European Journal of Social Sciences Studies ISSN: 2501-8590 ISSN-L: 2501-8590 Available on-line at: www.oapub.org/soc Volume 2 │ Issue 9 │ 2017 doi: 10.5281/zenodo.1043610 BODY ATTITUDE AND BODY EXPERIENCE IN GREEK AND FLEMISH FEMALES WITH AND WITHOUT EATING DISORDERS Maria Efstratopoulou1i, Michel Probst2, Elfi Fotiou2, Johan Simons2 School of Social Sciences, Bishop Grosseteste University, UK 1 Department of Rehabilitation Sciences, KU Leuven, 2 University of Leuven, Belgium Abstract: Assessment of young females with anorexia nervosa was carried out at the time of hospitalization. Findings were compared to those from two typical weight control groups from Belgium and Greece. The total sample consisted of three groups: a) a clinical sample of 75 Belgian females with anorexia nervosa (mean age=19.01, sd=2.20), b) a typical Greek sample of 137 females (mean age=18.68, sd=1.92) and c) a control sample of 130 typical Flemish females (mean age=18.61, sd=1.34). The Body Attitude Test (BAT; Probst, et al., 1995) for female patients with eating disorders (ED) was used to measure the subjective body experience and attitudes toward body. The Body Satisfaction Scale, Silhouette Chart and the Semantic Differential were also used. Oneway analysis of variance, revealed group differences on body attitudes. As it was initially hypothesised, the female patients indicated more negative attitudes and a poorer self-evaluation of their body in comparison to the non clinical groups. However, analysis of the data from Silhouette Chart and the Semantic Differential revealed that in some items there were no significant differences on body experience and satisfaction between the typical Greek female group and the clinical Belgian female group, which was an interesting and unexpected finding. The authors examined the outcomes from a cross-cultural viewpoint. Research into the cultural factors that could contribute to body dissatisfaction could help us understand the underline mechanisms and create effective preventive interventions for young females. Corresponding author: Dr. Maria A. Efstratopoulou, School of Social Sciences, Longdales Road, Lincoln, UK, LN13DY, email maria.efstratopoulou@bishopg.ac.uk i Copyright © The Author(s). All Rights Reserved. © 2015 – 2017 Open Access Publishing Group 1 Maria Efstratopoulou, Michel Probst, Elfi Fotiou, Johan Simons BODY ATTITUDE AND BODY EXPERIENCE IN GREEK AND FLEMISH FEMALES WITH AND WITHOUT EATING DISORDERS Keywords: body attitude, body dissatisfaction, body experience, anorexia nervosa, eating disorders 1. Introduction A spectrum of eating and weight-related problems, which affects at least 10–15% of girls and women between the ages of 9 and 19 years, exists, ranging from negative body image and weight/shape concerns to eating disorders such as anorexia nervosa and bulimia nervosa (Levine & Smolak, 2006; Neumark-Sztainer, 2005). This number is much higher taking into account the percentages of individuals engaged in unhealthy, but not necessarily extreme, weight control behaviours, such as meal skipping, fasting, and smoking. Incidence studies examining secular trends enhance our understanding of how eating disorders develop, because changes in incidence over time may uncover risk factors. Anorexia nervosa is a serious and potentially fatal eating disorder and its etiology is still largely unknown (Walsh, 2013). Existing theories suggest a number of definable risk factors for anorexia nervosa: an impairment in the maternal environment (Bruch, 1973), a particular pattern of family interactions (Minuchin, Baker, & Roman 1978), and perhaps some predisposing endocrine factor. Most often cited are popular media images of women that suggest thinness is fashionable (Gardner, & Brown, 2014), prevailing societal pressures for women to diet and conform to unrealistic weight standards, and belief in the greater importance of body image held by more women than men, on mandate for physical attractiveness and thinness (Gardner, & Brown, 2014; Brooks-Gunn, Burrow & Warren, 1988). Perception of body Social climate factors such as pressure for thinness, traditional female sex-role socialization, and competitiveness have been proposed as contributing to the development of poor body esteem and disordered eating (Brown, Cross & Nelson, 1990). The definition of anorexia nervosa was recently revised for the DSM-V (APA, 2013). One of the leading reasons for the revision was to reduce the number of patients who receive the diagnosis eating disorder not otherwise specified (EDNOS), who constituted up to 60% of patients in specialized eating disorder units (Fairburn & Bohn 2005; Zimmerman et al., 2008). DSM-V introduced three changes to the criteria defining anorexia nervosa: the weight loss criterion was revised, fear of weight gain does not need to be verbalized if behaviours interfering with weight gain can be observed, and amenorrhea was no longer required (APA, 2013; Attia et al., 2013). A core feature of anorexia nervosa ‚N is a disturbance in the experience of one s body weight or shape and an undue influence of body weight and shape on self-evaluation (APA, 2013). The European Journal of Social Sciences Studies - Volume 2 │ Issue 9 │ 2017 2 Maria Efstratopoulou, Michel Probst, Elfi Fotiou, Johan Simons BODY ATTITUDE AND BODY EXPERIENCE IN GREEK AND FLEMISH FEMALES WITH AND WITHOUT EATING DISORDERS distorted perception of one s body weight, size, shape and the intense fear to gain weight, even when is severely underweight, indicate how patients with anorexia nervosa (AN) experience their bodies. Research suggests that body image disturbance is comprised of a behavioural, a perceptual and a cognitive attitudinal component (Gardner, & Brown, 2010; Gardner, 1996). The perceptual