Essstörungen, wie Anorexia Nervosa oder Bulimia Nervorsa, gehen mit einer hohen psychischen Belastung einher und können gesundheitliche Schäden zur Folge haben. Bei Athleten mit einer Essstörung kann es darüber hinaus zu Einbußen in der Sportleistung kommen. Gerade für den Hochleistungssport ist es daher wichtig zu wissen, welches Risiko für Essstörungen besteht und wodurch das Risiko bedingt wird. Bisherige Studien zeigen deutliche Unterschiede zwischen den Sportarten. Eliteathleten aus ästhetischen Sportarten, wie rhythmische Sportgymnastik oder Eiskunstlauf, scheinen ein besonders hohes Essstörungsrisiko aufzuweisen. Deutlich geringere Prävalenzraten finden sich in Ballsportarten, wie Handball oder Basketball. Um zu verstehen, welche Aspekte der Sportart das Essstörungsrisiko beeinflussen, beschäftigt sich die vorliegende Arbeit mit der Rolle sportbezogener Variablen. In die Studien einbezogen wurden insgesamt 171 Athleten zwischen 11 und 18 Jahren (im Mittel 14.1 ± 1.8 Jahre) aus ästhetischen Sportarten und Ballsportarten, die einen Fragebogenpaket mit Instrumenten zu gestörtem Essverhalten, allgemeiner Körperunzufriedenheit, sozialem Druck im Sport, sportbezogener Körperunzufriedenheit, Schlankheitsstreben zur Leistungssteigerung und negativen Gefühle bei Trainingsausfall ausfüllten. Nach einem Jahr wieder befragt wurden 65 Athleten aus ästhetischen Sportarten. Nach Kontrolle von Alter, Geschlecht, BMI und allgemeiner Körperunzufriedenheit trugen sportbezogene Variablen signifikant zur weiteren Varianzaufklärung gestörten Essverhaltens bei. Die Längsschnittanalysen bestätigten einen Risikofaktorstatus für Schlankheitsstreben zur Leistungssteigerung. Zusammenhänge zwischen sportbezogenen Aspekten und gestörtem Essverhalten zeigten sich sowohl in Hochrisikosportarten für gestörtes Essverhalten (ästhetischen Sportarten), als auch in Niedrigrisikosportarten für gestörtes Essverhalten (Ballsportarten). Mit Ausnahme von negativen Gefühlen nach Trainingsausfall traten die sportbezogenen Variabeln häufiger in den ästhetischen Sportarten auf als in den Ballsportarten. Die eigenen Befunde verdeutlichen somit, dass der Einbezug potentieller sportbezogener Risikofaktoren − zusätzlich zu den allgemeinen Risikofaktoren − zum besseren Verständnis der Essstörungssymptomatik von Athleten beiträgt. Vor allem die Bedeutung von Gewicht für die Leistung beeinflusst das Essstörungsrisiko bei Athleten und ist stärker ausgeprägt in Hochrisikosportarten für Essstörungssymptomatik. / Eating disorders such as Anorexia Nervosa and Bulimia Nervosa are serious, difficult-to-treat psychiatric disorders. For elite athletes, in addition to impairment in health and everyday life, an eating disorder can lead to a decline in sports performance. Knowledge of the risk for eating disorders in sports is therefore important. Prevalence rates for disordered eating vary depending on the type of sport. A particularly high risk was found in elite athletes from aesthetic sports such as figure skating or dance. Prevalence rates are lower in ballgame sports, such as handball or basketball. The purpose of this study was to focus on sport-specific variables in different sport types and to examine their relation to disordered eating. One hundred and seventy-one aesthetic and ballgame sports athletes participated in this study (mean age 14.1 ± 1.8 years). At a follow-up survey one year later, 65 athletes from aesthetic sports participated again. The questionnaire package included disordered eating, general body dissatisfaction, social pressure to be lean from sports environment, sports-related body dissatisfaction, desire to be leaner to improve sports performance and emotional distress resulting from missed exercise sessions. In predicting eating disorder symptoms in athletes from aesthetic sports, we observed that after controlling for sex, age, BMI, and body dissatisfaction, sports-related variables were able to account for an additional variance in disordered eating. The longitudinal analyses indicated that a desire to be leaner to improve sports performance is predictive of disordered eating in aesthetic sports. Sports-related variables were associated with disordered eating also in ballgame sports, but some risk factors, such as the desire to be leaner to improve sports performance, were less prevalent. In conclusion of these results, sports-related parameters are relevant for understanding eating disorder symptomatology in sports. Athletes seem to be more at risk if they perceive the possibility to enhance sports performance through weight-regulation, which is more prevalent in aesthetic sports.

