Annie Aimé

Developmental pathways of eating problems in adolescents

OBJECTIVE To examine the developmental eating trajectories of adolescents and identify psychological correlates and risk factors associated with those trajectories. METHOD Seven hundred thirty-nine adolescents completed self-reported measures of eating problems, internalizing and externalizing behaviors, alcohol and drug use, peer victimization, and depression. RESULTS Five eating trajectories were obtained. The proportions of males and females were the same in the increasing eating problems trajectory. For both genders, internalizing and externalizing problems were identified as associated risk factors of an eating pathology and reporting at least some eating problems was associated with an increased likelihood of psychological problems. Other risk factors found only in boys were frequency of drug use, victimization, and depressive symptoms. CONCLUSION Externalizing problems in girls and internalizing behaviors in boys with disordered eating should not be overlooked. Atypical eating behaviors in boys are of particular concern since it increases their risk of cooccurring psychopathology.

Lifestyle interventions targeting changes in body weight and composition among youth with an intellectual disability: A systematic review

Over the past three decades, the potential effects of lifestyle interventions targeting changes in body weight and composition (weight, body mass index, fat mass, waist circumference) among adults with an intellectual disability (ID) have been examined in various systematic reviews. Nevertheless, since the middle of the 1980s, the potential effects of these interventions for youth with an ID remain an open question. The purpose of this article is to review the effects of lifestyle interventions targeting changes in body weight and composition among youth with an ID. This review will focus on changes in body weight and composition, healthy lifestyle, and secondary health conditions. A systematic review of English- and French-language studies, published between 1981 and 2013, was performed on Academic Search Complete, PsycARTICLES, Medline and Scopus. The nine studies included in this review focused mainly on: a sample with a wide age range (e.g., 7-22 years); males; overweight-obese youth having a mild-to-moderate ID with Down or Prader-Willi syndrome; physical activity interventions; cohort pre- and post-test designs with/without a control group; and changes in body weight and composition. Taken together, results from these studies suggest successful changes in weight, body mass index and fat mass. However, intervention effects on healthy lifestyle and secondary health conditions are scarce and inconclusive. Given the weaknesses of the reviewed studies, the present findings should be considered preliminary and indicative of the need for future research.

Characteristics of Individuals With Insomnia Who Seek Treatment in a Clinical Setting Versus Those Who Volunteer for a Randomized Controlled Trial

The generalizability of outcome data derived from insomnia clinical trials is based largely on the extent to which research volunteers resemble clinical patients. This study compared sociodemographic, sleep, psychological, and medical characteristics of individuals who volunteered for an insomnia treatment study (n = 120) to patients who sought treatment in a clinical setting (n = 106). The samples did not differ on most sleep and medical variables, but clinical patients had a higher prevalence of mood disorders, greater anxiety and depression symptoms, and higher perceived insomnia severity. Differences on psychological variables were accentuated by the research selection process. It is suggested to minimize exclusion based on psychological comorbidity in order to enhance ecological validity of randomized controlled trials of insomnia treatments.

Comorbid Diabetes and Eating Disorders in Adult Patients Assessment and Considerations for Treatment

Purpose The lack of research concerning treatment for individuals with diabetes mellitus (DM) and comorbid eating disorders (ED) contributes to the gulf between the psychosocial needs of individuals with the two conditions and the treatment they receive. Empirical evidence has established that the prognosis of patients with this comorbid diagnosis (ED-DM) is poor in the absence of a specialized DM treatment specifically adapted to ED. In individuals with DM, comorbid ED is associated with numerous complications. Despite these interactions, current knowledge about the comorbid diagnosis is limited, and eating disorders in patients with diabetes often remain undiagnosed. This article presents standard procedures for assessment and optimal therapeutic interventions for patients with ED and DM. Conclusion In patients with diabetes, problematic eating behaviors and symptoms should be assessed routinely. When an eating disorder is detected, diabetes management needs to be adapted, binge eating or medication misuse needs to be addressed, and eating disorder specialists should be included in the multidisciplinary team.

The eating disturbed spectrum in relation with coping and interpersonal functioning

Although much has been written with regards to the interpersonal functioning of eating-disordered women, research in the domain of eating disorders (ED) has still overlooked the complex relationships between stressful life events, coping styles, social and marital support while considering the ED spectrum. OBJECTIVE: This study evaluates to what extent stressful life events, coping styles, and social support represent useful concepts for differentiating between four groups of participants with varying severity of eating preoccupations and disturbances. METHOD: One hundred twenty-five participants were divided into four groups: 40 women suffering from ED, 21 women in remission from an ED, 33 women with intense weight and shape preoccupations, and 31 women without eating preoccupations. Each participant completed the Eating Disorder Evaluation, as well as questionnaires concerning stressful life events, coping styles, social support, and couple satisfaction. RESULTS: There were significant differences between the groups in terms of negative impact of stressful events, social support, as well as task-oriented and emotion-oriented coping styles. Significant differences were not found between the groups for couple satisfaction. CONCLUSION: It appears that accurate cognitive appraisal of stressful situations, adaptive coping styles and improvement of the social network represent interesting dimensions to include in prevention and treatment programs for ED. Moreover, for women in remission from an ED, an effective relapse prevention strategy could be to learn to make better use of their social network.

Prevalence and correlates of bullying perpetration and victimization among school-aged youth with intellectual disabilities: A systematic review.

