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Acculturation and eating attitudes and behaviours in female Chinese and Caucasian university students:… Hyland, Colleen Anne 1995

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ACCULTURATION  AND EATING ATTITUDES AND BEHAVIOURS IN FEMALE  CHINESE AND CAUCASIAN UNIVERSITY  STUDENTS:  A CORRELATIONAL AND COMPARATIVE STUDY  By  C o l l e e n Anne Hyland  B.A., The U n i v e r s i t y o f B r i t i s h Columbia,  1990  A THESIS SUBMITTED IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF ARTS in THE FACULTY OF GRADUATE STUDIES (Department of C o u n s e l l i n g  Psychology)  We accept t h i s t h e s i s as conforming t o the r e q u i r e d s t a n d a r d  THE UNIVERSITY OF BRITISH COLUMBIA J u l y 1995 © C o l l e e n A. Hyland, 1995  In presenting this thesis in partial fulfilment of  the  requirements  for  an advanced  degree at the University of British Columbia, I agree that the Library shall make it freely available for reference and study. I further agree that permission for extensive copying of this thesis "for scholarly purposes may be 'granted by the head of  my  department  or  or  by  his  or  her  representatives.  It  is understood  that  ;  copying  publication of this thesis for financial gain shall not be allowed without my written permission.  Department of The University of British Columbia Vancouver, Canada  r v  \ '  Da* 3,A.» \~\\ a  DE-6 (2/88)  C  J  Abstract The purpose o f t h i s s t u d y was t o examine the r o l e of s o c i o c u l t u r a l f a c t o r s i n the o c c u r r e n c e o f pathological  e a t i n g a t t i t u d e s and b e h a v i o u r s by  d e t e r m i n i n g the r e l a t i o n s h i p between a c c u l t u r a t i o n t o Canada, as a Western c u l t u r e , and e a t i n g a t t i t u d e s  and  b e h a v i o u r s i n a n o n c l i n i c a l sample o f female Chinese and C a u c a s i a n u n i v e r s i t y s t u d e n t s . exploratory  g o a l any p o s s i b l e  acculuturative  I n a d d i t i o n , as an  r e l a t i o n s h i p between  s t r e s s and e a t i n g a t t i t u d e s  b e h a v i o u r s was a l s o  and  explored.  One hundred female C a u c a s i a n and 131 female Chinese undergraduate s t u d e n t s were r e c r u i t e d from the U n i v e r s i t y o f B r i t i s h Columbia.  Each s u b j e c t was  asked  to complete a Demographic Q u e s t i o n n a i r e as w e l l as the 2 6 item Eating A t t i t u d e s  T e s t (EAT; Garner, Olmsted,  Bohr, & G a r f i n k e l , 1982). subjects  A d d i t i o n a l l y , the C h i n e s e  were asked t o complete the Suinn-Lew A s i a n  Self-Identity Acculturation R i c k a r d - F i g u e r o a , Lew, SAFE A c c u l t u r a t i v e Ma'ldonado,  1987) .  S c a l e (SL-ASIA; S u i n n ,  & Vigil,  Stress  1987)  and the 24 i t e m  S c a l e (SAFE; Mean, P a d i l l a , &  S t a t i s t i c a l analyses r e v e a l e d  no d i f f e r e n c e i n EAT  scores across the two c u l t u r a l groups.  Correlational  analyses i n d i c a t e d n e g a t i v e r e l a t i o n s h i p s between l e v e l of a c c u l t u r a t i o n and p a t h o l o g i c a l  e a t i n g a t t i t u d e s and  behaviours f o r the Chinese s u b j e c t s , the  less acculturated  pathological  suggesting  Chinese s u b j e c t s  that  experience more  e a t i n g a t t i t u d e s and b e h a v i o u r s .  C o r r e l a t i o n a l analyses a l s o found p o s i t i v e r e l a t i o n s h i p s between a c c u l t u r a t i v e s t r e s s and e a t i n g a t t i t u d e s and behaviours f o r the Chinese  subjects,-  suggesting the h i g h e r a c c u l t u r a t i v e s t r e s s , the g r e a t e r e a t i n g pathology. analyses r e v e a l e d  Finally, that,  the r e s u l t s o f  i n general,  regressive  acculturative  s t r e s s was the best p r e d i c t o r of p a t h o l o g i c a l a t t i t u d e s and behaviours f o r the Chinese Implications  eating  subjects.  f o r these r e s u l t s and suggestions f o r  future research  are  discussed.  iv  Table o f C o n t e n t s Abstract  .  '  Table o f C o n t e n t s . .  i i iv  L i s t of Tables  viii  Acknowledgments  x  Chapter I : I n t r o d u c t i o n  1  Overview  . . . .  1  Purpose o f t h i s Study  4  S i g n i f i c a n c e and I m p l i c a t i o n s  6  D e f i n i t i o n o f Terms  7  Chapter I I : L i t e r a t u r e Review  10  The D i a g n o s i s o f E a t i n g D i s o r d e r s i n Reseach  10  The R o l e o f S o c i o c u l t u r a l F a c t o r s i n t h e Occurrence o f E a t i n g D i s o r d e r s  14  A c c u l t u r a t i o n , Body Image, & the Occurrence of E a t i n g Disorders  24  Summary  34  Chapter I I I : Method  37  Design  37  Sample  37  Procedure  40  Instrumentation  41  Demographic Q u e s t i o n n a i r e  42  V  E a t i n g A t t i t u d e s Test  43  Suinn-Lew A s i a n S e l f - I d e n t i t y A c c u l t u r a t i o n Scale  44  SAFE A c c u l t u r a t i v e S t r e s s S c a l e s  47  Hypothesis  51  Statistical Analysis..  52  Chapter IV: R e s u l t s Demographic D e s c r i p t i o n o f t h e Sample  54 54  H y p o t h e s i s 1: E a t i n g A t t i t u d e s and B e h a v i o u r s a c r o s s C u l t u r a l Groups.  62  H y p o t h e s i s 2 & 3: C o r r e l a t i o n a l A n a l y s i s  65  I n t e r c o r r e l a t i o n a l analysis of o f the EAT and SL-ASIA  67  L e v e l o f a c c u l t u r a t i o n and e a t i n g a t t i t u d e s and b e h a v i o u r s f o r the Chinese s u b j e c t s . .  68  A c c u l t u r a t i v e s t r e s s and e a t i n g a t t i t u d e s and b e h a v i o u r s f o r t h e Chinese s u b j e c t s H y p o t h e s i s 4: R e g r e s s i o n A n a l y s i s Chapter V: D i s c u s s i o n  71 73 84  Review o f the Research F i n d i n g s  84  C u l t u r a l group d i f f e r e n c e s  84  vi  L e v e l of a c c u l t u r a t i o n and  eating  a t t i t u d e s and b e h a v i o u r s A c c u l t u r a t i v e s t r e s s and  88 eating  a t t i t u d e s and b e h a v i o u r s  91  Regression analysis  93  Cross-Cultural  V a l i d i t y of the EAT  94  Limitations  97  Suggestions f o r Future Research  .99  Implications  101  for Counselling  Conclusions  104  References  106  Appendices  117  Appendix A.  Demographic Q u e s t i o n n a i r e  Appendix B. EAT  117  Questionnaire  119  Appendix C.  SL-ASIA Q u e s t i o n n a i r e . . . .  Appendix D.  SAFE Q u e s t i o n n a i r e  Appendix E.  Introductory  Letter  121 12 6  to  Professors Appendix F. I n t r o d u c t o r y  129 L e t t e r to Subjects  and L e t t e r of Consent  131  Appendix G.  Follow-up L e t t e r  133  Appendix H.  I n t e r c o r r e l a t i o n s of the A t t i t u d e s Test  (EAT)  Eating 135  vii  Appendix I. I n t e r c o r r e l a t i o n s of L e v e l o f Acculturation  (SL-ASIA)  137  viii  L i s t of Tables Table 1.  Break Down o f S u b j e c t s i n each Sample  Table 2.  ••••  56  Means and S t a n d a r d D e v i a t i o n s f o r Age, Years L i v i n g i n N o r t h America, EAT, & SL-ASIA between Samples  Table 3.  57  Demographic Data f o r a l l S u b j e c t s i n c l u d i n g S i b l i n g Order, Department, Program, P l a c e o f B i r t h and Generation Level  Table 4.  59  Means and S t a n d a r d D e v i a t i o n s f o r Demographic Data i n c l u d i n g Age, Years L i v i n g i n N o r t h America, and  Years  i n S c h o o l i n N o r t h America Table 5.  61  Means and S t a n d a r d D e v i a t i o n s f o r f u l l S c a l e and S u b s c a l e EAT Scores a c r o s s C u l t u r a l Groups  Table 6.  64  C o n t i n g e n c y Table o f Chinese and C a u c a s i a n S u b j e c t s who D i s p l a y E a t i n g P a t h o l o g y (EAT > 20) o r no E a t i n g P a t h o l o g y (EAT < 21)  Table 7.  66  C o r r e l a t i o n M a t r i x o f F u l l S c a l e and S u b s c a l e EAT and SL-ASIA Scores f o r the Chinese S u b j e c t s  69  ix  Table 8.  One-way A n a l y s i s o f V a r i a n c e f o r F u l l EAT S c a l e Scores a c r o s s L e v e l o f Acculturation  Table 9.  72  C o r r e l a t i o n M a t r i x o f F u l l S c a l e and S u b s c a l e EAT Scores w i t h SAFE....  '..74  Table 10. C o r r e l a t i o n M a t r i x o f F u l l S c a l e and S u b s c a l e SL-ASIA Scores w i t h SAFE  75  Table 11. M u l t i p l e R e g r e s s i o n A n a l y s i s o f Predictors of Pathological Eating A t t i t u d e s and B e h a v i o u r s . . . .  77  Table 12. Stepwise R e g r e s s i o n o f t h e F u l l S c a l e EAT on a l l o f the P r e d i c t o r Variables  79  Table 13. Stepwise R e g r e s s i o n o f the D i e t S u b s c a l e on a l l o f t h e P r e d i c t o r Variables  80  Table 14. Stepwise R e g r e s s i o n o f t h e B u l i m i a S u b s c a l e on a l l o f t h e P r e d i c t o r Variables  81  Table 15. Stepwise R e g r e s s i o n o f t h e O r a l C o n t r o l S u b s c a l e on a l l o f the Predictor Variables  82  X  Acknowledgments I would l i k e to express my deepest a p p r e c i a t i o n t o my committee members f o r s h a r i n g t h e i r time, and wisdom. supervisor,  support,  In p a r t i c u l a r , I wish to thank my Dr. Ishu Ishiyama, f o r h i s a s s i s t a n c e and  guidance throughout t h i s study.  I would a l s o l i k e to  thank Dr. Beth Haverkamp f o r her d i r e c t i o n on s t a t i s t i c a l matters, as w e l l as her warmth and support. Thanks a l s o to Dr. E l l i o t Goldner f o r s h a r i n g h i s e x p e r t i s e i n e a t i n g d i s o r d e r s , and f o r always t a k i n g time from h i s very busy schedule f o r c o n s u l t a t i o n and to a t t e n d my t h e s i s defence. Thanks you to f a m i l y and f r i e n d s f o r t h e i r encouragement and unending support d u r i n g of t h i s t h e s i s . partner  f o r being  Finally,  the w r i t i n g  a s p e c i a l thanks t o my  a p i l l a r o f support and s t r e n g t h , and  f o r p u t t i n g up with my c r a z i n e s s d u r i n g  this  process.  