Symptoms Of Anorexia Nervosa Research Articles

Examining affect and perfectionism in relation to eating disorder symptoms among women with anorexia nervosa

This study examined personality and affective variables in relation to eating disorder symptoms in anorexia nervosa (AN). Women (N=118) with DSM-IV AN completed baseline questionnaires (Beck Depression Inventory, Frost Multidimensional Perfectionism Scale) and interviews (Eating Disorder Examination, Yale-Brown-Cornell Eating Disorder Scale), followed by two weeks of ecological momentary assessment (EMA) involving multiple daily reports of affective states and eating disorder behaviors. Hierarchical regression analyses were conducted using eating disorder symptoms as dependent variables (i.e., EMA binge eating, EMA self-induced vomiting, eating disorder rituals, eating disorder preoccupations, dietary restraint). Predictor variables were maladaptive perfectionism (baseline), depressive symptoms (baseline), and affect lability (EMA). Results revealed that affect lability was independently associated with binge eating, whereas depressive symptoms were independently associated with self-induced vomiting. Depressive symptoms were independently associated with eating disorder rituals, whereas both depressive symptoms and maladaptive perfectionism were independently associated with eating disorder preoccupations. Finally, maladaptive perfectionism and affect lability were both independently associated with dietary restraint. This pattern of findings suggests the importance of affective and personality constructs in relation to eating disorder symptoms in AN and may highlight the importance of targeting these variables in the context of treatment.

Examining weight suppression as a predictor of eating disorder symptom trajectories in anorexia nervosa.

Research in individuals with bulimia nervosa has highlighted the clinical significance of weight suppression (WS), defined as the difference between one's highest and current weight. More recently, studies have suggested that WS also may play a role in symptom maintenance and weight gain during treatment in anorexia nervosa (AN) and that the influence of WS on AN outcomes may depend on an individual's body mass index (BMI). However, no study has investigated whether WS or the interaction between WS and BMI is associated with the longer-term course of eating pathology following treatment discharge in patients with AN. The current study examined a sample of females with AN (N = 180) who completed interviews and self-report questionnaires at discharge from intensive treatment and at 3, 6, and 12-months after discharge. Latent growth curve models tested whether WS, BMI, or the WS by BMI interaction significantly predicted the trajectory of eating disorder symptoms (i.e., Eating Disorder Examination global score, BMI, frequency of loss of control eating, frequency of purging) over the year following discharge. WS at discharge predicted change in BMI, and the interaction between WS and BMI predicted growth in eating disorder severity and purging frequency over time. Neither WS nor its interaction with BMI predicted growth in loss of control eating frequency. Results provide further support for the clinical significance of WS in AN symptom maintenance, but suggest that the influence of WS likely depends on an individual's BMI as well as the outcome being measured. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2016; 49:753-763).

A Randomised Controlled Trial of Neuronavigated Repetitive Transcranial Magnetic Stimulation (rTMS) in Anorexia Nervosa.

BackgroundAnorexia nervosa (AN) is associated with morbid fear of fatness, extreme food restriction and altered self-regulation. Neuroimaging data implicate fronto-striatal circuitry, including the dorsolateral prefrontal cortex (DLPFC).MethodsIn this double-blind parallel group study, we investigated the effects of one session of sham-controlled high-frequency repetitive transcranial magnetic stimulation (rTMS) to the left DLPFC (l-DLPFC) in 60 individuals with AN. A food exposure task was administered before and after the procedure to elicit AN-related symptoms.OutcomesThe primary outcome measure was ‘core AN symptoms’, a variable which combined several subjective AN-related experiences. The effects of rTMS on other measures of psychopathology (e.g. mood), temporal discounting (TD; intertemporal choice behaviour) and on salivary cortisol concentrations were also investigated. Safety, tolerability and acceptability were assessed.ResultsFourty-nine participants completed the study. Whilst there were no interaction effects of rTMS on core AN symptoms, there was a trend for group differences (p = 0.056): after controlling for pre-rTMS scores, individuals who received real rTMS had reduced symptoms post-rTMS and at 24-hour follow-up, relative to those who received sham stimulation. Other psychopathology was not altered differentially following real/sham rTMS. In relation to TD, there was an interaction trend (p = 0.060): real versus sham rTMS resulted in reduced rates of TD (more reflective choice behaviour). Salivary cortisol concentrations were unchanged by stimulation. rTMS was safe, well–tolerated and was considered an acceptable intervention.ConclusionsThis study provides modest evidence that rTMS to the l-DLPFC transiently reduces core symptoms of AN and encourages prudent decision making. Importantly, individuals with AN considered rTMS to be a viable treatment option. These findings require replication in multiple-session studies to evaluate therapeutic efficacy.Trial Registrationwww.Controlled-Trials.com ISRCTN22851337

