Gail McVey

Dieting among preadolescent and young adolescent females

WE EXAMINED THE PREVALENCE OF DIETING and negative eating attitudes among 2279 females (aged 10–14 years) in southern Ontario. Self-report questionnaires revealed that 29.3% of the girls were currently trying to lose weight and 10.5% had scores greater than the clinical threshold for disordered eating (Childrens version of the Eating Attitudes Test [ChEAT] score ≥ 20). Those with elevated ChEAT scores were more likely than those with lower scores to be engaged in dieting and other extreme weight control methods.

Risk and Protective Factors Associated with Disordered Eating During Early Adolescence

Risk and protective factors associated with disordered eating were examined among 363 girls (X age =12.9 years) in middle-level school. The variables included self-report ratings of competence and of the importance of physical appearance and social acceptance by peers, self-oriented and socially prescribed perfectionism, negative events, and parental support. In a multivariate regression analysis, low competence in physical appearance, high importance of social acceptance, high self-oriented perfectionism, and low paternal support were correlated significantly with reports of high levels of disordered eating. The negative influence of low physical appearance competence on disordered eating was attenuated for those girls who placed low, as compared with high, levels of importance on physical appearance. Paternal support was found to have a protective function in regard to disordered eating for those girls who experienced high, as compared with low, levels of school-related negative events. Implications for school-based prevention strategies are discussed.

Mental Health,Wellness, and Childhood Overweight/Obesity

Childhood obesity is a growing concern, and while progress has been made to understand the association between multiple biological factors (i.e., genetics, nutrition, exercise etc.), little is known about the relationship between mental health and childhood obesity. In this paper, we offer a review of current evidence about the association between mental health and childhood obesity. A systematic literature search of peer-reviewed, English-language studies published between January 2000 and January 2011 was undertaken and resulted in 759 unique records, of which 345 full-text articles were retrieved and 131 articles were included. A theoretical model is proposed to organize the paper and reflect the current state of the literature and includes psychological factors (i.e., depression and anxiety, self-esteem, body dissatisfaction, eating disordered symptoms, and emotional problems); psychosocial mediating variables (i.e., weight-based teasing and concern about weight and shape), and wellness factors (i.e., quality of life and resiliency/protective factors). We conclude with a number of recommendations to support the creation of solutions to the rise in childhood obesity rates that do not further marginalize overweight and obese children and youth and that can potentially improve the well-being of all children and youth regardless of their weight status.

School-Based Peer Support Groups: A New Approach to the Prevention of Disordered Eating

The goal of the present study was to evaluate the effectiveness of a school-based peer support group designed to improve body esteem and global self-esteem and to reduce negative eating attitudes and behaviors. A total of 214 girls in grades 7 and 8, 115 of whom were in the control group, completed self-report questionnaires immediately before and following the intervention, and three months later. The findings revealed that participation in the 10-session group, facilitated by public health nurses, led to increases in weight-related esteem and decreases in dieting. The role of peer support groups in the prevention of disordered eating is discussed.

Personality disorders in anorexia nervosa and bulimia nervosa

Two self-report questionnaires (MCMI and BSI) designed to measure personality disorder (PD) according to DSM-III (R) criteria were administered to patients with a diagnosis of anorexia nervosa (AN) (n = 19), bulimia nervosa (BN) (n = 16), or both diagnoses (AN + BN) (n = 9), both before and after treatment for the eating disorder. The main finding was that self-reported Personality Disorder (PD) diagnoses are not stable enduring characteristics among this group of eating disorder patients. A high rate of PD diagnoses occurred in all patient groups at admission (93%) and at discharge (79%). Both MCMI and BSI scales were subject to significant change following treatment. A high prevalence of borderline personality disorder was found in patients with BN. Changes in depression and self-esteem scores correlated most strongly with changes in schizoid, schizotypal, histrionic and narcissistic scales. Assessment of PD using self-report measures should be interpreted with caution in acutely symptomatic patients with eating disorders.

Dieting among preadolescent and young female adolescents.

WE EXAMINED THE PREVALENCE OF DIETING and negative eating attitudes among 2279 females (aged 10–14 years) in southern Ontario. Self-report questionnaires revealed that 29.3% of the girls were currently trying to lose weight and 10.5% had scores greater than the clinical threshold for disordered eating (Childrens version of the Eating Attitudes Test [ChEAT] score ≥ 20). Those with elevated ChEAT scores were more likely than those with lower scores to be engaged in dieting and other extreme weight control methods.

A Program to Promote Positive Body Image:: A 1-Year Follow-Up Evaluation

The effectiveness of a program designed to promote body image satisfaction and prevent eating problems in young adolescent girls was evaluated over a 1-year period. A total of 263 girls in Grade 6, one-half of whom were in the control group, completed questionnaires that assessed body image satisfaction and eating problems before and 1 week after the prevention program, and 6 and 12 months later. The six-session prevention program was developed around two principal components: (a) media literacy about the dangers associated with the idealization of thinness and (b) the promotion of life skills, including self-esteem enhancement strategies, stress management techniques, and peer relations skills. There was no program effect. Instead, the findings revealed significant increases in body image satisfaction and decreases in eating problem scores over time for participants in both the prevention and control groups.

Melatonin and cortisol «switches» during mania, depression, and euthymia in a drug-free bipolar patient

Low melatonin and elevated cortisol levels have typically been reported during depression. The evidence that the converse is true during mania has been less well documented. In a single case design, repeated measures of nocturnal melatonin and cortisol were taken during mania, depression, and euthymia. Elevated levels of melatonin during mania and elevated cortisol levels during depression were the principal findings. There also did not appear to be any marked change in circadian rhythm of hormone output during the three clinical states. The implications of these findings in relation to noradrenergic dysfunction are discussed.

A Controlled Evaluation of Web-Based Training for Teachers and Public Health Practitioners on the Prevention of Eating Disorders

The effectiveness of a web-based prevention program designed for elementary school teachers was examined in 78 elementary school teachers and 89 local public health practitioners (who provide support to schools). Participants were assigned to either the intervention (n = 95) or comparison (n = 72) study groups. All participants completed self-report online measures prior to, and following, the 60-day study period assessing knowledge about various factors that influence body image in children and efficacy to fight weight bias in the school. Information was also solicited on the feasibility of, and on the perceived benefit of the web-based program as a knowledge translation tool, in terms of layout and content. The Student Body program was found to be successful in improving knowledge concerning facts about dieting among the teacher participants, and in increasing efficacy to fight weight bias among the public health participants. Overall, the feedback was very positive concerning the layout and content of the Student Body. Participants reported an overall improvement in their awareness about how weight bias can be present in their teaching practices, and how this can trigger body image concerns among their students. Findings have implications for using the web to engage teachers in the prevention of disordered eating among school age children.

Replication of a Peer Support Program Designed to Prevent Disordered Eating: Is a Life Skills Approach Sufficient for All Middle School Students?

The evaluation of a school-based peer support group previously shown to improve body esteem and global self-esteem and reduce dieting in young adolescent girls was replicated in the present study. A total of 282 girls in grades 7 and 8, 196 of whom were in the control group, completed self-report questionnaires immediately before and after the life skills intervention, and 3 months later. Contrary to the findings reported in the original study, participation in the 10-session peer support group did not lead to improvements in body esteem or eating attitudes and behaviors beyond what was experienced by the control group. Interestingly, participants of the current intervention group exhibited higher disordered eating scores at baseline than those participants in the original study. Implications for matching prevention curriculum with the developmental and symptom levels of students are discussed.