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Biomedical subjects

E Stice

Publications and source records attributed to E Stice.

At least 19 recordsLinked to original sources
PubMed2001

A randomized trial of a dissonance-based eating disorder prevention program.

OBJECTIVE: As psychoeducational eating disorder prevention programs have not been shown to reduce bulimic pathology, we developed and evaluated a dissonance-based intervention for high-risk populations. METHOD: Young women (N = 87) with body image concerns were randomized to this intervention, which involves verbal, written, and behavioral exercises requiring them to critique the thin-ideal, or to a healthy weight management control group. Participants completed a baseline, termination, and 4-week follow-up survey. RESULTS: Participants in the dissonance intervention reported decreased thin-ideal internalization, body dissatisfaction, dieting, negative affect, and bulimic symptoms at termination and at 4-week follow-up. Unexpectedly, participants in the healthy weight management control group also reported some benefits. DISCUSSION: Taken in conjunction with past findings, these preliminary results suggest that the dissonance intervention, and to a lesser extent the healthy weight management intervention, may reduce bulimic pathology and risk factors for eating disturbances.

Adolescent↗
PubMed2001

Subtyping binge eating-disordered women along dieting and negative affect dimensions.

OBJECTIVE: Because etiologic and maintenance models of binge eating center around dieting and affect regulation, this study tested whether binge eating-disordered (BED) individuals could be subtyped along dieting and negative affect dimensions and whether subtypes differed in eating pathology, social functioning, psychiatric comorbidity, and response to treatment. METHOD: Three independent samples of interviewer-diagnosed BED women (N = 218) were subtyped along dieting and negative affect dimensions using cluster analysis and compared on the outcomes of interest. RESULTS: Cluster analyses replicated across the three independent samples and revealed a dietary subtype (63%) and a dietary-depressive subtype (37%). The latter subtype reported greater eating and weight obsessions, social maladjustment, higher lifetime rates of mood, anxiety, and personality disorders, and poorer response to treatment than did the dietary subtype. DISCUSSION: Results suggest that moderate dieting is a central feature of BED and that affective disturbances occur in only a subset of cases. However, the confluence of dieting and negative affect signals a more severe variant of the disorder marked by elevated psychopathology, impaired social functioning, and a poorer treatment response.

Adult↗
PubMed2001

Body-image and eating disturbances prospectively predict increases in depressive symptoms in adolescent girls: a growth curve analysis.

Using data from a longitudinal community study (N = 231), the authors tested whether body-image and eating disturbances might partially explain the increase in depression observed in adolescent girls. Initial pressure to be thin, thin-ideal internalization, body dissatisfaction, dieting, and bulimic symptoms, but not body mass, predicted subsequent increases in depressive symptoms, as did increases in these risk factors over the study. There was also prospective support for each of the hypothesized mediational relations linking these risk factors to increases in depressive symptoms. Effects remained significant when other established gender-nonspecific risk factors for depression (social support and emotionality) were statistically controlled. Results provide support for the assertion that body-image and eating disturbances, operating above and beyond gender-nonspecific risk factors, contribute to the elevated depression in adolescent girls.

Adolescent↗
PubMed2001

Relation of early menarche to depression, eating disorders, substance abuse, and comorbid psychopathology among adolescent girls.

This prospective study tested whether early menarche partially accounts for the increases in depression, eating pathology, substance abuse, and comorbid psychopathology that occur among adolescent girls, with structured interview data from a community sample (N = 496). Early menarche (prior to 11.6 years) was associated with elevated depression, substance abuse, and "any" disorder but did not confer increased risk for anorexia nervosa, bulimia nervosa, or binge eating disorder. Although there was significant comorbidity across all three classes of pathology, early menarche was associated only with comorbid depression and substance abuse. Results provide partial support for the assertion that early menarche is a general risk factor for psychopathology among adolescent girls but suggest that this risk may not apply to certain disorders and that the effects are modest in size.

Adolescent↗
PubMed2001

A prospective test of the dual-pathway model of bulimic pathology: mediating effects of dieting and negative affect.

