Jane Wardle

Eating style and eating behaviour in adolescents

The relationship between eating style, attitudes towards food and food intake was investigated in 846 British adolescent schoolchildren. Eating style was assessed with the Dutch Eating Behaviour Questionnaire, attitudes towards food with a series of specially prepared questions, and food intake with a diet history taken by a dietitian. The results showed that restraint, external and emotional eating were associated with very different profiles of attitudes and behaviour. Restrained subjects had a higher body weight, more negative attitudes towards food, a lower likelihood of overeating and a lower overall energy intake. External eaters had a lower body weight, positive attitudes to food, and reported a higher energy intake. Emotional eaters fell in between in some ways, with some signs of situational loss of control combined with a negative attitude towards overeating. While external eating appeared to be attenuated by restraint, emotional eating was enhanced by it. The implications of these eating styles for later patterns of eating and weight are discussed.

Restraint and food intake: An experimental study of eating patterns in the laboratory and in normal life

This study investigated food intake in restrained and unrestrained eaters during normal life, in a laboratory setting, and in the period after taking part in the laboratory experiment. Restraint was assessed with the Restrained Eating Scale of the Dutch Eating Behaviour Questionnaire. The data indicated that as predicted, restraint was associated with a lower food intake during everyday life, but with a higher intake in a laboratory taste test. A milk shake preload did not have a significant effect upon food intake in the laboratory. It had been predicted that participating in the laboratory experiment would disrupt the food intake of restrained eaters over the rest of that day and would engender overeating or even binges, but neither restrained nor unrestrained eaters reported any increase in food intake after the experiment. However neither group showed any reduction in food intake to compensate for what they had eaten in the laboratory. The results therefore indicated that disinhibition of restraint in the laboratory does not necessarily provoke the extended loss of control predicted by some theories of restrained eating, but may nevertheless threaten adherence to dieting intentions.

The psychological costs of screening for cancer

The benefits of cancer screening programmes accrue to those who have cancer or identifiable precancerous conditions, and in whom the disease progression is slowed or halted by earlier intervention. The costs accrue to the rest of the population for whom there is no direct benefit to health. Attention has been given to the medical risks of screening procedures and to the economic costs, but there has been very little regard paid to the psychological costs. The aim of this paper is to evaluate the psychological impact of screening. Screening participants who are found to have untreatable disease, or for whom the interventions prove ineffective, have a greater proportion of their life as a cancer patient with all the associated psychological (and perhaps physical) distress, but no increase in their life expectancy. Those who receive false positive results may experience acute psychological distress produced by the prospect of a grave diagnosis before they are found to be free from serious disease. Even the procedure of screening itself, with the disturbance of the invitation, the discomfort of the tests and the wait for the diagnosis, can have a significant impact upon some patients. This paper evaluates the psychological costs which may be involved across the whole screening procedure, from the possible alarm of receiving an invitation to participate in screening, to the trauma of a cancer diagnosis for someone who had been unaware of any symptoms.

Naughty but nice: a laboratory study of health information and food preferences in a community sample

The influence of information about the fat content of food and cardiovascular disease (CVD) prevention on taste ratings and food intake in a test meal was examined. Forty Ss were allocated at random to CVD information or control conditions. Ss rated 2 brands of yogurt and 2 cheese sandwiches, with 1 flavor of each food labeled full-fat and the other low-fat. In fact, fat levels were identical, and the label-flavor pairings were counterbalanced. Overall, Ss gave lower liking ratings to the low-fat labeled foods. However, Ss in the information condition tended to eat a smaller proportion of the full-fat sandwiches. The results supported the utility of a laboratory setting for evaluating the influence of health-relevant information on responses to food.

Psychological consequences of positive results in cervical cancer screening

Abstract This study was carried out to assess the psychological impact of abnormal cervical smear results. Existing literature contain only uncontrolled studies or controlled studies with non-standardised measures. Subjects were recruited from women attending two general practices for routine cervical smears over a six month period. A comparison was made between women with positive results who were referred for colposcopy, with mild abnormalities who were asked to return for a repeat smear in six months, or negative smear results. Psychometric assessment by postal questionnaire was carried out one week after receiving the result. The measures used were the 28-item General Health Questionnaire (GHQ-28), Spielberger State Anxiety (STAI), and a measure designed specifically for use in the study, the Cervical Screening Questionnaire (CSQ). Results indicated that women with positive smear test results who were referred for colposcopy had significantly higher scores on GHQ (p<.01) STAI-S (p<.05) and CSQ (p<.001...

