Psychosocial risk factors for Eating Disorders: a review and some considerations for prevention and intervention

Authors

DOI:

https://doi.org/10.33898/rdp.v31i115.354

Keywords:

eating disorders, ED, risk factors, longitudinal studies, body dissatisfaction

Abstract

Identifying risk factors is esential to develop strategies for prevention and to guide effective interventions for eating disorders (ED). The purpose of this review is to examine some socicultural, contextual and psychological factors that have proved to increase the risk to develop an ED, with special attention to findings from longitudinal prospective studies.
All factors linked with being exposed to the sociocultural idealization of thinnes in women and the pressure to attain it (media exposure, pressures for thinnes, thin-ideal internalization, thinnes expectancies) are risk factors that can predict increasing in body dissatisfaction levels, use of diets o bulimic symptoms, in adolescent and young women. Some personality factors (perfectionism, negative emotionality, depressive symptoms, low self-steem, impulsivity/negative urgency), as well as some maladaptative parental behaviors, and peers with similar worries and strategies, have been shown to predict the development of eating disorders symptoms.
We conclude with some suggestions to consider in the preventive and clinic interventions.

Downloads

Download data is not yet available.

Author Biography

María Elena Gismero González, Universidad Pontificia Comillas. Madrid. Spain

Profesora Propia Agregada/ Departamento de Psicología
Facultad de Ciencias Humanas y Sociales, Universidad Pontificia Comillas. Madrid. España
Coordinadora de Investigación UNINPSI

References

American Psychiatric Association (2013). The diagnostic and statistical manual of mental disorders, (5th ed.). Arlington, VA: American Psychiatric Association.

Annus, A. M., Smith, G. T. y Masters, K. (2008). Manipulation of thinness and restricting expectancies: Further evidence for a causal role of thinness and restricting expectancies in the etiology of eating disorders. Psychology of Addictive Behaviors, 22(2), 278–287. https://doi.org/10.1037/0893-164X.22.2.278

Bachner-Melman, R., Zontag-Oren, E., Zohar, A. H. y Sher, H. (2018). Lives on the line: The online lives of girls and women with and without a lifetime eating disorder diagnosis. Frontiers in Psychology, 9. https://doi.org/10.3389/fpsyg.2018.02128

Bardone-Cone, A. M., Abramson, L.Y., Vohs, K. D., Heatherton, T. F. y Joiner, T. E. (2006). Predicting bulimic symptoms: an interactive model of self-efficacy, perfectionism, and perceived weight status. Behavior Research Therapy, 44(1), 27–42. https://doi.org/10.1016/j.brat.2004.09.009

Beato-Fernández, L., Rodríguez-Cano, T., Belmonte-Llario, A. y Martínez-Delgado, C. (2004). Risk factors for eating disorders in adolescents: A Spanish community-based longitudinal study. European Child and Adolescent Psychiatry, 13, 287–294. https://doi.org/10.1007/s00787-004-0407-x

Bizeul C., Sadowsky N. y Rigaud D. (2001). The prognostic value of initial EDI scores in anorexia nervosa patients: a prospective follow-up study of 5–10 years. European Psychiatry, 16(4), 232–238. https://doi.org/10.1016/s0924-9338(01)00570-3

Brown, Z. y Tiggemann, M. (2016). Attractive celebrity and peer images on Instagram: Effect on women’s mood and body image. Body Image, 19, 37–43. https://doi.org/10.1016/j.bodyim.2016.08.007

Burnette, C. B., Kwitowski, M. A. y Mazzeo, S. E. (2017). ‘I don’t need people to tell me I’m pretty on social media:’ a qualitative study of social media and body image in early adolescent girls. Body Image, 23, 114-125. https://doi.org/10.1016/j.bodyim.2017.09.001

Button, E. J., Sonuga-Barke, E. J., Davies, J. y Thompson, M. (1996). A prospective study of self-esteem in the prediction of eating problems in adolescent schoolgirls: questionnaire findings. British Journal of Clinical Psychology, 35(2), 193-203. https://doi.org/10.1111/j.2044-8260.1996.tb01176.x

Cervera, S., Lahortiga, F., Martínez-González, M.A., Gual, P., de Irala-Estévez, J. y Alonso, Y. (2003). Neuroticism and low self-esteem as risk factors for incident eating disorders in a prospective cohort study. International Journal of Eating Disorders, 33(3), 271-80. https://doi.org/10.1002/eat.10147

Cohen, R., Newton-John, T. y Slater, A. (2017). The relationship between Facebook and Instagram appearance-focused activities and body image concerns in young women. Body Image, 23, 183-187. https://doi.org/10.1016/j.bodyim.2017.10.002

