The role of the perception of family environment in relation to body dissatisfaction, disordered eating and difficulties in close relationships.

PURPOSE: Invalidating childhood environments have been characterised as those in which caregivers do not validate a child's personal experiences and the communication of emotions is considered inappropriate, being either ignored or punished. The current study assessed the relationships among invalidating childhood environments, body dissatisfaction, disordered eating and difficulties in close relationships in a sample of college students. METHODS: In this study, 362 non-clinical participants with ages ranging from 17 to 25 years (M = 20.02, SD = 1.51) completed self-report measures. RESULTS: Difficulties in close relationships, body dissatisfaction and disordered eating were significantly higher in invalidating families than in validating families. Invalidating childhood environments were associated with higher body dissatisfaction and disordered eating, and both associations were mediated by difficulties in close relationships. Finally, body dissatisfaction mediates the effects of BMI and difficulties in close relationships on eating disorder symptoms. CONCLUSIONS: Perceived experiences of invalidation in childhood may be associated with eating disorder symptomatology. In addition, difficulties in close relationships during adulthood possibly contribute to the emergence of eating disorder symptoms. LEVEL OF EVIDENCE: Level V, descriptive study.

Psychometric properties of the Portuguese version of the Invalidating Childhood Environment Scale.

PURPOSE: The current study aimed to examine the psychometric properties of the Portuguese version of the invalidating childhood environment scale (ICES) in a non-clinical and clinical sample of eating disorder (ED) patients. This study also investigated the between-sample differences regarding invalidating parental behaviors and family styles and explored the associations between invalidating childhood environments and eating pathology. METHODS: A sample of 410 high school and college students and 101 patients with a diagnosis of ED completed self-report measures. Principal component analyses and confirmatory factor analyses were conducted to examine the factor structure of the ICES. The internal consistency and the between-sample differences and associations between invalidating childhood environments and eating pathology were also tested. RESULTS: Principal component analyses and confirmatory factor analyses indicated a two-factor solution for each parent. The ICES demonstrated high internal consistency and was able to differentiate between non-clinical and clinical samples. The perception of parental invalidation was higher in ED patients, and the clinical sample presented higher scores in the chaotic and perfect family styles and lower scores in the validating family style, in comparison with the non-clinical sample. Both maternal invalidation and invalidating styles were significantly associated with a higher ED symptomatology. CONCLUSIONS: The Portuguese version of the ICES revealed adequate psychometric properties. Considering the relationship between invalidation in family and eating pathology, the ICES may be useful in clinical practice, especially among ED patients. LEVEL OF EVIDENCE: Level V, cross-sectional descriptive study.

Eating and weight/shape criticism as a specific life-event related to bulimia nervosa: a case control study.

The present study aims to evaluate the occurrence of life events preceding the onset of eating problems in bulimia nervosa patients. A case-control design was used involving the comparison of 60 female subjects who meet DSM-IV criteria for bulimia nervosa with 60 healthy control subjects and 60 subjects with other psychiatric disorders. The RFI (Fairburn et al., 1998) subset of factors that represent exposure to life events in the 12 months immediately before the development of eating problems was used. Women with bulimia nervosa reported higher rates of major stress, criticism about eating, weight and shape and also a great number of antecedent life events during the year preceding the development of eating problems than the healthy control group. However, when compared with the general psychiatric control group only the exposure to critical comments about weight, shape, or eating emerged as a specific trigger for bulimia nervosa. Our findings support the fact that eating and shape/weight criticism in the year preceding the development of eating disturbance seems to be specifically related to bulimia nervosa.

Appearance Comparisons, Affect, Body Dissatisfaction and Eating Pathology in Portuguese Female University Students.

