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Psychological distress as a mediator in the relationships between biopsychosocial factors and disordered eating among Malaysian university students

Gan WY, Mohd Nasir MT, Zalilah MS, Hazizi AS

Appetite, 2012 Dec;59(3):679-87.
PMID: 22885453 DOI: 10.1016/j.appet.2012.08.002

The mechanism linking biopsychosocial factors to disordered eating among university students is not well understood especially among Malaysians. This study aimed to examine the mediating role of psychological distress in the relationships between biopsychosocial factors and disordered eating among Malaysian university students. A self-administered questionnaire measured self-esteem, body image, social pressures to be thin, weight-related teasing, psychological distress, and disordered eating in 584 university students (59.4% females and 40.6% males). Body weight and height were measured. Structural equation modeling analysis revealed that the partial mediation model provided good fit to the data. Specifically, the relationships between self-esteem and weight-related teasing with disordered eating were mediated by psychological distress. In contrast, only direct relationships between body weight status, body image, and social pressures to be thin with disordered eating were found and were not mediated by psychological distress. Furthermore, multigroup analyses indicated that the model was equivalent for both genders but not for ethnic groups. There was a negative relationship between body weight status and psychological distress for Chinese students, whereas this was not the case among Malay students. Intervention and prevention programs on psychological distress may be beneficial in reducing disordered eating among Malaysian university students.

Matched MeSH terms: Feeding and Eating Disorders/ethnology; Feeding and Eating Disorders/psychology*
Direct and indirect effects of sociocultural influences on disordered eating among Malaysian male and female university students. A mediation analysis of psychological distress

Gan WY, Mohd Nasir MT, Zalilah MS, Hazizi AS

Appetite, 2011 Jun;56(3):778-83.
PMID: 21435366 DOI: 10.1016/j.appet.2011.03.005

This study aimed to examine the role of psychological distress in the relationships between sociocultural influences (social pressure to be thin and weight teasing) and disordered eating. Data were collected from 584 university students (59.4% females and 40.6% males), aged 18-24 years old (M=20.6, SD=1.4), selected from four universities in the Klang Valley, Malaysia. Participants completed four standardized questionnaires which measured social pressure to be thin, weight-related teasing, psychological distress and disordered eating. A good fit structural equation modeling (SEM) model was developed for both sexes. For males, the SEM model revealed that sociocultural influences showed an indirect effect on disordered eating through psychological distress. For females, the model showed an indirect effect of sociocultural influences on disordered eating through psychological distress, as well as a direct effect of sociocultural influences on disordered eating. In conclusion, psychological distress mediated the relationships between sociocultural influences and disordered eating in both males and females. Our results suggest that disordered eating intervention programs on reducing psychological distress in university students may be beneficial.

Matched MeSH terms: Feeding and Eating Disorders/complications; Feeding and Eating Disorders/psychology*
Is thin in everywhere?: A cross-cultural comparison of a subsection of Tripartite Influence Model in Australia and Malaysia

Shagar PS, Donovan CL, Loxton N, Boddy J, Harris N

Appetite, 2019 03 01;134:59-68.
PMID: 30586595 DOI: 10.1016/j.appet.2018.12.025

Despite growing research investigating prevalence rates of BD among Malaysian women, there has been limited research conducted in Malaysia with respect to factors contributing to its development and consequences. This study tested a subsection of the Tripartite Influence Model, investigating whether sociocultural influences (family, peers, media) lead to thin ideal internalization, which in turn lead to body dissatisfaction (BD) and subsequently restrained eating and bulimic behaviours in both Australian and Malaysian women. Participants were 421 Australian and 399 Malaysian female emerging adults aged between 18 and 25 years, (M = 20.76; SD = 2.86) who completed questionnaires assessing sociocultural influences, thin ideal internalization, body dissatisfaction, restrained eating and bulimic behaviours. The model, largely supported in both cultures, had two points of difference. For Malaysian but not Australian women, family influence was significantly linked with internalization of the thin ideal. Although BD was significantly linked with restrained eating as predicted for Australian women (albeit rather weakly), it was not significantly linked with restrained eating for Malaysian women. The striking similarity of results across both cultures, suggests that Western body ideals, with their corresponding negative sequelae, have infiltrated the collectivist and developing nation of Malaysia.

