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Eating Disorders > Obesity & body image in children & adolescents > Flashcards

Obesity & body image in children & adolescents Flashcards

1
Q

Adipose tissue

A
  • white “bad” fat
  • brown “good” fat- generates heat, insulation
  • fat- more around organs- takes years for it to gather on organs so overweight children not have on organs.
  • enlargement of heart (led to death).
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2
Q

Measuring adiposity

A

-hard to do

Gold Standards

  • cadaver (boil them).
  • hydrostatic weighing
  • dual energy x-ray adsorptiometry (expensive or need to be dead).
  • magnetic resonance
  • computerised tomography
  • tracer
  • -these are most expensive.

Pragmatic options

  • skinfold
  • BMI
  • bio-impedance
  • easier & cheaper
  • -getting more accurate overtime
  • -OK for approximations
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3
Q

BMI

A
  • an index of adiposity
  • Weight(kg)/Height(m^2)
  • fine for adults but still issues:

–BMI cut offs due to race. muscularity, frame size, fat distribution.

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4
Q

Defining overweight & obesity in childhood by “analogy”

  • Cole et al 2000
  • Wang & Lobstein 2006
A

-unlike adults, no clear cut off points.

  • Cole et al 2000- longitudinal study- “resulting curves were avged to provide age & sex specific cut off points from 2-18 y/o”
  • look at ppl overtime to get a good judgement.
  • help describe where child is.
  • help hold weight more constant.
  • not trying get child lose weight.
  • just hold constant- don’t want dmg psych or physical of a child.

-Wang & Lobstein 2006- still say 50% North America & 38% EU children overweight.

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5
Q

Body fat in childhood

-McCarthy et al 2006

A

-McCarthy et al 2006- changes with age differ for boys & girls, particularly during & after puberty.

  • boys wider before they get taller.
  • girls slowly gain fat & remain similar in adulthood.
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6
Q

Media headlines

-National Child Measurement Programme 2014/15

A
  • headline msgs that obesity in children is out of control- not actually true.
  • National Child Measurement Programme 2014/15- 1.1 million children weighed & measured by NHS staff in school.
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7
Q

Obesity- Age

-National Child Measurement Programme 2014/15

A

-National Child Measurement Programme 2014/15:
Age- in reception (4-5 years) & Year 6 (10-11 years)
-it has remained pretty constant in reception.

-1/3 overweight or obese before high school, which is bad however it has not increases a huge amount- it has always been a problem (last decade+).

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8
Q

Obesity- Social Deprivation

  • reception
  • year 6
  • Puhl & Brownell 2001
  • Goffman 1963
A

Reception- 13% children living most deprived areas were obese v 6% in least deprived.
Year 6- 26% children living most deprived obese v 11% not living least deprived areas.
-key find these areas to focus.
-food instability? cooking equipment? no freezer?
–tower block less physical activity v village green village.

  • diff b/w obese children attending schools in most & least deprived areas has increased overtime.
  • Reception: 2007-2017 4.5-6.8% &
  • Year 6: 2007-2017 8.5-15%
  • -getting bigger.
  • Puhl & Brownell 2001- social marginalisation & stigmatisation in obese adults- in healthcare. education, employment- therefore need combat it in children= cycle.
  • Goffman 1963- devalued social identity due to child stigmatisation- for being obese/overweight.
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9
Q

Obesity- Ethnic Group

  • Latner et al 2005
  • Thompson et al 1997
A

Ethnic Group- ethnic diffs of where ppl carry weight.
-link b/w black, urban, decreased wealth & obesity.

Reception: 6% Chinese & 15% Black obese.
Year 6: 20% Chinese & 30% Black.

