Skip to main content
SpringerLink
Log in

Sociocultural Experiences of Bulimic and Non-Bulimic Adolescents in a School-Based Chinese Sample

  • Published:
Journal of Abnormal Child Psychology Aims and scope Submit manuscript

Abstract

From a large school-based sample (N = 3,084), 49 Mainland Chinese adolescents (31 girls, 18 boys) who endorsed all DSM-IV criteria for bulimia nervosa (BN) or sub-threshold BN and 49 matched controls (31 girls, 18 boys) completed measures of demographics and sociocultural experiences related to body image. Compared to less symptomatic peers, those in the BN group reported higher levels of appearance pressure from their network of close relationships and mass media, appearance comparisons and conversations, and fear of negative appearance evaluation. A hierarchical logistic regression analysis based seven predictors resulted in the correct identification of 82.7% of respondents, including 83.7% of the BN group and 81.7% of controls. Responses on sociocultural measures, especially those reflecting appearance pressure, added to the classification rate, after controlling for body mass index and household socioeconomic status. When repeated within each sex, classification accuracy was 90.3% for girls and 86.1% for boys. This study establishes clear links between sociocultural influences and BN among urban adolescent girls and boys living in the People’s Republic of China.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  • Bell, A. C., Ge, K., & Popkin, B. M. (2001). Weight gain and its predictors in Chinese adults. International Journal of Obesity, 25, 1079–1087.

    Article  PubMed  Google Scholar 

  • Bukowski, W. M., Hoza, B., & Boivin, M. (1993). Popularity, friendship, and emotional adjustment during early adolescence. New Directions for Child Development, 60, 23–37.

    Article  PubMed  Google Scholar 

  • Cafri, G., Yamamiya, Y., Brannick, M., & Thompson, J. K. (2005). The influence of sociocultural factors on body image: a meta-analysis. Clinical Psychology Science and Practice, 12, 421–433.

    Article  Google Scholar 

  • Chen, H., & Jackson, T. (2008). Prevalence and sociodemographic correlates of eating disorder endorsements among adolescents and young adults from China. European Eating Disorders Review, 16, 375–385.

    Article  PubMed  Google Scholar 

  • Chen, H., & Jackson, T. (2009a). Predictors of body image concerns among adolescent girls and boys in China: a nine month prospective study. Journal of Adolescence, 32, 977–994.

    Article  PubMed  Google Scholar 

  • Chen, H., & Jackson, T. (2009b). A longitudinal analysis of factors that predict changes in weight esteem among adolescent girls and boys in China. Developmental Psychology. In press.

  • Chen, H., Gao, X., & Jackson, T. (2007). Predictive models for understanding body dissatisfaction among young males and females in China. Behaviour Research & Therapy, 45, 1345–1356.

    Article  Google Scholar 

  • Du, S., Mroz, T., Zhai, F., & Popkin, B. (2004). Rapid income growth adversely affects diet quality in China—particularly for the poor!. Social Science & Medicine, 59, 1505–1516.

    Article  Google Scholar 

  • Engler, P., Crowther, J., Dalton, G., & Sanftner, J. (2006). Predicting eating disorder group membership: an examination and extension of the sociocultural model. Behavior Therapy, 37, 69–79.

    Article  PubMed  Google Scholar 

  • Frankenberger, K. D. (2000). Adolescent egocentrism: a comparison among adolescents and adults. Journal of Adolescence, 23, 343–354.

    Article  PubMed  Google Scholar 

  • Gilbert, N., & Meyer, C. (2005). Fear of negative evaluation and the development of eating psychopathology: a longitudinal study among nonclinical women. International Journal of Eating Disorders, 37, 307–312.

    Article  PubMed  Google Scholar 

  • Grabe, S., Ward, M. L., & Hyde, J. (2008). The role of the media in body image concerns among women: a meta-analysis of experimental and correlational studies. Psychological Bulletin, 134, 460–476.

    Article  PubMed  Google Scholar 

  • Hoek, H. W., & van Hoeken, D. (2003). Review of the prevalence and incidence of eating disorders. International Journal of Eating Disorders, 35, 383–396.

    Article  Google Scholar 

  • Huon, G. F., Qian, M. Y., Oliver, K., & Xiao, G. L. (2002). A large-scale survey of eating disorder symptomatology among female adolescents in the People's Republic of China. International Journal of Eating Disorders, 32, 192–205.

    Google Scholar 

  • Jackson, T., & Chen, H. (2007). Identifying the eating disorder symptomatic in China: the role of sociocultural factors and culturally-defined appearance concerns. Journal of Psychosomatic Research, 62, 241–249.

