Identifying the eating disorder symptomatic in China: the role of sociocultural factors and culturally defined appearance concerns.

OBJECTIVES: This study evaluated the extent to which eating disorder symptomatic Chinese adolescents and young adults could be differentiated from demographically similar peers on the basis of their sociocultural experiences and appearance perceptions.

METHODS: Forty-two students who endorsed all criteria for a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition eating disorder diagnosis on the Eating Disorder Diagnostic Scale [Stice E, Telch CF, Rizvi SL. Development and validation of the Eating Disorder Diagnostic Scale: a brief self-report measure of anorexia, bulemia, and binge-eating disorder. Psychol Assess 2000;12:123-31] and 42 less symptomatic classmates completed measures of perceived social pressure, teasing, social comparison, negative affect, and concern with facial features.

RESULTS: Symptomatic participants reported significantly more social pressure/teasing, appearance comparison, and concern with facial appearance than their less symptomatic peers, although groups did not differ in average levels of negative affect. In a jackknife discriminant classification analysis using these five predictors, 76.2% of the symptomatic group and 81.0% of the comparison group were correctly classified. Within the symptomatic group, 95% of respondents who reported either full or partial criteria for bulimia nervosa or binge-eating disorder were correctly identified compared to 59.10% of those who endorsed all criteria for eating disorders not otherwise specified related to anorexia nervosa.

CONCLUSIONS: This is the first study to link appearance-related social pressure and social comparison as well as appearance concerns not directly reflecting body size or weight with increased eating disorder symptomatology among young people from the People's Republic of China.