Abstract
Background
It has been reported that Internet addiction is associated with substance dependence. Eating disorders have high rates of co-morbidity with substance use disorders. The relationship between Internet addiction and eating disorders was reported in a previous study.
Aims
To examine the hypothesis that Internet addiction is closely associated with bulimia. The hypothesis that depression mediates the relationship between Internet addiction and bulimia symptoms was also tested.
Methods
2,036 Chinese college students were assessed on Internet addiction, eating behaviors and depression. Binge eating, compensatory behaviors, weight concern, menarche and weight change were also reported. Multiple regression analysis was used to test the mediating effect of depression.
Results
Internet addicts showed significantly higher scores on most subscales on EDI-1 than the controls. They reported significantly more binge eating, weight concern and weight change than the controls. Among all of the participants, depression was found to be a partial mediator in the relationship between Internet addiction and bulimia.
Conclusion
This survey provides evidence of the co-morbidity of Internet addiction and bulimia.
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Notes
Met three criteria mean criteria A–C, met four criteria mean criteria A–D, met five criteria mean criteria A–E.
References
Griffith MD (1998) Internet addition: does it really exist? In: Gackenbach J (ed) Psychology and the Internet: intrapersonal, interpersonal and transpersonal Applications. Academic Press, New York, pp 61–75
Young KS (1996) Psychology of computer use. XL. Addictive use of the Internet: a case that breaks the stereotype. Psychol Rep 79:899–902
O’Brien KM, Vincent NK (2003) Psychiatric co-morbidity in anorexia and bulimia nervosa: nature, prevalence, and causal relationships. Clin Psychol Rev 23:57–74
Herzog DB, Franko DL, Dorer DJ, Keel PK, Jackson S, Manzo MP (2006) Drug abuse in women with eating disorders. Int J Eat Disord 39:364–368
Holderness CC, Brooks-Gunn J, Warren MP (1994) Co-morbidity of eating disorders and substance abuse. Int J Eat Disord 6:1–34
Hudson JI, Pope HG, Wurtman J, Yurgelun-Todd D, Mark S, Rosenthal NE (1988) Bulimia in obese individuals. Relationship to normal-weight bulimia. J Nerv Mental Disord 176:144–152
Marcus MD, Wing RR, Ewing L et al (1990) Psychiatric disorders among obese binge eaters. Int J Eat Disord 9:69–77
Yen JY, Yen CF, Chen CC et al (2007) Family factors of Internet addiction and substance use experience in Taiwanese adolescents. Cyberpsychol Behav Soc Netw 10:323–329
Ko CH, Yen JY, Cheng CC et al (2006) Tridimensional personality of adolescents with Internet addiction and substance use experience. Can J Psychiatry 51:887–894
Tao ZL, Liu Y (2009) Is there a relationship between Internet dependence and eating disorders? A comparison study of Internet dependents and non-Internet dependents. Eat Weight Disord 14:77–83
Claes L, Müller A, Norré J, Van Assche L, Wonderlich S, Mitchell JE (2011) The relationship among compulsive buying, compulsive Internet use and temperament in a sample of female patients with eating disorders. Eur Eat Disord Rev 20:126–131
Young KS, Rodgers RC (1998) The relationship between depression and Internet addiction. Cyberpsychol Behav Soc Netw 1:25–28
Lacey JH (1993) Self-damaging and addictive behaviour in bulimia nervosa: a catchment area study. Br J Psychiatry 163:190–194
Young S (1998) Caught in the Net. Wiley, New York
Davis C, Katzman MK (1998) Chinese men and women in the United States and Hong Kong: body and self-esteem ratings as a prelude to dieting and exercise. Int J Eat Disord 23:99–102
Buddeberg-Fischer B, Bernet A, Sieber M, Schmid J, Buddeberg C (1996) Epidemiology of eating behaviour and weight distribution in 14-to 19-year-old Swiss students. Acta Psychiatr Scand 93:293–304
Miotto P, De Coppi M, Frezza M et al (2002) Social desirability and eating disorders. A community study of an Italian school-aged sample. Acta Psychiatr Scand. 105:372–377
Widyanto L, McMurran M (2004) The psychometric properties of the Internet addiction test. Cyberpsychol Behav Soc Netw 7:443–450
Garner DM, Olmstead M, Polivy J (1983) Development and validation of multidimensional Eating Disorder Inventory for anorexia nervosa and bulimia. Int J Eat Disord 2:15–34
Franko DL, Striegel-Moore RH, Barton BA et al (2004) Measuring eating concerns in black and white adolescent girls. Int J Eat Disord 35:179–189
Garner DM (1991) Eating Disorder Inventory-C. Psychological Assessment Resources, Lutz
Garner DM (1991) Eating Disorder Inventory-2. Professional manual. Psychological Assessment Resources, Lutz
Lee S, Lee AM, Leung T (1998) Cross-cultural validity of the Eating Disorder Inventory: a study of Chinese patients with eating disorders in Hong Kong. Int J Eat Disord 23:177–188
Machado PPP, Goncalves S, Martins C et al (2001) The Portuguese version of the Eating Disorders Inventory: evaluation of its psychometric properties. Eur Eat Disord Rev 9:43–52
Shoemaker C, Van Strien T, Van der Staak C (1994) Validation of the Eating Disorders Inventory in a non-clinical population using transformed an untransformed responses. Int J Eat Disord 15:387–393
Eklund K, Paavonen EJ, Almqvist F (2005) Factor structure of the Eating Disorder Inventory-C. Int J Eat Disord 37:330–341
Tao ZL (2010) Epidemiological-and risk factors studies on abnormal attitudes towards eating and adverse dieting behaviors among 12-to 25-year-old Chinese students. Eur Eat Disord Rev 18:507–514