  • Latner et al 2005- African American F more pos attitudes to obese peers v AA M & white M & F.
  • Thompson et al 1997- AA girls & boys v white picked heavier ideal body size for self.
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10
Q

Obesity: Location

A

Reception: 5% Kingston upon Thames v 14% Wolverhampton= obese.
Year 6: 11% Rutland v 29% Barking & Dagenham- obesity.
–link- urban more obese, rural less- link social adversity.
-availability of takeaways, safe places to cook etc.

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11
Q

Obesity: Parental Perception

  • Davidson & Birch 2004
  • Thelen & Cormier 1995
A

-tend think overweight child is normal- fathers more so than mothers.
Mothers: obese child 41% about right weight or too light. 59% said too heavy.
Fathers: 55% right/too light. 45% too heavy.
-parents not always aware- which is an issue.

  • Davison & Birch 2004- if parents emphasise importance thin shape/weight-child display neg stereotypes- obese parents are same. (fat child get less finical supp then thinner children).
  • Thelen & Cormier 1995- desire to be thinner correlated encouragement lose weight from both mother & father.
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12
Q

Physical consequences

  • short term
  • cardiovascular -Riley et al 2003
  • long-term
  • Hoffmanns et al 1998
A

Short term:
- asthma, chronic systematic inflammation, increased serum C reactive protein concentration.

Cardiovascular risk factors: high bp, abnormalities in left ventricular mass &/or function, abnormalities in endorthelial function, insulin resistance, atherosclerosis, type 2 diabetes. -Riley et al 2003.

Long term:

  • obesity persistence- most likely with 1 obese parent, obesity present at older ages.
  • cardiovascular risk factors- similar profile to that seen in childhood + myocardial infarcts (dead tissue)
  • -fat sitting on organs when obese for long time.

-Hoffmanns et al 1998- adult morbidity/mortality- BMI >25 at 18 years associated with increased mortality within 20 years of follow up.

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13
Q

Psychological & behavioural correlates of child obesity

  • Puder & Munsch 2010
  • Puder& Munsch 2010
A
  • to help prevent & treat child obesity, we need to know which psychological or behavioural aspects to target.
  • unfortunately, most evidence is correlational.

-Puder & Munsch 2010- child obesity not stable condition- dynamic process- which behaviour, cognition & emotional regulation interact mutually with each other- with biological parameters as well as contextual factors e.g. parental attitudes & familial eating, activity & nutritional patterns.

  • New evidence- prevalence of food at early age, shapes what parents do.
  • child temperament & adult feedings behaviour
  • Puder & Munsch 2010- Clinical Groups: pos ass b/w obese weight status &:
  • 1- Family Factors (behavioural modelling) portion sizes, eating styles etc…
  • 2- Externalising Features: ADHD & impulsivity.
  • 3- Internalising Features: depress symps, anx, social withdrawal, emotion regulation probs.
  • -also evidence for inter-generational transmission of psychopathology & weight probs together.
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14
Q

Psychological consequences

  • Reilly et al 2003
  • Birch 2005
  • Cash 2004
  • Schwimmer et al 2003; William et al 2005
A
  • (in community-based cohort & cross-sectional studies).
  • Reilly et al 2003- in girls obesity ass with depress & low s-e- girls more neg impacted then boys however boys still effected.
  • Birch 2005- depress in 5-7 y/o girls- predicted subsequent dietary restraint.
  • Cash 2004- increased risk of ED, weight cycling & neg body image.
  • Schwimmer et al 2003; William et al 2005- obese children & adolescents report lower health-related quality of life.
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15
Q

A conceptual model of weight, body image & disordered eating attitudes in children.
-Evans, Tovee, Boothroyd & Drewett 2013
(see model in notes)

A

(bmi, thin-ideal internalisation, dietary restraint, disordered eating attitudes, depression, body dissatisfaction).

-dieting symps in children in those overweight & more depressed.

