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What Mediates the Relationship Between Family Meals and Adolescent Health Issues?

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Debra L. Franko
Debra L. Franko
Debra L. Franko
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Douglas Thompson
Douglas Thompson
Douglas Thompson
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Sandra G Affenito at University of Saint Joseph
Sandra G Affenito
Bruce Alan Barton at University of Massachusetts Medical School
Bruce Alan Barton
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Abstract

To determine whether the frequency of family meals in childhood is associated with positive health outcomes in adolescence through the mediating links of increased family cohesion and positive coping skills. Data were obtained from the National Heart, Lung, and Blood Institute Growth and Health Study (NGHS), a 10-year longitudinal study of 2,379 black and white girls assessed annually from ages 9-19. The mediational analysis framework of H. C. Kraemer and colleagues (2001) was used to test the hypothesis that the frequency of family meals in childhood (Study Years 1 and 3) would be related to health outcomes (Study Year 10) through the mediating links of family cohesion and coping skills (Study Years 7/8), after adjusting for baseline (Year 1) demographics as well as previous levels of the outcome variables (Years 5/6). Several measures of adolescent health variables were included as outcome measures. These included the Perceived Stress Scale, three Eating Disorders Inventory subscales (drive for thinness, body dissatisfaction, and bulimia), number of days of alcohol and tobacco consumption, and engaging in extreme weight control behaviors (e.g., self-induced vomiting). More frequent family meals in the first 3 study years predicted greater family cohesion and problem- and emotion-focused coping in Years 7 and 8. Family cohesion mediated family meals and risk of smoking in Year 10. Problem-focused coping mediated family meals and both stress and disordered eating-related attitudes and behaviors in Year 10. Eating together as a family during childhood may have multiple benefits in later years.
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What Mediates the Relationship Between Family Meals and Adolescent
Health Issues?
Debra L. Franko
Northeastern University
Douglas Thompson
Maryland Medical Research Institute
Sandra G. Affenito
St. Joseph College
Bruce A. Barton
Maryland Medical Research Institute
Ruth H. Striegel-Moore
Wesleyan University
Objective: To determine whether the frequency of family meals in childhood is associated with positive
health outcomes in adolescence through the mediating links of increased family cohesion and positive
coping skills. Design: Data were obtained from the National Heart, Lung, and Blood Institute Growth and
Health Study (NGHS), a 10-year longitudinal study of 2,379 black and white girls assessed annually from
ages 9 –19. The mediational analysis framework of H. C. Kraemer and colleagues (2001) was used to test
the hypothesis that the frequency of family meals in childhood (Study Years 1 and 3) would be related
to health outcomes (Study Year 10) through the mediating links of family cohesion and coping skills
(Study Years 7/8), after adjusting for baseline (Year 1) demographics as well as previous levels of the
outcome variables (Years 5/6). Main Outcome Measures: Several measures of adolescent health
variables were included as outcome measures. These included the Perceived Stress Scale, three Eating
Disorders Inventory subscales (drive for thinness, body dissatisfaction, and bulimia), number of days of
alcohol and tobacco consumption, and engaging in extreme weight control behaviors (e.g., self-induced
vomiting). Results: More frequent family meals in the first 3 study years predicted greater family
cohesion and problem- and emotion-focused coping in Years 7 and 8. Family cohesion mediated family
meals and risk of smoking in Year 10. Problem-focused coping mediated family meals and both stress
and disordered eating-related attitudes and behaviors in Year 10. Conclusion: Eating together as a family
during childhood may have multiple benefits in later years.
Keywords: family meals, adolescence, adolescent health, smoking, disordered eating, stress
Familial variables are known to influence child and adolescent
health concerns, including nutrition, physical activity, and sub-
stance use (Kiesner & Kerr, 2004; Resnick, Harris, & Blum, 1993).
Eating together as a family (“family meals”) may be one compo-
nent of family life associated with positive health outcomes. More
specifically, investigators have found that frequent family meals
are associated with better nutrition and reduced risk of unhealthy
weight control behaviors, substance use, teenage sexual inter-
course, and suicidal risk (Borowsky, Ireland, & Resnick, 2001;
Fulkerson et al., 2006; Kingon & O’Sullivan, 2001; Neumark-
Sztainer, Hannan, Story, Croll, & Perry, 2003; Tepper, 1999).
