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Learning Experiences in Dance Class Predict Adult Eating Disturbance

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Abstract

Elite dancers are at increased risk of eating disorders. The authors hypothesized that specific learning about thinness in dance class, rather than simple participation in dance training, tends to be an important aspect of the risk process. Approximately 500 college women reported on their previous dance experiences, their dance-related learning about thinness, their eating behaviours and attitudes and their thinness expectancies. Results showed that lifetime amount of time spent in dance class was unrelated to adult eating disturbance, women's reports of learning experiences concerning thinness during their dance classes predicted adult disordered eating concurrently, and thinness expectancies appeared to mediate the relationship between learning about thinness and adult eating disturbance. Learning experiences about thinness in dance class seem more important than time spent in dance class when examining the relationship between dance study and eating disorders.

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... Weight related pressures have specifically been found to be an important contributor to the development of EDBs in aesthetic athletes, including dancers [68,78]. Studies that researched environmental pressures of ballet dancers found that coaches, parents and peers were great reinforces of EDBs [70,[79][80][81]. Kleposki [80] found this was because coaches, parents and peers encourage and support the maintenance of a low body weight. ...
... Kleposki [80] found this was because coaches, parents and peers encourage and support the maintenance of a low body weight. Annus and Smith [79] similarly found that what mediates the relationship between dance and EDBs are comments from teachers and peers about the benefits of dieting. Social comparison between peers, skinfold tests/weigh-ins, and observational learning of dieting also contributed to (EB)Bs in dance [79]. ...
... Annus and Smith [79] similarly found that what mediates the relationship between dance and EDBs are comments from teachers and peers about the benefits of dieting. Social comparison between peers, skinfold tests/weigh-ins, and observational learning of dieting also contributed to (EB)Bs in dance [79]. Sundgot-Borgen et al. [81] found the most important determinant to be where, how, and when the dancer is told to lose weight. ...
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Eating disorders among adolescent girls are a public health concern. Adolescent girls that participate in aesthetic sport, such as dance, are of particular concern as they experience the highest rates of clinical eating disorders. The purpose of this study is to explore the experiences of young girls in the world of competitive dance and examine how these experiences shape their relationship with the body; feminist poststructural discourse analysis was employed to critically explore this relationship. Interviews were conducted across Canada with twelve young girls in competitive dance (14–18 years of age) to better understand how the dominant discourses in the world of competitive dance constitute the beliefs, values and practices about body and body image. Environment, parents, coaches, and peers emerged as the largest influencers in shaping the young dancers’ relationship with their body. These influencers were found to generate and perpetuate body image discourses that reinforce the ideal dancer’s body and negative body image.
... The Thinness and Restricting Expectancy Inventory (TREI) consists of items that get at expectancies involving how thinness and restricting food intake lead to overgeneralized self-improvement. Scores on this measure were positively associated with greater levels of maladaptive cognitions, such as drive for thinness and body dissatisfaction, as well as dysfunctional behaviors, such as binge eating behaviors, compensatory exercise, and restricted eating in female adults (Annus and Smith 2009;Fister and Smith 2004;Garner et al. 2014;Stojek and Fischer 2013). ...
... Study 2: Construct Validity, Reliability, and Utility of the EEI-F and TREI-F Evidence for the construct validity of the EEI-F and TREI-F can be obtained if they are found to be positively associated with eating disturbances, which are consistent with previous studies on eating and thinness expectancies and various negative eating-related outcomes (e.g., (Annus and Smith 2009;Della Longa and De Young 2018). Thus, in the present study, we examined the correlations between scores on the EEI-F and TREI-F and scores on measures of eating disturbances (e.g., drive for thinness & bulimic symptoms). ...
... Specifically, frequency of eating expectancies was more strongly associated with bulimic symptoms, whereas frequency of thinness expectancies was more strongly associated with drive for thinness. These correlational patterns were in line with past literature showing the positive relationships between dysfunctional attitudes toward eating and thinness expectancies and eating disorder symptomology (e.g., Annus and Smith 2009;Fischer et al. 2018). Evidence so far suggests that the EEI-F and TREI-F are reliable and valid frequency measures of eating and thinness expectancies in females. ...
Article
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The present study drew on the act-frequency approach to study eating disturbances by modifying the items of the Eating Expectancy Inventory (EEI) and Thinness and Restricting Expectancy Inventory (TREI) to their frequency versions, namely, EEI-F and TREI-F. In Study 1, a total of 354 young females completed the EEI-F and TREI-F for factor analysis. In Study 2, to assess for construct validity and predictive utility, an independent sample of 241 young females completed a test battery including the EEI-F, TREI-F, and measures of eating disturbances. In Study 1, results from an exploratory factor analysis indicated a one-factor solution for both EEI-F and TREI-F that account for 65.65% and 72.97% of the common variance, respectively. In Study 2, both measures were found to possess good test-retest reliability (11-week) in a subset sample of participants from Study 1. Moreover, in support for construct validity, we found both EEI-F and TREI-F scores were positively associated with scores on measures of eating disturbances (i.e., drive for thinness, bulimic symptoms). Finally, in support of utility, frequency of eating and thinness expectancies predicted eating disturbances above and beyond general attitudes associated with eating and thinness expectancies (measured by the EEI and TREI). Overall, the present findings provide promising evidence for the validity, reliability, and utility of the EEI-F and TREI-F as reliable, valid, and useful measures of frequency of eating and thinness expectancies in young females. Implications for the theory and clinical assessments were discussed.
... Many have argued that the dance environment is implicated in DEA development by being highly stressful, competitive and/or pressured (e.g., Benn & Walters, 2001;Thomas et al., 2005;Toro et al., 2009;van Staden et al., 2009). Later studies concluded that it is the learning experiences within the environment that matter (e.g., learning that thinness is important; Annus & Smith, 2009;Penniment & Egan, 2011;Toro et al., 2009). These studies, however, are difficult to compare due to the use of study-specific measures and varying conceptualizations of the dance environment. ...
... That is, dancers in a range of styles, including females in classical dance who had over 10 years of dance experience and reported intense involvement in both dance and other forms of physical activity, were no more likely to report symptoms of DEA than dancers in modern, urban and South Asian styles who reported only a few months or years of dance experience and who participated only a few hours weekly. As such, it appears that intense involvement in dance is not necessarily a causal risk factor for DEA, and we agree with authors such as Annus and Smith (2009) and Anderson, Petrie, and Neumann (2012) that it is the perceived body-and appearance-related pressures in an environment e rather than just participation e which is likely to be important. ...
... Many have suggested that the behaviours of teachers or other aspects of the dance environment are implicated in DEA development (Ackard, Henderson, & Wonderlich, 2004;Annus & Smith, 2009;Benn & Walters, 2001;Penniment & Egan, 2011;Thomas et al., 2005;Toro et al., 2009;de Bruin et al., 2009;van Staden et al., 2009). However, none of these studies had confirmed the existence of such a relationship using a theory-driven, longitudinal design. ...