Because there have been few longitudinal investigations of integrative etiological theories of bulimia nervosa, this study prospectively tested the dual-pathway model using random regression growth curve models and data from a 3-wave community sample of adolescent girls (N = 231). Initial pressure to be thin and thin-ideal internalization predicted subsequent growth in body dissatisfaction, initial body dissatisfaction predicted growth in dieting and negative affect, and initial dieting and negative affect predicted growth in bulimic symptoms. There was prospective evidence for most of the hypothesized mediational effects. Results are consistent with the assertion that pressure to be thin, thin-ideal internalization, body dissatisfaction, dieting, and negative affect are risk factors for bulimic pathology and provide support for the dual-pathway model.

Adolescent↗
PubMed2001

Private high school students are at risk for bulimic pathology.

The objective of this study was to assess whether private high school students constitute a group that is at high risk for eating pathology. Female and male public and private high school students (N = 465) were compared on self-reported eating disordered attitudes and behaviors. Private high school students reported elevated eating disordered attitudes and behaviors when compared with students from public schools. The results were somewhat stronger for females than males. The findings suggest that private high school students are a group at high risk for eating pathology. The identification of such high risk groups may facilitate etiologic studies and aid in the implementation of targeted prevention programs.

Journal Article↗
PubMed2001

How do risk factors work together? Mediators, moderators, and independent, overlapping, and proxy risk factors.

OBJECTIVE: The authors developed a methodological basis for investigating how risk factors work together. Better methods are needed for understanding the etiology of disorders, such as psychiatric syndromes, that presumably are the result of complex causal chains. METHOD: Approaches from psychology, epidemiology, clinical trials, and basic sciences were synthesized. RESULTS: The authors define conceptually and operationally five different clinically important ways in which two risk factors may work together to influence an outcome: as proxy, overlapping, and independent risk factors and as mediators and moderators. CONCLUSIONS: Classifying putative risk factors into these qualitatively different types can help identify high-risk individuals in need of preventive interventions and can help inform the content of such interventions. These methods may also help bridge the gaps between theory, the basic and clinical sciences, and clinical and policy applications and thus aid the search for early diagnoses and for highly effective preventive and treatment interventions.

Causality↗
PubMed2000

Dissonance prevention program decreases thin-ideal internalization, body dissatisfaction, dieting, negative affect, and bulimic symptoms: A preliminary experiment.

OBJECTIVE: Because psychoeducational primary prevention programs for eating disorders have met with little success, this preliminary experiment tested a dissonance-based targeted preventive intervention. METHOD: Female undergraduates (N = 30) with elevated body image concerns were assigned to a three-session intervention, wherein they voluntarily argued against the thin ideal, or a delayed-intervention control condition. Participants completed a baseline, termination, and a 1-month follow-up survey. RESULTS: The intervention resulted in a subsequent decrease in thin-ideal internalization, body dissatisfaction, dieting, negative affect, and bulimic symptomatology, with most changes remaining at the 1-month follow-up. DISCUSSION: These preliminary results suggest that this dissonance-based targeted prevention intervention reduces bulimic pathology and known risk factors for eating disturbances, and provide experimental support for the claim that thin-ideal internalization contributes to body dissatisfaction, dieting, negative affect, and bulimic symptoms.

Adolescent↗
PubMed2000

Negative affect moderates the relation between dieting and binge eating.

OBJECTIVE: Although laboratory experiments suggest that negative affect inductions potentiate the relation between dieting and disinhibited eating, little research has tested whether this finding generalizes to binge eating in the natural environment. Thus, we assessed whether negative affect moderated the relation between dieting and binge eating in a passive-observational study. METHOD: This aim was addressed with longitudinal data from a community sample of adolescents (N = 631). RESULTS: For females, dieting and negative affect predicted binge eating in cross-sectional and prospective analyses, but negative affect potentiated the relation between dieting and binge eating only in the cross-sectional analyses. Similar, but attenuated results were found for males. DISCUSSION: Findings converge with those from laboratory studies in suggesting that negative affect moderates the relation between dieting and binge eating, but also imply that dieting and negative affect constitute independent risk factors for binge eating. The lack of prospective effects may suggest that the interactive relations have a short time lag or are difficult to detect prospectively.