Lee S (1995) Self-starvation in context: towards a culturally sensitive understanding of anorexia nervosa. Soc Sci Med 41:25–36
Zhang, Kong QM (2004) Applicability of EDI-I in Beijing, China. Chin J Mental Health 18:48–50 (in Chinese)
American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, 4th edn. American Psychiatric Association, Washington
Keel PK, Heatherton TF, Dorer DJ et al (2005) Point prevalence of bulimia nervosa in 1982, 1992, and 2002. Psychiatr Med 36:119–127
Pinheiro AP, Thornton LM, Plotonicov KH et al (2007) Patterns of menstrual disturbance in eating disorders. Int J Eat Disord 40:424–434
Beck AT (1967) Depression: clinical, experimental and theoretical aspects. Harper & Row, New York
Beck AT, Beck RW (1972) Screening depressed patients in family practice: a rapid technique. Postgrad Med 52:81–85
Beck AT, Rial WY, Rickels K (1974) Short form of depression inventory: cross validation. Psychol Rep 34:1184–1186
Scogin F, Beutler L, Corbishley A et al (1988) Reliability and validity of the short form Beck Depression Inventory with older adults. J Clin Psychiatr 44:853–856
Gould JA (1982) Psychometric investigation of the standard and long form Beck Depression Inventory. Psychol Rep 51:1167–1170
Baron R, Kenny D (1986) The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Per Soc Psychol 51:1173–1182
Wen ZL, Hou JT, Hang L (2005) A comparison of moderator and mediator and their applications. Acta Psychol Sin 37:268–274
Keel PK, Mitchell JE, Miller KB, Davis TL, Crow SJ (1999) Long-term outcome of bulimia nervosa. Arch Gen Psychiatr 56:63–69
Herzog DB, Keller MB, Sacks NR et al (1999) Recovery and relapse in anorexia and bulimia nervosa: a 7.5-year follow-up study. J Am Acad Child Adolesc Psychiatr 38:829–837
Keel PK, Klump KL, Miller KB et al (2005) Share transmission of eating disorders and anxiety disorders. Int J Eat Disord 38:99–105
Wonderlich SA, Mitchell JE (1997) Eating disorders and comorbidity: empirical, conceptual, and clinical implications. Psychopharmacol Bull 33:381–390
Berardis DD, D’Albenzio A, Gambi F et al (2009) Alexithymia and its relationships with dissociative experiences and Internet addiction in a nonclinical sample. Cyberpsychol Behav Soc Netw 12:67–69
Sexton MC, Sunday SR, Hurt S et al (1998) The relationship between alexithymia, depression, and axis II psychopathology in eating disorder inpatients. Int J Eat Disord 23:277–286
Garner DM, Garfinkel P (1982) Perceptive and cognitive disturbances. Anorexia nervosa: a multidimensional perspective. Brunner/Mazel, New York, pp 123–163
Davis MS, Marsh L (1986) Self-love, self-control and alexithymia: narcissistic features of two bulimic adolescents. Am J Psychother 15:224–232
Wade TD, Tiggemann M, Bulik CM et al (2008) Shared temperament risk factors for anorexia nervosa: a twin study. Psychosom Med 70:239–244
Russell G (1979) Bulimia nervosa: an ominous variant of anorexia nervosa. Psychiatr Med 9:429–448
Ross HE, Ivis F (1999) Binge eating and substance use among male and female adolescents. Int J Eat Disord 26:245–260
Flood M (1989) Addictive eating disorders. Nurs Clin North Am 24:45–53
Khantzian EJ (1985) The self-medication hypothesis of addictive disorders: focus on heroin and cocaine dependence. Am J Psychiatr 142:1259–1264
Johnson CL, Connors ME (1987) The etiology and treatment of bulimia nervosa. Basic Books, New York
Fahy T, Eisler I (1993) Impulsivity and eating disorders. Br J Psychiatr 162:193–197
Wiederman MW, Pryor T (1996) Multi-impulsivity among women with bulimia nervosa. Int J Eat Disord 20:359–365
Cao F, Su L, Liu T, Gao X (2007) The relationship between impulsivity and Internet addiction in a sample of Chinese adolescents. Eur Psychiatr 22:466–471
Vandereyecken W (1990) The addiction model in eating disorders: some critical remarks and a selected bibliography. Int J Eat Disord 9:95–101
Shisslak CM, Crago M, McKnight KM et al (1998) Potential risk factors associated with weight control behaviors in elementary and middle school girls. J Psychosom Res 44:301–313
Frankl G (2000) Foundations of morality—an investigation into the origin and purpose of moral concepts. Open Gate Press, London (translated into Chinese, China international culture and publishing company, print consent from Open gate press), p 105
Wilson GT (1991) The addiction model of eating disorders: a critical analysis. Adv Behav Res Ther 13:27–72
Zhang FC, Mitchell JE, Kuang L et al (1992) The prevalence of anorexia nervosa and bulimia nervosa among freshman medical college students in China. Int J Eat Disord 12:209–214
Acknowledgments
I wish to thank all the participants. I also wish to thank Dr. Dietmar for his statistical advice and Mr. Christopher Angell for corrections to the manuscript. The research was supported by grants from the education department, Jiangsu Province, China (Grand Nr: 2011SJD190001); by grant from the "the Fundamental Research Funds for the Central Universities". (Grand Nr: 3213002203) in Southeast University, China.
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The authors declare that they have no conflict of interest.
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Tao, Z. The relationship between Internet addiction and bulimia in a sample of Chinese college students: depression as partial mediator between Internet addiction and bulimia. Eat Weight Disord 18, 233–243 (2013). https://doi.org/10.1007/s40519-013-0025-z
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DOI: https://doi.org/10.1007/s40519-013-0025-z