Investigating Sociodemographic Features, Childhood Trauma, Personality and Psychological Symptoms as Predictors of Emotional Eating

Öz

This study examined the relationship of sociodemographic variables, childhood traumas, personality traits, and psychological symptoms with emotional eating in adults. The study was conducted on a total of 382 individuals aged 18-65 years. The Turkish Emotional Eating Scale, the Childhood Trauma Questionnaire (CTQ), the Brief Symptom Inventory, the Eysenck Personality Questionnaire Revised Abbreviated (EPQR-A), and the Demographic Information Form were administered to the participants. Non-parametric and regression analyses were performed due to the distribution pattern. All childhood trauma subscales were found to be associated with emotional eating except for the physical neglect subscale. When the relationship between psychological symptoms and emotional eating was examined, a significant positive relationship was found. The neuroticism sub-dimension of personality traits was positively associated with emotional eating. When socio-demographic variables were analyzed, a significant relationship was found between emotional eating and gender, marital status, educational status, income status, employment status, self-image, and efforts to lose weight. It was found that BSI anxiety, self-perception, age, occupation, mental disorder, gender, height, CTQ total score, emotional abuse, and somatization variables significantly predicted emotional eating behavior, and the variables explained 40.40% of the variance. The research findings were discussed in the context of the literature.

Anahtar Kelimeler

• Childhood Traumas
• Emotional Eating
• Personality Traits
• Psychological Symptoms

Duygusal Yemenin Öngörücü Faktörleri Olarak Sosyodemografik Özellikler, Çocukluk Çağı Travması, Kişilik Özellikleri ve Psikolojik Belirti Düzeyinin Değerlendirilmesi

Öz

Bu çalışmada yetişkin bireylerde sosyodemografik değişkenler, çocukluk çağı travmalarının, kişilik özelliklerinin ve psikolojik belirtilerin duygusal yeme ile olan ilişkisi incelenmektedir. 18-65 yaş arasında toplamda 382 kişiyle çalışma yürütülmüştür. Katılımcılara Türkçe Duygusal Yeme Ölçeği, Çocukluk Çağı Travmaları Ölçeği (ÇÇTÖ), Kısa Semptom Envanteri, Gözden Geçirilmiş Eysenck Kişilik Anketi-Kısaltılmış Formu (EKA-GGK) ve Demografik Bilgi Formu uygulanmıştır. Dağılım paterni nedeniyle parametrik olmayan analizler ve regresyon analizi yapılmıştır. Fiziksel ihmal alt boyutu dışında çocukluk çağı travmalarının tüm altı ölçekleri, duygusal yeme ile ilişkili bulunmuştur. Psikolojik belirtiler ile duygusal yeme davranışı arasındaki ilişki incelendiğinde ise pozitif yönde anlamlı ilişki saptanmıştır. Kişilik özelliklerinin nörotisizm alt boyutu ile duygusal yeme davranışının pozitif yönde ilişkili olduğu bulunmuştur. Sosyodemografik değişkenler incelendiğinde, cinsiyet, medeni durum, eğitim durumu, gelir durumu, çalışma durumu, kişinin kendini nasıl gördüğü ve kilo vermek için çaba sarf etme değişkenleri ile duygusal yeme arasında anlamlı ilişki bulunmuştur. KSE anksiyete, kişinin kendini nasıl gördüğü, yaş, meslek, psikolojik rahatsızlık, cinsiyet, boy, ÇÇTÖ toplam puanı, duygusal istismar, KSE somatizasyon değişkenlerinin duygusal yeme davranışını anlamlı olarak yordadığı saptanmıştır ve değişkenlerin varyansın %40,40’ını açıkladığı saptanmıştır. Literatür kapsamında araştırma bulguları tartışılmıştır.

