Catherine M. Shisslak

The spectrum of eating disturbances

OBJECTIVE The purpose of this paper was to review and summarize the research literature on the spectrum of eating disturbances. METHOD Literature was searched using a computer data base to identify recent articles related to the prevalence and occurrence of disturbed eating patterns as well as full and partial syndrome eating disorders (EDs). RESULTS This review indicates that the prevalence of partial syndrome EDs in nonclinical populations is at least twice that of full syndrome EDs, and that there is a progression in some individuals from less to more severe disturbances in eating behavior. DISCUSSION These findings suggest the need for careful, scientific evaluation of risk factors for EDs in both children and adults. A longitudinal research program in progress is described which aims to identify the risk factors for EDs.

Eating disturbances among American minority groups: A review

OBJECTIVE The purpose of this paper was to review the research literature related to eating behaviors and disturbances among American minority groups. METHOD A computer-based literature search was conducted to locate articles pertaining to this topic. RESULTS This review indicates that, compared to Caucasian females, eating disturbances are equally common among Hispanic females, more frequent among Native Americans, and less frequent among Black and Asian American females. Risk factors for eating disorders (EDs) are greater among minority females who are younger, heavier, better educated, and more identified with White, middle-class values. DISCUSSION Further studies of EDs among American minority groups are needed, especially studies that are longitudinal and developmental in nature and that focus more specifically on the effects of racism in the development of EDs.

Factors associated with weight concerns in adolescent girls.

OBJECTIVE This study examined the association of weight concerns with potential risk factors for the development of eating disorders. METHOD A self-report survey was given to 103 elementary (Grades 4 and 5) and 420 middle (Grades 6-8) school students in Arizona and California. Of these, 78 elementary and 333 middle school students provided complete data and were used in the analyses. RESULTS In a multivariate stepwise regression analysis, the importance that peers put on weight and eating was most strongly related to weight concerns in the elementary school girls, accounting for 34% of the variance after adjusting for site differences. Trying to look like girls/women on TV and in magazines as well as body mass index (BMI) entered the final model that accounted for 57% of the variance in weight concerns. In middle school, the importance that peers place on weight and eating was also the strongest predictor accounting for 33% of the variance followed by confidence, BMI, trying to look like girls/women on TV and in magazines, and being teased about weight. Together these variables accounted for 55% of the variance. DISCUSSION Prevention programs aimed at reducing weight concerns need to address these factors.

Development and evaluation of the McKnight Risk Factor Survey for assessing potential risk and protective factors for disordered eating in preadolescent and adolescent girls.

OBJECTIVE To describe the development, test-retest reliability, internal consistency, and convergent validity of the McKnight Risk Factor Survey-III (MRFS-III). The MRFS-III was designed to assess a number of potential risk and protective factors for the development of disordered eating in preadolescent and adolescent girls. METHOD Several versions of the MRFS were pilot tested before the MRFS-III was administered to a sample of 651 4th through 12th- grade girls to establish its psychometric properties. RESULTS Most of the test-retest reliability coefficients of individual items on the MRFS-III were r > .40. Alpha coefficients for each risk and protective factor domain on the MRFS-III were also computed. The majority of these coefficients were r > .60. High convergent validity coefficients were obtained for specific items on the MRFS-III and measures of self-esteem (Rosenberg Self-Esteem Scale) and weight concerns (Weight Concerns Scale). CONCLUSIONS The test-retest reliability, internal consistency, and convergent validity of the MRFS-III suggest that it is a useful new instrument to assess potential risk and protective factors for the development of disordered eating in preadolescent and adolescent girls.

Body weight and bulimia as discriminators of psychological characteristics among anorexic, bulimic, and obese women

Bulimic women from underweight (n = 20), normal-weight (n = 31), and overweight (n = 22) categories were compared with restrictor anorexics (n = 20), normal controls (n = 31), and obese subjects (n = 22). Each subject was administered the Minnesota Multiphasic Personality Inventory, the Internal-External Locus of Control Scale, the Rosenberg Self-Esteem Scale, and the Semantic Differential Potency Scale. Bulimic women in all 3 weight categories exhibited greater psychopathology, more external locus of control, lower self-esteem, and lower sense of personal effectiveness than nonbulimic women at similar weight levels. The highest psychopathology, lowest self-esteem, and most external locus of control were found among the underweight bulimic women. Significant differences between bulimic women of different weight levels suggest the need for some modification of treatment approaches depending on the bulimic womens weight level.

Prevention of Eating Disorders among Adolescents

Since eating disorders frequently begin during adolescence, high school students represent a high risk population for the development of these disorders. For this reason, a pilot project for the prevention of eating disorders was instituted at the high school level. The primary goal of this pilot project was to educate students, faculty, and staff at the school about the incidence, symptoms, and consequences of eating disorders. Consultation and referral services were also provided. An evaluation component of the project assessed the informational impact of the prevention program on the students. On a questionnaire designed for the project, a significantly greater number of questions about eating disorders were answered correctly by students who were recipients of the prevention program than by those who were not. The results of this project demonstrate the feasibility of using the high school setting to promote increased awareness of eating disorders and their consequences among high school students.

Ethnic differences in dieting, binge eating, and purging behaviors among American females: A review

The research literature related to ethnic differences in dieting, binge eating, and purging behaviors among American females was reviewed. Relevant publications were located by means of computer searches utilizing MedLine and PsycInfo databases. The majority of the dieting studies that have been published thus far indicate that this behavior is more prevalent among White females while most studies of binge eating and purging behaviors indicate that these behaviors are as common among minority females as among White females. Factors that may influence the results of studies focusing on ethnic differences in eating-related behaviors are discussed. Recommendations for improving future research in this area are proposed.

Family dysfunction in normal weight bulimic and bulimic anorexic families

A group of 24 normal weight bulimics and 13 bulimic anorexics were compared with each other and a normal control group (n = 41) on two self-report measures of family functioning (Family Environment Scale and Family Dynamics Survey). The two bulimic groups perceived their families as more dysfunctional than did the normal control group on the dimensions of cohesion, expressiveness, conflict, recreational orientation, emotional support, communication, and need for counseling. There were few significant differences in the family perceptions of the two bulimic groups.

Self-esteem and the prevention of eating disorders

Abstract This article begins by reviewing the literature linking self esteem to eating disorders (EDs) in girls. Prevention strategies used to enhance self-esteem and some of the limitations of these approaches are then discussed. The article concludes with a presentation of a model that addresses these shortcomings and that will help guide the design, implementation, and evaluation of future, prevention programs targeting EDs.

Overcommitment to sport: Is there a relationship to the eating disorders?

AbstractThis article explores recent research in psychology, physiology, endocrinology, and animal behavior that bears on the relationship between compulsive athleticism and the eating disorders. There are several differences and a number of likenesses between these groups. Both groups are composed of persistent, perfectionistic, high-achieving persons. Compulsive (“addicted”) athletes appear healthier than eating-disordered patients on psychological tests, even though the athletes may do or say things that appear irrational. The relationship between compulsive athleticism and the eating disorders can best be described in terms of a risk-factor model. Perfectionistic persons can be easily caught up in a diet or exercise program and can become even more committed through social reinforcement and the formation of a reciprocal feedback loop. When perfectionistic persons engage in extreme exertion while following a restricted, “healthy” diet, this can increase obsessional behavior by affecting mood and cognition. Eating-disordered patients experience similar changes in personality and behavior secondary to stress and dietary restriction.