Eating Disorder Diagnostic Scale Research Articles

Predicting and comparing the long-term impact of lifestyle interventions on individuals with eating disorders in active population: a machine learning evaluation.

This study aims to evaluate and predict the long-term effectiveness of five lifestyle interventions for individuals with eating disorders using machine learning techniques. This study, conducted at Dr. Irandoust's Health Center at Qazvin from August 2021 to August 2023, aimed to evaluate the effects of five lifestyle interventions on individuals with eating disorders, initially diagnosed using The Eating Disorder Diagnostic Scale (EDDS). The interventions were: (1) Counseling, exercise, and dietary regime, (2) Aerobic exercises with dietary regime, (3) Walking and dietary regime, (4) Exercise with a flexible diet, and (5) Exercises through online programs and applications. Out of 955 enrolled participants, 706 completed the study, which measured Body Fat Percentage (BFP), Waist-Hip Ratio (WHR), Fasting Blood Sugar (FBS), Low-Density Lipoprotein (LDL) Cholesterol, Total Cholesterol (CHO), Weight, and Triglycerides (TG) at baseline, during, and at the end of the intervention. Random Forest and Gradient Boosting Regressors, following feature engineering, were used to analyze the data, focusing on the interventions' long-term effectiveness on health outcomes related to eating disorders. Feature engineering with Random Forest and Gradient Boosting Regressors, respectively, reached an accuracy of 85 and 89%, then 89 and 90% after dataset balancing. The interventions were ranked based on predicted effectiveness: counseling with exercise and dietary regime, aerobic exercises with dietary regime, walking with dietary regime, exercise with a flexible diet, and exercises through online programs. The results show that Machine Learning (ML) models effectively predicted the long-term effectiveness of lifestyle interventions. The current study suggests a significant potential for tailored health strategies. This emphasizes the most effective interventions for individuals with eating disorders. According to the results, it can also be suggested to expand demographics and geographic locations of participants, longer study duration, exploring advanced machine learning techniques, and including psychological and social adherence factors. Ultimately, these results can guide healthcare providers and policymakers in creating targeted lifestyle intervention strategies, emphasizing personalized health plans, and leveraging machine learning for predictive healthcare solutions.

Impact of parenthood on eating pathology in young adults.

Few studies investigated parenthood as a predictor of eating pathology in young adulthood. We studied the association between parenthood, in the first year after becoming a parent and beyond, and eating pathology. Furthermore, we examined whether moving in together with a partner affected this association. This study used data of four measurement waves from TRAILS (Tracking Adolescents' Individual Lives Survey), a Dutch community cohort study (N = 2229) from preadolescence into young adulthood. The Eating Disorder Diagnostic Scale (EDDS), a measure to assess eating pathology, was assessed at ages 22, 26, and 29. Risk for eating disorder was assessed at age 19. Pregnant participants were excluded. Parenthood was not associated with an increase of eating pathology in the first year after becoming a parent and beyond. Instead, parents were more likely to report being free from eating pathology symptoms compared to childless individuals (OR 2.07, 95% CI: 1.11-3.84). Among those who reported experiencing at least one eating problem, parenthood was not associated with the number of eating problems. Moving in together with a partner did not alter the association between parenthood and eating problems and neither did this association differ between males and females. Parenthood in young adulthood was associated with a decreased risk of having eating pathology. In this longitudinal study among young adults, parenthood was not associated with the development of eating pathology.