Article
Objectives This longitudinal study examined potential predictors of disordered eating attitudes (DEA) for male and female dancers, with a particular focus on whether environmental predictors (perceptions of task- and ego-involving motivational climate) added significantly to the prediction made by intrapersonal predictor variables (demographics/training, self-esteem, perfectionism). Methods and Design Young dancers (N = 597, 73.4% female, M = 14.69 years old, SD = 2.04) from UK Centres for Advanced Training completed questionnaires 1–5 times over a two-year period, depending on how long they were enrolled at their centre. Multilevel modelling was employed to examine both between- and within-person predictors of DEA. Results For females, lower self-esteem and higher perfectionistic concerns were significant between-person predictors of DEA. Increased levels of perfectionistic strivings and perfectionistic concerns were significant within-person predictors. For males, increased perfectionistic concerns and perceptions of the motivational climate as more task- and ego-involving were significant between-person predictors of DEA. No significant within-person predictors emerged. Conclusions Findings contribute to the literature on DEA in aesthetic activities and the debate concerning the (mal-)adaptiveness of perfectionistic strivings. They also raise questions about how environmental aspects should best be conceptualized and measured in studies of this type. In particular, however, results demonstrate that the predictors of DEA among males and females may not be the same, and suggest that future interventions may therefore need to be sex-specific.
... It is also hypothesised there may be a reactive relationship involved, where individuals with higher perfectionism may react more strongly to TRL experiences in dance class. Annus and Smith (2009) proposed that participation in dance alone cannot explain ED risk in dancers, as dance training environments vary in the degree to which they emphasise thinness and dieting. In a sample of 500 college women who were asked to retrospectively report their participation in dance class and current ED symptoms on the EDE-Q (Fairburn & Beglin, 1994), it was found that the mere amount of involvement in dance class was unrelated to ED symptomatology; instead reports of learning experiences during dance classes concerning thinness or restricting food predicted adult disordered eating. ...
... In a sample of 500 college women who were asked to retrospectively report their participation in dance class and current ED symptoms on the EDE-Q (Fairburn & Beglin, 1994), it was found that the mere amount of involvement in dance class was unrelated to ED symptomatology; instead reports of learning experiences during dance classes concerning thinness or restricting food predicted adult disordered eating. Annus and Smith (2009) defined thinness and restricting expectancies (TRE) as 'expectations that being thin or restricting food intake will lead to reinforcement, such as. . .becoming more attractive' (p. ...
... Thinness and restricting expectancies were measured on the 44 item thinness and restricting expectancy inventory (TREI; Hohlstein, Smith, & Atlas, 1998), an example of an item being 'if I were thin, I would feel more worthwhile'. Annus and Smith (2009) defined thinness related learning (TRL) as the degree to which the individual is exposed to learning about thinness in a dance class, and measured this via the dance experience questionnaire (DEQ; Annus & Smith, 2009) which they designed for the study, an example item being 'how often did the instructor emphasise weight or shape in class' (p. 53). ...
Article
There is strong evidence that perfectionism is a risk factor for eating disorders. Women who engage in dance training have been reported to be at risk for eating disorders, and it has been hypothesised that expectancies about thinness and restricting food intake are formed partly as a result of exposure to thinness related learning (TRL) experiences in this environment, which may increase their risk. To clarify the relative contribution of perfectionism and learning in accounting for eating disorder symptoms in this group, 142 female ballet dancers completed an online survey. Through structural equation modelling it was found that the association between perfectionism and eating disorder symptoms was partially mediated by learning about thinness and restriction. The results suggest that eating disorder symptoms in dancers are significantly influenced by the interaction of perfectionism and learning, and future research should investigate the efficacy of prevention programs to target these risk factors in female dancers.
... É importante destacar que a prevalência de sintomas de transtornos alimentares parece ser mais aparente em grupos específicos da sociedade como modelos, atletas e bailarinos [8][9][10][11] . Nota-se que há uma forte associação com os distúrbios e fatores específicos como baixa autoestima, padrões pessoais elevados 8 , perfeccionismo 4 , busca pela magreza 10 e ambientes competitivos 3 . ...
... O ambiente de dança, pode ser considerado uma subcultura que amplia as pressões já existentes na sociedade, a fim de tornar aceitável as expectativas e estereótipos provocados por outros do mesmo meio, depositando bailarinos em risco para o desenvolvimento de sintomas de transtornos 6 . Neste sentido, a expectativa da conquista de uma silhueta magra utilizando a restrição alimentar, pode levar os bailarinos a cair em um confronto psicológico fazendo-os a acreditar que o alcance de um corpo esguio trará ascensão social, melhor aparência física e elevará a autoestima 10 . ...
Article
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Analisar a relação entre os domínios da qualidade de vida e os sintomas de transtornos alimentares. Participaram 156 bailarinos do 31º Festival de Dança de Joinville – Santa Catarina, os quais responderam a um questionário autoaplicável contendo as variáveis sociodemográficas, medidas antropométricas, qualidade de vida (WHOQOL-bref.), Teste de Atitudes Alimentares (EAT-26) e Bulimic Inventory Test Edinburgh (BITE). Observou-se associação significativa entre presença e ausência dos sintomas de anorexia em relação ao sexo feminino e masculino (p=0,001) e as três modalidades de dança (p=0,018), bem como na presença e ausência da escala sintomática de bulimia (p=0,044) na associação com o sexo feminino e masculino. Foram encontradas relações entre o domínio físico da qualidade de vida e os sintomas de anorexia (p=0,012) e de bulimia na escala de gravidade (p=0,015). Em relação à escala sintomática de bulimia percebe-se relação com os domínios físico (p=0,000), psicológico (p= 0,032) e social (p= 0,010) da qualidade de vida. Os bailarinos do sexo feminino apresentam tendência para a presença de sintomas de anorexia e sintomas de bulimia, bem como as modalidades de ballet clássico e dança contemporânea podem ser fator influenciador. Encontrou-se forte associação entre a presença de sintomas de transtornos alimentares aos domínios da qualidade de vida.
... Among college women, thinness expectancy was found to be positively associated with compensatory exercise, restricted eating, and body dissatisfaction [10][11][12]. Additionally, Annus and Smith [13] found that college women's reports of previous learning experiences about thinness during their dance classes, instead of their lifetime amount of time spent in dance class, predicted both adult drive for thinness and bulimic symptoms. Of recent, most studies on thinness and restricting expectancy investigated the developmental trajectories of maladaptive eating behaviors in adolescents. ...
... Comparisons of the correlation magnitude showed that both expectancies were positively associated with drive for thinness and bulimic symptoms in European Americans and Chinese; however, thinness expectancy was more strongly correlated with both measured outcomes in European Americans than in Chinese. When we examined eating and thinness expectancies as predictors of eating disturbances in European American and Chinese females, independent of age and BMI, our first hypothesis was partially supported and results were generally in line with past research (e.g., [5,13]). The present findings indicated that the expectancy set consistently predicted large amounts of additional variance in the drive for thinness and bulimic symptoms, beyond age and BMI, in both cultural groups. ...
Article
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Purpose This study sought to examine the utility of eating expectancy, thinness expectancy, and the interactive role of both, in predicting eating disturbances (viz., bulimic symptoms and drive for thinness) in European American and Chinese female college students. Methods A sample of 237 European American and 221 Chinese female college students completed measures of eating and thinness expectancies and eating disturbances. Results Results of hierarchical regression analyses revealed that thinness expectancy significantly predicted increases in both drive for thinness and bulimic symptoms (with these increases being greater for European Americans), whereas eating expectancy predicted increases in bulimic symptoms only. In addition, for European Americans, a significant interaction for bulimic symptoms was found, revealing a synergistic increase in bulimic symptoms for those with both a high thinness expectancy and a high eating expectancy. For Chinese, a significant interaction for drive for thinness was found, demonstrating that for those with a high thinness expectancy, a higher eating expectancy was actually associated with a lower drive for thinness. Conclusion The present findings point to the value of examining for the co-presence of both expectancies in predicting eating disturbances while also highlighting cultural variations in the study of eating pathology. Level of evidence Descriptive cross-sectional study, level V.
