Risk and Maintenance Factors for Eating Pathology: A Meta-Analytic Review by Eric Stice Presented by Catherine Perkins Radford University

Purpose To determine which risk factors for eating pathology have or have not received empirical support. –What is the predictive power of individual risk factors? –Are certain factors more likely to predict vs. maintain eating pathology? –What are the limitations of research regarding eating pathology?

Literature Review Methods –Electronic Sources PsychINFO ( ) MedLine ( ) –Tables of Contents for the Following Journals International Journal of Eating Disorders Journal of Abnormal Psychology Journal of Counseling and Clinical Psychology –Article Bibliographies Studies –136 were found –25 were excluded

Issues to Consider Articles found focused on bulimic symptoms, binge eating, or eating disorder composites Bulimia, anorexia, and binge eating disorders are characterized by different patterns and symptoms Conclusions should be generalized with care to anorexic symptoms

Studies to Include Focused on potential risk and maintenance factors for eating pathology Used only prospective and experimental studies Did not use cross-sectional data or retrospective studies Studies that did not include initial levels of eating pathology were not used Focused on methodologically rigorous studies

Dependent Measures Body Mass Socio-cultural Pressure to be Thin Modeling by Family and Peers Thin-Ideal Internalization Body Dissatisfaction Dieting Negative Affect Perfectionism Early Menarche Impulsivity Non-Established Risk Factors

Potential Moderators Type of Eating Disorder Age of the Individual Possible Substance Abuse Individual risk and maintenance factors combine to form many different patterns in regard to eating pathology Other unknown risk factors

Results (Effect Size r over N/K) * Significant Eating Pathology Increased Eating Pathology Maintain Increase in Body Dis. Pressure to be Thin Increase in Dieting Increase in Negative Affect Body Mass.04* / / 2.16* 6298 / 5.33* 87 / 1.11* 5516 / / 3 Socio-cultural Pressure.12* 4895 / / 1.09* 5820 / 5.07* 5899 / 5.21* 231 / 1 Modeling by family & peers.16* 449 / / / 1 Thin- Idealization.08* / 4.21* 320 / 3.18* 715 / 2.17* 449 / 2.17* 231 / 1 Body Dissatisfaction.13* / 13.30* 218 / 1.26* 1174 / 5.14* 2452 / 4

Results (Effect Size r over N/K) *Significant Eating Pathology Increased Eating Pathology Maintain Increase in Body Dis. Pressure to be Thin Increase in Dieting Increase in Negative Affect Dieting.15* / 9.22* 320 / 2.16* 1255 / 2 Negative Affect.09* / 13.13* 320 / 2 Perfectionism.06* 2860 / 5.22* 72 / 1 Early Menarche.04* 8790 / / / / 1 Impulsivity / 4

Meta-Analysis Conclusions Almost all factors contributed in some way to eating pathology, but the individual effect sizes were generally small. There may be other risk factors for eating pathology that have yet to be discovered (biological factors) Risk factors differ for specific eating disorders Supports the cumulative stressor model –Perfectionism x Body Dissatisfaction x Low Self-Esteem Predictive power of individual risk and maintenance factors is low