Functional gastrointestinal symptoms and increased risk for orthorexia nervosa.

PURPOSE: Recent guidelines point out the possible risk for orthorexia nervosa in functional gastrointestinal disorders, however, to date, no study has investigated this association. The present study aimed to explore the potential relationship between irritable bowel syndrome-related functional gastrointestinal symptoms and certain maladaptive eating behaviours, such as symptoms of orthorexia nervosa and emotional eating. METHODS: A sample of 644 Hungarian volunteers (Mage = 22.37; SDage = 3.95) completed a survey with the following questionnaires: the Rome IV Diagnostic Questionnaire (R4DQ) for adults-Irritable bowel syndrome module for the measurement of functional gastrointestinal symptoms, the Hungarian version of the ORTO-15 questionnaire (ORTO-11-Hu) to assess symptoms of orthorexia nervosa, the Three-Factor Eating Questionnaire (TFEQ) Emotional Eating subscale to measure symptoms of emotional eating and the Short Health Anxiety Inventory (SHAI) for the assessment of health anxiety. Spearman's rank correlation was used to explore the associations between the measured variables, and structural equation modeling was used to test the proposed mediation models. RESULTS: Functional gastrointestinal symptoms were positively related to symptoms of orthorexia nervosa and emotional eating. The relationship between functional gastrointestinal symptoms and symptoms of orthorexia nervosa was partially mediated by health anxiety, while the association between functional gastrointestinal symptoms and symptoms of emotional eating was partially mediated by symptoms of orthorexia nervosa. CONCLUSION: Our findings highlight the possible risk for developing orthorexic symptoms in functional gastrointestinal symptoms, which could lead to other types of disordered eating patterns, such as emotional eating. The results also underscore the potential role of health anxiety in these relationships. LEVEL OF EVIDENCE: Level V (descriptive cross-sectional study).

The associations between orthorexia nervosa and the sociocultural attitudes: the mediating role of basic psychological needs and health anxiety.

PURPOSE: Given the range of negative correlates associated with orthorexia nervosa (ON), it is important to identify factors that might contribute to the elevated ON tendencies. Based on the tripartite model of influence, we tested whether sociocultural attitudes towards appearance (i.e., thin and muscular internalization as well as family, peer and media pressure) could contribute to ON. We hypothesized that these attitudes could exert their effect through the intervening processes basic psychological need fulfillment and health anxiety. METHODS: The hypotheses were tested on a sample of 710 young adults (Mage = 21.79, SDage = 2.31). Participants completed validated questionnaires measuring the constructs of interest. RESULTS: According to the structural equation modeling results, ON was predicted by thinness and muscular internalization as well as media pressure. Need fulfillment and health anxiety partially mediated these relationships. Family and peer pressure were not related to ON. DISCUSSION: The present results suggest that internalization of appearance ideas and media pressure contribute to ON through need fulfillment and health anxiety. These findings also provide novel insight into the nature of ON. LEVEL OF EVIDENCE: Level V (descriptive cross-sectional study.

Posttraumatic stress disorder symptomology as measured by PCL-5 and its relationships to resilience, hostility and stress among paramedics and social professionals.

This survey study aimed to contribute to the extensive debate on the dimensionality of the Posttraumatic Stress Disorder Checklist for the DSM-5 (PCL-5) questionnaire by examining the psychometric properties and construct validity of its Hungarian version and relying on the inspection of a conceptual network of related variables, that is, perceived stress, hostility, and resilience. Confirmatory factor analysis (CFA), exploratory structural equation modelling (ESEM) and path analysis were applied on data collected from 177 paramedics and 66 professionals from the social field (58.4% male; Mage = 43.5 ± 9.96 years). Despite the acceptable fit indices gained with CFA when testing the original four-factor DSM-5 model of PCL-5, strong associations (r = 0.69-0.90) between subscales were found. Thus, ESEM was applied and as a result a new, three-factor version of the DSM-5 model of PCL-5 was proposed due to significant crossloadings that was theoretically also supported. The Reexperiencing and Avoidance subscales were merged and named Difficulty with Assimilation of Experience (DAE). In the path analysis only two of the tested associations were not significant using the new factor structure, in which stress fully mediated the relationship between resilience and DAE, and resilience and Hyperarousal. Overall, the hypothesised pathways between variables fit the collected data well. (weighted least squares mean-and variance-adjusted χ2 = 503.750 (df = 270), comparative fit index = 0.948, Tucker-Lewis index = 0.939, root mean square error of approximation (90% confidence interval) = 0.064 (0.055-0.073), weighted root mean square residual = 1.024). Our analysis of the Hungarian version of PCL-5 contributes to the testing of a DSM-5-based questionnaire measuring posttraumatic stress disorder symptomology.

