Advertisement

Community Mental Health Journal

, Volume 53, Issue 1, pp 107–116 | Cite as

Investigating Vulnerability for Developing Eating Disorders in a Multi-confessional Population

  • Rita DoumitEmail author
  • Georges Khazen
  • Ioanna Katsounari
  • Chant Kazandjian
  • JoAnn Long
  • Nadine Zeeni
Original Paper

Abstract

The present study aimed to examine the vulnerability to eating disorders (ED) among 949 Lebanese female young adults as well as its association with stress, anxiety, depression, body image dissatisfaction (BID), dysfunctional eating, body mass index, religious affiliation (Christian, Muslim, Druze or Other), religiosity and activity level. Results showed that anxiety had the greatest effect on increasing the predisposition to ED, followed by stress level, BID, depression and restrained eating. Affiliating as Christian was found to significantly decrease the vulnerability to developing an ED. Furthermore, the interaction of anxiety with intrinsic religiosity was found to have a protective role on reducing ED. The current study emphasized a buffering role of intrinsic religiosity against anxiety and ED vulnerability.

Keywords

Predisposition Vulnerability Eating disorders Religiosity Anxiety Depression Stress 

References

  1. Abdel Khalek, A. M., & Thomas-Sabado, J. (2005). Anxiety and death anxiety in Egyptian and Spanish nursing students. Death Studies, 29, 157–169. doi: 10.1080/07481180590906174.PubMedCrossRefGoogle Scholar
  2. Afifi, R. A., Yeretzian, J. S., & Mack, A. (2011). Differential impact of intrinsic and extrinsic measures of religiosity on self-perceived health, self-esteem, and health risk behaviors among adolescents living in impoverished neighborhoods in Beirut. Unpublished raw data.Google Scholar
  3. Afifi-Soweid, R., Najem-Kteily, M., & Shediac-Rizkallah, M. (2002). Preoccupation with weight and disordered eating behaviours of entering students at a university in Lebanon. International Journal of Eating Disorder, 32, 52–57. doi: 10.1002/eat.1083.CrossRefGoogle Scholar
  4. Akaike, H. (1974). A new look at the statistical model identification. IEEE Transactions on Automatic Control, 19(6), 716–723.CrossRefGoogle Scholar
  5. Al-Subaie, A. (1999). Eating attitudes test in Arabic. Psychometric features and normative data. Neuroscience, 4, 46–52.Google Scholar
  6. Annalakshmi, N., & Abeer, M. (2011). Islamic worldview, religious personality and resilience among Muslim adolescent students in India. Europe’s Journal of Psychology, 7(4), 716–738.Google Scholar
  7. Aukst-Margetić, B., & Margetić, B. (2005). Religiosity and health outcomes: Review of literature. Collegium Antropologicum, 29, 365–371.PubMedGoogle Scholar
  8. Bailly, N., Maitre, I., Amanda, M., Hervé, C., & Alaphilippe, D. (2012). The Dutch Eating Behaviour Questionnaire (DEBQ). Assessment of eating behaviour in an aging French population. Appetite, 59(3), 853–858.PubMedCrossRefGoogle Scholar
  9. Buckner, J. D., Silgado, J., & Lewinsohn, P. M. (2010). Delineation of differential temporal relations between specific eating and anxiety disorders. Journal of Psychiatric Research, 44(12), 781–787.PubMedPubMedCentralCrossRefGoogle Scholar
  10. Chaaya, M., Osman, H., Naassan, G., & Mahfoud, Z. (2010). Validation of the Arabic version of the Cohen perceived stress scale (PSS-10) among pregnant and postpartum women. BioMed Central Psychiatry, 10, 111–118. doi: 10.1186/1471-244X-10-111.PubMedPubMedCentralCrossRefGoogle Scholar
  11. Chaaya, M., Sibai, A. M., Fayad, R., & El Roueiheb, Z. (2007). Religiosity and depression in older people: Evidence from underprivileged refugee and non-refugee communities in Lebanon. Aging Mental Health, 11(1), 37–44.PubMedPubMedCentralCrossRefGoogle Scholar
