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Hansson, E., Daukantaité, D. & Johnsson, P. (2017). Disordered eating and emotion dysregulation among adolescents and their parents. BMC Psychology, 5, Article ID 12.
Open this publication in new window or tab >>Disordered eating and emotion dysregulation among adolescents and their parents
2017 (English)In: BMC Psychology, E-ISSN 2050-7283, Vol. 5, article id 12Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Research on the relationships between adolescent and parental disordered eating (DE) and emotion dysregulation is scarce. Thus, the aim of this study was to explore whether mothers' and fathers' own DE, as measured by SCOFF questionnaire, and emotion dysregulation, as measured by the difficulties in emotion regulation scale (DERS), were associated with their daughters' or sons' DE and emotion dysregulation. Furthermore, the importance of shared family meals and possible parent-related predictors of adolescent DE were explored.

METHOD: The total sample comprised 1,265 adolescents (M age  = 16.19, SD = 1.21; age range 13.5-19 years, 54.5% female) whose parents had received a self-report questionnaire via mail. Of these, 235 adolescents (18.6% of the total sample) whose parents completed the questionnaire were used in the analyses. Parents' responses were matched and compared with those of their child.

RESULTS: Adolescent girls showed greater levels of DE overall than did their parents. Furthermore, DE was associated with emotion dysregulation among both adolescents and parents. Adolescent and parental emotion dysregulation was associated, although there were gender differences in the specifics of this relationship. The frequency of shared dinner meals was the only variable that was associated to DE and emotion dysregulation among adolescents, while parental eating disorder was the only variable that enhanced the probability of adolescent DE.

CONCLUSION: The present study contributes to the literature by demonstrating that there are significant associations between parents and their adolescent children in terms of DE, emotion dysregulation, and shared family meals. Future studies should break down these relationships among mothers, fathers, girls, and boys to further clarify the specific associational, and possibly predictive, directions.

Keywords
Adolescents, Disordered eating, Emotion dysregulation, Parents, Shared meals
National Category
Psychology
Identifiers
urn:nbn:se:hkr:diva-16643 (URN)10.1186/s40359-017-0180-5 (DOI)28376909 (PubMedID)
Available from: 2017-04-26 Created: 2017-04-26 Last updated: 2017-11-29Bibliographically approved
Hansson, E., Daukantaitė, D. & Johnsson, P. (2016). Typical patterns of disordered eating among Swedish adolescents: associations with emotion dysregulation, depression, and self-esteem. International Journal of Eating Disorders, 4, Article ID 28.
Open this publication in new window or tab >>Typical patterns of disordered eating among Swedish adolescents: associations with emotion dysregulation, depression, and self-esteem
2016 (English)In: International Journal of Eating Disorders, ISSN 0276-3478, E-ISSN 1098-108X, Vol. 4, article id 28Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Using the person-oriented approach, we determined the relationships between four indicators (restraint and eating, shape, and weight concerns) of disordered eating (DE), as measured by the self-reported Eating Disorders Examination Questionnaire (EDE-Q), to identify typical DE patterns. We then related these patterns to clinical EDE-Q cut-off scores and emotion dysregulation, depression, self-esteem, and two categories of DE behaviors (≥2 or ≤1 "yes" responses on the SCOFF questionnaire).

METHOD: Typical patterns of DE were identified in a community sample of 1,265 Swedish adolescents (Mage  = 16.19, SD = 1.21; age range 13.5-19 years) using a cluster analysis. Separate analyses were performed for girls (n = 689) and boys (n = 576).

RESULTS: The cluster analysis yielded a six-cluster solution for each gender. Four of the six clusters for girls and five for boys showed scores above the clinical cut-off on at least one of the four DE indicators. For girls, the two clusters that scored above the clinical cut-offs on all four DE indicators reported severe psychological problems, including high scores on emotion dysregulation and depression and low scores on self-esteem. In contrast, for boys, although two clusters reported above the clinical cut-off on all four indicators, only the cluster with exceedingly high scores on shape and weight concerns reported high emotion dysregulation and depression, and extremely low self-esteem. Furthermore, significantly more girls and boys in the most problematic DE clusters reported ≥2 "yes" responses on the SCOFF questionnaire (as opposed to ≤1 response), indicating clear signs of DE and severe psychological difficulties.