Cross-cultural comparison of the motivations for healthy eating: investigating the validity and invariance of the motivation for healthy eating scale.

Objective: Applying self-determination theory, the present study examined the different regulatory processes of healthy eating motivations and their determinants in a cross-cultural sample by exploring the factor structure, measurement invariance, and construct validity of the Motivation for Healthy Eating Scale (MHES).Design: 381 Hungarian, 264 Japanese, and 293 Norwegian university students participated in the cross-sectional survey study. The psychometric evaluation was done by applying confirmatory factor analysis (CFA), correlation analysis, and CFA with covariates testing.Main outcome measures: Besides the six factors of MHES (Amotivation, External, Introjected, Integrated, Identified regulation and Intrinsic motivation), validating variables included obesity status, breakfast skipping, wellbeing, and emotional, external and restrained eating styles.Results: The a priori six-factor model of MHES adequately fit the sample data from all three cultures. The questionnaire demonstrated invariance of the factor structure and factor loadings across all of the groups. The different types of regulatory processes showed weak associations with the validating variables in the expected directions, with somewhat varied patterns across cultures.Conclusion: The MHES is a valid tool that measures different types of behavioural regulations of healthy eating. The measure is interpreted similarly across different cultures, which makes further investigations of the factors promoting healthy eating possible.

Intuitive eating in light of other eating styles and motives: Experiences with construct validity and the Hungarian adaptation of the Intuitive Eating Scale-2.

Intuitive eating (IE), an adaptive eating approach, has been identified as a plausible positive determinant of physical and mental well-being. This cross-sectional survey study aimed to examine the construct validity of IE measured by the Intuitive Eating Scale-2 (IES-2). The conceptual network of different adaptive and maladaptive eating behaviors was also explored. Confirmatory factor analysis (CFA), measurement invariance testing, and correlation analyses were applied on the data from a sample of 732 Hungarian university students. Validating variables included several eating behavior styles (i.e., obesogenic eating behaviors, mindful eating [ME], and dieting practices) and motivational factors (i.e., autonomous, controlled, and amotivational sources of healthy eating, and internalization of the thin and muscular body ideals). The results of the CFA supported the original four-factor structure of the IES-2 without a global second-order factor. The scale exhibited measurement invariance on the scalar level across sexes and BMI categories. The IES-2 subscales showed adequate reliability. IE and ME were found to be positively related but conceptually distinct constructs. Autonomous motivation for healthy eating, restrained eating, and current dieting exhibited different yet meaningful associations to IE on the subscale level. Undertaking subscale-level analyses is recommended when using the IES-2.

Alcohol consumption and risk for feeding and eating disorders in adolescence: The mediating role of drinking motives.

BACKGROUND: A complex and bidirectional association has been assumed between feeding and eating disorders (FEDs) and alcohol consumption. Previous research has demonstrated that alcohol use among individuals with different forms of FEDs is more frequently motivated by two subtypes of internal drinking motives: coping and enhancement motives. Namely, these individuals might use alcohol primarily to regulate internal states, such as to mitigate negative emotions or enhance positive emotions. OBJECTIVES: The present study investigated the mediating role of internal drinking motives on the association between risk for FEDs and alcohol consumption over the effects of relevant covariates, such as depressive symptoms or body mass index (BMI). METHODS: Hungarian data of the European School Survey Project on Alcohol and Other Drugs (ESPAD) from 2015 were used. The final sample included responses from 5457 adolescents (50% males; mean age: 16.62 years). Validated self-report psychometric instruments assessed the level of alcohol use, depressive symptoms and risk for FEDs, and drinking motives. RESULTS: Risk for FEDs presented a significant positive relationship with internal drinking motives and alcohol use. In the mediation analysis, a significant indirect effect was identified between risk for FEDs and alcohol use via internal drinking motives among females. CONCLUSIONS: Results demonstrated that risk for FEDs was positively associated with internal drinking motives and alcohol use. An indirect effect of risk for FEDs on alcohol consumption via internal drinking motives was discriminated over the impact of depressive symptoms. However, the latter relationship was only found among females which may highlight the gender differences in the relationship between risk for FEDs and alcohol use.