Psychosocial correlates of disordered eating in female collegiate athletes: validation of the ATHLETE questionnaire

Female athletes may be at greater risk for disordered eating than their nonathletic peers, but the psychological antecedents of this dysfunctional behavior in athletes have yet to be elucidated. The objective of this study was to develop an athletics-oriented measure of psychological predictors of disordered eating and to test its initial reliability and validity. Female athletes from 3 National Collegiate Athletics Association (NCAA) Division I universities completed the ATHLETE, a written questionnaire designed to assess psychosocial factors associated with disordered eating in athletes. Five distinct and internally consistent factors (Drive for Thinness and Performance, Social Pressure on Eating, Performance Perfectionism, Social Pressure on Body Shape, and Team Trust) were positively associated with and predictive of disordered eating behaviors in female athletes. The ATHLETE is a reliable and valid measure of psychological predictors of disordered eating in athletics and will be useful in studying the etiology of disordered eating in female athletes.     

Implicit Family Process Rules in Eating-Disordered and Non-Eating-Disordered Families

Family environment has been shown to be one of the factors related to the presence of eating disorders among young-adult females. Clinical experience and theories about eating disorders postulate that implicit family rules are an intricate part of family process that may have a great effect on the creation and maintenance of such problems. This study compared implicit family process rules (specifically rules pertaining to kindness; expressiveness and connection; constraining thoughts, feelings, and self; inappropriate caretaking; and monitoring) in families with a young-adult female diagnosed with an eating disorder—either anorexia nervosa, bulimia nervosa, or eating disorder not otherwise specified—and families with a young-adult female without an eating disorder diagnosis. One hundred two families (51 eating disordered and 51 comparison) participated in the study. Mothers, fathers, young-adult female children, and siblings completed the Family Implicit Rules Profile ( Harper, Stoll, & Larson, 2007 ). Results indicated that eating-disordered families are governed by a greater proportion of constraining family rules than are non-eating-disordered families. Additionally, eating-disordered youth reported a lower proportion of facilitative family rules and a higher proportion of constraining family rules than did parents and siblings. Theoretical, research, and clinical implications are discussed.     

A Description of Disordered Eating Behaviors in Latino Males

Abstract

Objective: To explore disordered eating and eating disorders (EDs) in Latino males. Participants: Participants are 722 male college students from a larger prevalence study conducted in the University of Puerto Rico system. Methods: Participants were selected from a list of sections of required courses for first-year students on each campus. Self-report instruments were used to explore ED symptoms (the Eating Attitudes Test [EAT-26] and the Bulimia Test–Revised [BULIT-26-R] and the Beck Depression Inventory depression (BDI). Results: Overall, 2.26% scored above the cut-off point on the BULIT-R and 5.08% score above the cut-off point on the EAT-26. Of the males, 4.43% reported sufficient frequency and severity to approximate DSM-IV criteria for bulimia nervosa. Depression symptomatology was found in those who scored above the cut-off point on both instruments of EDs. Conclusion: College health practitioners should be aware of disordered eating in Latino males and include them in efforts to detect disordered eating behaviors in college students.     

Attachment Representations and Parental Memories of Incarcerated Fathers

This article presents the findings of a study designed to apply attachment theory concepts to a group of incarcerated fathers in a minimum-security facility. Participants in this convenience sample were either immediate graduates of a 13-week parenting skills program or currently involved in the parenting skills program. This exploratory study sought to examine first, whether the Adult Attachment Interview (AAI) could effectively determine current mental representations of attachment relationships with a group of incarcerated fathers. Secondly, to gain further knowledge of this population regarding the impact of familial aspects by use of a survey measure, along with two other standardized measures were implemented. Thirty-eight voluntary subjects participated in the intensive AAI in scheduled individual sessions, completing child abuse additional measures. Differences among a three-category adult attachment classifications and five-category attachment classifications were identified. Both qualitative and quantitative results are discussed.     

Two distinct mediated pathways to disordered eating in response to weight stigmatization and their application to prevention programs

ABSTRACT

Objective: Disordered eating behaviors among undergraduate women are common and, thus, are an important public health concern. Weight stigmatization, stress, and social withdrawal are often associated with disordered eating behaviors; however, it is unclear whether stress and social withdrawal act as mediators between weight stigmatization and disordered eating. By testing specific pathways to disordered eating, theory-driven prevention programs can be implemented. Methods: Self-reported surveys were administered to 217 undergraduate women during the Fall 2014 semester. Results: There were 2 distinct mediational pathways in response to weight stigmatization. Stress partially mediated the path between weight stigmatization and emotional eating (38%), whereas social withdrawal partially mediated the path between weight stigmatization and dietary restraint (44%). Conclusions: Stress and social withdrawal mediate the relationship between weight stigmatization and disordered eating. The results of this study identified potentially critical risk factors that, if addressed, may improve outcomes of campus-based disordered eating programs for women.     

