Background Eating Disorders (EDs) comprise a significant portion of the mental health morbidity of young people, yet underdetection is a major problem. To identify and tackle the barriers to service engagement, health promotion initiatives require concrete information about how EDs are viewed by adolescents. This study sought to explore young people’s ED literacy and their attitudes towards people with EDs.
Methods Ethical approval was granted by St John of God Research Ethics Committee. 260 schools from across Ireland were invited to participate. 63 schools agreed to recruit students to the survey, which could be completed either online or on paper. Participants were randomly allocated to view one of five vignettes depicting a young person with symptoms consistent with Anorexia Nervosa (AN), Bulimia Nervosa (BN), Binge Eating Disorder (BED), Depression or Type 1 Diabetes. Participants were asked to identify the illness described. They also indicated their beliefs regarding illness duration, level of personal control over the illness, likely causes of the illness, and the target’s personal characteristics. Differences between the vignette conditions were explored in SPSS via chi-square tests (for categorical variables) and analyses of variance with post hoc Bonferroni-corrected comparisons (for continuous variables that met the necessary statistical conditions).
Results 290 students completed the survey. Participants were aged between 15–19 (M = 16.76, SD = 0.89), attended a range of school types (single-sex/mixed-sex, public/private), and 51% were female.
Six participants had been affected by an ED themselves, and 62.4% knew someone with an ED. However, responses to the vignettes showed poor recognition of the symptoms of EDs in comparison with Depression (χ² [4, n = 283] = 36.125, p < 0.001). Only small minorities of those who encountered the AN (20.4%), BN (12.5%) and BED (0%) vignettes correctly named the illness described.
Analysis of the attitude variables showed that all three EDs were seen as significantly longer in duration than Depression (F[4,267] = 6.208, p < 0.001). All three EDs were rated more individually-caused than either Depression or T1 Diabetes (F[4,269] = 18.53, p < 0.001), and participants believed that the BED target had significantly more personal control over their disorder than the Depression or T1 Diabetes targets (F[4,264] = 3.56, p = 0.008). All three ED targets were ascribed significantly less positive personality traits than the T1 Diabetes target (F[4,255] = 12.91, p < 0.001).
Conclusion The results indicate the need for greater public education regarding the symptoms of EDs, so that young people can identify and seek help for problematic eating in themselves and their peers. Health promotion initiatives should also address the stigmatising or blaming attitudes to EDs that can inhibit detection and treatment, particularly the perception that EDs are self-inflicted.
- eating disorders
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