Fourteen women in the United States were interviewed to determine the role mothers played in shaping their daughters’ attitudes toward their bodies and eating, and the extent to which women negotiated the messages they received from their family and larger culture concerning weight and appearance. Results of this study complicated existing theories concerning the factors that most influence women’s self-esteem and body image. The results demonstrated that the women within this sample engaged in a variety of disordered eating patterns, but did not recognize their own actions as out-of-the-ordinary; rather they re-produced familial and cultural messages about women’s “normative body discontent.” Despite their seeming adherence to cultural and familial pressures, women in this sample also demonstrated the ability to be agents and practice resistance within the boundaries and limitations of cultural structure. A number of strategies for gaining family or personal power were introduced.

Harsh and punitive parenting styles have been historically associated with the development of eating pathology. More recently, early maladaptive schemas and experiential avoidance have also been implicated in disordered eating. Maladaptive schemas are cognitive scripts that are theorized to be learned within maladaptive environments and repeated throughout an individual’s life. Experiential avoidance involves a tendency to avoid negative emotional experiences through maladaptive strategies. Both maladaptive schemas and experiential avoidance have been implicated in the development of many psychological issues, including eating pathology. The current study attempts to bridge these bodies of literature to develop a model in which cognitive and emotional processes relate to perceived maladaptive parenting styles and the development of eating pathology. Two studies are presented within the current dissertation. The first is a survey based quantitative study that assesses the influence of perceived authoritarian parenting style on the development of binge and restrictive eating pathology. This study examines the mediating role of maladaptive schemas and the moderating role of experiential avoidance. Results of the study demonstrate that specific maladaptive schemas (i.e., mistrust/abuse, emotional deprivation, and defectiveness/shame) mediate the relation between perceived authoritarian parenting and restrictive eating, particularly for those participants with higher levels of experiential avoidance. A different set of maladaptive schemas (i.e., defectiveness/shame, subjugation, and insufficient self-control/self-discipline) was found to significantly mediate the relation between perceived authoritarian parenting and binge eating pathology. Within this model however, low levels of experiential avoidance did not mitigate the effects of maladaptive schemas on the development of binge eating. Using a thematically driven exploratory qualitative analysis in the second study, similar themes were observed in a series of interviews, highlighting the influence of parenting style, participant characteristics, and specific food/weight related issues in the development of disordered eating. New and interesting themes not addressed within Study 1 emerged, providing insight relevant to future clinical and theoretical work. The results of both studies emphasize the role of particular cognitive and emotional factors in the development of different forms of eating pathology. Implications for theory and clinical practice are discussed.

The purpose of the present study is twofold: First, to assess to what extent gender, age, body mass index, weight satisfaction, body satisfaction and coping styles predict disordered eating attitudes of Turkish university students. Second, to examine whether there is a significant difference between female and male university students&rsquo / expert preference in case of a weight problem and importance of significant other&rsquo / s opinion regarding their weight. Three instruments- Eating Attitudes Test, Coping Styles Inventory, and a Demographic Data Form were administered to 525 students from four (3 state, 1 private) universities of Ankara. A stepwise multiple regression analysis was conducted to evaluate how well emotion focused coping, problem focused coping, gender, age, body mass index, weight satisfaction and body satisfaction predicted the disordered eating attitudes of Turkish university students. A two way contingency table analysis was conducted to evaluate whether there was a significant difference between female and male university students regarding their expert preference in case of a weight problem, and whether there was a significant difference between female and male university students with respect to the importance of significant other&rsquo / s opinion regarding their weight. The variables found to be most predictive of disordered eating attitudes and entered the regression equation were weight satisfaction, gender, emotion focused coping, age, and body mass index. Of the five variables, weight satisfaction was strongly negatively related to disordered eating attitudes. Results indicated that proportions of female students preferring dietitian and fitness expert in case of a weight problem were nearly same, whereas male students prefered fitness expert, medical doctor and dietitian, respectively. Regarding the importance of significant other&rsquo / s opinion in relation to weight, there were no significant differences between two groups. Opposite sex friend&rsquo / s opinion in relation to weight was found to be the most important source for both female and male students.