  12. Chrousos, G. P. (1998). Stressors, stress, and neuroendocrine integration of the adaptive response. The 1997 Hans Selye Memorial Lecture. Annals of the New York Academic Sciences, 853, 311–335.CrossRefGoogle Scholar
  13. Cilliers, J., Senekal, M., & Kunneke, E. (2006). The association between the body mass index of first-year female university students and their weight-related perceptions and practices, psychological health, physical activity and other physical health indicators. Public Health Nutrition, 9(2), 234–243. doi: 10.1079/PHN2005846.PubMedCrossRefGoogle Scholar
  14. Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24, 386–396.CrossRefGoogle Scholar
  15. Costarelli, V., Antonopoulou, K., & Mavrovounioti, C. (2011). Psychosocial characteristics in relation to disordered eating attitudes in Greek adolescents. European Eating Disorders Review, 19, 322–330.PubMedCrossRefGoogle Scholar
  16. Cotton, S., Zebracki, K., Rosenthal, S. L., Tsevat, J., & Drotar, D. (2006). Religion/spirituality and adolescent health outcomes: A review. Journal of Adolescent Health, 38, 472–480.PubMedCrossRefGoogle Scholar
  17. Croghan, I., Bronars, C., Patten, C., Schroeder, D., Nirelli, L., Thomas, J., et al. (2006). Is smoking related to body image satisfaction, stress, and self-esteem in young adults? American Journal of Health Behavior, 30, 322–333.PubMedCrossRefGoogle Scholar
  18. Delinsky, S. S., & Wilson, T. F. (2008). Weight gain, dietary restraint, and disordered eating in the freshman year of college. Eating Behaviors, 9(1), 82–90.PubMedCrossRefGoogle Scholar
  19. Derenne, J. L., & Beresin, E. V. (2006). Body image, media and eating disorders. Academic Psychiatry, 30(3), 257–261.PubMedCrossRefGoogle Scholar
  20. Doumit, R., Afifi, R., & Devon, H. (2015). Serenity in Political Uncertainty. Holistic Nursing Practice, 29(2), 78–86. doi: 10.1097/HNP.0000000000000077.PubMedCrossRefGoogle Scholar
  21. Eapen, V., Mobrouk, A. A., & Bin-Othman, S. (2006). Disordered eating attitudes and symptomatology among adolescent girls in the United Arab Emirates. Eating Behaviors, 7, 53–60.PubMedCrossRefGoogle Scholar
  22. Eaton, W. W., Smith, C., Ybarra, M., Muntaner, C., & Tien, A. (2004). Center for Epidemiologic Studies Depression Scale: Review and revision (CESD and CESD-R). The use of psychological testing for treatment planning and outcomes assessment (3rd ed.). Mahwah, NJ: Lawrence Erlbaum.Google Scholar
  23. Feinson, M. C., & Meir, A. (2012). Disordered eating and complexities of cultural origin: A focus on Jews from Muslim countries. Eating Behaviors, 13, 135–138.PubMedCrossRefGoogle Scholar
  24. Ferreiro, F., Seoane, G., & Senra, C. (2012). Gender-related risk and protective factors for depressive symptoms and disordered eating in adolescence: A 4-year longitudinal study. Journal of Youth and Adolescence, 41(5), 607–622. doi: 10.1007/s10964-011-9718-7.PubMedCrossRefGoogle Scholar
  25. Forney, K. J., & Ward, R. M. (2013). Examining the moderating role of social norms between body dissatisfaction and disordered eating in college students. Eating Behaviors, 14(1), 73–78.PubMedCrossRefGoogle Scholar
  26. Forthun, L. F., Pidcock, B. W., & Fischer, J. L. (2003). Religiousness and disordered eating: Does religiousness modify family risk? Eating Behaviors, 4, 7–26.PubMedCrossRefGoogle Scholar
  27. Garner, D. M., Olmsted, M. P., Bohr, Y., & Garfinkel, P. (1982). The eating attitudes test. Psychometric features and clinical correlates. Psychological Medicine, 12, 871–878.PubMedCrossRefGoogle Scholar
  28. Ghareeb, E. (2000). New media and the information revolution in the Arab world: An assessment. The Middle East Journal, 54(3), 395–418.Google Scholar