Eating disorder symptoms and diagnoses in adults with celiac disease

Introduction: Treatment for Celiac Disease (CeD) includes strict adherence to a Gluten-Free Diet (GFD) which may result in preoccupation with food choice, unwanted weight gain, and body dissatisfaction. Objective: To determine frequency of Eating Disorder (ED) diagnoses and symptoms in adults with CeD. Method: The Eating Disorder Diagnostic Scale (EDDS-DSM-5) and the Eating Pathology Symptoms Inventory (EPSI) were administered in a cross-sectional study of 50 adults with biopsy-confirmed CeD on a GFD for >1 year attending their routine clinic visits. Results: Based on the EDDS, one participant met criteria for Diagnostic and Statistical Manual of Mental Disorders (DSM-5) diagnosis of binge eating disorder and four met criteria for possible diagnosis of Other Specified Feeding and Eating Disorders; none had previously been diagnosed with an ED. EDDS symptom scores were lower (i.e., better) than established cut-points, yet females scored higher than males when asked if they felt fat (p<0.001), feared weight gain (p<0.001), and felt undue influence of weight/ shape (p=0.034). EPSI scores were lower (i.e., better) than normative values, yet females scored significantly higher than males on body dissatisfaction (p<0.001), cognitive restraint (p=0.011), and purging (p=0.044) subscales. Conclusion: Although disordered eating behaviors and weight/ shape concerns were apparent, only one patient met full criteria for an ED diagnosis. The EDDS and EPSI may be useful in screening for comorbidity among adults with CeD; however, clinical assessment is needed to assign a DSM-5 ED diagnosis.

Attachment style to body dissatisfaction, restrained eating, and disordered eating in adolescent girls: Differential weight communication mediators

Body dissatisfaction and eating behaviors are disproportionately elevated amongst adolescent girls. Family relationships represent a context in which adolescent girls’ body image issues emerge. Thus, we integrated attachment and confirmation theories to examine whether weight related supportive messages (i.e., acceptance and challenge) mediated the relationship between attachment style (i.e., anxiety and avoidance) and body image outcomes (i.e., body dissatisfaction (BD), restrained eating (RE), and disordered eating (DE)). Acceptance refers to weight related support that is characterized by warmth and accepting messages; challenge refers to weight related support that is characterized by instrumental assistance and problem-solving messages. A sample of 106 adolescent girls, ages 11 to 21, completed self-report measures on attachment (Relationship Structures Questionnaire), acceptance and challenge (weight related Parental Behavior Questionnaire), body dissatisfaction (Eating Disorders Inventory), and eating behaviors (Dutch Eating Behavior Questionnaire; Eating Disorder Diagnostic Scale). Attachment anxiety directly related to all body image outcomes, whereas attachment avoidance only directly related to RE. Attachment avoidance only related to BD and DE indirectly through perceived acceptance. Those with high anxiety endorsed lower perceived challenge, whereas avoidant individuals endorsed lower perceived acceptance and challenge. We concluded that attachment dimension characteristics to be either hyperactivated regarding relationships (i.e., anxiety), or deactivated and distant (i.e., avoidance), are associated with how individuals perceive support, and in turn, are related to body image and eating behavior outcomes. Further, we clarify the differential roles of acceptance and challenge. Although both supportive, acceptance encompasses a layer of warmth that is more meaningful in body image, particularly for avoidantly attached individuals. By integrating qualities of attachment and supportive weight communication, we reveal that potential pathways of attachment to body image and eating behaviors.

Low Overlap and High Heterogeneity Across Common Measures of Eating Disorder Pathology: A Content Analysis.

This study evaluated symptoms assessed in common measures of eating disorder pathology and tested overlap to evaluate the extent to which measures may be interchangeable. Six measures were included: Bulimia Test-Revised, Eating Attitudes Test-26, Eating Disorder Diagnostic Scale, Eating Disorder Examination Questionnaire, Eating Pathology Symptoms Inventory, and Questionnaire for Eating Disorder Diagnoses. Content overlap was quantitatively estimated using the Jaccard Index. Mean overlap was low (.195), likely due to the wide range of symptoms (87) assessed. The mean overlap of each measure with all others was .117 - .267, and the overlap among individual measures was .083 - .382. Implications of low overlap among measures include variable characterization of eating disorder phenotypes and the risk for lower generalizability of findings due to measurement variability.

