Body dissatisfaction and psychosocial variables associated with eating disorders
Keywords:
body dissatisfaction; self-esteem; anger expression; locus of control; depression; anxiety; eating disorders
Abstract
The aim of this study was to analyze the relationship between body dissatisfaction and personality variables among anorexic and bulimic women. Method: 109 patients with a DSM-IV-based diagnosis of anorexia (n = 65) or bulimia nervosa (n = 44) were examined. The control group consisted of 65 healthy women. The Body Dissatisfaction subscale of the Eating Disorders Inventory, Self- -Esteem Inventory, the Self-Expression and Control Scale, the Hospital Anxiety and Depression Scale, and the Internal Powerful Others and Chance Scale were used in the study. Results: Body dissatisfaction, anger out, external control and belief in chance were significantly lower in the anorexic group as compared to the bulimic group. Additionally, the women suffering from anorexia had significantly higher family self-esteem and internal control. In the clinical sample of female adolescents suffering from anorexia, a correlation was found between body dissatisfaction and: age (r = 0,440; p<0,01), family self-esteem (r = -0,433; p<0,01) and professional self-esteem (r = -0,412; p<0,01). However, the body dissatisfaction in patients with bulimia nervosa was related to anger out (r = 0,434; p<0,01), anger out control (r = 0,350; p<0,01), general self-esteem (r = -0,438; p<0,01) and family self-esteem (r = -0,364; p<0,05). Conclusion: In the population suffering from anorexia and bulimia nervosa, the slim silhouette was found to be an important factor affecting self-image. Body dissatisfaction should be regarded as one of many factors influencing the development of psychopathology of eating disorders.
References
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American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association.
Bennett, W., Gurin, J. (1982). The dieter’s dilemma. New York: Basic Books.
Bomba, J., Józefik, B. (2003). Leczenie anoreksji i bulimii psychicznej: co, kiedy, komu? Kraków: Biblioteka Psychiatrii Polskiej.
Bruch, H. (1962). Perceptual and conceptual disturbances in anorexia nervosa. Psychosomatic Medicine, 24, 187-194.
Brytek, A. (2005). Contribution des modèles sur l’autorégulation du comportement dans la compréhension des troubles alimentaires. Perspectives interculturelles (mps pracy doktorskiej, Metz, Université Paul Verlaine).
Brytek-Matera, A. (2007). Ocena poczucia własnej wartości w jadłowstręcie i bulimii psychicznej: badania porównawcze. Psychoterapia, 3, 53-65.
Brytek-Matera, A. (2008a). Obraz ciała - obraz siebie. Wizerunek własnego ciała w ujęciu psychospołecznym. Warszawa: Difin.
Brytek-Matera, A. (2008b). Anorexia nervosa and emotional symptoms: A cross-cultural study.
Archives of Psychiatry and Psychotherapy, 4, 39-46.
Brytek-Matera, A., Schiltz, L. (2009). Cross-cultural examination of the relationship between negative mood states, body image and eating disorders. Bulletin de la Société des Sciences Médicales du Grand Duché de Luxembourg, 1, 11-25.
Bulik, C. M. (2002). Anxiety, depression and eating disorder. W: C. G. Fairburn, K. D. Brownell (red.), Eating disorders and obesity. A comprehensive handbook (s. 193-199). New York: Guilford Press.
Chuchra, M., Drzazga, K., Pawłowska, B. (2006). Postawy rodzicielskie a poczucie kontroli w percepcji dziewcząt z anoreksją. Psychiatria Polska, 40, 4, 731-742.
Coopersmith, S. (1984). Manuel d’inventaire d’Estime de Soi. Paris: CPA.
Dixon, R., Adair, V., O’Connor, S. (1996). Parental influences on the dieting beliefs and behaviors of adolescent females in New Zealand. Journal of Adolescent Health, 19, 4, 303-307.
Espina, A., Asunción Ortego, M., Ochoa de Alda, I., Aleman, A., Juaniz, M. (2002). Body shape and eating disorders in a sample of students in the Basque country. Psychology in Spain, 6, 3-11.