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16
Q

Obesity- Weight Stigma

  • Leeds 2013
  • Latner & Stunkard 2003
  • Cramer & Steinwert 1998
  • Musher-Eizenman et al 2003
A
  • Leeds 2013- 126 children read book with adult, 3 versions- main character either normal, wheelchair or fat- child rated fat as less favourable on athletic, academic, competence, s-e, social success & behaviours.
  • -stigma occurs early.
  • Latner & Stunkard 2003- stigmatisation not help- otherwise would be decrease in obesity over last 40 years.
  • Cramer & Steinwert 1998- overweight pre-schoolers- show stronger neg stereotypes v normal weight peers.
  • Musher-Eizenman et al 2003- 5 y/o wider range of acceptable body types v tee & adults.
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17
Q

Obesity- Peer Relationships

  • Hill & Silver 1995
  • Strauss & Pollack 2003
  • Anesbury & Tiggemann 2000
  • Richardson et al 1961
  • Latner & Stunkard 2003
A
  • Hill & Silver 1995- obese children stereotyped as unhealthy, academically unsuccessful, socially inept, unhygienic & lazy.
  • Strauss & Pollack 2003- obese teens listed as other teens’ “friend” less freq than non-obese teens.
  • Anesbury & Tiggemann 2000- extent of obesity stigma influenced by children’s controllability beliefs but changing controllability beliefs does not immediately reduce stereotyping.
  • -can’t just educate, it’s hard to shift.
  • Richardson et al 1961- 640 school children, 10-11 y/o- 6 pics, 4 disabilities, 1 normal, 1 fat- who want to be your friend= fat was lowest rated.
  • -Latner & Stunkard 2003- worse now- increase 40%+
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18
Q

Obesity- Bullying

  • Fairburn et al 1998
  • Janssen et al 2004
  • Rand & Wright 2000
A

-overweight & obese teens more likely to be victim of bullying than non-overweight teens at any age.

  • Fairburn et al 1998- plausible teasing may lead to development of eating disturbances.
  • relational (e.g. withdrawing friendship) & overt (name calling) bullying common, but not sexual harassment.

BUT -Janssen et al 2004- obese also more likely to bully at 15-16 years old.

-Rand & Wright 2000- older adolescents rated larger sized figures more acceptable v younger.

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19
Q

Factors that influence impact of obesity upon child psychological health.

  • National Obesity Observatory 2011.
  • (see diagram in notes)
A

-National Obesity Observatory 2011

Moderating Factors:

  • Age- older children experience more probs.
  • Gender- girls experience more probs.

Mediating Factors: for obesity causing psychological probs.

  • lack of physical activity, low s-e, body dissatisfaction, EDs & weight-based teasing.
  • -for psychological probs causing obesity: lack of energy to exercise, medication, family breakdown & poverty.
  • -also mediators (social, behavioural, biological & psychological factors)
  • –same as adults.
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20
Q

Obeso-genetic environment

-public health campaigns

A

-had to be normal weight in this enviro- fast food, bigger portions, computer games, more driving etc…

Public Health Campaigns- more stigmatised in America. -also mugshot esq.
-Change 4 Life (good) & Michelle Obama’s Let’s move campaign.

-shame of self= deceased motivation- can make it worse.

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21
Q

Body image schemas & attitudes

A

Schema:
-central Organising Constructs in the interplay of cog, behavioural & emotional processes, in context of enviro events.

Attitudes:

  • i- Body Image Investment- cog-behavioural importance individuals place on appearance.
  • ii- Body Image Evaluations- pos-to-neg appraisals of & beliefs about one’s appearance…
  • -based on discrepancy b/w self-perceived characteristics & personally-valued appearance ideals.
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22
Q

Cognitive Behavioural model of body image- Cash 2004.

see diagram in notes

A

-Cash- 2004

History (dev factors): cultural socialisation, interpersonal experiences, physical characteristics, personality attributes.

Current ( precipitating & maintaining): appearance schematic processing, activating events, internal dialogues, body image emotions, self-regulatory, adjustive behaviours.

all feed into= Body Image Schemas & Attitudes.