Anahtar Kelimeler

• Duygusal Yeme
• Kişilik Özellikleri
• Psikolojik Belirtiler
• Çocukluk Çağı Travmaları

Kaynakça

1. Aktay, M. (2020). İstismar ve ihmalin çocuk üzerindeki etkileri ve tedavisi. Journal of Development and Psychology, 1(2), 169-184.
2. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Association.
3. Arslantaş, H., Dereboy, İ. F., İnalkaç, S., & Yüksel, R. (2021). Sağlık eğitimi alan üniversite öğrencilerinde duygusal yeme ve etkileyen faktörler. İzmir Katip Çelebi Üniversitesi Sağlık Bilimleri Fakültesi Dergisi, 6(1), 105-111.
4. Aslan, S. (2017). Duygusal yeme ile çocukluk çağı travmaları arasındaki ilişki [Unpublished master thesis]. Üsküdar Üniversitesi Sosyal Bilimler Enstitüsü.
5. Bailer, U. F., Price, J. C., Meltzer, C. C., Mathis, C. A., Frank, G. K., Weissfeld, L., McConaha, C. W., Henry, S. E., Brooks-Achenbach, S., Barbarich, N. C., & Kaye, W. H. (2004). Altered 5-HT2A receptor binding after recovery from bulimia-type anorexia nervosa: Relationships to harm avoidance and drive for thinness. Neuropsychopharmacology, 29(6), 1143-1155. https://doi.org/10.1038/sj.npp.1300430
6. Barak, R. E., Shuval, K., Li, Q., Oetjen, R., Drope, J., Yaroch, A. L., Fennis, B. M., & Harding, M. (2021). Emotional eating in adults: The role of sociodemographics, lifestyle behaviours, and self-regulation-Findings from a U.S. national study. International Journal of Environmental Research and Public Health, 18(4), 1744. https://doi.org/10.3390/ijerph18041744
7. Batum, P. (2008). Kişilik bozuklukları ve yeme bozuklukları : Etiyolojik ilişkiler ve cevaplanmamış sorular. Türk Psikoloji Yazıları, 11(21), 65-76.
8. Bernstein, D., Fink, L., Handelsman, L., & Foote, J. (1997). Childhood Trauma Questionnaire (CTQ) APA PsycTests. https://doi.org/10.1037/t02080-000