1  Chapter I Introduction Overview Preoccupation  w i t h body weight and t h e chase  p r e s e n t a t i o n o f e a t i n g d i s o r d e r s such as a n o r e x i a n e r v o s a and b u l i m i a n e r v o s a a r e commonly  recognized  phenomena f o r women l i v i n g i n Western c u l t u r e s . researchers  have h y p o t h e s i z e d  Some  that the occurrence o f  e a t i n g d i s o r d e r s may be l i n k e d t o Western v a l u e s i n r e l a t i o n t o t h e emphasis on t h i n n e s s  as t h e d e s i r e d  female shape (Garner & G a r f i n k e l , 1980; N a s s e r , 1988a, 1988b).  For instance, research  i n t o c e r t a i n sub-  c u l t u r e s , where t h e demand f o r t h i n n e s s  i s heightened,  gives support t o the c u l t u r a l determination  of eating  d i s o r d e r s and p a t h o l o g i c a l e a t i n g a t t i t u d e s (Garner & G a r f i n k e l , 1980).  In t h e i r i n v e s t i g a t i o n of eating  a t t i t u d e s and b e h a v i o u r s , Garner and G a r f i n k e l found t h a t female models and dancers had an o v e r r e p r e s e n t a t i o n o f e a t i n g d i s o r d e r s and e x c e s s i v e d i e t i n g concerns. A d d i t i o n a l l y , two l i n e s o f e p i d e m i o l o g i c a l r e s e a r c h have examined t h e o c c u r r e n c e o f e a t i n g d i s o r d e r s and p a t h o l o g i c a l e a t i n g a t t i t u d e s i n  •2  nontraditional populations  such as non-Western c u l t u r e s  and e t h n i c m i n o r i t i e s l i v i n g i n Western c u l t u r e s . F i r s t , c r o s s - c u l t u r a l r e s e a r c h has  suggested t h a t  e a t i n g d i s o r d e r s are most common amongst Western c u l t u r e s , or amongst .those c u l t u r e s , l i k e Japan, have r e c e n t l y i n t r o d u c e d Western v a l u e s and t h e i r s o c i e t y (Kamata, Nogarni,  ideals into  & Momma, 1987;  1988a, 1988b; Suematsu, 1985).  Nasser,  S i m i l a r l y , non-Western  c u l t u r e s t h a t do not i d e a l i z e t h i n n e s s , such as r a r e l y r e p o r t cases of e a t i n g d i s o r d e r s Lee, 1989;  1993;  Lee,  Ho,  & Hsu,  who  1993;  Lee,  (Lee,  Chui,  China, 1991;  & Chen,  McCarthy, 1990). The  r e s u l t s of e p i d e m i o l o g i c a l c r o s s - c u l t u r a l  s t u d i e s s h o u l d , however, be i n t e r p r e t e d w i t h c a u t i o n  as  some c u l t u r e s do not r e c o g n i z e  eating disorders  distinct entities.  Therefore,  i t i s possible that  b e h a v i o u r which may  be d i a g n o s e d as a n o r e x i a or b u l i m i a  i n Western c u l t u r e s i s d i a g n o s e d as h y s t e r i a or  as  anxiety  i n other c u l t u r e s . The  second area o f e p i d e m i o l o g i c a l r e s e a r c h  e x p l o r e d the o c c u r r e n c e o f e a t i n g d i s o r d e r s  has  and  p a t h o l o g i c a l e a t i n g a t t i t u d e s i n non-white i n d i v i d u a l s l i v i n g i n Western c u l t u r e s ( i e . C r i s p , Palmer, K a l l l u c y , 1976;  Gray, Ford, K e l l y , 1987;  Gross & Rosen,  3  1988;  Hsu, 1987; Lacey & Dolan, 1988'; L u c e r o ,  Bramlette, The  Brassington,  Hicks,  & W e l t e r , 1992; Nevo, 1985).  r e s u l t s o f t h e s e s t u d i e s appear t o i n d i c a t e t h a t  e a t i n g d i s o r d e r s and p a t h o l o g i c a l e a t i n g a t t i t u d e s and b e h a v i o u r s o c c u r l e s s f r e q u e n t l y i n non-white individuals.  These s t u d i e s , however, s i m p l y  address  r a c i a l d i f f e r e n c e s , r a t h e r than d i f f e r e n c e s i n c u l t u r a l orientation.  Thus, as Dolan (1991)  discussed,  i n f e r e n c e s as t o t h e r o l e o f s o c i o c u l t u r a l f a c t o r s must be made t e n t a t i v e l y . I n an attempt t o address some o f t h e methodological  l i m i t a t i o n s o f t h e above c i t e d  research  while continuing to i n v e s t i g a t e the r o l e of s o c i o c u l t u r a l f a c t o r s i n the occurrence of eating disorders, researchers  have begun e x p l o r i n g t h e  r e l a t i o n s h i p between l e v e l o f a c c u l t u r a t i o n t o Western c u l t u r e s and t h e o c c u r r e n c e o f e a t i n g d i s o r d e r s and p a t h o l o g i c a l e a t i n g a t t i t u d e s i n non-white women. These r e s e a r c h  s t u d i e s a r e based on t h e premise t h a t  Western c u l t u r e s ' v a l u e s , thinness  such as t h e i d e a l i z a t i o n o f  f o r women, i s r e l a t e d t o r e p o r t s o f a n o r e x i a  and b u l i m i a .  Thus, t h e o c c u r r e n c e o f e a t i n g  and p a t h o l o g i c a l e a t i n g a t t i t u d e s s h o u l d v a r y  disorders according  4  t o t h e degree t o which i n d i v i d u a l s a s c r i b e t o and i n t e r n a l i z e Western v a l u e s and i d e a l s . Work i n t h i s a r e a however i s s t i l l  i n i t s infancy.  To d a t e , o n l y f o u r s t u d i e s have attempted t o determine the r e l a t i o n s h i p between l e v e l o f a c c u l t u r a t i o n t o a Western c u l t u r e and o c c u r r e n c e o f e a t i n g d i s o r d e r s and pathological eating attitudes 1993;  (Abrams, A l l e n , Gray,  Furnham & P a t e l , 1994; Mumford, Whitehouse, &  P'latts, 1991; Pumariega, 1986).  Unfortunately,  r e s u l t s o f t h e s e s t u d i e s a r e somewhat l e a v i n g many q u e s t i o n s unanswered.  the  contradictory,  I t i s hoped t h a t  t h i s s t u d y may h e l p address some o f t h e s e  questions.  Purpose o f t h i s Study The  purpose o f t h i s s t u d y i s t o i n v e s t i g a t e t h e  r o l e of s o c i o c u l t u r a l f a c t o r s i n the occurrence of p a t h o l o g i c a l e a t i n g a t t i t u d e s by d e t e r m i n i n g t h e r e l a t i o n s h i p between l e v e l o f a c c u l t u r a t i o n t o a Western c u l t u r e and e a t i n g a t t i t u d e s i n a n o n c l i n i c a l sample o f female Chinese and C a u c a s i a n u n i v e r s i t y s t u d e n t s from t h e U n i v e r s i t y o f B r i t i s h Columbia. S p e c i f i c a l l y , t h i s s t u d y w i l l attempt t o address the f o l l o w i n g r e s e a r c h 1.  questions:  Is there a s i g n i f i c a n t difference i n the e a t i n g a t t i t u d e s o f Chinese female u n i v e r s i t y  5  students and Caucasian female u n i v e r s i t y students? 2.  Is there a r e l a t i o n s h i p between l e v e l o f a c c u l t u r a t i o n to a Canada, as a Western c u l t u r e , and e a t i n g a t t i t u d e s i n Chinese female u n i v e r s i t y students?  In a d d i t i o n , because i t has been suggested that a r e l a t i o n s h i p between a c c u l t u r a t i v e s t r e s s and e a t i n g a t t i t u d e s may e x i s t which c o u l d  f u n c t i o n to o b s t r u c t  a  true understanding of the r e l a t i o n s h i p between l e v e l o f a c c u l t u r a t i o n and the occurrence o f p a t h o l o g i c a l attitudes  (DiNicola,  eating  1990a, 1990b; Mumford, Whitehouse,  & Choudry, 1992; Mumford e t a l . , 1991), t h i s study w i l l a l s o e x p l o r e the p o s s i b i l i t y o f a r e l a t i o n s h i p between a c c u l t u r a t i v e s t r e s s and e a t i n g a t t i t u d e s . following exploratory  research  Thus, the  questions w i l l be  addressed: 3.  Is there a r e l a t i o n s h i p between p e r s o n a l and f a m i l i a l acculturative stress.and  eating  a t t i t u d e s i n Chinese female u n i v e r s i t y students? 4.  Is there a r e l a t i o n s h i p between l e v e l of a c c u l t u r a t i o n to Canada, as a Western Culture,  and e a t i n g a t t i t u d e s i n Chinese  6  f e m a l e . u n i v e r s i t y students  independent o f  the e f f e c t s o f a c c u l t u r a t i v e s t r e s s ? S i g n i f i c a n c e and I m p l i c a t i o n s o f t h i s Study E a t i n g d i s o r d e r s d i s r u p t t h e l i v e s o f many i n d i v i d u a l s , most o f whom a r e women. chronic fatigue, depression  and s o c i a l  They c r e a t e withdrawal,  l e a d i n g t o s e v e r e p e r s o n a l unhappiness ( C r i s p , Hsu, Harding, Hartshorn, complications  1980).  As w e l l , many p h y s i o l o g i c a l  r e s u l t from e a t i n g d i s o r d e r s , i n c l u d i n g  a l t e r a t i o n s t o c a r d i o v a s c u l a r f u n c t i o n s , lowered blood pressure  and h e a r t r a t e s , g a s t r o i n t e s t i n a l  c o m p l i c a t i o n s , and even d e a t h ( C u e l l a r , Van T h i e l , 1986 Hsu,  1990; I s n e r , R o b e r t s ,  Heymsfield,  1985).  s e v e r i t y o f these d i s o r d e r s as w e l l as t h e i r  The prevelence  i n Western c u l t u r e s has s t i m u l a t e d a l o t o f r e s e a r c h i n t o t h e areas o f b o t h e t i o l o g y and t r e a t m e n t . C u r r e n t l y , however, many q u e s t i o n s  remain unanswered.  S o c i o c u l t u r a l t h e o r i s t s have emphasized t h e importance o f s o c i o c u l t u r a l l y d r i v e n f a c t o r s , f o r example t h e i d e a l i z a t i o n o f t h i n n e s s , i n t h e development o f e a t i n g d i s o r d e r s and p a t h o l o g i c a l e a t i n g attitudes.  A l t h o u g h r e c o g n i z i n g and acknowledging t h e  r o l e of s o c i o c u l t u r a l f a c t o r s i n the occurrence of e a t i n g d i s o r d e r s p r o v i d e s no s i m p l e answers, i t i s a  7  first  and necessary step.  more r e s e a r c h  However, beyond r e c o g n i t i o n ,  i s needed to b e t t e r understand the r o l e  of c u l t u r e i n the development o f e a t i n g d i s o r d e r s and pathological eating attitudes. begin.  