... Regarding the years of practice, significant differences were found regarding the symptoms of ED in females in the study, indicating that ED symptoms are less present in dancers with more years of experience than in those with less experienced. Although other studies indicate that the effort to conform to strict aesthetic standards for professional success may increase vulnerability to ED 15,47,48 , conversely, in our research more experience is related to absence of ED symptoms. ...
... Ao analisar os sintomas de TA, observouse no estudo uma prevalência para presença de sintomas de TA de 32.4%, em bailarinos de dança clássica de ambos os gêneros, superior à encontrada nas investigações com bailarinos de dança clássicas profissionais (11.5%) 25 e com bailarinos de dança clássica adolescentes (30%) 26 No que se refere ao tempo de prática, foram encontradas diferenças significativas relativamente aos sintomas de TA no gênero feminino no estudo, indicando que os sintomas de TA são menos presentes em bailarinas com mais anos de experiência do que nas menos experientes. Apesar de outros estudos indicarem que o esforço para estar de acordo com rígidos padrões estéticos para o sucesso profissional pode aumentar a vulnerabilidade a TA 15,47,48 , contrariamente, em nossa investigação a maior experiência está relacionada com ausência de sintomas de TA. ...
... Esto coincide con lo investigado por Esnaola (34), quien concluyó que, como consecuencia de los cambios que sufren los individuos durante la pubertad, terminan adquiriendo cierto grado de madurez psicológica. Estos resultados también podrían deberse a que las alumnas de mayor edad llevan más tiempo en el mundo de la danza y, por tanto, han podido incorporar mayores conocimientos sobre cuál es su físico real y también el físico esperado como bailarinas (35). Sin embargo, en otra investigación se encontró que las bailarinas con una formación superior tienden a tener un mayor afán por alcanzar un cuerpo esbelto y a presentar TCA (30). ...
... Un grupo de investigadores encontró que la prevalencia de TCA en bailarinas suele reducirse a medida que ellas van creciendo (30). Por otra parte, en otra investigación se halló que uno de los factores que termina condicionando la aparición de TCA es el ambiente y grado de aceptación que exista en el centro académico de danza en torno a la delgadez (35,28). De todos modos, en los centros de formación de bailarinas es sumamente importante instruir adecuadamente al personal docente. ...
Article
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Introduction: young dancers are at a higher risk of developing body image distortion. Objective: to analyze body image perception and distortion in dancer students based on academic year and age. Methods: two hundred and ninety-eight women dancers between 11 and 24 years, who were studying between the 1st and 6th year of Professional Program, were evaluated. Dancers completed the "silhouette scale for adolescents" in order to determine their perception of the female and male figures, their perceived and ideal images, and the distortion, dissatisfaction and real-ideal indexes. Results: participants were more severe with male figures than with female ones. Dancers of the lower courses, especially from the 1st year, and youngest showed the highest values in distortion and real-ideal indexes. They thought that they look like thicker than they are, but their ideal figure was thicker than they really were (p < 0.001). In relation to the dissatisfaction index, all dancers desired to be thinner, without differences based on academic year or age (p > 0.05). Ten dancers showed a high risk to develop an eating disorder. Conclusions: dancers of the initial courses and youngest have a tendency to see themselves fatter than they are. They want to look thinner, but they are thinner than they would like to be. This could act as a trigger for developing body dissatisfaction.
... Esto coincide con lo investigado por Esnaola (34), quien concluyó que, como consecuencia de los cambios que sufren los individuos durante la pubertad, terminan adquiriendo cierto grado de madurez psicológica. Estos resultados también podrían deberse a que las alumnas de mayor edad llevan más tiempo en el mundo de la danza y, por tanto, han podido incorporar mayores conocimientos sobre cuál es su físico real y también el físico esperado como bailarinas (35). Sin embargo, en otra investigación se encontró que las bailarinas con una formación superior tienden a tener un mayor afán por alcanzar un cuerpo esbelto y a presentar TCA (30). ...
... Un grupo de investigadores encontró que la prevalencia de TCA en bailarinas suele reducirse a medida que ellas van creciendo (30). Por otra parte, en otra investigación se halló que uno de los factores que termina condicionando la aparición de TCA es el ambiente y grado de aceptación que exista en el centro académico de danza en torno a la delgadez (35,28). De todos modos, en los centros de formación de bailarinas es sumamente importante instruir adecuadamente al personal docente. ...
Article
Introducción: La danza presenta un elevado riesgo para sus practicantes de sufrir trastornos de la imagen corporal desde la etapa de formación.Objetivo: Analizar la percepción y distorsión de la imagen corporal en bailarinas en edad de formación en función del curso académico.Metodología: Se evaluaron a doscientas noventa y ocho bailarinas que cursaban entre 1º y 6º de enseñanzas profesionales en el conservatorio de danza. Se les solicitó que completaran el “test de siluetas para adolescentes” para poder valorar su percepción de la figura femenina y masculina, así como su imagen percibida e ideal, y sus índices de distorsión, insatisfacción y real-ideal.Resultados: Las bailarinas fueron más severas al valorar las figuras masculinas que las femeninas, clasificando en la mayoría de los casos como normal la figura de su imagen percibida. Las bailarinas de los cursos inferiores, especialmente las de 1º, fueron quienes presentaron un mayor índice de distorsión y real-ideal, entendiendo que eran menos delgadas, pero considerando ideal estar más gruesas de cómo en realidad eran (p < 0,001). Respecto al índice de insatisfacción, en todos los cursos se detectó un deseo de querer estar más delgadas, si bien no hubo diferencias significativas. Diez bailarinas presentaron un riesgo elevado de poder desarrollar desórdenes alimenticios.Conclusiones: Las bailarinas de los cursos iniciales se ven más gruesas de cómo están, quieren ser más delgadas de cómo se ven, pero están más delgadas de cómo les gustaría ser. Esto podría favorecer la aparición de trastornos de insatisfacción corporal.
... A mean score for each subscale is calculated with higher scores reflecting greater levels of eating psychopathology. The EDEQ is a well-validated and reliable measure and has been used previously among university-aged dancers (Annus & Smith, 2009). In the current study, the EDEQ subscales demonstrated Cronbach's alpha values of 0.84 (restraint), 0.83 (eating concern), 0.90 (weight concern) and 0.92 (shape concern). ...
... Of the total sample, 4.5% (n = 11) reported self-induced vomiting at least once, 2.9% (n = 6) reported engaging in laxative usage at least once and 36.1% (n = 88) reported engaging in 'driven' or 'compulsive' exercise as a means of controlling weight or shape, or to burn off calories. These figures are similar to a previous sample that recruited university-aged dancers (Annus & Smith, 2009). ...
Article
This study examined the associations between conscientious perfectionism (high standards), self-evaluative perfectionism (self-criticism) and eating psychopathology among dancers. A sample of 244 female dancers, with a mean age of 20.11 years (standard deviation = 1.97) completed the Perfectionism Inventory and Eating Disorder Examination Questionnaire. Self-evaluative perfectionism predicted eating psychopathology (eating restraint, eating concern, weight concern and shape concern). This relationship was not moderated by conscientious perfectionism. The mediation analyses showed that although conscientious perfectionism predicted eating psychopathology, this relationship was fully mediated by self-evaluative perfectionism. These findings demonstrate the greater influence of self-evaluative perfectionism, rather than conscientious perfectionism, on eating psychopathology in dancers. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.