Matched MeSH terms: Feeding and Eating Disorders
A brief report of two cases of chondro-osteo-dystrophy

GUNN DR

Med J Malaya, 1954 Sep;9(1):84-90.
PMID: 13213457
Matched MeSH terms: Feeding and Eating Disorders*
Fulltext A Case Report of Steroid Withdrawal Syndrome

Wahab F, Rahman RA, Yaacob LH, Noor NM, Draman N

Korean J Fam Med, 2020 Sep;41(5):359-362.
PMID: 32961047 DOI: 10.4082/kjfm.18.0181

We report a case of steroid withdrawal syndrome in a 74-year-old woman who was suspected of having an occult exogenous Cushing's syndrome secondary to prolonged traditional complementary medicine use. She presented with non-specific symptoms of lethargy, malaise, and poor oral intake with weight loss for 1 month, and investigations showed suboptimal 9 AM cortisol level. She has responded well to steroid replacement.

Matched MeSH terms: Feeding and Eating Disorders
Fulltext Transverse myelopathy and hyperphagia in systemic lupus erythematosus: a case report

Chong YH, Cheong I

Med J Malaysia, 1985 Dec;40(4):333-4.
PMID: 3870350

We report a case of systemic lupus erythematosus complicated by transverse myelopathy and hyperphagia. To our knowledge the latter has not been reported before.

Matched MeSH terms: Feeding and Eating Disorders/etiology*
Fulltext Parental concern of feeding difficulty predicts poor growth status in their child

Lee WS, Tee CW, Tan AG, Wong SY, Chew KS, Cheang HK, et al.

Pediatr Neonatol, 2019 12;60(6):676-683.
PMID: 31056340 DOI: 10.1016/j.pedneo.2019.04.004

BACKGROUND: Parents often express concerns about feeding difficulties in their child. We hypothesized that these parental concerns were associated with adverse growth status in early childhood. We aimed to determine the prevalence of such concerns and whether these concerns were associated with adverse growth status in early childhood.
METHODS: We performed a cross-sectional study among healthy children aged 12-36 months attending three well-baby clinics in three urban areas in Malaysia and Singapore between December 2016 and February 2017. Parents were interviewed for concerns about their child's feeding and presence of behavioral and organic red flags for feeding difficulties. We defined growth faltering as weight-for-age < 3rd centile and short stature as height-for-age < 3rd centile according to World Health Organization Growth Standards.
RESULTS: Of the 303 children studied (boys = 160, 52.8%; mean [± SD] chronological age at interview 21.3 [± 4.0] months), 13% (n = 38/292) had growth faltering and 19.5% (n = 50/256) had short stature. Overall, 36.3% (n = 110) of parents expressed concerns about their child's feeding behavior. Sixty-eight percent (n = 206) of parents reported presence of at least one behavioral and 18.5% (n = 56) had at least one organic red flag for feeding difficulties, respectively. 9.9% (n = 30) had both behavioral and organic red flags for feeding difficulties. Growth faltering was significantly associated with parental concern about feeding (odds ratio [OR] 3.049, p

Matched MeSH terms: Feeding and Eating Disorders of Childhood/complications*
Disordered eating and its association with overweight and health-related quality of life among adolescents in selected high schools of Tehran

Jalali-Farahani S, Chin YS, Mohd Nasir MT, Amiri P

Child Psychiatry Hum Dev, 2015 Jun;46(3):485-92.
PMID: 25173517 DOI: 10.1007/s10578-014-0489-8

This study aimed to determine the association between disordered eating and overweight and also health-related quality of life (HRQOL) among adolescents in high schools of Tehran. The participants were 465 adolescents, aged 14-17 years. After anthropometric measurements, body mass index-for-age and body weight status were determined using World Health Organization cut offs. The Eating Attitudes Test-26 (EAT-26) and Pediatric Quality of Life Inventory (PedsQL™4.0) were used to assess disordered eating and HRQOL, respectively. Disordered eating was prevalent in 18.9% of adolescents, with higher prevalence in girls (26.4%) compared to boys (11.8%; χ(2):16.29, p < 0.05). Disordered eating was associated with overweight in girls (χ(2) = 11.07, p < 0.05), but not in boys (χ(2) = 2.01, p = 0.16). Disordered eating was associated with poor HRQOL especially in psychosocial domains of HRQOL. Considering the high prevalence of disordered eating and its association with overweight and poor HRQOL, preventive interventions targeting adolescents are recommended.