I t i s hoped t h i s r e s e a r c h  Only then can change study w i l l make an  important c o n t r i b u t i o n to the scant r e s e a r c h a v a i l a b l e in this  area.  Additionally,  i t i s hoped t h a t t h i s study w i l l  shed some l i g h t on the s p e c i f i c p o p u l a t i o n s developing behaviours.  at r i s k f o r  p a t h o l o g i c a l e a t i n g a t t i t u d e s and Once i t i s known which p o p u l a t i o n s  greatest r i s k ,  education,  programs can be m o d i f i e d  prevention,  are a t  and treatment  accordingly.  D e f i n i t i o n s o f t h e Terms There are s e v e r a l terms which are u t i l i z e d throughout t h i s study. controversy  Because there i s o f t e n  as t o what d e f i n i t i o n s are a p p r o p r i a t e f o r  many o f these terms, i t i s necessary to d e f i n e the f o l l o w i n g terms i n the ways t h a t are r e l e v a n t f o r the current  study.  A c c u l t u r a t i o n or Level of Acculturation:  the degree to which an immigrant adopts or shares the same values,  a t t i t u d e s , and  8  behaviours of the r e c e i v i n g s o c i e t y ; c u l t u r e change which r e s u l t s from continuous contact  between two  distinct  c u l t u r a l groups, Acculturative  Stress:  r e f e r s to one k i n d of s t r e s s , t h a t i n which the s t r e s s o r s are  i d e n t i f i e d as having t h e i r  source i n the process of acculturation. Race:  a b i o l o g i c a l term r e f e r r i n g to the g e n e t i c  differences  between groups w i t h i n species Culture:  a  (Dolan, 1991).  an a n t h r o p o l o g i c a l  term,  d e f i n i n g a complex whole includes  that  the knowledge,  behavior, morals, customs, and often r e l i g i o n .  R e f e r r i n g to  something a r b i t r a r y and v a r i a b l e which i s a c q u i r e d  by  b e i n g and/or growing up as a member o f a s o c i e t y 1991) .  (Dolan,  9  Eating  Disorders:  r e f e r s to c l i n i c a l case of anorexia nervosa and  bulimia  nervosa as d e f i n e d by the  D i a g n o s t i c and S t a t i s t i c a l Manual of Mental Fourth Revised Pathological  Disorders,  (DSM-IV,1994).  eating  a t t i t u d e s & behaviours or e a t i n g pathology:  a broad range of a t t i t u d e s and behaviours c h a r a c t e r i s t i c of anorexia nervosa and nervosa.  Attitudes  bulimia and  behaviours which may  indicate  someone i s at r i s k of d e v e l o p i n g an e a t i n g Caucasian:  an i n d i v i d u a l of Western European  background  born i n North Chinese:  disorder,  who  was  America,  an i n d i v i d u a l who  is self-  r e f e r r e d as Chinese.  10  Chapter I I L i t e r a t u r e Review The  l a s t s e v e r a l decades have w i t n e s s e d an upsurge  of r e s e a r c h  i n v e s t i g a t i n g the e t i o l o g y of eating  d i s o r d e r s such as a n o r e x i a n e r v o s a and b u l i m i a n e r v o s a . In t h i s c h a p t e r , beginning  I w i l l r e v i e w some o f t h i s  w i t h an o u t l i n e o f some g e n e r a l  information concerning eating disorders.  literature  diagnostic Next, I w i l l  review the l i t e r a t u r e e x p l o r i n g the r o l e of s o c i o c u l t u r a l f a c t o r s i n t h e development o f e a t i n g d i s o r d e r s and p a t h o l o g i c a l e a t i n g a t t i t u d e s .  Finally,  I w i l l explore the current research u t i l i z i n g the concept o f l e v e l o f a c c u l t u r a t i o n as a measure t o t a p i n t o t h e r o l e p l a y e d by s o c i o c u l t u r a l f a c t o r s . The  Diagnosis The  of Eating Disorders  i n Research  two most commonly r e c o g n i z e d  eating  are a n o r e x i a n e r v o s a and b u l i m i a n e r v o s a . n e r v o s a was f i r s t d e s c r i b e d 1860's by p h y s i c i a n s ( P r i n c e , 1985).  disorders  Anorexia  as a d i s t i n c t e n t i t y i n t h e  i n England, France and R u s s i a  I n 1874 S i r W i l l i a m Withey G u l l  p u b l i s h e d a f u l l paper on an i l l n e s s he c a l l e d a n o r e x i a nervosa.  G u l l ' s g e n e r a l d e s c r i p t i o n . h o l d s up  incredibly well i n i t s clinical  d e t a i l ; over one  hundred y e a r s l a t e r a l l t h a t has been added i s a  11  d i f f e r e n t i a t i o n o f subtypes  ( i n 1979, R u s s e l l  d i s t i n g u i s h e d b u l i m i a n e r v o s a from a n o r e x i a n e r v o s a ) , and more d e t a i l s , which,  i n general, served only to  confirm G u l l ' s i n i t i a l description.  Gull's early  d e s c r i p t i o n s i n c l u d e d body image d i s t u r b a n c e , an intense d e s i r e f o r thinness t o the p o i n t of emaciation ( i n a n o r e x i c s ) , and p e r i o d s o f a b s t i n e n c e from food f o l l o w e d by consumption o f enormous q u a n t i t i e s o f food and subsequent s e l f - i n d u c e d v o m i t i n g and/or l a x a t i v e abuse ( i n b u l i m i c s ) .  I t i s i n t e r e s t i n g t o compare  these e a r l y d e s c r i p t i o n s w i t h t h a t p r o v i d e d i n DSM IV (1994), t h e c u r r e n t d i a g n o s t i c manual o f t h e American Psychiatric Association. The D i a g n o s t i c and S t a t i c a l Manual o f M e n t a l Disorders, Fourth Revised  (DSM-IV, 1994) r e c o g n i z e s  b o t h a n o r e x i a n e r v o s a and b u l i m i a n e r v o s a as d i s t i n c t disorders.  A c c o r d i n g l y , t h e DSM-IV d i a g n o s t i c c r i t e r i a  f o r a n o r e x i a nervosa a r e : weight  (a) maintenance o f body  15% below t h a t expected;  g a i n i n g weight  (b) i n t e n s e f e a r o f  even though underweight;  i n t h e way i n which one's body weight,  (c) d i s t u r b a n c e s i z e , o r shape  i s e x p e r i e n c e d ; and (d) absence o f a t l e a s t t h r e e c o n s e c u t i v e m e n s t r u a l c y c l e s i n females when o t h e r w i s e expected t o o c c u r .  S i m i l a r l y , the d i a g n o s t i c c r i t e r i a  12  f o r b u l i m i a nervosa are:  (a) r e c u r r e n t  binge e a t i n g i n which l a r g e  amounts o f food are  consumed i n a d i s c r e t e p e r i o d o f time 2 hour p e r i o d ) ; the binges;  exercise;  (e.g. w i t h i n any  (b) a sense o f l a c k o f c o n t r o l  (c) r e c u r r e n t  inappropriate  behaviour such as vomiting, diuretics,  episodes o f  during  compensatory  use o f l a x a t i v e s o r  s t r i c t d i e t i n g o f f a s t i n g , or vigorous (d) binge e a t i n g and  Inappropriate  compensatory behaviour which occurs, l e a s t twice a week f o r 3 months;  on average, at  (e) s e l f - e v a l u a t i o n  unduly i n f l u e n c e d by body shape and weight; and (f) when such d i s t u r b a n c e s during  which do not occur e x c l u s i v e l y  episodes o f anorexia  nerovsa  C u r r e n t l y , most r e s e a r c h e r s ,  (DSM-IV, 1994).  t h e o r i s t s , and  c l i n i c i a n s working i n the area o f e a t i n g  disorders  agree t h a t the o n l y way to a c c u r a t e l y i d e n t i f y a case of anorexia  nervosa o r b u l i m i a nervosa i s by p e r s o n a l  i n t e r v i e w u s i n g c l i n i c a l assessment measures such as the DSM-IV c r i t e r i a . for  two reasons.  Clinical  First,  interviews  are r e q u i r e d  a wide spectrum o f  p a t h o l o g i c a l e a t i n g behaviours and a t t i t u d e s occur i n the p o p u l a t i o n ,  ranging  from c u l t u r a l l y  accepted  d i e t i n g to acute cases o f e a t i n g d i s o r d e r s , and as i t stands no o b j e c t i v e measure i s s e n s i t i v e enough t o  13  d i f f e r e n t i a t e the r i g i d i t y behaviours that represent  i n b e l i e f s , a t t i t u d e s , and a c l i n i c a l eating disorder.  Second, d e s p i t e t h e i n c r e a s i n g p r e v e l e n c e o f e a t i n g d i s o r d e r s , they are s t i l l  a r e l a t i v e l y uncommon  phenomenon.  W i l l i a m s , Hand, and  Accordingly,  T a r n a p l o s k y (1982) suggest t h a t because t h e p r e v e l e n c e o f e a t i n g d i s o r d e r s remains r e l a t i v e l y low, t h e p o s i t i v e p r e d i c t i v e v a l u e o f any s e l f - r e p o r t i n s t r u m e n t i s l i k e l y t o be q u i t e low r e g a r d l e s s o f t h e s e n s i t i v i t y or s p e c i f i c i t y o f t h e i n s t r u m e n t u t i l i z e d .  In other  words, i t i s l i k e l y t h a t many i n d i v i d u a l s who p a t h o l o g i c a l l y on a q u e s t i o n n a i r e  score  may i n f a c t n o t have  a c l i n i c a l eating disorder. For b o t h o f these reasons t h e most w i d e l y  accepted  s t r a t e g y o f i d e n t i f y i n g c l i n i c a l cases o f e a t i n g disorders i n research screening  s t u d i e s has become t h e two-stage  s u r v e y ( W i l l i a m s e t a l . , 1982) i n which a  questionnaire  i s used i n c o n j u n c t i o n w i t h , r a t h e r t h a n  as a s u b s t i t u t e f o r , c l i n i c a l judgment.  Thus, i n  s i t u a t i o n s where o b j e c t i v e measures a r e used without further v a l i d a t i o n of c l i n i c a l researchers  alone,  assessments,  are only able t o i d e n t i f y p a t h o l o g i c a l  e a t i n g a t t i t u d e s and b e h a v i o u r s commonly a s s o c i a t e d w i t h e a t i n g d i s o r d e r s , and n o t e a t i n g d i s o r d e r s p e r s e .  14  The R o l e o f S o c i o c u l t u r a l F a c t o r s Eating  i n the Occurrence o f  Disorders  Eating disorders  such as a n o r e x i a  n e r v o s a and  b u l i m i a n e r v o s a a r e most f r e q u e n t l y c o n c e p t u a l i z e d multidetermined disorders Garner, 1982).  as  (Anderson, 1985; G a r f i n k e l &  G a r f i n k e l and Garner (1982) s t a t e  an e a t i n g d i s o r d e r such as a n o r e x i a  that  or bulimia i s a  "syndrome t h a t i s the p r o d u c t o f an i n t e r p l a y o f a number o f f o r c e s " personal  forces;  (p. 188).  