... Regardless of body type, ability, and vulnerability, dancers feel the pressure to maintain strong, limber, and lithe bodies (Abraham, 1996;Hamilton, 1997;Schnitt & Schnitt, 1987). Studies have shown that exposure to weight pressures is related to increased likelihood of developing body image concerns and ED symptomology in dancers (Annus & Smith, 2009;Reel, Jamieson, SooHoo, & Gill, 2005;Toro et al., 2009). Weight pressures can be characterized by any environmental factor that places an extreme emphasis on appearance, achievement and maintenance of a lean physique and low body weight. ...
... Results from this study provide additional evidence that pressure to be thin in the dance environment is associated with negative affect (Barrell & Terry, 2003) and ED symptomatology (Annus & Smith, 2009;Reel et al., 2005;Toro et al., 2009). Additionally, although studies have highlighted the psychological benefits of using athletic coping skills (Estanol, 2004;Hanrahan, 2005;Smith, 1998;Taylor & Taylor, 1995;Tremayne & Ballinger, 2008), this study clarified which mental skills appear to have the most benefit in a sample of dancers with regard to coping with negative affect and ED symptoms. ...
Article
The aim of this study was to determine whether negative affect (anxiety and depression) mediates the relationship between environmental weight pressures and eating disorder risk (measured by the EDI-3 - risk composite); and furthermore, whether mental skills (ACSI-28) can decrease strength of said relationship (serving as protective factor) in dancers. Our study suggested that negative affect partially mediated the relationship between environmental pressure and ED risk, and that mental skills did serve a protective factor, thus decreasing the risk. Specifically, coping with adversity, freedom from worry and self-confidence emerged as the most protective skills against eating disorders.
... Previous qualitative research has also investigated specific risk factors which may make dancers more susceptible to the development of EDs. Thinness-Related Learning (TRL), which is the degree to which an individual is exposed to learning about thinness in a dance class, such as comments from teachers and peers about the benefits of dieting, social comparisons between peers and observational learning of dieting and restriction through a teacher or peer modeling, may play a role (15). Indeed, food restriction and the pressure to be thin are characteristics commonly reported by dancers in the classical ballet environment (16). ...
Article
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Aim: We aimed to explore how a group of classical ballet dancers perceived their eating attitudes and their bodies, with special attention to the potential presence of eating disorders (EDs) symptoms and body image (dis)satisfaction. Methods: A cross-sectional, mixed-method study was conducted on fourteen trained classical ballet dancers (18–30 years old). Their experiences, perceptions, and feelings regarding eating attitudes and body image concerning classical ballet were acquired through qualitative focus groups. The presence of EDs symptoms and perception and (dis)satisfaction with body image was analyzed quantitatively through self-report questionnaires. Results: Participants reported concerning eating attitudes during the focus groups, such as the regular practice of several restrictive popular diets, constant restriction of foods considered “heavy” or “fatty,” meal skipping and ignoring signs of hunger, presence of overeating episodes due to stress and anxiety, feeling guilty about breaking their usual diet, classifying foods as “good” and “bad” or “lean” and “fat,” and excluding some of those foods from their usual diets. These reports were partially reflected in the questionnaires, with 50% of the ballerinas showing bulimic symptoms indicative of an unusual eating pattern (only two of them with a significant risk index), 7.1% showing symptoms of moderate binge eating, and 14.3% symptoms of EDs in general. Additionally, when considering their bodies in the context of everyday life, participants were satisfied; however, in the “classical ballet” context, they reported feeling dissatisfied with their shape. These findings were in line with results from the Stunkard's Scale, which revealed that 50% of the sample was dissatisfied with their current body shape and 57.1% indicated that their desired body shape was a leaner figure than one they considered healthy. Conclusions: The constant practice of restrictive diets and other weight-loss strategies to achieve a leaner body were associated with symptoms of EDs and body dissatisfaction in this sample. Importantly, the questionnaires used seemed to underestimate the presence of a disordered eating pattern reported by the participants during focus groups. These data could help to inform psychological and nutritional strategies aimed at improving performance, physical and psychological well-being, and quality of life of ballet dancers.
... While the dance students within each school participating in this study were exposed to the same ballet context, there is of course potential for variation in terms of how early, late and on-time dancers perceived their learning environment within that context. The findings of this study highlight perceptions of thinness related learning and ego-oriented climates as particularly salient for on-time dancers (Annus & Smith, 2009;de Bruin et al., 2009). Further research is needed to consider why on-time dancers may be particularly sensitive. ...
Article
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This study employed semi-structured interviews and Interpretative Phenomenological Analysis to explore experiences of on-time maturation in nine adolescent ballet dancers from across three vocational ballet schools in the United Kingdom. Two themes were identified as central to their experiences: ‘A right and a wrong way to grow’, and fitting in and moving forward. Instead of perceiving themselves as ‘average’ and experiencing a relatively easy pubertal transition, on-time dancers described unique challenges associated with a fluctuation between fitting in and not fitting in within their social context. The implications of on-time maturation in this context are complex and do not appear to follow the same trajectory as early maturing ballet dancers nor on-time non-dancers.
... Annus and Smith, who studied women exposed to a wide range of dance experiences, proposed that participation in dance alone cannot explain risk for eating problems in dancers; instead, the risk may be a function of the thinness-related learning environment present at a given class (Annus and Smith 2009). Accordingly, we found that BMI, and not the type of dance, is an important contributing factor. ...
Article
Professional ballet dancers are known as a high-risk group for adopting disordered eating behaviours. However, research regarding the professionals of other dance styles/genres is quite limited. The present study explored disordered eating, social physique anxiety (SPA) and perceived pressure for a thin body in professional dancers of different dance styles and genres. The Eating Attitude Test questionnaire (EAT-26), the Social Physique Anxiety Scale (SPAS), and the questionnaire for thin body by significant others were administered to 108 professional dancers of ballet (n = 37), Latin (n = 31) and traditional dance (n = 40). The results showed that seven dancers had an EAT-26 score ≥20, indicating abnormal eating behaviour. No statistically significant differences were found among the three dance groups in any assessment tool, even after controlling for age, sex and professional experience. However, when Body Mass Index (BMI) was added as a potential confounder in the model, significant differences were revealed. Our results indicate that BMI and not the dance genre is an important contributing factor for both the self-control of eating and the perceived pressure from co-dancers and choreographers. If a better ‘dance life’ is to be accomplished, actions aiming at enhancing positive relationships within professional dance environment would be beneficial for dancers.
... It is well recognized that disordered eating most likely results from a combination of risk factors (e.g., Annus & Smith, 2008;Berry & Howe, Correlates of Disordered Eating Attitudes in Dance 213 2000; Garner & Garfinkel, 1980;Thomas et al., 2005). These include environmental factors such as teacher and peer pressure (Berry & Howe, 2000;de Bruin, Oudejans, & Bakker, 2007;Garner & Garfinkel, 1980;Reel et al., 2005;Thomas et al., 2005;Toro et al., 2009) and individual factors. ...
Article
Correlates of disordered eating attitudes were examined with a mixed-sex sample of 347 young talented dancers aged 10-18 years from all UK Centres for Advanced Training. Equal proportions of females (7.3%) and males (7.6%) were symptomatic for disordered eating but correlates differed: for females, self-evaluative perfectionism, waking up > twice/night and hours of non-dance physical activity were predictive while for males, only the combination of self-evaluative and conscientious perfectionism was significant. Differences between menstrual status groups were evident, with young dancers (pre-menarcheal/within first year of menarche) reporting the least disordered eating attitudes and those with dysfunctional menses reporting the most.
... Actually seen as a national problem it can be observed the body image distortion cases in different contexts 33 . The importance of the thinness and the taken ideal appearance demand on the dance world could take to undesired pathologic behaviors and higher prevalence levels of eating disorders like anorexia and bulimics 9,10,13,34,35 . ...