The Effect of Attachment Theory in the Development of Eating Disorders: Can Symptoms Be Proximity-Seeking?

The relationship between attachment theory, proximity seeking behaviors and the development of eating disorders was investigated in three groups of adolescent females from various settings; 44 individuals with eating disorders, 28 clinical controls, and 36 non-clinical controls. The Inventory of Parent and Peer Attachment and the Parental Attachment Questionnaire were both used in this study and both found that the clinical groups demonstrated a weaker sense of attachment quality compared to their non-clinical counterparts. This study also expands upon John Bowlby's concept of proximity seeking, to offer a possible explanation of the function for eating disorder symptomatology. A new measure, the Proximity-Seeking Scale, found that self-reported changes in both the physical and psychological proximity needs of those with eating disorders had transpired since the clinical diagnosis of the disorder.     

An exploration of the drive for muscularity in adolescent boys and girls

Much of the existing research on disordered eating has centered on the drive for thinness, which is most commonly observed in girls and women. The male standard of bodily attractiveness, however, is bigger, bulkier, and more muscular. Are boys and men motivated to be big and muscular in the same way that girls and women are motivated to be thin? The authors constructed a 15-item survey and administered it to 197 adolescents. The findings showed that the drive for muscularity measure displayed good reliability; that individuals high in the drive were more likely to be boys who were trying to gain both weight and muscle mass; that the drive was related to poor self-esteem and higher levels of depression among boys, but not among girls; and that the drive for muscularity was relatively unrelated to the drive for thinness.     

Appropriate Terminology for the Alcohol,Eating, and Physical Activity Relationship

Abstract

“Drunkorexia” merges prior literature identifying positive relationships between (a) alcohol use/abuse and disordered eating/eating disorders, (b) alcohol use/abuse and physical activity, and (c) disordered eating/eating disorders and physical activity. The term, highlighting an individual's proactive and/or reactive weight management behaviors (ie, disordered eating, physical activity) in relation to alcohol consumption, originated in news editorials and has recently gained recognition via use in scholarly publications. The purpose of this commentary is to recommend discontinuing use of the term “drunkorexia” due to (a) inconsistent definitions of drunkorexia across investigations, (b) drunkorexia being a misnomer, and (c) the medical community's lack of recognition/acceptance of drunkorexia. Because the behaviors encompassed by drunkorexia are of concern to researchers and health professionals, future investigations are still warranted. However, until a medically recognized term/phrase is accepted, scholars should utilize more appropriate characterizations such as “weight-conscious drinkers,” “weight management behaviors of drinkers,” or “Eating Disorders Not Otherwise Specified” (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision).     

Drunkorexia: Understanding the Co-occurrence of Alcohol Consumption and Eating/Exercise Weight Management Behaviors

Abstract

Objective: Examine the co-occurrence of alcohol consumption, physical activity, and disordered eating behaviors via a drunkorexia perspective. Participants: Nationally representative sample (n = 22,488) of college students completing the Fall 2008 National College Health Assessment. Methods: Hierarchical logistic regression was employed to determine if physical activity and disordered eating behaviors uniquely predicted binge drinking, while controlling for age, race, gender, year in college, Greek membership, and place of residence. Results: Physical activity and disordered eating made unique, statistically significant contributions. Moreover, including physical activity and disordered eating behaviors allowed for the correct classification of an additional 431 cases (ie, binge drinkers) over and above the predictive ability of the covariate-only model. Conclusions: Findings corroborate prior research indicating highly active college students are more likely to binge drink than their nonactive peers, and highlight the potential of a drunkorexia perspective in explaining the counterintuitive alcohol–activity association among college students.     

Female Collegiate Athletes: Prevalence of Eating Disorders and Disordered Eating Behaviors

Objective: The authors assessed the prevalence of pathogenic eating and weight-control behaviors among female college athletes, using a psychometrically valid measure. Participants: Participants were 204 college athletes (M age = 20.16 years, SD = 1.31 years) from 17 sports at 3 universities. On average, they participated in their sport for 10.88 years (SD = 16.68 years) and on their college team for 2.10 years (SD = 1.03 years). Methods: Participants completed a demographic and weight background questionnaire, Questionnaire for Eating Disorder Diagnoses, and the Bulimia Test-Revised. Results: The authors classified participants as eating disordered (n = 4, 2.0%), symptomatic (n = 52, 25.5%), and asymptomatic (n = 148, 72.5%). Few participants engaged in binge eating; most used exercise, as opposed to vomiting, dieting, laxatives, or diuretics, to control their weight. Conclusions: Female athletes suffer from eating disorders, and most experience symptom levels that are subclinical but problematic.     

