Advertisement

The relationship between Internet addiction and bulimia in a sample of Chinese college students: depression as partial mediator between Internet addiction and bulimia

  • ZhuoLi Tao
Original Article

Abstract

Background

It has been reported that Internet addiction is associated with substance dependence. Eating disorders have high rates of co-morbidity with substance use disorders. The relationship between Internet addiction and eating disorders was reported in a previous study.

Aims

To examine the hypothesis that Internet addiction is closely associated with bulimia. The hypothesis that depression mediates the relationship between Internet addiction and bulimia symptoms was also tested.

Methods

2,036 Chinese college students were assessed on Internet addiction, eating behaviors and depression. Binge eating, compensatory behaviors, weight concern, menarche and weight change were also reported. Multiple regression analysis was used to test the mediating effect of depression.

Results

Internet addicts showed significantly higher scores on most subscales on EDI-1 than the controls. They reported significantly more binge eating, weight concern and weight change than the controls. Among all of the participants, depression was found to be a partial mediator in the relationship between Internet addiction and bulimia.

Conclusion

This survey provides evidence of the co-morbidity of Internet addiction and bulimia.

Keywords

Internet addiction Eating disorders Comorbidity Depression Mediator 

Notes

Acknowledgments

I wish to thank all the participants. I also wish to thank Dr. Dietmar for his statistical advice and Mr. Christopher Angell for corrections to the manuscript. The research was supported by grants from the education department, Jiangsu Province, China (Grand Nr: 2011SJD190001); by grant from the "the Fundamental Research Funds for the Central Universities". (Grand Nr: 3213002203) in Southeast University, China.