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Abstract: body image (BMI) is multidimensional, dynamic and fully linked to the body in motion, causing bodily concerns relevant to routine professional dancers (BP), which require a rigid body aesthetics. The objective summarize the scientific production of IC BP and understand how they perceive the same. Review composed of 7 studies investigating BP of classical ballet forms, jazz and contemporary. The results demonstrate that even though they have lean bodies and appropriate body mass index, BP are dissatisfied with their bodies and wish to be thinner, meaning BP constitute a risk group for the development of eating disorders.
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Four sets of findings support the theory that alcohol expectancy plays a causal-mediational role in teenage problem drinking: (a) Alcohol expectancies correlate with drinking behavior in adults and adolescents who range from low-level social drinkers to alcoholics; (b) expectancies predict the future onset of problem drinking in teenagers, and they have been measured in preadolescent children prior to any drinking experience; (c) expectancies mediate family influences on teen drinking, and they appear to operate in a vicious cycle--high expectancy leads to more drinking, which in turn leads to higher expectancy and still more drinking; and (d) experimental manipulation of expectancies can produce significant drinking reductions in heavy-drinking college students. We review the theory and this evidence and then present data from a 3-year longitudinal study that indicates that expectancy assessment may contribute to the identification of individual high-risk adolescents before drinking onset.
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Examined 55 female student ballet dancers (mostly aged 16–21 yrs) and found that the majority weighed significantly below national norms and engaged in patterns of eating and hyperactivity seen in patients with anorexia nervosa. The cases of 3 typical Ss are described in more detail. Ss' most conspicuous occupation was with food and weight, and they harbored a preponderance of nutritional misinformation, food faddism, and unhealthy methods of weight loss. Menstrual dysfunction was common in 18 Ss. Dating was infrequent, and the majority were virgins. They frequently expressed doubts concerning their appearance and dancing ability, although most of their feelings were understood in terms of the progress of their dance careers. In addition to rationalizing their difficulties, Ss tended to minimize their own anorexic behavior but freely reported what they had seen in others. Conspicuous social reinforcement was found for their low weights and bizarre eating behaviors in the ballet world in which they were immersed. (6 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
A review of recent evidence indicates that contingent reinforcement is neither a necessary nor a sufficient condition for operant learning. This dilemma reopens the old question of "what is learned." It is proposed that what laboratory Ss characteristically learn is not a response to a stimulus, but rather 2 kinds of expectancies. 1 kind of expectancy corresponds rather accurately with environmental stimulus-outcome contingencies, while the 2nd is a less faithful representation of response-outcome contingencies. The reinforcement procedure merely permits both expectancies to be learned. (36 ref.) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Social-learning models of drug motivation and relapse often include the constructs of affect and drug expectancies. Most research has taken a molar approach to examining relations between these constructs and level of drug use. An experiment examined the roles of affect and expectancies in multiple measures of situation-specific motivation to smoke tobacco. Undergraduate smokers ( n = 101) received either a positive or negative mood manipulation (false feedback on an intelligence test). Self-reported urge was influenced by both negative affect and expectancies for positive reinforcement from smoking. Actual consumption was related only to smoking expectancies and only among abstaining smokers. affect by expectancy interactions were also found. Findings support a limited role of affect and expectancies in smoking motivation. Poor coherence among the motivational indexes challenges the assumptions of existing models of drug motivation. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Instruments for measuring learned expectations for reinforcement from eating and from dieting and thinness were constructed and validated. Five eating reinforcement expectancies and 1 dieting-thinness reinforcement expectancy were identified and their factor structure replicated on an independent sample. The expectancy that dieting and thinness lead to overgeneralized self-improvement characterized bulimia nervosa and anorexia nervosa patients and correlated with dieting behavior in a general sample. Expectancies for negative reinforcement from eating (e.g., eating helps manage negative affect) characterized bulimic but not anorexic individuals and were correlated with indexes of restraint plus disinhibition in a general sample. Positive reinforcement expectancies (e.g., eating is pleasurable and rewarding) were unrelated to disinhibited eating, but anorexic patients expected significantly less positive reinforcement from eating than did bulimic patients or controls. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Background: Eating disorders are frequent among elite performers of certain sports or physical activities; however, little is known about non-professional performers. Method: 113 female non-elite ballet dancers, 54 female gymnasium users, 44 male non-competitive body builders, 105 female controls and 30 male controls were evaluated using the Body Uneasiness Test, the State-Trait Anxiety Inventory, the Beck Depression Inventory, and the Eating Disorder Examination 12th edition (EDE-12). Results: Non-elite ballet dancers reported the highest prevalence of eating disorders (anorexia nervosa 1.8%; bulimia nervosa 2.7%; eating disorders not otherwise specified 22.1%), followed by gymnasium users (anorexia nervosa 2.6%; eating disorders not otherwise specified 18%). Significant differences (p < 0.01) between athletes and their controls were found in the following parameters (median values): Beck Depression Inventory (female dancers 5.7, gymnasium users 6.1, female controls 2.8, body builders 1.6, and male controls 1.3), Body Uneasiness Test (female dancers 1.08, gymnasium users 0.62, female controls 0.54, body builders 0.35, and male controls 0.27), EDE total scores (female dancers 1.6, gymnasium users 1.7, female controls 1.0, body builders 1.0, and male controls 0.4), EDE - restraint subscale scores (female dancers 0.8, gymnasium users 1.6, female controls 0.0, body builders 0.8, and male controls 0.0), EDE--eating concern subscale scores (female dancers 0.4, gymnasium users 0.2, female controls 0.0, body builders 0.0, and male controls 0.0), EDE--weight concern subscale scores (female dancers 2.1, gymnasium users 2.1, female controls 1.6, body builders 1.4, and male controls 0.5), and EDE--shape concern subscale scores (female dancers 2.7, gymnasium users 2.8, female controls 2.0, body builders 2.1, and male controls 0.9). EDE scores were highly related to Body Uneasiness Test scores, especially in non-elite ballet dancers and in non-competitive body builders (p < 0.01). Conclusion: Non-professional performers of sports emphasising thinness or muscularity, such as ballet and body-building, show a high degree of body uneasiness and inappropriate eating attitudes and behaviours.
Article
Fifty-five white and eleven black female dancers in nine regional and national ballet companies in America and Europe (mean age 24.9) were surveyed for eating disorders. The dancers, as a whole, weighed 12% below their ideal weight for height. None of the black American dancers reported anorexia nervosa or bulimia, while 15% of the white American dancers reported anorexia nervosa and 19% reported bulimia. All instances of anorexia nervosa were in national rather than regional companies, making the incidence among whites in the former 22%. Self-reported anorectics scored higher on the EAT-26, had lower weights, exhibited more psychopathology, and a poorer body image than the nonanorectics. In addition, all but one of the self-reported anorectics weighed, or had weighed, less than 20% of ideal weight for height. The bulimics valued their careers less, dieted more, and exercised less frequently than the nonbulimics. Weight did not differ for these two groups. The data suggest that the anorectic dancers differ from dancers with no eating disorders and that sociocultural factors are related to the report of eating disorders. Specifically, level of competition is related to reported anorexia nervosa and ethnicity to anorexia nervosa and bulimia.