9. Bilgen, Ş. S. (2018). Türkçe duygusal yeme ölçeği geliştirimesi, geçerlilik ve güvenirliği çalışması [Unpublished master thesis]. Üsküdar Üniversitesi Sosyal Bilimler Enstitüsü.
10. Burns, E. E., Fischer, S., Jackson, J. L., & Harding, H. G. (2012). Deficits in emotion regulation mediate the relationship between childhood abuse and later eating disorder symptoms. Child Abuse and Neglect, 36(1), 32-39. https://doi.org/10.1016/j.chiabu.2011.08.005
11. Caslini, M., Bartoli, F., Crocamo, C., Dakanalis, A., Clerici, M., & Carrà, G. (2016). Disentangling the association between child abuse and eating disorders: a systematic review and meta-analysis. Psychosomatic medicine, 78(1), 79-90. https://doi.org/10.1097/psy.0000000000000233
12. Çobanoğlu, B. (2020). Çocukluk çağında travmaya uğramış bireylerin, beliren yetişkinlik döneminde duygusal yeme davranışı ve benlik saygısı oluşumu arasındaki ilişki [Unpublished master thesis]. İstanbul Gelişim Ünivesitesi Lisansüstü Eğitim Enstitüsü.
13. De Lauzon, B., Romon, M., Rie Deschamps, V., Lafay, L., Borys, J. M., Karlsson, J., Ducimetié, P., & Charles, M. A. (2015). The Three-Factor Eating Questionnaire-R18 is able to distinguish among different eating patterns in a general population. The Journal of nutrition, 134(9), 2372-2380. https://doi.org/10.1093/jn/134.9.2372
14. Derogatis, L. R., & Melisaratos, N. (1983). The brief symptom inventory: an introductory report. Psychological medicine, 13(3), 595-605. https://doi.org/10.1017/S0033291700048017
15. Derogatis, L. R., & Cleary, P. A. (1977). Confirmation of the dimensional structure of the SCL‐90: A study in construct validation. Journal of clinical psychology, 33(4), 981-989. https://doi.org/10.1002/1097-4679(197710)33:4<981::AID-JCLP2270330412>3.0.CO;2-0
16. Dicle, A. N., & Ersanlı, K. (2015). Turkish standardization and the validity and reliability studies of the cope. Akademik Sosyal Araştırmalar Dergisi, 16, 111-126. https://doi.org/10.16992/ASOS.783
17. Dohle, S., Hartmann, C., & Keller, C. (2014). Physical activity as a moderator of the association between emotional eating and BMI: evidence from the Swiss food panel. Psychology & Health, 29(9), 1062-1080. https://doi.org/10.1080/08870446.2014.909042
18. Durna, U. (2010). A tipi ve B tipi kişilik yapilari ve bu kişilik yapilarini etkileyen faktörlerle ilgili bir araştirma. Atatürk Üniversitesi İktisadi ve İdari Bilimler Dergisi, 19(1), 275-290.
19. Echeverri-Alvarado, B., Pickett, S., & Gildner, D. (2020). A model of post-traumatic stress symptoms on binge eating through emotion regulation difficulties and emotional eating. Appetite, 150, e104659. https://doi.org/10.1016/j.appet.2020.104659
20. Elfhag, K., & Morey, L. C. (2008). Personality traits and eating behavior in the obese: poor self-control in emotional and external eating but personality assets in restrained eating. Eating Behaviors, 9(3), 285-293. https://doi.org/10.1016/j.eatbeh.2007.10.003
21. Elran Barak, R., Shuval, K., Li, Q., Oetjen, R., Drope, J., Yaroch, A. L., Fennis, B. M., & Harding, M. (2021). Emotional eating in adults: The role of sociodemographics, lifestyle behaviors, and self-regulation—findings from a US National Study. International Journal of Environmental Research and Public Health, 18(4), 1744. https://doi.org/10.3390/ijerph18041744
22. Eysenck, H. J., & Eysenck, S. B. G. (1975). Manual of the Eysenck Personality Questionnaire. Hodder and Stoughton.
23. Fassino, S., Leombruni, P., Pierò, A., Abbate-Daga, G., & Rovera, G. G. (2003). Mood, eating attitudes, and anger in obese women with and without binge eating disorder. Journal of psychosomatic research, 54(6), 559-566. https://doi.org/10.1016/S0022-3999(02)00462-2
24. Field, A. (2013). Discovering statistics using IBM SPSS statistics (5th Edition). Sage Publications.
25. Fox, J. & Weisberg, S. (2019). An R Companion to applied regression (3rd Edition). Sage Publications.
26. Francis, L. J., Brown, L. B., & Philipchalk, R. (1992). The development of an abbreviated form of the Revised Eysenck Personality Questionnaire (EPQR-A): Its use among students in England, Canada, the USA and Australia. Personality and individual differences, 13(4), 443-449. https://doi.org/10.1016/0191-8869(92)90073-X
