پرخوری و پریشانی روانی در مردان و زنان در مقطع کارشناسی با تنوع قومی فراوان

Binge eating symptomatology affects African Americans and Caucasians at similar rates. Moreover, compared to anorexia nervosa (AN) and bulimia nervosa (BN), binge eating and BED are more evenly distributed across genders. Undergraduates are likely to be affected by binge eating, yet, relatively few studies have investigated this behavior and its correlates in college samples. This study examined the influence of alexithymia, depression, and anxiety on binge eating among ethnically diverse undergraduates. Results indicated that these variables significantly predicted eating symptomatology among Caucasian and African American women but not among Caucasian men. Further, among Caucasian women, depression was the only unique predictor of eating pathology. In contrast, anxiety was the only unique predictor of disordered eating in African American women. There were no differences between Caucasians and African Americans in severity of disordered eating symptomatology; however, in both ethnic groups, women reported greater eating pathology than men. Eating disorders of all types may be more prevalent among African American undergraduates than previously thought. These results highlight the need to study binge eating and its correlates in this traditionally underserved group.

1.1. Binge eating, obesity, and young adults Binge eating has recently been the focus of significant research attention, in part because of its association with obesity (e.g., Fairburn et al., 1998 and Mussell et al., 1995). Rates of obesity in Western society have increased dramatically in recent years (e.g., Mokdad et al., 2001 and Mokdad et al., 1999), and more than half the U.S. population is currently overweight (i.e., has a body mass index (BMI)≥25, Flegal, Carroll, Kuczmarski, & Johnson, 1998). Moreover, rates of obesity are increasing faster among 18- to 29-year-olds than among all other adult age groups (Mokdad et al., 1999). One of the few studies to investigate binge eating among college women (Vanderlinden, Dalle Grave, Vandereycken, & Noorduin, 2001) found that 41% of participants reported binge eating, and 15% binged daily. Yet, despite these data, as well as research suggesting that binge eating typically begins in early adulthood (e.g., Mussell et al., 1995), few studies have examined binge eating within college samples Vanderlinden et al., 2001 and Womble et al., 2001. Additional investigations of the prevalence and correlates of binge eating symptomatology among college students could lead to earlier identification of this behavior, which, in turn, could help prevent obesity and the chronic health problems associated with it American Psychiatric Association, 2000 and Must et al., 1999. 1.2. Binge eating symptomatology among African American women There is also an especially urgent need for additional investigations of the correlates of binge eating in ethnically diverse groups Johnson et al., 2002, Pike et al., 2001, Smith et al., 1998 and Striegel-Moore et al., 2000. In particular, African Americans have higher rates of obesity and associated physical complications than Caucasians (e.g., Melnyk & Weinstein, 1994 and Pi-Sunyer, 2002). Beginning in early childhood, African Americans are more likely than their Caucasian peers to be overweight (Ogden, Flegel, Carroll, & Johnson, 1997), and these ethnic differences persist into adulthood for African American women (e.g., Flegal et al., 1998). Yet, although these BMI disparities are well documented, eating problems among African American women remain understudied. Most extant eating disorder research has focused on Caucasian women, who manifest higher rates of anorexia nervosa (AN) and bulimia nervosa (BN; American Psychiatric Association, 2000). Preliminary evidence suggests that rates of binge eating and BED are similar among Caucasians and African Americans Cachelin et al., 2000, le Grange et al., 1997, Mulholland & Mintz, 2001 and Smith et al., 1998. Several authors have hypothesized that African American women might be particularly susceptible to binge eating due to cultural differences between African Americans and Caucasians in body image satisfaction Cachelin et al., 2000, Flegal et al., 1998, Melnyk & Weinstein, 1994 and Smolak & Striegel-Moore, 2001. Specifically, although African American women typically have greater BMIs than their Caucasian counterparts Cachelin et al., 2000, Striegel-Moore et al., 2000 and Striegel-Moore et al., 2000, they are generally more satisfied with their bodies (e.g., Baskin et al., 2001 and Striegel-Moore et al., 2000). This acceptance of higher BMIs may decrease African Americans' risk for eating disorders such as AN and BN, which focus on the attainment of an extremely thin body. Conversely, their risk of binge eating and BED may be greater than that of Caucasian women Cachelin et al., 2000 and Striegel-Moore et al., 2000. Two recent community-based studies found support for this hypothesis. In the first study, Striegel-Moore, Wilfley, et al. (2000) found that African American women had higher rates of recurrent binge eating than Caucasian women. Moreover, in both ethnic groups, binge eating was associated with greater psychological distress. Similarly, Pike et al. (2001) found that, compared to Caucasian women, African American women with BED were more likely to be obese and to engage in a greater number of binge episodes per week. However, African American women were less likely to have sought treatment for an eating problem. These results regarding treatment seeking are consistent with those found in previous investigations (e.g., Striegel-Moore, Wilfley, et al., 2000), and suggest that there remains a strong need to study how disordered eating is manifested in nonclinical minority populations. 