    Article  PubMed  Google Scholar 

  • Jackson, T., & Chen, H. (2008a). Sociocultural influences on body image concerns of young Chinese males. Journal of Adolescent Research, 23, 154–171.

    Article  Google Scholar 

  • Jackson, T., & Chen, H. (2008b). Predicting changes in eating disorder symptoms among Chinese adolescents: a nine month prospective study. Journal of Psychosomatic Research, 64, 87–95.

    Article  PubMed  Google Scholar 

  • Jackson, T., & Chen, H. (2008c). Changes in eating disorder symptoms among adolescent girls and boys in China: an 18 month prospective study. Journal of Clinical Child & Adolescent Psychology, 37, 874–885.

    Article  Google Scholar 

  • Jacobi, C., Hayward, C., de Zwaan, M., Kraemer, H. C., & Argas, W. S. (2004). Coming to terms with risk factors for eating disorders: application of risk terminology and suggestions for a general taxonomy. Psychological Bulletin, 130, 19–65.

    Article  PubMed  Google Scholar 

  • Johnson, J. G., Cohen, P., Kasen, S., & Brook, J. S. (2002). Eating disorders during adolescence and the risk for physical and mental disorders during early adulthood. Archives of General Psychiatry, 59, 545–552.

    Article  PubMed  Google Scholar 

  • Jones, D. C. (2004). Body image among adolescent girls and boys: a longitudinal study. Developmental Psychology, 40, 823–835.

    Article  Google Scholar 

  • Jones, D. C., & Crawford, J. K. (2006). The peer appearance culture during adolescence: gender and body mass variations. Journal of Youth and Adolescence, 35, 257–269.

    Article  Google Scholar 

  • Jones, D. C., Vigfusdottir, T. H., & Lee, Y. (2004). Body image and the appearance culture among adolescent girls and boys. Journal of Adolescent Research, 19, 323–339.

    Article  Google Scholar 

  • Karazsia, B. T., & Crowther, J. H. (2008). Psychological and behavioral correlates of the SATAQ-3 with males. Body Image, 5, 109–115.

    Google Scholar 

  • Keel, P. K., & Klump, K. L. (2003). Are eating disorders culture-bound syndromes? Implications for conceptualizing their etiology. Psychological Bulletin, 129, 747–769.

    Article  PubMed  Google Scholar 

  • Keel, P. K., Crow, S., Davis, T. L., & Mitchell, J. E. (2002). Assessment of eating disorders: comparison of interview and questionnaire data from a long-term follow-up study of bulimia nervosa. Journal of Psychosomatic Research, 53, 1043–1047.

    Article  PubMed  Google Scholar 

  • Lee, H. Y., & Lock, J. (2007). Anorexia nervosa in Asian-American adolescents: do they differ from their non-Asian peers? International Journal of Eating Disorders, 40, 227–231.

    Article  PubMed  Google Scholar 

  • Leung, F., Lam, S., & Sze, S. (2001). Cultural expectations of thinness in Chinese women. Eating Disorders, 9, 339–350.

    Article  PubMed  Google Scholar 

  • Li, Y. P., Hu, X. Q., Ma, W. J., Wu, J., & Ma, G. (2005). Body image perception among Chinese children and adolescents. Body Image, 2, 91–103.

    Article  PubMed  Google Scholar 

  • Lundgren, J. D., Anderson, D. A., & Thompson, J. K. (2004). Fear of negative appearance evaluation: development and evaluation of a new construct for risk factor work in the field of eating disorders. Eating Behaviors, 5, 75–84.

    Article  PubMed  Google Scholar 

  • Mitchell, J. E., & Crow, S. (2006). Medical complications of anorexia nervosa and bulimia nervosa. Current Opinions in Psychiatry, 19, 438–443.

    Article  Google Scholar 

  • Morgan, G. A., Vaske, J. J., Gliner, J. A., & Harmon, R. J. (2003). Logistic regression and discriminant analysis: use and interpretation. Journal of the American Academy of Child and Adolescent Psychiatry, 42, 994–997.

    Article  PubMed  Google Scholar 

  • Mussap, A. (2007). Motivational processes associated with unhealthy body change attitudes and behaviours. Eating Behaviors, 8, 423–428.

    Article  PubMed  Google Scholar 

  • Presnell, K., Bearman, S., & Stice, E. (2004). Risk factors for body dissatisfaction in adolescent boys and girls: a prospective study. International Journal of Eating Disorders, 36, 389–401.

    Article  PubMed  Google Scholar 

  • Shi, Z., Lien, N., Nirmal Kumar, B., & Holmboe-Ottesen, G. (2005). Socio-demographic differences in food habits and preferences of school adolescents in Jiangsu Province, China. European Journal of Clinical Nutrition, 59, 1439–1448.

