Presenter:

Dr. Priscilla Gitimu,

Other investigators in the research group- Dr. Moly Cox, & Dr. Taci Turel

Dr. Rachel Pohle-Krauza, Dr. Jeanine Mincher, Dr. Zara Rowlands, Dr. Janice Elias1

In summer of 2012, we lost a student to Bulimia. Many of us wondered how many students could be suffering similarly and how could we intervene. This study will;

1. Assist to approximate a % how many students at could be at risk of a DE.

2.Study variables related to DE.

3.Use the knowledge we gain from this study to intervene.

Why this study????

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Synergy can be defined as “the cooperation of two or more people, to produce a combined effect greater than the sum of their separate efforts”

This study is a product of cooperation among seven faculty, with various expertise, coming together to have a deeper understanding on disordered eating, not just for research, but to actually help our students.

Synergy advantage

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Faculty have varying expertise hence compliment each other Nutrition faculty – have in-depth

understanding on dieting and disordered eating

Fashion faculty - have in-depth understanding of body image & appearance issues

Psychology - have in-depth understanding on statistics and psychological issues e.g. depression.

Synergy advantage examples

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To investigate Disordered Eating (DE) and its relationship to the following variables among college female students.

Body image, Social cultural attitudes towards

appearance, Appearance anxiety, & Depression

Objective of the study?

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Disordered eating can lead to an eating disorder.

DE is more of a habit, while ED is an illness.

For DE usually education and/or self-help group can assist with change, but for ED, requires specific professional medical and mental health treatment.

Facts about Disordered Eating(DE) and Eating Disorders (ED)

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It is estimated that 8 million Americans have an eating disorder – seven million women and one million men.

Nearly half of all Americans personally know someone with an eating disorder.

Eating disorders have the highest mortality rate of any mental illness (Arcelus, 2011).

Facts about Eating Disorders

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*It is estimated that clinical eating disorders affects 10 to 20% of female university students, and 4 to 10 % of male university students (Schlesinge, 2014 & The National Eating Disorders Association (NEDA).

Facts about Eating Disorders

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“… exposure to thin models could also play a role on development of eating disorders” HuffPost blogger Susan Albers, Psy.D., a psychologist at the Cleveland Clinic.

Hence the Every-BODY Fashion show on ALL BODY TYPES! This year it is on April 19th.

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The current study based its discourse through the lenses of four theories and their modern day interpretations; 1.Social comparison theory by Festinger (1954), -humans always strive to improve their lives and they do so by comparing themselves with other individuals.2. Social cultural perspectives- the social cultural ideal female beauty many times differs from the actual appearance of many women. (Jung-Hee, Lennon & Rudd, 2001),

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Theoretical Framework for this study

3. Self-discrepancy theory - differences may exist between the actual (real) the ideal (desired) appearance. These discrepancies may lead to an unfavorable mental state of mind, which again may lead to a decline in recognizing of apparent self-discrepancies. When the discrepancy is large, it may yield to a mental condition such as depression (Higgins, Klein, & Strauman, 1987).

4. Normative discontent theory – dissatisfaction with one’s weight has become so widespread among females that feeling undesirably about one’s appearance is allegedly to be the “norm” rather than the exception (Rodin, Silberstein, Striegel-Moore, 1984).

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Theoretical Framework for this study

1. Demographic information including n current weight, desired weight, height (hence BMI).

2. Stunkard Body Figure Scale (BFS) 3. EAT -26 4. Social Cultural Attitudes towards

Appearance Scale- (SATAQ-3) 5. Social Appearance Anxiety Scale

(SAAS) 6. Beck Depression Inventory (BDI)

Variables measured in the study and why

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The combined scales took about 15-20 minutes to fill.

Got Human Subjects permission. The consent letter gave information on

where participants can get counseling help.

Distributed most surveys in classes.

Study method

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“If you would like to talk with someone about your health or body perceptions, you can contact the YSU

student health clinic at 330-941-3489.  YSU also offers services to you at the Community Counseling

Clinic which you can contact at 330-941-3056 during business hours, both of these confidential services

are available to all YSU students at no cost.  You can also receive confidential help via the Youngstown

area Crisis Hotline at 330 747-2696.”  14

Counseling help contact, inserted in the consent letter to all participants

Scale used Why it was importantEAT -26 If participant scored EAT 26≥20, then they were considered at

risk of having an eating disorder.

BMI Body dissatisfaction has shown to be positively correlated with body weight and BMI (Gardner, Brown, & Boice, 2012).

Stunkard Body Figure Scale (BFS)

Gave current body shape and ideal body shape.

Social Cultural Attitudes towards Appearance Scale- (SATAQ-3)

Internalization of media influences is a dominant predictor of appearance dissatisfaction (Swami, Taylor, & Carvalho, 2011).

Social Appearance Anxiety Scale (SAAS)

Given that social anxiety and eating disorders typically exist concurrently, it seems likely that social appearance anxiety may be a missing connection between social anxiety and eating disorders. (Levinson & Rodebaugh 2012).

Beck Depression Inventory (BDI)

There are common associations between depression and disordered eating symptoms and anxiety sensitivity. (Fink, Bodell, Smith, & Joiner (2013).

