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The perfectionism model of binge eating : idiographic and nomothetic tests of an integrative modelSherry, Simon B. 15 June 2006
Perfectionism is implicated in the onset, course, and remission of disordered eating (Bastiani, Rao, Weltzin, & Kaye, 1995; Bruch, 1979; Cockell et al., 2002; Stice, 2002; Tozzi, et al., 2005; Vohs, Bardone, Joiner, & Abramson, 1999; references are contained in Appendix F on p. 271). Building on the above research tradition, this dissertation proposed and evaluated a model relating perfectionism to binge eating. This new model is termed the Perfectionism Model of Binge Eating (PMOBE). According to the PMOBE, perfectionism confers vulnerability to binge eating by generating encounters with and by magnifying responses to specific triggers of binge eating: namely, perceived discrepancies, low self-esteem, depressive affect, and dietary restraint. <p>A multi-site, 7-day, web-based structured daily diary study was conducted to test the PMOBE. Overall, 566 female university students participated, and these individuals provided 3509 useable diary responses. A data analytic strategy involving structural equation modeling and multilevel modeling generally supported the PMOBE. For example, a structural model relating socially prescribed perfectionism (i.e., perceiving that others are demanding perfection of oneself) to binge eating through the aforementioned binge eating triggers demonstrated acceptable fit. Multilevel mediation also indicated that the influence of self-oriented perfectionism (i.e., demanding perfection of oneself) and socially prescribed perfectionism on binge eating operated through the abovementioned binge eating triggers (excepting dietary restraint). Support for multilevel moderation was limited, but suggested that the relationship between self-oriented perfectionism and binge eating was conditional upon dietary restraint. <p>This study is, to my knowledge, the first to examine the perfectionism-disordered eating connection using a structured daily diary methodology. Thus, this study offered a unique perspective apart from the usual cross-sectional and nomothetic research on perfectionism and eating pathology. In particular, this study suggested that, in their day-to-day lives, perfectionistic individuals (especially socially prescribed perfectionists) inhabit a world permeated with putative triggers of binge eating. Although perfectionism appeared to generate exposure to binge eating triggers, by and large, it did not seem to magnify responses to these same triggers (Bolger & Zuckerman, 1995, p. 890). A somewhat qualified version of the PMOBE was thus supported, with socially prescribed perfectionism assuming greater importance than self-oriented perfectionism and with perfectionism conferring vulnerability to binge eating by generating environments with, but not magnifying responses to, binge triggers. Overall, this dissertation contributed new knowledge to our understanding of the precipitants and the correlates of binge eating and highlighted the idea that perfectionism may play an important part in binge eating.
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The perfectionism model of binge eating : idiographic and nomothetic tests of an integrative modelSherry, Simon B. 15 June 2006 (has links)
Perfectionism is implicated in the onset, course, and remission of disordered eating (Bastiani, Rao, Weltzin, & Kaye, 1995; Bruch, 1979; Cockell et al., 2002; Stice, 2002; Tozzi, et al., 2005; Vohs, Bardone, Joiner, & Abramson, 1999; references are contained in Appendix F on p. 271). Building on the above research tradition, this dissertation proposed and evaluated a model relating perfectionism to binge eating. This new model is termed the Perfectionism Model of Binge Eating (PMOBE). According to the PMOBE, perfectionism confers vulnerability to binge eating by generating encounters with and by magnifying responses to specific triggers of binge eating: namely, perceived discrepancies, low self-esteem, depressive affect, and dietary restraint. <p>A multi-site, 7-day, web-based structured daily diary study was conducted to test the PMOBE. Overall, 566 female university students participated, and these individuals provided 3509 useable diary responses. A data analytic strategy involving structural equation modeling and multilevel modeling generally supported the PMOBE. For example, a structural model relating socially prescribed perfectionism (i.e., perceiving that others are demanding perfection of oneself) to binge eating through the aforementioned binge eating triggers demonstrated acceptable fit. Multilevel mediation also indicated that the influence of self-oriented perfectionism (i.e., demanding perfection of oneself) and socially prescribed perfectionism on binge eating operated through the abovementioned binge eating triggers (excepting dietary restraint). Support for multilevel moderation was limited, but suggested that the relationship between self-oriented perfectionism and binge eating was conditional upon dietary restraint. <p>This study is, to my knowledge, the first to examine the perfectionism-disordered eating connection using a structured daily diary methodology. Thus, this study offered a unique perspective apart from the usual cross-sectional and nomothetic research on perfectionism and eating pathology. In particular, this study suggested that, in their day-to-day lives, perfectionistic individuals (especially socially prescribed perfectionists) inhabit a world permeated with putative triggers of binge eating. Although perfectionism appeared to generate exposure to binge eating triggers, by and large, it did not seem to magnify responses to these same triggers (Bolger & Zuckerman, 1995, p. 890). A somewhat qualified version of the PMOBE was thus supported, with socially prescribed perfectionism assuming greater importance than self-oriented perfectionism and with perfectionism conferring vulnerability to binge eating by generating environments with, but not magnifying responses to, binge triggers. Overall, this dissertation contributed new knowledge to our understanding of the precipitants and the correlates of binge eating and highlighted the idea that perfectionism may play an important part in binge eating.