Taveras and colleagues (Taveras et al., 2005) reported that eating
dinner together as a family was related to overweight prevalence at
study entry but was not associated in longitudinal analyses of their
data. In a single-wave survey of 4,746 middle and high school
students (ages 11–18), frequency of family meals was evaluated by
asking how many times over the previous 7 days did all or most of
the family eat a meal together. After controlling for factors including
family connectedness and demographics, girls reporting more fre-
quent family meals exhibited reduced substance use (cigarettes, alco-
hol, and marijuana), higher grade point average, fewer depressive
symptoms, and decreased risk of a suicide attempt (Eisenberg, Olson,
Debra L. Franko, Department of Counseling and Applied Educational
Psychology, Northeastern University; Douglas Thompson and Bruce A. Bar-
ton, Maryland Medical Research Institute, Baltimore, Maryland; Sandra G.
Affenito, St. Joseph College; Ruth H. Striegel-Moore, Wesleyan University.
This research was supported by a grant from the National Heart, Lung, and
Blood Institute (NHLBI; HL/DK71122) and contract HC55023-26 and coop-
erative agreement U01-HL-48941-44. Participating NGHS centers included
the following: Children’s Medical Center, Cincinnati, Ohio: Stephen R.
Daniels, MD, (principal investigator) and John A. Morrison, PhD (co-
investigator); Westat, Inc., Rockville, Maryland: George B. Schreiber, ScD
(principal investigator) and Ruth Striegel-Moore, PhD (co-investigator); and
University of California, Berkeley, California: Zak I. Sabry, PhD (principal
investigator) and Patricia B. Crawford, DrPH, RD (co-investigator). Maryland
Medical Research Institute, Baltimore, Maryland (Bruce A. Barton, PhD,
principal investigator) served as the data coordinating center. Program office
was NHLBI: Eva Obarzanek, PhD, MPH, RD (project officer 1992-2007) and
Gerald H. Payne, MD (project officer 1985–1991).
We acknowledge with gratitude the long-term commitment of all NGHS
participants and their families who contributed to this study and the NGHS
study personnel for their dedication to the project.
Correspondence concerning this article should be addressed to Debra L.
Franko, Department of Counseling and Applied Educational Psychology,
Northeastern University, 203 Lake Hall, Boston, MA 02115-5000. E-mail:
d.franko@neu.edu
Health Psychology Copyright 2008 by the American Psychological Association
2008, Vol. 27, No. 2(Suppl.), S109–S117 0278-6133/08/$12.00 DOI: 10.1037/0278-6133.27.2(Suppl.).S109
S109
This document is copyrighted by the American Psychological Association or one of its allied publishers.
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... Previous studies on the association between family meals and smoking have predominantly focused on adolescents, both domestically and internationally. Cohort studies conducted by the National Heart, Lung, and Blood Institute in the United States and studies on Minnesota adolescents indicated that dining with family members increases the sense of kinship within the family and ultimately inhibits smoking behavior through the structure and flow of family dynamics [21][22][23]. Moreover, based on data like the National Longitudinal Survey of Youth in the U.S., studies have analyzed the correlation between the frequency of family meals among adolescents and smoking [24]. ...
... When considering individuals who had meals with their families as the reference category, both genders showed a linear increase in the ORs for current smoking status as the frequency of shared meals decreased ( Figure 2 presents the analysis of the association between having a meal with family and current smoking status as well as past smoking experience, types of tobacco products used, and smoking cessation attempts or plans among people who currently smoke. Generally, when not having a meal with family, people who currently smoke had higher ORs than people who previously smoked (male: OR 1. 21 ...