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23
Q

What’s body image” when it comes to children?

A
  • like their own bodies early.
  • body image investment?
  • body eval & satisfaction?
  • weight & shape concerns?
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24
Q

Developmental of body image

A
  • self percep & recog (0-2 y)
  • self-representation (4-5 y)
  • self-other comparison (5-7 y)
  • self-image & ideal-image (8+y)

-multiple representations of body, conscious & unconscious (late adolescence)= adult.

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25
Q

developmental of body image: Self-Perception Recog

A

Self-Perception Recog
-schemata develop from birth, synchronic imitation, mirror-self recog, use of personal pronouns, photo self-recog, pretend play.

–pre 18 months- not recog it is them, 18 months+ they do (also trolley video with carpet).

26
Q

developmental of body image: Self-Representation

A

Self-Representation

  • Object-Mediated: toys, tools, drawing, photos.
  • Perspective Taking: theory of mind.

—the meaning of “me”: gender, physical characteristics, personality, preferences, role, clothing, family, friends, school etc…

27
Q

developmental of body image: Assessing Children’s Body Image

-Ricciardeli & McCabe 2002

A
  • pick your ideal- girls tend to go 1 body size smaller- suggests slight pref for thinness.
  • this was down with computer generated bodies.
  • might also feel they have to pick one that was not their own.
  • Ricciardeli & McCabe 2002- Body Change Inventory- consists 3 subscales.
  • -1- Decrease Body Size.
  • -2- Increase Body Size.
  • -3- Increase Muscle Size.
  • -applicable to M & F.
  • –well developed scale.
28
Q

developmental of body image: Social Comparison

A

Social Comparison

-to do this you need.. stable idea of your own body shape, size, proportions, ability to hold this in mind AND think about another’s shape, size etc…

  • -AND to compare these directionally, poss from point of view of observer.
  • -AND possibly an awareness & internalised image of socio-culturally-promoted thin-ideal.
  • very complex cognitive task.

-it is almost impossible to access children’s idea of body image- 7 y/o won’t fully understand concepts of culture & society etc…

29
Q

Children’s body image in numbers-

  • Ricciardelli & McCabe 2011
  • Smolak 2004
  • Birch & Fisher 1998
A

-Ricciardelli & McCabe 2011- 50% girls & 30% boys aged 6-9 want to be thinner.

  • Smolak 2004- 40% preadolescent children report that they have tried to lose weight.
  • -not full blown diets, learn methods early due to adults doing it.

-Birch & Fisher 1998- early dieting in long run ass with chronic body image probs, weight cycling etc..

30
Q

The developmental course of body dissatisfaction

  • Tremblay, Lovsin, Zecevic & Lariviere 2011
  • Davison, Markey & Birch 2000
  • Murnen et al 2003
  • Davison, Markey & Birch 2003
  • Smolak 2004-
A
  • Tremblay, Lovsin, Zecevic & Lariviere 2011- 4 y/o, articulate Weight Stigma.
  • Davison, Markey & Birch 2000- 5 y/o knows own Weight Status & report weight concerns.
  • Murnen et al 2003- 6 y/o awareness & Internalisation of thin ideal & muscular ideal.
  • Davison, Markey & Birch 2003- 9 y/o body dissatisfaction Linked to BMI.
  • Smolak 2004- 13 y/o body dissatisfaction as Common as in adults.
  • pref thin ideal, show images, Disney princesses, hyper muscular.
31
Q

Physical characteristics

  • Stice 2002
  • Smolak 2002
A
  • social stigma, PE, less socially accepted= body dissatisfaction.
  • Stice 2002- overweight men & women are most vulnerable to body diss in adulthood & adolescence.
  • Smolak 2002- the same relationships gradually emerges during childhood, becoming stronger with age.
32
Q

Cultural socialisation

A
  • children like sponges.
  • dove improvements on range of beauties but still not any fat ppl.
  • parents need teach children to critically accept ads etc…
  • men’s move to muscular.
33
Q