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Correlates of weight in adolescents: A path analysisSheble, Angela T 01 June 2006 (has links)
This study examined the interrelationships between adolescent weight and several other variables thought to impact weight and obesity: physical activity, depressive symptoms, binge-eating symptoms, dieting, socio-economic status, special education status, gender, and ethnicity. The sample consisted of 251 high school students in rural Florida who completed measures of depression, binge-eating, dieting, and physical activity. Measurement instruments included the Reynolds Adolescent Depression Scale-2nd Edition (RADS-2), the bulimia scale of the Eating Disorder Inventory-2 (EDI-2), the dieting scale of the Dutch Eating Behavior Questionnaire (DEBQ), and a physical activity questionnaire derived from the Youth Risk Behavior Scale for Students (YRBSS). The study utilized path analysis, a group correlational design, to determine whether the proposed path model fit the data. Obese and non-obese students also were compared with regard to a) the levels of binge-eating symptoms,
and b) the relationship between binge-eating and depression. Path analysis results were not statistically or clinically significant, suggesting a poor fit of the model to the data. Results indicated 19% of participants were obese and 20% were overweight. More than three times as many obese students than non-obese students reported experiencing a binge-eating experience at some time in the past. However, on the bulimia scale of the EDI-2, obese and non-obese participants did not differ statistically in their responses. Statistically but not clinically significant correlations were revealed between depression and binge-eating for the sample and also for non-obese students. For the sub-sample of 13 students who had both binged and dieted, 7 had binged first, 3 had dieted first, and 3 binged and dieted for the first time at the same age. Future research should continue to investigate the relationships of the variables related to obesity. Future directions might include a larger sampl
e size and a modified sample selection process. Action research should continue in the areas of obesity prevention and intervention, and student services personnel should promote healthy lifestyle choices and a recognition of obesity as a socio-cultural problem.
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Perfectionism and self-defeating behaviours: Studying individuals and dyads over timeMushquash, Aislin 07 September 2012 (has links)
People high in socially prescribed perfectionism (i.e., those who perceive others demand perfection of them) often behave in ways that are incongruent with their efforts to be perfect for others. This research proposes and tests two models that explain why socially prescribed perfectionism is related to self-defeating behaviours (i.e., behaviours with negative effects on the self that are often detrimental to achieving one’s goals). In Study 1, socially prescribed perfectionism was proposed to contribute to a cycle of self-defeat involving perfectionistic discrepancies, perfectionistic self-presentation, depressive affect, and self-defeating behaviours (i.e., binge eating, procrastination, interpersonal conflict). To test the model, data was collected from 317 undergraduates who completed structured online daily diaries. Results of multilevel structural equation modeling largely supported hypothesized relations such that participants high in socially prescribed perfectionism engaged in, or experienced, patterns of self-evaluation, self-presentation, and emotion that contributed to their imperfect, self-defeating behaviours. These behaviours undermined their efforts to be or look perfect for others—creating a sense of deficiency that sets the stage for another cycle of self-defeat. In Study 2, I tested the perfectionism model of binge eating in 218 mother-daughter dyads using a mixed longitudinal and daily diary design. Results largely supported hypotheses suggesting daughters’ socially prescribed perfectionism and mothers’ psychological control contribute indirectly to daughters’ binge eating by generating situations or experiences that trigger binge eating (i.e., discrepancies, depressive affect, and dietary restraint). For young women who believe their mothers rigidly require them to be perfect and whose mothers are demanding and controlling, binge eating appears to provide a means of coping with or escaping from an unhealthy, unsatisfying mother-daughter relationship. Together, the results of Study 1 and Study 2 help to explain why people who strive to be perfect for others often engage in self-defeating behaviours. These findings have numerous implications for theory and research on personality, relationships, and self-defeating behaviours, and for prevention, assessment, and treatment of perfectionism and associated difficulties. These implications, along with the limitations and future directions of this research are discussed.
