patients with a complicated relationship with food. Concerned about the potential of an independent Lebanese approach, and also because prior international research has revealed a link between eating intake or choice and ischemic stroke risk, it was considered vital to broaden the scope of the literature and evaluate further the association of disordered eating attitudes and focus on the distinct relationship with food in the case of orthorexia nervosa (ON) in the Lebanese community. Consequently, the purpose of the present study is to investigate the potential association between pre-existing disordered eating attitudes, specifically ON, and ischemic stroke risk, with an emphasis on the evidence supporting a Mediterranean-style diet. This research is a case-control survey study involving 113 Lebanese individuals with ischemic stroke and 451 age-(within 5 years) and sex-matched controls recruited from several hospitals in Lebanon (April 2020-April 2021). According to the findings of our first regression model, living 100 m from a crowded road (adjusted odds ratio [aOR]: 3.421, 95% confidence interval [CI]: 1.585-7.387), living 100 m from an electricity generator (aOR: 3.686, 95% CI: 1.681-8.085), higher waterpipe dependence (aOR: 1.204, 95% CI: 1.117-1.297), higher exposure to passive smoking (aOR: 2.651, 95% CI: 2.051-3.426), being married (aOR: 3.545, 95% CI: 1.297-9.689), having a low educational attainment (aOR: 0.239, 95% CI: 0.084-0.679), vigorous physical activity (aOR: 1.003, 95% CI: 1.001-1.006), and having more inappropriate eating (aOR: 1.040, 95% CI: 1.006-1.074) were all associated with higher odds of having ischemic stroke. Furthermore, atrial fibrillation (aOR: 2.945, 95% CI: 1.010-8.585), diabetes (aOR: 2.550, 95% CI: 1.169-5.561), heart diseases (aOR: 6.193, 95% CI: 2.196-17.463), and hypertension (aOR: 2.744, 95% CI: 1.049-7.180) were also linked to an increased risk of stroke. Moreover, having more orthorexia nervosa tendencies (aOR: 1.123, 95% CI: 1.021-1.235) was related to a higher odds of having an ischemic stroke, whereas better adherence to the MeD was significantly linked (aOR: 0.691, 95% CI: 0.583-0.819) to lower odds of ischemic stroke. Ischemic stroke patients were more likely to have disordered eating attitudes and orthorexic behaviors. Furthermore, the MeD has been found to be beneficial in reducing ischemic stroke risk. Despite the study's focus, outdoor pollution, waterpipe dependence, and passive smoking were linked to ischemic stroke. In summary, this review suggests that improving one's nutritional status and making a few lifestyle changes are key stroke prevention and treatment methods.

The Relationship Between Body Mass Index and Depression, Anxiety, Body Image, and Eating Attitudes in Adolescents in Iran.

Background:The aim of this study was to investigate the relationship between body mass index (BMI) and depression, anxiety, body image, and eating attitudes in 12- to 16-year-old adolescents.Materials and Methods:In this descriptive-analytical study on 437 students in Shahrekord, Iran, selected by two-step random sampling (selection of schools and students), participants were divided into normal weight (BMI: 5–85th), overweight (BMI: 85–95th), and obese (BMI >95th) groups and completed the questionnaires and data were analyzed by SPSS version 23.Results:BMI had a positive correlation with anxiety, depression, and dysfunctional eating attitudes, and negative correlation with body image in adolescents. Mean scores of depression and anxiety in both overweight and obese groups were significantly higher than those in normal weight adolescents but scores of body image and eating attitudes were not different between overweight and normal weight groups.Conclusion:Obesity and overweight may have adverse effects on mental health of adolescents and more attention to psychological aspect of obesity can help us to provide better health services to overweight and obese adolescents.

Perfectionism and Eating Behavior in the COVID-19 Pandemic.

