Obligatory exercise and coping in treatment-seeking women with poor body image.

PURPOSE: Obligatory exercise is characterized by continued exercise despite negative consequences, and intense negative affect when unable to exercise. Research suggests psychosocial differences between individuals that exercise in an obligatory manner and those that do not. It also has been speculated that obligatory exercise may serve coping and affect regulation functions, yet these factors have not been routinely examined in community women with poor body image. The purpose of the current study was to investigate psychosocial differences between obligatory and non-obligatory exercisers, and to examine the use of obligatory exercise as an avoidant coping strategy in a sample of women with poor body image. METHODS: Women (n = 70) seeking treatment for body dissatisfaction were divided into obligatory and non-obligatory exercise groups based on their scores on the Obligatory Exercise Questionnaire. Participants then completed an assessment battery about eating pathology, body image, reasons for exercise, coping strategies, and negative affect. RESULTS: Independent t test analyses indicated that obligatory exercisers had significantly greater eating disorder symptomatology, avoidant coping, and appearance- and mood-related reasons for exercise than non-obligatory exercisers. Multiple regression analyses revealed that eating disorder symptomatology and avoidant coping were significant predictors of obligatory exercise. CONCLUSIONS: There are distinct psychosocial differences between women with poor body image who exercise in an obligatory fashion and those who do not. The current study suggests that obligatory exercise may serve as an avoidant coping strategy for women with poor body image. Enhancing healthy coping strategies may be an important addition to body image improvement programs. LEVEL OF EVIDENCE: V, cross-sectional descriptive study.

Can the Theory of Planned Behavior predict dietary intention and future dieting in an ethnically diverse sample of overweight and obese veterans attending medical clinics?

Obesity has become a world-wide epidemic; in the United States (U.S.) approximately two-thirds of adults are classified as overweight or obese. Military veterans' numbers are even higher, with 77% of retired or discharged U.S. veterans falling in these weight categories. One of the most common methods of changing one's weight is through dieting, yet little is known regarding the factors that facilitate successful dieting behavior. The current investigation tested the Theory of Planned Behavior's (TPB) ability to predict dietary intention and future dieting in a sample of 84 overweight and obese patients attending medical clinics at a Veterans Affairs Hospital in the southwestern part of the U.S. Participants primarily were male (92%) and ethnic/racial minorities (58%). Perceived need and anticipated regret were added to the standard TPB model. While the TPB predicted dietary intention, it did not significantly account for improved dietary behaviors. Anticipated regret significantly enhanced the basic TPB's ability to predict intention to diet, while perceived need did not. These findings highlight the difficulty in predicting sustained change in a complex behavior such as dieting to lose weight. The need for more work with older, overweight/obese medical patients attending veterans' facilities is stressed, as is the need for such work with male patients and ethnic minorities in particular.

Testing the measurement invariance of the Eating Disorder Inventory in nonclinical samples of Hispanic and Caucasian women.

OBJECTIVE: The factor structure of the Eating Disorder Inventory (EDI) has not been thoroughly tested in Hispanic populations, yet researchers commonly use this instrument in Hispanic samples. Thus, it is important to establish the validity of the EDI in Hispanic populations. This article investigated measurement invariance of the EDI's three eating- and weight-related (eat/wt) scales because they are the most frequently used and are often used in isolation. These scales include Drive for Thinness, Bulimia, and Body Dissatisfaction. METHOD: Female undergraduates were recruited for a study on body image. The final sample (N = 688) included participants categorized as Hispanic (N = 385) or Caucasian (N = 303). They completed the EDI-3 and a measure of acculturation. RESULTS: Measurement invariance analyses of the EDI-3 in Caucasian and Hispanic samples were conducted. The configural model provided an acceptable fit, providing support for the three-factor structure of the eat/wt scales in both the Caucasian and the Hispanic sample. However, weak invariance of the three-factor structure was not supported. When measurement invariance analyses were conducted on the three eat/wt scales separately, Drive for Thinness was the only scale to demonstrate measurement invariance. DISCUSSION: The theoretical three-factor structure of the EDI eat/wt scales was supported in both ethnic groups. Furthermore, the Drive for Thinness scale can readily be used to make group comparisons across nonclinical samples of Caucasian and Hispanic women, but researchers should be cautious when using the other two eat/wt scales to make comparisons across these two groups.

Measurement invariance of the Eating Attitudes Test-26 in Caucasian and Hispanic women.

To determine whether the EAT-26 functions similarly in Caucasian and Hispanic samples, the current study investigated the factor structure of the Eating Attitudes Test (EAT-26) in 235 undergraduate Caucasian (53.6%) and Hispanic (46.4%) women, and tested for measurement invariance across the two samples. A Confirmatory Factor Analysis (CFA) of the original 3-factor structure of the EAT resulted in a poor fit in both the Caucasian and Hispanic samples. We then performed a CFA using a previously discovered 4-factor, 16-item structure. This abbreviated measure was a good fit in both the Caucasian and Hispanic samples, and the model was invariant across all dimensions tested. The 16-item EAT is a better-fitting measure in Caucasian and Hispanic women than the commonly used EAT-26. This replicates an earlier finding and generalizes those conclusions to a Hispanic sample.

The Community Reinforcement Approach.

This chapter reviews two behavioral substance abuse treatments: The Community Reinforcement Approach (CRA) and Community Reinforcement and Family Training (CRAFT). Both of these programs were built on the concept that an individual's recovery is greatly affected by his or her unique environment. This environment, or reinforcing "community," is composed of family, friends, work/school, social activities, and perhaps spiritual affiliations. CRA, the first of these two programs to be developed, was created specifically for the problem drinker (Hunt & Azrin, 1973). The goal of CRA is to rearrange multiple aspects of an individual's "community" so that a clean and sober lifestyle is more rewarding than one that is dominated by alcohol and drugs. Subsequently, CRAFT was developed for the many individuals with substance abuse problems who are vehemently opposed to treatment (Institute of Medicine, 1990). CRAFT works through concerned family members and friends of these treatment refusers in an effort to get them to seek therapy (Sisson & Azrin, 1986). Descriptions and the empirical support for CRA and CRAFT follow.