INVESTIGATION OF THE DISEASE-AFFECTING FACTORS IN ADOLESCENTS WITH EATING DISORDERS

Year 2025, Volume: 34 Issue: 2, 230 - 236, 15.08.2025

Sema Bayraktar , Özlem Şensoy , Murat Coşkun , Ayfer Aydın , Ali Karayağmurlu , Gökçe Güldiken , Yahya Esad Özdemir , Emine Ulutaş

https://doi.org/10.34108/eujhs.1550532

Abstract

This study was designed to investigate peer bullying, psychological issues, and dissociative behavior, which are some of the factors that may influence the condition in adolescents with eating disorders. The study consists of persons diagnosed with eating disorders (ED) (n:29) and undiagnosed adolescents (n:52). In collecting the data, the sociodemographic characteristics form, the Eating Attitudes Test (EAT-40) scale, the Peer Bullying Identification Scale, the Strengths and Difficulties Questionnaire (SDQ), and the Adolescent Dissociative Experiences Scale (ADES) were used to provide extensive literature support for the field. Eighty percent of the ED group had anorexia, while twenty percent had bulimia. The eating attitudes of adolescents in the ED group were substantially higher than those in the control group (Z:-3.947, p<0.05). At the same time, the differences in the victim and bully sub-dimensions of the peer bullying identification scale were not statistically significant (p>0.05). The EAT-40 showed a strong positive correlation with the total score of the SDQ and the SDQ-Peer sub-dimension (r:0.700, r:0.642, p<0.01). A substantial correlation was also found between the EAT-40 and the total score of the ADES (r=0.442, p<0.05), although no strong correlation with peer bullying was established. This study highlights the impact of dissociative experiences and behavioral and emotional problems on eating attitudes in adolescents. Factors influencing the severity of the disorder should be considered in the ED treatment. These factors should be considered when establishing treatment protocols for adolescents with eating disorders. Furthermore, health professionals should engage in the treatment by offering awareness training to families.

Keywords

Adolescents , eating problems , emotional problems , peer bullying.

YEME BOZUKLUĞU OLAN ERGENLERDE HASTALIĞI ETKİLEYEN FAKTÖRLERİN ARAŞTIRILMASI

Abstract

Bu çalışma, yeme bozukluğu olan ergenlerde durumu etkileyebilcek faktörler arasında olan akran zorbalığı, ruhsal sorunlar ve dissosiyasyon davranışlarıaraştırmak amacıyla tasarlanmıştır. Bu çalışmayı yeme bozukluğu (YB) tanısı alan (n:29) ve almayan (n:52) ergenler oluşturmuştur. Verilerin toplanmasında sosyodemografik özellikler bilgi formu ve Yeme Tutum Testi (EAT-40) Ölçeği, Akran Zorbalığını Tanımlama Ölçeği, Güçlü Yönler ve Zorluklar Anketi (SDQ) ve Ergen Dissosiyatif Deneyimleri Ölçeği (ADES) alana litertür desteği sağlamak için kullanılmıştır. YB grubunun %80'inde anoreksiya ve %20'sinde blumia vardı. YB grubundaki hastaların yeme tutumları kontrol grubuna göre anlamlı düzeyde yüksek bulunurken (Z:-3.947, p<0.05), akran zorbalığını tanımlama ölçeğinin mağdur ve zorba alt boyutlarında istatistiksel olarak anlamlı değildi (p >0.05). YYT-40'ın SDQ toplam puanı ve SDQ-Akran sorunları alt boyutu ile pozitif yönde yüksek düzeyde korelasyon gösterdiği belirlendi (r:0.700, r:0.642 p<0.01). YYT-40 toplam puanı ile ADES toplam puanı arasında anlamlı bir korelasyon mevcuttu (r=0.442, p<0.05) ve akran zorbalığı ile güçlü bir korelasyon bulunmadı. Çalışma, dissosiyatif deneyimlerin ve davranışsal ve duygusal sorunların ergenlerde yeme tutumları üzerindeki etkisini göstermektedir. Yeme bozukluklarının tedavisinde bozukluğun şiddetini etkileyen faktörler dikkate alınmalıdır. Yeme bozukluğu olan ergenlere yönelik tedavi protokolleri belirlenirken bu faktörler dikkate alınmalıdır. Ayrıca sağlık profesyonellerinin de ailelere farkındalık eğitimleri vererek tedavinin bir parçası olmaları gerekmektedir.

