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... with high scores showing strong symptoms of anxiety [25]. General self-worth was measured using the Global Self-Worth subscale of a revised version of the Harter’s Perception Profile for Adolescents =-=[26,27]-=-. A 4-point response scale was applied, ranging from 1 (’corresponds very poorly’) to4(’corresponds very well’). A mean score was computed, with high scores reflecting high self-worth. Alcohol consump...

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...ter distinguish binging from normal eating. This matter bears further investigation. Third, even though it has been argued that full-syndrome ED may not differ qualitatively from sub-threshold levels =-=[45,46]-=-, it remains to be seen whether the findings from this study will be supported in studies using diagnostic categories of ED and in those using diagnostic interviews. Fourth, age-related differences in...

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... preceding week. Mean scores were calculated, with high scores indicating high levels of depressive symptoms. Symptoms of anxiety were measured by six items derived from the Hopkins Symptom Checklist =-=[24]-=-. Item responses ranged from 1 to 4 and were restricted to the preceding week. A mean score was computed, with high scores showing strong symptoms of anxiety [25]. General self-worth was measured usin...

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...ion subscale suggest parental obstruction of independent behaviour, parental control and parental intrusion [28]. Self-concept was measured by a revised version of Rosenberg’s Stability of Self Scale =-=[29]-=-. The scale has four items, each with a response range from 1 to 4. Low mean scores indicate stability and high scores instability in terms of self-concept [29,30]. Social support wasmeasuredbyfiveite...

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...ore reflects greater loneliness. Body mass index (BMI, kg/m2) was computed from self-reported measures of height and weight. Selfreported BMI has been demonstrated to be a valid measure of actual BMI =-=[33]-=-. Age was recorded at the time of each survey. Gender was coded as 1 for male and 2 for female. Statistical analysis We applied c 2 tests to determine the significance of the differences in prevalence...

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...ated’ during the preceding 12 months. The response scale ranged from 1 (’never’) to6 (’more than 50 times’). Relationship to parents was assessed by a short version of the Parental Bonding Instrument =-=[28]-=-. The scale measures the emotional relationship between participants and parents by focusing on two dimensions, parental care and parental overprotection. Each dimension consists of five items and has...

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... current classification systems for ED have been criticised for assigning too large a proportion of diagnosed ED patients to the residual EDNOS category [3] - nearly half of those receiving treatment =-=[4]-=-. Recent studies argue that binge eating with and without purging and non-purging CB needs to be more appropriately classified within diagnostic systems of ED [5-9]. Some suggest that purging without ...

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...s indicate stability and high scores instability in terms of self-concept [29,30]. Social support wasmeasuredbyfiveitemsofthe Social Support Questionnaire, modeled after Sarason and colleagues’ scale =-=[31]-=-. The response alternatives range from 1 (’very poorly satisfied’) to 4 (’veryAbebe et al. BMC Public Health 2012, 12:32 http://www.biomedcentral.com/1471-2458/12/32 Page 4 of 10 satisfied’). High me...

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...fied’). A mean score was computed, with high scores indicating a high level of satisfaction. Depressive symptoms were measured by the 6-item Depressive Mood Inventory constructed by Kandel and Davies =-=[23]-=-. Using a response scale ranging from 1 to 4, participants were asked to restrict their ratings to the preceding week. Mean scores were calculated, with high scores indicating high levels of depressiv...

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..., as binge eating and CB were not measured at T0. Measures Binging and compensatory behaviours were measured by the six items on the severity scale of the Bulimic Investigatory Test, Edinburgh (BITE) =-=[19]-=-. These items measure the frequency of binge eating and CB, ranging from ‘never’ to ‘2-3 times per day.’ The scale consists of the following questions: ‘Do you ever binge on large amounts of food?’; ‘...

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...ter distinguish binging from normal eating. This matter bears further investigation. Third, even though it has been argued that full-syndrome ED may not differ qualitatively from sub-threshold levels =-=[45,46]-=-, it remains to be seen whether the findings from this study will be supported in studies using diagnostic categories of ED and in those using diagnostic interviews. Fourth, age-related differences in...

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...igh levels of symptoms. The second additional measure, the Eating Attitude Test-12 (EAT-12), measures eating problems and concerns related to dieting, bulimia and food preoccupation, and oral control =-=[20,21]-=-. The scale has 12 items with response alternatives ranging from 1 (’never’) to 4 (’always’). Mean scores were calculated, with high scores reflecting high levels of eating problems. Appearance satisf...

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...those with non-purging bulimia nervosa and binge eating disorder, thereby demonstrating that purging behaviors may increase the severity level of psychopathology among those with the fullthreshold ED =-=[35,36]-=-. These studies support our finding that purging behaviors are related to particularly serious levels of psychosocial problems. Due to few participants with a combination of binging and purging in our...

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... Health 2012, 12:32 http://www.biomedcentral.com/1471-2458/12/32 Page 9 of 10 over age. This may be related to a greater perception on the part of females that binge eating is a problematic behaviour =-=[40]-=-. Along the same line of thought, males report a more positive affect (feeling happy) than females after binging [41,42]. Overall, the prevalence rates of symptoms in this study are lower when compare...