Risk factors and the prevalence of anorexia nervosa among female students in Serbia.

The widespread symptoms of anorexia netvosa (AN) in young women require to draw professional attention to this problem in Serbia. In previous research on AN, insecure attachment styles, perfectionism and concerns about body shape were identified as notable risk factors. The aim of this study was to identify the prevalence of AN among female students and assess the importance of these factors in its development. The Eating Attitudes Test (EAT-40), the Experiences in Close Relationships Scale (ECR), the Frost Multidimensional Perfectionism Scale (FMPS) and the Body Shape Questionnaire (BSQ) were applied to a sample of 500 randomly selected female students of the University of Belgrade, the mean age of 22.44 years (min 18, max 35). In addition, Body Mass Index (BMI) was also calculated. Although 38 (7.6%) female students displayed symptoms of AN (EAT > 30) and 13 (2.6%) had BMI indicating anorexia nervosa syndrome (B4I < or = 17.50 kg/m2), only 1 (0.2%) student fulfilled both criteria. The majority of female students (60.4%) had some type of insecure attachment style. There is a significant influence of attachment styles on symptoms of AN: female students with insecure attachment styles have a significantly higher mean score on the EAT compared to those with secure attachment style (F = 7.873; p < 0.01). There was a positive correlation between scores on the EAT and FMPS (r = 0.217;p < 0.01), and scores on the EAT and BSQ (r = 0.388; p < 0.01). The obtained results show the prevalence of AN of 0.2% among female students and indicate the importance of insecure attachment styles, perfectionism and concern about body shape as risk factors. Activities for the prevention of AN in this subpopulation should include internet-based therapy and special counseling services with specific programs focusing on emotion-regulation skills through mindfulness, acceptance and commitment techniques, as well as specific cognitive-behavioral techniques.

Seeing things differently: An experimental investigation of social cognition and interpersonal behavior in anorexia nervosa.

Interpersonal difficulties among individuals with anorexia nervosa (AN) may stem in part due to misperceiving social cues. The current study investigated social functioning by comparing interpersonal self-efficacy, perceptions of dominance/submission (i.e., agency) and coldness/warmth (i.e., communion), and hypothetical behavioral reactions among individuals with and without AN. Seventy-seven women (AN/Other Specified Feeding or Eating Disorder OSFED-AN n = 41, nonclinical comparison group n = 36) completed questionnaires assessing mood symptoms and interpersonal self-efficacy, followed by an experimental video-rating task in which they received critical feedback from job supervisors varying in degrees of agency and communion. AN respondents perceived more coldness overall, even after adjusting for differences in depression and anxiety symptoms, and tended to respond with coldness even to videos that they perceived as being warm. However, perceptual accuracies for agency were similar across groups. Interpersonal self-efficacy moderated the relationship between diagnostic status and behavioral responses: among those who felt competent being cold-submissive, AN respondents selected cold-submissive responses more frequently than did the nonclinical comparison group. Among those with AN symptoms, there may be a tendency toward social perceptual inaccuracies regarding communion and non-complementary cold behavioral responses. Results suggest that improving social perceptions may be a fruitful intervention target for enhancing interpersonal functioning among individuals with AN. © 2015 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:499-506).