Abstract P412: Exploration of Eating Disorder Behaviors in Adolescent Girls Engaged in a Cardiovascular Risk Assessment Study

Introduction: Cardiovascular disease risk factors and eating disorders are both common in young women. There is scant research regarding eating disorder behaviors within the context of cardiovascular health interventions focused on nutrition, physical activity, and weight reduction. This project explored eating disorder behaviors while developing a cardiovascular health promotion tool for young women. Methods: We used an exploratory sequential mixed-methods approach. We interviewed 10 young women about an existing adult cardiovascular risk assessment tool. Three independent coders analyzed the interview data for themes pertaining to weight, food, exercise, and eating disorder behaviors. We used this qualitative data to inform modifications to the adult tool and create the new tool, HerHeart, focusing on teen-friendly language that deprioritized feedback surrounding weight. We then recruited 60 young women ages 13-21 years to complete HerHeart during a clinical visit; 12 participants returned for a three-month follow-up visit. Participants completed the Eating Disorder Diagnostic Scale (EDDS; score ranges from 0-128) at the baseline and follow-up visits. Hypothesis: We hypothesized that there would be no deterioration in EDDS scores over the intervention phase of HerHeart. Results: We identified themes in interviews, such as the importance of word choice when discussing weight (“words can hurt […] especially if you're overweight”, "when you're telling somebody they [are] obese, I feel like [you] should word it differently”), influences on body image and dieting (“some people see people who are […] very fit and they're like, okay, I'm going to starve myself”), and emotional eating (“I shouldn’t be eating this much because I am emotional eater […] When I do get sad […] I mostly eat”). At baseline, one participant met criteria for binge eating disorder and one met criteria for night eating syndrome. At follow-up, a separate individual met criteria for night eating syndrome. The median EDDS composite score for these 12 participants changed from 19 (IQR 10.5, 24) to 21 (IQR 10.5, 26). Conclusion: In conclusion, there was no significant change in EDDS composite score for young adult participants in a cardiovascular health intervention; very few participants met criteria for eating disorders. This emphasizes the importance of thoughtful language surrounding weight, eating habits, and body image in interventions involving adolescents.

Validation of the EDDS-5 self-report survey against the SCID-5 diagnostic interview in US veterans

The aim of our study was to validate the Eating Disorder Diagnostic Scale (EDDS-5) updated for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) with a diverse veteran population against a clinician-administered interview based on the Structured Clinical Interview for DSM-5 (SCID-5). Our sample included 343 veterans, 18–75 years, recruited April 2019 to December 2022 who completed the EDDS-5 as well as other eating disorder and mental health measures. A subsample of these veterans received clinical interviews (n = 166), which were used to validate the EDDS-5. We found that despite multiple proposed modifications, the EDDS-5 performed poorly at correctly identifying diverse veterans who were diagnosed as having eating disorders through clinician-administered interviews. The sensitivity was very low, indicating that using the EDDS-5 did not identify many true positives and may also over diagnose those without true eating disorders. The EDDS-5 may not be the best for screening or diagnostic purposes among diverse samples like veterans.

Body image perception is associated with nutritional status of adolescent girls: A cross-sectional study in Denpasar City, Bali Province, Indonesia

Background and purpose: Adolescent psychopathological conditions influence body image perception which can lead to eating disorders, resulting in nutritional and health problems The objective of this study is to analyze the relationship between body image perception, eating disorders, and the nutritional status of adolescent girls. Methods: This is a quantitative observational study using a cross-sectional design. The study was conducted at SMP Negeri 8 Denpasar and SMP Raj Yamuna in 2022 involving 90 students. Data collected included characteristics, body image perception, eating disorders, weight, and height. Data collection instruments included questionnaire, Multidimensional Body Self Relations Questionnaire-Appearance Scales (MBSRQ-AS) for body image perception, anthropometric measurement tools and the Eating Disorder Diagnostic Scale (EDDS). The data was analysed including descriptive analysis and Chi-square test. Results: The respondents were aged between 12–15 years, with the highest proportion was age 13 years at 42.2%. The majority of adolescent girls (44.8%) were in grade VIII. More than half (54.4%) tend to have a positive body image perception, whilst the majority experienced eating disorders at 86.7%, and had normal nutritional status at 75.6%. Body image perception associated with nutritional status of adolescent girls (OR=4.587; 95%CI: 1.589-13.237; p=0.003). Conclusion: Body image perception is related to the nutritional status of adolescent girls in Denpasar. Therefore, peer counselors are needed to improve adolescent communication, including promoting nutritional action messages through appealing social media approaches. Then, interventions at school are also needed including to define the role of peer supports.