Culbert, K. M., Racine, S. E y Klump, K. L (2015). Research Review: What we have learned about the causes of eating disorders – a synthesis of sociocultural, psychological, and biological research. The Journal of Child Psychology and Psyquiatry, 56(11), 1141-1164. https://doi.org/10.1111/jcpp.12441

de Vos, J. A., La Marre, A., Radstaak, M., Birjerk, C. A., Bohlmeijer, E. T. y Westrhof, G. J. (2017). Identifying fundamental criteria for eating disorder recovery: a systematic review and qualitative meta-analysis. Journal of Eating Disorders, 5, 34. https://doi.org/10.1186/s40337-017-0164-0

Eisenberg, M. E. y Neumark-Sztainer, D. (2006). Friends’ Dieting and Disordered Eating Behaviors Among Adolescents Five Years Later: Findings From Project EAT. Journal of Adolescent Health, 47(1), 67-73. https://doi.org/10.1016/j.jadohealth.2009.12.030

Fairburn, C. G., Cooper, Z., Doll, H. A. y Davies, B. A. (2005). Identifying dieters who will develop an eating disorder: A prospective, population-based study. American Journal of Psychiatry, 162(12), 2249–2255. https://doi.org/10.1176/appi.ajp.162.12.2249

Fardouly, J., Pinkus, R. T. y Vartanian, L. R. (2017). The impact of appearance comparisons made through social media, traditional media, and in person in women’s everyday lives. Body Image, 20, 31-39. https://doi.org/10.1016/j.bodyim.2016.11.002

Ferguson, C. J., Muñoz, M. E., Garza, A. y Galindo, M. (2014). Concurrent and prospective analyses of peer, television and social media influences on body dissatisfaction, eating disorder symptoms and life satisfaction in adolescent girls. Journal of Youth and Adolescence, 43(1), 1-14. https://doi.org/10.1007/s10964-012-9898-9

Festinger, L. (1954). A theory of social comparison processes. Human Relations, 7, 117–140. https://doi.org/10.1177/001872675400700202

Frost, R. L. y Rickwood, D. J. (2017). A systematic review of the mental health outcomes associated with Facebook use. Computers In Human Behavior, 76, 576-600. https://doi.org/10.1016/j.chb.2017.08.001

Ghaderi, A. y Scott, B. (2001). Prevalence, incidence and prospective risk factors for eating disorders. Acta Psychiatrica Scandinavica, 104, 122–130. https://doi.org/10.1034/j.1600-0447.2001.00298.x

Gismero, M. E. (2008). Ideales vendidos, necesidades incorporadas: cambiar de cuerpo. En M.A. Roldán (coord.), Trastornos psicológicos en el Siglo XXI (pp.140-158). Madrid, España: Universidad Pontificia Comillas.

Gismero, M. E. (2016). Los riesgos del “mercado de las apariencias”: reflexiones sobre la mejora estética. En J. De la Torre (Ed.), Cultura de la mejora humana y vida cotidiana (pp. 49-68). Madrid, España: Universidad Pontificia Comillas.

Gual, P., Pérez-Gaspar, M., Martínez-González, M. A., Lahortiga, F., de Irala-Estévez, J. y Cervera-Enguix, S. (2002). Self-esteem, personality, and eating disorders: baseline assessment of a prospective population-based cohort. International Journal of Eating Disorders, 31(3), 261-73. https://doi.org/10.1002/eat.10040

Gusella, J., Goodwin, J. y van Roosmalen, E. (2008). ‘I want to lose weight’: Early risk for disordered eating? Paediatrics & child health, 13(2), 105–110. https://doi.org/10.1093/pch/13.2.105

Hausenblas, H. A., Campbell, A., Menzel, J. E., Doughty, J., Levine, M. y Thompson, J. K. (2013). Media effects of experimental presentation of the ideal physique on eating disorder symptoms: A meta-analysis of laboratory studies. Clinical Psychology Review, 33(1), 168–181. https://doi.org/10.1016/j.cpr.2012.10.011

Holland, L. A., Bodell, L. P. y Keel, P. K. (2013). Psychological factors predict eating disorder onset and maintenance at 10-year follow-up. European eating disorders review: the journal of the Eating Disorders Association, 21(5), 405–410. https://doi.org/10.1002/erv.2241

Jacobi, C. y Fittig, E. (2010). Psychosocial risk factors for eating disorders. En W. S. Agras (Ed.), The Oxford handbook of eating disorders (pp. 123–136). Nueva York, NY: Oxford University Press.

Jacobi, C., Fittig, E., Bryson, S. W., Wilfley, D., Kraemer, H. C. y Taylor, C. B. (2011). Who is really at risk? Identifying risk factors for subthreshold and full syndrome eating disorders in a high-risk sample. Psychological Medicine, 41(9), 1939–1949. https://doi.org/10.1017/S0033291710002631

Jacobi, C., Hütter, K. y Fittig, E. (2018). Psychosocial risk factors for eating disorders. En W. S. Agras y A. Robinson (Eds.), The Oxford handbook of eating disorders, 2nd ed. (pp. 106-125). Nueva York, NY: Oxford University Press.