27. Geliebter, A., & Aversa, A. (2003). Emotional eating in overweight, normal weight, and underweight individuals. Eating behaviors, 3(4), 341-347. https://doi.org/10.106/S1471-0153(02)00100-9
28. Gewirtz-Meida, A. (2020). The relationship between child sexual abuse, self-concept and psychopathology: The moderating role of social support and perceived parental quality. Children and Youth Services Review, 113, e104938. https://doi.org/10.1016/j.childyouth.2020.104938
29. Grote, N. K., Spieker, S. J., Lohr, M. J., Geibel, S. L., Swartz, H. A., Frank, E., Houck, P. R., & Katon, W. (2012). Impact of childhood trauma on the outcomes of a perinatal depression trial. Depression and Anxiety, 29(7), 563-573. https://doi.org/10.1002/da.21929
30. Gür, T. (2020). Yetişkin kadınlarda öz duyarlılık ile beden algısnın duygusal yeme arasındaki ilişkinin incelenmesi [Unpublished master thesis]. Maltepe Üniversitesi.
31. Herman, C. P., & Mack, D. (1975). Restrained and unrestrained eating. Journal of Personality, 43(4), 647-660. https://doi.org/10.1111/j.1467-6494.1975.tb00727.x
32. Hochgraf, A. K., Kahn, R. E., & Kim-Spoon, J. (2017). The moderating role of emotional reactivity in the link between parental hostility and eating disorder symptoms in early adolescence. Eating Disorders, 25(5), 420–435. https://doi.org/10.1080/10640266.2017.1347417
33. Huh, H. J., Kim, S. Y., Yu, J. J., & Chae, J. H. (2014). Childhood trauma and adult interpersonal relationship problems in patients with depression and anxiety disorders. Annals of General Psychiatry, 13, 26, https://doi.org/10.1186/s12991-014-0026-y
34. İnalkaç, S., & Arslantaş, H. (2018). Duygusal yeme. Arşiv Kaynak Tarama Dergisi, 27(1), 70-82. https://doi.org/10.17827/aktd.336860
35. Jamshed, H., & Arslan, J. (2022). Loneliness, Emotional Eating, and COVID-19 in Youth. Current Developments in Nutrition, 6 (Suppl 1), 206. https://doi.org/10.1093/cdn/nzac048.020
36. Kansky, J., Allen, J. P., & Diener, E. (2019). The young adult love lives of happy teenagers: The role of adolescent affect in adult romantic relationship functioning. Journal of Research in Personality, 80, 1-9. https://doi.org/10.1016/j.jrp.2019.03.006
37. Karancı, A., Dirik, G., & Yorulmaz, O. (2007). Eysenck kişilik anketi-gözden geçirilmiş kısaltılmış formunun (EKA-GGK) Türkiye’de geçerlik ve güvenilirlik çalışması. Türk Psikiyatri Dergisi, 18(3), 1-8.
38. Karlsson, J., Persson, L. O., Sjöström, L., & Sullivan, M. (2000). Psychometric properties and factor structure of the Three-Factor Eating Questionnaire (TFEQ) in obese men and women. Results from the Swedish Obese Subjects (SOS) study. International Journal of Obesity, 24(12), 1715-1725. https://doi.org/10.1038/sj.ijo.0801442
39. Kaisari, P., Dourish, C. T., & Higgs, S. (2017). Attention Deficit Hyperactivity Disorder (ADHD) and disordered eating behaviour: A systematic review and a framework for future research. Clinical Psychology Review, 53, 109-121. https://doi.org/10.1016/j.cpr.2017.03.002
40. Konttinen, H., Männistö, S., Sarlio-Lähteenkorva, S., Silventoinen, K., & Haukkala, A. (2010). Emotional eating, depressive symptoms and self-reported food consumption. A population-based study. Appetite, 54(3), 473-479. https://doi.org/10.1016/j.appet.2010.01.014
41. Kramer, I., & Orbach, I. (2013). Violence and Victims, 28(2), 259-273. https://doi.org/10.1891/0886-6708.VV-D-12-00015
42. Kuruoğlu, A. Ç. (2000). Yeme bozukluklarında genetik etkenler. Klinik Psikofarmakoloji Bülteni, 10(1), 32-37.
43. Larsen, J. K., van Strien, T., Eisinga, R., & Engels, R. C. (2006). Gender differences in the association between alexithymia and emotional eating in obese individuals. Journal of Psychosomatic Research, 60(3), 237-243. https://doi.org/j.jpsychores.2005.07.006
44. Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping (1st Edition). Springer publishing company.