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Dichotomous Thinking Toward Food as a Mediator Between Eating Behavior and BMIJanuary 2018 (has links)
abstract: Long-term results of dietary weight loss interventions are not promising, with rates of weight loss maintenance at a mere 20%. Psychological factors related to weight maintenance include setting unrealistic weight goals, poor problem-solving skills, low self-efficacy, dichotomous thinking, and external locus of control. The ability to maintain a stable bodyweight over time has been associated with optimal health outcomes, lower stress levels, and higher general well-being. Dichotomous thinking has been associated with overeating and increased bodyweight. Cognitive restraint, disinhibition, and hunger are three dimensions of human eating behavior that appear to be important to understanding weight loss maintenance. Individuals who attempt to maintain their bodyweight via dietary restraint mechanisms are more susceptible to excessive eating episodes. Disinhibition has been found to be the strongest predictor of weight gain, while the research on the association between hunger and bodyweight is mixed. This study sought to evaluate the relationship between dichotomous thinking toward food and various eating behaviors (binge eating, cognitive restraint, disinhibition, and hunger). A multiple regression analysis revealed that binge eating, cognitive restraint, disinhibition, and hunger were each significant unique predictors of higher body mass index (BMI). Higher levels of hunger predicted lower BMI, controlling for cognitive restraint, disinhibition, and binge eating. Mediation analyses revealed that dichotomous thinking mediated the relationships between binge eating and BMI, cognitive restraint and BMI, and disinhibition and BMI. Further analysis revealed that binge eating mediated the relationship between dichotomous thinking and BMI, indicating that thinking of food in black-and-white could lead to higher rates of binge eating, and the excess calorie consumption could lead to increased BMI. The study findings suggest that a strong focus should be made to promote a more flexible attitude toward food in an effort to improve weight loss maintenance in the population. / Dissertation/Thesis / Masters Thesis Psychology 2018
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Pode a compulsão alimentar ser programada por desnutrição perinatal ou manipulação do sistema serotoninérgico?FECHINE, Madge Farias 31 May 2016 (has links)
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Previous issue date: 2016-05-31 / CAPES / Objetivo: Investigar os efeitos da desnutrição proteica perinatal ou manipulação do sistema serotoninérgico durante a lactação sob o comportamento alimentar compulsivo após ciclos de Restrição/Realimentação (R/R). Materiais e métodos: Foram formados quatro grupos conforme os tratamentos dietéticos e farmacológicos: Controle (17% caseína na vida perinatal) e Desnutrido (8% caseína na vida perinatal); Salina (10mg/Kg) e Fluoxetina (10mg/Kg) foram submetidos a três consecutivos ciclos de Restrição/Realimentação (ciclos R/R). Cada ciclo R/R é composto por uma fase de restrição (4 dias com 40% do consumo individual médio de dieta padrão nos 7 dias antes de iniciar os ciclos R/R) seguida por uma fase realimentação (4 dias com dieta padrão ad libitum). Assim, os quatro grupos anteriormente descritos foram subdivididos ou não de acordo com a fase de restrição dos ciclos R/R para formar oito grupos: Grupos não restritos [Controle Naïve (CN) n=6 e 10 ou Desnutrido Naïve (DN) n=7 e 11 e Salina Naïve (SN) n=13/15 ou Fluoxetina Naïve (FN) n=12/13] e Grupos restritos [Controle Restrito (CR) n=6 e 11 ou Desnutrido Restrito (DR) n=7 e 10 e Salina Restrito (SR) n=11/13 