CONCLUSION: We suspect that the various problematic DE patterns will require different paths back to a healthy diet. However, more research is needed to determine the developmental trajectories of these DE patterns and ensure more precise clinical cut-off scores, especially for boys. Comprehensive understanding of DE patterns might be of use to healthcare professionals for detecting DE before it develops into an eating disorder.

TRIAL REGISTRATION: Lund, EPN (dnr: 2012/499).

National Category
Psychology Medical and Health Sciences
Identifiers
urn:nbn:se:hkr:diva-16261 (URN)10.1186/s40337-016-0122-2 (DOI)000395714500001 ()27822375 (PubMedID)
Available from: 2016-11-25 Created: 2016-11-25 Last updated: 2017-08-14Bibliographically approved
Hansson, E., Daukantaité, D. & Johnsson, P. (2015). SCOFF in a general adolescent population. Journal of Eating Disorders
Open this publication in new window or tab >>SCOFF in a general adolescent population
2015 (English)In: Journal of Eating Disorders, ISSN 2050-2974Article in journal (Refereed) Published
Abstract [en]

Background

Although Disordered Eating Behaviors (DEB) is an ill-defined concept, multiple studies have examined prevalence of DEB and its relations to other variables in various populations. DEB have been shown to predict more serious eating disorders which in turn can lead to death. Mostly girls seem to suffer from DEB, but the question has been raised whether this, at least, partially is due to the methods used for screening. The SCOFF-questionnaire has been suggested as a quick and easily administered tool to assess DEB. However, the psychometric results regarding SCOFF suggest some inconsistencies, and more research is needed in various countries and age samples.

Method

To validate SCOFF, a total of 1265 Swedish adolescents (51.6 % girls) completed self-report questionnaires using the Eating Disorder Examination Questionnaire (EDE-Q) as a reference standard.

Results

The factor analyses show inconclusive results as to whether SCOFF should be regarded as a comprehensive scale; furthermore, the results indicate a correlation between SCOFF and the EDE-Q in both girl and boy samples. Girls scored significantly higher on SCOFF and also had a higher total score, indicating more severe problems than boys.

Conclusions

The results raised questions as to whether the SCOFF might be interpreted and responded to in different ways by girls and boys, risking overlooking boys’ DEB and also whether one “yes” answer, instead of the stipulated two, could be sufficient when using SCOFF for screening purposes. In sum, the results challenge the use of SCOFF in a general adolescent population.

Keywords
Subclinical, disordered eating behaviors, SCOFF
National Category
Psychology
Identifiers
urn:nbn:se:hkr:diva-15207 (URN)10.1186/s40337-015-0087-6 (DOI)26677411 (PubMedID)
Available from: 2016-01-19 Created: 2016-01-19 Last updated: 2017-06-15Bibliographically approved
Hansson, E. & Masche, J. G. (2014). Disordered eating in a general population: just an­other depressive symptom or a specific problem?. In: : . Paper presented at Biennial NEDS (Nordic Eating Disorder Society)Conference, Stockholm, September 16-18 2014.
Open this publication in new window or tab >>Disordered eating in a general population: just an­other depressive symptom or a specific problem?
2014 (English)Conference paper, Poster (with or without abstract) (Refereed)
Abstract [en]