Pregorexia and its significance for physiological processes in the fetus - a review of current knowledge.

Anorexia occurring during pregnancy can have a devastating effect on the pregnant woman's physiological clinical picture, mental health, and fetal development. This is because eating behaviors, the fetal programming process, and behavioral-cognitive relationships all contribute to shaping intrauterine conditions. Dysfunction at the neural level predisposes to a disturbed relationship with food, reduced self-acceptance, perinatal depression, and a negative perception of body image. The health consequences of reduced energy intake in the course of anorexia during pregnancy contribute to the manifestation of maternal ketonuria, ketonemia, increased excretion (excretion) of nitrogen during diuresis, decreased synthesis of gluconeogenic amino acids after starvation in pregnancy. Scientific reports confirm the destructive impact of behavioral disorders focused on significant food restriction. Medical and psychological care in pregorexia (anorexia of pregnancy) is an integral part of support during pregnancy and the perinatal period. Support includes psychoeducation and includes monitoring of weight, mental and physical health, and identified risk factors. The interdisciplinary team taking care of a pregnant woman with anorexia should include a gynecologist, midwives, a psychiatrist, a clinical nutritionist, a psychodietitian, a psychotherapist, a psychologist and involved family members. Long-term, consecutively implemented nutrition education along with the use of dedicated diagnostic tools in the form of Eating Disorders Diagnostic Scale (EDDS) and psychodietetic intervention based on motivational dialogue should be an integral part of cognitive-behavioral therapy.

Distinguishing probable atypical anorexia nervosa from weight loss alone in a national sample of U.S. Military Veterans: Disentangling the roles of weight suppression and cognitive concerns.

Veterans are at high risk for eating disorders (EDs), and specifically for atypical anorexia nervosa (atypical AN). The current study aimed to better understand this under-studied disorder and how it differs from weight loss without ED cognitive features. Secondary analyses were conducted with data from a national study of Veterans (N = 882, 49.4% women). Participants were categorized into four mutually exclusive groups using the Eating Disorder Diagnostic Scale 5: probable atypical AN, a cognitive concerns group (Cog Only), a weight suppressed group (WS Only), and a no ED control group. Adjusted regression models were used to compare groups on measures of eating pathology and mental health. Three weight suppression thresholds (5%, 10%, and 15%) for probable atypical AN were also tested. The sample was comprised of 12% probable atypical AN, 23.6% Cog Only, 16.3% WS Only, and 48.1% Control. The probable atypical AN group was most like the Cog Only group except for higher levels of dietary restraint. Atypical AN fared worse and was least like the Control group followed by the WS Only group. All weight suppression thresholds significantly predicted dietary restraint, with 5% being the best predictor. Results found that probable atypical AN is a distinct clinical entity and that the exact weight suppression threshold associated with atypical AN is less important than having any weight suppression. Findings highlight the clinical significance of atypical AN and the importance of gaining a better understanding of how to address this clinical entity. Atypical anorexia nervosa is a relatively underexamined but highly prevalent eating disorder in the Veteran population. Results show that ED cognitive features are more closely linked to clinically significant eating pathology and poor mental health than weight suppression alone suggesting that negative thinking about weight gain and appearance, regardless of the presence or severity of weight loss, may signal the need for specialized intervention.

