Bridget Dolan

Cross-cultural aspects of anorexia nervosa and bulimia: A review

This review pulls together information about ethnicity and eating disorders from a variety of case series, epidemiological surveys, and clinical case reports in recent scientific literature

Cultural factors in the eating disorders: A study of body shape preferences of Arab students

A replication of an American study of body shape preference was conducted in a group of 218 Arab students attending the American University in Cairo, Egypt. Arab female students felt their ideal shape to be significantly thinner than their current shape, while male students did not. Hence the appraisal of body shape shows gender differences in Egypt consistent with the American study. The Arab women reported a current shape similar to American women but had a smaller discrepancy between ratings of their ideal and current body shape. There was no difference for either Arab women or men between the shape thought most attractive to the opposite sex and that which the other gender actually reported as most attractive. The study shows a clear preference for thinness in the Arabic culture, inferences are made to its role in predisposing to eating disorders.

Body image distortion in non-eating disordered women and men

This study of body image perception in 100 non-eating disordered women and men demonstrates that overperception of body widths, whilst accurately perceiving a neutral object, is not restricted to populations with eating disorders, nor is it peculiar to women. Men consistently overestimated body widths to the same extent as female subjects. Overall, 84% of women and 52% of men wished to weigh less. Considering those subjects within the 10% range of Mean Matched Population Weight (MMPW), men wished to be 0.75 kg heavier, whilst women at MMPW wished to weigh 3.25 kg less. For women, the subjects who were most satisfied with their actual weight were those who were well below MMPW. There is a tendancy that the greater the deviation of weight from normal, in either direction, the greater the degree of body width overestimation. These results suggest that the overperception of body width is more related to current weight than to concern about weight and shape, or to the presence or absence of an eating disorder. They question the use of empirical body size estimation measurement in eating disordered populations.

Special women, special needs: A descriptive study of female special hospital patients

All 87 women patients who were detained in Broadmoor Hospital during the first 6 months of 1994 are described in terms of their demographic and offence characteristics, their behaviours prior to and during admission, their diagnostic categories and treatment needs. Histories of sexual victimization and physical abuse were present in a substantial number of the population. Acts of self-harm represented a more significant management problem (present in 94% of women) than aggression towards others. The most common behaviours leading to admission were assault (71.3%) and arson (47.1%), although 23% of the women had not been convicted of any offence. The findings are discussed with reference to the need to develop within secure settings psychotherapeutic approaches that reflect the complexity of these womens lives as well as the multiple levels of trauma most have experienced.

Therapeutic Community Treatment for Personality Disordered Adults: Changes in Neurotic Symptomatology on Follow-Up

Personality disordered patients are important as they place high continuing demands on services and are often refractory to traditional treatments. Often personality disorders may co-exist with neurotic symptomatology, worsening prognosis of the latter. This paper reports change in neurotic symptomatology following intensive, long term, therapeutic community treatment for such patients. Sixty two subjects with personality disorder were followed up for eight months after discharge (response rate 65%). Results showed a highly significant reduction in symptomatic distress as measured by the SCL.-90R questionnaire. Investigation of the reliability and clinical importance of the change in individual subjects demonstrated that 55% of subjects had improved reliably, and in 32% this change was also clinically significant, whilst only 6.5% of subjects had deteriorated reliably.

Acting out and the institutional response

Abstract The responses of institutions to ‘acting out’ in personality disordered individuals may perpetuate such behaviour. Inadvertently, such responses remove the potential for these individuals to learn from experience and to mature psychologically, to individualize. This is because institutions, first and foremost, serve the needs of society. In performing this wider function, they often do not meet, sufficiently, the therapeutic needs of the individual. The result is a stalemate in which both the individual who acts out and the institution continue to suffer. An awareness of the interaction between the individual and the ‘institution’, and particularly an awareness of the often complementary style of their interaction, victim-victimizer, may empower professionals working in institutions to break the therapeutic stalemate. However, to achieve this requires changes in attitudes and behaviour on the part of staff and some restructuring of the internal organization of their institutions so as to influenc...

Family composition and social class in bulimia. A catchment area study of a clinical and a comparison group.

Many theories of the etiology of eating disorders focus on the role of the family. However, these theories are based on clinical experience and uncontrolled clinical case series. We report a study comparing 50 bulimic women with 40 non-eating-disordered women all from the same clinical catchment area. This study revealed no significant differences in social class, family size, birth position, or sibling sex ratio between the two groups. However, the parents of bulimic women were found to have been significantly older than those of the control group at the time of birth of their daughter. These findings are discussed with reference to previous family studies of eating disorders.

Binge eating and dietary restraint: A cross‐cultural analysis

Investigation of binge eating and dietary restraint has previously been limited to subjects within Western societies. We investigated these two phenomena in 218 Arab students in Egypt, using the Restraint Scale (Polivy, Herman, & Warsh, 1978) and the Binge Scale (Hawkins & Clement, 1980). The psychometric characteristics of the scales were investigated. Although exploratory factor analysis showed support for the Restraint Scale subscales in women, no coherent factor structure was found for men. Factor analysis also revealed differing factor structures for men and women in the Binge Scale. The internal validity of the scales for men was also poor, thus the application of these two instruments to Arab men is questionable. A significant correlation of Binge Scale and Restraint Scale scores was found for both genders indicating support for the hypothesized link between the phenomena in a non-Western culture. Further comparison of the Arab womens scores with those previously reported in Western studies showed a significantly lower level of restraint for the Arab women. We suggest that restraint theory is cross-culturally applicable for women, although cultural factors may mediate the level of restraint shown.

The natural history of disordered eating behavior and attitudes in adult women

This paper reports a survey of the natural history of eating behavior and attitudes to weight and shape in British women attending a family planning clinic. Sixty-two women completed a battery of standardized tests, followed by a second questionnaire 18 months later. This rescreening represents the first report of an adult sample not self-defined as ill. The Eating Attitudes Test (EAT)-26 total score showed stability over time (r =.68) but also showed a nonsignifirant increase in the number of «cases.» The self-reported weight and desired weight increased slightly but statistically over the whole sample in the follow-up period

Weight Satisfaction of Nigerian Women in Nigeria and Britain: Inter-Generational and Cross-Cultural Influences

This study investigates intergenerational and cross-cultural aspects of body weight satisfaction in 103 female Yoruba students, 48 adult women in Western Nigeria and 68 Nigerian women living in Britain. The groups were compared on anthropometric parameters of height, body weight and desired weight. It was found, in line with predictions, that the students living in Nigeria had a lower current and desired body mass index (BMI), than the adult Nigerian group. The students also showed a discrepancy between their current and desired BMI which was greater than the adult sample although, in contrast to Western populations, neither group showed a marked overall dissatisfaction with their current BMI. The 68 Nigerian women living in Britain were matched pairwise for age, marital status and parity with 68 women from the Nigerian sample. Despite a similar current BMI the sample living in Britain showed significantly lower desired weight than their matched counterparts in Nigeria and significantly greater discrepancy between their current and desired BMI. These findings suggest that younger women in Nigeria may be moving towards a Western body image dissatisfaction which is already evident in their peers in Britain. The study also supports the contention that culture exposure may cause immigrants from cultures where thinness is not highly valued to adopt Western positive valuations of thinness.