Previous research has shown that about 30% of adolescent girls and 15% of adolescent boys suffer from disordered eating (DE) which can be defined as problematic eating below criteria for eating disorders according to DSM-V (Hautala et al., 2008; Herpertz-Dahlman et al., 2008). Even sub-clinical unhealthy weight-control behaviors have predicted outcomes related to obesity and eating disorders five years later (Neumark-Sztainer et al., 2006). However, two issues question the validity of DE. First, in contrast to eating disorders, under- or overweight/obesity are not necessary parts of DE. Second, some symptoms and correlates of DE are similar to those of depression. E.g., parent-adolescent relationships seem to play an important role in explaining both DE (Hautala et al., 2011; Berge et al., 2010) and internalizing problems (Soenens et al., 2012). Thus, this study examined associations between DE and a wide range of internalizing and externalizing problems, parent-adolescent relationship characteristics, and food intake and sleep habits in a general population of adolescents. Comparing results with and without controlling for depression reveals whether DE is a specific problem or merely a depressive symptom. This study also explored whether DE and the other variables under study are associated independently of weight status (underweight, overweight/obesity, and normal weight), specific to under- or overweight, or spurious if taking weight status into account.

The study is based on the first wave of an on-going longitudinal study, and all measures are child-reported (N=1,281). Adolescents attending grades 7 to 10 in a Southern Swedish municipality (age 12.5 to 19.3, M = 15.2, SD = 1.2) filled out questionnaires in class.  DE was measured using the SCOFF, a five-item screening scale validated for use in general populations (e.g. Muro-Sans et al., 2008; Noma et al., 2006).

The results of univariate ANOVAs indicate that associations with DE were largely independent of weight status. Moreover, most associations with disordered eating were spurious when controlling for depression. However, some associations remained. Above and beyond depression effects, adolescents with DE reported lower self-esteem, stronger feelings of being over-controlled by their parents and active withholding of information towards them, consumption of fewer meals during the week, and higher levels of daytime sleepiness. Boys with ED slept more hours during the week and ate more fruits and vegetables than boys without ED. In conclusion, despite an overlap between depressive symptoms and disordered eating, this study provides ample evidence that sleep, nutrition habits, self-esteem, and parental control issues distinguish eating disordered adolescents from those suffering from general depressive symptoms.

Keywords
Disordered eating, eating disorder, parent-child relation, depression, dietary practices, comorbidity
National Category
Psychology
Identifiers
urn:nbn:se:hkr:diva-15206 (URN)
Conference
Biennial NEDS (Nordic Eating Disorder Society)Conference, Stockholm, September 16-18 2014
Available from: 2016-01-19 Created: 2016-01-19 Last updated: 2017-01-04Bibliographically approved
Hansson, E. & Masche, J. G. (2014). Disordered eating in a general population: just an­other depressive symptom or a specific problem?. In: : . Paper presented at 15th Biennial Meeting of the Society for Research on Adolescence (SRA), Austin, TX, USA, March 20-22, 2014.
Open this publication in new window or tab >>Disordered eating in a general population: just an­other depressive symptom or a specific problem?
2014 (English)Conference paper, Poster (with or without abstract) (Refereed)
Abstract [en]

Previous research has shown that about 30% of adolescent girls and 15% of adolescent boys suffer from disordered eating (DE) which can be defined as problematic eating below criteria for eating disorders according to DSM-V (Hautala et al., 2008; Herpertz-Dahlman et al., 2008). Even sub-clinical unhealthy weight-control behaviors have predicted outcomes related to obesity and eating disorders five years later (Neumark-Sztainer et al., 2006). However, two issues question the validity of DE. First, in contrast to eating disorders, under- or overweight/obesity are not necessary parts of DE. Second, some symptoms and correlates of DE are similar to those of depression. E.g., parent-adolescent relationships seem to play an important role in explaining both DE (Hautala et al., 2011; Berge et al., 2010) and internalizing problems (Soenens et al., 2012). Thus, this study examined associations between DE and a wide range of internalizing and externalizing problems, parent-adolescent relationship characteristics, and food intake and sleep habits in a general population of adolescents. Comparing results with and without controlling for depression reveals whether DE is a specific problem or merely a depressive symptom. This study also explored whether DE and the other variables under study are associated independently of weight status (underweight, overweight/obesity, and normal weight), specific to under- or overweight, or spurious if taking weight status into account.

