Stress plays a role in the association between cognitive constructs and measures of eating disorders in male subjects

  • S. Sassaroli
  • C. Mezzaluna
  • A. Amurri
  • R. Bossoletti
  • T. Ciccioli
  • A. Perrotta
  • A. Romualdi
  • A. Stronati
  • S. Urbani
  • V. Valenti
  • G. Milos
  • G. M. Ruggiero
Original Research Paper

Abstract

Objective: Several theorists have hypothesized that stressful situations may trigger abnormal eating and even eating disorders in predisposed people. The purpose of this study was to assess whether a stressful situation would reveal an association between perfectionism and low self-esteem, and measures of eating disorder symptoms in male high school students. Method: A sample of 61 male high school students completed the Eating Disorder Inventory, the Multidimensional Perfectionism Scale, and the Self Liking and Competence Scale three times: on an average school day, on the day of an exam and on the day the subjects received the results of that exam. Linear regression analysis was carried out to verify whether the dimensions of perfectionism were associated with the measures of eating disorders. Results: Interoceptive awareness was associated with ‘Bulimia’ only during the stressful situation and with ‘Drive for thinness’ both in stress and non stress situations. Other results were contradictory and difficult to interpret. Discussion: The results suggest that in nonclinical male individuals stress might bring out a previously absent association between some psychological predisposing factors for eating disorders and an actual desire or plan for ED related thoughts and behaviours. Such a finding suggests that stress may stimulate behaviours related to eating disorders in a predisposed personality. A central role may be played by interoceptive awareness in male subjects.