Recent literature reviews show that bullying perpetration and victimization are major public health concerns for typically developing (TD) youth. Nevertheless, the magnitude of this phenomenon among youth with intellectual disabilities (ID) remains unclear. Therefore, the purpose of this review is to provide a synthesis of the empirical studies examining the prevalence and correlates of bullying perpetration and victimization among youth with ID. A systematic literature search was performed and 11 studies met the inclusion criteria. The findings from these studies showed weighted mean prevalence rates of general bullying perpetration, bullying victimization and both of 15.1%, 36.3%, and 25.2%, respectively. Weighted mean prevalence rates of bullying perpetration and victimization differed according to the characteristics of the studies (e.g., assessment context, school setting, information source, type of measures, time frame). Additionally, high weighted mean prevalence rates of physical (33.3%), verbal (50.2%), relational (37.4%), and cyber (38.3%) victimization were found among youth with ID. When youth with ID were compared to youth with other disabilities or TD peers, no clear differences were found. Finally, the present review shows that correlates of bullying perpetration and victimization in this population remain understudied.

Heterogeneity of sex-stratified BMI trajectories in children from 8 to 14 years old.

OBJECTIVE Describe and predict sex-stratified trajectories of weight change in youths transitioning from childhood to adolescence. METHODS Using an accelerated longitudinal design, 461 children between 8 and 12 years old at baseline were followed over three years. Body mass index was calculated from self-reported height and weight. Latent class growth analysis was used to identify BMI trajectories and multinomial logistic regressions, to predict group membership. RESULTS A four-group heterogeneous trajectory model emerged for boys and girls alike. Characteristics of the trajectories differed between sexes and no obesity group was found for boys. Sociocultural factors, such as media influence, body dissatisfaction, weight victimization, awareness of thin-ideal standards and related pressures were important correlates of trajectory membership. CONCLUSION BMI trajectories during preadolescence are stable over time for heavier children. Body image concerns and weight stigmatization stand out as important factors in the prediction of developmental weight trajectories and could therefore be integrated in weight gain prevention programs for children of all weights as well as in weight management interventions for overweight and obese children.

Trajectories of Eating and Clinical Symptoms Over the Course of a Day Hospital Program for Eating Disorders

Although it is well-established that day hospital programs for eating disorders significantly reduce clinical symptoms, the pre-test/post-test designs that were previously used do not provide information regarding the trajectory of symptoms during treatment. This study observed, on a weekly basis, the evolution of symptoms of 61 women suffering from eating disorders engaged in a day hospital program, and compared the trajectories of specific subgroups of patients. Results show that (a) the first half of the program was crucial for symptom changes; (b) although completers and non-completers presented similar initial improvement, their trajectories rapidly differentiated; and (c) poorer respondents initially reported more symptoms, showed a slower improvement, and never reached the non-clinical zone, whereas better-respondents reached the non-clinical cut-off point more rapidly.

Predictors of Comorbid Eating Disorders and Diabetes in People with Type 1 and Type 2 Diabetes

OBJECTIVES The objective of this study was to identify psychosocial predictors of comorbid eating disorders (EDs) in individuals with type 1 and type 2 diabetes. METHODS In this cross-sectional study, 140 people with diabetes answered an online survey covering sociodemographic information, body esteem, restrictive eating, medication omission, coping styles and depressive symptoms. Participants were recruited through advertisements on more than 100 websites, including forums, community organizations and Facebook groups focusing on either diabetes or EDs. Recruitment took place in Canada, Europe, Australia and the United States. RESULTS On average, EDs developed after diabetes diagnoses in participants with type 1 diabetes but prior to diabetes diagnosis in participants with type 2 diabetes. In type 1 diabetes, avoidance coping styles and depressive symptoms predicted an additional diagnosis of EDs. Co-occurring EDs and type 2 diabetes were predicted by body mass indexes and task-oriented coping strategies. CONCLUSIONS Variables potentially influencing the development of EDs in people with diabetes differ according to the type of diabetes, body mass indexes, coping styles and depressive symptoms; they should be more systematically evaluated and closely monitored. In the context of diabetes management, prevention strategies for ED onset based on increased knowledge of the risk factors associated with EDs are necessary and could help decrease the risk for the health complications of diabetes.

Psychometric properties of the Weight Self-Stigma Questionnaire (WSSQ) among a sample of overweight/obese French-speaking adolescents

PurposeThe Weight Self-Stigma Questionnaire (WSSQ) was recently developed to assess the internalization of weight stigma among English-speaking overweight and obese adults. The objective of the present study was to develop and examine the psychometric properties of a French version of the WSSQ, as well as its applicability to adolescents.MethodsThe sample comprised 156 overweight and obese adolescents (81 boys, 75 girls, Mage = 16.31). The factor validity and the convergent validity of the French version of the WSSQ were examined using a confirmatory factor analysis and a structural equation model, respectively.ResultsThe a priori two-factor structure of the WSSQ and the composite reliability of its subscales (self-devaluation and fear of enacted stigma) were supported. Convergent validity analyses revealed that both WSSQ subscales were significantly and (a) negatively correlated with measures of self-esteem and physical appearance, and (b) positively correlated with measures of anxiety, depression, fear of negative appearance evaluation, and eating-related pathology (fear of getting fat, eating-related control, food preoccupation, vomiting-purging behaviors, and eating-related guilt subscales). However, no significant relation was found between the WSSQ subscales and body mass index.ConclusionThese results suggest that the French version of the WSSQ has acceptable psychometric properties and can be used to assess weight self-stigma among overweight and obese adolescents.