45. Liebenberg, H., & Papaikonomou, M. (2010). " Complex trauma": reflections on the effect of early childhood abuse among a small adult group of bariatric patients. South African Journal of Psychology, 40(3), 327-337. https://doi.org/10.1177/008124631004000311
46. Liu, H., Yang, Q., Luo, J., Ouyang, Y., Sun, M., Xi, Y., Yong, C., & Lin, Q. (2020). Association between emotional eating, depressive symptoms and laryngopharyngeal reflux symptoms in college students: A cross-sectional study in Hunan. Nutrients, 12(6), 1595. https://doi.org/10.3390/nu12061595
47. Macht, M. (1999). Characteristics of eating in anger, fear, sadness and joy. Appetite, 33(1), 129-139. https://doi.org/10.1006/appe.1999.0236
48. Macht, M. (2008). How emotions affect eating: A five-way model. Appetite, 50(1), 1-11. https://doi.org/10.1016/j.appet.2007.07.002
49. Macht, M., & Mueller, J. (2007). Increased negative emotional responses in PROP supertasters. Physiology & Behavior, 90(2-3), 466-472. https://doi.org/10.1016/j.physbeh.2006.10.011
50. Maner, F. (2011). Is binge eating a type of addiction? Klinik Psikofarmakoloji Bulteni, 21(2).
51. McGrane, D., & Carr, A. (2002). Young women at risk for eating disorders: Perceived family dysfunction and parental psychological problems. Contemporary Family Therapy, 24, 385-395. https://doi.org/10.1023/A:1015359610774
52. Miller, J. L., Schmidt, L. A., Vaillancourt, T., McDougall, P., & Laliberte, M. (2005). Neuroticism and introversion: A risky combination for disordered eating among a non-clinical sample of undergraduate women. Eating Behaviors, 7(1), 69-78. https://doi.org/10.1016/j.eatbeh.2005.07.003
53. Miotto, P., Pollini, B., Restaneo, A., Favaretto, G., & Preti, A. (2008). Aggressiveness, anger, and hostility in eating disorders. Comprehensive Psychiatry, 49(4), 364-373. https://doi.org/10.1016/j.comppsych.2008.01.004
54. Mond, J. M., Robertson-Smith, G., & Vetere, A. (2006). Stigma and eating disorders: is there evidence of negative attitudes towards anorexia nervosa among women in the community? Journal of Mental Health, 15(5), 519-532. https://doi.org/10.1080/09638230600902559
55. Nguyen-Rodriguez, S. T., Unger, J. B., & Spruijt-Metz, D. (2009). Psychological determinants of emotional eating in adolescence. Eating disorders, 17(3), 211-224. https://doi.org/10.1080/10640260902848543
56. Oğlağu, Z. (2012). Yeme Bozukluklarında Çocukluk Çağı Travmalarının Benlik Saygısı Ve Beden Algısı Değişkenleri Üzerine Etkisi [Yayımlanmamış tıpta uzmanlık tezi]. İstanbul Üniversitesi Tıp Fakültesi.
57. Ouwens, M. A., van Strien, T., & van der Staak, C. P. (2003). Tendency toward overeating and restraint as predictors of food consumption. Appetite, 40(3), 291-298. https://doi.org/10.1016/S0195-6663(03)00006-0
58. Ouwens, M. A., van Strien, T., & van Leeuwe, J. F. (2009). Possible pathways between depression, emotional and external eating. A structural equation model. Appetite, 53(2), 245-248. https://doi.org/10.1016/j.appet.2009.06.001
59. Özer, S., & Okat, Ç. (2021). Yeni koronavirüs (Covid-19) günlerinde bireylerin yeme tutumlarının incelenmesi. Türk Turizm Araştırmaları Dergisi, 5(1), 84-102. https://doi.org/ 10.26677/TR1010.2021.653
60. Papageorgiou, C., & Wells, A. (2004). Depressive rumination: Nature, theory and treatment (1st Edition). John Wiley & Sons.
61. Pinaquy, S., Chabrol, H., Simon, C., Louvet, J. P., & Barbe, P. (2003). Emotional eating, alexithymia, and binge‐eating disorder in obese women. Obesity Research, 11(2), 195-201. https://doi.org/10.1038/oby.2003.31
62. Rassart, J., Luyckx, K., Verdyck, L., Mijnster, T., & Mark, R. E. (2019, 14-15th May). Adjusting to refractory epilepsy in young adulthood: The importance of patients’ personality [Poster]. Annual Meeting of the Belgian Association for Psychological Sciences (BAPS), Liège, Belgium.
63. Rawana, J. S., McPhie, M. L., & Hassibi, B. (2016). Eating-and weight-related factors associated with depressive symptoms in emerging adulthood. Eating behaviors, 22, 101-108. https://doi.org/10.1016/j.eatbeh.2016.04.002
64. Roohafza, H. R., Afshar, H., Keshteli, A. H., Mohammadi, N., Feizi, A., Taslimi, M., & Adibi, P. (2014). What’s the role of perceived social support and coping styles in depression and anxiety? Journal of Research in Medical Sciences, 19(10), 944-949.