An examination of the impact of care giving styles (accommodation and skilful communication and support) on the one year outcome of adolescent anorexia nervosa: Testing the assumptions of the cognitive interpersonal model in anorexia nervosa

BackgroundThe cognitive interpersonal model predicts that parental caregiving style will impact on the rate of improvement of anorexia nervosa symptoms. The study aims to examine whether the absolute levels and the relative congruence between mothers' and fathers' care giving styles influenced the rate of change of their children's symptoms of anorexia nervosa over 12 months. MethodsTriads (n=54) consisting of patients with anorexia nervosa and both of their parents were included in the study. Caregivers completed the Caregiver Skills scale and the Accommodation and Enabling Scale at intake. Patients completed the Short Evaluation of Eating Disorders at intake and at monthly intervals for one year. Polynomial Hierarchical Linear Modeling was used for the analysis. ResultsThere is a person/dose dependant relationship between accommodation and patients' outcome, i.e. when both mother and father are highly accommodating outcome is poor, if either is highly accommodating outcome is intermediate and if both parents are low on accommodation outcome is good. Outcome is also good if both parents or mother alone have high levels of carer skills and poor if both have low levels of skills. LimitationsIncluding only a sub-sample of an adolescent clinical population; not considering time spent care giving, and reporting patient's self-reported outcome data limits the generalisability of the current findings. ConclusionAccommodating and enabling behaviours by family members can serve to maintain eating disorder behaviours. However, skilful behaviours particularly by mothers, can aid recovery. Clinical interventions to optimise care giving skills and to reduce accommodation by both parents may be an important addition to treatment for anorexia nervosa.

Specialist supportive clinical management (SSCM) for anorexia nervosa: Content analysis, change over course of therapy, and relation to outcome

Specialist Supportive Clinical Management (SSCM) is a psychotherapy with promising potential for the treatment of anorexia nervosa. SSCM has two distinct components: clinical management, which involves alleviation of the symptoms of anorexia nervosa, particularly focusing on weight gain via resumption of eating; and a supportive psychotherapeutic approach to issues identified by the patient as important. The current study aimed to categorise, quantify and describe SSCM content across outcomes and over the course of therapy. SSCM therapy transcripts from ten participants in the original clinical trial of SSCM for anorexia nervosa were examined using thematic and content qualitative analyses. Clinical management content declined over time, whereas supportive psychotherapy content increased. Overall, there was more clinical management content for participants with a good outcome relative to participants with a poor outcome

Using the Activity-based Anorexia Rodent Model to Study the Neurobiological Basis of Anorexia Nervosa

Anorexia nervosa (AN) is a psychiatric illness characterized by excessively restricted caloric intake and abnormally high levels of physical activity. A challenging illness to treat, due to the lack of understanding of the underlying neurobiology, AN has the highest mortality rate among psychiatric illnesses. To address this need, neuroscientists are using an animal model to study how neural circuits may contribute toward vulnerability to AN and may be affected by AN. Activity-based anorexia (ABA) is a bio-behavioral phenomenon described in rodents that models the key symptoms of anorexia nervosa. When rodents with free access to voluntary exercise on a running wheel experience food restriction, they become hyperactive – running more than animals with free access to food. Here, we describe the procedures by which ABA is induced in adolescent female C57BL/6 mice. On postnatal day 36 (P36), the animal is housed with access to voluntary exercise on a running wheel. After 4 days of acclimation to the running wheel, on P40, all food is removed from the cage. For the next 3 days, food is returned to the cage (allowing animals free food access) for 2 hr daily. After the fourth day of food restriction, free access to food is returned and the running wheel is removed from the cage to allow the animals to recover. Continuous multi-day analysis of running wheel activity shows that mice become hyperactive within 24 hr following the onset of food restriction. The mice run even during the limited time during which they have access to food. Additionally, the circadian pattern of wheel running becomes disrupted by the experience of food restriction. We have been able to correlate neurobiological changes with various aspects of the animals’ wheel running behavior to implicate particular brain regions and neurochemical changes with resilience and vulnerability to food-restriction induced hyperactivity.