ou Fluoxetina Restrito (FR) n=13/14]. Após os três ciclos R/R, todos os animais foram submetidos ao teste alimentar (dieta padrão e palatável por 24hs). Após uma semana, os animais dos grupos [Controle Naïve (CN) n=10 ou Controle Restrito (CR) n=11 e Desnutridos Naïve (DN) n=11 ou Desnutrido Restrito (DR) n=10] foram submetidos a um teste de privação alimentar (24hs sem dieta padrão) e em seguida receberam dieta palatável (2hs) e dieta padrão (22hs). Já todos os animais dos grupos Salina e Fluoxetina, aos 120 dias de vida foram submetidos a outro teste alimentar semelhante ao primeiro teste alimentar (após os ciclos R/R). Resultados: Após ciclos R/R os animais Desnutrido Restrito demonstraram hiperfagia por dieta palatável comparados com os animais do grupo Controle Naïve, como também aumentaram o peso corporal sugerindo o desenvolvimento de obesidade. Contudo, estes animais perderam a capacidade para aumentar o consumo de dieta palatável quando estavam com fome, após a privação alimentar. Em relação aos grupos Salina e Fluoxetina não houve diferenças significativas no consumo alimentar (dieta palatável e padrão) nos dois testes alimentares. Conclusão: Desnutrição proteica perinatal ou tratamento de fluoxetina no aleitamento não contribuem para o desenvolvimento de compulsão alimentar após três ciclos R/R. / Objective: To investigate the effects of the perinatal protein undernourishment or manipulation of the serotonergic system in breastfeeding on the binge eating behavior after Restriction/Refeeding cycles (R/R cycles). Materials and methods: Four groups were formed as dietary and pharmacological treatments: Control (17% casein in perinatal life) and Undernourished (8% casein in perinatal life); Saline (10mg/kg) and Fluoxetine (10mg/kg) were submitted to three consecutive cycles of Restriction/Refeeding cycles (R/R cycles). Each R/R cycle was composed of a restriction phase (4 days with 40% of the mean individual consumption standard diet 7 days before starting cycles R/R) followed by a feedback phase (4 days with a standard diet ad libitum). Thus, the four groups described above were subdivided or not according to the restriction phase of R/R cycles to form eight groups: not restricted Groups [Control Naïve (CN) n=6 and 10 or Undernourished Naïve (UN) n=7 and 11 and Saline Naïve (SN) n=13/15 or Fluoxetine Naïve (FN) n=12/13] and Restricted Groups [Restricted Control (CR) n=6 and 11 or Undernourished Restricted (DR) n=7 and 10 and Saline Restricted (SR) n=11/13 or Fluoxetine Restricted (FR) n=13/14]. After three R/R cycles, all animals were subjected to the feeding test (standard diet and palatable food for 24hrs). After one week, the animals of the groups [Control Naïve (CN) n=10 or Restricted Control (CR) n=11 and Undernourished Naïve (DN) n=11 or Undernourished Restricted (UR) n=10] were subjected to a test food deprivation (24hrs without standard diet) and then received palatable food (2hrs) and standard diet (22hrs). Already all the animals of Saline and Fluoxetine groups at 120 days of age were subjected to a similar feeding test the first test (after R/R cycles). Results: After R/R cycles the Restricted Undernourished animals showed hyperphagia by palatable food compared to animals Naïve control group, as well as increased body weight suggesting the development of obesity. However, these animals have lost the ability to increase the intake of palatable food when they were hungry after food deprivation. Regarding Saline and Fluoxetine groups there was not significant differences in food intake (standard diet and palatable food) in both feeding tests. Conclusion: Perinatal protein undernourishment or treatment of fluoxetine in breastfeeding do not contribute to the development of binge eating after three R/R cycles.