Impaired eating behaviors but intact metabolic hormone levels in individuals with major depressive disorder and generalized anxiety disorder

BackgroundMajor depressive disorder (MDD) and generalized anxiety disorder (GAD) contribute significantly to global health burdens. Identifying disease markers for these comorbid disorders can increase understanding of pathogenesis and improve screening and intervention strategies. This study examined the association of physical health factors with MDD and MDD + GAD, across sexes. MethodsTwo samples of participants from the Tulsa-1000 study (exploratory cohort: N = 136; confirmatory cohort: N = 185) completed body composition measurements, eating behavior (Three Factor Eating Questionnaire [TFEQ], Eating Disorder Diagnostic Scale [EDDS]), exercise questionnaires, and a blood draw. Metabolic hormone concentrations (leptin, insulin, and adiponectin) were analyzed from blood samples. Within each cohort, a two-way analysis of variance compared three groups (MDD, MDD + GAD, and healthy controls [HC]), sex, and their interaction on dependent variables. Hedges g was calculated to reflect effect size magnitude. ResultsMedium-to-large group main effects across cohorts indicated that compared to HC: (1) MDD (g = 1.71/0.57) and MDD + GAD (g = 0.93/0.69) reported higher TFEQ Disinhibition scores; (2) MDD endorsed higher TFEQ Hunger scores (g = 0.66/0.48); and (3) MDD (g = 1.60/1.30) and MDD + GAD (g = 0.92/1.72) reported greater EDDS scores. Large sex main effects across cohorts indicated that females exhibited higher levels than males for percent body fat (g = 1.07/1.17), leptin (g = 1.27/1.12), and adiponectin (g=0.82/0.88). LimitationsThe power to detect group*sex interactions was limited due to a greater number of females (than males) in the study, and over half of clinical participants were taking medications. ConclusionsIndividuals with MDD and MDD + GAD demonstrate difficulties in regulating eating behaviors, potentially contributing to functional impairment and increased disease burden.

Understanding the Relationship Between Emotional Intelligence, Eating disorders, Blood group and Cognitive functioning among Asian and African University Students

Abstract Introduction - The overall purpose of the study was to examine the relationship between emotional intelligence, eating disorders, blood group and cognitive functioning among Asian and African university students in India. That’s how emotional intelligence and blood group type serves as aetiological factors for eating disorders and the degree to which these three Variables influence cognitive functioning among university students. Objectives - The first aim of the study was to determine if any relationship exist between emotional intelligence, eating disorders, blood groups and cognitive functioning among Asian and African Students. Our second aim was to investigate the impact of eating disorders, emotional intelligence and blood groups on cognitive functioning, as well as to find the role of blood groups on aetiology of eating disorders. And finally, to also investigate the role of cultural differences on emotional intelligence, eating disorders and cognitive functioning Methods and Material - The study considered sample size of 120 African and Asian university students at National forensic sciences university (NFSU) who were residing in India and continuing their studies from undergraduate to PhD in all academic streams during the time of the study with ratio of equal African and Asian as well as male to female. Tools used in the study were eating disorders diagnostic scale by Stice, E., Fisher, M., & Martinez, E. (2004), Schutte Self Report Emotional Intelligence Test (SSEIT) and Montreal cognitive assessment (MOCA). Results – We found positive correlation between blood group and cognitive functioning with correlation value of .241** at 0.01 significant level. Blood group was also found to be negatively correlated to eating disorders with correlation value of -237** at 0.01 significant level and positively correlated with emotional intelligence with correlation value of .187* at 0.01 significant level. We also found that, cognitive functioning was negatively correlated to eating disorders with correlation value of -.842** and positively correlated to emotional intelligence with correlation value of .781. ** This reveals that, people who are having eating disorders are more likely to perform poorly in cognitive functioning. Our results also shows that, emotional intelligence was negatively correlated to eating disorders with correlation value of -.745.** This can be interpreted as people who have high emotional intelligence are of low risk of developing eating disorders compare to those with low emotional intelligence. Finally, we also found significant difference between Asian and African students on the basis of emotional intelligence level, cognitive functioning and eating disorders. Conclusion - In conclusion, the result of this study shows that, there is a correlation between emotional intelligence, eating disorders, blood groups and cognitive functions. Also, Asian and African students differ on emotional intelligence level, cognitive functioning and eating disorders. But emotional intelligence, eating disorders and cognitive functioning is not dependent on different academic level. That’s no significant difference was found between different academic level, that’s undergraduate, post-graduate and PhD on eating disorders, emotional intelligence and cognitive task Keywords: Emotional intelligence, blood group, eating disorders, cognitive functioning, Asian and African student