Association between having a meal together with family and smoking: a cross-sectional nationwide survey
Article
Full-text available
  • Nov 2023
  • BMC PUBLIC HEALTH
Background Smoking is a major risk factor that significantly affects public health. Although the South Korean government spends significant money on smoking cessation services, the smoking rate remains stagnant. Families influence health-conscious decisions, and family meals can positively affect smoking suppression and health behaviors. Therefore, this study investigated whether family meals are correlated with adults’ smoking behaviors. Methods This study used data from the 2019–2021 Korean National Health and Nutrition Examination Survey. Having a meal together with family was defined as “yes” for those who have at least one meal with their family each day and “no” for those who do not. Current smoking status was classified as having smoked at least 5 packs of cigarettes (100 cigarettes) in one’s lifetime and having used either conventional cigarettes or e-cigarettes in the last 30 days. Multiple logistic regression analyses were used to examine the association between eating together, smoking, and weight application. Results When comparing the group that ate with their family compared to the group that did not, the odds ratio for current smoking status was 1.27 (95% confidence interval [CI]: 1.05–1.54) for male participants and 1.90 (95% CI: 1.33–2.71) for female participants. This showed a dose-dependent effect according to the frequency of family meals. Those who smoked conventional cigarettes had a strong association (men: OR 1.28, 95% CI 1.00–1.67; women: OR 2.22, 95% CI 1.42–3.46). However, those who only vaped e-cigarettes or used both conventional cigarettes and e-cigarettes had no statistically significant correlations. Conclusion This study provides evidence suggesting that eating meals as a family is related to smoking behavior and can positively affect smoking cessation intentions in adults. Consequently, a smoking cessation program can be developed that uses social support, such as encouraging family meals.
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... While some studies have examined the association between family meals and depression [18e20], anxiety [21e23] or stress [24,25], no study has examined the association between social eating behaviour and these outcomes in adolescents. Although they are closely related, there are important differences between family meals and social eating behaviour [13]. ...
... Concerning stress symptoms, we found that higher social eating behaviour was inversely related to this condition. This result seems to agree with a previous study among 2379 adolescent girls, which indicated that family meals can offer the opportunity to see the parents' model of positive coping through problem-focused coping, learning healthier coping strategies to deal with social pressure and thus reducing stress symptoms [24]. To cope with stress, adolescents may seek support from family or friends more often than emotional venting or withdrawal. ...
Are family meals and social eating behaviour associated with depression, anxiety, and stress in adolescents?
Article
Full-text available
  • Feb 2023
  • CLIN NUTR
Objective This study examined the association between family meals and social eating behaviour with depression, anxiety and stress symptoms among Spanish adolescents. Methods This was a cross-sectional study with data obtained from a representative sample of adolescents aged 12 to 17 years from Valle de Ricote, Murcia, Spain. Emotional symptomatology was evaluated with the Depression, Anxiety and Stress Scale. The frequency of family meals and social eating behaviour were self-reported. Results Each additional point in social eating behaviour decreased the probability of having a higher number of depressive (OR=0.83; 95%CI, 0.75−0.92), anxiety (OR=0.88; 95%CI, 0.80−0.97) and stress (OR=0.90; 95%CI, 0.82−0.99) symptoms. Conclusions Higher social eating behaviour was associated with lower probabilities of higher number of depressive, anxiety and stress symptoms.
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... For example, a family might have a dinner routine that includes going around the table with each family member describing his or her "high and low" for the day. This serves as an opportunity for family members to provide emotional support and encouragement, which are protective processes in the family emotion system (see Franko, Thompson, Affenito, Barton, & Striegel-Moore, 2008). Families might routinely attend members' extracurricular activities (e.g., concerts, sporting events), which would show commitment to the family member participating in the activity as well as encouraging the family to interact together outside the home (Barge & Loges, 2003). ...
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... Desde el inicio de la historia de la humanidad, las reuniones alrededor del fuego o de la mesa para compartir alimentos han sido un ritual central en la vida diaria de los individuos y una práctica familiar por excelencia (Beltrán & Cuadrado, 2014;Chang et al., 2020;Huergo, 2016;Moreno & Galiano, 2006). Comer en familia representa la forma más antigua de interacción familiar, un medio para fortalecer la cohesión, la identidad y los vínculos familiares (Beltrán & Cuadrado, 2014;Brown et al., 2016;Fiese et al., 2006;Franko et al., 2008;Fruh et al., 2011;Larson et al., 2006;Moreno & Galiano, 2006;Prior & Limbert, 2013) y una actividad fundamental para potenciar y facilitar las conexiones sociales, la comunicación humana y familiar (Beltrán & Cuadrado, 2014;De la Torre-Moral et al., 2021;Larson et al., 2006;Middleton et al., 2020;Offer, 2013;Prior & Limbert, 2013;Skeer & Ballard, 2013;Story & Neumark-Sztainer, 2005). ...
