Cohort survey of college students’ eating attitudes: interventions for depressive symptoms and stress coping were key factors for preventing bulimia in a subthreshold group

Abstract

BackgroundThe aim of this study was to examine the necessity of early intervention for students with potential bulimia by investigating how the eating attitudes of college students change and examining the relation between bulimic symptoms and depressive symptoms or the ability to cope with stress.MethodsThe study participants were students who entered Hiroshima University in 2014. This study was conducted at two time points: Time-1 in 2014 and Time-2 in 2017. The Eating Attitudes Test-26 (EAT-26), Bulimic Inventory Test, Edinburgh (BITE), Beck Depression Inventory-II (BDI-II), and Coping Inventory for Stressful Situations (CISS) were administered at Times 1 and 2, and the responses were compared between the time points. Next, we compared the BDI-II scores of the BITE improved and worsened groups. In addition, we divided the participants into a clinical group, subthreshold group, and healthy group based on the BITE score at Time-1to compared their depressive symptoms and the ability to cope with stress.ResultsSignificantly higher BITE and BDI-II scores were recorded for both males and females at Time-2 than at Time-1. The BDI-II score at Time-1 was significantly higher in the BITE worsened group than in the BITE improved group. The BDI-II scores at Time-1 were significantly higher for both males and females in the subthreshold group than in the healthy group. Furthermore, significantly higher CISS-T and CISS-E scores were recorded at Time-1 for females in the subthreshold group than for females in the healthy group.ConclusionsBased on these results, intervention for students the subthreshold group is important, and the key to intervention may be to address not only eating behaviors but also depressive symptoms and stress coping.Trial registrationUMIN000029474 Registered 9 October, 2017 (retrospectively).

Changes in Eating Attitudes and Risk for Developing Disordered Eating Behaviors in College Students with Subthreshold Eating Disorders: A Cohort Study

“…EDs are associated with substantial psychological, physical, interpersonal, and social impairment as well as considerable direct and indirect costs [4,5]. Patients with EDs have high dropout rates and limited responses to interventions, and long-term treatment is often required [6][7][8]. Thus, the prevention of EDs is important.…”

“…Stice et al [17] suggested that perceived pressure to be thin, pursuit of the thin-ideal, weight concerns and body dissatisfaction, self-reported dieting, emotional distress, and substance use have consistently been shown to be risk factors for the future onset of ED symptoms. Colleges are the last educational institution that most young adults attend before entering society [6]. Therefore, these institutions present the possibility for early interventions aimed at reducing disordered eating behaviors to prevent the development of EDs in college students.…”

“…Even in the subthreshold group, many students had considerable changes in weight, and most were suffering from depressive states during their time on campus. A lack of campus resources creates a combination of factors that may result in crisis [6,24]. Several studies have indicated that the persistence of depressive symptoms in late adolescents is predictive of subsequent mental health problems [24][25][26].…”