Bulimia symptoms and anger and aggression among adolescents

BackgroundPrevious research has indicated that anger and aggression may be elevated in adolescents with a bulimia nervosa (BN) diagnosis. However, as yet, little is known about whether bulimia symptoms are linked to anger and aggression in adolescents in the general population. To address this deficit this study aimed to explore the associations between a clinical level of bulimia symptoms (CLBS) and anger, anger rumination and aggression in community-based adolescents, and determine whether gender is important in this context.MethodsThis study was conducted on a representative sample of youth from northwestern Russia (n = 2613, age 13–17 years old, 59.5% female) using self-report scales. A proxy variable for a CLBS was created using the Eating Disorder Diagnostic Scale. Aggression, anger and anger rumination were assessed by the Trait Anger Scale of the State Trait Anger Expression Inventory, the Anger Rumination Scale, and scales created to assess physically and verbally aggressive behavior. Multivariate analysis of covariance was used to examine the associations between the study variables.ResultsA CLBS was more prevalent in girls than in boys (13.4% vs. 3.5%). The association with anger and aggression was stronger in both genders with a CLBS, compared to those adolescents without a CLBS. In the CLBS group, boys as compared to girls scored higher on verbal and physical aggression, anger rumination and social aggression. In both the CLBS and Non-CLBS groups higher anger and aggression scores were associated with increasing age.ConclusionsFindings suggest that aggression and anger rumination are elevated in adolescents with BN symptoms, and that the associations between anger, aggression and BN symptoms may be stronger in boys. As previous research has indicated that the presence of aggressive behaviors may affect the prognosis of BN and complicate management of the disorder, clinician screening for these behaviors in adolescents with BN symptoms may facilitate the provision of more effective treatment, especially among boys.

Exploring differences in disordered eating and related appetitive traits among women based on childhood and current food security status

Despite emerging evidence that food insecurity (FI) is associated with elevated rates of eating pathology, little is known about the lasting impact of FI on eating behaviors. Studies that have explored the association between FI during childhood and eating behavior in adulthood have not accounted for current FI. The present study explored differences in disordered eating (DE) and related appetitive traits among four groups of cisgender female mothers: individuals who (1) endorsed childhood FI only (n = 96), (2) endorsed current FI only (n = 134), (3) endorsed both childhood and current FI (n = 257), and (4) denied both childhood and current FI (n = 146). Participants responded to online questionnaires including items from the USDA Household Food Security Survey Module, the 7-item Eating Disorder Examination-Questionnaire, the Eating Disorder Diagnostic Scale, and the Adult Eating Behavior Questionnaire. Adjusting for age and race/ethnicity, ANCOVAs explored mean differences between groups in DE and appetitive traits, and a modified Poisson regression model examined differences in binge-eating prevalence across the four FI groups. The “current FI only” group consistently endorsed the highest levels of DE and related appetitive traits followed by the “current and childhood FI” group, suggesting newly food-insecure women may be at highest risk for DE. Interestingly, across almost all constructs, the “childhood FI only” group did not differ significantly from the “no FI” group. These findings suggest that improved access to food may help offset risk for adult DE related to experiences of FI in childhood.

Validation of Eating Screen in Hindi: A Step Forward to Combat an Under-researched Menace of Eating Disorders in India