Fassino, S., Daga, G. A., Piero, A., Leombruni, P., Rovera, G. G. (2001). Anger and personality in eating disorders. Journal of Psychosomatic Research, 51, 6, 757-764.
Gamer, D. M., Olmsted, M. P., Polivy, J. (1983). The Eating Disorder Inventory: A measure of cognitive-behavioral dimensions of anorexia nervosa and bulimia. W: P. L. Darby, P. E. Garfin- kel, D. M. Garner, D. V. Coscina (red.), Anorexia nervosa: Recent developments in research (s. 173-184). New York: Alan R. Liss.
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Gokart, N. T., Perdereau, F., Curt, F., Lang, F., Venisse, J. L., Halfon, O., Bizouard, P., Loas, G., Corcos, M., Jeammet, P., Flament, M. F. (2004). Predictive factors of social disability in anorexic and bulimic patients. Eating and Weight Disorders, 9, 4, 249-257.
Grabhorn, R., Stenner, H., Kaufbold, J., Overbeck, G., Stangier, U. (2005). Shame and social anxiety in anorexia and bulimia nervosa. Zeitschrift für Psychosomatische Medizin und Psychotherapie, 51, 2, 179-193.
Hinrichsen, H., Sheffield, A., Waller, G. (2007). The role of parenting experiences in the development of social anxiety and agoraphobia in the eating disorders. Eating Behaviors, 8, 3, 285-290.
Jablow, M. (2000). Na bakier z jedzeniem. Anoreksja, bulimia, otyłość. Gdańsk: GWP.
Jakubczyk, A., Żechowski, C. (2000). Psychoanalityczne poglądy na zaburzenia odżywiania się. W: I. Namysłowska (red.), Zaburzenia psychiczne dzieci i młodzieży. Wybrane zagadnienia (s. 95-106). Kraków: Biblioteka Psychiatrii Polskiej.
Józefik, B. (2006). Relacje rodzinne w anoreksji i bulimii psychicznej. Kraków: Wydawnictwo Uniwersytetu Jagiellońskiego.
Józefik, B., Ulasińska, R. (1999). Perspektywa rodzinna a rozumienie zaburzeń odżywiania się. W: B. Józefik (red.), Anoreksja i bulimia psychiczna. Rozumienie zaburzeń odżywiania (s. 88-103). Kraków: Wydawnictwo Uniwersytetu Jagiellońskiego.
Knauss, C., Paxton, S. J., Alsaker, F. D. (2007). Relationships amongst body dissatisfaction, internalisation of the media body ideal and perceived pressure from media in adolescent girls and boys. Body Image, 4, 4, 353-360.
Leung, F., Schwartzman, A., Stieger, H. (1996). Testing a dual-process family understanding the development of eating disorders psychopathology: A structural modeling analysis. International Journal of Eating Disorders, 20, 4, 367-375.
Levine, M. P., Piran, N. (2004). The role of body image in the prevention of eating disorders. Body Image, 1, 57-70.
Loas, G., Dardennes, R., Dhee-Perot, P., Leclerc, V., Fremaux, D. (1994). Opérationnalisation du concept de „lieu de contrôle”: traduction et première étude de validation de l’échelle de contrôle de Levenson (IPC: The Internal Powerful Others and Chance Scale). Annales Médico-Psychologiques, 152, 7, 466-469.
Łucka, I. (2004). Zaburzenia depresyjne współwystępujące z jadłowstrętem psychicznym. Psychiatria Polska, 38, 4, 621-629.
Malinowska, K. (2007). Realny i idealny obraz siebie u osób po próbach samobójczych. Annales Universitatis Mariae Curie-Skłodowska, 20 (sectio J), 87-100.
Pawłowska, B., Masiak, M. (2007). Analiza danych demograficznych i relacji w rodzinach kobiet z bulimią. Psychiatria Polska, 41, 3, 365-376.
Peñas-Lledó, E., Vaz, F. J., Ramos, M. I., Waller, G. (2002). Impulsive behaviors in bulimic patients: Relation to general psychopathology. International Journal of Eating Disorders, 32, 1, 98-102.
