Conductas alimentarias de riesgo y habilidades sociales en una muestra de adolescentes mexicanas / Risk eating behaviors and social skills in a sample of Mexican adolescents

ABSTRACT

Research about ED (eating disorder) has shown important advances in the last decades. We have distinguished two main ways of aproaching this topic. On the one hand there are several works in the clinical field, focused in studying the symptomatology, psychiatric taxonomy and treatment of those disorders. On the other hand, there is significant research on the epidemiological field, which is more focused towards the understanding of the phenomenon. In fact, this second approach led to the development of the preventive approach in the late 90s. This approach focuses in the population at risk and this work is framed in the preventive approach. The difference between a TCA and a risk factor is that the first one forms a syndrome, a set of symptoms (quantitatively and qualitatively) grouped as diagnostic criteria identified in the DSM-IV-TR. On the other hand, risk factors are those isolated manifestations or symptoms that appear with a lesser magnitude and frequency. For example, abnormal eating behavior like following a diet to control weight or excessive concern about personal body weight. One of the most important factors that occurs before the development of an ED is following a restricted diet. Hence, the risk for people on a diet of turning into clinical cases increases eight times. Moreover, such behavior has become a normative practice, specifically in Western societies. Thus, several authors have pointed out that patients show autonomy problems previous to the disorder. Examples include interpersonal problems such as introversion, insecurity, dependency, social anxiety, lack of assertiveness, difficulty to establish relationships with the opposite gender, inefficiency feelings, failure and lack of control in the academic, working and social fields. All these are indicators of a latent discrepancy of social skills. Considering that restricted dieting represents a fundamental risk factor on the development of an ED, and under the assumption that the deficit in social skills is a predisposing factor in such disorders, the aim of this work was to determine if there is a relation between various social skills and abnormal eating behaviors (following a restricted diet or concern about weight and food) in Mexican adolescent women. We worked with a sample of N = 700 women, coming from five different public middle schools mixed with or = 12.81 years old and SD = 0.73. The data was collected through two instruments Health and Nourishing Questionnaire, and Pluridimensional Assertive Behavior Scale, adapted to the Mexican population. Among the more relevant results we found a significant correlation between the following two variables social skills and eating behaviors (dieting r = 0.148, p<0.01 and concern about weight and food r = 0.081, p< 0.05). Although the correlation was low, it can be interpreted as a tendency in the following way <social skills the person has, the more restricted diets and concerns about weight and food we can observe>>. In a second analysis, in which extreme groups (high and low social skills) were compared, our results confirmed the theory about relating these two variables. The mean values indicate that in the first group (low social skills) restricted dieting was a greater problem [t (306) = -1.329, p= .002] than in the second group (high social skills). Other results showed that more than half of the participants (56%) have followed a restricted dieting in the past and 65% of them are concerned about their body weight. Additionally, a significant correlation between these two variables was found (r = 0.677, p<0.01), confirming that these behaviors have become normative among women at this age and these constitute a latent risk to the development of ED. Furthermore, it is a cause of concern that the findings of this study show that girls are involved in restricted dieting even at an early age (seven years old) and that at six years old they begin to be concerned about their body weight. These results are similar to other studies that show women starting practices that might produce eating disorders at very early stages nowadays, due to being more exposed and more vulnerable to social pressure that promotes the thinness culture. One of the most interesting contributions was the fact that among Mexican adolescent women, similarly to women in the western world (USA, France or Spain), we have found a relation between low levels in social skills and restricted dieting. This phenomenon increases the risk of suffering from an ED, and shows the effects of social pressure referring to the thinness culture in countries such as Mexico, with its still developing society. It is important to point out that, in order to make the relation clear, it is necessary to accomplish more research towards determining a causal relationship between the two variables. In this way, data can be obtained in order to build up prevention strategies in the following way training in Social Skills (TSS) could act as a protection factor against the development of these disorders. If a deficit in social skills can predict weight control dieting, the TSS might decrease or eliminate the risk in adolescents frequently subdued to dieting and/or show risky eating behavior as a consequence of social pressure towards thinness. Among the limitations of this study we can mention that the results cannot be generalized from the particular study sample. For this purpose we propose working with probabilistic samples and with different features, as well as implementing a new analysis that could show the specific social skills in which the problem is accentuated. This would contribute to search the possible causal link between the variables <<social skills>> and <<risk eating behaviors>>.

RESUMEN

En las investigaciones relacionadas con los trastornos de la conducta alimentaria (TCA) se distinguen dos vertientes principales. Por una parte proliferan los trabajos en el ámbito clínico, éstos se enfocan en la sintomatología, en esclarecer la taxonomía psiquiátrica y en el tratamiento de dichos trastornos. Por otra parte, se constata la investigación en el ámbito epidemiológico, la cual está más enfocada en la comprensión del fenómeno. De esta segunda vertiente se deriva, a principios de la década de los noventa, el enfoque preventivo, el cual centra su interés en la población de riesgo. Es en este enfoque en el cual se enmarca el presente trabajo. La distinción entre un TCA y un factor de riesgo es que el primero conforma un síndrome, un conjunto de síntomas (cuantitativa y cualitativamente) agrupados como criterios diagnósticos señalados en el DSM-IV-TR, mientras que los factores de riesgo son aquellas manifestaciones o síntomas aislados que se presentan con menor magnitud y frecuencia. El presente trabajo tuvo como objetivo determinar si existe relación entre las variables habilidades sociales y conductas alimentarias anómalas (seguimiento de dieta restringida y preocupación por el peso y la comida) en mujeres adolescentes mexicanas. Se trabajó con una muestra de N = 700 mujeres de cinco distintas secundarias públicas mixtas con revistas/sm/v31n6/a4s1.jpg" > o = 12.81 de edad y DE = 0.73. Los datos se recopilaron mediante dos instrumentos el Cuestionario de Alimentación y Salud, y la Escala Pluridimensional de Conducta Asertiva adaptada a población mexicana. Entre los resultados de mayor relevancia se encontró una correlación significativa entre las variables habilidades sociales y conductas alimentarias anómalas (dieta r = 0.148, p< 0.01 y preocupación por el peso y la comida r = 0.081, p< 0.05). Aunque la correlación fue baja resultó ser positiva, esto se puede interpretar como una tendencia en la siguiente dirección <habilidades sociales, mayor seguimiento de dieta restringida y mayor preocupación por el peso y la comida>>. En un segundo análisis en el cual se compararon grupos extremos (nivel alto y nivel bajo de habilidades sociales), se encontraron resultados que confirman la relación entre estas variables. El valor de las medias indica que en el grupo con nivel bajo de habilidades sociales se reportó una mayor problemática durante el seguimiento de una dieta restringida [t (306) = -1 .329, p = .002], comparado con el grupo de nivel alto de habilidades. Una de las aportaciones más interesantes fue el hecho de que entre las adolescentes mexicanas, a semejanza de mujeres que habitan en países de primer mundo como EU, Francia y España, se encontró una relación entre niveles bajos de habilidades sociales y el seguimiento de una dieta restringida. Este fenómeno incrementa el riesgo de padecer un TCA y pone de manifiesto el efecto de la presión social con referencia a la cultura de la delgadez en países como México, que es una sociedad en vías de desarrollo.