Media consumption by age & modality

  • OFCOM Report 2016
  • Flannery-Schroeder & Chrisler 1996
  • Stice 1994
  • Blowers et al 2003
A
  • OFCOM Report 2016- look at mean hours media consumption.
  • -still increasing, more sedentary, media consumption= games, YouTube- not avg body- attractive, athletic etc…
  • Flannery-Schroeder & Chrisler 1996- family, friends & media- fat bad, thin good.
  • Stice 1994- media important transmitter of sociocultural ideals about body size & shape.
  • Blowers et al 2003- most child exposed media thin beauty ideal before formal schooling.
34
Q

Cultural socialisation

  • a-d
  • c- Cash 2004
  • d- Murnen et al 2003
A
  • via socialisation, children learn about:
  • a- which physical characteristics are Valued.
  • b- their social Meaning: what possessing them (or not) implies about the owner’s character, health & eating behaviour.
  • c- Strategies to attain these characteristics, such as dieting & exercise- Cash 2004.
  • d- implication that such standards are Attainable by all given sufficient effort
  • –Murnen et al 2003- body modification- makeup, nails, hair etc…
35
Q

Interpersonal Experiences

  • Cramer & Steinwert 1998
  • Musher-Eisenmann et al 2004
  • Anesbury & Tiggemann 2000
A
  • Cramer & Steinwert 1998- weight stigma: the “relative devaluation of an overweight figure size”.
  • communicated by parents, teachers, doctors, peers & media.

-Musher-Eisenmann et al 2004 -children think being overweight means: child is unpopular, suggests laziness & non-conformity is child’s own fault

  • Anesbury & Tiggemann 2000- weight discrimination widespread.
  • -less likely to get a job.
  • -attribute symptoms to weight etc…
36
Q

What are longer-term consequences of body dissatisfaction?

  • Field et al 2003; Stice & Bearman 2001
  • Killen et al 1994
A
  • Field et al 2003; Stice & Bearman 2001-
  • -EDs, depress, binge-eating, weight gain, rigid dietary restraint, disengagement with physical activity, decreased fruit & veg consumption.
  • –more true for girls but increase in boys, tend to gain more weight overtime.

-Killen et al 1994- + many others- longitudinal study of adolescent F & adult F- body diss one of main RFs leading to problematic eating attitudes.

37
Q

Pathways from early body image to later disordered eating?

-Sroufe 2009

A
  • Sroufe 2009 -not guaranteed.
  • Alternative pathways may lead to the same common outcome (equi-finality).
  • Similar pathways may lead to diff outcomes (multi-finality).
38
Q

Adolescence as “trigger point” for EDs

-Wichstrom 2000

A

-body image & eating schemata are in place prior to puberty- they shape the Context in which pubertal changes are experienced by the individual.

  • Schemata Strongly shape individual’s reaction to major changes ass with puberty: weight gain (40lbs), increased autonomy, increased sexual objectification, loosened parental ties.
  • schemata continue to dev: depress &/or dieting pave way to disordered eating OR pos experiences mitigate risk.

-Wichstrom 2000- by 12 y/o already have ED symps similar to those in late adolescences.

39
Q

(lec 9) EDs & adolescent prob?

A
  • historically, the physical & psychosexual changes of puberty- thought underpin ED dev, so studies & theories have focussed on adolescents.
  • idea was big in 1960s it was trigger- however now know it is not true.
40
Q

2 key questions

A

what are diffs & similarities with adolescents & adult EDs?

  • large number of children will dev symps with potential turn into later clinical EDs, though most won’t.
  • what can this tell us about the dev processes that typically underline adolescent/adult EDs?
41
Q

Age distribution of ED diagnoses

-Nicholls et al 2011

A

Nicholls et al 2010- 3 in 100,000 children = 13 years dev clinical EDs.