Presnell, K., Bearman, S. K., Stice, E. (2004). Risk factors for body dissatisfaction in adolescent boys and girls: A prospective study. International Journal of Eating Disorders, 36, 4, 389-401.
Preti, A., Incani, E., Camboni, M. V., Petretto, D. R., Masala, C. (2006). Sexual abuse and eating disorder symptoms: The mediator role of bodily dissatisfaction. Comprehensive Psychiatry, 47, 6, 475-481.
Preti, A., Incani, E., Camboni, M. V., Petretto, D. R., Masala, C. (2008). Prevalence of symptoms of anorexia nervosa and dissatisfaction with body image among female adolescents in Floranó- polis, Santa Catarina State, Brazil. Cadernos de Saúde Pública, 24, 3, 503-512.
Raimbault, G., Eliacheff, C. (1989). Les indomptables. Figures de l’anorexie. Paris: Éditions Odile Jacob.
Rosen, J. C., Ramizer, E. (1998). A comparison of eating disorders and body dysmorphic disorder on body image and psychological adjustement. Journal of Psychosomatic Research, 44, 3-4, 441-449.
Schilder, P. (1950). The image and appearance of the human body. New York: International Universities Press.
Shafran, R., Cooper, Z., Fairburn, C. G. (2002). Clinical perfectionism: A cognitive-behavioural analysis. Behavior Research and Therapy, 40, 7, 773-791.
Sjôô, M., Mor, B. (1987). The great cosmic mother: Rediscovering the religion of the Earth. San Francisco: Harper San Francisco.
Slade, P. D. (1982). Towards a functional analysis of anorexia nervosa and bulimia nervosa. British Journal of Clinical Psychology, 21, 167-179.
Strober, M. (1982). Locus of control, psychopathology, and weight gain in juvenile anorexia nervosa. Journal of Abnormal Child Psychology, 10, 1, 97-106.
Troisi, A., Di Lorenzo, G., Alcini, S., Nanni, R. C., Di Pasquale, C., Siracusano, A. (2006). Body dissatisfaction in women with eating disorders: Relationship to early separation anxiety and insecure attachment. Psychosomatic Medicine, 68, 3, 449-453.
Vandereycken, W. (2002). Families of patients with eating disorders. W: C. G. Fairburn, K. D. Brownell (red.), Eating disorders and obesity. A comprehensive handbook (s. 215-220). New York: Guilford Press.
Van Elderen, T., Maes, S., Komproe, I., van der Kamp, L. (1997). The development of an anger expression and control scale. British Journal of Health Psychology, 2, 269-281.
Zigmond, A., Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 6, 361-370.
American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association.
Bennett, W., Gurin, J. (1982). The dieter’s dilemma. New York: Basic Books.
Bomba, J., Józefik, B. (2003). Leczenie anoreksji i bulimii psychicznej: co, kiedy, komu? Kraków: Biblioteka Psychiatrii Polskiej.
Bruch, H. (1962). Perceptual and conceptual disturbances in anorexia nervosa. Psychosomatic Medicine, 24, 187-194.
Brytek, A. (2005). Contribution des modèles sur l’autorégulation du comportement dans la compréhension des troubles alimentaires. Perspectives interculturelles (mps pracy doktorskiej, Metz, Université Paul Verlaine).
Brytek-Matera, A. (2007). Ocena poczucia własnej wartości w jadłowstręcie i bulimii psychicznej: badania porównawcze. Psychoterapia, 3, 53-65.
Brytek-Matera, A. (2008a). Obraz ciała - obraz siebie. Wizerunek własnego ciała w ujęciu psychospołecznym. Warszawa: Difin.
Brytek-Matera, A. (2008b). Anorexia nervosa and emotional symptoms: A cross-cultural study.
Archives of Psychiatry and Psychotherapy, 4, 39-46.
Brytek-Matera, A., Schiltz, L. (2009). Cross-cultural examination of the relationship between negative mood states, body image and eating disorders. Bulletin de la Société des Sciences Médicales du Grand Duché de Luxembourg, 1, 11-25.