Matched MeSH terms: Feeding and Eating Disorders/epidemiology*
Fulltext Cross-Cultural Adaptation And Validation Of The Bahasa Malaysia Version Of The Eating Disorder Examination Questionnaire (Ede-Q)

Ramli, M., Jamaiyah, H., Noor Azimah, M., Khairani, O., Adam, B.

Malaysian Journal of Psychiatry, 2008;17(2):1-8.
MyJurnal

Introduction: As eating disorders such as anorexia nervosa and others are generally becoming more prevalent, it is essential to have a culturally accepted and locally validated questionnaire that is able to detect abnormal eating habits. Objective: To translate the Eating Disorders Examination Questionnaire (EDE-Q) into Bahasa Malaysia (BM) and to determine the construct validity, reliability and other psychometric properties of the BM version. Method: Two parallel forward and backward translations were done in BM in accordance to guideline. Its validation was determined by using confirmatory factor analysis among 298 secondary school children. Results: The BM EDE-Q had very good internal consistency with global Cronbach’s alpha value of 0.879. For construct validity, majority of the items managed to produce values of more than 0.4 for confirmatory factor analysis with four unforced distinct factors detected. Conclusions: Analyses of reliability and validity of this BM version of EDE-Q yielded satisfactory results. The BM version produced in this study had good psychometric properties and it is applicable to the Malaysian population. Findings indicated that cultural factors in eating habits certainly influences the effort to adapt the questionnaire within a Malaysian setting.

Matched MeSH terms: Feeding and Eating Disorders
Validity and reliability of the english version of the sick, control, one stone, fat, food (SCOFF) in Malaysia

Wan Wahida WMZ, Lai PSM, Abdul Hadi H

Clin Nutr ESPEN, 2017 Apr;18:55-58.
PMID: 29132739 DOI: 10.1016/j.clnesp.2017.02.001

BACKGROUND & AIMS: Several questionnaires to screen for eating disorders have been validated in Malaysia. However, these tools are lengthy, and require specialist interpretation. The sick, control, one stone, fat, food (SCOFF) is easy to administer by non-specialists, but has not been validated in Malaysia. Therefore, the aim of our study was to validate the SCOFF on a non-clinical sample of tertiary students to determine if it could identify individuals with an eating disorder.
METHODS: We recruited second year tertiary students from five faculties in a university in Malaysia, from June-November 2014, who could understand English. The SCOFF and the EAT-26 were administered at baseline. Two weeks later, the SCOFF was re-administered to assess for reliability.
RESULTS: A total of 292 students were approached, and all agreed to participate (response rate = 100%). There was moderate correlation between the total SCOFF score with the EAT-26's dieting domain (spearman's rho = 0.504, p < 0.001), bulimia and food preoccupation domain (spearman's rho = 0.438, p < 0.001), and total score (spearman's rho = 0.483, p < 0.001). The internal consistency of the SCOFF was low (Cronbach alpha = 0.470). At retest, kappa scores ranged from 0.211 to 0.591. The sensitivity of the SCOFF was 77.4%, and its specificity was 60.5%. The positive predictive value was 18.9%, and its negative predictive value was 95.8%.
CONCLUSIONS: The SCOFF was found to have adequate convergent validity and stable reliability. However, its internal consistency was low. The SCOFF can still be used in clinical practice. However, its positive results should be interpreted with caution due to its low positive predictive value.
KEYWORDS: Eating disorder; Malaysia; SCOFF; Sensitivity; Specificity; Validation

Matched MeSH terms: Feeding and Eating Disorders/diagnosis*; Feeding and Eating Disorders/prevention & control