Johnson, J. G., Cohen, P., Kasen, S. y Brook, J. S. (2002). Childhood adversities associated with risk for eating disorders or weight problems during adolescence or early adulthood. American Journal of Psychiatry, 159(3), 394–400. https://doi.org/10.1176/appi.ajp.159.3.394

Keel, P. K. y Forney, K. J. (2013). Psychosocial risk factors for eating disorders. International Journal of Eating Disorders, 46(5), 433–439. https://doi.org/10.1002/eat.22094

Keel, P. K., Forney, K. J., Brown, T. A. y Heatherton, T. F. (2013). Influence of college peers on disordered eating in women and men at 10-year follow-up. Journal of Abnormal Psychology, 122(1), 105–110. https://doi.org/10.1037/a0030081

Killen, J. D., Taylor, C. B., Hayward, C., Wilson, D. M., Haydel, K. F., Hammer, L.D., …, Kraemer, H. (1994). Pursuit of thinness and onset of eating disorder symptoms in a community sample of adolescent girls: a three-year prospective analysis. International Journal of Eating Disorders, 16(3), 227–238. https://doi.org/10.1002/1098-108X(199411)16:3%3C227::AID-EAT2260160303%3E3.0.CO;2-L

Kraemer, H. C., Kazdin, A. E., Offord, D. R., Kessler, R. C., Jensen, P. S. y Kupfer, D. J. (1997). Coming to terms with the terms of risk. Archives of General Psychiatry, 54(4), 337–343. https://doi.org/10.1001/archpsyc.1997.01830160065009

Leon, G. R., Fulkerson, J. A., Perry, C. L., Keel, P. K. y Klump, K. L. (1999). Three to four year prospective evaluation of personality and behavioral risk factors for later disordered eating in adolescent girls and boys. Journal of Youth and Adolescence, 28(2), 181–196. https://doi.org/10.1023/a:1021649314458

Liechty, J.M. y Lee, M.-J. (2013). Longitudinal predictors of dieting and disordered eating among young adults in the U.S. International Journal of Eating Disorders,46(8), 790-800. https://doi.org/10.1002/eat.22174

Martínez-González, M. A. e Irala, J. de. (2003). Los trastornos del comportamiento alimentario en España: ¿estamos preparados para hacerles frente desde la salud pública? Gaceta Sanitaria, 17(5), 347-350. Recuperado de: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0213-91112003000500001

Martinez-Gonzalez, M. A., Gual, P., Lahortiga, F., Alonso, Y., Irala-Estevez, J. y Cervera, S. (2003). Parental factors, mass media influences, and the onset of eating disorders in a prospective population-based cohort. Pediatrics, 111(2), 315–320. https://doi.org//10.1542/peds.111.2.315

McLean, S. A., Wertheim, E. H., Masters, J. y Paxton, S. J. (2017). A pilot evaluation of a social media literacy intervention to reduce risk factors for eating disorders. International Journal of Eating Disorders, 50(7), 841-851. https://doi.org/10.1002/eat.22708

Müller, S. y Stice, E. (2013). Moderators of the intervention effects for a dissonance-based eating disorder prevention program; results from an amalgam of three randomized trials. Behaviour Research and Therapy, 51(3), 128–133. https://doi.org/10.1016/j.brat.2012.12.001

Murray, M., Maras, D. y Goldfield, G. S. (2016). Excessive time on social networking sites and disordered eating behaviors among undergraduate students: Appearance and weight esteem as mediating pathways. Cyberpsychology, Behavior, And Social Networking, 19(12), 709-715. https://doi.org/10.1089/cyber.2016.0384

Olmsted, M. P., Kaplan, A. S. y Rockert, W. (1994). Rate and prediction of relapse in bulimia nervosa. American Journal of Psychiatry, 151(5), 738–743. https://doi.org/10.1176/ajp.151.5.738

Patton, G. C., Selzer, R., Coffey, C., Carlin, J. B. y Wolfe, R. (1999). Onset of adolescent eating disorders: population based cohort study over 3 years. British Medical Journal, 318, 765–768. https://dx.doi.org/10.1136%2Fbmj.318.7186.765

Paxton, S. J., Eisenberg, M. E. y Neumark-Sztainer, D. (2006). Prospective predictors of body dissatisfaction in adolescent girls and boys: A five-year longitudinal study. Developmental Psychology, 42(5), 888–899.

https://doi.org/10.1037/0012-1649.42.5.888

Pearson, C. M., Combs, J. L., Zapolski, T. C. B. y Smith, G. T. (2012). A longitudinal transactional risk model for early eating disorder onset. Journal of Abnormal Psychology, 121(3), 707-718. https://doi.org/10.1037/a0027567