Bulik, C. M. (2002). Anxiety, depression and eating disorder. W: C. G. Fairburn, K. D. Brownell (red.), Eating disorders and obesity. A comprehensive handbook (s. 193-199). New York: Guilford Press.
Chuchra, M., Drzazga, K., Pawłowska, B. (2006). Postawy rodzicielskie a poczucie kontroli w percepcji dziewcząt z anoreksją. Psychiatria Polska, 40, 4, 731-742.
Coopersmith, S. (1984). Manuel d’inventaire d’Estime de Soi. Paris: CPA.
Dixon, R., Adair, V., O’Connor, S. (1996). Parental influences on the dieting beliefs and behaviors of adolescent females in New Zealand. Journal of Adolescent Health, 19, 4, 303-307.
Espina, A., Asunción Ortego, M., Ochoa de Alda, I., Aleman, A., Juaniz, M. (2002). Body shape and eating disorders in a sample of students in the Basque country. Psychology in Spain, 6, 3-11.
Fassino, S., Daga, G. A., Piero, A., Leombruni, P., Rovera, G. G. (2001). Anger and personality in eating disorders. Journal of Psychosomatic Research, 51, 6, 757-764.
Gamer, D. M., Olmsted, M. P., Polivy, J. (1983). The Eating Disorder Inventory: A measure of cognitive-behavioral dimensions of anorexia nervosa and bulimia. W: P. L. Darby, P. E. Garfin- kel, D. M. Garner, D. V. Coscina (red.), Anorexia nervosa: Recent developments in research (s. 173-184). New York: Alan R. Liss.
Głębocka, A., Bednarska, M. (2005). Wizerunek ciała kobiet cierpiących na anoreksję. W: A. Głębocka, J. Kulbat (red.), Wizerunek ciała. Portret Polek (s. 79-93). Opole: Wydawnictwo Uniwersytetu Opolskiego.
Gokart, N. T., Perdereau, F., Curt, F., Lang, F., Venisse, J. L., Halfon, O., Bizouard, P., Loas, G., Corcos, M., Jeammet, P., Flament, M. F. (2004). Predictive factors of social disability in anorexic and bulimic patients. Eating and Weight Disorders, 9, 4, 249-257.
Grabhorn, R., Stenner, H., Kaufbold, J., Overbeck, G., Stangier, U. (2005). Shame and social anxiety in anorexia and bulimia nervosa. Zeitschrift für Psychosomatische Medizin und Psychotherapie, 51, 2, 179-193.
Hinrichsen, H., Sheffield, A., Waller, G. (2007). The role of parenting experiences in the development of social anxiety and agoraphobia in the eating disorders. Eating Behaviors, 8, 3, 285-290.
Jablow, M. (2000). Na bakier z jedzeniem. Anoreksja, bulimia, otyłość. Gdańsk: GWP.
Jakubczyk, A., Żechowski, C. (2000). Psychoanalityczne poglądy na zaburzenia odżywiania się. W: I. Namysłowska (red.), Zaburzenia psychiczne dzieci i młodzieży. Wybrane zagadnienia (s. 95-106). Kraków: Biblioteka Psychiatrii Polskiej.
Józefik, B. (2006). Relacje rodzinne w anoreksji i bulimii psychicznej. Kraków: Wydawnictwo Uniwersytetu Jagiellońskiego.
Józefik, B., Ulasińska, R. (1999). Perspektywa rodzinna a rozumienie zaburzeń odżywiania się. W: B. Józefik (red.), Anoreksja i bulimia psychiczna. Rozumienie zaburzeń odżywiania (s. 88-103). Kraków: Wydawnictwo Uniwersytetu Jagiellońskiego.
Knauss, C., Paxton, S. J., Alsaker, F. D. (2007). Relationships amongst body dissatisfaction, internalisation of the media body ideal and perceived pressure from media in adolescent girls and boys. Body Image, 4, 4, 353-360.