The study is based on the first wave of an on-going longitudinal study, and all measures are child-reported (N=1,281). Adolescents attending grades 7 to 10 in a Southern Swedish municipality (age 12.5 to 19.3, M = 15.2, SD = 1.2) filled out questionnaires in class.  DE was measured using the SCOFF, a five-item screening scale validated for use in general populations (e.g. Muro-Sans et al., 2008; Noma et al., 2006).

The results of univariate ANOVAs indicate that associations with DE were largely independent of weight status. Moreover, most associations with disordered eating were spurious when controlling for depression. However, some associations remained. Above and beyond depression effects, adolescents with DE reported lower self-esteem, stronger feelings of being over-controlled by their parents and active withholding of information towards them, consumption of fewer meals during the week, and higher levels of daytime sleepiness. Boys with ED slept more hours during the week and ate more fruits and vegetables than boys without ED. In conclusion, despite an overlap between depressive symptoms and disordered eating, this study provides ample evidence that sleep, nutrition habits, self-esteem, and parental control issues distinguish eating disordered adolescents from those suffering from general depressive symptoms.

Keywords
disordered eating, eating disorder, parent-child relation, depression, dietary practices, comorbidity
National Category
Psychology (excluding Applied Psychology)
Identifiers
urn:nbn:se:hkr:diva-13549 (URN)
Conference
15th Biennial Meeting of the Society for Research on Adolescence (SRA), Austin, TX, USA, March 20-22, 2014
Projects
Development of parent-child relation during adolescence from a systems and psychological health perspective
Note

Poster paper presented at the 15th Biennial Meeting of the Society for Research on Adolescence (SRA), Austin, TX, USA

Available from: 2015-02-17 Created: 2015-02-17 Last updated: 2015-03-02Bibliographically approved
Masche, J. G. & Hansson, E. (2014). It takes two to tango: teen internalizing and exter­nalizing problems are predicted by the interaction of parent and teen behaviors. In: : . Paper presented at 15th Biennial Meeting of the Society for Research on Adolescence (SRA), Austin, TX, USA, March 20-22, 2014.
Open this publication in new window or tab >>It takes two to tango: teen internalizing and exter­nalizing problems are predicted by the interaction of parent and teen behaviors
2014 (English)Conference paper, Oral presentation only (Refereed)
Abstract [en]

Associations between parenting behaviors of support, behavior control and overcontrol, and psychological control/disrespect with adolescent internalizing and externalizing problems have been studied extensively (Barber et al., 2012; Kerr & Stattin, 2000), and also adolescent behaviors of disclosure and secrecy in the context of these problems (Frijns et al., 2010). However, few studies have assessed how parent and child behaviors might moderate each other’s associations with problems (Keijsers et al., 2009). This study investigates interaction effects of the above-mentioned parent and adolescent behaviors when predicting depression, loneliness, and low self-esteem (internalizing), and delinquency, aggression, and drug/alcohol use (externalizing). Given the variety of behaviors and problems under study, it is hypothesized that various kinds of moderation effects will emerge.

An ethnically diverse sample of 1,281 adolescents attending grades 7 to 10 in a Southern Swedish municipality (age 12.5 to 19.3, M = 15.2, SD = 1.2) filled out questionnaires in class. All scales have been published internationally; however, some items were added to short scales. Each of the internalizing and externalizing problems was regressed on all possible combinations of one of the four parenting variables and one of the two adolescent behaviors under study, resulting in 48 regression analyses.