Drunkorexia refers to a set of disordered eating behaviors that occur in the context of a drinking episode for the purpose of 1) off setting caloric intake of the alcohol or 2) increasing the effects of alcohol. The Compensatory Eating and Behaviors in Response to Alcohol Consumption Scale (CEBRACS) was developed with the purpose of measuring drunkorexia behaviors at three time points: before, during, and after a drinking episode. The purpose of this study was to further validate the measure for use in men and women by examining measurement invariance, reliability, and validity. First, single group confirmatory factor analyses (CFA) were conducted separately by gender to examine the underlying factor structure of the measure. The two groups independently showed similar factor structure. The factor structure for both men and women indicated the removal of the original CEBRACS Restriction subscale. A multi-group CFA was conducted on the modified factor structure using gender as the grouping variable. This revised measure was found to have scalar invariance suggesting that means and variances of this measure can be compared. The current study addressed several limitations of previous measurement validation studies including a large diverse sample and thorough examination of the psychometric properties of the CEBRACS. This work provides additional evidence supporting the validity of the CEBRACS and suggests measurement invariance between genders.

The path to an eating disorder (ED) always leads through a borderland, which, in this thesis, is referred to as disordered eating (DE) (Neumark-Sztainer, Wall, Eisenberg,Story, & Hannan, 2006; Waaddegaard, Thoning, & Petersson, 2003). In this borderland, people tend to make unhealthy eating choices, such as greatly reducing their food intake, self-inducing vomiting, or engaging in binge eating, but not to the extent that they would receive an ED diagnosis. Nevertheless, DE can have a strong negative effect on psychological health. Approximately 15%–52% of all adolescents, depending on the gender and the study’s focus, are found within the borderland between a healthy diet accompanied by psychological well-being and full-blown ED (e.g. Hautala et al., 2011; Herpertz-Dahlmann et al., 2008). While most of these individuals return to a more or less healthy diet after engaging in DE for some time, others continue to engage in DE and also tend to have trouble regulating their emotions, depression, and low self-esteem. For these reasons, DE itself, apart from being a springboard to EDs, is well worth exploring.At the outset of this thesis, an instrument assessing DE among 1265 adolescents (54.5% girls) was validated. This easily administered questionnaire, referred to by the acronym SCOFF (Morgan, Reid, & Lacey, 1999), comprises five questions assessing possible eating disturbances that are all answered using a “yes”/“no” answer format. The results showed that more girls than boys suffered from DE, and that girls also suffered from more severe DE, which is in line with previous research (e.g. Hautala et al., 2008). Additionally, this assessment of the SCOFF gave rise to the question of whether a positive answer on only certain items (instead of the stipulated cut-off of two) is necessary for indicating the possible presence of DE among adolescents, such as the item assessing whether individuals had ever vomited because they felt uncomfortably full.To further explore DE among adolescents, a person-oriented approach to identify specific patterns of DE based on the subscales of the Eating Disorders Examination Questionnaire (EDE-Q) (restraint, eating, weight, and shape concerns) was used. There were six different DE patterns for both boys and girls. The associations of these patterns with emotion dysregulation, depressive symptoms, and self-esteem, which all are related to DE (e.g. Shea & Pritchard, 2007; Svaldi, Griepenstroh, Tuschen- Caffier, & Ehring, 2012), were also assessed. Four of the six girl clusters and five of the six boy clusters showed scores above the cut-off for a clinical ED on at least one of the four indicators. Furthermore, although the “non-problematic” pattern was substantial, including 50% and 76% of girls and boys, respectively, a large portion of adolescents were part of clusters reporting generally high levels of DE. This might partly have to do with my use of an overly permissive cut-off, but nevertheless indicates that a considerable amount of adolescents suffer from DE. Generally, individuals in the DE patterns showed worse emotion regulation, depressive thoughts, and self- esteem than did those in the “non-problematic” patterns. However, some exceptions were found, which emphasizes the utility of analyzing different patterns of DE, not merely severity. Specifically, both girls and boys belonging to the pattern characterized by scores well above the cut-off on shape and weight concerns reported the lowest levels of self-esteem. Moreover, girls and boys in the pattern with scores above the cut-off on restraint showed good emotion regulation skills, few depressive symptoms, and high self-esteem.In Study III, the possible links between adolescents’ and parents’ possible DE and emotion dysregulation were explored, alongside the possible impact of shared family meals on DE. This study further examined whether it is possible to predict DE among adolescents according to their parents’ behaviors. Both DE and emotion dysregulation were found to be more frequent among adolescents than among parents. Furthermore, both adolescents and parents showed weak but significant associations between DE and emotion dysregulation, and showed similarities regarding specific aspects of emotion regulation, although the associations were gender specific. For example, parental emotional strategies were associated with girls’ emotional strategies, impulse control, and emotional goals, but only with boys’ emotional strategies. The only factor that was (weakly) associated with DE and emotion regulation among adolescents was the number of dinners that they shared with the family. Additionally, parental ED was the only predictor of current adolescent DE.In summary, the results of this thesis showed that many adolescents, especially girls, suffer from DE as well as poor emotional regulation, depressive thoughts, and low self-esteem. This is a problem, especially given that existing instruments for evaluating DE do not seem optimal, especially for boys. For instance, answering “yes” to the question of ever having engaged in self-induced vomiting because you have felt too full is probably best followed by a visit to the school nurse. Furthermore, the results indicated the importance of viewing DE not as a singular problem, but as a collection of different problems, even among individuals of the same gender. These differences call for different strategies aimed at helping adolescents achieve a healthier diet. Finally, while the parental influence of DE was significant, more research is required,preferably in a Swedish or Nordic context, where parental responsibility is not as heavily reliant on the mother as in other countries.

