Personal standards,self‐evaluation and perceived benefits of thinness in girls and young women with disturbed eating

The aim of this study was to examine personal standards, self‐evaluation and perceived benefits of thinness in Swedish females 14–21 years with disturbed eating (DE) and to compare these to a group with other psychosocial problems and to a symptom free group. Seventy subjects with DE‐group, 65 subjects with psychosocial problems and 70 symptom free subjects were compared regarding items selected from four questionnaires. High personal standards expressed in a competitive way were specific for the DE‐group. In comparison with the other groups the DE‐group also reported significantly more perceived benefits of thinness and they more frequently believed that thinness would make them more popular. The DE‐group also reported a more negative self‐evaluation, although this was a trait shared with the subjects with other psychosocial problems and consequently not specific for the DE‐group. Identifying specific factors that perpetuate DE habits is important in order to improve our understanding and enhance the treatment of eating disorders. Copyright © 2008 John Wiley & Sons, Ltd and Eating Disorders Association.     

Self‐care versus self‐harm: piercing,tattooing, and self‐injuring in eating disorders

Eating disordered patients seem to have a love–hate relationship with their bodies. Why do some decorate their bodies by means of tattooing and piercing, while others deliberately injure themselves and make parts of their body unattractive? We have explored this question in 101 eating‐disordered patients by means of self‐reporting questionnaires about the presence and characteristics of tattooing, piercing and self‐injuring as well as the underlying motives. Furthermore, we studied the co‐occurrence of impulsive behaviours as well as personality traits. In our patient sample, 11.9 per cent had one or more tattoos, 25.7 per cent a piercing and 64.9 per cent showed some form of self‐injurious behaviour (SIB). Tattooing and piercing are clearly driven by esthetical reasons, whereas SIB can have various explanations. All three behaviours were significantly more often linked to substance (ab)use. With respect to personality traits, piercing was positively linked to extraversion (positive affectivity) and openness, and negatively to conscientiousness. SIB, on the contrary, was positively linked to neuroticism (negative affectivity) and conscientiousness, and negatively to extraversion and openness. Tattooing did not show significant correlations with particular personality traits (probably due to the small number of tattooed patients). In summary, piercing and tattooing seem to reflect more self‐care, and might protect some patients against more self‐harm. Copyright © 2005 John Wiley & Sons, Ltd and Eating Disorders Association.     

Does Self‐Esteem Mediate the Relationship between Interpersonal Problems and Symptoms of Disordered Eating?

It has been proposed that interpersonal problems play a role in the maintenance of disordered eating because of an adverse effect on self‐esteem, which in turn encourages the pursuit of achievement in the valued domain of weight and shape. This study aimed to identify the types of interpersonal problems that are associated with disordered eating and to determine whether self‐esteem mediates the relationship between interpersonal problems and eating disorder symptoms. Female university students (n = 227) completed the Inventory of Interpersonal Problems‐32, Eating Disorder Examination Questionnaire and Rosenberg Self‐Esteem Scale. Regression analysis identified two forms of interpersonal problems that were associated with disordered eating: difficulties being sociable and being too dependent on the opinion of others. Self‐esteem mediated the relationship between interpersonal problems and overevaluation of weight and shape but did not mediate the relationship between interpersonal problems and dietary restraint. Copyright © 2011 John Wiley & Sons, Ltd and Eating Disorders Association.     

The Role of Non‐Suicidal Self‐Injury and Binge‐Eating/Purging Behaviours in Family Functioning in Eating Disorders

This study aimed to investigate family functioning of restrictive and binge‐eating/purging eating disordered adolescents with or without non‐suicidal self‐injury (NSSI), as perceived by the patients and their parents (mothers and fathers). In total, 123 patients (between 14 and 24 years), 98 mothers and 79 fathers completed the Family Assessment Device. Patients completed the Self‐Injury Questionnaire‐Treatment Related and the Symptom Checklist 90‐Revised. No main effects were found of restrictive versus binge‐eating/purging behaviour nor of presence/absence of NSSI. For the parents, a significant interaction between binge‐eating/purging behaviour and NSSI emerged: Mothers and fathers reported worse family functioning in the binge‐eating/purging group in presence of NSSI, whereas mothers reported worse family functioning in the restrictive group without NSSI. Parental perception of family functioning is affected by the combined presence of binge‐eating/purging behaviour and NSSI. This finding should be taken into account when treating families living with eating disorders. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.     

Putative Risk Factors for Non‐Suicidal Self‐Injury in Eating Disorders

Evidence suggests a common association between eating disorders (EDs) and non‐suicidal self‐injury (NSSI). The present study aimed to investigate the potential risk factors for NSSI among ED patients. We assessed 245 ED patients with the Oxford Risk Factor Interview for ED. The results showed that 33% of ED patients reported NSSI in their lifetime. NSSI appeared to occur more frequently among binge eating/purging type ED patients than among patients with other ED and to be related to a more severe eating pathology. A younger age at the onset of eating problems, more negative self‐evaluation, suicide attempts, substance abuse, parents' low weight, family tension at mealtime, parental alcohol problems, childhood abuse, peer aggression, and negative antecedent life events were more common among patients with co‐occurring EDs and NSSI than among patients without NSSI. The results may inform the risk assessment and treatment of NSSI in EDs in the early detection period. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.     