Comer en familia: su relación con la comunicación familiar y la agresividad de los adolescentes
Article
  • Mar 2023
La sociedad postmoderna ha transformado muchas conductas familiares, entre ellas, la comunicación familiar y el hábito de comer en familia, práctica que ha disminuido en España en las últimas décadas, al tiempo que han aumentado la agresividad y las conductas violentas en adolescentes. El objetivo principal de este trabajo fue determinar la relación de la frecuencia de comidas en familia con la comunicación familiar y con la agresividad en población adolescente. Participaron 1117 adolescentes (51.1% mujeres y 48.9% varones), entre 14 y 18 años (M = 16.20; DT = 1.31), procedentes de 23 centros educativos, 10 grados universitarios y 18 centros específicos de menores de Castilla y León (España). Se utilizó el Cuestionario de Agresividad de Buss y Perry (BPAQ) y la Escala de Comunicación Familiar (FCS). Los resultados muestran que la ausencia de comidas en familia está asociada con un descenso de la comunicación familiar y un aumento de la agresividad física, la ira y la hostilidad del adolescente. Si comer en familia va acompañado de comunicación familiar, una mayor frecuencia de comidas en familia se relaciona con una disminución de las tres dimensiones mencionadas de la agresividad. Sin embargo, si se deja al margen la influencia de la comunicación familiar, comer frecuentemente en familia se relaciona con una reducción de la agresividad (física, ira y hostilidad), pero comer siempre en familia está asociado con un nuevo incremento de la agresividad física y hostilidad. Los hallazgos revelan la importancia de potenciar las comidas en familia y la comunicación familiar.
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... Additionally, results from a large, prospective study of children (approximately aged 4 years at baseline and 8 years at follow-up) indicated that frequent family meals were associated with better diet quality (Mou et al., 2021). Although the protective effects of family meals for youth development may be attributed to a range of factors, including the nutritional quality of family meals, the structure and routine that family meals provide, opportunities afforded for positive food parenting, family connection, cohesion, and scaffolding of adaptive coping strategies (Fiese & Bost, 2016;Franko et al., 2008;Hammons & Fiese, 2011), family meal atmosphere appears to play an integral role. For example, chaos, distractions, and negative interpersonal interactions during family meals may undermine potential benefits, whereas positive communication and interactions may promote better psychological and physical health outcomes for youth, including less engagement in disordered eating (Berge et al., 2014;Fiese & Bost, 2016;Loth et al., 2015;Neumark-Sztainer et al., 2004). ...
Spillover From Parent Stress to Family Meals Among Diverse Families: An Ecological Momentary Assessment Study
Article
Full-text available
  • Feb 2024
Family meals are beneficial for youth healthy development. However, parents’ experiences of daily stressors may hinder their capacity to facilitate family meals, serve healthful foods, and have implications for the family meal atmosphere. Using data from ecological momentary assessment, we examined whether family meals are less likely to occur, meals are less healthful, and meal atmosphere is less positive on days when parents experience higher-than-usual stress and whether coparenting support buffers these associations. We also explored the role of family stressors in these links. Participants were 497 parents (Mage = 35.86 years; 91% female) of 5- to 9-year-old children who identified as Asian (15%), Black (17%), Hispanic (10%), Native American (10%), Native Hawaiian (<1%), White (38%), multiracial (8%), or other (<1%). Results from multilevel models indicated that daily deviations in parents’ stress levels were not correlated with family meal occurrence, healthfulness, or positive atmosphere. However, on days when the source of parents’ stress was family related (e.g., family demands), odds of a positive meal atmosphere were significantly lower (OR = 0.92, 95% CI [0.88, 0.96]), adjusting for other sources of stress. Coparenting relationship quality was positively associated with family meal occurrence (OR = 1.34, 95% CI [1.01, 1.79]) and healthfulness (γ = 0.20, p < .001), however, it did not moderate links between stress and family meal occurrence, healthfulness, or atmosphere. Findings suggest that day-to-day fluctuations in parents’ stress levels may not disrupt whether a family meal occurs, the healthfulness of foods served, or the atmosphere of family meals. However, family stressors and coparenting relationship quality merit investigation as potential intervention targets.