Adolescent↗
PubMed2000

Development and validation of the Eating Disorder Diagnostic Scale: a brief self-report measure of anorexia, bulimia, and binge-eating disorder.

This article describes the development and validation of a brief self-report scale for diagnosing anorexia nervosa, bulimia nervosa, and binge-eating disorder. Study 1 used a panel of eating-disorder experts and provided evidence for the content validity of this scale. Study 2 used data from female participants with and without eating disorders (N = 367) and suggested that the diagnoses from this scale possessed temporal reliability (mean kappa = .80) and criterion validity (with interview diagnoses; mean kappa = .83). In support of convergent validity, individuals with eating disorders identified by this scale showed elevations on validated measures of eating disturbances. The overall symptom composite also showed test-retest reliability (r = .87), internal consistency (mean alpha = .89), and convergent validity with extant eating-pathology scales. Results implied that this scale was reliable and valid in this investigation and that it may be useful for clinical and research applications.

Adolescent↗
PubMed2000

Body-image and eating disturbances predict onset of depression among female adolescents: a longitudinal study.

This study examined data from a 4-year school-based longitudinal study (n = 1,124), to test whether the increase in major depression that occurs among girls during adolescence may be partially explained by the body-image and eating disturbances that emerge after puberty. Elevated body dissatisfaction, dietary restraint, and bulimic symptoms at study entry predicted onset of subsequent depression among initially nondepressed youth in bivariate analyses controlling for initial depressive symptoms. Although the unique effect for body dissatisfaction was not significant in the multivariate model, this set of risk factors was able to fairly accurately foretell which girls would go on to develop major depression. Results were consistent with the assertion that the body-image- and eating-related risk factors that emerge after puberty might contribute to the elevated rates of depression for adolescent girls.

Adolescent↗
PubMed1999

Clinical implications of psychosocial research on bulimia nervosa and binge-eating disorder.

Bulimia nervosa and binge-eating disorder are characterized by a persistent course, are associated with comorbid psychopathology, and can result in serious medical complications. Although current treatments for these disorders show promise, they are not effective for approximately 40% of clients. Significant advances have been made in psychosocial research on the etiology and maintenance of bulimia nervosa and binge-eating disorder, as well as on the predictors of treatment response. This article reviews these advances and discusses the clinical implications of these findings. Research on etiology and maintenance suggests that eating-disorder treatments might be improved by focusing greater attention on promoting healthy weight-control techniques, increasing resiliency to sociocultural pressures to be thin, reducing thin-ideal internalization, and fostering adaptive affect-regulation skills. Research on the predictors of response to treatment suggests that matching treatments to client characteristics might further bolster intervention effectiveness.

Adolescent↗
PubMed1999

Risk factors for the emergence of childhood eating disturbances: a five-year prospective study.

OBJECTIVE: Research suggests that eating problems are often present by preadolescence, yet little is known about the age of emergence of these early eating disturbances or risk factors for these behaviors. Thus, we investigated the timing of onset of disturbed eating during childhood and the predictors of these behaviors. METHOD: These aims were addressed by following a sample of children and their parents (N = 216) for the first 5 years of the children's lives. RESULTS: Data suggested that the risk for emergence of inhibited eating, secretive eating, overeating, and vomiting increased annually through age 5. Maternal body dissatisfaction, internalization of the thin-ideal, dieting, bulimic symptoms, and maternal and paternal body mass prospectively predicted the emergence of childhood eating disturbances. Infant feeding behavior and body mass during the first month of life also predicted the emergence of these behaviors. DISCUSSION: Results suggest that eating disturbances emerge during childhood and may be a function of certain parental and child characteristics.

