Eating symptomatology and general psychopathology in patients with anorexia nervosa from China, UK and Spain: a cross-cultural study examining the role of social attitudes

Cultural studies exploring differences in the manifestation of anorexia nervosa (AN) have primarily focus on Western and non-Western cultures. However, no study so far has considered the role that social attitudes (i.e. Collectivist vs. Individualist cultural values) have in the clinical manifestati...

Full description

Bibliographic Details
Main Authors: Aguera, Zaida, Brewin, Nicola, Chen, Jue, Granero, Roser, Kang, Qing, Fernandez-Aranda, Fernando, Arcelus, Jon
Format: Article
Published: Public Library of Science 2017
Subjects:
Online Access:https://eprints.nottingham.ac.uk/41031/
_version_ 1848796181148205056
author Aguera, Zaida
Brewin, Nicola
Chen, Jue
Granero, Roser
Kang, Qing
Fernandez-Aranda, Fernando
Arcelus, Jon
author_facet Aguera, Zaida
Brewin, Nicola
Chen, Jue
Granero, Roser
Kang, Qing
Fernandez-Aranda, Fernando
Arcelus, Jon
author_sort Aguera, Zaida
building Nottingham Research Data Repository
collection Online Access
description Cultural studies exploring differences in the manifestation of anorexia nervosa (AN) have primarily focus on Western and non-Western cultures. However, no study so far has considered the role that social attitudes (i.e. Collectivist vs. Individualist cultural values) have in the clinical manifestations of eating disorders, including AN patients. With this in mind, the aim of this study is to compare eating and general psychopathology in a large sample of individuals diagnosed with AN from China, Spain, and United Kingdom (UK), in order to study the differences according to belonging to Western or non-Western country, or the country's Individualist Index (IDV). The total sample comprised on 544 adults with a diagnosis of AN recruited from People“s Republic of China (n=72), UK (n=117), and Spain (n=355). Assessment measures included the Eating Disorders Inventory and the Symptom Checklist-90- Revised. Our results show significant differences in most of the eating and psychopathological indices between the three countries. Patients from Western societies (Spain and UK) share more similarities regarding psychopathological expression of AN than the non-Western country (China). While Western countries show higher levels of body dissatisfaction, somatization and overall psychopathology, Chinese patients tend to deny or minimize depression, anxiety and other psychopathological symptoms. Besides, the IDV shows cultural differences in the interpersonal sensitivity scale, being AN patients from UK (the more individualistic society) who presented with higher levels of interpersonal sensitivity (i.e. discomfort during interpersonal interactions and more negative expectations concerning interpersonal behavior). In conclusion, our findings suggest that psychopathological expression of AN is better explained by Western/Eastern influence than by individualist/collectivist values. Although the diagnosis for the eating disorder may be the same, differences in the psychopathology comorbid to the eating disorders may suggest the need for treatments to be modified according to the culture.
first_indexed 2025-11-14T19:43:54Z
format Article
id nottingham-41031
institution University of Nottingham Malaysia Campus
institution_category Local University
last_indexed 2025-11-14T19:43:54Z
publishDate 2017
publisher Public Library of Science
recordtype eprints
repository_type Digital Repository
spelling nottingham-410312020-05-04T18:37:59Z https://eprints.nottingham.ac.uk/41031/ Eating symptomatology and general psychopathology in patients with anorexia nervosa from China, UK and Spain: a cross-cultural study examining the role of social attitudes Aguera, Zaida Brewin, Nicola Chen, Jue Granero, Roser Kang, Qing Fernandez-Aranda, Fernando Arcelus, Jon Cultural studies exploring differences in the manifestation of anorexia nervosa (AN) have primarily focus on Western and non-Western cultures. However, no study so far has considered the role that social attitudes (i.e. Collectivist vs. Individualist cultural values) have in the clinical manifestations of eating disorders, including AN patients. With this in mind, the aim of this study is to compare eating and general psychopathology in a large sample of individuals diagnosed with AN from China, Spain, and United Kingdom (UK), in order to study the differences according to belonging to Western or non-Western country, or the country's Individualist Index (IDV). The total sample comprised on 544 adults with a diagnosis of AN recruited from People“s Republic of China (n=72), UK (n=117), and Spain (n=355). Assessment measures included the Eating Disorders Inventory and the Symptom Checklist-90- Revised. Our results show significant differences in most of the eating and psychopathological indices between the three countries. Patients from Western societies (Spain and UK) share more similarities regarding psychopathological expression of AN than the non-Western country (China). While Western countries show higher levels of body dissatisfaction, somatization and overall psychopathology, Chinese patients tend to deny or minimize depression, anxiety and other psychopathological symptoms. Besides, the IDV shows cultural differences in the interpersonal sensitivity scale, being AN patients from UK (the more individualistic society) who presented with higher levels of interpersonal sensitivity (i.e. discomfort during interpersonal interactions and more negative expectations concerning interpersonal behavior). In conclusion, our findings suggest that psychopathological expression of AN is better explained by Western/Eastern influence than by individualist/collectivist values. Although the diagnosis for the eating disorder may be the same, differences in the psychopathology comorbid to the eating disorders may suggest the need for treatments to be modified according to the culture. Public Library of Science 2017-03-16 Article PeerReviewed Aguera, Zaida, Brewin, Nicola, Chen, Jue, Granero, Roser, Kang, Qing, Fernandez-Aranda, Fernando and Arcelus, Jon (2017) Eating symptomatology and general psychopathology in patients with anorexia nervosa from China, UK and Spain: a cross-cultural study examining the role of social attitudes. PLoS ONE, 12 (3). e0173781/1-e0173781/13. ISSN 1932-6203 Anorexia Nervosa; cross-cultural study; Western; non-Western collectivism; Individualism http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0173781 doi:10.1371/journal.pone.0173781 doi:10.1371/journal.pone.0173781
spellingShingle Anorexia Nervosa; cross-cultural study; Western; non-Western
collectivism; Individualism
Aguera, Zaida
Brewin, Nicola
Chen, Jue
Granero, Roser
Kang, Qing
Fernandez-Aranda, Fernando
Arcelus, Jon
Eating symptomatology and general psychopathology in patients with anorexia nervosa from China, UK and Spain: a cross-cultural study examining the role of social attitudes
title Eating symptomatology and general psychopathology in patients with anorexia nervosa from China, UK and Spain: a cross-cultural study examining the role of social attitudes
title_full Eating symptomatology and general psychopathology in patients with anorexia nervosa from China, UK and Spain: a cross-cultural study examining the role of social attitudes
title_fullStr Eating symptomatology and general psychopathology in patients with anorexia nervosa from China, UK and Spain: a cross-cultural study examining the role of social attitudes
title_full_unstemmed Eating symptomatology and general psychopathology in patients with anorexia nervosa from China, UK and Spain: a cross-cultural study examining the role of social attitudes
title_short Eating symptomatology and general psychopathology in patients with anorexia nervosa from China, UK and Spain: a cross-cultural study examining the role of social attitudes
title_sort eating symptomatology and general psychopathology in patients with anorexia nervosa from china, uk and spain: a cross-cultural study examining the role of social attitudes
topic Anorexia Nervosa; cross-cultural study; Western; non-Western
collectivism; Individualism
url https://eprints.nottingham.ac.uk/41031/
https://eprints.nottingham.ac.uk/41031/
https://eprints.nottingham.ac.uk/41031/