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... Family dinners have been associated with a lowered risk for eating unhealthy foods [49,50], lower rates of obesity [51], better academic performance [52], and fewer behavioral problems in children [53], among other benefits. However, the health benefits of family meals may be mediated by more unified families, better communication during mealtimes [54], parenting styles [25,47], or children's temperament [55]. Thus, creating a constructive or positive atmosphere at home may be challenging for families of children with ND [29]. ...
Changes in Eating Behaviors Following Taste Education Intervention: Focusing on Children with and without Neurodevelopmental Disorders and Their Families: A Randomized Controlled Trial
Article
Full-text available
  • Sep 2022
Fussy-eating children often display problematic behaviors around mealtimes, such as irritation, opposition, or may even throw tantrums. This may lead to reduced food variety and poor nutritional profiles, which may increase parents’ worries about their children’s diet, particularly when the children also have neurodevelopmental disorders (ND) such as Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactive Disorder (ADHD). To investigate the effect of Taste Education on problematic mealtime behaviors, 81 children aged 8–12 years, with ND (n = 33) and without (n = 48), and their parents, participated in a 7-week Taste Education intervention. Children were matched on age, sex, and ND, and allocated at random into Immediate-intervention and Delayed-intervention groups. Parents completed the Meals in Our Household Questionnaire (MiOH). To examine changes in MiOH-scores, repeated-measures analysis-of-variance with time-points were used, with condition as factors (Immediate intervention and Delayed intervention). Baseline measures were adjusted for, and a robust linear mixed-model was fitted. Results showed superior outcomes for Intervention compared to waiting on all measures of MiOH, with stable effects through six-month follow-up. Differences were non-significant between children with and without ND. The Taste Education program suggests a promising, simple, and non-intrusive way to reduce children’s problematic mealtime behaviors in the long term.
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... Family meal frequency was also related to family functioning [13], family communication, and level of family satisfaction [14]. A longitudinal study of family meal frequency and family cohesion targeting children from school-age through adolescence showed that family meal frequency was a predictor of increasing family cohesion [15]. ...
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... 2,6 Home food availability has been associated with better child and adolescent eating outcomes. 7 In addition, a number of indices related to family meals, including family meal frequency, [8][9][10][11] regularly serving foods such as milk or vegetables during family meals, 12,13 a positive family mealtime environment, 14 and meals occurring in the absence of television watching, 15,16 have also been associated with positive child and adolescent eating outcomes. Thus, consistent relationships between the home food and meal environment and child eating behaviors have been reported. ...
Intuitive Eating Among Parents: Associations with the Home Food and Meal Environment
Article
  • Jan 2022
Background Mothers and fathers have roles in shaping the eating behaviors of young children and the intergenerational transmission of eating attitudes. However, little is known regarding how parental intuitive eating practices are related to characteristics of home food and meal environments. Objective To investigate the relationship between parental intuitive eating and the home food and meal environment. Design Cross-sectional analysis of survey data collected online and by mail in 2015-2016 as part of the Project EAT cohort study. Participants and Setting Participants from 750 unique households (470 mothers, 280 fathers) were surveyed in young adulthood (Mean (M)age=31.4 years, Standard Deviation (SD) = 1.5). Baseline enrollment of participants in the population-based, Project EAT study was conducted in Minneapolis-St. Paul, Minnesota schools. Main Outcome Measures Intuitive eating was assessed via self-report. Statistical Analyses Modified Poisson regression models were conducted, adjusting for age, race/ethnicity, and socioeconomic status. Results Among mothers, higher intuitive eating scores were associated with greater likelihood of usually having fruits and vegetables in the home (prevalence ratio (PR) = 1.03) and with lower likelihood of usually having salty snacks and soda pop in the home (PR = 0.91). Higher intuitive eating scores were also associated with greater likelihood of usually serving fruits and vegetables at dinner among mothers (PR = 1.07). Among both mothers (PR = 1.08) and fathers (PR = 1.07), higher intuitive eating scores were associated with greater likelihood of usually having enough time and energy to prepare meals. Conclusions Intuitive eating practices in parents are associated with specific home food environment characteristics. Extending the understanding of these relationships in longitudinal data has the potential to inform the directionality of influences and may help to identify targets for intervention.