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Estudo sobre a compulsão alimentar em pacientes submetidos à cirurgia bariátrica / Influence of bariatric surgery in eating behavior of obese patientsCristiane Evangelista Machado 14 October 2008 (has links)
A obesidade é considerada distúrbio de difícil controle que gera sérios riscos à saúde e representa grave problema para a saúde pública. Os pacientes portadores de obesidade mórbida que apresentam compulsão diferem em vários aspectos dos não compulsivos e a operação, como recurso de tratamento para estes pacientes, influencia diferentemente na sua evolução. Obesidade e compulsão alimentar podem estar associadas em uma relação que compromete o resultado da cirurgia e contribui para complicações pós-operatórias. Neste sentido, o objetivo deste estudo foi analisar os indícios de compulsão alimentar em pacientes submetidos à cirurgia bariátrica, pela técnica de Fobi-Capella, antes e pelo menos dois anos após a operação. Participaram deste estudo 50 pacientes submetidos à cirurgia bariátrica no Serviço de Cirurgia do Aparelho Digestivo do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Destes 43 (86%) eram mulheres e 7 (14%) homens, com idade média de 42,4 anos, IMC inicial médio de 48,5 e tempo médio de seguimento pós-operatório de 36,6 meses. Os pacientes foram submetidos à avaliação psicológica antes e dois a cinco anos após a operação. Os instrumentos utilizados foram o teste das Pirâmides Coloridas de Max Pfister, aplicado antes e após a operação, para identificar indícios de compulsão e entrevista clínica semiestruturada, aplicada somente no pós-operatório para observar os hábitos alimentares e mecanismos associados à compulsão referidos pelo paciente antes e após a operação. Os dados foram submetidos à análise estatística e pode-se perceber características de compulsão através da identificação de pacientes com estrutura emocional prejudicada, ansiedade, depressão, necessidade de controle, dificuldade na elaboração das emoções, rigidez e busca da comida diante de situações conflitivas, de mo do que a diminuição da ingestão alimentar poderia ter contribuído para alterações na estrutura emocional destes pacientes. Observou-se alterações nas preferências alimentares; passaram a comer mais, em intervalos curtos, doces, torradas, bolachas e outros petiscos, de modo que os pacientes permaneceram recorrendo à comida por não encontrarem recursos que favorecessem uma ação adequada e adaptada. A partir da análise dos dados concluiu-se que os pacientes portadores de obesidade mórbida submetidos à cirurgia bariátrica apresentam indícios de compulsão alimentar antes e após a operação. A compulsão alimentar estaria relacionada a aspectos psicológicos como dificuldade em organizar emoções, ansiedade, depressão e estrutura emocional prejudicada. Características de impulsividade, controle, rigidez e instabilidade emocional também contribuiria m para a manifestação de episódios compulsivos. Os hábitos e preferências alimentares modificaram-se após a operação, uma vez que os pacientes passaram a consumir alimentos de fácil ingestão frente a situações que os faziam comer compulsivamente, não sendo observado trocas de compulsão / Obesity is considered a disorder that is difficult to control, creates serious health risks and represents a serious problem for public health. Patients with morbid obesity who present compulsiveness differ in several aspects of non-compulsive patients, so the operation, may have a different outcome. Obesity and binge eating may be associated, compromising the outcome of surgery and contributing to postoperative complications. The aim of this study was to analyze the influence of bariatric surgery using Fobi- Capellas technique on compulsive behavior. Fifty patients were studied, 43 (86%) women and 7 (14%) men, with an average age of 42.4 years, an average baseline BMI of 48.5 and an average follow-up time of 36.6 months. The patients were psychologically evaluated before and two to five years after surgery using the Colorful Pyramids of Max Pfister test and semi-structured clinical interviews. Evidence of compulsiveness was observed in patients with emotional disorders, anxiety, depression, controlling attitudes, difficulties in dealing with emotions, stiffness and demand for food in situations of emotional difficulty. Therefore, a decrease in food intake could have contributed to emotional alterations in these patients. Changes in food preferences were also observed. The patients began to eat more sweets, toast, biscuits and other snacks in short intervals, indicating that they were not finding resources to encourage appropriate action. Data analysis suggested that patients with morbid obesity who submitted to bariatric surgery show evidence of binge eating before and after the operation. Binge eating is related to psychological issues such as difficulty organizing emotions, anxiety, depression and a damaged emotional structure. Characteristics of impulsivity, self-control, rigidity and emotional instability also contribute to the onset of compulsive episodes. Habits and food preferences changed after the operation. The patients began consuming foods that were easier to ingest (eating small amounts throughout the day instead of meals) in response to situations that would have stimulated compulsive episodes preoperatively. Transfers or exchanges in compulsive attitudes, such as using drugs, drinking or shopping in excess, were not demonstrated
