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      Disentangling body image: The relative associations of overvaluation, dissatisfaction, and preoccupation with psychological distress and eating disorder behaviors in male and female adolescents

      research-article
      , BPsych(Hons), MSc, MClinPsych, PhD 1 , 2 , , , MB ChB, FRANZCP, MD, DPhil, FAED 3 , , BPsych(Hons), PhD 4 , , BPsych(Hons), DClinPsych, PhD 5 , , BSc(Hons) 6 , , BA(Hons), DPsych(Clin) 6 , , BPsych(Hons), PhD(Clin) 6 , , BA(Hons), MA(Hons), PhD, MPH 2
      The International Journal of Eating Disorders
      John Wiley and Sons Inc.
      mediation, community‐based, body image, dissatisfaction, preoccupation, overvaluation, boys, girls, eating disorder behaviours

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          ABSTRACT

          Objective

          The distinctiveness and relative clinical significance of overvaluation, dissatisfaction, and preoccupation with body weight/shape remains inconclusive. This study sought to add to the evidence by testing associations between these three body image constructs and indicators of clinical significance.

          Method

          Male and female secondary students ( N = 1,666) aged 12–18 years completed a survey that included measures of dissatisfaction with, overvaluation of, and preoccupation with weight/shape, psychological distress, eating disorder behaviors, and basic demographic information. Conditional process analysis was employed to test the independent and mediating effects of overvaluation, dissatisfaction, and preoccupation on distress, dietary restraint, and objective binge eating.

          Results

          Overvaluation, dissatisfaction, and preoccupation were highly correlated ( r = 0.47–0.84). In girls, preoccupation demonstrated the strongest independent and mediating effects on distress, dietary restraint, and binge eating; whereas neither the direct or indirect effects of dissatisfaction on distress and overvaluation on binge eating were significant. Among boys however, the direct and indirect effects of overvaluation, dissatisfaction, and preoccupation on distress and eating disorder behaviors were relatively equal.

          Discussion

          Preoccupation with weight/shape may be particularly clinically significant in girls, whereas all constructs of body image disturbance may be equally clinically significant in boys. The findings are consistent with the view that these constructs, while closely related, are distinct. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2017; 50:118–126)

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          Most cited references27

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          The Eating Attitudes Test: an index of the symptoms of anorexia nervosa

          Psychological Medicine, 9(2), 273-279 Data on the development of a 40-item measure of the symptoms in anorexia nervosa are reported. The scale (EAT) is presented in a 6-point, forced choice, self-report format which is easily administered and scored. The EAT was validated using 2 groups of female anorexia nervosa patients ( = 32 and 33) and female control subjects ( = 34 and 59). Total EAT score was significantly correlated with criterion group membership( = 0·87, < 0·001), suggesting a high level of concurrent validity. There was very little overlap in the frequency distributions of the 2 groups and only 7% of the normal controls scored as high as the lowest anorexic patient. Female obese and male subjects also scored significantly lower on the EAT than anorexics. Recovered anorexic patients scored in the normal range on the test, suggesting that the EAT is sensitive to clinical remission.
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            Psychometric evaluation of the eating disorder examination and eating disorder examination-questionnaire: a systematic review of the literature.

            The purpose of this study was to systematically review the reliability of scores on the Eating Disorder Examination (EDE) and the Eating Disorder Examination-Questionnaire (EDE-Q) and to examine the validity of their use as measures of eating disorder symptoms. Articles describing the psychometric properties of the EDE and EDE-Q were identified in a systematic search of major computer databases and a review of reference lists. Articles were selected based on a priori inclusion and exclusion criteria. Fifteen studies were identified that examined the psychometrics of the EDE, whereas 10 studies were found that examined the psychometrics of the EDE-Q. Both instruments demonstrated reliability of scores. There is evidence that scores on the EDE and EDE-Q correlate with scores on measures of similar constructs and support for using the instruments to distinguish between cases and non-cases. Additional research is needed to broaden the generalizability of the findings. Copyright © 2011 Wiley Periodicals, Inc.
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              Eating Disorder Examination Questionnaire (EDE-Q): norms for young adult women.

              In order to establish norms for the Eating Disorder Examination Questionnaire (EDE-Q) among young adult women, the questionnaire was administered to a large general population sample of women aged 18-42 yr in the Australian Capital Territory (ACT) region of Australia. Normative data were derived for EDE-Q subscales and for the occurrence of specific eating disorder behaviours, for each of five age bands (18-22, 23-27, 28-32, 33-37, 38-42 yr). Mean scores (SDs) for the Restraint, Eating Concern, Weight Concern and Shape Concern subscales for the total sample (n = 5,255) were, respectively, 1.30 (1.40), 0.76 (1.06), 1.79 (1.51) and 2.23 (1.65). The mean global score was 1.52 (1.25). The regular occurrence of objective and subjective overeating episodes was reported by 10.6% and 12.7% of participants, respectively. The regular use of self-induced vomiting, laxative misuse, and use of diuretics, was reported by 1.4%, 1.0%, and 0.3%, of participants, respectively, while 2.2% of participants reported regularly using diet pills. "Extreme dietary restraint" and "excessive exercise" were reported by 3.4% and 4.9% of participants, respectively. Both attitudinal and behavioural features of eating disorder psychopathology tended to decrease with increasing age. These data will inform researchers intending to use the EDE-Q in epidemiological studies.
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                Author and article information

                Contributors
                deborah.mitchison@mq.edu.au
                Journal
                Int J Eat Disord
                Int J Eat Disord
                10.1002/(ISSN)1098-108X
                EAT
                The International Journal of Eating Disorders
                John Wiley and Sons Inc. (Hoboken )
                0276-3478
                1098-108X
                19 August 2016
                February 2017
                : 50
                : 2 ( doiID: 10.1002/eat.v50.2 )
                : 118-126
                Affiliations
                [ 1 ] Department of Psychology Macquarie University Sydney New South Wales Australia
                [ 2 ] School of Medicine Western Sydney University Sydney New South Wales Australia
                [ 3 ] Centre for Health Research, Sydney, Western Sydney University New South Wales Australia
                [ 4 ] Department of Psychology University of Canberra Canberra Australian Capital Territory Australia
                [ 5 ] Department of Psychiatry University of California San Francisco California
                [ 6 ] Research School of Psychology Australian National University Canberra Australian Capital Territory Australia
                Author notes
                [*] [* ] Correspondence to: D. Mitchison; E‐mail: deborah.mitchison@ 123456mq.edu.au
                Article
                EAT22592
                10.1002/eat.22592
                6585604
                27539911
                afb829a0-7d10-4b55-b9da-1db954124a65
                © 2016 The Authors International Journal of Eating Disorders Published by Wiley Periodicals, Inc.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 18 March 2016
                : 30 June 2016
                : 01 July 2016
                Page count
                Figures: 0, Tables: 3, Pages: 9, Words: 5466
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                eat22592
                February 2017
                Converter:WILEY_ML3GV2_TO_NLMPMC version:5.6.4 mode:remove_FC converted:20.06.2019

                Clinical Psychology & Psychiatry
                mediation,community‐based,body image,dissatisfaction,preoccupation,overvaluation,boys,girls,eating disorder behaviours

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