  29. Glauert, R., Rhodes, G., Bryne, S., Fink, B., & Grammer, K. (2009). Body dissatisfaction and the effects of perceptual exposure on body norms and ideals. International Journal of Eating Disorders, 42, 443–452.PubMedCrossRefGoogle Scholar
  30. Gorsuch, R. L., & McPherson, S. E. (1989). Intrinsic/extrinsic measurement: I/E-revised and single-item scales. Journal for the Scientific Study of Religion, 28(3), 348–354.CrossRefGoogle Scholar
  31. Granillo, T. M., Grogan-Kaylor, A., Delva, J., & Castillo, M. (2011). Eating disorders among a community-based sample of Chilean female adolescents. Journal of Research on Adolescence, 21(4), 762–768. doi: 10.1111/j.1532-7795.2010.00733.x.PubMedPubMedCentralCrossRefGoogle Scholar
  32. Grös, D. F., Antony, M. M., Simms, L. J., & McCabe, R. E. (2007). Psychometric properties of the State-Trait Inventory for Cognitive and Somatic Anxiety (STICSA): Comparison to the State-Trait Anxiety Inventory (STAI). Psychological Assessment, 19, 369–381.PubMedCrossRefGoogle Scholar
  33. Hackney, C. H., & Sanders, G. S. (2003). Religiosity and mental health: A meta-analysis of recent studies. Journal for the Scientific Study of Religion, 42(1), 43–55. doi: 10.1111/1468-5906.t01-1-00160.CrossRefGoogle Scholar
  34. Hill, P. C., & Pargament, K. J. (2003). Advances in the conceptualization and measurement of religion and spirituality. American Psychologist, 58, 64–74.PubMedCrossRefGoogle Scholar
  35. Hoyt, W. D., & Ross, S. D. (2003). Clinical and subclinical eating disorders in counseling center clients: A prevalence study. Journal of College Student Psychotherapy, 17(4), 39–54. doi: 10.1300/J035v17n04_06.CrossRefGoogle Scholar
  36. Iancu, I., Spivak, B., Ratzoni, G., Apter, A., & Weizman, A. (1994). The sociocultural theory in the development of anorexia nervosa. Psychopathology, 27, 29–36.PubMedCrossRefGoogle Scholar
  37. Juarascio, A. S., Perone, J., & Timko, C. A. (2011). Moderators of the relationship between body image dissatisfaction and disordered eating, eating disorders. The Journal of Treatment & Prevention, 19(4), 346–354. doi: 10.1080/10640266.2011.584811.Google Scholar
  38. Kalliny, M., Beydoun, A. R., Saran, A., & Gentry, L. (2009). Cultural differences in television celebrity use in the United States and Lebanon. Journal of International Business Research, 8(1), 91–106.Google Scholar
  39. Kandiah, J., Yake, M., Jones, J., & Meyer, M. (2006). Stress influences appetite and comfort food preferences in college women. Nutrition Research, 26(3), 118–123.CrossRefGoogle Scholar
  40. Katsounari, I. (2009). Self-esteem, depression and eating disordered attitudes: A cross-cultural comparison between Cypriot and British young women. European Eating Disorders Review, 17, 455–461.PubMedCrossRefGoogle Scholar
  41. Katsounari, I., & Zeeni, N. (2012). Preoccupation with weight and eating patterns of Lebanese and Cypriot female students. Psychology, 3(6), 507–512.CrossRefGoogle Scholar
  42. Kazarian, S. S., & Taher, D. (2010). Validation of the Arabic Center for Epidemiological Studies Depression (CES-D) scale in a Lebanese community sample. European Journal of Psychological Assessment, 26(1), 68–73. doi: 10.1027/1015-5759/a000010.CrossRefGoogle Scholar
  43. King, M., Marston, L., McManus, S., Brugha, T., Meltzer, H., & Bebbington, Paul. (2013). Religion, spirituality and mental health: Results from a national study of English households. The British Journal of Psychiatry, 202, 68–73. doi: 10.1192/bjp.bp.112.112003.PubMedCrossRefGoogle Scholar
  44. Latzer, Y., Azaiza, F., & Tzischinsky, O. (2009). Eating attitudes and dieting behavior among religious subgroups of Israeli-Arab adolescents females. Journal of Religion and Health, 48, 189–199.PubMedCrossRefGoogle Scholar