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Compulsão alimentar periódica e fatores associados em mulheres com síndrome metabólicaFranco, Cláudia Rocha 08 July 2016 (has links)
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Previous issue date: 2016-07-08 / A síndrome metabólica é um aglomerado de fatores de risco metabólico e cardiovascular, que apresenta como um dos principais componentes a obesidade abdominal. A obesidade associase frequentemente à compulsão alimentar periódica. O objetivo do presente estudo foi avaliar a presença da compulsão alimentar periódica em mulheres com Síndrome Metabólica e a possível associação com parâmetros sociodemográficos, clínicos e comportamentais. Em estudo transversal, foram selecionados 124 indivíduos com Síndrome Metabólica, distribuídos em dois grupos: Grupo 1 (ausência de compulsão alimentar periódica) e Grupo 2 (presença de compulsão alimentar periódica). A avaliação clínica incluiu medidas de peso e altura, circunferência da cintura e pressão arterial de consultório. Foram também avaliados parâmetros comportamentais, como presença de compulsão alimentar periódica, nível de atividade física, consumo de álcool, imagem corporal, sintomas depressivos e qualidade de vida. A avaliação laboratorial incluiu as dosagens de glicose e insulina em jejum, TSH, perfil lipídico e taxa de filtração glomerular estimada. A média de idade foi 41 ± 10,9 anos, 64% se declararam como não brancas, 60% tinham escolaridade igual ou superior a oito anos de estudo, 56% se declararam casadas ou em união estável e 59% não tinham ocupação formal. A totalidade da amostra apresentava obesidade abdominal, com média da circunferência da cintura de 110 ± 11,0 cm, 70% eram hipertensas, com média de Pressão arterial sistólica de 133 ± 13,0 mmHg e Pressão arterial diastólica de 89 ± 11,0 mmHg. Além disso, 95% eram sedentárias, 7% eram fumantes, 12% faziam uso nocivo do álcool, 98% declararam insatisfação com a imagem corporal e 62% apresentavam depressão. Observou-se presença de compulsão alimentar periódica em 57% das mulheres avaliadas. Houve associação entre compulsão alimentar periódica e idade, com predomínio na faixa etária entre 20 e 39 anos (p = 0,010) e entre compulsão alimentar periódica e pior qualidade de vida (p = 0,039). Quanto aos parâmetros laboratoriais, não foi observado diferença significativa entre os grupos. Em conclusão, a presença de compulsão alimentar periódica foi um achado frequente em indivíduos com Síndrome Metabólica, sendo observada associação da compulsão alimentar periódica com faixa etária mais jovem e com pior qualidade de vida. / Metabolic syndrome is a cluster of metabolic and cardiovascular risk factors in which abdominal obesity is one of the main components. Obesity is frequently associated with binge eating. The aim of this study was to evaluate the occurrence of binge eating in women with metabolic syndrome and its possible association with sociodemographic, clinical, and behavioral parameters. This was a cross-sectional study that included 124 individuals with MS distributed in two groups: Group 1 (without binge eating) and Group 2 (with binge eating). Clinical evaluation included measurement of weight and height, waist circumference, and office blood pressure. We also evaluated behavioral parameters including the occurrence of binge eating, level of physical activity, alcohol consumption, body image, depressive symptoms, and quality of life. Laboratory evaluation included the determination of fasting glucose and insulin, TSH, lipid profile, and estimated glomerular filtration rate. The mean age of the participants was 41 ± 10.9 years. Sixty four percent were self-reported non-Whites, 60% had received education for 8 or more years, 56% reported being married or in a stable relationship, and 59% had no formal occupation. The entire cohort presented abdominal obesity, with an average waist circumference of 110 ± 11.0 cm, and 70% of the individuals were hypertensive. In addition, 95% were sedentary, 7% were smokers, 12% abused alcohol, 98% declared dissatisfaction with body image, and 62% had depression. We observed the occurrence of binge eating in 57% of the women evaluated. There was an association between binge eating and age, which predominated in the age range of 20 to 39 years (p = 0.010) and between binge eating and poor quality of life (p = 0.039). Regarding laboratory parameters, there were no significant differences between the groups. In conclusion, the occurrence of BE was a frequent finding in individuals with MS and was associated with younger age and poorer quality of life.