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...included in future classification schemes [5,10,11]. In contrast, others propose that future diagnostic categories be reserved for combinations of binge eating with CB, whether purging or non-purging =-=[7,9]-=-. In addition to clinical data, population-based studies examining the epidemiology of subclinical symptoms of binge eating and CB may prove informative for the © 2012 Abebe et al; licensee BioMed Cen...

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...el of satisfaction with their social support network. Loneliness was measured by a 5-item version of the UCLA Loneliness Scale, each item having response options ranging from 1 (’never’) to4(’often’) =-=[32]-=-.A higher mean score reflects greater loneliness. Body mass index (BMI, kg/m2) was computed from self-reported measures of height and weight. Selfreported BMI has been demonstrated to be a valid measu...

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...igh levels of symptoms. The second additional measure, the Eating Attitude Test-12 (EAT-12), measures eating problems and concerns related to dieting, bulimia and food preoccupation, and oral control =-=[20,21]-=-. The scale has 12 items with response alternatives ranging from 1 (’never’) to 4 (’always’). Mean scores were calculated, with high scores reflecting high levels of eating problems. Appearance satisf...

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... have disproportionately high rates among females, binge eating and CB are found at comparatively high rates in both genders [15]. However, there remains a female preponderance for purging behaviours =-=[16]-=-, whereas males and females are equally apt to report binge eating and excessive exercise [15]. Such findings from community-based studies provide ample support to capture the types of binge eating an...

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... affect (feeling happy) than females after binging [41,42]. Overall, the prevalence rates of symptoms in this study are lower when compared with the rates from two studies of US college men and women =-=[43,44]-=-. They are, however, similar to rates found in two community-based studies conducted in Australia and the USA, respectively [5,8]. Nonetheless, factors such as the use of different assessment measures...

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...ticle otherwise specified (EDNOS) [2]. However, current classification systems for ED have been criticised for assigning too large a proportion of diagnosed ED patients to the residual EDNOS category =-=[3]-=- - nearly half of those receiving treatment [4]. Recent studies argue that binge eating with and without purging and non-purging CB needs to be more appropriately classified within diagnostic systems ...

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...s to be more appropriately classified within diagnostic systems of ED [5-9]. Some suggest that purging without other ED symptoms (purging disorder) should be included in future classification schemes =-=[5,10,11]-=-. In contrast, others propose that future diagnostic categories be reserved for combinations of binge eating with CB, whether purging or non-purging [7,9]. In addition to clinical data, population-bas...

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...ed from the Hopkins Symptom Checklist [24]. Item responses ranged from 1 to 4 and were restricted to the preceding week. A mean score was computed, with high scores showing strong symptoms of anxiety =-=[25]-=-. General self-worth was measured using the Global Self-Worth subscale of a revised version of the Harter’s Perception Profile for Adolescents [26,27]. A 4-point response scale was applied, ranging fr...

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...ter perception on the part of females that binge eating is a problematic behaviour [40]. Along the same line of thought, males report a more positive affect (feeling happy) than females after binging =-=[41,42]-=-. Overall, the prevalence rates of symptoms in this study are lower when compared with the rates from two studies of US college men and women [43,44]. They are, however, similar to rates found in two ...

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...age-related decline in prevalence rates for binge eating and CB may be partially explainable by roles associated with the transition to adulthood, specifically partnering and motherhood (for females) =-=[17,39]-=-. However, it may be possible that psychological problems which in many cases are associated with disordered eating may not be reduced to a comparable degree as disordered eating symptoms in the trans...

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... eating and CB was associated with higher ED psychopathology and impairment in mental and physical functioning than was the occurrence of CB alone, regardless of the type, i.e. purging or non-purging =-=[8]-=-. These divergent findings may be the result of different definitions for binge eating and different scales for measuring psychopathology. We defined binge eating only in terms of the amount of food c...

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...dolescence to young adulthood. Unlike the full-threshold forms of ED, which have disproportionately high rates among females, binge eating and CB are found at comparatively high rates in both genders =-=[15]-=-. However, there remains a female preponderance for purging behaviours [16], whereas males and females are equally apt to report binge eating and excessive exercise [15]. Such findings from community-...

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...national study of high school students in the USA also reported vomiting for weight control as the most clinically significant behaviour and one that may be a particularly deleterious component of ED =-=[34]-=-. In this respect, individuals engaging in purging behaviours should probably be targeted as a high-risk group. In contrast, Mond and colleagues reported that the combination of routine binge eating a...

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...ese groups, which, in turn, could have important implications for the future classification of subclinical ED. To an extent, findings from this study parallel those of earlier community-based studies =-=[16,37]-=-. The prevalence of binge eating and several CB behaviours appears to be higher among females than males. The gender difference in the prevalence of symptoms was especially notable for purging, with f...

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...s to be more appropriately classified within diagnostic systems of ED [5-9]. Some suggest that purging without other ED symptoms (purging disorder) should be included in future classification schemes =-=[5,10,11]-=-. In contrast, others propose that future diagnostic categories be reserved for combinations of binge eating with CB, whether purging or non-purging [7,9]. In addition to clinical data, population-bas...