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Griffith MD (1998) Internet addition: does it really exist? In: Gackenbach J (ed) Psychology and the Internet: intrapersonal, interpersonal and transpersonal Applications. Academic Press, New York, pp 61–75Google Scholar
  2. 2.
    Young KS (1996) Psychology of computer use. XL. Addictive use of the Internet: a case that breaks the stereotype. Psychol Rep 79:899–902PubMedCrossRefGoogle Scholar
  3. 3.
    O’Brien KM, Vincent NK (2003) Psychiatric co-morbidity in anorexia and bulimia nervosa: nature, prevalence, and causal relationships. Clin Psychol Rev 23:57–74PubMedCrossRefGoogle Scholar
  4. 4.
    Herzog DB, Franko DL, Dorer DJ, Keel PK, Jackson S, Manzo MP (2006) Drug abuse in women with eating disorders. Int J Eat Disord 39:364–368PubMedCrossRefGoogle Scholar
  5. 5.
    Holderness CC, Brooks-Gunn J, Warren MP (1994) Co-morbidity of eating disorders and substance abuse. Int J Eat Disord 6:1–34CrossRefGoogle Scholar
  6. 6.
    Hudson JI, Pope HG, Wurtman J, Yurgelun-Todd D, Mark S, Rosenthal NE (1988) Bulimia in obese individuals. Relationship to normal-weight bulimia. J Nerv Mental Disord 176:144–152CrossRefGoogle Scholar
  7. 7.
    Marcus MD, Wing RR, Ewing L et al (1990) Psychiatric disorders among obese binge eaters. Int J Eat Disord 9:69–77CrossRefGoogle Scholar
  8. 8.
    Yen JY, Yen CF, Chen CC et al (2007) Family factors of Internet addiction and substance use experience in Taiwanese adolescents. Cyberpsychol Behav Soc Netw 10:323–329CrossRefGoogle Scholar
  9. 9.
    Ko CH, Yen JY, Cheng CC et al (2006) Tridimensional personality of adolescents with Internet addiction and substance use experience. Can J Psychiatry 51:887–894PubMedGoogle Scholar
  10. 10.
    Tao ZL, Liu Y (2009) Is there a relationship between Internet dependence and eating disorders? A comparison study of Internet dependents and non-Internet dependents. Eat Weight Disord 14:77–83Google Scholar
  11. 11.
    Claes L, Müller A, Norré J, Van Assche L, Wonderlich S, Mitchell JE (2011) The relationship among compulsive buying, compulsive Internet use and temperament in a sample of female patients with eating disorders. Eur Eat Disord Rev 20:126–131PubMedCrossRefGoogle Scholar
  12. 12.
    Young KS, Rodgers RC (1998) The relationship between depression and Internet addiction. Cyberpsychol Behav Soc Netw 1:25–28CrossRefGoogle Scholar
  13. 13.
    Lacey JH (1993) Self-damaging and addictive behaviour in bulimia nervosa: a catchment area study. Br J Psychiatry 163:190–194PubMedCrossRefGoogle Scholar
  14. 14.
    Young S (1998) Caught in the Net. Wiley, New YorkGoogle Scholar
  15. 15.
    Davis C, Katzman MK (1998) Chinese men and women in the United States and Hong Kong: body and self-esteem ratings as a prelude to dieting and exercise. Int J Eat Disord 23:99–102PubMedCrossRefGoogle Scholar
  16. 16.
    Buddeberg-Fischer B, Bernet A, Sieber M, Schmid J, Buddeberg C (1996) Epidemiology of eating behaviour and weight distribution in 14-to 19-year-old Swiss students. Acta Psychiatr Scand 93:293–304CrossRefGoogle Scholar
  17. 17.
    Miotto P, De Coppi M, Frezza M et al (2002) Social desirability and eating disorders. A community study of an Italian school-aged sample. Acta Psychiatr Scand. 105:372–377PubMedCrossRefGoogle Scholar
  18. 18.
    Widyanto L, McMurran M (2004) The psychometric properties of the Internet addiction test. Cyberpsychol Behav Soc Netw 7:443–450CrossRefGoogle Scholar
  19. 19.
    Garner DM, Olmstead M, Polivy J (1983) Development and validation of multidimensional Eating Disorder Inventory for anorexia nervosa and bulimia. Int J Eat Disord 2:15–34CrossRefGoogle Scholar
  20. 20.
    Franko DL, Striegel-Moore RH, Barton BA et al (2004) Measuring eating concerns in black and white adolescent girls. Int J Eat Disord 35:179–189PubMedCrossRefGoogle Scholar
  21. 21.
    Garner DM (1991) Eating Disorder Inventory-C. Psychological Assessment Resources, LutzGoogle Scholar
  22. 22.
    Garner DM (1991) Eating Disorder Inventory-2. Professional manual. Psychological Assessment Resources, LutzGoogle Scholar
  23. 23.
    Lee S, Lee AM, Leung T (1998) Cross-cultural validity of the Eating Disorder Inventory: a study of Chinese patients with eating disorders in Hong Kong. Int J Eat Disord 23:177–188PubMedCrossRefGoogle Scholar
  24. 24.
    Machado PPP, Goncalves S, Martins C et al (2001) The Portuguese version of the Eating Disorders Inventory: evaluation of its psychometric properties. Eur Eat Disord Rev 9:43–52CrossRefGoogle Scholar
  25. 25.
    Shoemaker C, Van Strien T, Van der Staak C (1994) Validation of the Eating Disorders Inventory in a non-clinical population using transformed an untransformed responses. Int J Eat Disord 15:387–393CrossRefGoogle Scholar
  26. 26.
    Eklund K, Paavonen EJ, Almqvist F (2005) Factor structure of the Eating Disorder Inventory-C. Int J Eat Disord 37:330–341PubMedCrossRefGoogle Scholar
  27. 27.
    Tao ZL (2010) Epidemiological-and risk factors studies on abnormal attitudes towards eating and adverse dieting behaviors among 12-to 25-year-old Chinese students. Eur Eat Disord Rev 18:507–514PubMedCrossRefGoogle Scholar
  28. 28.
    Lee S (1995) Self-starvation in context: towards a culturally sensitive understanding of anorexia nervosa. Soc Sci Med 41:25–36PubMedCrossRefGoogle Scholar
  29. 29.
    Zhang, Kong QM (2004) Applicability of EDI-I in Beijing, China. Chin J Mental Health 18:48–50 (in Chinese)Google Scholar
  30. 30.
    American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, 4th edn. American Psychiatric Association, WashingtonGoogle Scholar