1.3. Binge eating symptomatology among men Men have also been traditionally understudied by eating disorder researchers. While rates of AN and BN are much lower among men than women, evidence suggests that men and women are equally vulnerable to binge eating and BED (Barry, Grilo, & Masheb, 2002). For example, in a study of 42 men and women meeting DSM-IV criteria for BED, Tanofsky, Wilfley, Spurrell, Welch, and Brownell (1997) found no significant gender differences on measures of eating disturbance. These findings were later supported in a larger study (Barry et al., 2002), which found no gender differences in the frequency of binge eating and eating concerns. Two recent studies have investigated both racial and gender differences in the prevalence of binge eating. Smith et al. (1998) found no differences in BED rates among Caucasian males and Caucasian and African American females in a community sample. Only African American males demonstrated significantly lower rates of BED than the other groups. In contrast, Johnson et al. (2002) found an even higher prevalence of binge eating among boys than girls in their sample of Caucasian and African American adolescents. These mixed results may perhaps be attributable to differences in the average age of the samples; nonetheless, they highlight the need for additional investigation of the prevalence and correlates of binge eating among males. 1.4. Psychological correlates of binge eating symptomatology 1.4.1. Depression and BED symptomatology In addition to its association with obesity (e.g., Fairburn et al., 1998), binge eating is a significant clinical concern because of its positive relationship with psychological distress, particularly depression Bulik et al., 2002, Mussell et al., 1995, Raymond et al., 1995, Smith et al., 1998, Telch & Agras, 1994 and Telch & Stice, 1998. For example, Yanovski, Nelson, Dubbert, and Spitzer (1993) found that participants with BED were more likely to have a lifetime diagnosis of any Axis I disorder, particularly Major Depression, than obese, noneating disordered (NED) controls. Similar results have subsequently been found in a community sample (Telch & Stice, 1998). Both gender and ethnic differences in the association between depression and BED were also found in a community-based study (Smith et al., 1998); Caucasian males with BED manifested higher levels of depressive symptomatology than other subgroups with BED. This result highlights the need for additional research on correlates of binge eating and BED among males. 1.4.2. Anxiety and BED symptomatology Several studies have found an association between BED and anxiety symptomatology in clinical samples (e.g., Antony et al., 1994 and Yanovski et al., 1993). This association has been found in both men and women with BED (Tanofsky et al., 1997). However, although these results suggest that there may be an important association between anxiety and binge eating, this relationship has not been sufficiently explored among diverse ethnic groups, or within younger, college-aged samples. Consequently, anxiety was included in the current study. 1.4.3. Binge eating symptomatology and alexithymia Similarly, although several researchers have identified a significant association between alexithymia, a condition in which an individual has difficulty identifying and describing his or her emotions (Sifneos, 1973), and disordered eating (e.g., de Zwaan et al., 1995, Mazzeo & Espelage, 2002, Schmidt et al., 1993 and Sexton et al., 1998), relatively few studies have investigated alexithymia and binge eating, specifically. Results of one study (de Zwaan et al., 1995) indicated that levels of alexithymia were higher among individuals with BED compared to those without BED. The current study attempted to expand our understanding of the association between alexithymia and binge eating in an ethnically diverse undergraduate sample. 1.5. Overview Although previous research has found that depression, anxiety, and alexithymia are associated with binge eating Antony et al., 1994, Bulik et al., 2002, de Zwaan et al., 1995, Mussell et al., 1995, Raymond et al., 1995, Smith et al., 1998, Tanofsky et al., 1997, Telch & Agras, 1994, Telch & Stice, 1998 and Yanovski et al., 1993, their simultaneous contribution to disordered eating symptomatology has not yet been examined between genders or within an African American college-aged sample. Because this study was somewhat exploratory, no specific hypotheses were proposed regarding the relative contributions of depression, alexithymia, and anxiety to binge eating symptomatology in the groups under investigation. Rather, the purpose of this study was to evaluate potential differences in the relative importance of these variables to disordered eating behaviors in Caucasian and African American men and women. A secondary purpose was to examine differences in the severity of binge eating symptomatology across gender and ethnic groups.