Psychosocial Characteristics in Relation to Disordered Eating Attitudes in Greek Adolescents

The study explores possible links between eating attitudes in Greek adolescents and certain psychosocial characteristics such as self‐esteem, empathy and anxiety. A total of 202 students (109 boys and 93 girls), 15–18 years old, have been recruited. The following questionnaires were used: the Eating Attitudes Test (EAT‐26), the State‐Trait Anxiety Inventory, the Self‐Perception Profile for Adolescents, the Multidimensional Body‐Self‐Questionnaire‐Overweight Preoccupation and the Index of Empathy of Children and Adolescents. The EAT‐26 revealed that 18.3% of the total sample of students (12.8% of boys and 24.7% of girls) reported having disordered eating attitudes. Adolescents with disordered eating attitudes had significantly higher levels of anxiety and scored less in self‐reported physical appearance and romantic appeal. Empathy and global self‐esteem did not differ significantly between the two groups. Adolescents with disordered eating attitudes have certain psychosocial characteristics which differentiate them from the students with healthier eating attitudes. Copyright © 2010 John Wiley & Sons, Ltd and Eating Disorders Association.     

Can adolescents' perceptions of their weight be used in screening for eating disorders? A pilot study of a short screening questionnaire

A Short Screening Questionnaire (SSQ) was devised to select schoolgirls who are underweight but see themselves as overweight. It was predicted that this would identify girls with eating disorders. This was unsuccessful. A comparison was made with the Eating Attitude Test (EAT). Inaccuracy in self‐reports of weight and height may be a factor in the failure. Copyright © 2004 John Wiley & Sons, Ltd and Eating Disorders Association.     

Self‐Discrepancy and Eating Disorder Symptoms Across Eating Disorder Diagnostic Groups

This study examined self‐discrepancy, a construct of theoretical relevance to eating disorder (ED) psychopathology, across different types of EDs. Individuals with anorexia nervosa (AN; n = 112), bulimia nervosa (BN; n = 72), and binge eating disorder (BED; n = 199) completed semi‐structured interviews assessing specific types of self‐discrepancies. Results revealed that actual:ideal (A:I) discrepancy was positively associated with AN, actual:ought (A:O) discrepancy was positively associated with BN and BED, and self‐discrepancies did not differentiate BN from BED. Across diagnoses, A:O discrepancy was positively associated with severity of purging, binge eating, and global ED psychopathology. Further, there were significant interactions between diagnosis and A:O discrepancy for global ED psychopathology and between diagnosis and A:I discrepancy for binge eating and driven exercise. These results support the importance of self‐discrepancy as a potential causal and maintenance variable in EDs that differentiates among different types of EDs and symptom severity. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.     

Early Maladaptive Schemas in Eating Disordered Patients With or Without Non‐Suicidal Self‐Injury

This study investigates early maladaptive schemas (EMSs) in function of eating disorder (ED) subtypes (restrictive/bulimic) and the presence/absence of non‐suicidal self‐injury (NSSI). Female inpatients (N = 491) completed the Young Schema Questionnaire and the Self‐Injury Questionnaire. The influence of ED subtype and the presence/absence of NSSI and their interaction on the EMS were investigated by means of a MANCOVA. The results showed main effects of ED subtype and the presence of NSSI on EMS. Patients with bulimia scored significantly higher on insufficient self‐control and emotional deprivation, which are more related to cluster B compared with restrictive patients, whereas restrictive patients scored significantly higher on social undesirability, failure to achieve, subjugation and unrelenting standards compared with patients with bulimia that are more related to cluster C. Patients with ED with NSSI reported significantly higher EMS levels compared with patients without NSSI, suggesting that they could be of particular interest to benefit from schema therapy. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.     

Eating disorders and non‐suicidal self‐injury: Structural equation modelling of a conceptual model

Evidence suggests several risk factors for both eating disorders (ED) and nonsuicidal self‐injury (NSSI), but the relationships between these factors are not well understood. Considering our previous work and a conceptual model, this cross‐sectional study aimed to assess the relationships among distal and proximal factors for the presence of NSSI in ED. We assessed 245 ED patients with the Oxford Risk Factor Interview for ED. Structural equation modelling revealed that both distal and proximal factors were related to the presence of NSSI in ED, disclosing a mediating role of the proximal factors. Stressful life events mediated the relationship between childhood sexual abuse, peer aggression, and both ED and NSSI. Childhood physical abuse was related to ED and NSSI via substance use, negative self‐evaluation, and suicide attempts. Findings provided support for the conceptual model and highlight the possible mechanisms by which psychosocial factors may lead to ED and NSSI.