Key words

Interoceptive awareness cognitive constructs stress bulimia 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Striegel-Moore R.H., Garvin V., Dohm F.A., Rosenheck R.A.: Eating disorders in a national sample of hospitalized female and male veterans: detection rates and psychiatric comorbidity. Int. J. Eat. Disord., 25, 405–414, 1999.PubMedCrossRefGoogle Scholar
  2. 2.
    Grabhorn R., Kopp W., Gitzinger I., von Wietersheim J., Kaufhold J.: Differences between female and male patients with eating disorders. Psychother. Psychosom. Med. Psychol., 53, 15–22, 2003.PubMedCrossRefGoogle Scholar
  3. 3.
    Yager J., Kurtzman F., Landsverk J., Wiesmeier E.: Behaviors and attitudes related to eating disorders in homosexual male college students. Am. J. Psychiatry, 145, 495–497, 1988.PubMedGoogle Scholar
  4. 4.
    Bauer B.G., Anderson W.P.: Bulimic beliefs: Food for thought. J. Couns. Dev, 67, 416–419, 1989.CrossRefGoogle Scholar
  5. 5.
    Bruch H.: Eating disorders: Obesity, anorexia nervosa, and the person within. New York, Basic Books, 1973.Google Scholar
  6. 6.
    Casper R.C.: Some provisional ideas concerning the psychologic structure in anorexia nervosa and bulimia. In: Dasrby P.L., Garfinkel P.E., Garner D.M. Coscina D.V. (Eds.), Anorexia nervosa: Recent developments in research. New York, Alan R. Liss, 1983, pp. 387–392.Google Scholar
  7. 7.
    Garner D.M.: Cognitive therapy for anorexia nervosa. In: Brownell K.D. Foreyyt J.P. (Eds.), Handbook of eating disorders: Physiology, psychology, and treatment of obesity, anorexia, and bulimia. New York, Basic Books, 1986, pp. 301–327.Google Scholar
  8. 8.
    Davis C.: Normal and neurotic perfectionism in eating disorders: An interactive model. Int. J. Eat. Disord., 22, 421–426, 1997.PubMedCrossRefGoogle Scholar
  9. 9.
    Davis C., Claridge G., Fox J.: Not just a pretty face: Physical attractiveness and perfectionism in the risk for eating disorders. Int. J. Eat. Disord., 27, 63–73, 2000.CrossRefGoogle Scholar
  10. 10.
    Bastiani A.M., Rao R., Weltzin T., Kaye W.H.: Perfectionism in anorexia nervosa. Int. J. Eat. Disord., 17, 147–152, 1995.PubMedCrossRefGoogle Scholar
  11. 11.
    Vitousek K.B., Hollon K.B.: The investigation of schematic content and processing in eating disorders. Cogn. Ther. Res., 14, 191–214, 1990.CrossRefGoogle Scholar
  12. 12.
    McLaren L., Gauvin L., White D.: The role of perfectionism and excessive commitment to exercise in explaining dietary restraint: Replication and extension. Int. J. Eat. Disord., 29, 307–313, 2001.PubMedCrossRefGoogle Scholar
  13. 13.
    Ruggiero G.M., Levi D., Ciuna A., Sassaroli S.: Stress situation reveals association between perfectionism and drive for thinness. Int. J. Eat. Disord., 34, 220–226, 2003.PubMedCrossRefGoogle Scholar
  14. 14.
    Button E.J., Sonuga-Barke E.J.S., Davies J., Thompson M.: A prospective study of self-esteem in the prediction of eating problems in adolescent schoolgirls: questionnaire findings. Br. J. Clin. Psychol., 35, 193–203, 1996.PubMedCrossRefGoogle Scholar
  15. 15.
    Fairburn C.G., Welch S.L., Doll H.A., Davies B.A., O’Connor M.E.: Risk factors for bulimia nervosa: a community-based case-control study. Arch. Gen. Psychiatry, 54, 509–517, 1997.PubMedCrossRefGoogle Scholar
  16. 16.
    Fairburn C.G., Shafran R., Cooper Z.: A cognitive behavioural theory of eating disorders. Behav. Res. Ther., 37, 1–13, 1999.PubMedCrossRefGoogle Scholar
  17. 17.
    Fairburn C.G., Cooper Z., Shafran R.: Cognitive behaviour therapy for eating disorders: A “transdiagnostic” theory and treatment. Behav. Res. Ther., 41, 509–528, 2003.PubMedCrossRefGoogle Scholar
  18. 18.
    Frost R. O., Marten P. Lahart C., Rosenblate R.: The dimensions of perfectionism. Cogn. Ther. Res., 14, 449–468, 1990.CrossRefGoogle Scholar
  19. 19.
    Hewitt P.L., Flett G.L.: Perfectionism in the self and social context: Conceptualization, assessment, and association with psychopathology. J. Person. Soc. Psychol., 60, 456–470, 1991.CrossRefGoogle Scholar
  20. 20.
    Frost R.O., Heimberg R.G., Holt C.S., Mattia J.I., Neubauer A.L.: A comparison of two measures of perfectionism. Person. Individ. Diff., 14, 119–126, 1993.CrossRefGoogle Scholar