Physical appearance comparisons have been theorized to be associated with negative indicators of body image. This study aimed to study appearance comparisons and their association to affect, body dissatisfaction, and eating pathology. Three hundred and ten female university students with ages between 17 and 25 years (M = 20.2, SD = 1.9) completed sociodemographic and clinical data, self-reported questionnaires, and questions about appearance comparisons. Among the participants, 98.71% reported making appearance comparisons, and 42.15% of these reported making them frequently or always. Higher reported frequencies of appearance comparisons were related to higher levels of body dissatisfaction, negative affect, and eating pathology. Appearance comparisons to acquaintances were the most frequent. Comparisons in person and through media were reported in similar proportions. Upward comparisons were more frequent than lateral and downward comparisons and were related to higher levels of body dissatisfaction than downward comparisons and to higher levels of body dissatisfaction, negative affect, and eating pathology than lateral comparisons. Upward comparisons to close peers were associated with higher body dissatisfaction as opposed to models/celebrities. Results, limitations, and implications are discussed.

Coping as a Mediator and Moderator between Psychological Distress and Disordered Eating Behaviors and Weight Changes during the COVID-19 Pandemic.

Previous research has already shown the negative impact of the COVID-19 pandemic on college students' well-being and mental health. Eating problems and weight gain due to changes in eating habits and physical activity experienced during this period have also been noticed. However, few studies have explored the role of students' resources as used during the COVID-19 pandemic, such as coping strategies. This study aimed to (1) explore the associations among psychological distress, disordered eating, coping strategies, and weight changes; (2) examine the moderating role of coping strategies in the process of weight gain and weight loss; and (3) study the mediating role of coping strategies in the process of weight gain and weight loss. The participants in this study were 772 students at a Portuguese university. The data collected included sociodemographic data and three self-reported questionnaires (Depression, Anxiety, and Stress Scale; Eating Disorder Examination Questionnaire; Brief COPE) during the first few months of the pandemic, which included a 72-day full national lockdown. The results showed that depression, anxiety, stress, and disordered eating were related to increased weight. Guilt, denial, self-distraction, use of substances, and behavior disinvestment were also related to increased weight. Behavioral disinvestment had a strong mediating effect on weight gain. Additionally, planning, positive reframing, and acceptance all showed a moderating effect between psychological distress and weight changes. In conclusion, coping strategies allow for a better understanding of the mechanisms by which psychological distress and disordered eating were related to weight changes during the pandemic.

Loss of Control over Eating, Inhibitory Control, and Reward Sensitivity in Children and Adolescents: A Systematic Review.

OVERVIEW: In recent years, there has been increasing clinical and empirical interest in the concept of pediatric loss of control over eating, particularly about its link with the executive functions related to the concept of impulsivity, such as inhibitory control and reward sensitivity. However, there has yet to be a comprehensive literature synthesis about the associations between these variables. A comprehensive literature synthesis would help identify future research directions to advance the field in this area. Therefore, this systematic review aimed to synthesize evidence concerning the associations between loss of control over eating, inhibitory control, and reward sensitivity in children and adolescents. METHODS: The systematic review was conducted according to the guidelines proposed by PRISMA in Web of Science, Scopus, PubMed, and PsycINFO. The Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies was used to assess the risk of bias. RESULTS: Twelve studies met the selection criteria and were included in the final review. Overall, methodological heterogeneity, variability in assessment methods, and the age of participants make it difficult to draw general conclusions. Nevertheless, most studies with community samples of adolescents indicate that inhibitory control difficulties are linked to the concept of loss of control eating. The presence of obesity seems to be associated with inhibitory control difficulties, regardless of the presence of loss of control eating. Studies on reward sensitivity are scarcer. However, it has been suggested that higher reward sensitivity is related to loss of control eating behaviors in young people, particularly binge eating. CONCLUSIONS: The literature on the link between loss of control eating and trait-level facets of impulsivity (low inhibitory control and higher reward sensitivity) among young people remains limited, and more studies on children are needed. Findings from this review may make healthcare professionals more aware of the potential clinical importance of targeting the trait-level facets of impulsivity and help to inform existing and future weight-loss/maintenance interventions in childhood and adolescence.

Food Addiction and Grazing-The Role of Difficulties in Emotion Regulation and Negative Urgency in University Students.

