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Self-stigma of seeking
help and being male
predict an increased
likelihood of having an
undiagnosed eating
disorder
Griffi...
#1 Approximately 75% of eating disorders
are undiagnosed (Hart et al., 2011)
#2 Diagnosis is important because it
facilita...
#3 Self-stigma of seeking psychological
help may contribute to undiagnosed eating
disorders (Griffiths et al., 2014)
#4 Ma...
Methods - procedure
An online survey requested participants who:
a. were currently diagnosed with an eating disorder;
b. h...
Q1 “Have you ever been diagnosed with
an eating disorder by a health
professional, such as a general
practitioner or psych...
485 persons with eating disorders
360 diagnosed
125 undiagnosed
~50% of diagnosed group in treatment
0% of undiagnosed gro...
Comparison of EDE-Q global scores
0
1
2
3
4
5
6
Clinical norm
(Welch et al. 2011)
Community norm
(Mond et al. 2006)
Diagno...
Comparison of EDE-Q subscale scores
0
1
2
3
4
5
6
Clinical norms
(Welch et al. 2011)
Community norms
(Mond et al. 2006)
Di...
Methods – statistical analyses
#1 Hierarchical binary logistic regression
#2 Outcome: Undiagnosed vs. diagnosed
#3 Predict...
#1 Men were four times more likely to be
undiagnosed than women
OR = 4.04 (95% CI: 1.43, 11.43), p = .009
#2 Self-stigma o...
#3 Significant interaction between sex and
self-stigma of seeking psychological help
OR = 6.81 (95% CI: 1.39, 33.25), p = ...
Females
1
No
self-stigma of
treatment
5
Maximum
self-stigma
of treatment
Predictedprobabilityofbeing
undiagnosed
0%
20%
40...
1
No
self-stigma of
treatment
5
Maximum
self-stigma
of treatment
Predictedprobabilityofbeing
undiagnosed
0%
20%
40%
60%
80...
Females
1
No
self-stigma of
treatment
5
Maximum
self-stigma
of treatment
Predictedprobabilityofbeing
undiagnosed
0%
20%
40...
Females
1
No
self-stigma of
treatment
5
Maximum
self-stigma
of treatment
Predictedprobabilityofbeing
undiagnosed
0%
20%
40...
#1 Findings consistent with the view that
males with eating disorders are more
reluctant to seek treatment and more likely...
#3 Conflict between traditional masculine
gender roles and the act of reaching out
for help may explain why self-stigma of...
#1 Cross-sectional design
#2 The experience of treatment may
reduce self-stigma about seeking
treatment
#3 Relatively few ...
#4 Certain subgroups of sufferers may
have been underrepresented
#5 Factors likely to have influenced
diagnosis, such as a...
Investigate men with muscle dysmorphia
and men who use steroids
Muscle dysmorphia sufferers tend to be
more traditionally ...
#1 Self-stigma of seeking psychological
help may be a salient barrier to eating
disorder diagnosis and treatment,
particul...
Griffiths, S., Mond, J. M., Murray, S. B., & Touyz, S. (2014). The prevalence and adverse associations of
stigmatization i...
Griffiths, S., Mond., J. M., Li, Z.,
Gunatilake, S., Murray, S. B., Sheffield, J.,
& Touyz, S. (2015). Self-stigma of seek...
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Self-stigma of Seeking Help and Being Male Predict an Increased Likelihood of Having an Undiagnosed Eating Disorder

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To examine whether self-stigma of seeking psychological help and being male would be associated with an increased likelihood of having an undiagnosed eating disorder. A multi-national sample of 360 individuals with diagnosed eating disorders and 125 individuals with undiagnosed eating disorders were recruited. Logistic regression was used to identify variables affecting the likelihood of having an undiagnosed eating disorder, including sex, self-stigma of seeking psychological help, and perceived stigma of having a mental illness, controlling for a broad range of covariates. Being male and reporting greater self-stigma of seeking psychological help were independently associated with an increased likelihood of being undiagnosed. Further, the association between self-stigma of seeking psychological help and increased likelihood of being undiagnosed was significantly stronger for males than for females. Perceived stigma associated with help-seeking may be a salient barrier to treatment for eating disorders – particularly among male sufferers.