  • most common in 12-13 y/o.
  • younger children less EDs.
  • not include avoidant/restrictive ED.
42
Q

EDs in children

-van Son et al 2006

A
  • serious cus disrupt normal physical & psychological growth & dev.
  • often missed by clinicians/parents particularly in young children.
  • -often think picky eater or autism etc… misdiagnoses.
  • van Son et al 2006- age at presentation in AN is decreasing.
  • longer child has harder is to recover from.
43
Q

DSM-V ED diagnoses applied to children.

-Nicely et al 2014

A
  • Avoidant & restrictive food intake disorder (ARFID), AN & BN= most common in children.
  • BED, OSFED, Pica (non-food), rumination disorder (regurg), UFED- still occur but rare.

ARFID- food phobia, disturbance in eating as evidenced by 1 or more of:

  • -substantial weight loss, nutritional deficient (vit c…), dependence feeding tube or dietary supplements, sig psychosocial interference,
  • -not due to unavailability of food, AN or BN & no disturbances in body shape/weight.
  • -not better explained by other medical condition.
  • -sometimes ASD, however ED well beyond “typical” issues with other disorders.
  • -shapes of food, diff foods can’t touch each other, carbs tend to be safe,
  • -sometimes seen if premature birth: don’t ass food with pos emotions- feeding tubes & oxyegen etc…
  • Nicely et al 2014- retrospectively reviewed charts patients 7-17 y/o seen in outpatient ED clinic b/w 2008-2012.
  • -ARFID found in younger ptcpts & proportionally there were more boys than compared to other EDs.
  • -AN, BN & OSFED- similar psych co-morbidities to each other & symps & features.
  • —ARFID has diff with far higher Psych co-morbidities.
44
Q

Challenges in diagnosis in children

A
  • children may not experience their body weight, shape & size like adults.
  • younger child lack vocab for their illness: may not state that afraid of certain foods, getting fat, dislike their bodies.
  • even before vocab “catches up” actions still consistent with classic ED behaviour of food refusal, compensatory behaviours & resultant failure to grow as expected.
  • -can’t express themselves.
  • -extra running on spot & usually socially accepted/encouraged.
45
Q

ED children v adolescents: features compared

  • Peebles et al 2016
  • Walsh & Sysko 2009
A

Peebles et al 2016- more males <13 years v older.

  • EDs less prevalent <13 -sig less BN- less freedom eat & don’t have knowledge of laxatives etc.
  • might be a move to muscular ideal from <13 to 13-19 y/o.

-Walsh & Sysko 2009- cognitions & behaviours may be full ED or sub-syndromal.

46
Q

Treatment for EDs in children & adolescents.

-maudsley model of family therapy (FT-AN)

A

Maudsley Model of Family Therapy (FT-AN)

  • doesn’t blame anyone, makes family part of treatment, empowers parents to combat early ED onset.
  • -increasing use in BN not just AN.
  • BN: FT-BN or CBT.
  • BED: nothing clear -not very common in children.
  • ARFID: still very new, but desensitization & CBT appear promising- works as a “phobia”
  • minimise time child stays in hospitals- focus instead on restoring physical stability.
  • use of day-treatment or/followed by outpatient treatment preferred.
47
Q

Maudsley Family-Based Treatment

-steps 1-3

A
  • deved at Maudsley hospital London.
  • intensive outpatient treatment.
  • for: children/adolescence, medically stable, ill for only relatively short time.
  • opposes view the parents/families are part of prob or cause of illness: instead parents are essential resource for recovery.