Food choices and health evaluation

Abstract The role of health considerations in food choices was evaluated in a sample of 86 family members who had volunteered to participate in a study of family health beliefs. The aim of the investigation was to explore the use of individually-based methods of assessing health motivation in food choices. An index of health-motivation was derived by correlating consumption frequency and healthiness ratings of 31 foods within each individual. This index was then compared with global ratings of motivations in food choice and with data on dietary quality. There was great variation in the health-motivation index and it was higher in mothers than sons, with daughters falling between the two. It was significantly associated with frequency of fat and fruit intake and with global ratings of health motivation. The results suggested that this individually-based method can generate a meaningful index of the extent to which health considerations play a part in food choices.

Tobacco smoking in young adults from 21 European countries: Association with attitudes and risk awareness.

Information concerning tobacco smoking was obtained in a survey of 16,483 students aged 18-30 years from 21 European countries. Belief in the benefits to health of not smoking were also assessed. Risk awareness was measured in terms of knowledge of the links between smoking and disease. The overall age-adjusted prevalence of smoking was 33.1% in men and 29.0% in women, but wide variations were observed across country samples. Significant sex differences were found in only a minority of cases. The inclusion of respondents who stated that they had sometimes smoked in the past substantially reduced variations in prevalence across country samples. Beliefs in the health benefits of not smoking were consistently associated with smoking behaviour. Awareness of the link between smoking and lung cancer was uniformly high, but awareness of the role of smoking in heart disease varied considerably across country samples, and averaged only 64.4% in men and 62.9% in women. In the majority of countries, risk awareness was greater among smokers than non-smokers. The results suggest that in this selected sector of the population of young adults in Europe, sex differences in smoking are relatively minor, robust associations between attitudes and smoking behaviour can be identified, and there are major gaps in risk awareness.

Adult Disclosure of Sexual Abuse: A Primary Cause of Psychological Distress?.

There is evidence for a high incidence of childhood sexual abuse among adult psychiatric populations and some practitioners have noted a worsening of psychiatric symptomatology around the time of disclosure. Disclosure of abuse can result in hostile and rejecting responses from significant others in the victims social support network. This paper surveys research evidence relating to the disclosure of abuse, and it is argued that for some adults, the disclosure of sexual abuse may be a primary cause of psychological distress, resulting in the dissolution of social support systems and increasing the individuals vulnerability to psychiatric disorder. The implications of the model for therapeutic practice are discussed.

Cholesterol and psychological well-being

The debate about possible adverse effects associated with low or lowered serum cholesterol has raised important scientific questions concerning the links between lipids and behaviour. One of the most unexpected findings has been an association between cholesterol-lowering treatment and accidental death. A similar association has also emerged among the prospective cohort studies, with higher-than-expected numbers of suicide deaths in the lowest cholesterol groups. These observations have prompted speculation that behavioural or emotional disturbances could be part of the process linking lipids and accidental death. In this paper, the epidemiological literature is reviewed briefly, then the evidence for depression as a mediating condition is discussed. Two conclusions are drawn from this review of the literature. One is that understanding the relationship between the biology of lipids and the psychobiology of mood is demonstrably an important scientific and public health issue. The second is that the introduction of new treatments or preventive programmes should include a careful evaluation of the psychological as well as the physical effects.

Cognitive and emotional responses to food

The present study evaluated the cognitive and emotional responses to eating a high-calorie food. Restrained and unrestrained, normal-weight women were given either a high-calorie food or a low-calorie food and completed ratings of hunger and questionnaires concerning their emotional and cognitive states before and after eating. Finally, they were given a taste test, then debriefed, and interviewed about their experience of the study. The interview data and the psychometric results indicated that the restrained eaters experienced increased feelings of rebelliousness and defiance after both eating situations, with this increase being particularly pronounced after the high-calorie food. The unrestrained eaters did not show an increase in rebelliousness nor any differentiation between the high- and low-calorie foods. The restrained eaters also showed a decrease in anxiety after the high-calorie food. The results are analyzed in terms of recent theories of restrained eating and their implications for pathological eating regulation are discussed.