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Prevalência de compulsão alimentar, depressão e ansiedade entre os universitários de diferentes cursos de Juiz de Fora, Minas Gerais - 2008Chaves, Gilmara Cristina Jaques 30 August 2010 (has links)
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Previous issue date: 2010-08-30 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / O objetivo deste trabalho exploratório foi investigar a prevalência de Compulsão Alimentar Periódica, Síndrome Depressiva, Síndrome Ansiosa e Insatisfação corporal, bem como verificar suas possíveis associações entre si, ao consumo de psicoativos, a outras variáveis sócio-demográficas e comportamentais entre 1.590 universitários do 1º e 7º períodos de todos os cursos de graduação da Universidade Federal de Juiz de Fora. O questionário aplicado na pesquisa foi semiestruturado, autoaplicável, anônimo, sigiloso, contendo variáveis diversas — estudantis, demográficas, sociais, pessoais, relativas à sexualidade, comportamentais ligadas ao uso de psicoativos, estéticas, de tratamento médico, massa corporal, bem como resultados de rastreamento para compulsão alimentar periódica, depressão, ansiedade e insatisfação corporal. Foram efetivadas análises exploratórias, bivariadas e, para caracterizar o peso relativo das variáveis estudadas sobre os desfechos analisados, utilizou-se a regressão logística. Os resultados indicaram que, dentre os estudantes avaliados, foi positivamente identificado pelos instrumentos de rastreamento que: 8,2% apresentavam compulsão alimentar periódica; 3,8%, depressão; 13,9%, ansiedade e 10,1%, insatisfação corporal. Nos modelos de regressão logística desenvolvidos, observou-se que as escalas de compulsão alimentar periódica e de ansiedade associaram-se significantemente à presença de depressão e de insatisfação corporal. As escalas de depressão e de insatisfação corporal associaram-se à presença de compulsão alimentar periódica e de ansiedade. Os universitários com Índice de Massa Corporal elevado tiveram maior probabilidade de apresentar compulsão alimentar periódica e insatisfação corporal e, os que usaram psicoativos sob prescrição médica, de desenvolver compulsão alimentar periódica e depressão. As mulheres foram vulneráveis aos quadros de ansiedade e de insatisfação corporal e, aqueles que mencionaram sentir-se nunca ou raramente felizes, aos de depressão e de ansiedade. Universitários que relataram fazer tratamento para alguma doença crônica e com renda familiar de até 10 salários mínimos apresentaram maiores chances de ter ansiedade e, os possíveis dependentes alcoólicos, de ter depressão. Finalmente, os que mencionaram ser o abdome a parte do corpo de que menos gostavam, que tinham vontade de fazer cirurgia plástica e que cursavam disciplinas da saúde foram suscetíveis à insatisfação corporal. / The objective of this exploratory study was to investigate the prevalence of Binge Eating, Depressive Syndrome, Anxiety Syndrome and Body dissatisfaction as well as to verify their possible associations within these different disorders, with the use of psychoactive drugs and with other socio-demographic and behavioral variables among 1,590 college students attending the 1st and 7th semesters of all undergraduate courses at the Federal University of Juiz de Fora. The questionnaire applied for this research was semi-structured, self-applied, anonymous, confidential, containing several variables — related to student life style, demographic, social, personal, sexuality, related behaviorally to the use of psychoactive drugs, aesthetic, related to medical treatment, body mass/weight, as well as to traced results for Binge Eating, Depressive Syndrome, Anxiety Syndrome and Body image dissatisfaction. Exploratory bivariate analyzes were executed and logistic regression was used to characterize the relative weight of the studied variables over the analyzed outcomes. Among the students evaluated, it was indicated that the following results were positively identified through the tracing instruments utilized: 8.2% presented Binge Eating; 3.8% presented Depression; 13.9% presented Anxiety and 10.1% presented Body dissatisfaction. In the logistic regression models developed it was observed that the levels of Binge Eating and anxiety were associated to the presence of depression and body dissatisfaction. The levels of depression and body dissatisfaction were associated to the presence of Binge Eating and anxiety. The students with elevated body mass indexes were more likely to present Binge Eating and body dissatisfaction and the ones taking psychoactive prescription drugs were more likely to develop Binge Eating and depression. Female students were vulnerable to present anxiety and body dissatisfaction and the students who reported rarely or never feeling happy were prone to present depression and anxiety. College students that reported being under treatment for any chronic diseases and placed in the monthly income bracket of up to 10 minimum wages showed higher likelihood to display anxiety as well as the presence of alcoholism and depression among their children. Finally, the students that reported dissatisfaction with their bodies, particularly with their midsection, the desire to undergo plastic surgery and were taking health related courses were more susceptible to body dissatisfaction.