The novel coronavirus disease 2019 (COVID-19) represents a massive global health crisis leading to different reactions in people. Those reactions may be adaptive or not depending on situational or psychological processes. Disordered eating attitudes and behaviors are likely to be exacerbated by the pandemic through multiple pathways as suggested by Rodgers et al. (2020). Among the psychological variables that may have increased dysfunctional eating attitudes and behaviors as a consequence of the social distancing and isolation, we looked at perfectionism. Perfectionism is a well-recognized risk and maintaining factor of eating-related symptoms and interact with stress increasing the probability of dysfunctional reactions (e.g., Wang and Li, 2017). The present study investigated the relationship between multidimensional perfectionism and eating behaviors by considering the mediating role of psychological distress. Data were collected from two countries (Italy and Spain) by means of an online survey. The samples included 465 (63.4% female) participants from Italy and 352 (68.5% female) from Spain. Participants completed the short form of the Hewitt and Flett Multidimensional Perfectionism Scale (Lombardo et al., 2021) to assess self-oriented, other-oriented and socially prescribed perfectionism, as well as the short form of Three Factors Eating Questionnaire (Karlsson et al., 2000) and the Italian version of Depression Anxiety and Stress Scale-21 (Bottesi et al., 2015), respectively used to assess restrictive, emotional and uncontrolled eating on one hand, and depression, anxiety and stress on the other. Multigroup analysis was performed to test the hypothesized model. Results showed that other-oriented and socially prescribed perfectionism were indirectly related to most of the dysfunctional eating aspects through the mediation of psychological distress, and the pattern obtained was consistent in both countries. These findings evidence that the psychological distress potentially related to the COVID-19 disease mediates the negative impact of interpersonal perfectionism and the tendency to eat in response to negative emotions.

Traits of pathological narcissism and dysfunctional eating in women: The role of perfectionistic discrepancy

Dysfunctional eating attitudes and behaviors are very common among women. Recent findings suggest that these attitudes are linked to traits of pathological narcissism. However, mechanisms underlying this association need to be elucidated. We investigated the relationship between traits of pathological narcissism and dysfunctional eating attitudes and behaviors in women, testing whether perfectionistic tendencies mediate this association. The study involved a community-based sample of women (N = 306) who completed measures of grandiose and vulnerable narcissistic traits, attitudes of perfectionistic discrepancy and perfectionistic self-presentation, and dysfunctional eating attitudes and behaviors. Results show that vulnerable narcissistic traits are linked to dysfunctional eating attitudes and behaviors. Moreover, discrepancy between the actual self and the ideal self partially explains why women high in vulnerable narcissism engage in dysfunctional eating attitudes and behaviors. Grandiose narcissism was not uniquely associated with dysfunctional eating. The study suggests that the narcissistic need for being perfect, but not the narcissistic need for presenting oneself as perfect to others, promotes dysfunctional eating attitudes and behaviors in women.

The Effect of Mindfulness-Based Stress Reduction on Affective Control Dimensions in Adolescent Girls with Dysfunctional Eating Attitudes

Adolescents often take an inappropriate approach to eating to confront critical stress during puberty, which might, in turn, result in inefficient nutritional attitudes. The present study aimed to investigate the effect of Mindfulness-Based Stress Reduction (MBSR) on the dimensions of affective control in adolescent girls with dysfunctional eating attitudes. The population of this experimental study included 200 high school girls in the third educational zone of Isfahan, Iran, of whom 30 were selected by convenience sampling, considering the inclusion and exclusion criteria, and were randomly divided into experimental and control groups. The experimental group received the MBSR intervention and were followed up 40 days after the end of the treatment. The data were collected by the Eating Attitude Test and Affective Control Scale and were analyzed using repeated-measures analysis of variance (ANOVA). The results revealed the efficacy of MBSR on affective control in adolescent girls with dysfunctional eating attitudes. It might be concluded that MBSR can be effective in improving the mental health of adolescent girls with dysfunctional eating attitudes. In fact, mindfulness might influence an individual’s emotional and behavioral responses by altering the distorted thought processes that form the basis of the general aspects of well-being, especially mental health.