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Social Environment and Food and Beverage Intake in European Adolescents: The Helena Study
Article
  • Apr 2022
  • J AM DIET ASSOC
Background: The family environment influences food consumption and behaviours, which impact adolescent's eating habits, diet and health. Young individuals who frequently eat family meals are less likely to develop risk- and behaviour-related outcomes as obesity. Aim: To assess the relationship between the family meal environment and food and macronutrient consumption in European adolescents. Methods: 1,703 adolescents aged 12.5-17.5 years (46.5% male) from the European HELENA cross-sectional study were selected. Sociodemographic variables and dietary intake using two non-consecutive self-reported 24-hour dietary recalls were collected from all the included participants. The relationship between family meals' environment and food and macronutrient consumption was analized using analysis of covariance. Results: Adolescents who used to take their main meals with their family were associated with high consumption of healthy foods and beverages (i.e. vegetables, fruit, milk, water) and low consumption of energy dense food and beverages as chocolate, savoury snacks, sugar or juices compared with those who used to eat alone, with friends or other people (p < 0.05). Conclusion: The company/people with whom adolescents consume their meal have an important influence on the adolescent's consumption of different types of food (especially at lunch). Family's environment during meals has been associated with a high consumption of healthy foods.
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Pathways of parental influence on adolescent diet and obesity: a psychological stress–focused perspective
Article
  • Feb 2022
Youth obesity has become increasingly prevalent, with 34.5% of US adolescents 12–19 years old estimated to have overweight or obesity. Disordered eating and weight concern peak in adolescence, and overeating to cope with negative emotions can affect long-term health and obesity risk. Parents significantly influence adolescent diet quality, and parental stress may influence parenting behaviors that increase the risk for stress-motivated eating and obesity in adolescents. Chronic or repeated exposure to parental stress may lead to stress-related neurophysiological changes that promote consumption of palatable foods and obesogenic eating habits in adolescents. Understanding how parental stress influences adolescents’ eating behavior may reveal novel access points for reducing adolescent obesity. Here, we aim to provide a new stress-focused framework for developing intervention strategies targeted at obesity prevention in adolescents.
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A comparison of methods to test the mediation and other intervening variable effects
Article
Full-text available
  • Jan 2002
  • PSYCHOL METHODS
A Monte Carlo study compared 14 methods to test the statistical significance of the intervening variable effect. An intervening variable (mediator) transmits the effect of an independent variable to a dependent variable. The commonly used R. M. Baron and D. A. Kenny (1986) approach has low statistical power. Two methods based on the distribution of the product and 2 difference-in-coefficients methods have the most accurate Type I error rates and greatest statistical power except in 1 important case in which Type I error rates are too high. The best balance of Type I error and statistical power across all cases is the test of the joint significance of the two effects comprising the intervening variable effect.
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Predictors of eating disorder scores in children ages 6 through 14
Article
Full-text available
  • Sep 2000
  • J PSYCHOSOM RES
The objective of this study was to identify variables that predict higher eating disorder scores in non-clinical boys and girls ages 6 through 14. Two hundred sixteen children participated and were tested annually for 3 years. A TV–video procedure was used to measure the accuracy of body size judgments. Variables examined included demographic, familial, sociocultural, social, esteem, and clinical variables. Predictors of higher eating disorder scores for both sexes included height and weight, children's perceptions of parental concerns about their body size, low body esteem, and depression. For girls only, a larger perceived body size and smaller idealized body size were also predictors. Teasing was a predictor for boys only. An analysis of longitudinal changes suggests that low body esteem becomes a significant factor around age 9, depression emerges as a predictor at age 10, and body size judgments in perceived and ideal sizes at ages 11 and 12. Changes over 2 years in individuals' weight and height, teasing, body dissatisfaction, and eating disorder scores were also found to predict higher eating disorder scores.