  45. Loth, K., Van Den Berg, P., Eisenberg, M. E., & Neumark-Sztainer, D. (2008). Stressful life events and disordered eating behaviors: Findings from project EAT. Journal of Adolescence Health, 43(5), 514–516.CrossRefGoogle Scholar
  46. Macht, M., Haupt, C., & Ellgring, H. (2005). The perceived function of eating is changed during examination stress: A field study. Eating Behaviors, 6(2), 109–112.PubMedCrossRefGoogle Scholar
  47. Mansar, S. L., Jariwala, S., Behih, N., Shahzad, M., & Anngraini, A. (2014). Adapting a database of text messages to a mobile-based weight loss program: The case of the middle east. International Journal of Telemedicine and Applications, 2014, 1–10. doi: 10.1155/2014/658149.CrossRefGoogle Scholar
  48. Musaiger, A. O., Al-Mannai, M., Tayyem, R., Al-Lalla, O., et al. (2013). Risk of disordered eating attitudes among adolescents in seven Arab countries by gender and obesity: A cross-cultural study. Appetite, 60, 162–167.PubMedCrossRefGoogle Scholar
  49. Nasser, M. (1986). Comparative study of the prevalence of abnormal eating attitudes among Arab female students of both London and Cairo universities. Psychological Medicine, 16, 612–625.CrossRefGoogle Scholar
  50. Neighbors, L. A., & Sobal, J. (2007). Prevalence and magnitude of body weight and shape dissatisfaction among university students. Eating Behaviors, 8(4), 429–439.PubMedCrossRefGoogle Scholar
  51. Nolan, L., Halperin, L., & Geliebter, A. (2010). Emotional Appetite Questionnaire. Construct validity and relationship with BMI. Appetite, 54, 314–319. doi: 10.1016/j.appet.2009.12.004.PubMedCrossRefGoogle Scholar
  52. Ohara, K., Kato, Y., Mase, T., Kouda, K., Miyawaki, C., Fujita, Y., & Nakamura, H. (2014). Eating behavior and perception of body shape in Japanese university students. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 19, 1–8.CrossRefGoogle Scholar
  53. Orbitello, R., Ciano, M. Corsaro, et al. (2006). The EAT-26 as screening instrument for clinical nutrition unit attenders. International Journal of Obesity, 30(6), 977–981.PubMedCrossRefGoogle Scholar
  54. Oweini, A. (1998). How students coped with the war: The experience of Lebanon. Journal of Higher Education, 69(4), 406–423.CrossRefGoogle Scholar
  55. Polivy, J., & Herman, P. C. (2002). Causes of eating disorders. Annual Review of Psychology, 53, 187–213.PubMedCrossRefGoogle Scholar
  56. R Core Team. (2013). R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. http://www.R-project.org/. ISBN:3-900051-07-0.
  57. Richards, P. S., Hardman, R. K., & Berrett, M. E. (2007). Scholarship on religion, spirituality and eating disorders. Spiritual approaches in the treatment of women with eating disorders (Vol. xiii). Washington, DC: American Psychological Association.CrossRefGoogle Scholar
  58. Rivas, T., Bersabe, R., Jimenez, M., & Berrocal, C. (2010). The eating attitudes test (EAT-26). Reliability and validity in Spanish female samples. The Spanish Journal of Psychology, 13, 1044–1056.PubMedCrossRefGoogle Scholar
  59. Rosen, J. C., Compas, B. E., & Tacy, B. (1993). The relation among stress, psychological symptoms, and eating disorder symptoms: A prospective analysis. International Journal of Eating Disorders, 14(2), 153–162.PubMedCrossRefGoogle Scholar
  60. Schwartz, M. B., & Brownell, K. D. (2001). Vulnerability to eating disorders in childhood and adolescence. In Rick E. Ingram & Joseph M. Price (Eds.), Vulnerability to psychopathology (pp. 389–411). New York: Guilford Press.Google Scholar
  61. Smith, M. H., Bar, J., & Richard, P. S. (2007). Outcomes of religious and spiritual adaptations to psychotherapy: A meta-analytic review. Psychotherapy Research, 17(6), 643–655. doi: 10.1080/10503300701250347.CrossRefGoogle Scholar
