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- Adult attachment in eating disorders mediates the association between perceived invalidating childhood environments and eating psychopathologyPublication . Gonçalves, Sónia; Vieira, Ana Isabel; Rodrigues, Tânia; Machado, Paulo P.; Brandão, Isabel; Timóteo, Sertório; Nunes, Patrícia; Machado, BárbaraThis study aimed to evaluate the associations between perceived invalidating childhood environments, attachment in intimate relationships and eating psychopathology, to explore how these variables interact with each other, and to explore potential mediators to this pattern of association in a clinical eating disorder (ED) sample. One hundred thirty-seven ED outpatients were evaluated with the Invalidating Childhood Environments Scale (ICES), the Eating Disorder-15 (ED-15) and the Experiences in Close Relationships Inventory (ECR). Paternal invalidation was associated to the ED-15 total score through avoidance of proximity and anxiety over abandonment, while maternal invalidation was only associated to the ED-15 total score through avoidance of proximity. Our results highlight the potential role of the perception of an invalidating family environment in the development of eating pathology and of difficulties in intimate relationships. These results endorse the relevance of address parental invalidation and promote adequate emotion regulation strategies and interpersonal competencies in the context of intimate relationships.
- Psychometric properties of the Portuguese version of the invalidating childhood environment scalePublication . Vieira, Ana Isabel; Gonçalves, Mónica; Machado, Bárbara César; Rodrigues, Tânia; Machado, Paulo P. P.; Brandão, Isabel; Timóteo, Sertório; Nunes, Patrícia; Gonçalves, SóniaPurpose The current study aimed to examine the psychometric properties of the Portuguese version of the invalidating childhood environment scale (ICES) in a non-clinical and clinical sample of eating disorder (ED) patients. This study also investigated the between-sample differences regarding invalidating parental behaviors and family styles and explored the associations between invalidating childhood environments and eating pathology. Methods A sample of 410 high school and college students and 101 patients with a diagnosis of ED completed self-report measures. Principal component analyses and confirmatory factor analyses were conducted to examine the factor structure of the ICES. The internal consistency and the between-sample differences and associations between invalidating childhood environments and eating pathology were also tested. Results Principal component analyses and confirmatory factor analyses indicated a two-factor solution for each parent. The ICES demonstrated high internal consistency and was able to differentiate between non-clinical and clinical samples. The perception of parental invalidation was higher in ED patients, and the clinical sample presented higher scores in the chaotic and perfect family styles and lower scores in the validating family style, in comparison with the non-clinical sample. Both maternal invalidation and invalidating styles were significantly associated with a higher ED symptomatology. Conclusions The Portuguese version of the ICES revealed adequate psychometric properties. Considering the relationship between invalidation in family and eating pathology, the ICES may be useful in clinical practice, especially among ED patients. Level of Evidence Level V, cross-sectional descriptive study.
- The role of the perception of family environment in relation to body dissatisfaction, disordered eating and difficulties in close relationshipsPublication . Gonçalves, Sónia; Moreira, Célia; Gonçalves, Mónica; Vieira, Ana Isabel; Machado, Bárbara CésarPurpose Invalidating childhood environments have been characterised as those in which caregivers do not validate a child’s personal experiences and the communication of emotions is considered inappropriate, being either ignored or punished. The current study assessed the relationships among invalidating childhood environments, body dissatisfaction, disordered eating and difficulties in close relationships in a sample of college students. Methods In this study, 362 non-clinical participants with ages ranging from 17 to 25 years (M = 20.02, SD = 1.51) completed self-report measures. Results Difficulties in close relationships, body dissatisfaction and disordered eating were significantly higher in invalidating families than in validating families. Invalidating childhood environments were associated with higher body dissatisfaction and disordered eating, and both associations were mediated by difficulties in close relationships. Finally, body dissatisfaction mediates the effects of BMI and difficulties in close relationships on eating disorder symptoms. Conclusions Perceived experiences of invalidation in childhood may be associated with eating disorder symptomatology. In addition, difficulties in close relationships during adulthood possibly contribute to the emergence of eating disorder symptoms. Level of Evidence Level V, descriptive study.
- Frequency and correlates of picky eating and overeating in school-aged children: a Portuguese population-based studyPublication . Machado, Bárbara Cesar; Dias, Pedro; Lima, Vânia Sousa; Carneiro, Alexandra; Gonçalves, SóniaUsing the Achenbach System of Empirically Based Assessment (ASEBA) battery in a non-clinical Portuguese population-based study, we aimed to examine a broad spectrum of emotional and behavioral problems and competencies, including picky eating and overeating behaviors in children and youth. Overall, 2687 children from 6 to 18 years old were evaluated by their parents, teachers and, in the case of children older than 11 years old, by themselves. Picky eating and overeating were assessed using the Child Behavior Checklist (CBCL) and Youth Self Report (YSR). The frequency of picky eating and overeating was 23.1% and 24%, respectively. Picky eaters, compared with over eaters and non-picky/non-over eaters, tended to belong to the younger group of participants, and in turn, over eaters tended to belong to the older group. Overeating was significantly associated with overweight, which also emerged as a predictor of belonging to the overeating group. Both picky eaters and over eaters scored significantly higher on all emotional and behavioral problems and DSM-5-oriented subscales. The results of two independent binary logistic regression analyses indicated that internalizing and externalizing problems, together with the total problems score emerged as a predictor for both groups, including picky eater and overeater school-aged children. In accordance with previous studies, our results also supported the possibility that a broader pattern of potentially non-adaptive emotional and behavioral problems could also be associated with both pickiness and excessive eating.