65. Sahin, N. H., & Durak, A. (1994). Kisa Semptom Envanteri (Brief Symptom Invetory-BSI): Turk Gencleri Icin Uyarlanmasi [A study of the Brief Symptom Inventory in Turkish Youth]. Türk Psikoloji Dergisi, 9(31), 44-56.
66. Samuel, L., & Cohen, M. (2018). Expressive suppression and emotional eating in older and younger adults: An exploratory study. Archives of Gerontology and Geriatrics, 78, 127-131. https://doi.org/10.1016/j.archger.2018.06.012
67. Şar, V., Öztürk, E., & İkikardeş, E. (2012). Çocukluk çağı ruhsal travma ölçeğinin Türkçe uyarlamasının geçerlilik ve güvenilirliği. Türkiye Klinikleri Tıp Bilimleri Dergisi, 32(4), 1054-1063.https://doi.org/ 10.5336/medsci.2011-26947
68. Schachter, S. (1968). Obesity and eating: internal and external cues differentially affect the eating behavior of obese and normal subjects. Science, 161(3843), 751-756. https://doi.org/10.1126/science.161.3843.751
69. Schneider, K. L., Appelhans, B. M., Whited, M. C., Oleski, J., & Pagoto, S. L. (2010). Trait anxiety, but not trait anger, predisposes obese individuals to emotional eating. Appetite, 55(3), 701-706. https://doi.org/10.1016/j.appet.2010.10.006
70. Spoor, S. T., Bekker, M. H., Van Strien, T., & van Heck, G. L. (2007). Relations between negative affect, coping, and emotional eating. Appetite, 48(3), 368-376. https://doi.org/10.1016/j.appet.2006.10.005
71. Stice, E. (2002). Risk and maintenance factors for eating pathology: a meta-analytic review. Psychological bulletin, 128(5), 825. https://doi.org/10.1037/0033-2909.128.5.825
72. Tan, C. C., & Chow, C. M. (2014). Stress and emotional eating: The mediating role of eating dysregulation. Personality and individual differences, 66, 1-4. https://doi.org/10.1016/j.paid.2014.02.033
73. Taner, Y., & Gökler, B. (2004). Çocuk istismarı ve ihmali: Psikiyatrik yönleri. Hacettepe Tıp Dergisi. 35(2), 82-86.
74. Tanofsky, M. B., Wilfley, D. E., Spurrell, E. B., Welch, R., & Brownell, K. D. (1997). Comparison of men and women with binge eating disorder. International Journal of Eating Disorders, 21(1), 49-54. https://doi.org/10.1002/(SICI)1098-108X(199701)21:1<49::AID-EAT6>3.0.CO;2-3
75. Thompson, S. H. (2015). Gender and racial differences in emotional eating. Journal of Diabetes and Obesity 2(2), 93-98. https://doi.org/10.15436/2376-0494.15.035
76. Troop, N. A., Allan, S., Treasure, J. L., & Katzman, M. (2003). Social comparison and submissive behaviour in eating disorder patients. Psychology and psychotherapy: theory, research and practice, 76(3), 237-249. https://doi.org/10.1348/147608303322362479
77. Truglia, E., Mannucci, E., Lassi, S., Rotella, C. M., Faravelli, C., & Ricca, V. (2006). Aggressiveness, anger and eating disorders: A review. Psychopathology 39(2), 55-68. https://doi.org/10.1159/000090594
78. Turkmen, G., & Kuzgun Bayram, T. (2023). The mediating role of emotional eating in the relationship between aggression and eating attitudes. Journal of Health Science Medicine, 6(6), 1405-1410. https://doi.org/10.32322/jhsm.1361353
79. Wedin, S., Madan, A., Correll, J., Crowley, N., Malcolm, R., Byrne, T. K., & Borckardt, J. J. (2014). Emotional eating, marital status and history of physical abuse predict 2-year weight loss in weight loss surgery patients. Eating Behaviors, 15(4), 619-624. https://doi.org/10.1016/j.eatbeh.2014.08.019
80. Williams, G. J., Chamove, A. S., & Millar, H.R. (1990). Eating disorders, perceived control, assertiveness and hostility. British Journal of Clinical Psychology, 29(3), 327-335. https://doi.org/10.1111/j.2044-8260.1990.tb00889.x
81. Wonderlich, S. A., Crosby, R. D., Mitchell, J. E., Thompson, K. M., Redlin, J., Demuth, G., & Haseltine, B. (2001). Eating disturbance and sexual trauma in childhood and adulthood. International journal of eating disorders, 30(4), 401-412. https://doi.org/10.1002/eat.1101
82. Yilmaz, T. S., Gülücü, A., & Demirci, H. (2020). Erişkin obezitesinde çocukluk çağı travmalarının rolü. Anatolian Journal of Psychiatry/Anadolu Psikiyatri Dergisi, 21(3), 261-268. https://doi.org/ 10.5455/apd.58955