The effect of mindfulness‐based stress reduction on body image concerns of adolescent girls with dysfunctional eating attitudes

ObjectiveIn order to face the gain weight stress during puberty, adolescents often adopt an improper approach to eating which might lead to ineffective nutritional attitudes. Therefore, the purpose of the present study was to investigate the effectiveness of Mindfulness‐Based Stress Reduction (MBSR) intervention on the body image concerns of adolescent girls with dysfunctional eating attitudes.MethodFor this purpose, an experimental design with pre‐test, post‐test, control group, and follow‐up was used. The population included 200 high school girls of Isfahan, Iran, from whom a sample of 30 students was selected based on the inclusion criteria and was randomly assigned into experimental and control groups. The experimental group received MBSR intervention for eight 90‐min sessions and the control group received no intervention. Following the intervention, the two groups were post‐tested and to assess the sustainability of the intervention effect, both groups were followed up 40-days later. Data were collected by the Eating Attitude Test and Body Image Concern Inventory and analysed using analysis of variance.ResultsThe findings of the study indicated that MBSR influenced the body image of adolescent girls with dysfunctional eating attitudes, and there was a significant difference between the experimental and the control groups in body image concerns (p < .001).ConclusionIt might be concluded that MBSR can be effective in improving the body image of adolescent girls with dysfunctional eating attitudes.

Do Personal Factors Make Women and Men more Susceptible to Self-Objectification and the Development of Dysfunctional Eating Attitudes?

Personality factors can make individuals more susceptible to society’s beauty ideals and can explain the differences between people who do and do not develop eating disorders and concerns about their body shape. This study has two main aims. First, we investigated the degree to which self-objectification mediated the associations between trait anxiety, self-esteem, and eating attitudes in a sample of 698 undergraduate students (375 women, 323 men). Second, we evaluated whether these associations showed analogous patterns across the genders. Our results demonstrated that self-esteem and trait anxiety might contribute to the internalization processes of societal beauty ideals, which may, in turn, lead to dysfunctional eating attitudes in both women and men. The findings suggested the importance of identifying the roles personality factors play in self-objectification for practitioners seeking to improve intervention and prevention strategies. These results are valuable in social contexts where women and men can learn functional and dysfunctional models of culture and behavior. Additionally, the results are useful in a clinical context for a more complete understanding of the etiological factors and outcomes associated with eating disorders.

60.3 PEDIATRIC, NUTRITIONAL, AND LIMITED PSYCHOSOCIAL INTERVENTION FOR AVOIDANT/RESTRICTIVE FOOD INTAKE DISORDER (ARFID) IN AN ITALIAN LONGITUDINAL STUDY FROM INFANCY TO 11 YEARS OF AGE

The objective of this presentation is to evaluate the evolution of malnutrition and long-term psychopathological risk factors in an Italian cohort of children diagnosed with the first subtype of ARFID. Following a transactional model, which recognizes the complex interplay between the individual characteristics of the mother and the child in the origin of developmental psychopathology, this clinical study explored longitudinally the children’s malnutrition, maternal psychopathology, and dysfunctional eating attitudes and the emotional/behavioral development of children from infancy to prepuberty.

Relationship Between Dysfunctional Eating Attitudes and Parental Marital Status in Female Adolescents

The purpose of this study is to investigate the relationship between dysfunctional eating attitudes and anorexic or bulimic symptoms with regard to the marital status of parents and also to investigate the difference in eating attitudes scores by means of body and weight satisfaction in adolescents. 60 adolescent girls attending high school participated in the study. Half of the involved participants consisted of families whose parents lived together, and the other half had divorced parents. The questionnaire data collection method was used in this study. A moderately severe significantly positive relationship was found between eating attitudes and both anorexic and bulimic symptoms scales in participants whose parents lived separately or got divorced. The group of participants whose parents were divorced and who presented higher scores in anorexic symptoms also scored statistically significantly higher on the parameter of eating attitudes median. The participants who were dissatisfied with their weight scored the highest eating attitudes scales median when compared to the participants who had body dissatisfaction. Selective prevention and treatment methods should be used during adolescence to prevent eating disorders. Special attention should be paid to body image disturbances, inappropriate weight control behaviors, and disturbed self-perceived weight during adolescence in order to prevent eating disorders.

Eating Pathology Among Patients With Anorexia Nervosa and Bulimia Nervosa: The Role of Narcissism and Self-Esteem.