Confirming previous findings, parent psychological control and overcontrol were associated with internalizing and externalizing problems, and behavior control and insufficient support with internalizing problems. Adolescent disclosure predicted low levels of both kinds of problems and secrecy predicted high levels. Two-way interactions of parent and adolescent behaviors added significantly (p < .05) to the variance in 13 of 48 analyses which is beyond chance level (p < .001). In addition to the inspection of significant effects, t-values across all analyses were analyzed in order to distinguish between more general trends and solitary effects on specific internalizing or externalizing problems only. Confirming the hypothesis, interaction effects varied across the combinations of parent and adolescent behaviors (η2 = .26) and were further moderated by the distinction between internalizing and externalizing problems (η2 = .38). These effects were grouped into five kinds of interaction effects: In mutually enhancing and mutually exacerbating effects, two positive or two negative, respectively, behaviors increased each other’s associations with problem levels. In protection effects, usually adolescents’ behavior reduced associations between negative parenting and problems. Relationship split effects might reflect an alienated parent-adolescent relationship in which negative behaviors cannot do much additional harm. Finally, maintained relationship/sabotage means that the lowest level of problems occurred if one generation maintained the relationship by a positive behavior and the other generation abstained from “sabotaging” it by a negative behavior. Otherwise, problem behaviors increased sharply without the other generation’s behavior having any large effect any longer.

In conclusion, analyses provide ample evidence that adolescents’ behavior moderates links between parents’ behaviors and adolescents’ internalizing and externalizing problems. Possible causal interpretations include adolescents as “gatekeepers” of parenting efforts, families’ functional and dysfunctional adaptations, and parent and child behavior combinations as consequences of internalizing and externalizing problems.

Keywords
internalizing problems, externalizing problems, depression, adolescents, parent-child communication, parent-adolescent relationship
National Category
Psychology (excluding Applied Psychology)
Identifiers
urn:nbn:se:hkr:diva-13548 (URN)
Conference
15th Biennial Meeting of the Society for Research on Adolescence (SRA), Austin, TX, USA, March 20-22, 2014
Projects
Development of parent-child relation during adolescence from a systems and psychological health perspective
Available from: 2015-02-17 Created: 2015-02-17 Last updated: 2015-03-02Bibliographically approved
Hansson, E. & Lennernäs, M. (2014). The difficulties of measuring adolescents' food intake and behaviors . In: : . Paper presented at Food, Children and youth, what's eating?, February, 21-22, Lisbon, Portugal.
Open this publication in new window or tab >>The difficulties of measuring adolescents' food intake and behaviors
2014 (English)Conference paper, Oral presentation only (Refereed)
Abstract [en]

The fundamental cause of weight-related problems, from obesity to anorexia, is an imbalance between calories consumed and calories expended. The "nutritional status" concept embraces more than food-intake. It elucidates the dynamics between supply, demand and factors that affect metabolism, energy balance and energy expenditure. In recent years, major changes in the spatial-temporal structures of everyday life that could be possible contributors to weight-related issues of adolescents have emerged. A modern life style of low activity, irregular meal times, late-night food intake, stress and sleep deprivation possibly leads to a disturbed regulation of food intake which further can generate physical and/or psychological illnesses. Traditional studies of eating behavior use food diaries focusing on the average intake of energy and nutrients (e.g. Bellisle et al., 2003). Such methods are demanding for the respondent and require details about consumed amounts. A "Meal Matrix" (Lennernas & Andersson, 1999) has been used in studies of several different Swedish cohorts (e.g. Wissing et al., 2000). The Meal Matrix consists of seven food categories and eight different meal "types". Categorization is based on visible properties (food types) but at the same time reflecting invisible properties (nutrients). In the present study the Meal Matrix was developed further to be used as part of a questionnaire in a study of eating behaviors in 1281 adolescents between 12 and 17 years old in a southern Swedish municipality. Meal patterns in adolescents were assessed in relation to time of day for intake, sleep and physical activity. The aim of the study was to 1) test a self-report concept for food based classification of eating behaviors in adolescents, 2) to evaluate the nutritional quality of food and meals among them and 3) to get information about the rhythm of eating and slee-ping in relation to time of day and the biological clock.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hkr:diva-15205 (URN)
Conference
Food, Children and youth, what's eating?, February, 21-22, Lisbon, Portugal
Available from: 2016-01-19 Created: 2016-01-19 Last updated: 2016-01-19Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-0823-0164

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