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... affect (feeling happy) than females after binging [41,42]. Overall, the prevalence rates of symptoms in this study are lower when compared with the rates from two studies of US college men and women =-=[43,44]-=-. They are, however, similar to rates found in two community-based studies conducted in Australia and the USA, respectively [5,8]. Nonetheless, factors such as the use of different assessment measures...

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...s to be more appropriately classified within diagnostic systems of ED [5-9]. Some suggest that purging without other ED symptoms (purging disorder) should be included in future classification schemes =-=[5,10,11]-=-. In contrast, others propose that future diagnostic categories be reserved for combinations of binge eating with CB, whether purging or non-purging [7,9]. In addition to clinical data, population-bas...

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...included in future classification schemes [5,10,11]. In contrast, others propose that future diagnostic categories be reserved for combinations of binge eating with CB, whether purging or non-purging =-=[7,9]-=-. In addition to clinical data, population-based studies examining the epidemiology of subclinical symptoms of binge eating and CB may prove informative for the © 2012 Abebe et al; licensee BioMed Cen...

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...ter perception on the part of females that binge eating is a problematic behaviour [40]. Along the same line of thought, males report a more positive affect (feeling happy) than females after binging =-=[41,42]-=-. Overall, the prevalence rates of symptoms in this study are lower when compared with the rates from two studies of US college men and women [43,44]. They are, however, similar to rates found in two ...

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...gnostic and Statistical Manual of Mental Disorders-V. Background Binge eating and compensatory behaviours (CB) are the most frequent symptoms of full- and sub-threshold forms of eating disorders (ED) =-=[1,2]-=-. CB are inappropriate weight control behaviours and are divided into purging behaviours such as self-induced vomiting and the use of laxatives and diuretics, and non-purging behaviours such as the us...

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...ined changes in binge eating and CB from adolescence to adulthood [12-14]. Heartherton and colleagues suggest that the transition to adulthood is related to a decline in binge eating and CB for women =-=[12]-=-. Recently, however, another study reported no significant decreases in point-of-time prevalence of purging among men and women over time, indicating stability in the frequency of purging behaviours a...

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...al. reported most part of adolescent eating disorders to be limited to the teens, co-morbid conditions, such as depression, anxiety and binge drinking persisted to a much larger degree into adulthood =-=[14]-=-. Such findings may indicate that the decline of symptoms of disordered eating not necessarily is related to symptom alleviation for other mental health problems. Moreover, even though we saw this dec...

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... self-worth, alcohol consumption, relationship to parents, self-concept, social support and loneliness. Methods Procedure and participants We analysed data from the longitudinal study Young in Norway =-=[17,18]-=-, a national representative study that was conducted at four time points: 1992 (T0), 1994 (T1), 1999 (T2) and 2005 (T3). The initial sample at T0 comprised 12 287 students in grades 7-12 (12-20 years ...

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... 1 (’never’) to 4 (’always’). Mean scores were calculated, with high scores reflecting high levels of eating problems. Appearance satisfaction was assessed by the Body Areas Satisfaction Scale (BASS) =-=[22]-=-. The scale rates respondents’ level of satisfaction with seven body areas: face, lower torso, mid-torso, upper torso, muscle tone, weight and height. Response options varied from 1 (’very dissatisfie...

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... of Rosenberg’s Stability of Self Scale [29]. The scale has four items, each with a response range from 1 to 4. Low mean scores indicate stability and high scores instability in terms of self-concept =-=[29,30]-=-. Social support wasmeasuredbyfiveitemsofthe Social Support Questionnaire, modeled after Sarason and colleagues’ scale [31]. The response alternatives range from 1 (’very poorly satisfied’) to 4 (’ver...

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...those with non-purging bulimia nervosa and binge eating disorder, thereby demonstrating that purging behaviors may increase the severity level of psychopathology among those with the fullthreshold ED =-=[35,36]-=-. These studies support our finding that purging behaviors are related to particularly serious levels of psychosocial problems. Due to few participants with a combination of binging and purging in our...

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... weight and a higher drive for thinness than males, leading them to engage in more purging behaviours [16,37]. Alternatively, males may be more uncomfortable reporting purging behaviours than females =-=[38]-=-. In both genders, the age-related decline in prevalence rates for binge eating and CB may be partially explainable by roles associated with the transition to adulthood, specifically partnering and mo...

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...ssociated with growing into adulthood. Other studies suggest that a wide range of ED behaviours remain relatively stable over time, supporting the negligible effect of time on the trend of prevalence =-=[5,47]-=-. Furthermore, separating the effect of age from period and cohort through statistical model estimation has proven problematic and has led to incorrect conclusions [48]. Fifth, limited statistical pow...

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...me on the trend of prevalence [5,47]. Furthermore, separating the effect of age from period and cohort through statistical model estimation has proven problematic and has led to incorrect conclusions =-=[48]-=-. Fifth, limited statistical power resulting from the small sample sizes should be considered. More specifically, because the number of participants in the purging CB and bingingCB groups was rather s...