History of sexual abuse and parental alcohol misuse: Risk,outcomes and protective factors in adolescents

This study examined the school performance, suicidal involvement, disordered eating behaviors, pregnancy risk and chemical use of teenagers with a history of sexual abuse or parental alcohol misuse and found that they had higher rates of these adverse outcomes than among a comparison group of teenagers without such background risk factors. Adolescents with dual-risk background reported higher levels of suicide risk, disordered eating, sexual behaviors and chemical abuse than teenagers with only one background risk factor. Among index group members, protective factors against these adverse outcomes included a high degree of religiosity and the ability to discuss problems with family or friends. Risk factors that increased the likelihood of adverse outcomes included depression, perceived substance use in school and worries about family financial security.The first author was supported in the preparation of this article by a grant from the Lois and Samuel Silberman Fund of New York.     

The Child in the Family of a Drug-Using Father: Attachment Styles and Family Characteristics

SUMMARY

The study examined the impact of family characteristics and parental attachment styles on the children of drug-using (DU) fathers in fifty-six families (n = 168) in Israel. Of the DU fathers, 60.7% were characterized by avoidant attachment style. Among the non-DU mothers, 53.6% were characterized by secure attachment style, 42.9% by avoidant style, and 3.6% by anxious/ambivalent style. Surprisingly, family cohesion and adaptability scores were similar to the Israeli norm, perhaps because the DUs had completed detoxification treatment and participated in rehabilitation programs. Of the children, 61.8% were characterized by secure attachment style, 21.8% by avoidant style, and 16.4% by anxious/ambivalent style. Stepwise regression to predict children's attachment styles revealed that maternal security of attachment and paternal anxious/ambivalent style predict similar attachment styles among the children. The important combined effects of spousal attachment styles on the children are discussed.     

Adolescent Attachment Trajectories With Mothers and Fathers: The Importance of Parent–Child Relationship Experiences and Gender

This longitudinal study investigated how attachment with mothers and fathers changes during adolescence, and how gender and parent–child relationship experiences are associated with attachment trajectories. The relative importance of specific positive and negative relationship experiences on attachment trajectories was also examined. An initial sample of 223 adolescents reported on relationship experiences and attachment avoidance and anxiety with mothers and fathers in Grades 6, 8, 10, and 12 (final N = 110; M_age = 11.90 years at onset, SD = .43). Mothers and fathers reported on relationship experiences with adolescents. Hierarchical linear modeling showed that security with parents increased during adolescence. Positive relationship experiences (companionship, satisfaction, approval, support) predicted increases in security, and negative experiences (pressure, criticism) predicted decreases in security. Females reported less avoidance than males.     

Assessing Adolescents' Attachment Hierarchies: Differences Across Developmental Periods and Associations With Individual Adaptation

Adolescents' attachment hierarchies were assessed in a sample of 212 high school and 198 college students. The Important People Interview (IPI) differentiated attachment bonds from other supportive or affiliative relationships and indicated that adolescents show a hierarchical ordering of preferences for multiple attachment figures. Differences in the composition and structure of adolescents' attachment hierarchies were found between the early high school (9(th) and 10(th) grades), later high school (11(th) and 12(th) grades), and college samples. In the college sample, romantic partners were placed in higher positions in adolescents' hierarchies, fathers were placed in lower positions, and the structure of adolescents' hierarchies were less differentiated than in the high school samples. Individual differences in the composition of adolescents' hierarchies were associated with adjustment outcomes. Friends' placement in higher positions and fathers' exclusion from or placement in quaternary positions was associated with increased behavior problems. Findings demonstrate that the IPI provides a measure of adolescents' attachment hierarchies that is sensitive to developmental stage and individual differences.     