Using the Activity-based Anorexia Rodent Model to Study the Neurobiological Basis of Anorexia Nervosa

Anorexia nervosa (AN) is a psychiatric illness characterized by excessively restricted caloric intake and abnormally high levels of physical activity. A challenging illness to treat, due to the lack of understanding of the underlying neurobiology, AN has the highest mortality rate among psychiatric illnesses. To address this need, neuroscientists are using an animal model to study how neural circuits may contribute toward vulnerability to AN and may be affected by AN. Activity-based anorexia (ABA) is a bio-behavioral phenomenon described in rodents that models the key symptoms of anorexia nervosa. When rodents with free access to voluntary exercise on a running wheel experience food restriction, they become hyperactive – running more than animals with free access to food. Here, we describe the procedures by which ABA is induced in adolescent female C57BL/6 mice. On postnatal day 36 (P36), the animal is housed with access to voluntary exercise on a running wheel. After 4 days of acclimation to the running wheel, on P40, all food is removed from the cage. For the next 3 days, food is returned to the cage (allowing animals free food access) for 2 hr daily. After the fourth day of food restriction, free access to food is returned and the running wheel is removed from the cage to allow the animals to recover. Continuous multi-day analysis of running wheel activity shows that mice become hyperactive within 24 hr following the onset of food restriction. The mice run even during the limited time during which they have access to food. Additionally, the circadian pattern of wheel running becomes disrupted by the experience of food restriction. We have been able to correlate neurobiological changes with various aspects of the animals’ wheel running behavior to implicate particular brain regions and neurochemical changes with resilience and vulnerability to food-restriction induced hyperactivity.

Impaired processing of self-face recognition in anorexia nervosa.

Body image disturbances and massive weight loss are major clinical symptoms of anorexia nervosa (AN). The aim of the present study was to examine the influence of body changes and eating attitudes on self-face recognition ability in AN. Twenty-seven subjects suffering from AN and 27 control participants performed a self-face recognition task (SFRT). During the task, digital morphs between their own face and a gender-matched unfamiliar face were presented in a random sequence. Participants' self-face recognition failures, cognitive flexibility, body concern and eating habits were assessed with the Self-Face Recognition Questionnaire (SFRQ), Trail Making Test (TMT), Body Shape Questionnaire (BSQ) and Eating Disorder Inventory-2 (EDI-2), respectively. Subjects suffering from AN exhibited significantly greater difficulties than control participants in identifying their own face (p=0.028). No significant difference was observed between the two groups for TMT (all p>0.1, non-significant). Regarding predictors of self-face recognition skills, there was a negative correlation between SFRT and body mass index (p=0.01) and a positive correlation between SFRQ and EDI-2 (p<0.001) or BSQ (p<0.001). Among factors involved, nutritional status and intensity of eating disorders could play a part in impaired self-face recognition.

Does childhood bullying predict eating disorder symptoms? A prospective, longitudinal analysis.

Bullying is a common childhood experience with enduring psychosocial consequences. The aim of this study was to test whether bullying increases risk for eating disorder symptoms. Ten waves of data on 1,420 participants between ages 9 and 25 were used from the prospective population-based Great Smoky Mountains Study. Structured interviews were used to assess bullying involvement and symptoms of anorexia nervosa and bulimia nervosa as well as associated features. Bullying involvement was categorized as not involved, bully only, victim only, or both bully and victim (bully-victims). Within childhood/adolescence, victims of bullying were at increased risk for symptoms of anorexia nervosa and bulimia nervosa as well as associated features. These associations persisted after accounting for prior eating disorder symptom status as well as preexisting psychiatric status and family adversities. Bullies were at increased risk of symptoms of bulimia and associated features of eating disorders, and bully-victims had higher levels of anorexia symptoms. In terms of individual items, victims were at risk for binge eating, and bully-victims had more binge eating and use of vomiting as a compensatory behavior. There was little evidence in this sample that these effects differed by sex. Childhood bullying status was not associated with increased risk for persistent eating disorder symptoms into adulthood (ages 19, 21, and 25). Bullying predicts eating disorder symptoms for both bullies and victims. Bullying involvement should be a part of risk assessment and treatment planning for children with eating problems.