  21. 21.
    Rosenberg M.: Society and adolescent self-image. Princeton, Princeton University Press, 1965.Google Scholar
  22. 22.
    Tafarodi R.W., Swann W.B.Jr.: Self-liking and selfcompetence as dimensions of global self-esteem: Initial validation of a measure. J. Person. Assess., 65, 322–342, 1995.CrossRefGoogle Scholar
  23. 23.
    Silvera D.H., Bergersen L., Biørgum J.A., Perry J.A., Rosenvinge J.H., Holte A.: Analyzing the relation between self-esteem and eating disorders: Differential effects of self-liking and self-competence. Eat. Weight Disord., 2, 95–99, 1998.Google Scholar
  24. 24.
    Connan F., Treasure J.: Stress, eating and neurobiology. In: Hoeck H.W., Treasure J.L., Katzman M. (Eds.), Neurobiology in the treatment of eating disorders. Chichester, Wiley, 1998, pp. 211–236.Google Scholar
  25. 25.
    Brown E.J., Heimberg R.G., Frost R.O., Makris S.G., Juster H.R., Leung A.W.: Relationship of perfectionism to affect, expectations, attributions and performance in the classroom. J. Soc. Clin. Psychol., 18, 98–120, 1999.CrossRefGoogle Scholar
  26. 26.
    Garner D.M., Olmsted M.P., Polivy J.: Development and validation of a multidimensional Eating Disorder Inventory for anorexia nervosa and bulimia. Int. J. Eat. Disord., 2, 15–34, 1983.CrossRefGoogle Scholar
  27. 27.
    Hewitt P.L., Flett G.L., Turnbull-Donovan W., Mikail S.F.: The Multidimensional Perfectionism Scale: Reliability, validity, psychometric properties in psychiatric samples. Psychological assessment. J. Consult. Clin. Psychol., 3, 464–468, 1991.CrossRefGoogle Scholar
  28. 28.
    Garner D.M.: The Eating Disorder Inventory — 2: Professional Manual. Odessa, FL, Psychological Assessment Resources, 1991.Google Scholar
  29. 29.
    SPSS Inc. SPSS 10.0 per Windows. Bologna, SPSS Italia, 1999.Google Scholar
  30. 30.
    Hewitt P.L., Flett G.L, Ediger E.: Perfectionism traits and perfectionistic self-presentation in eating disorder attitudes, characteristics, and symptoms. Int. J. Eat. Disord., 18, 317–326, 1995.PubMedCrossRefGoogle Scholar
  31. 31.
    Burns D.D.: The perfectionist’s script for self-defeat. Psychological Today, 1980, pp. 34–51.Google Scholar
  32. 32.
    Hamachek D.E.: Psychodynamics of normal and neurotic perfectionism. Psychology, 15, 27–33, 1978.Google Scholar
  33. 33.
    Hollander M.H.: Perfectionism. Compr. Psychiatry, 6, 94–103, 1965.CrossRefGoogle Scholar
  34. 34.
    Patch A.R.: Reflections on perfection. American Psychologist, 39, 386–390, 1984.CrossRefGoogle Scholar
  35. 35.
    Humphrey L.L.: Relationships with subtypes of anorexic, bulimic, and normal families. J. Am. Acad. Child Adolesc. Psychiatry, 27, 544–551, 1988.PubMedCrossRefGoogle Scholar
  36. 36.
    Råstam M., Gillberg C.: The family background in anorexia nervosa: A population based-study. J. Am. Acad. Child Adolesc. Psychiatry, 30, 283–289, 1991.PubMedCrossRefGoogle Scholar
  37. 37.
    Thienemann M., Steiner H.: Family environment of eating disordered and depressed adolescents. Int. J. Eat. Disord., 14, 43–48, 1993.PubMedCrossRefGoogle Scholar
  38. 38.
    Slade P.: Toward a functional analysis of anorexia nervosa and bulimia nervosa. Br. J. Clin. Psychol., 21, 167–179, 1982.PubMedCrossRefGoogle Scholar
  39. 39.
    Bardone A.M., Perez M., Abramson L.Y., Joiner Jr., T.E.: Self-competence and self-liking in the prediction of change in bulimic symptoms. Int. J. Eat. Disord., 34, 361–369, 2003.PubMedCrossRefGoogle Scholar

Copyright information

© Editrice Kurtis 2005

Authors and Affiliations

  • S. Sassaroli
    • 1
  • C. Mezzaluna
    • 1
  • A. Amurri
    • 1
  • R. Bossoletti
    • 1
  • T. Ciccioli
    • 1
  • A. Perrotta
    • 1
  • A. Romualdi
    • 1
  • A. Stronati
    • 1
  • S. Urbani
    • 1
  • V. Valenti
    • 1
  • G. Milos
    • 3
  • G. M. Ruggiero
    • 1
    • 2
  1. 1.Studi CognitiviPost-graduate Cognitive Psychotherapy SchoolMilanoItaly
  2. 2.Studi CognitiviPost-graduate Cognitive Psychotherapy SchoolSan Benedetto del TrontoItaly
  3. 3.Eating Disorders Unit, Psychiatric DepartmentUniversity HospitalZurichSwitzerland

Personalised recommendations