component means inaccurate judgment of body size, whereas the attitudinal component stands for dissatisfaction with body size, shape or appearance (Thompson, 2001). These components have frequently been explored in relation to the person s own body in eating disorders and body image disturbance in anorexia nervosa (AN) has been widely studied with regard to the patient s own body. The definition of body image has been argued for a long time. Cash and ‛rown (1987) indicated that there are two aspects to body image: one is perceptual disturbance as body size distortion, and the other is cognitive and affective disturbance as body dissatisfaction. Perceptual disturbance has been studied by various methods, for example, movable calliper technique, and video distortion method and so on. These methods were used mainly to detect how patients estimate their body size (overestimation or underestimation). Overestimation of their own body size is a common feature seen in AN patients although evidence especially with adolescent populations is still scarce (Conley, & Boardman, 2007; Schneider, Frieler, Pfeiffer, Lehmkuhl, & Salbach-Andrae, 2009). Because cognition and affect influence the estimation of one s body size, disturbances of these aspects also should be focused on as regards body image disturbance. This is why several questionnaires were developed to aspects such as the subjective attitude towards the body (Ben-Tovim, Walker, 1991; Probst, Vandereycken, Van Coppenolle, &Vanderlinden, 1995). Despite the theoretical and practical limitations, the body image concept would seem to be clinically relevant to anorexia nervosa where the patient s experiences of his/her body are so different from those of others. Body image disturbance in eating disorders (ED) has been associated with disturbances in the perception of body shape and size that manifest as an intense fear of weight gain (A.P.A. 2013). Grogan (2008) defines body dissatisfaction as a person’s negative thoughts about his or her own body p. 4). This includes judgements about size, shape, and muscle tone and generally involves a discrepancy between one s own body type and an ideal body type. ‚lthough there are several techniques for measuring a discrepancy between an individual s own body weight and their ideal body weight, figure rating scales are most commonly used (e.g., Gardner, Jappe, & Gardner, 2009). Cultural beliefs and attitudes have been identified as significant contributing factors in the development of eating disorders. Body experience and body attitudes in anorexia nervosa (AN) have been widely studied with regard to European Journal of Social Sciences Studies - Volume 2 │ Issue 9 │ 2017 3 Maria Efstratopoulou, Michel Probst, Elfi Fotiou, Johan Simons BODY ATTITUDE AND BODY EXPERIENCE IN GREEK AND FLEMISH FEMALES WITH AND WITHOUT EATING DISORDERS the patient s own body, but little is known about cross cultural differences and comparison between females from different countries and especially between young women suffering from AN compared to healthy females belonging to different BMI categories. Research addressing cross-cultural variation suggests there is a lower prevalence of disordered eating in non-Western countries. In developing countries, for example, increasing industrialization, urbanization and globalization are associated with an increase in eating disorders (Pike, Hoek, & Dunne, 2014). Whether the incidence of eating disorders in Western, industrialized countries has changed over time has been the subject of much debate (Hoek, 2006; Smink, van Hoeken, Oldehinkel, & Hoek, 2014). For ‚N, reports of an epidemic have been downsized to a modest increase in ‚N incidence over the 0th century Keel & Klump, 00 , by the identification of methodological confounders in long-term incidence studies such as variations in registration policy, diagnostic criteria, detection methods, and the availability of services; demographic differences between the populations; and faulty inclusion of readmissions (Smink, van Hoeken, & Hoek, 2013). Examination of risk factors for eating disorders has typically concentrated on individuals from the dominant culture within Western societies and despite recognition that sociocultural factors influence disordered eating (Wiseman, Cray, Mossiman & Ahrens, 1992), the important sociocultural factor of ethnicity has been largely overlooked (Dolan,1991). As the occurrence of eating disorders in young women has grown in Western society in recent years (Smink, van Hoeken, & Hoek, 2013), research into body image dissatisfaction has increased, with a large amount of research highlighting a link between body image disturbances and eating disorders (Thompson, 2001) and a large number of females and males in Western society are dissatisfied with some aspect of their bodies (Tiggemann, & Slater, 2013). Consequently, the measurement of body dissatisfaction is an important aspect of research concerned with body image dissatisfaction and disturbances. During the last 50 years, the prevalence of eating disorders has been studied, both in clinical samples and on a population level. However, a few studies have attempted to assess the prevalence of eating disorders on a national scale and in a population of typical adolescents; a group of individual s known to be at special risk for eating disorders. The aim of this study was to investigate possible cross-cultural differences in body experience between female population from South and North Europe using typical and clinical sample from Greece and Belgium. For viewing / downloading the full article, please access the following link: https://oapub.org/soc/index.php/EJSSS/article/view/238 European Journal of Social Sciences Studies - Volume 2 │ Issue 9 │ 2017 4