Keywords

Adölesanlar , yeme bozukluğu , duygusal sorunlar , akran zorbalığı.

References

• Diagnostic and statistical manual of mental disorders (5th ed, [DSM-5TM] ed.). American Psychiatric Association. Inc, 2013:90–1 Accessed March 12, 2024.
• Fitzgerald A, Heary C, Kelly C, Nixon E, Shevlin M. Self-efficacy for healthy eating and peer support for unhealthy eating are associated with adolescents’ food intake patterns. Appetite. 2013;63:48-58.doi:10.1016/j.appet.2012.12.011.
• Al-Sheyab NA, Gharaibeh T, Kheirallah K. Relationship between peer pressure and risk of eating disorders among adolescents in Jordan. J Obes.2018;1:1-8. doi:10.1155/2018/7309878.
• Quattropani MC, Geraci A, Lenzo V, Sardella A, SchimmentiA. Failures in reflective functioning, dissociative experiences, and eating disorder: A study on a sample of Italian adolescents. J Child Adolesc Trauma. 2022;15(2):365-374.doi:10.1007/s40653-022-00450-9
• Gander M, Sevecke K, Buchheim A. Eating disorders in adolescence: attachment issues from a developmental perspective. Front Psychol.2015;6:1136-1147. doi:10.3389/fpsyg.2015.01136.
• Copeland WE, Bulik CM, Zucker N, Wolke D, Lereya ST, Costello E J. Is childhood bullying involvement a precursor of eating disorder symptoms? A prospective analysis. Int J Eat Disord. 2015;48(8):1141.doi:10.1002/eat.22459.
• Perzow SE, Petrenko CL, Garrido EF, Combs MD, Culhane SE, Taussig HN. Dissociative symptoms and academic functioning in maltreated children: A preliminary study. J Trauma Dissociation. 2013;14:302-311.doi:10.1080/15299732.2012.736928.
• La Mela C, Maglietta M, Castellini G, Amoroso L,Lucarelli S. Dissociation in eating disorders: relationship between dissociative experiences and binge-eating episodes. Compr Psychiatry. 2010;51(4):393-400.doi:10.1016/j.comppsych.2009.09.008.
• Waller G, Babbs M, Wright F, Potterton C, Meyer C, Leung N. Somatoform dissociation in eating-disordered patients. Behav Res Ther. 2003;41:619-627. doi:10.1016/S0005-7967(03)00019-6.
• Hasan HÇ. Ergenlerde yeme bozukluğu görülme sıklığı ve ruhsal semptomlarla ilişkisi. Turk J Public Health. 2017;15(2):96-105.
• Cohen H.Statistical Power Analysis for Behavioral Sciences [Second Edition]. Hillsdale, NJ: Lawrence Erlbaum Associates, Publishers, 1988
• Garner D.M, Garfinkel P.E. The Eating Attitudes Test: An Index of the Symptoms of Anorexia Nervosa. Psychol Med. 1979;9(2):273-279. doi:10.1017/S00332 91700030762.
• Savaşır I, Erol N. Yeme tutum testi: anoreksi nervoza belirtileri indeksi.TPD.1989;7(23):19-25.
• Mynard H, Joseph S. Development of the Multidimentional Peer Victimization Scale. Aggressive Behavior 2000;26:169-178. doi:10.1002/(SICI)1098-2337(2000)26:2<169::AID-AB3>3.0.CO;2-A
• Gültekin Z, Sayıl M. Akran Zorbalığını Belirleme Ölçeği Geliştirme Çalışması.TPY.2005;8(15):47-61.
• Armstrong JG, Putnam FW, Carlson EB, Libero DZ, Smith SR.Development and validation of a measure of adolescent dissociation: the Adolescent Dissociative Experiences Scale. J Nerv Ment Dis.1997;185:491-497. doi:10.1097/00005053 199708000 00003