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Effects of coping style and negative body image on eating disturbance
Article
  • Jul 1997
  • INT J EAT DISORDER
Objective Relationships among coping strategies, negative body image, and eating disturbance were studied. Method: Subjects were 128 college women; measures included the Eating Attitudes Test (EAT‐26), the Coping Inventory for Stressful Situations (CISS), and three indices of negative body image. Results: Higher use of both emotion‐oriented coping and avoidance‐oriented coping via distraction was associated with higher EAT scores; higher use of emotion‐oriented coping also was associated with more negative body image. Findings agree with data associating these coping styles with other measures of psychological distress and psychopathology. Task‐oriented coping also was high, but unrelated to negative body image or eating disturbance. Hierarchical regression analysis yielded a significant interaction between emotion‐oriented coping and negative body image: The higher the use of emotion‐oriented coping, the less the level of negative body image appeared to affect EAT score. Discussion: Both the main effect for coping and the interaction suggest that high use of emotion‐oriented coping should be considered a risk factor for eating disturbance. © 1997 by John Wiley & Sons, Inc. Int J Eat Disord 22: 51–56, 1997.
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Self-Complexity and Health Promotion: Promising but Premature
Article
  • Jun 1990
Self-complexity, the number of nonredundant aspects by which the self is cognitively represented, was reported in 1987 by Linville to function as a buffer against the adverse consequences of stress under conditions of high stress. An attempt was made to increase the self-complexity of 110 undergraduates through the use of psychoeducational interventions, with the goal of decreasing physical symptoms. None of four interventions produced an increase in self-complexity or a decrease in physical symptoms. Using multiple regression, the previously reported buffering interaction was evident only among those experiencing the strongest intervention, and Linville's results were not replicated when the entire data set was analyzed. The hypothesis of a relationship between self-complexity and individuals' sense of meaning and purpose in life was not corroborated by correlational analysis. It is concluded that the relationship between self-complexity and health remains intriguing but inadequately tested.
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Development and validation of a multidimensional eating disorder inventory for anorexia nervosa and bulimia
Article
  • Jan 1982
The development and validation of a new measure, the Eating Disorder Inventory (EDI) is described. The EDI is a 64 item, self-report, multiscale measure designed for the assessment of psychological and behavioral traits common in anorexia nervosa (AN) and bulimia. The EDI consists of eight subscales measuring: Drive for Thinness, Bilimia, Body Dissatisfaction, Ineffectiveness, Perfectionism, Interpersonal Distrust, Interoceptive Awareness and Maturity Fears. Reliability (internal consistency) is established for all subscales and several indices of validity are presented. First, AN patients (N=113) are differentiated from femal comparison (FC) subjects (N=577) using a cross-validation procedure. Secondly, patient self-report subscale scores agree with clinician ratings of subscale traits. Thirdly, clinically recovered AN patients score similarly to FCs on all subscales. Finally, convergent and discriminant validity are established for subscales. The EDI was also administered to groups of normal weight bulimic women, obese, and normal weight but formerly obese women, as well as a male comparison group. Group differences are reported and the potential utility of the EDI is discussed.
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Test-retest reliability of the Eating Disorder Inventory
Article
  • Nov 1987
  • INT J EAT DISORDER
The Eating Disorder Inventory (EDI) has been demonstrated to have high internal consistency in the form of split-half reliability. Demonstration of stability in the form of test-retest reliability has been absent. Test-retest reliability for the EDI was obtained with a sample of 70 university undergraduates. Test-retest reliability was also obtained with a restricted group drawn from the original sample who were considered to be at risk on the basis of their EDI scores. The interval between test administrations was 3 weeks. With both samples, test-retest reliability of the total EDI score was exceptionally high. Test-retest reliability for the eight subscales was, with one exception, within the usual range of acceptability.
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