  62. Smith, M. H., Richard, P. S., & Maglio, C. J. (2004). Examining the relationship between religious orientation and eating disturbances. Eating Behaviors, 5(2), 171–180.PubMedCrossRefGoogle Scholar
  63. Sobel, M. E. (1982). Asymptotic confidence intervals for indirect effects in structural equation models. Sociological Methodology, 13, 290–312. doi: 10.2307/270723.CrossRefGoogle Scholar
  64. Stice, E. (2002). Risk and maintenance factors for eating pathology: A meta-analytic review. Psychological Bulletin, 128(5), 825–848.PubMedCrossRefGoogle Scholar
  65. Stice, E., & Shaw, H. (2003). Prospective relations of body image, eating, and affective disturbances to smoking in adolescent girls: How Virginia slims. Journal of Consulting and Clinical Psychology, 71, 129–135.PubMedCrossRefGoogle Scholar
  66. Swami, V., Frederick, D. A., Aavik, T., Alcalay, L., Allik, J., Anderson, D., & Shashidharan, S. (2010). The attractive female body weight and female body dissatisfaction in 26 countries across 10 world regions: Results of the International Body Project I. Personality and Social Psychology Bulletin, 36(3), 309–325.PubMedCrossRefGoogle Scholar
  67. Tamim, H., Dumit, N., Terro, A., Al-Hourany, R., Sinno, D., Seif, F., & Musharrafieh, U. (2004). Weight control measures among university students in a developing country: A cultural association or a risk behavior. Journal of the American College of Nutrition, 23(5), 391–396.PubMedCrossRefGoogle Scholar
  68. Tamim, H., Tamim, R., Almawi, W., Rahi, A., Shamseddeen, W., Ghazi, A., et al. (2006). Risky weight control among university students. International Journal of Eating Disorders, 39, 80–83.PubMedCrossRefGoogle Scholar
  69. Thompson, A., & Gray, J. J. (1995). Development and validation of a new body image assessment scale. Journal of Personality Assessment, 64(2), 258–269.PubMedCrossRefGoogle Scholar
  70. Tiggerman, M., Verri, A., & Scaravaggi, S. (2005). Body dissatisfaction, disordered eating, fashion magazines, and clothes: A cross-cultural comparison between Australian and Italian young women. International Journal of Psychology, 40(5), 293–302.CrossRefGoogle Scholar
  71. Van Strien, T., Frijters, J. E. R., Bergers, G. P. A., & Defares, P. B. (1986). The Dutch Eating Behavior questionnaire (DEBQ) for assessment of restrained, emotional, and external eating behavior. International Journal of Eating Disorder, 5, 295–315.CrossRefGoogle Scholar
  72. Vidal, (2006). Eating behaviour in a sample of Portuguese health science students: Relationships with obesity, dieting and self-esteem. Alimentação Humana, 12(3), 120–127.Google Scholar
  73. Yahia, N., El-Ghazale, H., Achkar, A., & Rizk, S. (2011). Dieting practices and body image perception among Lebanese university students. Asia Pacific Journal of Clinical Nutrition, 20, 21–28.PubMedGoogle Scholar
  74. Zeeni, N., Gharibeh, N., & Katsounari, I. (2012). The influence of socio-cultural factors on the eating attitudes of Lebanese and Cypriot students: A cross-cultural study. Journal of Human Nutrition & Dietetics, 26(1), 45–52.Google Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Rita Doumit
    • 1
    Email author
  • Georges Khazen
    • 2
  • Ioanna Katsounari
    • 3
  • Chant Kazandjian
    • 1
  • JoAnn Long
    • 4
  • Nadine Zeeni
    • 5
  1. 1.Alice Ramez Chagoury School of NursingLebanese American UniversityByblosLebanon
  2. 2.Department of Mathematics and Computer SciencesLebanese American UniversityByblosLebanon
  3. 3.Department of Social WorkFrederick UniversityNicosiaCyprus
  4. 4.School of NursingLubbock Christian UniversityLubbockUSA
  5. 5.Department of Natural SciencesLebanese American UniversityByblosLebanon

Personalised recommendations