Exploring the associations between behavioral health risk factors, abnormal eating attitudes and socio-demographic factors among Chinese youth: Survey of 7,984 vocational high school students in Hunan in 2020.

Background: This study investigated the associations between behavioral health risk factors (anxiety, depression, stress, insomnia, drinking, smoking) and abnormal eating attitudes among Chinese vocational high school students (CVHSS). Potential moderating relationships were also explored with relevant socio-demographic factors of the student's age, sex, rural or urban community, household income, family type and educational level of the father and mother. Methods: A total of 7,984 students from three vocational high schools in Hunan, China completed a questionnaire about their socio-demographic characteristics, alcohol use, smoking, and symptoms of depression, anxiety, stress (21-item version of the Depression Anxiety Stress Scale), insomnia (8-item Athens Insomnia Scale), and abnormal eating attitudes (19-item Chinese version of Eating Attitudes Test). Results: The prevalence rates for behavioral health problems among these students ranged widely depending on the risk factor: 42.5% insomnia, 41.3% anxiety, 26.2% depression, 14.4% stress, 13.7% drinking, and 8.3% smoking. Additionally, 61.7% of students were at-risk for at least one of these six behavioral health disorders. Abnormal eating attitudes were associated with depression (r = 0.422), anxiety (r = 0.490), stress (r = 0.490), and insomnia (r = 0.375), with all of these relationships being significant (p < 0.01) and large size statistical effects. However, other analyzes found that none of the socio-demographic background factors had meaningful associations with the behavioral health risk factors (0 of 28 tests) and very few background factors were associated with the abnormal eating attitude measures (only 3 of 35 tests). Females had higher levels than males on dieting and bulimia but not on the other two eating attitude components. Conclusions: This study determined that behavioral health risk factors (sleep problems and anxiety in particular) were common among high school students in China and that mental health and sleep disorder risks also tended to co-occur in some students with abnormal eating attitudes. Therefore, prevention and early identification programs for behavioral risk factors are needed for this population. It is important to pay more attention to students with abnormal eating attitude-related symptoms, who may have also underlying mental health problems and need further evaluation.

Examining simultaneous associations of four emotion regulation strategies with abnormal eating behaviors/attitudes in early adolescents.

Previous research has suggested that emotion regulation strategies (ERSs) are associated with abnormal eating behaviors and attitudes (AEBs). Available data have demonstrated that frequent rumination, a major maladaptive ERS, is associated with elevated AEBs, whereas adaptive ERSs, such as problem-solving and cognitive reappraisal, showed negative associations with AEBs. Most previous studies examined the association of a single ERS with AEBs. Therefore, any significant associations between an individual ERS and AEB reported in previous research might stem from spurious correlations. The current cross-sectional study sought to examine simultaneous associations of four ERSs (rumination, problem-solving, distraction, and cognitive reappraisal) with two categories of ED symptoms (i.e., drive for thinness and bulimic symptoms) in early adolescents in Japan (ages 10-15, N = 5301). Participants self-reported their use of the different ERSs and the ED symptoms. We found certain ERSs were uniquely associated with levels of drive for thinness and bulimic symptoms even after controlling for body mass index, depression, and socioeconomic status. Particularly, frequent rumination in both boys and girls was associated with a severe drive for thinness and bulimic symptoms. Regarding adaptive strategies, frequent uses of problem-solving was associated with decreased bulimic symptoms only in girls, with the effect size being small. In addition, contrary to our expectation, greater use of distraction was associated with elevated AEBs, except the association with drive for thinness in boys. Although this study extended findings of previous research, prospective studies are required to clarify the causal relationship between ERSs and eating pathology.

A study on the relationship between exercise addiction, abnormal eating attitudes, anxiety and depression among athletes in Israel.

BACKGROUND AND AIMS: The aim of this study was to investigate the relationship between exercise addiction, abnormal eating attitudes, anxiety, and depression among competitive and amateur athletes. METHODS: Participants were 100 athletes of mean age 28.3 years (18-62), of which there were 67 males and 35 females. The sample consisted of competitive and amateur athletes who participated in individual and group sports. They filled in the Exercise Addiction Inventory, Body Shape Questionnaire, a questionnaire assessing Eating Attitudes Test, Spielberger State-Trait Anxiety Inventory, and Beck Depression Inventory (BDI). RESULTS: Ratings of exercise addiction were positively correlated with BDI scores across the study sample. Exercise addiction ratings were associated with abnormal eating attitudes, but not with trait or state anxiety. Athletes engaging in individual sports scored marginally higher on depression scores than group athletes but there was no difference in depression scores between competitive and amateur athletes. Multiple regression analysis revealed that abnormal eating attitudes contributed significantly to ratings of exercise addiction and explained 7.7% of the variance. According to the Sobel test, the difference in the association between exercise addiction and eating disorder was significant. Therefore, body shape was a mediating factor between eating disorder and exercise addiction. DISCUSSION AND CONCLUSIONS: This study extends our preliminary findings of an association between exercise addiction and depression. Second, abnormal eating attitudes may explain most of the variance of exercise addiction. This is a further support for previous evidence of comorbidity between exercise addiction and eating disorders.