Abstract Background: A culturally appropriate tool to screen and diagnose eating disorders (EDs) is lacking in India. Aim: This study aims to translate, adapt, and validate ED Diagnostic Scale (EDDS) in Hindi. Methodology: Hindi translation of EDDS was done by three psychiatrists, two of whom were familiar with Western culture, their mother tongue being Hindi. The bilingual panel of experts, including three surgeons, one Professor in the English language, and one person with severe obesity (International English Language Testing System score Band 8.5) resolved translation inconsistencies. Back translation to the English language was done by an independent translator. Pretesting/focused-group discussion/cognitive interviewing was done in persons with severe obesity (n = 55). Hindi-version so-developed was administered to students (n = 120) after a week. Test–retest reliability was assessed. The original EDDS, Modified Weight Bias Internalization Scale (WBIS-M), and Fat Phobia Scale-Short Form (FPS-SF) were applied to 175 participants (students [n = 120], patients [n = 55]). The psychometric properties of Hindi-EDDS were investigated. Results: The mean age of students and patients was 18.60 and 43.38 years, respectively. Students and patients’ mean body mass index was 21.77 and 43.21 kg/m2, respectively. Kaiser–Meyer–Olkin and Bartlett’s Test of Sphericity for sample adequacy were 0.859 and χ2 = 3155.775; P = 0.000, respectively. The Spearman–Brown coefficient for Hindi-EDDS was 0.755 and 0.707, respectively. Internal consistency (Cronbach’s alpha and Kuder–Richardson - 20) was α = 0.898. Cross-language concordance had a significant intra-class correlation coefficient (0.725–1.000). WBIS-M and FPS-SF showed a significant correlation with various items of Hindi-EDDS. Conclusion: The Hindi EDDS is a culturally sensitive tool with acceptable psychometric properties.

The Association of Perceived Vulnerability to Disease with Cognitive Restraint and Compensatory Behaviors

Individual differences exist in perceived vulnerability to disease (PVD). PVD is associated with negative responses (e.g., disgust) towards individuals with obesity and heightened sensitivity regarding personal appearance. Through increasing fear of fat (FOF), PVD may be associated with cognitive restraint and compensatory behaviors. We utilized an adult sample (n = 247; 53.3% male sex assigned at birth) recruited through Amazon's MTurk prior to the COVID-19 pandemic to investigate associations between PVD, cognitive restraint and compensatory behaviors. Participants completed the Perceived Vulnerability to Disease Scale, Eating Disorder Diagnostic Scale, Dutch Eating Behaviors Questionnaire, and Goldfarb's Fear of Fat Scale. Mediation analyses were used to test our hypotheses. Perceived infectability (PVD-Infection) was associated with cognitive restraint and compensatory behaviors through increased FOF. Perceived germ aversion (PVD-Germ) was associated with cognitive restraint, but FOF did not mediate this association. Sex-stratified analyses revealed no significant sex differences. PVD may be an overlooked factor associated with cognitive restraint and compensatory behaviors in males and females. FOF was an important mediating factor in these associations. Increased engagement in cognitive restraint and compensatory behaviors may reflect attempts to reduce FOF. Future longitudinal research should explore whether PVD is a risk factor for cognitive restraint and compensatory behaviors.

Prevalence of Exercise Addiction and Its Correlation with Body Image Dissatisfaction and Eating Disorders among Physiotherapy Students during COVID-19 Pandemic

Background and Objectives: Exercise addiction (EA) may happen when an individual fails to perform exercise moderately causing exercise to turn into a compulsive behavior. Although there are growing evidence suggested that EA may be comorbid with other issue such as body image dissatisfaction (BID) and eating disorders (ED), however there are limited studies targeted on the Malaysian undergraduate population. Hence, the present study aimed to investigate the prevalence of EA and its relationship with BID and ED among physiotherapy students in Klang Valley, Malaysia during the COVID-19 pandemic. Methods: A cross-sectional study was conducted by sharing the online questionnaires which consists of 3 main components: (i) Exercise Addiction Inventory (EAI) (ii) Body Shape Questionnaire-8C (BSQ-8C) and (iii) Eating Disorder Diagnostic Scale (EDDS) to the physiotherapy students in Klang Valley, Malaysia to assess the risk of EA together with the correlation between EA with BID and EA with ED during the COVID-19 pandemic. Results: A total of 282 students has participated in the study. The prevalence of EA among the physiotherapy undergraduate students during the COVID-19 pandemic was 8.2%. There was a significant correlation between the mean score of EA and BID (p=0.0.037, r=0.124). The correlation between EA and ED was proved significant in the current study (p<0.001, r=0.224). Conclusions: The relatively low prevalence of EA (8.2%) among physiotherapy undergraduates in Klang Valley, Malaysia during the COVID-19 pandemic was observed. There are significant but weak correlations between EA with BID and ED.