Leung, F., Schwartzman, A., Stieger, H. (1996). Testing a dual-process family understanding the development of eating disorders psychopathology: A structural modeling analysis. International Journal of Eating Disorders, 20, 4, 367-375.
Levine, M. P., Piran, N. (2004). The role of body image in the prevention of eating disorders. Body Image, 1, 57-70.
Loas, G., Dardennes, R., Dhee-Perot, P., Leclerc, V., Fremaux, D. (1994). Opérationnalisation du concept de „lieu de contrôle”: traduction et première étude de validation de l’échelle de contrôle de Levenson (IPC: The Internal Powerful Others and Chance Scale). Annales Médico-Psychologiques, 152, 7, 466-469.
Łucka, I. (2004). Zaburzenia depresyjne współwystępujące z jadłowstrętem psychicznym. Psychiatria Polska, 38, 4, 621-629.
Malinowska, K. (2007). Realny i idealny obraz siebie u osób po próbach samobójczych. Annales Universitatis Mariae Curie-Skłodowska, 20 (sectio J), 87-100.
Pawłowska, B., Masiak, M. (2007). Analiza danych demograficznych i relacji w rodzinach kobiet z bulimią. Psychiatria Polska, 41, 3, 365-376.
Peñas-Lledó, E., Vaz, F. J., Ramos, M. I., Waller, G. (2002). Impulsive behaviors in bulimic patients: Relation to general psychopathology. International Journal of Eating Disorders, 32, 1, 98-102.
Presnell, K., Bearman, S. K., Stice, E. (2004). Risk factors for body dissatisfaction in adolescent boys and girls: A prospective study. International Journal of Eating Disorders, 36, 4, 389-401.
Preti, A., Incani, E., Camboni, M. V., Petretto, D. R., Masala, C. (2006). Sexual abuse and eating disorder symptoms: The mediator role of bodily dissatisfaction. Comprehensive Psychiatry, 47, 6, 475-481.
Preti, A., Incani, E., Camboni, M. V., Petretto, D. R., Masala, C. (2008). Prevalence of symptoms of anorexia nervosa and dissatisfaction with body image among female adolescents in Floranó- polis, Santa Catarina State, Brazil. Cadernos de Saúde Pública, 24, 3, 503-512.
Raimbault, G., Eliacheff, C. (1989). Les indomptables. Figures de l’anorexie. Paris: Éditions Odile Jacob.
Rosen, J. C., Ramizer, E. (1998). A comparison of eating disorders and body dysmorphic disorder on body image and psychological adjustement. Journal of Psychosomatic Research, 44, 3-4, 441-449.
Schilder, P. (1950). The image and appearance of the human body. New York: International Universities Press.
Shafran, R., Cooper, Z., Fairburn, C. G. (2002). Clinical perfectionism: A cognitive-behavioural analysis. Behavior Research and Therapy, 40, 7, 773-791.
Sjôô, M., Mor, B. (1987). The great cosmic mother: Rediscovering the religion of the Earth. San Francisco: Harper San Francisco.
Slade, P. D. (1982). Towards a functional analysis of anorexia nervosa and bulimia nervosa. British Journal of Clinical Psychology, 21, 167-179.
Strober, M. (1982). Locus of control, psychopathology, and weight gain in juvenile anorexia nervosa. Journal of Abnormal Child Psychology, 10, 1, 97-106.
Troisi, A., Di Lorenzo, G., Alcini, S., Nanni, R. C., Di Pasquale, C., Siracusano, A. (2006). Body dissatisfaction in women with eating disorders: Relationship to early separation anxiety and insecure attachment. Psychosomatic Medicine, 68, 3, 449-453.
Vandereycken, W. (2002). Families of patients with eating disorders. W: C. G. Fairburn, K. D. Brownell (red.), Eating disorders and obesity. A comprehensive handbook (s. 215-220). New York: Guilford Press.
Van Elderen, T., Maes, S., Komproe, I., van der Kamp, L. (1997). The development of an anger expression and control scale. British Journal of Health Psychology, 2, 269-281.
Zigmond, A., Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 6, 361-370.
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