Article
Objective With the goal of developing a model relating family of origin experiences to maladaptive cognitions to bulimic symptom formation, the authors developed a measure of family of origin food-related experiences called the Family History Inventory.MethodA number (N = 662) of sixth to eighth-grade adolescents completed the inventory, eating and dieting expectancy measures, and the Bulimia Test-Revised (BULIT-R).ResultsFourteen scales were identified in the inventory. They emphasized family teasing about weight, negative maternal modeling regarding food, and family rules concerning eating. Eleven of the 14 scales correlated with the BULIT-R. Two superordinate factors called Family Teasing and Negative Maternal Modeling summarized 8 of the 14 subscales. Statistical tests were consistent with the hypothesis that eating and dieting expectancies mediate the influence of Family Teasing and Negative Maternal Modeling on bulimic symptomatology.DiscussionThere was good evidence for the validity of the Family History Inventory. The theoretical implications of the mediation tests are discussed. © 2001 by John Wiley & Sons, Inc. Int J Eat Disord 30: 149–160, 2001
Article
This investigation studied the presence of a memory bias for words connoting fatness in persons diagnosed with an eating disorder. Eating disorder subjects were compared to a nonsymptomatic control group and to a symptomatic (weight-preoccupied) control group. A memory bias for fatness words in eating disorder patients was found. There was no evidence for a memory bias in either group of control subjects, i.e., those who were preoccupied with body size and shape nor those without extreme preoccupation. The three groups did not differ in the recall of nonfat or neutral words. These results were interpreted as evidence in support of the hypothesis that activating self-schemata in eating disorder patients results in a recall bias for fat-related stimuli.
Article
This study examined the effects of negative mood induction on body image and recall bias for fatness stimuli in women of normal weight with high body dysphoria. The experimental design contrasted subjects scoring high and low on a measure of body dysphoria. One half of the subjects in each group were administered a negative mood induction procedure. Dependent variables were a) body size estimation measures, b) body dysphoria, and c) recall for fatness, thinness, and depressive words. The negative mood induction resulted in increased current body size estimation and body dysphoria. A free recall bias for fatness stimuli was found in subjects high in body dysphoria. Thus, current body size estimation and body dysphoria were found to be reactive to negative mood states, whereas, ideal body size and recall for fatness stimuli were not affected by the negative mood state.
Article
The selective processing of food- and body size-related information was investigated using a modified version of the Stroop task. Anorexic subjects were generally slower than controls in colour-naming all words, and particularly slow with food-related words. This interference effect appeared to operate maximally amongst subjects who fell into the higher end of the anorexic weight range. The findings appeared to be a reflection of current concerns with food and eating.
Article
Features important in the diagnosis of anorexia nervosa were common in a sample of 100 ballet students. Defining a "case" of anorexia nervosa proved difficult. Follow-up one year later showed that seven girls who were designated "possible cases" had continued to dance and were considerably improved in their physical status without medical intervention.
Article
A detailed comparison was made of two methods for assessing the features of eating disorders. An investigator-based interview was compared with a self-report questionnaire based directly on that interview. A number of important discrepancies emerged. Although the two measures performed similarly with respect to the assessment of unambiguous behavioral features such as self-induced vomiting and dieting, the self-report questionnaire generated higher scores than the interview when assessing more complex features such as binge eating and concerns about shape. Both methods underestimated body weight.
Article
Using a 3-wave longitudinal design, adolescents were studied over a 2-year period during which many first began to drink. Covariance structure modeling showed that teens' expectancy for social facilitation from alcohol and their drinking experience influenced each other in a reciprocal, positive feedback fashion: the greater the expectancy endorsement, the higher subsequent drinking levels, and the higher the drinking levels, the greater the subsequent expectancy endorsement. This model fit the data quite well; comparison models, in which expectancy (or drinking) had no independent influence on future drinking (or expectancy), showed significantly poorer fit than the present model. Initial nondrinkers' social expectancy predicted individual differences in the rate of drinking increase over the 2 years. Results bolster the hypothesis that expectancy actively influences drinking and point to the importance of expectancy-based intervention efforts.
Article
Competitive pressures to achieve a slim body shape may be of importance in the etiology of eating disorders in ballet dancers. This study examines the presence of anorexia nervosa-like symptoms in a group of 49 female ballet students (mean age = 18.9 years, SD +/- 1.9). All students were assessed for certain physical (weight and height) and psychological (Eating Attitude Test [EAT]) indices at the start of their academic training year. Thereafter, all subjects who presented with anorexia nervosa-like symptoms (EAT > or = 30, and/or with current secondary amenorrhea or primary amenorrhea if aged 16 years or over) at the initial assessment, were invited for a semistructured interview (Morgan-Russel scales) to determine their diagnostic status. Another aim of the study was to assess the prognostic implications of a diagnosis of anorexia nervosa in this sample. All subjects previously interviewed were invited for a follow-up assessment at 10 months. Anorexia nervosa could be diagnosed in 2 students (4.1%), whilst another 4 students (8.2%) presented with "partial syndrome" anorexia nervosa. All diagnosed students managed to complete their academic training year. The development and implications of a diagnosis of anorexia nervosa in the ballet students are discussed.
Article
The association between eating disorders, substance use, and emotional distress is well recognized in the literature. To determine whether dancers who are known to be at risk for eating disorders were also at risk for other emotional disorders, the co-occurrence of eating disorders, substance use, and emotional distress among dancers (N = 50) and nondancers (N = 56) was examined. These young adult women were part of a longitudinal study of the complications of decreased bone density. Participants filled out questionnaires about eating behavior, substance use, and emotional functioning. A clinical interview determined the existence of eating disorders (DSM-III-R). Physiological data, including an assessment of current health, also were collected. There were no differences in disordered eating between the two subject groups. Associations existed within each group, however. Many associations including substance use and emotional distress were found among the nondancers, while no associations were found among the dancers. Thus, eating disorders in a group of subjects at risk because of professional pressures to remain thin revealed a profile which differed significantly from that of women developing eating disorders in the general population.
Article
Substantial correlational evidence supports a causal (mediational) interpretation of alcohol expectancy operation, but definitive support requires a true experimental test. Thus, moderately to heavily drinking male college students were randomly assigned to 1 of 3 conditions in a pre-post design: Expectancy challenge (designed to manipulate expectancy levels), "traditional" information, and assessment-only control. Expectancy challenge produced significant drinking decreases, compared with the other 2 groups. Decreases in measured expectancies paralleled drinking decreases in the challenge condition. Significant increases in alcohol knowledge in the traditional program were not associated with decreased drinking. These experimental findings support a causal (mediational) interpretation of expectancy operation. The implications for a cognitive (memory) model of expectancies and for prevention and intervention programs for problem drinking and alcoholism are discussed.
Article
A number of researchers have suggested that the syndrome of exercise dependence (addiction) is paralleled by a tendency towards eating disorders such as anorexia nervosa and bulimia. As considerable research has reported a high incidence of eating disorders among dancers and as rigorous physical demands are inherent in dance, we hypothesized that dancers would present a higher profile of exercise dependence on the Negative Addiction Scale than other athletes. To test this hypothesis, 47 female ballet and modern dancers completed a survey on exercise dependence adapted from Hailey and Bailey (1982) to assess quantitatively exercise dependence. Scores were compared with those obtained from 39 female endurance (running) athletes and 16 female nonendurance (field hockey) athletes. Significantly higher scores on dependence for dancers than for endurance or nonendurance athletes were noted. The data indicate that dancers may be at greater risk for psychophysiological problems associated with exercise dependence than other athletes and so should be monitored for symptoms.