These f o r c e s i n c l u d e :  (b) f a m i l i a l f o r c e s ;  (a)  (c). b i o l o g i c a l  f o r c e s ; and (d) s o c i o c u l t u r a l f o r c e s . . A l t h o u g h a l l o f these f o r c e s a r e c o m p l e x l y i n t e r w o v e n , the purpose o f t h i s study to b e t t e r understand the e f f e c t s of sociocultural factors. S i n c e the e a r l i e s t d e s c r i p t i o n s o f e a t i n g d i s o r d e r s made over a c e n t u r y ago by G u l l and Lasegue, the s o c i o c u l t u r a l importance o f f a c t o r s such as gender, age,  and s o c i a l s t a t u s have been i n v e s t i g a t e d  (Anderson  & Hay, 1985; Bruch, 1973; C r i s p & Toms, 1972; G i b b s , 1985; Rastam, G i l l b e r g , & Garton, 1989). abundance o f r e s e a r c h  Despite the  a d d r e s s i n g the p o s s i b l e  s o c i o c u l t u r a l importance o f t h e s e i s s u e s , fewer have attempted t o address s p e c i f i c c u l t u r a l  studies  15  d e t e r m i n a n t s o f e a t i n g d i s o r d e r s i n t h e form o f c u l t u r a l v a l u e s , b e l i e f s , and i d e a l s . One  c u l t u r a l i d e a l which has been a s s o c i a t e d  with  the h i g h e r p r e v e l e n c e o f e a t i n g d i s o r d e r s i n Western c u l t u r e s i s the i d e a l i z a t i o n of thinness  advocated i n  the West (Garner & G a r f i n k e l , 1980/ Garner, G a r f i n k e l , Schwartz, & Thompson, 1980; N a s s e r , 1988a, 1988b). research  The  team o f Garner and G a r f i n k e l (1980) was one o f  the f i r s t t o address t h i s c u l t u r a l i d e a l i n t h e i r i n v e s t i g a t i o n o f t h e r e l a t i o n s h i p between a t t e n t i o n t o Western c u l t u r e ' s t h i n n e s s  i d e a l and t h e o c c u r r e n c e o f  e a t i n g d i s o r d e r s and p a t h o l o g i c a l e a t i n g a t t i t u d e s . Accordingly,  t h e y i n v e s t i g a t e d t h e e a t i n g a t t i t u d e s and  b e h a v i o u r s o f female dancers and models.  I t was t h e i r  assumption t h a t because o f t h e i r c a r e e r c h o i c e  these  women would be more f o c u s e d on t h e i r appearance and body shape and thus be more a t t e n t i v e t o t h e t h i n n e s s i d e a l than a n o r m a t i v e sample o f women.  Their r e s u l t s  i n d i c a t e d t h a t a n o r e x i a n e r v o s a and e x c e s s i v e d i e t i n g concerns were o v e r r e p r e s e n t e d modelling  students,  i n t h e dance and  l e a v i n g the authors t o conclude  t h a t those i n d i v i d u a l s under s o c i e t a l p r e s s u r e s s l i m are at greater r i s k o f developing The  t o be  eating disorder.  a u t h o r s went on t o suggest t h a t t h e i r  "observations  16  underscore  t h e p o s s i b l e importance  o f our s o c i e t y ' s  c u r r e n t v a l u e o f t h i n n e s s i n women as a d e t e r m i n a n t o f the p u r p o r t e d i n c r e a s e i n t h e p r e v e l e n c e o f a n o r e x i a nervosa"  (Garner & G a r f i n k e l , 1980, p. 6 5 5 ) .  In l i g h t of the reports suggesting that the i d e a l i z a t i o n o f t h i n n e s s may c o n t r i b u t e t o t h e p r e v e l e n c e o f e a t i n g d i s o r d e r s and p a t h o l o g i c a l e a t i n g attitudes  (Garner &  G a r f i n k e l , Schwartz,  G a r f i n k e l , 1980),  Garner,  and Thompson (1-98 0) attempted t o  gauge Western c u l t u r e ' s e x p e c t a t i o n s r e g a r d i n g body image and shape f o r women.  They found t h a t , d u r i n g t h e  20-year p e r i o d from 1959-1978, M i s s America  Contestants  and P l a y b o y c e n t e r f o l d s had become p r o g r e s s i v e l y thinner.  Garner and h i s a s s o c i a t e s a l s o d i s c o v e r e d a  s i g n i f i c a n t i n c r e a s e i n t h e number o f d i e t a r t i c l e s i n s i x p o p u l a r women's magazines d u r i n g t h i s same 20 y e a r period. More r e c e n t l y , Wiseman, Gray, Mosimann, and Ahrens (1992) have attempted study  t o r e p l i c a t e Garner e t a l . ' s  (1980) f o r t h e p e r i o d o f 1979-1988.  Once a g a i n  the i d e a l body shape i n Western s o c i e t y , as r e p r e s e n t e d by M i s s America C o n t e s t a n t s and P l a y b o y has c o n t i n u e d t o decrease i n s i z e .  centerfolds,  Wiseman e t a l . ,  a l s o noted an i n c r e a s e i n d i e t a r t i c l e s , as w e l l as  17  exercise advertisements, f o r t h e i r h i s t o r i c a l period. In a s i m i l a r s t u d y o f magazine a d v e r t i s e m e n t s , Anderson and DiDomenico  (1992) found t h a t women's magazines  c o n t a i n 10.5 t i m e s t h e number o f d i e t p r o m o t i o n s as do men's magazines. T h i s t r e n d has n o t been n o t e d o n l y i n t h e p r i n t media.  I n t h e i r h i s t o r i c a l l o o k a t TV c o m m e r c i a l s ,  Wiseman, Gunning, and Grey (1993) found a s i g n i f i c a n t i n c r e a s e i n t h e amount o f TV commercials f o r d i e t foods and d i e t p r o d u c t s shown on t h e t h r e e major American networks o v e r t h e y e a r s 1973-1991. Thus, t h e s e s t u d i e s appear t o i n d i c a t e t h a t w h i l e e a t i n g d i s o r d e r s c o n t i n u e t o pervade Western c u l t u r e s , so does Western c u l t u r e ' s i d e a l i z a t i o n o f t h e u l t r a t h i n body shape f o r f e m a l e s .  Whereas t h i s t r e n d  appears t o be q u i t e p r e v a l e n t i n Western c u l t u r e s , i t i s i n no way u n i v e r s a l .  In fact, obesity i s often  admired as a s i g n o f w e a l t h , s u c c e s s and b e a u t y i n nonWestern c u l t u r e s  (Furnham & A l i b h a i ,  1983; N a s s e r ,  1986) . The C h i n e s e , f o r example, a s s o c i a t e f a t n e s s w i t h p r o s p e r i t y and l o n g e v i t y , and t h e i r Gods a r e o f t e n d e p i c t e d as b e i n g f a t (Lee, 1991; Lee, C h i u , & Chen, 1989; N a s s e r , 1988a; 1988b).  S i m i l a r l y , C h i n a does n o t  18  s t i g m a t i z e the obese as h a v i n g p h y s i c a l , mental o r m o r a l impairments as i s f r e q u e n t l y done i n Western cultures  (Lee, C h i u & Chen, 1989).  A d d i t i o n a l l y , the  Chinese o f t e n a s s o c i a t e t h i n n e s s w i t h i l l - h e a l t h and bad  l u c k and n o t , as i n t h e West, w i t h  a t t r a c t i v e n e s s o r economic w e l l - b e i n g Popular  self-discipline, (Lee, 1992).  Chinese b e l i e f s a r e t h a t "being a b l e t o  eat i s t o have l u c k " , " g a i n i n g weight means good fortune".  S i m i l a r l y , t o g r e e t somebody w i t h "You have  put on w e i g h t " i s viewed as a complement, e s p e c i a l l y amongst t h e o l d e r g e n e r a t i o n et a l . , 1989).  o f Chinese (Lee, 1991; Lee  I t appears, however, t h a t t h e s e b e l i e f s ,  are n o t l i m i t e d s i m p l y t o t r a d i t i o n a l v a l u e s  and  customs, as the media i n Hong Kong has r e c e n t l y conveyed the message t h a t a number o f c u r r e n t  female  s i n g i n g s t a r s s h o u l d be g a i n i n g weight (Lee, 1991). G i v e n the d i f f e r e n t v a l u e p l a c e d on t h i n n e s s i n China,  one might p r e d i c t t h a t the p r e v a l e n c e  of eating  d i s o r d e r s and p a t h o l o g i c a l e a t i n g a t t i t u d e s and b e h a v i o u r s i n t h a t c o u n t r y may be lower than i n Western cultures.  Unfortunately,  about t h e p r e v a l e n c e  v e r y l i t t l e has been n o t e d  o f e a t i n g d i s o r d e r s and  p a t h o l o g i c a l e a t i n g a t t i t u d e s i n China.  In t h e i r  a r t i c l e , Lee, C h u i , & Chen d e t a i l e d an  unpublished  1989  19  s u r v e y conducted by the P s y c h i a t r i c E p i d e m i o l o g y U n i t of the Department o f P s y c h i a t r y a t the U n i v e r s i t y o f China i n Hong Kong.  T h i s s u r v e y , u s i n g the D i a g n o s t i c  I n t e r v i e w Schedule,  r e v e a l e d o n l y one p o s s i b l e case o f  a n o r e x i a n e r v o s a out o f a community sample p o p u l a t i o n of  7229 s u b j e c t s d u r i n g the p e r i o d ' f r o m 1984-1986. More r e c e n t l y , a s t u d y e x p l o r i n g the p r e v a l e n c e o f  a n o r e x i a and b u l i m i a i n China was his  conducted by Chun and  team o f c o l l e a g u e s (1992). T h i s s t u d y employed  s e l f - r e p o r t measures, as w e l l as s e l e c t i v e f o l l o w up i n t e r v i e w s , t o examine the p r e v a l e n c e o f e a t i n g d i s o r d e r s among 509  .(108 males, 401 females)  freshman  m e d i c a l s t u d e n t s i n two u n i v e r s i t i e s i n C h i n a . r e s u l t s i n d i c a t e d 1.1%  The  o f the sample ( a l l female)  met  the domestic and DSM-III-R c r i t e r i o n f o r b u l i m i a ; however, none were b i n g e e a t i n g and p u r g i n g on a r e g u l a r b a s i s and none met for b u l i m i a nervosa.  the purposed  DSM-IV c r i t e r i a  None o f the s u b j e c t s met  the  d i a g n o s t i c c r i t e r i a f o r anorexia nervosa. F i n a l l y , i n h i s 1993  s t u d y Lee employed the 40  i t e m E a t i n g A t t i t u d e s Test i n a two-stage 1020  (646 female and 374 male) Chinese  u n i v e r s i t y students i n China.  screening of  bilingual  Lee found t h a t a l t h o u g h  the female s t u d e n t s were c o g n i t i v e l y i n c l i n e d t o d i e t  20  and weigh l e s s , few were d r i v e n t o a c t u a l weight control behaviours.  S p e c i f i c a l l y , t h e mean EAT s c o r e s  f o r t h e female s t u d e n t s was r e p o r t as 11.33 (SD=6.71) f o r t h e 4 0 i t e m EAT.  T h i s s c o r e i s lower than t h e  f i g u r e o f 15.60 (SD=9.30) r e p o r t e d by Garner & Garfinkel  (1979) f o r t h e i r c o n t r o l sample o f female  Western u n i v e r s i t y s t u d e n t s .  