Self-Concept and Disturbed Eating Behavior in a Clinical Population of Adolescents with Eating Disorders
Keywords:Adolescents, Anorexia Nervosa, Bulimia Nervosa, Self-concept
Introduction: Changes in self-concept have been considered to play a crucial role in the etiology of eating disorders. In this study, we evaluate the levels of self-concept and severity of the disturbed eating behavior in a clinical population of adolescents with Eating Disorders (ED) and study their correlations.
Method: A sample of 50 patients of an Adolescent Psychiatric Service completed two validated self-report scales: the Piers- Harris Children’s Self-concept Scale (PHCSCS) and the Eating Disorder Examination - Questionnaire (EDE-Q). Anthropometric data were also collected.
Results:Total self-concept had a negative correlation with disease severity [total EDE-Q (rs= -0.48)], as well as with four subscales of the EDE-Q [Dietary Restraint (rs =-0.30); Weight Concern (rs=-0.44); Shape Concern (rs=-0.56); and Eating Concern (rs=-0.40)]. Four of the PHCSCS subscales showed a negative correlation with the severity of the disease [Behavioral Adjustment (rs=-0.39); Freedom from Anxiety (rs=-0.56); Popularity (PO) (rs=-0.43) and Happiness and Satisfactions (HS) (rs=-0.39)]. Then the sample was divided into two groups: Compulsive / Purgative [5 Bulimia Nervosa (BN) + 3 Unspecified Feeding and Eating Disorder (UFED) with insufficient criteria for BN] and Restrictive (38 Anorexia Nervosa + 4 UFED with insufficient criteria for AN). The Compulsive / Purgative group had lower Self-concept than the Restrictive group (p <0.05). This first group also presented lower values than the Restrictive group in all subscales of the PHCSCS, but with statistical significance only in the Intellectual and School Status and HS. It also presented higher disease severity (p <0.05), with higher values in all four EDE-Q subscales, but with statistical significance only in Weight Concern (p <0.05).
Conclusions: These results are in agreement with the literature that the Self-concept is altered in ED. In our study, we report an inverse correlation between self-concept and dysfunctional eating behaviors. The Compulsive/Purgative group reported a lower self-concept and greater severity of the eating behavior pathology, but there were no clinical differences between the two groups. This finding may be explained by the lower morbidity awareness of the Restrictive group.
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