Adult↗
PubMed1999

Natural history of disordered eating attitudes and behaviors over a 6-year period.

OBJECTIVE: This study investigated the course of eating attitudes and eating-disordered behaviors in a community sample of adult women. METHOD: Participants (N = 166; mean age = 32.8 years) completed the Eating Disorder Inventory (EDI), the Three-Factor Eating Questionnaire (TFEQ), and a questionnaire assessing bulimic behaviors at two time points, 6 years apart. RESULTS: Correlations for rank ordering of scores on these measures were all significant, indicating high rank stability over time. Although rates of specific bulimic behaviors decreased over time, mean scores on eating disorder attitude scales tended to increase. DISCUSSION: Findings challenge the commonly held belief that disturbed eating attitudes decline with age.

Adult↗
PubMed1999

Subtyping bulimic women along dietary restraint and negative affect dimensions.

Etiologic models of bulimia center on dieting and negative affect, yet no research has subtyped bulimic individuals according to whether they fit dietary versus negative affect profiles. This study subtyped 265 bulimic women along dieting and depressive dimensions and tested whether subtypes showed differences in eating pathology, clinical correlates, and treatment response. Cluster analysis revealed a pure dietary subtype (62%) and a mixed dietary-depressive subtype (38%). Whereas dietary and dietary-depressive bulimic women showed similar levels of bulimic behaviors, the latter reported more eating and weight obsessions; social maladjustment; higher rates of mood, anxiety, eating, impulse control, and personality disorders; and poorer treatment response. Results suggest dieting is a central feature of bulimia, but depressive affect occurs in only a subset of cases. However, the combination of dieting and depressive affect seems to signal a more severe variant of bulimia.

Adolescent↗
PubMed1999

Naturalistic weight-reduction efforts prospectively predict growth in relative weight and onset of obesity among female adolescents.

This study examined the prospective relations of naturalistic weight-reduction efforts to growth in relative weight and onset of obesity with data from a community study of female adolescents (N = 692). Initial self-labeled dieting, appetite suppressant/laxative use, incidental exercise, vomiting for weight-control purposes, and binge eating predicted elevated growth in relative weight over the 4-year period. Dietary restraint, self-labeled dieting, exercise for weight-control purposes, and appetite suppressant/laxative use predicted an increased risk for obesity onset. Data imply that the weight-reduction efforts reported by adolescents are more likely to result in weight gain than in weight loss and suggest the need to educate youth on more effective weight-control strategies.

Adolescent↗
PubMed1999

Cross-validation of the Temptation Coping Questionnaire: adolescent coping with temptations to use alcohol and illicit drugs.

OBJECTIVE: The present study had two primary objectives: (1) to examine differences in adolescent coping with temptations to use alcohol versus temptations for marijuana and/or other drug use and (2) to replicate and extend previous findings regarding the factor structure and psychometric validity of the Temptation Coping Questionnaire (TCQ). METHOD: This was a cross-sectional study of 1,273 high school students, 52% female and, on average, 16.6 years old. The TCQ was completed as part of a school-wide survey of cigarette, alcohol and other drug involvement. Responses to the TCQ were elicited in response to two hypothetical temptation situations, one involving offers of alcohol only and the other involving offers of marijuana and/or other drugs. RESULTS: The factor structure of the TCQ coping scale was confirmed for the original 11 items, both within and across situations representing temptations to use alcohol or marijuana and/or other drugs. In addition, the mean levels of perceived importance of abstaining and extent of coping efforts endorsed were higher for a marijuana and other drug than for an alcohol temptation situation. Finally, construct and criterion validity of the TCQ was replicated in the present sample. CONCLUSIONS: Present results suggest that similar coping strategies are employed regardless of the particular substance encountered in a temptation situation. However, situation appraisal and extent of coping efforts appeared to differ for distinct substance types. These findings corroborate previous evidence for the utility of the TCQ as a brief, reliable measure of adolescent temptation coping and provide convergent support for the temptation-coping construct.

Adaptation, Psychological↗