3 phases of treatment (15-20 sessions over 12 months)

  • 1- Weight Restoration: dangers malnutrition & low weight status- assessing family’s typical interaction, eating patterns & meals -focus is on eating & weight gain. (bring a meal in).
  • 2- Returning Control Over Eating to Patient: once eating happens, child takes more control on what they eat & broader family issues are dealt with in therapy.
  • 3- Establishing Healthy Adolescent Identity: catch-up with what missed & give them confidence & independence back to them.
48
Q

Family based therapy for EDs

-Couturier et al 2013

A
  • Couturier et al 2013- effectiveness v individual therapy.
  • -Immediate Post-Treatment- no statistical significance that family was better than individual.
  • -6-12 Month Follow-Up- overtime family based is more sustainable.
49
Q

Disordered eating attitudes

A
  • weight & shape issues from age of 5.
  • exercise more common in children v purging.
  • food rituals & compulsions.
50
Q

Disordered eating attitudes are dimensional not categorical.

A
  • attitudes/behaviours exist along continuum of severity rather than “all or nothing” distribution.
  • the behaviours of children with clinical ED feats are at the extreme end of this distribution.
  • as in EDs are the extreme of disordered eating.
51
Q

Disordered eating attitudes arise early in childhood.

  • Schur, Sanders & Steiner 2000
  • Scunk & Birch 2004

Erickson & Gerstle 2007
-Damiano et al 2015
-Ricciardelli et al 2003-
Gordon 2000-

A
  • b/w 7-11 y/0, key concepts, behaviours & attitudes to food & body emerge:
  • Schur, Sanders & Steiner 2000- 8 y/o children an describe Weight Loss Strategies- bariatric surgery etc…
  • Scunk & Birch 2004- 9 y/o girls with higher BMI report higher dietary restraint.

Erickson & Gerstle 2007- 10-20% pre-peri-pubertal children report clinically sig disordered eating attitudes.

  • Damiano et al 2015- 34% 5 y/o girls report moderate dietary restraint- attempted cog restraint.
  • Ricciardelli et al 2003- from age 8, boy desire muscles & large size then girls- utilize muscle gaining strats & perceive greater pressure to gain muscle size.

Gordon 2000- disordered eating attitudes involve, in exaggerated form, behaviour that is normal in our culture & highly valued.
–children like sponge- learn this early (weight/shape in magazines, TV- want to be part of it- emulate social ideals/norms.

52
Q

Measures of childhood disordered eating attitudes

  • Wood et al 1996
  • Mendelson et al 1996
A
  • Wood et al 1996- Body Dissatisfaction Scale of ED Inventory (BD-EDI)
  • -questionnaire, used assess body image concerns- reliable & consistent with those 8 years+.
  • Mendelson et al 1996- Body-Esteem Scale- attitudes & feeling their body & appearance- good internal consistency & moderate test/re-test reliability.
  • Other questionnaires: Offer Self Image Questionnaire & Harter Scales- work both child & teen- good longitudinal.
53
Q

what contributes to dev of disordered eating attitudes?- Gender

  • Smolak 2004
  • Murnen et al 2003
  • Truby & Paxton 2002
  • Ricciardelli & McCabe 2011
  • Fredrickson & Roberts 1997
  • Clark & Tiggemann 2006
  • Kraig & Keel 2001
A

Gender
-Smolak 2004- girls have greater eating attitudes then boys aged 9.

  • Murnen et al 2003- girls report greater Pressures Towards Thinness from age 6.
  • Truby & Paxton 2002- girls id Thinner Ideal bodies than boys from age 7.
  • Ricciardelli & McCabe 2011- girls express Greater Body Dissatisfaction than boys age 7.
  • -this is very young.
  • girls are Differentially “acculturated to internalise an observer’s perspective as a primary view of their physical states”.
  • Fredrickson & Roberts 1997- internalise msgs that their body is a project to work on & be judged on.
  • Clark & Tiggemann 2006- men look at women. Women watch themselves being looked at.
  • -this determines not only most relations b/w men & women but also the relation of women to themselves.

-Kraig & Keel 2001- however found- no sex diffs in victimisation.