    Article  PubMed  Google Scholar 

  • Shroff, H., & Thompson, J. K. (2006). Peer influences, body-image dissatisfaction, eating dysfunction and self-esteem in adolescent girls. Journal of Health Psychology, 11, 533–551.

    Article  PubMed  Google Scholar 

  • Stein, M. B., Jang, K., & Livesley, W. S. (2002). Heritability of social anxiety-related concerns and personality characteristics: a twin study. Journal of Nervous & Mental Disease, 190, 219–224.

    Article  Google Scholar 

  • Stice, E. (2002). Risk and maintenance factors for eating pathology: a meta-analytic review. Psychological Bulletin, 128, 825–848.

    Article  PubMed  Google Scholar 

  • Stice, E., & Agras, W. S. (1998). Predicting onset and cessation of bulimic behaviors during adolescence: a longitudinal grouping analysis. Behavior Therapy, 29, 257–276.

    Article  Google Scholar 

  • Stice, E., & Shaw, H. (2004). Eating disorder prevention programs: a meta-analytic review. Psychological Bulletin, 130, 206–227.

    Article  PubMed  Google Scholar 

  • Stice, E., & Whitenton, K. (2002). Risk factors for body dissatisfaction in adolescent girls: a longitudinal investigation. Developmental Psychology, 38, 669–678.

    Article  PubMed  Google Scholar 

  • Stice, E., Telch, C. F., & Rizvi, S. L. (2000). Development and validation of the eating disorder diagnostic scale: a brief self-report measure of anorexia, bulimia, and binge-eating disorder. Psychological Assessment, 12, 123–131.

    Article  PubMed  Google Scholar 

  • Stice, E., Fisher, M., & Martinez, E. (2004). Eating disorder diagnostic scale: additional evidence of reliability and validity. Psychological Assessment, 16, 60–71.

    Article  PubMed  Google Scholar 

  • Striegel-Moore, R. H., Silberstein, L. R., & Rodin, J. (1993). The social self in bulimia nervosa: Public self-consciousness, social anxiety, and perceived fraudulence. Journal of Abnormal Psychology, 102, 297–303.

    Google Scholar 

  • Thompson, J. K., Heinberg, L. J., & Tantleff, S. (1991). The physical appearance comparison scale (PACS). The Behavior Therapist, 14, 174.

    Google Scholar 

  • Thompson, J. K., Coovert, M., & Stormer, S. (1999a). Body image, social comparison and eating disturbance: a covariance structure modeling investigation. International Journal of Eating Disorders, 26, 43–53.

    Article  Google Scholar 

  • Thompson, J. K., Heinberg, L. J., Altabe, M., & Tantleff-Dunn, S. (1999b). Exacting beauty: Theory, assessment, and treatment of body image disturbance. Washington, DC: American Psychological Association.

    Book  Google Scholar 

  • Thompson, J. K., van den Berg, P., Roehrig, M., Guarda, A., Heinberg, L. J., Thompson, J. K., et al. (2004). The sociocultural attitudes towards appearance questionnaire-3 (SATAQ-3): development and validation. International Journal of Eating Disorders, 35, 293–304.

    Article  PubMed  Google Scholar 

  • Xie, B., Chou, C. P., Spruijt-Metz, D., Reynolds, K., et al. (2006). Weight perception and weight-related sociocultural and behavioral factors in Chinese adolescents. Preventive Medicine, 42, 229–234.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Key Laboratory of Cognition and Personality, China Ministry of Education, Southwest University, Chongqing, China

    Todd Jackson & Hong Chen

  2. Department of Psychology, James Cook University, Townsville, Australia

    Todd Jackson

  3. School of Psychology, Southwest University, Chongqing, China

    Hong Chen

Authors
  1. Todd Jackson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hong Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hong Chen.

Additional information

This research was supported by grants from the Foundation program for Humanities and Social Science research, State Education Commission (08JAXLX014), the Chinese National Natural Science Foundation (30870774), and the School of Arts and Social Sciences, James Cook University. We thank Zhang Tingyan, Rao Ying, He Yulan, Liang Yi, Jiang Xiaxia, Chen Minyan, Pan Chenjing, Liukun, Yang Tingting, and Zhao Yi for assistance with data collection.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Jackson, T., Chen, H. Sociocultural Experiences of Bulimic and Non-Bulimic Adolescents in a School-Based Chinese Sample. J Abnorm Child Psychol 38, 69–76 (2010). https://doi.org/10.1007/s10802-009-9350-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10802-009-9350-0

Keywords

Search

Navigation