The field of treating and learning about eating disorders in athletes is a growing field that continues to flourish as more knowledge is acquired. The purpose of this study is to examine the influence that length of time in the sport, age at which an individual starts a competitive sport, level of competitiveness, and type of sport (leanness vs. non-leanness focused) has on disordered eating behaviors. The participants were college students who were involved in at least one competitive sport in their life. They completed the EAT-26 questionnaire as well as a basic questionnaire. There was not enough data collected to conduct a logistic regression so descriptive statistics are reported. This remains an area to be further explored as there is a gap in the literature on the age at which individuals begin competitive sports and the length of time in sports and how that relates to disordered eating behaviors.

No description available.

In research on disordered eating in female collegiate athletes, psychosocial correlates including elevated scores on measures of body image concerns, weight pressures, sociocultural internalization, and mood state were found significantly more often in either the eating disorder or symptomatic group as opposed to the asymptomatic group. Unique or nuanced pressures exist for male athletes as well, specifically a different ideal for body image, often described by a drive for muscularity. I examined these effects in a sample of 698 male collegiate athletes. All participants completed questionnaires, which provided measures of drive for muscularity, social desirability, body satisfaction, negative affect, sociocultural pressures, sport weight pressures, and internalization and social comparison among other factors not pertinent for this analysis as part of a larger study. Exploratory factor analysis confirmed the existence of five factors (general and sport pressures, internalization, body dissatisfaction, negative affect and drive for muscularity) to which a sixth was added to reflect dietary intent, all of which are explained in the Petrie and Greenleaf sociocultural model. A logistic regression showed that dietary intent and drive for muscularity differentiated significantly between the symptomatic/eating disordered athletes and those who were asymptomatic.

Thesis advisor: Barbara E. Wolfe / Studies suggest that eating disorder (ED) pathology may be linked to ovulatory and unexplained infertility in women who present to reproductive treatment centers. Specifically, studies have linked hypothalamic amenorrhea, oligomenorrhea, and anovulatory cycles to disordered eating. Advances in Assisted Reproductive Technology can lead to successful conception for women with ED; however, they have a higher risk for poor maternal and fetal outcomes. This descriptive, comparative, quantitative study examined disordered eating and psychological symptoms in women with ovulatory and unexplained infertility compared with women receiving routine health care from their primary care providers. Women ages 20 to 44 were recruited. After providing verbal consent, a study packet was mailed to the study participant's home. The Eating Disorder Inventory-3-Referral Form and Herman and Polivy Restraint Scale measured disordered eating symptoms. The Speilberger Anxiety Inventory and Beck Depression Inventory-II examined psychological symptoms. Provisional DSM IV TR diagnoses were ascertained using the Eating Disorder Inventory-3-Symptom Checklist, along with other scale items. Multivariate analysis of covariance (MANCOVA) confirmed that women with ovulatory and unexplained infertility had significantly higher Desire for Thinness (p = .001) and Bulimia (p = .007) subscale scores putting them at risk for Anorexia Nervosa or Bulimia. Women receiving routine care had significantly higher Body Dissatisfaction (p = .000) subscale scores consistent with their higher weight and tendency toward overeating. Women receiving routine care also had significantly higher Restraint (p = .000) scale scores, leaving them at risk for dietary disinhibition. The groups did not differ on psychological symptoms. Women with infertility had lifetime ED diagnoses many times the national ED prevalence rate, similar to the research findings of Freizinger et al. (2010). The study results support that women with ovulatory and unexplained infertility are at risk for having an occult ED. The critical import of integrating ED assessment into infertility evaluation, reproductive and primary care was implicated. Further study to isolate biobehavioral markers to better identify women at risk for ED and improve their maternal and fetal outcomes was recommended. / Thesis (PhD) — Boston College, 2010. / Submitted to: Boston College. Connell School of Nursing. / Discipline: Nursing.