Infants' Behavioral Strategies for Emotion Regulation With Fathers and Mothers: Associations With Emotional Expressions and Attachment Quality

This study examined 12‐ and 13‐month‐old infants' behavioral strategies for emotion regulation, emotional expressions, regulatory styles, and attachment quality with fathers and mothers. Eighty‐five infants participated in the Strange Situation procedure to assess attachment quality with mothers and fathers. Infants' behavioral strategies for emotion regulation were examined with each parent during a competing demands task. Emotion regulation styles were meaningfully related to infant‐father attachment quality. Although expressions of distress and positive affect were not consistent across mothers and fathers, there was consistency in infant strategy use, emotion regulation style, and attachment quality with mothers and fathers. Furthermore, infants who were securely attached to both parents showed greater consistency in parent‐oriented strategies than infants who were insecurely attached to one or both parents. Limitations of this study include the constrained laboratory setting, potential carryover effects, and a homogeneous, middle‐class sample.     

Problem behaviors,substance abuse and sexual abuse in psychiatrically hospitalized adolescents with bulimia nervosa

Twenty-eight adolescent bulimics were compared to 201 psychiatrically hospitalized non-eating disordered patients. Non-eating disordered patients were found to be reliably more aggressive, delinquent, and under-controlled than patients with bulimia nervosa. Sexual abuse was found to be less prevalent among bulimic adolescents than comparison adolescents. No significant between group differences were achieved on any measure of alcohol/drug abuse. The behavioral profiles of substance abusing bulimics were highly similar to those of non-eating disordered patients. Three months follow-up of bulimic patients found that they were less depressed, had less somatization, and were less overcontrolled; however, they showed no reliable improvements in eating attitudes/behaviours or drug/alcohol use.     

Toward Disentangling Fathering and Mothering: An Assessment of Relative Importance

This study employed dominance analysis to assess the relative importance of maternal and paternal support, behavioral control, and psychological control in explaining depression, antisocial behavior, and social initiative within 644 adolescents. We noted the lack of replicated findings concerning differential effects of mothers and fathers and employed an approach that considered mothers’ and fathers’ overlapping predictive abilities in determining their relative importance. Results lend support to the overall parental framework and additionally suggest (a) mothers’ behavioral control is relatively more important than fathers’ in explaining sons’ subsequent antisocial behavior, (b) fathers’ support is relatively more important than mothers’ support in explaining subsequent youth social initiative, and (c) mothering and fathering tend to have a cross‐gendered effect on early adolescents’ depression.     

Unequal Treatment by Mothers and Fathers Matters Differently for Daughters and Sons

Research in attachment has yet to examine the differential effects of unequal treatment by mothers versus unequal treatment by fathers and how unequal treatment affects daughters and sons differently. Moreover, research examining the link between differential treatment and relationship outcomes such as jealousy in romantic relationship has suggested that romantic attachment may mediate this process but has not effectively examined this association. In the current study, researchers found that for daughters, unequal control (but not affection) by mothers (but not fathers) predicted jealousy. For sons, unequal affection (but not control) by mothers (but not fathers) predicted jealousy. For sons, attachment mediated the relationship between differential maternal affection and jealousy in romantic relationships.     

Body mass index, disordered eating behavior, and acquisition of health information: examining ethnicity and weight-related issues in a college population

OBJECTIVE AND PARTICIPANTS: To investigate ethnic differences related to weight, the authors assessed body mass index, dysfunctional eating, receipt of health information, and perceived obstacles to healthy lifestyles of 210 ethnically diverse college women. METHODS: The authors used the Eating Attitudes Test to assess dieting, food preoccupation, and bulimic behaviors. RESULTS: The authors found no ethnic differences in body mass index or disordered eating, but African Americans were more likely than were European Americans and Latina Americans to receive nutrition information from professionals and less likely than European Americans to perceive time as an obstacle. Overall, receipt of health information from a professional was related to fewer disordered eating behaviors; however, the specific eating behavior that was reduced varied by ethnicity. CONCLUSIONS: Health professionals should reconsider traditional assumptions of disordered eating behavior as a European American problem and consider cultural appropriateness in the development of effective health programs.     

Male Pregnancy Intendedness and Children's Mental Proficiency and Attachment Security During Toddlerhood

Using a sample of biological resident fathers and their children from the Early Childhood Longitudinal Study Birth Cohort (ECLS‐B) 9‐ and 24‐month surveys (N = 5,300), this study examines associations and the direct and indirect pathways through which men's pregnancy intentions influence toddlers' mental proficiency and attachment security. Findings indicate that unwanted and mistimed pregnancies for fathers had negative consequences for toddlers' mental proficiency and attachment security. Additionally, men's pregnancy intentions were found to work indirectly through lower prenatal behaviors and father engagement and greater mother‐father relationship conflict to negatively influence toddlers' mental proficiency. Men's pregnancy intentions also worked indirectly through greater relationship conflict and higher father involvement to influence attachment security.