Caractéristiques associées à l’attachement insécure dans l’anorexie mentale

ObjectivesThe aim of the study is to assess whether insecure attachment based on the model developed by Bartholomew and Horowitz (1991) is associated with more severe symptoms in anorexia nervosa, including self-esteem, personal concerns and disease severity. This attachment-based model, inspired by the theory of Bowlby, is conceptualized on two dimensions: Thoughts of self and thoughts of others. MethodOnly patients with anorexia nervosa have been taken in the study, with a screening using the Mini International Neuropsychiatric Interview (MINI). Based on Bartholomew and Horowitz attachment theory, all new patients with anorexia nervosa at the Nantes University Hospital addiction service were classified according to their mode of attachment (secure versus insecure) and scores on the Relationship Scales Questionnaire (RSQ). Scores assessing bodily concerns (Body Shape Questionnaire), self-esteem (Rosenberg scale) and disease severity (Morgan-Russell Scale) were then compared with a Wilcoxon test. In addition, we took into account body mass index (BMI), age and type of anorexia because these parameters could affect our variables. ResultsThe prevalence of insecure attachment was high (82.8%) in our sample with a higher value for the preoccupied attachment style. Patients in the insecure group have a particular profile and have a more severe psychopathology: Lower self-esteem, more important bodily concerns and lower scores on Russell and Morgan Scale. Statistical analysis showed no significant difference between the two groups on the variables BMI, age and type of anorexia. DiscussionThese results highlight the high prevalence of insecure attachment among patients with anorexia nervosa. They also invite clinicians to therapeutic strategies focusing on attachment and how to help these patients to work on their relationship difficulties.

The two dimensions of the body representation in women suffering from Anorexia Nervosa

A core symptom of Anorexia Nervosa (AN) is a severe alteration of body representations. Evidence from somatoperception studies point to a generic disturbances of somatosensory components of body representations. Here we have investigated whether AN patients (N=18) and controls differed in the perception of tactile stimuli differently oriented along the body axes. We tested the hypothesis that patients perceive and represent their body selectively larger in only one dimension. To this aim we used elementary tactile measures for tactile acuity (Von Frey's test and two-point discrimination thresholds – 2PD) and tactile discrimination measures. The rationale is based on the assumption that AN patients have a wider body representation, and that tactile body representation tasks (Tactile Distance task) oriented across the bodies (horizontally) are influenced by distorted body representations compared with tactile stimuli oriented along the bodies (vertically) which should not be influenced by body representations. Results showed that patients judged horizontal tactile stimuli significantly wider than the same stimuli oriented vertically.These results suggest that human brain perceives things differently based on body representations and that the beliefs concerning body size influence the specific somatosensory process of tactile experience.

Gender differences in the magnitude of the associations between eating disorders symptoms and depression and anxiety symptoms. Results from a community sample of adolescents

Background: Studies reporting comorbidities of eating disorders (EDs) with depression and anxiety disorders during adolescence used clinical samples of female adolescents with few attempts to present the magnitude of these associations in population-based samples and to assess gender differences in the strength of these associations.Aims: This study assesses significant gender differences in the association of anorexia nervosa (AN) and bulimia nervosa (BN) symptoms with depression and generalized anxiety symptoms in a community sample of adolescents.Method: We collected anonymous self-reported data from 235 adolescent boys and 471 adolescent girls, through an online platform. To identify correlations between symptoms of AN and BN, and symptoms of depression and generalized anxiety, we used the Mann–Whitney U test. To identify differences between independent correlation coefficients, we converted each correlation coefficient into a z-score using Fisher's r-to-z transformation and, making use of the sample size employed to obtain each coefficient, we compared the z-scores.Results: The magnitude of the associations between EDs symptomatology and depression and anxiety symptomatology was similar in adolescent boys and girls.Conclusion: Our results show an urgent need to address EDs prevention in adolescent girls and boys from the community.