Additionally,  following  p e r s o n a l i n t e r v i e w s w i t h t h e s u b j e c t s s c o r i n g over t h e c u t - o f f p o i n t on t h e EAT, Lee found no cases o f a n o r e x i a n e r v o s a o r b u l i m i a n e r v o s a and o n l y t h r e e cases  ( a l l female) o f p a r t i a l syndrome b u l i m i a n e r v o s a ,  y i e l d i n g a low p r e v a l e n c e o f 0.4 6% f o r t h e spectrum o f eating disorders. The p r e v a l e n c e r a t e s n o t e d by Chen e t a l . (1992) and Lee (1993) a r e lower t h a n t h e r a t e s commonly r e p o r t e d i n Western c u l t u r e s .  E a r l i e r research,  conducted i n t h e mid-1980s, r e p o r t e d t h e p o i n t p r e v a l e n c e o f a n o r e x i a n e r v o s a amongst females  ranged  from 0.7%-2.1% (Morgan & S y l v e s t e r , 1977; Pope, Hudson, Jonas, & Yurgelum-Todd, 1983) w h i l e t h e p r e v a l e n c e o f b u l i m i a n e r v o s a ranged from 2%-4.5% ( i . e . , Cooper & F a i r b u r n , 1983; Johnson, Lewis, Love, Lewis, & Studkey, 1983; Katzman, W o l c h i k , & B r a v e r , 1984; Pope, Hudson, Jonas, & Yurgelum-Todd, 1983; P y l e , H a l v o r s o n , Neuman,  21  & M i t c h e l l , 1986).  More r e c e n t s t u d i e s , u s i n g more  s e n s i t i v e i n s t r u m e n t s and methodology, have r e p o r t e d p o i n t p r e v a l e n c e r a t e s r a n g i n g from l % - 2 % f o r b u l i m i a nervosa  (Goldbloom & G a r f i n k e l ; 1993, Hoek, 1993; K i n g ,  1989; P y l e , Neuman, H a l v o r s o n , & M i t c h e l l , 1991) and 0.5%-1.3% f o r a n o r e x i a n e r v o s a 1993; Rathner & Messner,  (Goldbloom & G a r f i n k e l ,  1993).  W h i l e these s t u d i e s appear t o i n d i c a t e t h a t p a t h o l o g i c a l e a t i n g a t t i t u d e s and b e h a v i o u r s as w e l l as cases o f e a t i n g d i s o r d e r s such as a n o r e x i a n e r v o s a and b u l i m i a n e r v o s a a r e l e s s common i n . C h i n a t h a n i n Western c u l t u r e s o r those c u l t u r e s , such as Japan, who have r e c e n t l y i n t r o d u c e d Western v a l u e s and i d e a l s their society  (Kamata e t a l . ,  into  1987; Nasser, 1988a,  1988b; Suematsu, I s h i k a w a , Kuboke, & I t o , 1985) such c o n c l u s i o n s must be made w i t h c a u t i o n .  I t i s possible  t h a t b e h a v i o u r s which may be d i a g n o s e d as a n o r e x i a o r b u l i m i a i n Western c u l t u r e s a r e d i a g n o s e d as h y s t e r i a or a n x i e t y i n other c u l t u r e s 1986; Pate, Pumariega,  (Dolan, 1991;  H e s t e r , & Garner,  Nasser,  1992).  A d d i t i o n a l l y , even i f e a t i n g d i s o r d e r s do o c c u r l e s s f r e q u e n t l y i n C h i n a compared t o o t h e r more W e s t e r n i z e d c u l t u r e s , i t would be premature  to attribute  such  f i n d i n g s t o d i f f e r e n c e s i n s o c i o c u l t u r a l v a l u e s , such  22  as the i d e a l i z a t i o n o f t h i n n e s s , w i t h o u t  further  investigation. In an e f f o r t t o b e t t e r u n d e r s t a n d the r o l e o f s o c i o c u l t u r a l f a c t o r s such as t h e t h i n n e s s McCarthy  ideal,  (1990) compared the absence o r p r e s e n c e o f  e a t i n g d i s o r d e r s w i t h the absence o r p r e s e n c e o f the thinness i d e a l i n several c u l t u r e s .  She r e p o r t e d  that  o f the seven c u l t u r e s f o r which i n f o r m a t i o n on b o t h e a t i n g d i s o r d e r s and body image were a v a i l a b l e , a l l cultures reporting eating disorders also advocating  the t h i n n e s s i d e a l .  reported  A d d i t i o n a l l y , no  c u l t u r e t h a t d i d not advocate the t h i n n e s s r e p o r t e d cases o f e a t i n g d i s o r d e r s .  ideal  Thus, McCarthy  c o n c l u d e d t h a t her r e s u l t s suggest t h a t "exposure t o m i d d l e - c l a s s v a l u e s i n the west, which i n c l u d e the i d e a l i z a t i o n o f t h i n n e s s i n women, i n c r e a s e s the r i s k of e a t i n g d i s o r d e r s " (p. 210). A n o t h e r body o f r e s e a r c h t h a t has e x p l o r e d  the  o c c u r r e n c e o f e a t i n g d i s o r d e r s and p a t h o l o g i c a l e a t i n g attitudes i n n o n t r a d i t i o n a l populations  has f o c u s e d  on  non-white i n d i v i d u a l s l i v i n g i n Western c u l t u r e s ( i e . C r i s p , Palmer, K a l l l u c y , 1976; Gray, Ford, K e l l y , Gross & Rosen, 1988; Hsu, 1987; Lacey & Dolan, Lucero e t a l . , 1992, Nevo, 1985).  1987;  1988;  The r e s u l t s o f t h e s e  23  s t u d i e s appear t o i n d i c a t e t h a t the o c c u r r e n c e o f e a t i n g d i s o r d e r s and p a t h o l o g i c a l e a t i n g a t t i t u d e s are more p r e v a l e n t  amongst w h i t e or C a u c a s i a n i n d i v i d u a l s .  These s t u d i e s , however, s i m p l y use d i f f e r e n t i a t i n g f a c t o r , and cultural orientation.  race as  their  i n c l u d e no measure of  Accordingly,  the r o l e of  s o c i o c u l t u r a l f a c t o r s i n the e t i o l o g y o f e a t i n g disorders i s limited. I n a r e v i e w of c r o s s - c u l t u r a l r e s e a r c h on d i s o r d e r s Dolan (1991) encouraged r e s e a r c h e r s c a r e f u l l y d e l i n e a t e w h i c h v a r i a b l e t h e y are  to addressing,  r a c e or c u l t u r e , and urged t h a t c o n c l u s i o n s accordingly.  eating  be l i m i t e d  Thus, Dolan d e f i n e d r a c e as a " b i o l o g i c a l  term r e f e r r i n g t o the g e n e t i c d i f f e r e n c e s between groups w i t h i n a s p e c i e s "  (p.74),  and culture  as  an  " a n t h r o p o l o g i c a l term, d e f i n i n g a complex whole of knowledge, b e h a v i o r , religion"  (p.75).  m o r a l s , customs, and  Dolan c o n t i n u e d  often  t h a t one's c u l t u r a l  o r i e n t a t i o n i s a r b i t r a r y and v a r i a b l e , and  i s acquired  by b e i n g and/or growing up as a member of s o c i a l group. Thus, i f the g o a l i s t o i d e n t i f y the r o l e o f s o c i o c u l t u r a l f a c t o r s , such as the i d e a l i z a t i o n o f thinness,  i n the o c c u r r e n c e of e a t i n g d i s o r d e r  and  p a t h o l o g i c a l e a t i n g a t t i t u d e s (as i s the g o a l of  this  24  p a p e r ) , i t may  be more a p p r o p r i a t e  t o address  i n v e s t i g a t e one's c u l t u r a l o r i e n t a t i o n r a t h e r  and than  simply t h e i r race. R e c e n t l y , a new  l i n e o f r e s e a r c h has  attempted to  e x p l o r e the r e l a t i o n s h i p between s o c i o c u l t u r a l f a c t o r s and  the o c c u r r e n c e of e a t i n g d i s o r d e r s  and  pathological  e a t i n g a t t i t u d e s i n more d e t a i l by i n v e s t i g a t i n g the e a t i n g a t t i t u d e s and b e h a v i o u r s of non-Western women a t d i f f e r e n t s t a g e s of a c c u l t u r a t i o n t o Western c u l t u r e s . A c c u l t u r a t i o n . Body Image, and D i s o r d e r s and  the Occurrence  Pathological Eating  Acculturation i s defined  Eating  Attitudes  as c u l t u r a l change which  r e s u l t s from c o n t i n u o u s f i r s t hand c o n t a c t between d i s t i n c t c u l t u r a l groups (Berry, Kim, B u j a k i , 1989). l e v e l and  Powers, Young, &  A c c u l t u r a t i o n o c c u r s at b o t h the  the i n d i v i d u a l or p s y c h o l o g i c a l  k i n d o f changes t h a t i n d i v i d u a l s w i t h i n a c c u l t u r a t i n g group may  two  group  level.  The  an  undergo can be c a t e g o r i z e d  into  f i v e d i f f e r e n t types: p h y s i c a l , b i o l o g i c a l , c u l t u r a l , s o c i a l and p s y c h o l o g i c a l 1987).  I n t h e i r 1986  (Berry, Kim,  a r t i c l e , Kim  Minde,  Mok,  and B e r r y d e t a i l e d  these f i v e changes: F i r s t l y , p h y s i c a l changes may p l a c e t o l i v e , new  o c c u r , such as a  h o u s i n g , and  a new  climate.  new  25  Secondly, b i o l o g i c a l changes may and  new  o c c u r , such as  new  n u t r i t i o n status  diseases.  new  s e t of s o c i a l r e l a t i o n s h i p s may  Thirdly,  be  formed  i n c l u d i n g a r e c l a s s i f i c a t i o n of i n g r o u p outgroup.  Fourthly,  and  and  c u l t u r a l changes may  w i t h the o r i g i n a l p o l i t i c a l ,  economic,  Finally, psychological  occur,  religious  s o c i a l i n s t i t u t i o n s becoming a l t e r e d  replaced.  a  or  changes  may  occur, i n c l u d i n g s h i f t s i n a t t i t u d e s , values, b e l i e f s and mental h e a l t h Theoretically, e i t h e r of the two p r a c t i c e one  status,  (p.159)  a c c u l t u r a t i v e changes can o c c u r i n  groups i n c o n t a c t ; however, i n  group comes t o dominate another and  greater c u l t u r a l influence  exerts  (Berry et a l . , 1987).  The  dominant group p r o v i d e s a c o n t e x t o f a c c u l t u r a t i o n c r e a t i n g a norm of what i s to be a c c e p t e d , and  encouraged.  acculturation.  tolerated  Thus, the dominant group s e t s  l i m i t a t i o n s , b o u n d a r i e s , g o a l s and Accordingly,  up  the e n d - p o i n t of  the members of  a c c u l t u r a t i n g group must choose to a d j u s t , reject„or change the g i v e n c o n t e x t .  by  the adapt,  Acculturative  a t t i t u d e s r e s u l t when i n d i v i d u a l s d i f f e r i n the  way  t h a t t h e y choose t o become i n v o l v e d w i t h o t h e r p e r s o n s  26  and groups i n s o c i e t y ( B e r r y e t a l . , al.,  1989; Kim & B e r r y ,  1987; B e r r y e t  1986).  A c c u l t u r a t i o n i s by no means an easy p r o c e s s f o r those members o f t h e a c c u l t u r a t i n g group.  