title: Comprehensive examination of the trans-diagnostic cognitive behavioral model of eating disorders in males.
abstract: The Trans-diagnostic Model (TM) of eating pathology describes how one or more of four hypothesized mechanisms (i.e., mood intolerance, core low self-esteem, clinical perfectionism and interpersonal difficulties) may interrelate with each other and with the core psychopathology of eating disorders (i.e., over-evaluation of weight and shape) to maintain the disordered behaviors. Although a cognitive behavioral treatment based on the TM has shown to be effective in treating eating disorders, the model itself has undergone only limited testing. This is the first study to both elaborate and test the validity of the TM in a large sample (N=605) of undergraduate men. Body mass index was controlled within structural equation modeling analyses. Although not all expected associations for the maintenance variables were significant, overall the validity of the model was supported. Concern about shape and weight directly led to exercise behaviors. There was a direct path from binge eating to exercise and other forms of compensatory behaviors (i.e., purging); but no significant path from restriction to binge eating. Of the maintaining factors, mood intolerance was the only maintaining variable directly linked to men's eating disorder symptoms. The other three maintaining factors of the TM indirectly impacted restriction through concerns about shape and weight, whereas only interpersonal difficulties predicted low self-esteem and binge eating. Potential implications for understanding and targeting eating disturbances in men are discussed.
authors.affiliation: Department of Brain and Behavioural Sciences, University of Pavia, Italy. Electronic address: antonios.dakanalis@unipv.it.
authors.forename: Antonios
authors.initials: A
authors.lastname: Dakanalis
authors.affiliation: Behavioral and Social Sciences Department, University of the Sciences, Philadelphia, PA, USA.
authors.forename: C Alix
authors.initials: CA
authors.lastname: Timko
authors.affiliation: Department of Neurosciences and Biomedical Technologies, University of Milano-Bicocca, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Clerici
authors.affiliation: Department of Brain and Behavioural Sciences, University of Pavia, Italy.
authors.forename: M Assunta
authors.initials: MA
authors.lastname: Zanetti
authors.affiliation: Faculty of Psychology Catholic University of Milan, Italy; Applied Technology for Neuro-Psychology Laboratory, Istituto Auxologico Italiano, Milan, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Riva
mesh_terms: D000293:Adolescent; D000328:Adult; D000339:Affect; D015928:Cognitive Behavioral Therapy; D001068:Feeding and Eating Disorders / Q000523:psychology* / Q000628:therapy; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008960:Models, Psychological; D010551:Personality; D015203:Reproducibility of Results; D012649:Self Concept; D055815:Young Adult
keywords: Cognitive–behavioral; Eating disorders; Men; Structural equation modeling; Trans-diagnostic Model