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Binge-Eating Disorder and Obesity in Women: The Role of Attachment States of MindMaxwell, Hilary January 2017 (has links)
There is evidence that functions related to attachment may play an important role in the etiology and maintenance of eating disorders, particularly anorexia and bulimia nervosa (Kuipers & Bekker, 2012; Tasca & Balfour, 2014). However, there is little research available on attachment functioning in those with binge-eating disorder (BED). This dissertation consists of three studies that examine the role of attachment states of mind and attachment dimensions in understanding BED and co-morbid overweight, and to examine mechanisms related to group treatment response for those with BED. The first study assessed attachment state of mind classifications (i.e., attachment categories) to understand better: 1) the psychopathology and maintenance of BED and co-morbid overweight, and 2) the treatment response of women with BED who receive Group Psychodynamic Interpersonal Psychotherapy (GPIP; Tasca, Mikail, & Hewitt, 2005). Overweight women with BED (subsequently referred to as women with BED), overweight women without BED, and normal weight women without BED completed the Adult Attachment Interview (AAI; Main, Goldwyn, & Hesse, 2002). Those with BED completed the AAI pre- and six months post- GPIP and those without BED completed the AAI at one-time point. Women with BED have significantly higher rates of insecure (preoccupied) and unresolved/disorganized attachment states of mind compared to normal weight women without BED. Women with BED had similar rates of insecure and unresolved/disorganized attachment states of mind as overweight women without BED. With respect to treatment completers, changes in attachment states of mind were not statistically significant. However, follow-up analyses indicated clinically meaningful changes which are discussed in the study. The second study used attachment dimensions of coherence of mind and reflective functioning (measured using the AAI) to add to our understanding of the psychopathology and maintenance of BED and co-morbid overweight. Higher Reflective Functioning scores differentiated normal weight women from both women with BED and overweight women without BED, and the latter two groups did not differ from each other. Coherence of Mind scores did not differentiate the groups. The third study used attachment dimensions of coherence of mind and reflective functioning to understand better group psychotherapy response for those with BED who received GPIP. Greater reflective functioning at pre-treatment was associated with a decline in binge eating frequency at 12 months post-treatment. Pre-treatment levels of coherence of mind was not related to group treatment outcomes. Reflective Functioning scores significantly improved from pre- to six months post-treatment. Further, more than 39% of participants demonstrated clinically reliable improvement and almost 32% experienced clinically reliable recovery with respect to reflective functioning. These results were moderated by pre-treatment self-reported attachment anxiety. That is, those with lower attachment anxiety showed significant improvement in reflective functioning, whereas those with higher attachment anxiety did not show this improvement. A third of participants experienced clinically significant improvement in coherence of mind, but this change was not statistically significant. Overall, attachment dimensions and attachment state of mind classification contribute to our understanding of the etiology and maintenance of BED and co-morbid overweight, as well as to our understanding of the group treatment response of those with BED. Addressing attachment insecurity and low reflective functioning in those with BED may improve treatment outcomes.
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