Dynamic longitudinal relations between emotion regulation difficulties and anorexia nervosa symptoms over the year following intensive treatment.

Emotion regulation difficulties have been implicated in theoretical models of anorexia nervosa (AN) development/maintenance, and several treatments for AN have been designed to target emotion dysregulation. However, no research has used longitudinal methodology to examine whether emotion regulation difficulties predict the maintenance of AN symptoms, or vice versa. The current study evaluated dynamic longitudinal relations between emotion dysregulation and AN symptom severity over the year following discharge from intensive treatment in order to enhance theoretical models and treatments for AN. Participants were 191 patients with AN recruited during intensive treatment. Assessments including the Eating Disorders Examination and the Difficulties in Emotion Regulation Scale were completed at discharge from treatment and at 3-, 6-, and 12-month follow-ups. Bivariate latent change score models were used to examine the direction of associations between emotion dysregulation and AN symptom severity across time. Emotion dysregulation predicted change in AN symptom severity, but the reverse relationship did not occur. Individuals with high levels of emotion dysregulation experienced an increase and subsequent maintenance of AN psychopathology, whereas low emotion dysregulation predicted a decreasing AN symptom trajectory. Importantly, these dynamic temporal relationships could not be accounted for by body mass index or depressive symptoms and were present for patients with the restricting and binge-eating/purging subtypes of AN. Emotion regulation difficulties appear to be involved in the maintenance of AN symptom severity over time. Findings provide support for an increasing emphasis on emotion regulation in the development of novel treatments for AN.

The Practice of Holy Fasting in the Late Middle Ages: A Psychiatric Approach.

During the Late Middle Ages, the practice of fasting among religious women in an attempt to follow a pious and ascetic life was common. In this paper, three cases of medieval religious women are described with a particular attention to the figure of St. Catherine of Siena, her life, popularity, and iconography. In the Middle Ages, holy fasting was characterized by a refusal to eat that could involve binging and purging, lack of menstruation, an interest in cooking for others, and in some cases death due to inanition. In the Medieval narratives of fasting holy women, we can see patterns that are compatible with symptoms of anorexia nervosa. From a psychiatric perspective, it is possible to elucidate and understand the practice of fasting among religious people in the Late Middle Ages.

Altered Insula Activity during Visceral Interoception in Weight-Restored Patients with Anorexia Nervosa.

Anorexia nervosa (AN) is a devastating psychiatric illness that is associated with significant morbidity and mortality. Aberrant visceral interoceptive processing within the insula has been hypothesized to be an important mechanism in AN's pathophysiology due to the theoretical link between interoception and emotional experience. We therefore utilized functional magnetic resonance imaging (fMRI) to examine whether altered insula functioning underlies visceral interoception in AN. Fifteen females with restricting-type AN and 15 healthy control females underwent fMRI while performing an interoceptive attention task during which they focused on sensations in their heart, stomach, and bladder. Participants also performed an anxious rumination task while in the scanner. AN participants were weight-restored and free of psychotropic medications. Two distinct regions of the insula-anterior insula and dorsal mid-insula-exhibited a significant (p<0.05) interaction between group and interoceptive modality. The post hoc analyses revealed that in the dorsal mid-insula the interaction was driven by group differences during stomach interoception (p=0.002, Bonferroni corrected), whereas in the anterior insula the interaction was driven by group differences during heart interoception (p=0.03, Bonferroni corrected). In addition, individuals with AN displayed increased activation during anxious rumination in the dorsal mid-insula, and activation in this region during stomach interoception was correlated with measures of anxiety and psychopathology. This relationship between altered visceral interoception and clinical symptoms in AN suggests an important mechanism for the disorder. Additional research is needed to examine whether interventions targeting visceral interoception may increase the efficacy of treatments for AN.