Article
The characteristics of anorexia nervosa and bulimia nervosa were studied in ballet dancers in full-time training and compared with other young women at school. Dancers had higher scores on the Eating Attitudes Test. Dancers were more likely to have an eating disorder when strict modified DSM-3-R criteria were applied. Currently 1 dancer (1.6&percnt;) and no student had anorexia nervosa, 1 dancer (1.6&percnt;) and 3 students (1.3&percnt;) had bulimia nervosa and 5 dancers (8.3&percnt;) and 9 students (4.2&percnt;) had an unclassified eating disorder. Another dancer had been treated for anorexia nervosa in the past. One dancer was treated for bulimia nervosa and 6 for weight loss. Dancers were more likely to have been told to increase their body weight. Dancers were not more likely to be afraid of losing control of their weight and becoming obese if they attempted weight gain, to ignore the advice to gain weight or resist gaining weight. Regular self-induced vomiting was reported by 4&percnt; of women. Dancers are at risk for the development of eating disorders.
Article
The prevalence of amenorrhea was studied among 113 professional and student ballet dancers in the Netherlands (mean age 23.3 yr, SD 4.8). Sixty-one dancers not on oral contraceptives were included in the subsequent analyses. Six cases (prevalence 9.8 percent, 95 percent confidence interval: 2.4-17.2) with secondary amenorrhea (< or = 4 cycles per year; previous menstruation > or = 3 months prior to the study; menarche > or = 1 yr prior to the study) were found. Two dancers had primary amenorrhea (no menarche at the age of > or = 16). There was a negative correlation between the age of menarche and the number of menstrual cycles during the 12 months preceding the study (r = -0.46, P = 0.001). Body composition (four-compartment model), amount of dancing (recorded), resting energy expenditure (ventilated hood), dietary intake (recorded), and indices of eating disorders (Eating Disorders Inventory, EDI) were studied in 15 of the dancers, 5 amenorrheic and 10 eumenorrheic. No significant differences were found between the amenorrheic and eumenorrheic dancers. An explanation for the lower prevalence of amenorrhea in ballet dancers in the Netherlands, compared with U.S. dancers, was not obvious. Relatively low EDI scores (25.8, SD 14.5) in a subsample of 24 dancers could indicate less rigid emphasis on leanness and dieting.
Article
Differentiated examination of eating attitudes and behaviours of female and male German ballet school students with particular reference to their age and analysis of common points with and differences from female Anorexia nervosa (A.n.) patients. The Eating Attitudes Test (EAT-40) was used. Male and female adolescent students of a ballet school and a high school as well as anorectic patients participated in this study. EAT totals exhibited by female and male ballet school students were higher with significance than those recorded from high school students. EAT totals > 30 were reached by 21.6% of female ballet school students but by no male ballet school student at all. In the context of certain EAT items, a number of differences are described between female ballet school students, on the one hand, and female A.n. patients, on the other. No case was identifiable which would satisfy ICD-10 criteria for Anorexia nervosa. Attitudes and behaviours of adolescent female and male ballet dancers toward eating and their own body should be judged with due consideration of their specific living conditions.
Article
Twelve patients with anorexia nervosa and 12 control participants watched a series of 64 words. There were 4 word types: anorexia related, positive, negative, and neutral. The last 3 types were anorexia unrelated. Anorexia-related words had the same affective valence as the neutral control words. Next, the participants completed an explicit memory test (cued recall) and an implicit memory test (word stem completion). Results showed a strong explicit memory bias for anorexia-related words for patients with anorexia nervosa but not for nondieting controls. There was no evidence for a similar bias in implicit memory. Results are discussed in the context of cognitive biases in psychopathology.
Article
Body mass index (BMI) and body type of female and male adolescent ballet dancers (n = 90) and school students (n = 156) were determined. Participants were asked for the body weight she or he would prefer, and ballet students were administered the Eating Attitudes Test-40 (EAT-40). Results between age groups and with reference values were compared. Both in dancers and controls, girls wanted to lose more body weight than boys, with female ballet dancers more than female controls. The desire for reducing body weight was expressed by female ballet dancers of all BMI percentiles and body types, with the highest difference between real and desired body weight in 11-, 13-, and 16-year-olds. In the other groups, a quest for lower body weight was expressed only by adolescents of higher BMI and pyknomorphic and/or mesomorphic body type. Female ballet dancers of all age groups sought to reach body weights below the 5th percentile or below 82% of normal body weight. Desired body weight change was influenced by BMI and body type and correlated positively with EAT-40 score.
Article
To examine body image and possible distortion of body image among elite female dancers 10 members of a professional ballet company rated both current and ideal body shape. In addition, an objective measure of body composition was obtained via skinfold techniques. t tests indicated that the mean rating for current body image was significantly higher than the rating for ideal, despite the fact that body-composition measures for all subjects were in an "ideal" range according to normative standards. Analysis indicated a high distortion of body image among these dancers and support psychophysiological concerns previously raised.
Article
The relationship between athletic participation and eating problems is examined using meta-analysis. Both the risk and protective elements of athletic participation are considered. Data from 34 studies were used to examine the overall relationship between athletic participation and eating problems. Relationships for specific sports, elite athletes, and various age groups are also examined. Athletes appeared to be somewhat more at risk for eating problems than nonathletes. This was especially true of dancers. Significant effects did not emerge for gymnasts. Elite athletes, especially those in sports emphasizing thinness, were at risk. Nonelite athletes, especially in high school, had reduced risk of eating problems compared to controls. Body dissatisfaction was lower in athletes. There appear to be circumstances under which sports participation by women constitutes a risk factor for certain elements of eating problems. In other situations, athletic participation may be protective against eating problems.
Article
Ballet school students (n = 90) aged 11-17 years, and nondancing adolescents (n = 156) aged 13-17 completed the Eating Disorder Inventory (EDI). Significant differences between female dancers and controls were seen in five subscales, with higher scores for the dancers ('Drive for thinness', 'Bulimia', 'Interpersonal distrust', 'Ineffectiveness' and 'Perfectionism'). Their highest scores on most subscales were for the 16-year-olds. The only difference between male dancers and controls was seen for Ineffectiveness. Our data suggest important psychological inconsistency in the course of the adolescence of female ballet dancers, whilst the psychological profile of male ballet dancers appeared quite similar to that of nondancing adolescents.
Article
Ballet dancers are frequently regarded as having a higher risk of developing eating disorders (ED). This paper describes the eating habits and prevalence of ED in a group of female students from a dance academy in Rome, Italy. Participants were assessed with an array of measures conventionally employed (usually singly) in epidemiological studies of ED, namely: an anthropometrical-nutritional evaluation, the EAT, EDI, and BUT questionnaires, and the EDE interview. The 160 students who agreed to participate were evaluated anthropometrically, nutritionally and psychometrically and 83 underwent the EDE structured interview. Their calorie intake was insufficient in all age groups in terms of the nutritional standards required by their daily physical activity. EAT, EDI and BUT enhanced concerns about dieting, food intake control and body image. The significance of the correlations between calorie intake and the EAT Dieting and the EDI Perfectionism and Interceptive Awareness scores increased in function of age. Food, weight and body image concerns increased with age and length of time in the ballet environment The reduced calorie intake was not necessarily linked to the presence of psychopathological signs.
Article
To demonstrate the validity of two measures of eating and dieting expectancies (The Eating Expectancy Inventory [EEI] and the Thinness and Restricting Expectancy Inventory, [TREI]) for use with adolescents. Seventh (N = 392) and tenth graders (N = 300) completed the Bulimia Test-Revised (BULIT-R), the Eating Disorder Inventory (EDI-II), and two factors of the Three-Factor Eating Questionnaire (TFEQ). Findings replicated for the two adolescent samples. The expectancy that thinness leads to overgeneralized life improvement correlated with measures of "successful" dieting, dieting plus disinhibition, and bulimic symptomatology. Expectancies for negative reinforcement from eating (e.g., eating helps manage negative affect and alleviate boredom) correlated with dieting plus disinhibition and bulimic symptoms, but not with successful dieting. Negative reinforcement from eating and reinforcement from thinness expectancies accounted for different bulimic symptom variance than that accounted for by the personality factors of perfectionism, interpersonal distrust, and ineffectiveness. Results were consistent with prior work on college and clinical samples, thus supporting use of the expectancy measures with adolescents.