Ro, O., Martinsen, E. W., Hoffart, A. y Rosenvinge, J. H. (2003). Short-term follow-up of severe bulimia nervosa after inpatient treatment. European Eating Disorders Review, 11(5), 405–417. https://doi.org/10.1002/erv.533

Rohde, P., Stice, E. y Marti, C. N. (2015). Development and predictive effects of eating disorder risk factors during adolescence: Implications for prevention efforts. International Journal of Eating Disorders, 48(2), 187–198. https://doi.org/10.1002/eat.22270

Saiphoo, A. N. y Vahedi, Z. (2019). A meta-analytic review of the relationship between social media use and body image disturbance. Computers in human behavior, 101, 259-275. https://doi.org/10.1016/j.chb.2019.07.028

Santonastaso, P., Friederici, S. y Favaro, A. (1999). Full and partial syndromes in eating disorders: a 1-year prospective study of risk factors among female students. Psychopathology, 32(1), 50–56. https://doi.org/10.1159/000029067

Shafran, R., Cooper, Z. y Fairburn, C. G. (2002). Clinical perfectionism: A cognitive-behavioural analysis. Behavior Research Therapy, 40(7), 773–791. https://doi.org/10.1016/S0005-7967(01)00059-6

Stice, E. (2002). Risk and maintenance factors for eating pathology: A meta-analytic review. Psychological Bulletin, 128(5), 825–848. https://doi.org/10.1037/0033-2909.128.5.825

Stice, E., Davis, K., Miller, N. P. y Marti, C. N. (2008). Fasting increases risk for onset of binge eating and bulimic pathology: A 5-year prospective study. Journal of Abnormal Psychology, 117(4), 941–946. https://doi.org/10.1037/a0013644

Stice, E., Marti, C. N. y Durant, S. (2011). Risk factors for onset of eating disorders: Evidence of multiple risk pathways from an 8-year prospective study. Behaviour Research and Therapy, 49(10), 622–627.

http://doi.org/10.1016/j.brat.2011.06.009

Stice, E., Marti, N., Shaw, H. y O’Neil, K. (2008). General and program-specific moderators of two eating disorder prevention programs. International Journal of Eating Disorders, 41(7), 611–617. https://doi.org/10.1002/eat.20524

Stice, E., Rohde, P., Gau, J. y Shaw, H. (2011). Effect of a dissonance-based prevention program on risk for eating disorder onset in the context of eating disorder risk factors. Prevention Science, 13(2), 129–139. https://doi.org/10.1007/s11121-011-0251-4

Stronge, S., Greaves, L. M., Milojev, P., West-Newman, T., Barlow, F. K. y Sibley, C. G. (2015). Facebook is linked to body dissatisfaction: Comparing users and non-users. Sex Roles, 73(5-6), 200-213. https://doi.org/10.1007/s11199-015-0517-6

Tamplin, N. C., McLean, S. A. y Paxton, S. J. (2018). Social media literacy protects against the negative impact of exposure to appearance ideal social media images in young adult women but not men. Body Image, 26, 29-37. https://doi.org/10.1016/j.bodyim.2018.05.003

The McKnight Investigators. (2003). Risk factors for the onset of eating disorders in adolescent girls: Results of the McKnight longitudinal risk factor study. American Journal of Psychiatry, 160(2), 248–254. https://doi.org/10.1176/ajp.160.2.248

Tiggemann, M. y Slater, A. (2017). Facebook and body image concern in adolescent girls: A prospective study. International Journal Of Eating Disorders, 50(1), 80-83. https://doi.org/10.1002/eat.22640

Tiggemann, M. y Zaccardo, M. (2015). “Exercise to be fit, not skinny”: The effect of fitspiration imagery on women’s body image. Body Image, 15, 61–67. https://doi.org/10.1016/j.bodyim.2015.06.003

Tyrka, A. R., Waldron, I., Graber, J. A. y Brooks-Gunn, J. (2002). Prospective predictors of the onset of anorexic and bulimic syndromes. International Journal of Eating Disorders, 32(3), 282–290. https://doi.org/10.1002/eat.10094

Vohs, K. D., Bardone, A. M., Joiner, T. E., Abramson, L. Y. y Heatherton, T. F. (1999). Perfectionism, perceived weight status, and self-esteem interact to predict bulimic symptoms: a model of bulimic symptom development. Journal of Abnormal Psychology, 108(4), 695–700. Recuperado de: https://psycnet.apa.org/buy/1999-01906-016

Published

2020-03-01

How to Cite

Gismero González, M. E. (2020). Psychosocial risk factors for Eating Disorders: a review and some considerations for prevention and intervention. Revista de Psicoterapia, 31(115), 33–47. https://doi.org/10.33898/rdp.v31i115.354