54
Q

what contributes to dev of disordered eating attitudes
Weight Status/BMI
-NHS- Health & Social Care Information Centre
-Stice 2002; Hudson et al 2007
-

A
  • NHS- Health & Social Care Information Centre- looked at adiposity/weight- reception & year 6.
  • -larger children increased risk ED through body dissatisfaction.
  • being, or having been overweight increase other risk factors for disordered eating:

-Stice 2002; Hudson et al 2007- body dissatisfaction, thin-ideal internalisation, perceived pressure to be thin, dieting, depress, weight stigma.

55
Q

A conceptual model of disordered eating attitudes in children
-Evans, Tovee, Boothroyd & Drewett 2013
(look at notes for diagram)

A
  • Evans, Tovee, Boothroyd & Drewett 2013- help base framework in essay for exams.
  • -could be happening at same time, hard to disentangle (depress).
56
Q 
what contributes to dev of disordered eating attitudes-
Psychological Variables
-Jendrzyca &amp; Warschburger 2016
-Nichols et al 2018
-Evans et al 2017
A
  • Jendrzyca & Warschburger 2016- experiences weight stigma aged 6-11 led restrained eating 1 year later in girls not boys; body dissatisfaction explained this link for girls but not boys.
  • Nichols et al 2018- internalisation of appearance ideals & perfectionism at 6 y/o predicted body dissatisfaction at 7 y/o for girls & boys= prediction overtime.
  • Evans et al 2017- dietary restraint at age 7 predicted disordered eating at ages 9-13, but body dissatisfaction did not.
  • -however body diss tended to happen at same time as dietary restraint- was not a warning symptom.

-Body dissatisfaction appears to function best as longitudinal predictor of disordered eating after the age of 12 (roughly).

57
Q 
what contributes to dev of disordered eating attitudes-
Parents 
-Abramovitz &amp; Birch 2000
-Damiano et al 2015
-Allen et al 2014
-Collins 1991
A
  • Abramovitz & Birch 2000- 5 y/o daughters of dieting mothers had greater knowledge of & endorsement of dieting than girls of non-dieting mothers.
  • -modelling behaviour?
  • Damiano et al 2015- BUT no relationship b/w maternal dietary restraint & their 5 y/o daughter’s dietary restraint
  • -just greater knowledge.
  • Allen et al 2014- children of mothers with current or past ED reported sig higher lvls of ED symps & emotional eating than other children
  • -shared enviro + hereditary.

-Collins 1991- preschoolers body size rating correlated with their mother’s rating of her own body.

58
Q

What are the consequences of disordered eating attitudes?

  • key 3:
  • Keel et al 1997; Gardner et al 2000
  • Stice & Bearman 2001
  • Field et al 2003
A
  • 1- predict subsequent disordered eating- Keel et al 1997; Gardner et al 2000.
  • 2- predict subsequent depress- Stice & Bearman 2001.
  • 3- may (counter-intuitively) predict weight gain- Field et al 2003.
59
Q

Can we think of EDs as “developmental disorders”?

A
  • emerges during developmental process, with diagnosis often coming at a predictable age/stage?
  • -AN~ 13 years; BN ~ 17 years.
  • manifests on a continuum of severity at least partially grounded in typical developmental process?
  • -Dimensional , Not Categorical Phenomena, “Normative” Discontents.
  • shows variations in incidence/prevalence for which biology cannot fully account?
  • -More Prevalent Amongst Young Females- No Simple Physiological Reason For This.
  • diagnosis of AN ~ 13 years, BN ~ 16 years therefore could partially as marked peaks of occurrence.
  • diff b/w F & M is not simple physiological reason- developing in social context for F.
60
Q

Adolescence as “trigger point” for EDs,
(second one)
-Stice 2001
-Sands et al 1997

A

Schemata continue to dev: depress &/or dieting pave way to disordered eating- (Stice 2001) OR pos experiences mitigate risk.

-Sands et al 1997- girls’ disturbances of body image & eating- freq occur well before puberty.

Eating Disorders (4 decks)

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