Detection
of high-risk attitudes and behaviors is critical in the goal of preventing
eating disorders. In 1996, the National Eating Disorders Screening Program
(NEDSP) was launched on 409 college campuses across the United States. The
NEDSP reached a diverse student population and used a self-report screening
questionnaire to identify those at risk for eating disorders. NEDSP participants were offered an
opportunity to meet with an on-site counselor to review their responses to the
questionnaire in order to receive a recommendation for what, if any, further
clinical evaluation would be necessary.
Dr. Herzog and his team analyzed
data from 5,435 NEDSP questionnaires for a study of ethnic differences in the
prevalence of eating disorder symptoms and related distress. Questionnaire
items assessed the presence and frequency of restrictive eating, amenorrhea, binge eating, self-induced vomiting, use of laxatives and diuretics, and potentially problematic
exercise behaviors. Three questions were used to measure distress related to
the reported symptoms. Participants were asked to select the best response on
4-point scales ranging from ‘‘never’’ to ‘‘all of the time’’ reflecting the
degree to which eating and weight concerns (a) caused a great deal of distress,
(b) interfered with relationships, and (c) interfered with academic/work
performance.
The frequency of binge
eating, restrictive eating, vomiting, and amenorrhea
did not differ
significantly across ethnic groups. However,
significant between-group differences were found with respect to modes of
purging. Binge correlates (such as eating until uncomfortably full) were
significantly more frequent among Caucasian than African American participants.
Binge eating was the best predictor of distress among Caucasians, African
Americans, and Latinos, whereas vomiting was the best predictor of distress
among Asians. Asian participants who used laxatives were significantly less
likely to receive a recommendation for further evaluation than non-Asian
participants.
The findings suggest
there may be some important differences among ethnic groups in regard to eating
disorder symptoms, symptom-related distress, and likelihood for referral that
merit further investigation. Clinician recognition of this
potential diversity
may enhance culturally competent care for eating disorders.
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