University students are a vulnerable population to the development of disordered eating, such as food addiction (FA) and grazing. FA is an emerging concept characterized by an intense desire to eat hyper-palatable foods. Grazing is characterized by the repetitive and unplanned ingestion of food throughout a period of time. Both FA and grazing have been associated with increased scores of negative urgency (NU) and difficulties in emotion regulation (ER). This study aims to evaluate the frequency of FA and grazing in a university population and to test the direct, total, and indirect effects-via FA-of ER and NU on repetitive eating and compulsive grazing. A total of 338 participants responded to a set of psychological measures assessing these variables. Thirty-six (10.7%) participants met the criteria for FA diagnosis and 184 (54.4%) presented grazing. Confirmatory factor analysis showed acceptable fit indexes for the model tested (χ2(1695) = 3167.575; p < 0.001; CFI = 0.955; NFI = 0.908; TLI = 0.953; SRMR = 0.085; RMSEA = 0.051; CI 90% (0.048; 0.053); P[RMSEA ≤ 0.05] = 0.318) and suggested that FA partially mediated the effect of difficulties in ER and NU on grazing, specifically on compulsive grazing. The results indicate that individuals with difficulties in ER and impulse control under negative emotions are more likely to engage in grazing if food addiction scores are higher. These results highlight the importance of assessing these variables, particularly in at-risk populations such as university students.

Impact of the COVID-19 pandemic on the mental and physical health and overall wellbeing of university students in Portugal.

Throughout the pandemic of COVID-19 caused by SARS-CoV-2, university students were considered a vulnerable risk group for mental health impairment and wellbeing deterioration. This study aimed at evaluating the pandemic's impact on the physical and mental health and wellbeing among students of a Portuguese university. This cross-sectional study included 913 participants and ran from June to October 2020. Data collected included sociodemographics, three mental health self-report questionnaires (Depression Anxiety Stress Scale, Eating Disorder Examination Questionnaire and Brief COPE) and lifestyle practices (eating and sleeping patterns, media, and entertainment habits) during the first months of the pandemic, which included a 72-day full national lockdown. Descriptive and correlational statistical analysis were conducted. Students' food habits changed during the pandemic, namely on the consumption of snacks and fast food and, overall, less balanced meals became more prevalent. Additionally, almost 70% of the students reported Body Mass Index changes, while 59% went through sleep pattern changes-these were more pronounced in women and younger students. Over half (67%) of the inquirees exhibited an increase in their stress, depression, and generalized anxiety symptoms. Also, the study demonstrates that students' lifestyles trended negatively during the pandemic and highlights how important regular psychological, health monitoring and emotional support is, amongst this somehow overlooked population throughout the pandemic. Universities should provide support to overcome challenges in future stressful situations. This study might have an impact on how universities and higher education systems approach their students in terms of mental and physical health monitoring and promotion in future situations, non-related with COVID. Moreover, it has a large sample of students well characterized in terms of mental and physical health, which might be of interest for future comparison with other worldwide group of students throughout stressful situations, such as tragic events, wars, pandemics.

Behavioral/Emotional Problems of Preschoolers: Caregiver/Teacher Reports From 15 Societies.

This study tested societal effects on caregiver/teacher ratings of behavioral/emotional problems for 10,521 preschoolers from 15 societies. Many societies had problem scale scores within a relatively narrow range, despite differences in language, culture, and other characteristics. The small age and gender effects were quite similar across societies. The rank orders of mean item ratings were similar across diverse societies. For 7,380 children from 13 societies, ratings were also obtained from a parent. In all 13 societies, mean Total Problems scores derived from parent ratings were significantly higher than mean Total Problems scores derived from caregiver/teacher ratings, although the size of the difference varied somewhat across societies. Mean cross-informant agreement for problem scale scores varied across societies. Societies were very similar with respect to which problem items, on average, received high versus low ratings from parents and caregivers/teachers. Within every society, cross-informant agreement for item ratings varied widely across children. In most respects, results were quite similar across 15 very diverse societies.