  31. 31.
    Keel PK, Heatherton TF, Dorer DJ et al (2005) Point prevalence of bulimia nervosa in 1982, 1992, and 2002. Psychiatr Med 36:119–127Google Scholar
  32. 32.
    Pinheiro AP, Thornton LM, Plotonicov KH et al (2007) Patterns of menstrual disturbance in eating disorders. Int J Eat Disord 40:424–434CrossRefGoogle Scholar
  33. 33.
    Beck AT (1967) Depression: clinical, experimental and theoretical aspects. Harper & Row, New YorkGoogle Scholar
  34. 34.
    Beck AT, Beck RW (1972) Screening depressed patients in family practice: a rapid technique. Postgrad Med 52:81–85PubMedGoogle Scholar
  35. 35.
    Beck AT, Rial WY, Rickels K (1974) Short form of depression inventory: cross validation. Psychol Rep 34:1184–1186PubMedGoogle Scholar
  36. 36.
    Scogin F, Beutler L, Corbishley A et al (1988) Reliability and validity of the short form Beck Depression Inventory with older adults. J Clin Psychiatr 44:853–856CrossRefGoogle Scholar
  37. 37.
    Gould JA (1982) Psychometric investigation of the standard and long form Beck Depression Inventory. Psychol Rep 51:1167–1170PubMedCrossRefGoogle Scholar
  38. 38.
    Baron R, Kenny D (1986) The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Per Soc Psychol 51:1173–1182CrossRefGoogle Scholar
  39. 39.
    Wen ZL, Hou JT, Hang L (2005) A comparison of moderator and mediator and their applications. Acta Psychol Sin 37:268–274Google Scholar
  40. 40.
    Keel PK, Mitchell JE, Miller KB, Davis TL, Crow SJ (1999) Long-term outcome of bulimia nervosa. Arch Gen Psychiatr 56:63–69PubMedCrossRefGoogle Scholar
  41. 41.
    Herzog DB, Keller MB, Sacks NR et al (1999) Recovery and relapse in anorexia and bulimia nervosa: a 7.5-year follow-up study. J Am Acad Child Adolesc Psychiatr 38:829–837CrossRefGoogle Scholar
  42. 42.
    Keel PK, Klump KL, Miller KB et al (2005) Share transmission of eating disorders and anxiety disorders. Int J Eat Disord 38:99–105PubMedCrossRefGoogle Scholar
  43. 43.
    Wonderlich SA, Mitchell JE (1997) Eating disorders and comorbidity: empirical, conceptual, and clinical implications. Psychopharmacol Bull 33:381–390PubMedGoogle Scholar
  44. 44.
    Berardis DD, D’Albenzio A, Gambi F et al (2009) Alexithymia and its relationships with dissociative experiences and Internet addiction in a nonclinical sample. Cyberpsychol Behav Soc Netw 12:67–69CrossRefGoogle Scholar
  45. 45.
    Sexton MC, Sunday SR, Hurt S et al (1998) The relationship between alexithymia, depression, and axis II psychopathology in eating disorder inpatients. Int J Eat Disord 23:277–286PubMedCrossRefGoogle Scholar
  46. 46.
    Garner DM, Garfinkel P (1982) Perceptive and cognitive disturbances. Anorexia nervosa: a multidimensional perspective. Brunner/Mazel, New York, pp 123–163Google Scholar
  47. 47.
    Davis MS, Marsh L (1986) Self-love, self-control and alexithymia: narcissistic features of two bulimic adolescents. Am J Psychother 15:224–232Google Scholar
  48. 48.
    Wade TD, Tiggemann M, Bulik CM et al (2008) Shared temperament risk factors for anorexia nervosa: a twin study. Psychosom Med 70:239–244PubMedCrossRefGoogle Scholar
  49. 49.
    Russell G (1979) Bulimia nervosa: an ominous variant of anorexia nervosa. Psychiatr Med 9:429–448Google Scholar
  50. 50.
    Ross HE, Ivis F (1999) Binge eating and substance use among male and female adolescents. Int J Eat Disord 26:245–260PubMedCrossRefGoogle Scholar
  51. 51.
    Flood M (1989) Addictive eating disorders. Nurs Clin North Am 24:45–53PubMedGoogle Scholar
  52. 52.
    Khantzian EJ (1985) The self-medication hypothesis of addictive disorders: focus on heroin and cocaine dependence. Am J Psychiatr 142:1259–1264PubMedGoogle Scholar
  53. 53.
    Johnson CL, Connors ME (1987) The etiology and treatment of bulimia nervosa. Basic Books, New YorkGoogle Scholar
  54. 54.
    Fahy T, Eisler I (1993) Impulsivity and eating disorders. Br J Psychiatr 162:193–197CrossRefGoogle Scholar
  55. 55.
    Wiederman MW, Pryor T (1996) Multi-impulsivity among women with bulimia nervosa. Int J Eat Disord 20:359–365PubMedCrossRefGoogle Scholar
  56. 56.
    Cao F, Su L, Liu T, Gao X (2007) The relationship between impulsivity and Internet addiction in a sample of Chinese adolescents. Eur Psychiatr 22:466–471CrossRefGoogle Scholar
  57. 57.
    Vandereyecken W (1990) The addiction model in eating disorders: some critical remarks and a selected bibliography. Int J Eat Disord 9:95–101CrossRefGoogle Scholar
  58. 58.
    Shisslak CM, Crago M, McKnight KM et al (1998) Potential risk factors associated with weight control behaviors in elementary and middle school girls. J Psychosom Res 44:301–313PubMedCrossRefGoogle Scholar
  59. 59.
    Frankl G (2000) Foundations of morality—an investigation into the origin and purpose of moral concepts. Open Gate Press, London (translated into Chinese, China international culture and publishing company, print consent from Open gate press), p 105Google Scholar
  60. 60.
    Wilson GT (1991) The addiction model of eating disorders: a critical analysis. Adv Behav Res Ther 13:27–72CrossRefGoogle Scholar
  61. 61.
    Zhang FC, Mitchell JE, Kuang L et al (1992) The prevalence of anorexia nervosa and bulimia nervosa among freshman medical college students in China. Int J Eat Disord 12:209–214Google Scholar

Copyright information

© Springer International Publishing Switzerland 2013

Authors and Affiliations

  1. 1.Department of Medical HumanitiesSoutheast UniversityNanjingChina

Personalised recommendations