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Social appearance anxiety and bulimia nervosa

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Abstract

Social appearance anxiety is an unexplored concept in eating disorders (ED). It refers to social anxiety surrounding overall appearance, including body shape, and fear of negative evaluation by others. It is potentially relevant to those with bulimia nervosa (BN) as both social anxiety and body image disturbance are commonly experienced by patients. Thirty women with BN and forty healthy controls (HC) completed the Social Appearance Anxiety Scale (SAAS), a 16-item self-report questionnaire. ED cognitions and behaviours were assessed with the Eating Disorders Examination-Questionnaire. Women with BN have significantly higher SAAS scores than HC (z=−6.79, p<0.001). In BN, SAAS scores show significant positive correlation with global ED subscales and dietary restraint. In HC, SAAS scores are correlated with shape, weight, eating concern, and global eating disturbance subscales. Preliminary findings suggest the SAAS is potentially useful in future research concerning overall risk factors for eating disturbance and treatment outcome in BN.

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References

  1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-IV text revision). Washington DC, APA, 2000.

    Google Scholar 

  2. Brewerton TD, Lydiard RB, Ballenger JC, et al. Eating disorders and social phobia. Arch Gen Psychiatry 1993; 50: 70.

    CAS  PubMed  Google Scholar 

  3. Godart NT, Flament MF, Lecrubier Y, et al. Anxiety disorders in anorexia nervosa and bulimia nervosa: Co-morbidity and chronology of appearance. Eur Psychiatry 2000; 15: 38–45.

    Article  CAS  PubMed  Google Scholar 

  4. Rapee RM, Heimberg RG. A cognitive-behavioural model of anxiety in social phobia. Behav Res Ther 1997; 35: 741–56.

    Article  CAS  PubMed  Google Scholar 

  5. Gilbert N, Meyer C. Social anxiety and social comparison: Differential links with restrictive and bulimic attitudes among non-clinical women. Eat Behav 2003; 4: 257–264.

    Article  PubMed  Google Scholar 

  6. Gilbert N, Meyer C. Fear of negative evaluation and the development of eating psychopathology: A longitudinal study among nonclinical women. Int J Eat Disord 2005; 37: 307–12.

    Article  PubMed  Google Scholar 

  7. Vander Wal JS, Gibbons JL, Grazioso MP. The sociocultural model of eating disorder development: Application to a Guatemalan sample. Eat Behav 2008; 9: 277–84.

    Article  PubMed  Google Scholar 

  8. Lundgren JD, Anderson DA, Thompson JK. Fear of negative appearance evaluation: Development and evaluation of a new construct for risk factor work in the field of eating disorders. Eat Behav 2004; 5: 75–84.

    Article  PubMed  Google Scholar 

  9. Treasure J, Claudino AM, Zucker N. Eating Disorders. Lancet 2009; 375; 583–93.

    Google Scholar 

  10. Cash TE, Labarge AS. Development of the Appearance Schemas Inventory: A new cognitive body-image assessment. Cognit Ther Res 1996; 20: 37–50.

    Article  Google Scholar 

  11. Hinrichsen H, Waller G, van Gerko K. Social anxiety and agoraphobia in the eating disorders: Associations with eating attitudes and behaviours. Eat Behav 2004; 5: 285–90.

    Article  PubMed  Google Scholar 

  12. Hart TA, Flora DB, Palyo SA, et al. Development and examination of the social appearance anxiety scale. Assessment 2008; 15: 48–55.

    Article  PubMed  Google Scholar 

  13. Lundgren JD, Anderson DA, Thompson JK, et al. Perception of teasing in underweight persons: a modification of the perception of teasing scale. Eat Weight Disord 2004; 9:139–46.

    Article  CAS  PubMed  Google Scholar 

  14. Cuzzolaro M, Vetrone G, Marano G, et al. The Body Uneasiness Test (BUT): Development and validation of a new body image assessment scale. Eat Weight Disord 2006; 11: 1–13.

    Article  CAS  PubMed  Google Scholar 

  15. Rosen JC, Srebnik D, Saltzberg E, et al. Development of a body image avoidance questionnaire. Psychol Assess 1991; 3: 32–7.

    Article  Google Scholar 

  16. Hart E, Leary M, Rejeski WJ. The measurement of social physique anxiety. J Sport Exerc Psychol 1989; 11: 94–104.

    Google Scholar 

  17. Thompson AM, Chad KE. The relationship of social physique anxiety to risk for developing an eating disorder in young females. J Adolesc Health 2002; 31: 183–9.

    Article  PubMed  Google Scholar 

  18. Fairburn CG, Beglin SJ. Assessment of eating disorders: interview or self-report questionnaire? Int J Eat Disord 1994; 16: 363–70.

    CAS  PubMed  Google Scholar 

  19. Swinbourne JM, Touyz SW. The co-morbidity of eating disorders and anxiety disorders: A review. Eur Eat Disord Rev 2007; 15: 253–74.

    Article  PubMed  Google Scholar 

  20. Striegel-Moore RH, Silberstein LR, Rodin J. The social self in bulimia nervosa: Public self-consciousness, social anxiety and perceived fraudulence. J Abnorm Psychol 1993; 102: 297–303.

    Article  CAS  PubMed  Google Scholar 

  21. Stice E, Shaw H, Nemeroff C. Dual pathway model of bulimia nervosa: Longitudinal support for dietary restraint and affect-regulation mechanisms. J Soc Clin Psychol 1998; 17: 129–49.

    Article  Google Scholar 

  22. Ricciardelli LA, McCabe MP. Dietary restraint and negative affect as mediators of body dissatisfaction and bulimic behaviour in adolescent girls and boys. Behav Res Ther 2001; 39: 1317–28.

    Article  CAS  PubMed  Google Scholar 

  23. Troop NA, Allan S, Serpell L. Shame in women with a history of eating disorders. Eur Eat Disord Rev 2008; 16: 480–8.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Institute of Psychiatry, Section of Eating Disorders, King’s College London, Box PO59, London, SE5 8AZ, UK

    A. Koskina, F. Van den Eynde, S. Meisel, I. C. Campbell & U. Schmidt

Authors
  1. A. Koskina
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  2. F. Van den Eynde
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  3. S. Meisel
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  4. I. C. Campbell
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  5. U. Schmidt
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Correspondence to A. Koskina.

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Koskina, A., Van den Eynde, F., Meisel, S. et al. Social appearance anxiety and bulimia nervosa. Eat Weight Disord 16, e142–e145 (2011). https://doi.org/10.1007/BF03325321

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  • DOI: https://doi.org/10.1007/BF03325321

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