International comparisons of behavioral and emotional problems in preschool children: parents' reports from 24 societies.

International comparisons were conducted of preschool children's behavioral and emotional problems as reported on the Child Behavior Checklist for Ages 1½-5 by parents in 24 societies (N = 19,850). Item ratings were aggregated into scores on syndromes; Diagnostic and Statistical Manual of Mental Disorders-oriented scales; a Stress Problems scale; and Internalizing, Externalizing, and Total Problems scales. Effect sizes for scale score differences among the 24 societies ranged from small to medium (3-12%). Although societies differed greatly in language, culture, and other characteristics, Total Problems scores for 18 of the 24 societies were within 7.1 points of the omnicultural mean of 33.3 (on a scale of 0-198). Gender and age differences, as well as gender and age interactions with society, were all very small (effect sizes < 1%). Across all pairs of societies, correlations between mean item ratings averaged .78, and correlations between internal consistency alphas for the scales averaged .92, indicating that the rank orders of mean item ratings and internal consistencies of scales were very similar across diverse societies.

Prevalence and correlates of picky eating in preschool-aged children: A population-based study.

OBJECTIVE: The present study, conducted with a population-based preschool children sample, aimed to examine the prevalence rates of picky eating according to the presence of the avoidance or restriction of food intake, searching for picky-eating correlates. METHODS: 959 children from 1.5 to 6years old were evaluated by their parents and caregivers/teachers. Picky eating was assessed by CBCL 1.5-5 and C-TRF, following Cano et al.'s (2015) procedure. RESULTS: The prevalence of picky eating was 25.1%. The comparison of the picky-eating group and the non-picky-eating group indicated that picky eating was more common in older children and in children from lower-income families with younger parents. Significant associations were found between picky eating, pregnancy and birth delivery complications. Emotional and behavioral problems were also found to differentiate picky eaters and non-picky eaters using DSM-5-oriented subscales. The results of a binary logistic regression analysis revealed that children with somatic complaints and attention problems were more likely to be picky eaters. DISCUSSION: Picky eating in preschool children should be considered together with sociodemographic features, pregnancy and delivery issues, and the presence of emotional and behavioral problems. Our results support the possibility that picky eating, as a specific eating pattern, could also be part of a broader pattern of behavioral problems in children.

Dysfunctional eating behaviour, psychological well-being and adaptation to pregnancy: A study with women in the third trimester of pregnancy.

This study evaluated the prevalence and predictors of dysfunctional eating. Women in the third trimester of pregnancy participated in this study (N = 105). Dysfunctional eating was associated with a higher body mass index, enhanced negative body image, more somatic symptoms, poorer marital relationships, more negative attitudes regarding pregnancy and the baby and more emotional problems. A higher body mass index prior to the pregnancy, higher weight gain during pregnancy and a more negative perception of body image predicted dysfunctional eating. Clinicians must be aware of the presence of dysfunctional eating during pregnancy to prevent relevant physiological and psychosocial consequences during this stage.

Anorexia nervosa: divergent validity of a prototype narrative

The objetive of this paper was to test the divergent validity (degree of discrimination) of an anoretic prototype narrative (i.e., communality of themes in the individual, core autobiographical memories), as well different characteristics of the participants which may be associated with the degree of prototype discrimination. Seventy participants diagnosed with anorexia nervosa participated in the study and were asked to indicate their degree of identification with four different narrative prototypes (depressive, agoraphobia, anorexic, alcoholic and drug addiction prototypes). Results did not confirm the divergent validity of the anorexic prototype narrative. Participants tended to identify primarily with the depressive prototype narrative. No significant differences were found between levels of identification with the anorexic prototype and depression, or agoraphobia and alcoholism prototype. The only significant difference found was between the anorexic and drug addiction prototype. However, severity and duration of the clinical condition were found to be associated with the degree of identification of prototype narrative. Results are discussed in terms of a transdiagnostic versus a prototype approach to the eating disorders psychopathology.