• Zoroğlu SS, Sar V, Tuzun U, Tutkun H, Savaş HA. Reliability and validity of the Turkish Adolescent Dissociative Experiences Scale. Psychiatry Clin Neurosci. 2002;56(55):1-6. doi:10.1046/j.1440-1819.2002.01053.x.
• Goodman R. Psychometric properties of the Strengths and Difficulties Questionnaire (SDQ). J Am Acad Child Adolesc Psychiatry.2001;40:1337-45.doi:10.1097/00004583-200111000-00015.
• Güvenir T, Özbek A, Baykara B, Arkar H, Şentürk B, İncekaş S. Güçler ve güçlükler anketi’nin (gga) Türkçe uyarlamasının psikometrik özellikleri. Turk J Child Adolesc Ment Health. 2008;15(2):65-74.
• Çetin E, Özbıçakçı Ş. İlköğretim öğrencilerinde uyku alışkanlıklarının duygu-davranış sorunlarına etkisinin incelenmesi.HEMAR-G.2012;2:52-60. doi:10.69487/hemarge.695453
• Kuo JR, Khoury JE, Metcalfe R, Fitzpatrick S, Goodwill A.An examination of the relationship between childhood emotional abuse and borderline personality disorder features; The role of difficulties with emotion regulation. Child Abuse Negl. 2015;39:147-155.doi:10.1016/j.chiabu.2014.08.008.
• Lyke J, Matsen J. Family functioning and risk factors for disordered eating. Eat. Behav.2013;14:497-499.doi:10.1016/j.eatbeh.2013.08.009.
• Chronis AM, Lahey BB, Pelham Jr, WE, Kipp HL, Baumann BL, Lee SS. Psychopathology and substance abuse in parents of young children with attention deficit hyperactivity disorder. J Am Acad Child Adolesc Psychiatry. 2003;42(12):1424-1432.doi:10.1097/00004583-200312000-00009.
• Tambelli R, Cimino S, Cerniglia L, Ballarotto G. Early maternal relational traumatic experiences and psychopathological symptoms: A longitudinal study on mother-infant and father-infant interactions. Sci Rep. 2015;5:13984.doi:10.1038/srep13984.
• Holtom-Viesel A, Allan S. A systematic review of the literature on family functioning across all eating disorder diagnoses in comparison to control families. Clin Psychol Rev. 2014;34:29-43. doi:10.1016/j.cpr.2013.10.005.
• Pugh M, Waller G, Esposito M. Childhood trauma, dissociation, and the internal eating disorder 'voice'. Child Abuse Negl. 2018;86:197-205.doi:10.1016/j.chiabu.2018.10.005.
• Kakkad A, TrivediM, Trivedi G, Raichandani A. Study for adolescent problem and psychology. J of Evolution of Med and Dent Sci. 2014;3(37):9564-9574. doi:10.14260/jemds/2014/3237.
• Collins J, Bents JE. Behavioral and psychological factors in obesity.JLGH.2009;4(4):124-127.
• Nilsson D, Lejonclou A, Holmqvist R. Psychoform and somatoform dissociation among individuals with eating disorders, Nord J Psychiatry. 2020;74(1):1-8. doi:10.1080/08039488.2019.1664631.
• GrothT, Hilsenroth M, Boccio D & Gold J.Relationship between trauma history and eating disorders in adolescents.J Child Adolesc Trauma. 2020;13(4):443-453. doi:10.1007/s40653-019-00275-z.
• Öztürk E, Şar V. “Formation and functions of alter personalities in dissociative ıdentity disorder: a theoretical and clinical elaboration”.J Psychol Clinic Psychiatry. 2016;6(6):00385.doi:10.15406/jpcpy.2016.06.00385
• Dykas MJ, Ziv Y, Cassidy J. Attachment and peer relations in adolescence. Attach Hum Dev.2008;10(2):123-141. doi:10.1080/14616730802113679.