We sought to deepen our understanding of the relationship between pathological narcissism and eating disorders (ED) by examining specific facets that composed grandiose and vulnerable narcissism while taking into account self-esteem, a well-known and consistent risk factor for ED. Twenty-seven women diagnosed with anorexia nervosa (AN) and 23 women diagnosed with bulimia nervosa (BN) completed standardized measures of pathological narcissism, self-esteem, and dysfunctional eating attitudes and behaviors. Different patterns of associations between the facets of pathological narcissism and eating pathology arose between AN and BN diagnoses. Closer examination of the facets of pathological narcissism revealed that hiding the self, a vulnerable narcissistic facet, contributed significantly to dysfunctional eating attitudes and behaviors over and above self-esteem for women with AN. Hiding the self should continue to be explored in regard to treatment of ED.

Engaging Healthcare Providers to Help Mothers with Eating Disorders Create Healthy Eating Environments for Their Children

Eating disorders (EDs), such as anorexia, bulimia, and bingeeating disorder, involve extreme emotions, attitudes, and behaviors surrounding weight, food, and body image, all of which can lead to destructive health consequences. While EDs have innumerable effects on affected individuals, less is known about the consequences for the offspring of childbearing women with past or current EDs. Children of mothers with EDs are at increased risk of various problems during gestation and childhood, including higher rates of miscarriage, cesarean-section deliveries, and stillbirth; greater likelihood of preterm delivery, small- or large-for-gestational-age, low or high birth weight, and growth disturbances; and lower likelihood of being breastfed. These children are also more likely to develop dysfunctional eating habits, behaviors, and attitudes throughout adolescence. Possible effects of maternal EDs on parenting include withholding food from children, using food to reward or punish, a preoccupation with weight interfering with the mother’s responsiveness to her child, failure to express positive attitudes toward eating, and higher tension during mealtimes. These risks are influenced by a variety of factors and the consequences for children are difficult to predict. Complicating matters, the foundations of an ED are established long before diagnosis. The familial setting provides a unique opportunity for integrated and concurrent primary and tertiary ED-prevention strategies for both child and mother. It is imperative for healthcare providers to consider the potential value of educational programs and support for mothers with EDs, as early intervention could interrupt the cycle of risk associated with eating disorders and their effects on the developing child.

A content analysis of healthy living blogs: Evidence of content thematically consistent with dysfunctional eating attitudes and behaviors

"Healthy" living blogs are a recent addition to internet media that offer advice on improving physical and mental health. Often, these sites include information on eating, exercise, and self-image. This study was a content analysis designed to evaluate the information included on these sites. A sample of 21 blogs was selected from a larger sample for evaluation. These blogs were chosen based on two criteria: they had won an award for healthy blogs and they had a large number of pageviews (pageviews were calculated using a web analytics website). Two raters (kappa reliability = 0.82) rated these blogs on multiple variables related to the blogger's characteristics, the content provided by the blogger, and entries posted on the blog. Five of the bloggers self-identified as having had an eating disorder; seven mentioned difficulties with either menstruation or fertility; 11 referenced being on a diet; five indicated that they were using some form of dietary restraint; and 11 included some form of written negative/guilt-inducing message about food. Blog entries and About Me sections contained a variety of content indicative of problematic eating and body image information. These findings suggest the content of healthy living blogs might be problematic for viewers who have eating or body image issues. The content does not approach the inflammatory nature of pro-eating disorder websites, yet information promoted clearly indicates that future research should further evaluate these sites.

1038 – Perfectionism and body shape concerns in female students with dysfunctional eating attitudes and behaviour

Before fulfilling the criteria for anorexia nervosa syndrome, many young females already display symptoms of dysfunctional eating attitudes and behaviour. If also accompanied by increased perfectionism and body shape concerns and dissatisfaction, this can indicate a high-risk group for eating psychopathology. The study group consisting of 45 randomly selected female students of University of Belgrade, mean age of 22.27 years (min 19, max 27), scored above the cut-off of 30 on the Eating Attitude Test (EAT-40), indicating symptoms of anorexia nervosa.The Frost Multidimensional Perfectionism Scale (FMPS), which measures different dimensions of perfectionism, and the Body Shape Questionnaire (BSQ), which evaluates body concerns and dissatisfaction, were applied, and the Quetelet Index (QI) was calculated. Descriptive statistics indicate as follows: EAT (M=42.71; SD=13.541), FMPS (M=104.80; SD=14.609), BSQ (M=100.69; SD=29.215), QI (M=21.21; Min 15.64, Max 29.38). Only 24.4% (N=11) of the students were not concerned with body shape. 80% of the study group were of normal weight, 11.1% were underweight, 8.9% were obese, and one member of the group (2.2%) had QI=15.64, indicating anorexia nervosa syndrome. Correlation analysis indicates that there is a positive correlation (r=,393) between perfectionism scores and concerns about body shape (p< 0.01). Our results confirm previous research on the positive correlation between perfectionism and body shape concerns in females with disturbed eating attitudes and behaviour.This means that these features should be systematically assessed in female students and focus be given to prevention campaigns against eating psychopathology.