Published in: Health & Medicine
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Self-stigma of Seeking Help and Being Male Predict an Increased Likelihood of Having an Undiagnosed Eating Disorder

  1. 1. Self-stigma of seeking help and being male predict an increased likelihood of having an undiagnosed eating disorder Griffiths, S., Mond., J. M., Li, Z., Gunatilake, S., Murray, S. B., Sheffield, J., & Touyz, S. (2015). International Journal of Eating Disorders.
  2. 2. #1 Approximately 75% of eating disorders are undiagnosed (Hart et al., 2011) #2 Diagnosis is important because it facilitates access to appropriate and effective treatment (Striegel-Moore et al., 2000) Introduction
  3. 3. #3 Self-stigma of seeking psychological help may contribute to undiagnosed eating disorders (Griffiths et al., 2014) #4 Males may suffer disproportionately from self-stigma of seeking psychological help due to masculinity (Griffiths et al., 2015; Smiler, 2006) Introduction
  4. 4. Methods - procedure An online survey requested participants who: a. were currently diagnosed with an eating disorder; b. had recovered from an eating disorder; or c. thought they might have an eating disorder
  5. 5. Q1 “Have you ever been diagnosed with an eating disorder by a health professional, such as a general practitioner or psychologist?” YES = Diagnosed group, NO = Question 2 Q2 “Do you think you might have an eating disorder? YES = Undiagnosed group, NO = Excluded Methods - procedure
  6. 6. 485 persons with eating disorders 360 diagnosed 125 undiagnosed ~50% of diagnosed group in treatment 0% of undiagnosed group in treatment Methods - participants
  7. 7. Comparison of EDE-Q global scores 0 1 2 3 4 5 6 Clinical norm (Welch et al. 2011) Community norm (Mond et al. 2006) Diagnosed Undiagnosed EDE-Q Global score
  8. 8. Comparison of EDE-Q subscale scores 0 1 2 3 4 5 6 Clinical norms (Welch et al. 2011) Community norms (Mond et al. 2006) Dietary Restraint Eating Concern Shape Concern Weight concern Diagnosed Undiagnosed
  9. 9. Methods – statistical analyses #1 Hierarchical binary logistic regression #2 Outcome: Undiagnosed vs. diagnosed #3 Predictors: Demographic variables (sex, employment, etc.), psychiatric variables (eating disorder symptoms, duration of illness, etc.), psychosocial variables (self-stigma of seeking help, self- esteem, etc.)
  10. 10. #1 Men were four times more likely to be undiagnosed than women OR = 4.04 (95% CI: 1.43, 11.43), p = .009 #2 Self-stigma of seeking psychological help predicted a greater probability of being undiagnosed OR = 1.57 (95% CI: 1.07, 2.30), p = .022 Results
  11. 11. #3 Significant interaction between sex and self-stigma of seeking psychological help OR = 6.81 (95% CI: 1.39, 33.25), p = .018 Results
  12. 12. Females 1 No self-stigma of treatment 5 Maximum self-stigma of treatment Predictedprobabilityofbeing undiagnosed 0% 20% 40% 60% 80% 100%
  13. 13. 1 No self-stigma of treatment 5 Maximum self-stigma of treatment Predictedprobabilityofbeing undiagnosed 0% 20% 40% 60% 80% 100% Males
  14. 14. Females 1 No self-stigma of treatment 5 Maximum self-stigma of treatment Predictedprobabilityofbeing undiagnosed 0% 20% 40% 60% 80% 100% Males
  15. 15. Females 1 No self-stigma of treatment 5 Maximum self-stigma of treatment Predictedprobabilityofbeing undiagnosed 0% 20% 40% 60% 80% 100% Males R2 = .59 R2 = .11
  16. 16. #1 Findings consistent with the view that males with eating disorders are more reluctant to seek treatment and more likely to be undiagnosed #2 Self-stigma of seeking psychological help may be responsible, to some extent, for this reluctance Discussion