In fact,  r e s e a r c h e r s have found t h a t a c c u l t u r a t i n g i n d i v i d u a l s s u f f e r from s e v e r a l forms o f p s y c h o l o g i c a l d i s t r e s s and d y s f u n c t i o n such as, "lowered mental h e a l t h s t a t u s ( p a r t i c u l a r l y confusion, anxiety, depression), f e e l i n g s of m a r g i n a l i t y and a l i e n a t i o n , a  heightened  p s y c h o s o m a t i c symptom l e v e l , and i d e n t i t y (Berry e t a l . , The  confusion"  1987, p. 4 9 2 ) .  q u a n t i t a t i v e measurement o f a c c u l t u r a t i o n has  been h i n d e r e d by t h e c o m p l e x i t y o f t h e phenomena t h a t have c o g n i t i v e , b e h a v i o u r a l , and a t t i t u d i n a l components, each o f which i s composed o f m u l t i p l e c o n s t r u c t s and f a c t o r s ( C u e l l a r , H a r r i s , J a s s o , Thus, t h e c h a l l e n g e has become d e v e l o p i n g  1980).  s e l f report  measures which, w h i l e b r i e f and p r a c t i c a l , a r e a l s o comprehensive i n t h e i r scope.  Accordingly,  research  and i n s t r u m e n t  development i n t h e a r e a o f a c c u l t u r a t i o n  has p r o g r e s s e d  from t h e use o f s i n g l e i t e m  indexes,  such as g e n e r a t i o n a l l e v e l , t o m u l t i p l e s o c i o c u l t u r a l . c h a r a c t e r i s t i c s such as n a t i o n a l i t y , occupational status.  Finally,  language,  behavioural,  27  psychological incorporated  and a t t i t u d i n a l measures have a l s o been i n e f f o r t s t o measure a c c u l t u r a t i o n .  R e c e n t l y , r e s e a r c h e r s have begun t o u t i l i z e t h e concept o f a c c u l t u r a t i o n t o i n v e s t i g a t e t h e r o l e o f s o c i o c u l t u r a l factors i n the occurrence o f eating disorders  and p a t h o l o g i c a l e a t i n g a t t i t u d e s .  I f one  a c c e p t s t h a t Western c u l t u r e s ' i d e a l i z a t i o n o f t h i n n e s s f o r women i s r e l a t e d t o r e p o r t s o f a n o r e x i a and bulimia,  then t h e o c c u r r e n c e o f e a t i n g d i s o r d e r s and  p a t h o l o g i c a l eating a t t i t u d e s should vary according to the degree t o which i n d i v i d u a l s a s c r i b e t o and i n t e r n a l i z e Western v a l u e s and i d e a l s . Furnham and A l i b h a i (1983) were one o f t h e f i r s t r e s e a r c h teams t o i n v e s t i g a t e t h e e f f e c t s o f a c c u l t u r a t i o n t o a Western c u l t u r e by i n v e s t i g a t i n g how Kenyan A s i a n s i n B r i t a i n and Kenya, as w e l l as Caucasian B r i t a i n s , perceive  female body shapes.  Their  r e s u l t s seemed t o suggest t h a t when non-Western women are p l a c e d i n a Western c u l t u r e t h e y soon l o s e t h e i d e a l o f f e m i n i n e b e a u t y h e l d i n t h e i r home c u l t u r e s and b e g i n t o i n t e r n a l i z e t h e t h i n n e s s  i d e a l held i n the  West. In h i s 198 6 study, Pumariega d e v e l o p e d h i s own 15 item a c c u l t u r a t i o n scale t o survey the a c c u l t u r a t i o n  28  l e v e l , as w e l l as the e a t i n g a t t i t u d e s , of s c h o o l g i r l s l i v i n g i n the US.  His r e s u l t s detected a  s i g n i f i c a n t c o r r e l a t i o n between l e v e l of t o a Western c u l t u r e and  Hispanic  acculturation  e a t i n g a t t i t u d e s as measured  by the E a t i n g A t t i t u d e s Test (Garner & G a r f i n k e l , 1979).  Pumariega.concluded " t h a t e a t i n g  attitudes  v a r i e d d i r e c t l y i n the a n o r e x i c d i r e c t i o n w i t h i n c r e a s i n g a c c u l t u r a t i o n t o American c u l t u r e " A more r e c e n t s t u d y , examining the a t t i t u d e s and b e h a v i o u r s of b l a c k  and w h i t e female  Pumariega's r e s u l t s .  helped to  Abrams, A l l e n  Gray (1993) s u r v e y e d the a c c u l t u r a t i o n l e v e l and a t t i t u d e s of 100  black  college students.  female and  278).  eating  c o l l e g e s t u d e n t s l i v i n g the U n i t e d S t a t e s , substantiate  (p.  100  and eating  w h i t e female  For the purpose o f t h e i r s t u d y  the  a u t h o r s u t i l i z e d the R a c i a l I d e n t i t y A t t i t u d e S c a l e f o r Blacks  (RIAS-B; Helms, 1990)  acculturation.  t o measure l e v e l of  In an e f f o r t t o measure e a t i n g  a t t i t u d e s and b e h a v i o u r s , the f o l l o w i n g s c a l e s were u t i l i z e d : Hawkins' and The  Restraint Scale  Thinness and  Clement's Binge S c a l e  (1980);  (Herman & Mack, 1975); the D r i v e  of  the Body D i s s a t i s f a c t i o n s u b s c a l e s from  the E a t i n g D i s o r d e r I n v e n t o r y (EDI;  Garner, Olmsted, &  P o l i v y , 1983); the G o l d f a r b Fear of Fat S c a l e  (GFFS;  29  G o l d f a r b , Dykens, & Gerard, 1985);  as w e l l as  items t a k e n from Johnson's (1984) D i a g n o s t i c Eating  five  Survey o f  Disorders.  A n a l y s i s o f c o v a r i a n c e and revealed  correlational tests  t h a t the w h i t e females demonstrated  s i g n i f i c a n t l y greater  disordered  b e h a v i o u r s than the b l a c k  female.  eating attitudes  and  Additionally,  r e s e a r c h e r found t h a t among the b l a c k  subjects,  the higher  l e v e l s of a s s i m i l a t i o n t o Western c u l t u r e were s i g n i f i c a n t l y p o s i t i v e l y r e l a t e d to d i e t a r y Fear of Fat, and The  Drive  Restraint,  f o r Thinness.  t h i r d s t u d y t o u t i l i z e l e v e l of  acculturation  as a v a r i a b l e i n an attempt t o address the r o l e of s o c i o c u l t u r a l f a c t o r s i n the p r e v e l e n c e of disorders  and p a t h o l o g i c a l e a t i n g a t t i t u d e s  eating was  conducted i n B r i t a i n by Mumford, Whitehouse, and (1991). and  The  Platts  r e s u l t s o f t h i s study, however, are mixed  f a i l t o u n e q u i v o c a b l y s u p p o r t Pumariega's & Abrams  et a l . ' s f i n d i n g s . Mumford et a l . ( 1 9 9 1 ) a d d r e s s e d the r o l e of s o c i o c u l t u r a l f a c t o r s i n the p r e v e l e n c e o f disorders  eating  by i n v e s t i g a t i n g the a c c u l t u r a t i o n l e v e l  the e a t i n g a t t i t u d e s of A s i a n Caucasian school  (Indian subcontinent)  g i r l s l i v i n g i n B r a d f o r d , London.  and and  30  Although  the authors hypothesized  t h a t the  prevelence  of e a t i n g d i s o r d e r s would be lower amongst the A s i a n s c h o o l g i r l s and t h a t e a t i n g d i s o r d e r s would o n l y be found amongst the most 'Westernized' students,  of the A s i a n  t h e i r r e s u l t s i n d i c a t e d t h a t the A s i a n  s c h o o l g i r l s ' e a t i n g a t t i t u d e s were more p a t h o l o g i c a l than those of the Caucasian the A s i a n g i r l s diagnosed s i g n i f i c a n t l y higher  schoolgirls.  with an e a t i n g d i s o r d e r had  ' t r a d i t i o n a l ' scores than the  the A s i a n g i r l s ; however t h e i r not s i g n i f i c a n t l y  Similarly,  rest  'Western' scores were  different.  In an attempt to make meaning of t h e i r unexpected r e s u l t s the r e s e a r c h e r purposed s e v e r a l p o s s i b l e explanations.  One  p o s s i b l e methodological  explanation  i s t h a t the measure of l e v e l of a c c u l t u r a t i o n employed by Mumford and h i s a s s o c i a t e s was authors noted s c a l e was  not v a l i d .  The  t h a t because no a v a i l a b l e a c c u l t u r a t i o n  a p p r o p r i a t e f o r use with A s i a n s ,  attempted to measure the Western and A s i a n  they cultural  o r i e n t a t i o n of each A s i a n student with four questions, two  t a r g e t i n g a Western o r i e n t a t i o n and two t a r g e t i n g  an A s i a n o r i e n t a t i o n . • Thus, i t i s p o s s i b l e t h a t the means i n which Mumford et a l . chose to o p e r a t i o n a l i z e l e v e l of a c c u l t u r a t i o n f a i l e d to adequately  address  the  31  complex, m u l t i f a c e t e d t h e i r conclusion,  n a t u r e of a c c u l t u r a t i o n .  In  the a u t h o r s themselves s t a t e d  a c c u l t u r a t i o n i s a complex phenomenon and  that  agreed t h a t  " t h e r e i s a need t o d e v e l o p a more s o p h i s t i c a t e d measure o f these c u l t u r a l d i m e n s i o n s " (Mumford e t a l . , 1991,  p. 227).  A d d i t i o n a l l y , the a u t h o r s encouraged  f u r t h e r r e s e a r c h i n t o the r e l a t i o n s h i p between a c c u l t u r a t i o n t o Western c u l t u r e and eating disorders  the o c c u r r e n c e o f  i n an attempt t o h e l p c l a r i f y the  o f s o c i o c u l t u r a l f a c t o r s i n the o c c u r r e n c e o f disorders  and p a t h o l o g i c a l e a t i n g  role  eating  attitudes.  In t h e i r f u r t h e r attempt t o address t h e i r unexpected f i n d i n g s Mumford and h i s a s s o c i a t e s  explored  the r o l e o f a c c u l t u r a t i v e s t r e s s i n the o c c u r r e n c e o f p a t h o l o g i c a l e a t i n g a t t i t u d e s and b e h a v i o u r s et a l . , 1991;  (Mumford  Mumford, Whitehouse & Choudry, 1992).  C o r r e s p o n d i n g l y , G i l , Vega and  Dimas (1994) have  s t r e s s e d the importance of r e c o g n i z i n g  acculturative  s t r e s s as an i m p o r t a n t concept i n r e s e a r c h ; d i s t i n c t from l e v e l of  one  acculturation.  Acculturative stress i s defined  kind  of  s t r e s s , t h a t i n which the s t r e s s o r s are i d e n t i f i e d  as  h a v i n g t h e i r source i n the p r o c e s s o f (Berry, Kim,  Minde, & Mok,  1987,  as,  "one  acculturation"  p. 492') .  