The relationship between personality traits and eating pathology in adolescent girls

This research investigated the relationship between personality and the tendency towards developing eating disorders in adolescent females Personality traits were assessed using the High School Personality Questionnaire (HSPQ) and dysfunctional eating attitudes and behaviours were assessed using the Eating Attitudes Test (EAT-26) and the Eating Disorder Inventory (EDI). The sample consisted of 244 students from a high school in Johannesburg, South Africa. Significant relationships were found between certain personality traits and eating dysfunction. Reservation, emotional instability, excitability, opportunism, shyness, individualism, proneness to guilt feelings, self-sufficiency and high tension were the personality factors that were significant in relation to eating dysfunction. This thus suggests that personality appears to influence the tendency towards developing eating disorders.

Longitudinal Associations Between Externalizing Behavior and Dysfunctional Eating Attitudes and Behaviors: A Community-Based Study

This study investigated longitudinal associations between externalizing behavior and dysfunctional eating attitudes and behaviors. Participants were girls drawn from the community-based Minnesota Twin Family Study and assessed at ages 11, 14, and 17. Cross-sectional correlations indicated that the strength of the associations between externalizing behavior and dysfunctional eating attitudes and behaviors increased over time. Mixed-model analyses indicated that earlier externalizing behavior predicted increases in weight preoccupation, body dissatisfaction, and use of inappropriate compensatory behaviors. Earlier use of inappropriate compensatory behaviors predicted increases in externalizing behavior.

A Treatment for College Women at Risk for Bulimia: A Controlled Evaluation

Twenty‐nine college women evidencing low body esteem, repeated dieting efforts, and other dysfunctional eating behaviors or attitudes were randomly assigned to group treatment or control conditions. At posttest and follow‐up, participants who received the intervention reported significantly improved levels of self‐esteem and body satisfaction, as well as reductions in their reliance on potentially dangerous methods of weight management compared with controls. They also reported fewer fears of negative evaluation by others and endorsed fewer stereotypes about thinness and attractiveness. Finally, participants in the treatment condition showed significantly reduced levels of perfectionism at posttest, but this change was not maintained at follow‐up. Clinical implications and research recommendations are discussed.

Eating attitudes in seasonal affective disorder and bulimia nervosa

Markedly increased appetite and eating are commonly found in seasonal affective disorder (SAD) and Bulimia nervosa (BN). To investigate dysfunctional eating attitudes, we administered the Eating Disorders Inventory (EDI), a self-rating questionnaire that assesses abnormal eating attitudes and behaviours, to 30 female SAD patients, 30 matched BN patients, and 30 non-clinical subjects. The SAD patients had higher scores on most EDI subscales compared to the non-clinical subjects; the BN patients had higher scores that the SAD patients on only two of three EDI subscales that are specific to eating disorders. These data add to the evidence supporting a clinical overlap between SAD and BN.

Effectiveness of the intensive group process-retreat model in the treatment of bulimia

The present study examined the effectiveness of a short-term, intensive, group process-retreat treatment model for bulimia. The multicomponent, two-day treatment and follow-up booster session focused primarily on the interpersonal deficits associated with the disorder. A sample of 24 subjects who met the DSM-III criteria for bulimia and who binged-purged at least one time per week participated in the study. Compared to a control group (N=12), the women who received the group treatment (N=12) evidenced significant improvements in self-esteem and severity of binge eating. The frequency of binge-purge episodes and dysfunctional eating attitudes were also significantly reduced. The results of this study suggest that the intensive group-process retreat model is an effective adjunct in the treatment of bulimia.