  17. 17. #3 Conflict between traditional masculine gender roles and the act of reaching out for help may explain why self-stigma of seeking psychological help has a stronger influence on males #4 Addressing males’ negative beliefs about seeking treatment is important for early intervention initiatives Discussion
  18. 18. #1 Cross-sectional design #2 The experience of treatment may reduce self-stigma about seeking treatment #3 Relatively few males recruited Discussion - limitations
  19. 19. #4 Certain subgroups of sufferers may have been underrepresented #5 Factors likely to have influenced diagnosis, such as access to services, were not examined #6 Eating disorders were self-reported and not confirmed with interview assessments Discussion - limitations
  20. 20. Investigate men with muscle dysmorphia and men who use steroids Muscle dysmorphia sufferers tend to be more traditionally ‘masculine’ than men with anorexia nervosa and ‘healthy’ control men (Kanayama et al., 2006; Murray et al., 2013) Discussion – future research
  21. 21. #1 Self-stigma of seeking psychological help may be a salient barrier to eating disorder diagnosis and treatment, particularly for males Conclusion
  22. 22. Griffiths, S., Mond, J. M., Murray, S. B., & Touyz, S. (2014). The prevalence and adverse associations of stigmatization in people with eating disorders. International Journal of Eating Disorders. http://doi.org/10.1002/eat.22353 Griffiths, S., Murray, S. B., & Touyz, S. (2015). Extending the masculinity hypothesis: An investigation of gender role conformity, body dissatisfaction, and disordered eating in young heterosexual men. Psychology of Men & Masculinity. http://doi.org/10.1037/a0035958 Hart, L. M., Granillo, M. T., Jorm, A. F., & Paxton, S. J. (2011). Unmet need for treatment in the eating disorders: A systematic review of eating disorder specific treatment seeking among community cases. Clinical Psychology Review, 31(5), 727–735. http://doi.org/10.1016/j.cpr.2011.03.004 Kanayama, G., Barry, S., Hudson, J. I., & Pope, H. G. (2006). Body Image and Attitudes Toward Male Roles in Anabolic-Androgenic Steroid Users. American Journal of Psychiatry, 163(4), 697–703. http://doi.org/10.1176/appi.ajp.163.4.697 Mond, J. M., Hay, P. J., Rodgers, B., & Owen, C. (2006). Eating Disorder Examination Questionnaire (EDE-Q): Norms for young adult women. Behaviour Research and Therapy, 44, 53–62. Murray, S. B., Rieger, E., Karlov, L., & Touyz, S. W. (2013). Masculinity and femininity in the divergence of male body image concerns. The Journal of Eating Disorders, 1(11), 1–8. http://doi.org/10.1186/2050-2974-1-11 Striegel-Moore, R. H., Leslie, D., Petrill, S. A., Garvin, V., & Rosenheck, R. A. (2000). One-year use and cost of inpatient and outpatient services among female and male patients with an eating disorder: evidence from a national database of health insurance claims. International Journal of Eating Disorders, 27(4), 381–389. Welch, E., Birgegård, A., Parling, T., & Ghaderi, A. (2011). Eating disorder examination questionnaire and clinical impairment assessment questionnaire: General population and clinical norms for young adult women in Sweden. Behaviour Research and Therapy, 49(2), 85–91. http://doi.org/10.1016/j.brat.2010.10.010 References
  23. 23. Griffiths, S., Mond., J. M., Li, Z., Gunatilake, S., Murray, S. B., Sheffield, J., & Touyz, S. (2015). Self-stigma of seeking help and being male predict an increased likelihood of having an undiagnosed eating disorder. International Journal of Eating Disorders. # Publication Presentation Download from Academia or ResearchGate

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