Variables measured in the study and why

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SCALESScale Number of

itemsCronbach’s

AlphaExample Scoring

EAT-26 26 .87 ‘I have gone on eating binges where I feel that I may not be able

to stop’

EAT 26 ≥ 20 are considered to be at risk

of having an eating disorder.

SATAQ-3 30 .95 ‘I compare my appearance to the appearance of TV and movie

stars.’

Higher scores indicate more influence by

Social cultural attitudes towards appearance

SAAS 16 .97 ‘I am frequently afraid I would not meet others’ standards of

how I should look.’

Higher scores on the SAAS indicate higher

levels of social appearance anxiety.

BDI 

21 .92 Each item on the BDI scale is framed within a range of 0-3:

0 = I do not feel sad; 1= I feel sad;

Scores range from 0 to 63, with a score of 10 or more meaning one has

symptoms of depression

BFS 10 pictures   Difference between current and ideal body shape

Greater the difference indicate greater body

dissatisfaction

EAT- 26

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If participant scored EAT 26≥20, then they were considered at risk of having an eating disorder.

women

81%

19%

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  Total sample At-risk (EAT 26≥20) Not At-risk (EAT 26≥20)

Total N 342 65 277Race Caucasian African-American Hispanic Asian Native American Other

 2764663111

 59 (21%)4 (9%)0 (0%)0 (0%)0 (0%)3 (27%)

 217 (79%)42 (91%)6 (100%)3 (100%)1 (100%)8 (73%)

Marital Status Single Married Divorced

 2943610

 60 (20%)4 (11%)1 (10%)

 234 (80%)32 (89%)9 (90%)

Age 18-22 years 23-30 years 31-40 years 41-50 years 50 and over

 2366517611

 51 (12%)7 (11%)2 (12%)0 (0%)2 (18%)

 185 (78%)58 (89%)15 (88%)6 (100%)9 (82%)

Body satisfaction* 102 11 (11%) 91 (89%)Body dissatisfaction* 240 54 (22%) 186 (78%)

Table 2. Demographic and descriptive information for sample*Body satisfaction and dissatisfaction were determined by the Stunkard Body Figural Scale

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ANOVAs for WOMEN – EAT 26 ≥ 20 (at risk of ED) as dependent variable and other variables as independent variables

Predictor b SE b Wald’s c2

df p Odds Ratio

Constant -5.37 .966 30.937 1 <.001 .005

Appearance contentment

.478 .466 1.051 1 .305 1.613

BMI -.013 .024 .319 1 .572 .987

Sociocultural Attitudes Toward Appearance

.028 .009 10.088 1 .001 1.029

Social Appearance Anxiety

.027 .012 5.122 1 .024 1.028

Depression .014 .019 .594 1 .441 1.01520

Logistic Regression Analysis

The dichotomized risk of disordered eating behavior as measured by EAT-26 scores and categorized as at-risk or not at-risk was the outcome, and appearance contentment (BFS scale), BMI, scores on the SATAQ, scores on the SAAS, and scores on the BDI were predictor variables.

The combination of these variables is a strong predictor of disordered eating behavior. The Hosmer and Lemeshow goodness-of-fit test indicates a nonsignificant statistic (p = .226), suggesting that the model estimates fit the data well.

Furthermore, the classification table indicates that this model would correctly predict a female’s risk for disordered eating behavior 83.6% of the time.

Two of the five predictors were significantly contributing to this model fit.- the SATAQ (sociocultural attitudes toward appearance), and the SAAS, (social appearance anxiety), were significant predictors of female college students’ risk for disordered eating behavior.

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Regression explanation

Women who were at risk of an eating disorder differed significantly in their (SATAQ totals) Sociocultural Attitudes Towards

Appearance than those who were not at risk of an eating disorder.

Body image develops in the context of sociocultural factors, such as unrealistic media images (Clay, Vignoles, & Dittmar, 2005).

Discussion

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Women who were at risk of an eating disorder differed significantly in the following(see below) than those who were not at risk of an eating disorder.

social appearance anxiety totals (SAAS)

Current Shape – Ideal Shape (BFS)Depression symptomatic (BDI)

Discussion contd.

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Women who were at risk of an eating disorder did not differ significantly in their (BMI) than those who were not at risk of an eating disorder.

According to Lafrance et al. (2013)Regardless of a woman’s body size/BMI

the tendency to diet was the same for all women.

Discussion contd.

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BMI was not shown to differ significantly between those at risk for disordered eating behavior and those less at risk. --college females with a healthy body weight can never-the-less be at risk for the development of an eating disorder.

There should be campaigns, slogans and deliberate effort in society to ascribe value to women on attributes other than physical appearance, such as character.

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Practical Implications

Start early education interventions to help girls critique rather than internalize unrealistic media images (Clay, Vignoles, & Dittmar, 2005) and form their own more flexible physical goals.

Reduce appearance related thoughts and conversations which may cause social appearance anxiety (Bardone-Cone, et al. 2013).

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Practical Implications

Use the research findings of our study to try and reduce disordered eating through various avenues.

Currently we are having the EVERYBODY Fashion show. Every year the show’s theme is create awareness about disordered eating.

Research Plan ahead

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Some Photos from the last two EveryBODY fashion Show

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A Window Display in department with messages about good Body Image