Examining the Match Between Assessed Eating Disorder Recovery and Subjective Sense of Recovery: Preliminary Findings

This study examined how individuals clinically assessed as fully or partially recovered from an eating disorder subjectively perceived themselves in terms of stage of change in the recovery process. Individuals formerly seen for an eating disorder at a Midwestern clinic were recruited. Using validated definitions of recovery, 18 were fully recovered (physical, behavioral, and psychological recovery) and 15 were partially recovered (only physical and behavioral recovery); these groups were compared on overall stage of change and confidence related to this stage, dieting stage of change, and internality of motivation. The fully and partially recovered groups endorsed being fully recovered (overall and for dieting) at similar rates. There were trends for the fully recovered group seeking change primarily for themselves and being more confident in their stage of change choice. Results have implications for approaches when a client's assessed recovery stage does not match her subjective sense of recovery and for better understanding recovery from an eating disorder

Coping and social support as potential moderators of the relation between anxiety and eating disorder symptomatology

Trait anxiety and eating disorder (ED) symptomatology are often thought to be inextricably linked. Because anxiety often precedes an ED, predicts poor outcome, and persists even after recovery from an ED, it is important to examine whether certain factors have the ability to potentially attenuate anxiety’s effect on eating pathology. In the current study, we examined two possible moderating factors: coping skills and social support. Participants were 96 females seen at one point for an ED at a Midwestern clinic, including 53 with a current ED diagnosis and 43 who no longer met criteria for an ED and who were at varying levels of recovery. Results revealed that emotion-oriented coping moderated the relation between anxiety and ED symptoms. Individuals who were high in trait anxiety and who reported low levels of emotion-oriented coping reported much lower levels of ED symptomatology than those with high trait anxiety and high emotion-oriented coping. Contrary to our hypotheses, task-oriented coping, avoidance-oriented coping, and perceived social support (total, family, friend, and special person) did not emerge as moderators of the relation between trait anxiety and eating pathology. Results provide growing support that factors that interact with anxiety can lessen anxiety’s effect on eating pathology. Implications for treatment and future directions are discussed

Differences in coping across stages of recovery from an eating disorder

This study examined the relation between coping skills and eating disorder recovery by comparing these skills across healthy controls, fully recovered, partially recovered, and active eating disorder cases. Full recovery was defined using physical, behavioral, and psychological components

Objectified body consciousness in relation to recovery from an eating disorder

In Western society, the feminine body has been positioned as an object to be looked at and sexually gazed upon; thus, females often learn to view themselves as objects to be observed (i.e., objectified body consciousness (OBC)). This study examined the relation between OBC and eating disorder recovery by comparing its components across non-eating disorder controls, fully recovered, partially recovered, and active eating disorder cases. Results revealed that non-eating disorder controls and fully recovered individuals had similarly low levels of two components of OBC, body surveillance and body shame. Partially recovered individuals looked more similar to those with an active eating disorder on these constructs. The third component of OBC, control beliefs, and a conceptually similar construct, weight/shape self-efficacy, did not differ across groups. Results provide support for the importance of measuring aspects of self-objectification, particularly body surveillance and body shame, across the course of an eating disorder

Eating Expectancies in Relation to Eating Disorder Recovery

This study examined the relation between eating expectancies, assessed via the Eating Expectancy Inventory, and eating disorder recovery. Individuals formerly seen for an eating disorder were categorized as having an active eating disorder (n = 53), as partially recovered (n = 15), or as fully recovered (n = 20). The expectancies of these groups were compared to each other and to 67 non-eating disorder controls. Results revealed that three of the five eating expectancies differed across groups. Non-eating disorder controls and fully recovered individuals endorsed similar levels of the expectancies that eating helps manage negative affect, eating is pleasurable and useful as a reward, and eating leads to feeling out of control. Partially recovered individuals looked more similar to active eating disorder cases on these expectancies. The other two expectancies did not differ across groups. Results provide some indication that certain eating expectancies may be associated with eating disorder recovery

Race, Ethnicity, and Eating Disorder Recognition by Peers

We investigated racial/ethnic stereotyping in the recognition and referral of eating disorders with 663 university students. We explored responses to problem and eating disorder recognition, and health care referral after reading a vignette concerning a patient of different race/ethnic background presenting with eating disorders. A series of three 4 × 3 ANOVAs revealed significant main effects for eating disorder across all three outcome variables. There were no significant main effects across the four different race/ethnicity conditions and no significant race by condition interactions. Lack of general eating disorder recognition and health care referral by student participants were found

