Disordered Eating and Substance Use Among a Female Sample of Mexican Adolescents

Abstract

The relation between disordered eating and substance use was examined among Mexican female adolescents in a probabilistic sample of 2537 high school students in central Mexico, stratified by marginalization status and migratory intensity, obtained during –2007 school year. The Brief Disordered Eating Questionnaire and the World Health Organization and United Nations Division of Narcotic Drugs recommendations for substance use assessments were used. Prevalence and odds ratios for disordered eating and substance use items were calculated separately across low and high marginalization groups. Study's implications and limitations are noted, as well as future research and prevention strategies are suggested.

RÉSUMÉ

Conduite alimentaire de risque et utilisation de substances chez des d’adolescentes mexicaines

L’objectif de ce travail est d’examiner la relation entre conduites alimentaires de risque et l’utilisation de substances chez des adolescentes mexicaines de différents niveaux socioéconomiques. Méthodes: Nous avons étudié un échantillon probabilistique de 2357 étudiantes de lycée, de l’Etat de Mexico (Mexique), stratifié par le niveau de marginalisation et d’intensité de migration. Nous avons calculé la prévalence et les odds ratios séparément pour la conduite alimentaire et l’utilisation de substances par niveau de marginalisation; pour l’utilisation de substances par type de conduite alimentaire, et aussi, pour l’utilisation de substances par niveau de marginalisation et conduite alimentaire. Résultats: Nous avons trouvé des différences significatives pour la peur de grossir et la pratique excessive d’exercice entre groupes, avec plus de risques pour les jeunes filles avec le moindre niveau de marginalisation. Il y a des différences significatives pour l’utilisation de tabac, parfois, pendant la dernière année et ce dernier mois, et ce sont les adolescentes du groupe de moindre marginalisation celles qui présentent les pourcentages les plus élevés. Il n’y a pas eu de différences statistiquement significatives à propos de la consommation d’alcool, dans aucune évaluation réalisée. Il n’y a pas eu de différence significative, par niveau de marginalisation et de conduite alimentaire de risque dans l’utilisation de tabac ou d’alcool. Discussion: Cette étude offre des informations à propos de la conduite alimentaire de risque et l’utilisation de substances par niveau de marginalisation, et montre la relation positive qui existe entre ces deux conduites chez les adolescentes mexicaines lycéennes étudiées, et la tendance de ces conduites d’être plus présentes dans les groupes les moins marginalisés.

Mots clés: conduite alimentaire de risque, utilisation de substances, niveau de marginalisation, Mexique.

RESUMEN

Conducta alimentaria de riesgo y uso de sustancias en una muestra de mujeres adolescentes mexicanas

El objetivo del presente trabajo es examinar la relación entre conductas alimentarias de riesgo y el uso de sustancias en mujeres adolescentes pertenecientes a diversos niveles socioeconómicos. Método: estudiamos una muestra probabilística de 2357 estudiantes de nivel medio superior en el Estado de México, estratificada por nivel de marginación e intensidad de migración. Se calcularon la prevalencia y las razones de momios separadamente para la conducta alimentaria y el uso de sustancias por niveles de marginación; para el uso de sustancias por tipo de conducta alimentaria y para el uso de sustancias por nivel de marginación y conducta alimentaria. Resultados: se encontraron diferencias estadísticamente significativas para el miedo a engordar y la práctica excesiva de ejercicio entre grupos, mostrando mayor riesgo las adolescentes con menor nivel de marginación. Se encontraron diferencias estadísticamente significativas entre los grupos de marginación para el uso de tabaco alguna vez, en el último año y en el último mes, siendo las adolescentes en el grupo de menor marginación aquellas con mayores porcentajes; mientras que no se encontraron diferencias estadísticamente significativas en ninguna de las evaluaciones sobre uso de alcohol. Tampoco se encontraron diferencias estadísticamente significativas por nivel de marginación y conducta alimentaria de riesgo en el uso de alcohol o tabaco. Discusión: el presente estudio proporciona información acerca de la conducta alimentaria de riesgo y el uso de sustancias por nivel de marginación, mostrando evidencia sobre la relación positiva que existe entre la ambas conductas en mujeres adolescentes mexicanas, y la tendencia de ambas conductas a ser más prevalentes en las comunidades menos marginadas.

Palabras claves: conducta alimentaria de riesgo, uso de sustancias, nivel de marginación, México.

Keywords :

• disordered eating
• substance use
• marginalization status
• adolescents
• Mexico

THE AUTHORS

Claudia Unikel, Ph.D., is a full-time researcher and part-time clinician at the National Institute of Psychiatry in Mexico City. As a pioneer in the eating disorders research field in Mexico, her research has been focused on risk factors for eating disorders, the development of culturally sensitive assessment instruments for the detection of disordered eating among adolescents, and more recently on the application of prevention strategies. She received her Masters degree in Clinical Psychology and her Ph.D. in Health Psychology, both from the National Autonomous University of Mexico. She collaborates with many educational institutions around the country, is the author of many scientific papers, and is member of the National Research System.

Tammy L. Root, Ph.D., is a Postdoctoral Fellow in Eating Disorders in the School of Medicine in the Department of Psychiatry at the University of North Carolina at Chapel Hill. Dr. Root received her Ph.D. from the Department of Human Development and Family Studies at The Pennsylvania State University. She also has a Masters degree in Applied Statistics as well as a Masters degree in Psychology. Dr. Root's primary research interest focuses on understanding genetic and environmental influences on the comorbidity of eating disorders and substance use. She is currently involved with the Swedish Twin Registry Studies and the Price Foundation Studies. Her goal is to elucidate the current knowledge on this comorbidity in hopes of better informing prevention and treatment efforts, while simultaneously applying the most current and innovative methodology for best answering these research questions.

Ann Von Holle, M.S., is a statistician in the UNC Department of Psychiatry. She assists UNC Eating Disorders Program researchers with their computing and data analysis needs. Current work includes analysis of data from research projects such as the Norwegian Mother and Child Cohort Study, Price Foundation studies, and most currently the Swedish Twin Registry.

Cynthia M. Bulik, Ph.D., FAED, is the Jordan Distinguished Professor of Eating Disorders in the Department of Psychiatry in the School of Medicine at the University of North Carolina at Chapel Hill, where she is also Professor of Nutrition in the Gillings School of Global Public Health and the Director of the UNC Eating Disorders Program. Her research includes treatment, laboratory, epidemiological, twin and molecular genetic studies of eating disorders and body weight regulation. She also develops innovative means of integrating technology into treatment for eating disorders and obesity. She has active collaborations around the world, has published over 320 scientific papers and chapters on eating disorders, and is the author of the books Eating Disorders: Detection and Treatment (Dunmore), Runaway Eating: The 8 Point Plan to Conquer Adult Food and Weight Obsessions (Rodale), Crave: Why You Binge Eat and How To Stop (Walker), and Abnormal Psychology (Beidel, Bulik, Stanley; Prentice Hall). Dr. Bulik holds the first endowed professorship in eating disorders in the United States.

René Ocampo, M.D., psychiatrist, graduated from the National Institute of Psychiatry in Mexico City. He is a Masters Degree student in Public Mental Health at the National Autonomous University of Mexico. He is interested in the research of eating disorders’ epidemiology and substance use in adolescents.

Notes

2 Unikel Santoncini, C., Gómez-Peresmitré, G., and Bojorquez-Chapela, I. (2008). Manual de Aplicación del Cuestionarios de Factores de Riesgo de Trastornos de la Conducta Alimentaria. Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz. Conacyt SEP Project 2004-01-46560. Mexico, City.