According to  32  s o c i a l - s t r e s s models o f a c c u l t u r a t i v e s t r e s s , n e g a t i v e outcomes occur when s t r e s s o r s exceed the i n d i v i d u a l ' s coping resources, or mediators Several  ( G i l e t a l . , 1994).  types o f a c c u l t u r a t i v e s t r e s s o r s  i n c l u d i n g language problems, p e r c e i v e d perceived  exist  discrimination,  c u l t u r a l i n c o m p a t i b i l i t i e s , commitment or  l a c k o f commitment to c u l t u r a l l y p r e s c r i b e d  protective  values and behaviours as w e l l as a c c u l t u r a t i o n gaps i n which d i f f e r e n c e s  i n a c c u l t u r a t i o n l e v e l s between  c h i l d r e n and t h e i r parents produce or exacerbate communication problems and c h i l d - p a r e n t  family  c o n f l i c t s (Gil  et a l . , 1994). Thus, Mumford and h i s a s s o c i a t e s  speculated  the h i g h e r EAT scores found amongst the A s i a n with the h i g h e r  ' t r a d i t i o n a l ' scores  that  girls  (and s i m i l a r  'Western' scores) may r e f l e c t the f a c t t h a t they were experiencing  the g r e a t e s t  i n t e r n a l and f a m i l i a l  c o n f l i c t and i d e n t i t y c o n f u s i o n as they grew up w i t h two  sets o f c o n f l i c t i n g c u l t u r a l v a l u e s .  The authors  went on to suggest that t h e i r r e s u l t s may i n d i c a t e these same A s i a n g i r l s ,  that  because o f t h e i r exposure to  Western v a l u e s and i d e a l s , adopted Western p a t t e r n s o f r e a c t i n g to t h e i r p e r s o n a l and f a m i l i a l c o n f l i c t and  33  s t r e s s , thus r e s u l t i n g i n t h e i r more e a t i n g a t t i t u d e s and  pathological  behaviours.  A r e c e n t s t u d y conducted by Furnham and (1994) s u p p o r t s Mumford e t a l . s f i n d i n g s . 1  Patel  Patel Furnham  and  (1994) u t i l i z e d a s i m i l a r methodology as Mumford  e t a l . (1991) to i n v e s t i g a t e the e a t i n g a t t i t u d e s b e h a v i o u r s of A s i a n l i v i n g i n London. 2 6, BSQ,  (Indian  and  subcontinent) s c h o o l g i r l s  Accordingly,  as w e l l as t h e i r own  t h e y u t i l i z e d the  EAT-  questionnaire devised to  i n v e s t i g a t e the l e v e l of i n t e g r a t i o n o f A s i a n s c h o o l g i r l s i n t o B r i t i s h s o c i e t y and  t h e i r l e v e l of  resentment towards t h e i r f a m i l i e s f o r m a i n t a i n i n g t h e i r t r a d i t i o n a l v a l u e s and  customs.  L i k e Mumford e t a l .  (1991), the q u e s t i o n n a i r e a d d r e s s i n g l e v e l o f i n t e g r a t i o n was and  had  developed s p e c i f i c a l l y f o r t h e i r study  not been p r e v i o u s l y  A l t h o u g h Furnham and  validated.  Patel hypothesized that t h e i r  r e s u l t s would s u p p o r t Pumariega (1986) and Abrams e t al.*s  (1993)  findings, t h e i r results instead  Mumford e t a l . ' s  (1991) f i n d i n g s .  Accordingly,  less integrated Asian schoolgirls displayed scores.  Furnham and  supported the  higher  P a t e l a l s o noted that there  EAT was  some s u p p o r t f o r t h e i r h y p o t h e s i s t h a t A s i a n s c h o o l g i r l s e x p e r i e n c i n g g r e a t e r resentment towards  34  t h e i r families, display greater eating  pathology,  however the r e s u l t s d i d not reach s i g n i f i c a n c e . In c o n c l u s i o n ,  i t appears that any attempt to  f u r t h e r i n v e s t i g a t e the r o l e o f l e v e l o f a c c u l t u r a t i o n to a Western c u l t u r e i n the occurrence o f p a t h o l o g i c a l e a t i n g a t t i t u d e s must not o n l y take care to appropriately  operationalize  l e v e l of acculturation,  but a l s o r e c o g n i z e the r o l e o f p o s s i b l e mitigating  confounding or  f a c t o r s such as a c c u l t u r a t i v e  stress.  Summary A review o f the l i t e r a t u r e i n d i c a t e s  that  r e s e a r c h e r s have j u s t begun t o address the r o l e o f s o c i o c u l t u r a l f a c t o r s , such as c u l t u r a l i d e a l s and v a l u e s , i n the occurrence o f e a t i n g d i s o r d e r s and pathological  e a t i n g a t t i t u d e s by i n v e s t i g a t i n g the  r e l a t i o n s h i p between l e v e l o f a c c u l t u r a t i o n t o a Western c u l t u r e and e a t i n g a t t i t u d e s and behaviours o f non-Western women. i t s infancy  Such r e s e a r c h , however, i s s t i l l i n  and r e q u i r e s much more a t t e n t i o n .  One i s s u e the l i t e r a t u r e has i d e n t i f i e d as r e q u i r i n g a d d i t i o n a l a t t e n t i o n i s improving the means i n which important c o n s t r u c t s , acculturation, from p o s s i b l e  such as l e v e l o f  are o p e r a t i o n a l i z e d  and d i f f e r e n t i a t e d  confounding or m i t i g a t i n g  f a c t o r s such as  35  acculturative  stress.  T h i s s t u d y w i l l attempt t o  address t h i s concern i n two ways. '. F i r s t , a more p s y c h o m e t r i c a l l y sound measure o f l e v e l o f acculturation exploratory  w i l l be u t i l i z e d .  goal,  acculturative  any p o s s i b l e  s t r e s s and e a t i n g  Second, as an r e l a t i o n s h i p between attitudes w i l l  be  a d d r e s s e d i n an e f f o r t t o b e t t e r u n d e r s t a n d t h e r e l a t i o n s h i p between l e v e l o f a c c u l t u r a t i o n pathological  eating  Additionaly,  and  attitudes.  a l l of the previous  i n v e s t i g a t i n g the e a t i n g  literature  a t t i t u d e s and b e h a v i o u r s o f  A s i a n s has employed a v e r y s e l e c t A s i a n p o p u l a t i o n o f I n d i a n s u b c o n t i n e n t s c h o o l g i r l s l i v i n g i n t h e UK. Thus, i t would seem b e n e f i c i a l t o i n v e s t i g a t e eating  the  a t t i t u d e s and b e h a v i o u r s o f o t h e r A s i a n groups.  Thus, the purpose o f t h i s s t u d y i s t o  investigate  the r o l e o f s o c i o c u l t u r a l f a c t o r s i n t h e occurrence, o f eating disorders  by d e t e r m i n i n g t h e r e l a t i o n s h i p  between l e v e l o f a c c u l t u r a t i o n attitudes students.  t o Canada and  eating  i n a n o n c l i n i c a l sample o f C h i n e s e u n i v e r s i t y In addition,  i n l i g h t of previous research  (Furnham & P a t e l , 1994; Mumford e t a l . , 1991; Mumford e t a l . , 1992) an a d d i t i o n a l e x p l o r a t o r y  goal i s to  36  examine the r e l a t i o n s h i p between a c c u l t u r a t i v e and e a t i n g a t t i t u d e s and behaviours.  stress  37  Chapter I I I Methodology  In t h i s chapter  I w i l l attempt to d e t a i l  the  methodology employed to conduct t h i s study and the r e l e v a n t r e s e a r c h  answer  questions.  Design A c o r r e l a t i o n a l design was  employed to i n v e s t i g a t e  the r e l a t i o n s h i p s between l e v e l of a c c u l t u r a t i o n and a c c u l t u r a t i v e s t r e s s , and e a t i n g a t t i t u d e s . design was  chosen because there was  This  no d e s i r e to  manipulate s u b j e c t s or v a r i a b l e s , r a t h e r the purpose of t h i s study was frequency if  simply  to document the nature  of these p a r t i c u l a r v a r i a b l e s and  any r e l a t i o n s h i p e x i s t s .  administered  and determine  A l l s u b j e c t s were  a q u e s t i o n n a i r e package i n c l u d i n g a  demographic q u e s t i o n n a i r e as w e l l as psychological questionnaires  various  ( r e f e r to the. s e c t i o n on  instrumentation). Sample One  hundred and t h i r t y - o n e female Chinese and  female Caucasian  u n i v e r s i t y students  100  from the  U n i v e r s i t y of B r i t i s h Columbia were r e c r u i t e d f o r the purpose of t h i s study.  The  rather s p e c i f i c  population  38  was  s e l e c t e d f o r s e v e r a l reasons.  F i r s t , i t was  d e c i d e d t o t a r g e t o n l y one gender because gender, itself,  has l o n g been r e c o g n i z e d  as a p o s s i b l e  s o c i o c u l t u r a l f a c t o r c o n t r i b u t i n g to the d i s p r o p o r t i o n a t e d i s t r i b u t i o n o f e a t i n g d i s o r d e r s and pathological eating attitudes.  A d d i t i o n a l l y , a female  p o p u l a t i o n was chosen because t h e m a j o r i t y o f Western s o c i o c u l t u r a l pressures  f o r thinness  are d i r e c t e d  towards women (Anderson & DiDomenico, 1992). S i m i l a r l y , a p p r o x i m a t e l y 90% o f those i n d i v i d u a l s w i t h e a t i n g d i s o r d e r s a r e women.  Thus, because t h e purpose  of t h i s s t u d y was n o t t o i n v e s t i g a t e gender d i f f e r e n c e s , b u t t o examine any p o s s i b l e r e l a t i o n s h i p s between a c c u l t u r a t i o n t o a Western c u l t u r e and t h e o c c u r r e n c e o f p a t h o l o g i c a l e a t i n g a t t i t u d e s , a female p o p u l a t i o n was chosen as i t appears t o be t h e p o p u l a t i o n most a t r i s k o f e a t i n g p a t h o l o g y . A Chinese p o p u l a t i o n was chosen because t h e Chinese c u l t u r e t r a d i t i o n a l l y does n o t advocate t h e i d e a l i z a t i o n of thinness, nor are eating frequently reported al.,  disorders  i n C h i n a (Chun e t a l . , 1992; Lee e t  1989; Nasser, 1988a; Zheng, 1982).  hoped t h a t t h i s p o p u l a t i o n w i l l p r o v i d e  Thus, i t was a wide spectrum  of e a t i n g a t t i t u d e s as w e l l as a c c u l t u r a t i o n l e v e l s .  39  A d d i t i o n a l l y , a Chinese p o p u l a t i o n was because a l l of the p r e v i o u s  literature investigating  the r e l a t i o n s h i p between e a t i n g p a t h o l o g y acculturation  and l e v e l of  amongst A s i a n s has employed a p o p u l a t i o n  of Indian subcontinent  s c h o o l g i r l s l i v i n g i n the  (Furnham & P a t e l , 1994; a l . 1992).  