Article
This meta-analytic review of prospective and experimental studies reveals that several accepted risk factors for eating pathology have not received empirical support (e.g., sexual abuse) or have received contradictory support (e.g.. dieting). There was consistent support for less-accepted risk factors(e.g., thin-ideal internalization) as well as emerging evidence for variables that potentiate and mitigate the effects of risk factors(e.g., social support) and factors that predict eating pathology maintenance(e.g., negative affect). In addition, certain multivariate etiologic and maintenance models received preliminary support. However, the predictive power of individual risk and maintenance factors was limited, suggesting it will be important to search for additional risk and maintenance factors, develop more comprehensive multivariate models, and address methodological limitations that attenuate effects.
Article
Recent findings implicate body dissatisfaction in the development and maintenance of eating pathology. This paper reviews theory and empirical findings regarding the putative origins and consequences of body dissatisfaction because recent findings have not been synthesized or critically evaluated and because these findings have key etiologic and prevention implications. A computer-assisted literature review was conducted to locate relevant prospective and experimental studies. There is evidence that perceived pressure to be thin, thin-ideal internalization and elevated body mass, but not early menarche, increase the risk for subsequent body dissatisfaction. There is also consistent support for the assertion that body dissatisfaction is a risk factor for eating pathology and that this relation is mediated by increases in dieting and negative affect. This review provides support for the claim that sociocultural processes foster body dissatisfaction, which in turn increase the risk for bulimic pathology, and suggests that prevention and treatment interventions might be enhanced by focusing greater attention on body image disturbances.
Article
A set of tentative and declaredly non-sufficient postulates are presented to indicate a possible direction of rigorization of expectancy theory. The formulation lies somewhere between the constructs of Tolman and Hull. It identifies with S-R-reinforcement theory. 15 references.
Article
To assess the level at which patient chemotherapy education needs are being met by the health-care team in an outpatient clinic setting and to identify any unmet needs regarding patient chemotherapy education. A questionnaire comprising 17 questions was developed to evaluate patient preferences regarding chemotherapy education. In the clinic, patients were offered a copy of the questionnaire with a cover letter describing the study. A total of 282 questionnaires were completed, and 190 respondents had previously received chemotherapy. Of the 165 respondents who were previously treated at our institution, 66.7% (110) had received some form of chemotherapy education specifically from our clinic. The majority of all respondents (86.8%) reported that they preferred to receive information about their chemotherapy via written materials and/or through a conversation with a health-care professional. Regardless of the source of information, 62.6% of respondents (119) felt they were provided with adequate information about their chemotherapy treatment, and 42.4% reported that they would like more information about their chemotherapy. The current practice in our clinic is to provide patients with written information about their chemotherapy that is reviewed with a health-care professional. The data revealed that our current practice is consistent with our patients' preferences. However, this survey did identify new information that patients want to know about chemotherapy, such as how chemotherapy works, why chemotherapy stops working, and drug-drug as well as drug-food interactions. This information will be incorporated into future patient education materials.
Article
To examine the relationship between childhood dance participation and adult eating behavior and psychological health. A total of 546 undergraduate females at a large Midwestern university completed questionnaires regarding eating behavior and associated features, depression, self-esteem, and body image. Women who participated in childhood dance are more likely to score higher on measures of bulimic behaviors than nondancers. In addition, childhood dancers indicated greater drive for thinness and poorer impulse control compared to nondancers. Furthermore, there was a statistical trend for childhood dancers to report greater perfectionism and a smaller ideal body mass than nondancers. There were no significant differences between dance groups on measures of depression and self-esteem. These findings suggest that participating in dance as a child may influence one's eating behavior as an adult, including associated factors such as drive for thinness and impulse control and potentially perfectionism and preferred body size.
Article
This study compared two self-report methods for assessing binge eating in severely obese bariatric surgery candidates. Participants were 249 gastric bypass candidates who completed the Questionnaire on Eating and Weight Patterns-Revised (QEWP-R) and the Eating Disorder Examination-Questionnaire (EDE-Q) prior to surgery. Participants were classified by binge eating status (i.e., no or recurrent binge eating) with each of the measures. The degree of agreement was examined, as well as the relationship between binge eating and measures of convergent validity. The two measures identified a similar number of patients with recurrent binge eating (i.e., at least 1 binge/week); however, overlap was modest (kappa=.26). Agreement on twice weekly binge eating was poor (kappa=.05). The QEWP-R and EDE-Q both identified clinically meaningful groups of binge eaters. The EDE-Q appeared to differentiate between non/infrequent bingers and recurrent bingers better than the QEWP-R, based on measures of convergent validity. In addition, the EDE-Q demonstrated an advantage because it identified binge eaters with elevated weight and shape overconcern. Using the self-report measures concurrently did not improve identification of binge eating in this study. More work is needed to determine the construct validity and clinical utility of these measures with gastric bypass patients.
Article
The current study compared the prevalence of disordered eating attitudes and behaviors among adolescent ballet dancers at national, regional, and local schools. Female ballet students (N = 239; mean age = 15.0 +/- 1.5 years) from five geographically disparate summer programs completed the Eating Dis-order Inventory (EDI) and answered questions regarding eating disorder symptoms. Students from both national and local schools reported significantly higher EDI total, Drive for Thinness, and Perfectionism scores compared with regional students. In contrast, national students reported significantly greater dieting scores and lifetime histories of self-induced vomiting compared with regional and local students. Eating pathology among adolescent ballet dancers may be a function of both genetic and environmental risk. Dancers who exhibit high levels of perfectionism and, perhaps consequently, place themselves in highly competitive environments, may exhibit a significantly increased risk for disordered eating in comparison to dancers who are less perfectionistic and/or place themselves in less competitive environments.
Article
The current study sought to compare eating disorder symptomatology among ballet dancers and individuals with restricting anorexia nervosa (RAN), bulimia nervosa (BN), and no eating pathology. Twenty-nine female ballet dancers completed assessments and were compared with an archival dataset of 26 women with RAN, 47 women with BN, and 44 women with no eating pathology. Eating disorder diagnoses and behaviors were assessed with a semi-structured clinical interview, the Eating Disorder Inventory (EDI), and a weight history interview. Eighty-three percent of dancers met lifetime criteria for AN (6.9%), BN (10.3%), AN+BN (10.3%), or EDNOS (55.0%). Moreover, dancers looked more similar to eating-disordered individuals than to control individuals on measures of eating pathology. Despite previous emphasis on the pathology AN, the current findings suggest that dancers frequently engage in binge eating and purging behaviors. Moreover, it appears that their pathology is as severe as that of non-dancing women with eating disorders.
Article
This paper summarizes recent methodologic advances related to missing data and provides an overview of two "modern" analytic options, direct maximum likelihood (DML) estimation and multiple imputation (MI). The paper begins with an overview of missing data theory, as explicated by Rubin. Brief descriptions of traditional missing data techniques are given, and DML and MI are outlined in greater detail; special attention is given to an "inclusive" analytic strategy that incorporates auxiliary variables into the analytic model. The paper concludes with an illustrative analysis using an artificial quality of life data set. Computer code for all DML and MI analyses is provided, and the inclusion of auxiliary variables is illustrated.