Examining associations between symptoms of eating disorders and symptoms of anxiety, depression, suicidal ideation, and perceived family functioning in university students: A brief report.

We examined the relationships between eating disorders symptoms (EDs), suicidal ideation, depressive and anxiety symptoms, and perceived family functioning in a sample of university students aged 18-25 years (N=397). Assessment of symptoms was carried out with the Eating Disorder Diagnostic Scale, Beck Anxiety Inventory and Beck Depression Inventory, among others. We explored the associations between the domains using network analysis. We found that physical anxiety symptoms, followed by cognitive and physical depressive symptoms showed the greatest centrality in the current network. Perceived family functioning was negatively related to eating disorder symptoms. We provide evidence regarding the relevant role of anxiety and depression symptoms in the presentation of ED symptoms in university students. These findings provide new insights to improve preventive interventions to timely reduce symptoms and risk factors associated with EDs. Using a network approach, we found specific associations between physical anxiety symptoms, cognitive and physical depressive symptoms, eating disorders symptoms, suicidal ideation and perceived family functioning in university students. These variables can be potential targets to develop evidence-based preventive strategies in this population. A better understanding of these complex associations and the role of family variables could enhance the effectiveness of interventions in both clinical and educational settings.

The Relationship Between Physical Activity, Body Image, and Eating Disorders During the COVID-19 Pandemic in High-School Girls

Background and aims: Decreased levels of physical activity (PA) during the coronavirus disease 2019 (COVID-19) pandemic can cause physical and psychological problems for individuals. Therefore, the aim of this study was to investigate the relationship between PA, body image, and eating disorders (EDs) during the COVID-19 pandemic among high school girls in Farsan, Iran. Methods: This was a descriptive-analytical cross-sectional study, and the research population included female high school students from Farsan, Iran, who were studying in 2019-2020. In this regard, 535 high school girls (age: 15.95±1.42, weight: 53.07±10.01, BMI: 20.14±3.48) were selected based on cluster-random sampling to participate in the study. Multidimensional Body Self-relation Questionnaire (MBSRQ), Baecke’s Physical Activity Questionnaire, and the Eating Disorder Diagnostic Scale (EDDS) were used to collect data, and Pearson correlation coefficients were administered to establish statistical relationships. Results: The results indicated significant positive correlations between body image and PA levels (r=0.304, P=0.001). However, no significant correlations were observed between body image and anorexia nervosa (AN) (r=-0.035, P=0.424), bulimia nervosa (BN) (r=-0.033, P=0.446), and binge ED (r=-0.041, P=0.339). Likewise, no relationships were observed between PA and AN (r=0.084, P=0.052), BN (r=0.073, P=0.092), as well as binge ED (r=0.071, P=0.099). Conclusion: During the COVID-19 pandemic, PA was positively associated with body image but not with EDs. Based on the obtained results, it can be concluded that PA improved body image in adolescent girls during the COVID-19 pandemic.

Exploring mediation pathways on the relationship between acculturation and binge eating among Latino adolescents

The objective of this study was to explore the mediating effects of emotional eating, restrained eating, and external eating on the relationship between acculturation and binge eating among Latino adolescents. Adolescents who self-identified as Latino (N = 285) at public high schools in Southern California were recruited and completed a self-report survey. Acculturation was assessed using the 8-item Acculturation, Habits, Interests for Multicultural Adolescents (AHIMSA) scale for adolescents, mediators were assessed using Dutch Eating Behavior Questionnaire (DEBQ), and binge eating was assessed using a 13-item Eating Disorder Diagnostic Scale. A bootstrapped multiple mediation model was used to test mediation pathways. Findings suggest that individually each eating style—emotional, restrained and external eating pathway did not reach significance singly, but that jointly, their combined effect was significant with a total indirect effect (B = 0.15, CI 0.01-0.30) indicating an additive effect of the three eating styles. Future research should examine additional mediators of the relationship between acculturation and binge eating.