Examining the associations between emotion regulation difficulties, anxiety, and eating disorder severity among inpatients with anorexia nervosa

ObjectiveThere is growing interest in the role of emotion regulation in anorexia nervosa (AN). Although anxiety is also hypothesized to impact symptoms of AN, little is known about how emotion regulation, anxiety, and eating disorder symptoms interact in AN. In this study, we examined the associations between emotion regulation, anxiety, and eating disorder symptom severity in AN. MethodsQuestionnaires and interviews assessing emotion regulation difficulties, anxiety, eating disorder symptoms, and eating disorder-related clinical impairment were collected from group of underweight individuals with AN (n=59) at admission to inpatient treatment. Hierarchical linear regressions were used to examine the associations of emotion regulation difficulties, anxiety, and the interaction of these constructs with eating disorder symptoms and eating disorder-related clinical impairment. ResultsEmotion regulation difficulties were significantly positively associated with eating disorder symptoms and related clinical impairment only when anxiety levels were low and anxiety was significantly positively associated with eating disorder symptoms and related clinical impairment only when emotion regulation problems were not elevated. ConclusionsThis study adds to a growing literature suggesting that emotion regulation deficits are associated with eating disorder symptoms in AN. Certain individuals with AN may especially benefit from a focus on developing emotion regulation skills in the acute stages of illness.

Disordered eating and alcohol use among college women: Associations with race and big five traits

Excessive alcohol use and disordered eating are considerable health-related problems among college women. The purpose of the present study was to examine how specific patterns of disordered eating (i.e., anorexia, bulimia, binge eating) are related to alcohol use and related problems and the influence of racial group membership and Big Five personality traits on the co-occurrence of these behaviors. Participants were 153 undergraduate women. Results indicated that White women reported more binge drinking, alcohol-related problems, disordered eating, anorexia nervosa symptoms, and bulimia nervosa symptoms than non-White women. Women with higher levels of openness and who engage in extreme exercise, dieting, fasting, or purging were more at risk for heavy and problematic alcohol use. Implications for the treatment of co-occurring disorders among college students and further research are discussed.

Positive beliefs about anorexia nervosa and muscle dysmorphia are associated with eating disorder symptomatology.

The ego-syntonic nature of anorexia nervosa means that sufferers often deny their symptoms or experience them as positive or comforting. Positive beliefs about eating disorder symptoms may contribute to the development and/or maintenance of eating-disordered behaviour. To date, however, research in this field has been confined to women and anorexia nervosa. Given increasing scientific interest in muscle dysmorphia, a potential eating disorder with ego-syntonic qualities, there is a need to extend current research to include men and muscle dysmorphia. The present study examined whether positive beliefs about anorexia nervosa and muscle dysmorphia were associated with more marked eating disorder symptoms and explored sex differences in these associations. Male and female university students (n = 492) read descriptions of a male or female character with clinically significant symptoms of anorexia nervosa or muscle dysmorphia. Participants subsequently answered questions about the characters and completed a measure of disordered eating. Knowledge, personal history and interpersonal familiarity with the conditions were assessed. Results from two simultaneous multiple regressions showed that more positive beliefs about anorexia nervosa and muscle dysmorphia were uniquely associated with more eating disorder symptoms for both male and female participants. Effect sizes for these relationships were medium to large (partial eta-squared = 0.09-0.10). The relationships were not moderated by the sex of the participant, nor the sex of the character. Although preliminary, these findings suggest that, among young men and women, positive beliefs about anorexia nervosa and muscle dysmorphia may contribute to the development and maintenance of these conditions. Some symptoms of muscle dysmorphia may be perceived as ego-syntonic, providing another parallel with anorexia nervosa.