Perfectionism And Eating Disorders: Current Status And Future Directions

The literature examining the relation between perfectionism and eating disorders was reviewed and content and methodological comparisons were made with the perfectionism literature in anxiety disorders and depressive disorders. A PsychInfo search using the key words perfectionism/ perfect/ perfectionistic, anorexia, bulimia, and eating disorders was performed and the generated list of papers was supplemented based on a review of reference lists in the papers. A total of 55 papers published between 1990 and 2005 were identified that assessed perfectionism among individuals with diagnosed eating disorders. The key research questions were distilled from these publications and empirical findings were summarized for each question, followed by a comparison with perfectionism papers in the anxiety and depressive disorder literatures. Also, key research design methodological parameters were identified and comparisons made across the three literatures: eating disorders, anxiety disorders, depressive disorders. The current review concludes with conceptual and methodological recommendations for researchers interested in perfectionism and eating disorders

Mediators of the relationship between thin-ideal internalization and body dissatisfaction in the natural environment

Social comparisons (i.e., body, eating, exercise) and body surveillance were tested as mediators of the thin-ideal internalization-body dissatisfaction relationship using ecological momentary assessment (EMA). Participants were 232 college women who completed a 2-week EMA protocol, responding to questions three times per day. Multilevel path analysis was used to examine a 2-1-1 mediation model (thin-ideal internalization assessed as trait; between-person effects examined) and a 1-1-1 model (component of thin-ideal internalization [thin-ideal importance] assessed momentarily; within- and between-person effects examined). For the 2-1-1 model, only body comparison and body surveillance were significant specific mediators of the between-person effect. For the 1-1-1 model, all four variables were significant specific mediators of the within-person effect. Only body comparison was a significant specific mediator of the between-person effect. At the state level, many processes explain the thin-ideal internalization-body dissatisfaction relationship. However, at the trait level, body comparison and body surveillance are more important explanatory factors

Negative affective experiences in relation to stages of eating disorder recovery

The purpose of this study was to examine a collection of negative affect symptoms in relation to stages of eating disorder recovery. Depressive symptoms, anxiety symptoms, loneliness, and perceived stress are known to be present in individuals with eating disorders; however, less is known about the presence of such constructs throughout the recovery process. Does this negative affect fog continue to linger in individuals who have recovered from an eating disorder? Female participants seen at some point for an eating disorder at a primary care clinic were categorized into one of three groups using a stringent definition of eating disorder recovery based on physical, behavioral, and psychological criteria: active eating disorder (n =53), partially recovered (n =15; psychological criteria not met), and fully recovered (n =20; all recovery criteria met). Additionally, data were obtained from 67 female controls who had no history of an eating disorder. Self-report data indicated that controls and women fully recovered from an eating disorder scored significantly lower than partially recovered and active eating disorder groups in perceived stress, depression, and anxiety. Controls and the fully recovered group were statistically indistinguishable from each other in these domains, as were the partially recovered and active eating disorder groups, suggesting an interesting divide depending on whether psychological criteria (e.g., normative levels of weight/shape concern) were met. In contrast, controls and fully recovered and partially recovered groups all reported feeling significantly less lonely relative to those with an active eating disorder suggesting that improved perceptions of interpersonal, social support may act as a stepping stone toward more comprehensive eating disorder recovery. Future research may want to longitudinally determine if an increase in actual or perceived social support facilitates the movement toward full recovery and whether this, in turn, has salutatory effects on depression, anxiety, and perceived stress

Testing the Tripartite Influence Model Among Heterosexual, Bisexual, and Lesbian Women

This cross-sectional study explored similarities and differences between heterosexual, bisexual, and lesbian women in levels of, and relationships between, the following constructs using a Tripartite Influence Model framework: family, peer, and media appearance pressures, thin- and muscular-ideal internalization, and eating disorder (ED) pathology. Self-identified heterosexual (n = 1,528), bisexual (n = 89), and lesbian (n = 278) undergraduate women completed the Sociocultural Attitudes Towards Appearance Questionnaire-4 and the Eating Disorder Examination-Questionnaire. Sexual orientation differences in appearance pressures, appearance-ideal internalization, and ED pathology were examined via analysis of variance tests. Relationships between these variables were examined with multi-group path analyses, controlling for age, race/ethnicity, and body mass index. Compared with lesbian women, heterosexual and bisexual women reported higher levels of peer appearance pressures. Paths from peer appearance pressures and thin-ideal internalization to shape/weight overvaluation and body dissatisfaction were strongest for bisexual women. Overall, results indicate notable similarities between heterosexual, bisexual, and lesbian women. However, preliminary evidence for potential differences highlights the importance of examining variation in ED risk between sexual minority subgroups