chosen  Thus, i t was  Mumford e t a l . 1991;  UK  Mumford e t  hoped t h a t u t i l i z i n g a Chinese  p o p u l a t i o n would h e l p extend the knowledge r e g a r d i n g e a t i n g a t t i t u d e s and b e h a v i o u r s  i n Asian  populations.  In an e f f o r t t o access Chinese s t u d e n t s w i t h a wide range o f a c c u l t u r a t i o n  l e v e l s s u b j e c t s were  s o l i c i t e d from a v a r i e t y of d i f f e r e n t departments  and  f a c u l t i e s i n c l u d i n g S c i e n c e , A r t s and A s i a n S t u d i e s . A d d i t i o n a l l y , no e x t e r n a l parameters were p l a c e d on d e f i n i t i o n o f Chinese.  Thus, a l l female s t u d e n t  the  who  s e l f - r e f e r r e d as Chinese were welcome t o p a r t i c i p a t e . F i n a l l y , a u n i v e r s i t y p o p u l a t i o n was  chosen  because i t i s c o n s i d e r e d a h i g h r i s k s e t t i n g f o r the occurrence attitudes  of e a t i n g d i s o r d e r s and p a t h o l o g i c a l (Halmi, Jones, & Schwertz, 1981).  As  eating well,  a l l o f the measures employed i n t h i s s t u d y were d e v e l o p e d and v a l i d a t e d on u n i v e r s i t y  populations,  t h e r e f o r e the measures are c o n s i d e r e d most a p p r o p r i a t e for this population.  40  Procedure S u b j e c t s were r e c r u i t e d from v a r i o u s i n t a c t c l a s s e s throughout t h e campus.  This  researcher  approached s e v e r a l p r o f e s s o r s , f i r s t by l e t t e r and then by phone r e q u e s t i n g t h e i r p a r t i c i p a t i o n . A l l professors teaching 100-level Anthropology  and  S o c i o l o g y , F a m i l y and N u t r i t i o n a l S c i e n c e and A s i a n S t u d i e s course were sent a l e t t e r e x p l a i n i n g t h i s  study  and r e q u e s t i n g t h e use o f 15 minutes o f c l a s s time t o i n v i t e t h e i r students t o p a r t i c i p a t e .  During  c a l l s , t h e i r i n t e r e s t and a v a i l a b i l i t y was and,  i f necessary,  follow-up  confirmed,  a time t o a t t e n d t h e i r c l a s s and  conduct my r e s e a r c h was  arranged.  A d d i t i o n a l s u b j e c t s were r e c r u i t e d as p a r t o f a l a r g e r study i n v e s t i g a t i n g help seeking behaviours, of A s i a n u n i v e r s i t y s t u d e n t s c a r r i e d out by Dr. Ishu Ishiyama.  A c c o r d i n g l y , i f time p e r m i t t e d , t h e EAT and  the Suinn-Lew A s i a n S e l f - I d e n t i t y A c c u l t u r a t i o n S c a l e were i n c l u d e i n Dr. Ishiyama's t e s t packages. A c c o r d i n g l y , a d d i t i o n a l s u b j e c t s were r e c r u i t e d from 1 0 0 - l e v e l Chemistry,  Biochemistry, Fine A r t s , H i s t o r y ,  and P s y c h o l o g y c l a s s e s . I n a l l c a s e s , t h i s r e s e a r c h e r was p r e s e n t the a c t u a l d a t a c o l l e c t i o n .  Additionally,a l l  during  41  p o t e n t i a l s u b j e c t s were reminded t h a t a l l m a t e r i a l s would be kept c o n f i d e n t i a l , was  voluntary,  that t h e i r  participation  and t h a t they c o u l d choose to  d i s c o n t i n u e p a r t i c i p a t i o n at any p o i n t . permitted  I f time  the q u e s t i o n n a i r e s were completed d u r i n g  c l a s s time and r e t u r n e d to me  immediately.  However, i n  some i n s t a n c e s p r o f e s s o r s c o u l d not a l l o c a t e enough c l a s s time f o r students packages; i n these  to complete the  questionnaire  instances, p a r t i c i p a t i n g  subjects  were asked to complete the q u e s t i o n n a i r e s at t h e i r e a r l i e s t convenience and m a i l them back v i a campus m a i l i n provided The  s e l f addressed  envelops.  f i n a l page of the q u e s t i o n n a i r e package  c o n t a i n e d a t e a r o f f page so t h a t i n t e r e s t e d s u b j e c t s c o u l d c o n t a c t t h i s author f o r f u r t h e r i n f o r m a t i o n r e g a r d i n g the goals and outcomes of t h i s  study.  A d d i t i o n a l l y , because examining one's e a t i n g a t t i t u d e s and behaviours  may  b r i n g up i s s u e s f o r some s u b j e c t s ,  e s p e c i a l l y those with e a t i n g d i s o r d e r s , phone numbers of l o c a l resources  were a l s o be made a v a i l a b l e on  t e a r o f f page. Intrumentation The  instruments  used i n t h i s r e s e a r c h  i n c l u d e d : a demographic q u e s t i o n n a i r e  study  entitled  the  42  "Background Q u e s t i o n n a i r e " ,  t h e Suinn-Lew A s i a n  Self-  I d e n t i t y A c c u l t u r a t i o n Scale  (SL-ASIA) , t h e s h o r t form  of t h e E a t i n g A t t i t u d e s Test  (EAT-26), as w e l l as t h e  s h o r t form o f t h e SAFE A c c u l t u r a t i v e S t r e s s (SAFE-24).  Scale  A l l of the subjects received the  demographic q u e s t i o n n a i r e and t h e EAT-26; i n a d d i t i o n , the C h i n e s e s u b j e c t s were asked t o complete t h e SL-ASIA and t h e SAFE-24. Demographic Q u e s t i o n n a i r e .  The f i r s t s e c t i o n o f  the q u e s t i o n n a i r e was developed by t h e c u r r e n t i n v e s t i g a t o r and i n c l u d e s q u e s t i o n s about  generation  l e v e l , e t h n i c o r i g i n , age, f a m i l i a l background, as w e l l as o t h e r d e s c r i p t i v e d e t a i l s .  Other q u e s t i o n t o p i c s  i n c l u d e those which p r e v i o u s r e s e a r c h e r s , f o r i n s t a n c e B e r r y e t a l . (1987, 1989) and S u i n n , Lew,  & Vigil  Rickard-Figueroa,  (1987), have shown t o be r e l e v a n t t o l e v e l  of a c c u l t u r a t i o n and a c c u l t u r a t i v e s t r e s s .  As s t a t e d  e a r l i e r , some s u b j e c t s were r e c r u i t e d as p a r t o f a l a r g e r r e s e a r c h s t u d y conducted by Dr. Ishiyama.  While  these s u b j e c t s were a l s o asked t o complete a Demographic Q u e s t i o n n a i r e ,  they r e c e i v e d a b r i e f e r  v e r s i o n o f t h e q u e s t i o n n a i r e d e s i g n e d by t h i s r e s e a r c h e r and thus some o f t h e q u e s t i o n s were o m i t t e d .  43  E a t i n g A t t i t u d e s Test (EAT-2 6)• the E a t i n g A t t i t u d e s Test  The"short form o f  (EAT-26) c o n s i s t s o f 26 items  d e s i g n e d t o e v a l u a t e a b r o a d range o f b e h a v i o u r s and a t t i t u d e s c h a r a c t e r i s t i c of anorexia nervosa b u l i m i a nervosa 1982).  and  (Garner, Olmsted, Bohr, & G a r f i n k e l ,  The EAT-26 was d e v e l o p e d a f t e r f a c t o r a n a l y s i s  o f the o r i g i n a l EAT  (Garner & G a r f i n k e l ,  1979)  i n d i c a t e d 14 o f the o r i g i n a l 40 items c o u l d be d e l e t e d and s t i l l m a i n t a i n a h i g h c o r r e l a t i o n the two measures (Garner e t a l . ,  (r=.98) between  1982).  The EAT-26, l i k e i t s p r e d e c e s s o r , asks s u b j e c t s t o respond t o items on a 6-point L i k e r t s c a l e r a n g i n g from 'always' t o 'never'.  The items are summed f o r a t o t a l  s c o r e which can t h e n be compared t o the c u t - o f f s c o r e o f 20, which Garner and h i s coworker  found t o m a x i m a l l y  d i f f e r e n t i a t e a n o r e x i c s u b j e c t s from female c o n t r o l subjects  (Garner e t a l . ,  1982).  F a c t o r a n a l y s i s o f the  o r i g i n a l 40 i t e m EAT a l s o i d e n t i f i e d t h r e e s u b - s c a l e s c u r r e n t l y r e c o g n i z e d by the EAT-2 6. are:  (a) d i e t i n g  (13 i t e m s ) ,  p r e o c c u p a t i o n (6 i t e m s ) , and items).  These s u b s c a l e  (b) b u l i m i a and f o o d (c) o r a l c o n t r o l  (7  The s t a n d a r d i z e d r e l i a b i l i t y c o e f f i c i e n t s f o r  the t h r e e s u b s c a l e s range from 0.83  t o 0.90  f o r the  44  e a t i n g d i s o r d e r e d group and from 0.4 6 t o 0.8 6 f o r t h e i r female comparison group (Garner e t a l . , The EAT-2 6 was  f i r s t developed  1982).  and v a l i d a t e d . o n a  Canadian u n i v e r s i t y p o p u l a t i o n , s i m i l a r t o the one be used i n t h i s s t u d y .  to  A d d i t i o n a l l y , Mumford e t a l .  (1991) employed f a c t o r a n a l y s i s t o i n v e s t i g a t e the v a l i d i t y o f the EAT-2 6 w i t h an A s i a n p o p u l a t i o n .  Their  r e s u l t s i n d i c a t e d t h a t the f a c t o r s t r u c t u r e o f the  EAT-  26 f o r t h e i r sample o f A s i a n s t u d e n t s c l o s e l y resembled t h a t from a p r e v i o u s s t u d y o f C a u c a s i a n Thus,. Mumford and h i s coworkers c o n c l u d e d  schoolgirls. t h a t the  EAT-  26 i s a v a l i d measure o f e a t i n g a t t i t u d e s and behaviours  f o r A s i a n women l i v i n g i n Western c u l t u r e s .  Suinn-Lew A s i a n S e l f - I d e n t i t y A c c u l t u r a t i o n S c a l e . The  Suinn-Lew A s i a n S e l f - I d e n t i t y A c c u l t u r a t i o n S c a l e  (SL-ASIA) i s an i n s t r u m e n t  s p e c i f i c a l l y designed  measure l e v e l o f a c c u l t u r a t i o n i n A s i a n s 1987).  (Suinn e t a l . ,  D e s p i t e i t s r e l a t i v e newness, the measure has  a l r e a d y been adopted by r e s e a r c h e r s Gim,  to  1989;  A t k i n s o n , W h i t e l y , & Gim,  (e.g., A t k i n s o n & 1990).  I t was  modeled a f t e r the s u c c e s s f u l A c c u l t u r a t i o n R a t i n g S c a l e f o r M e x i c a n Americans ( C u e l l a r , H a r r i s , & J a s s o ,  1980)  a f t e r a r e v i e w o f the l i t e r a t u r e r e v e a l e d no o b j e c t i v e measure o f a c c u l t u r a t i o n f o r t h i s p o p u l a t i o n .  The  SL-  45  ASIA i s based on the t h e o r e t i c a l assumption t h a t a c c u l t u r a t i o n i s a m u l t i f a c e t e d phenomenon. A c c o r d i n g l y , the s c a l e attempts  t o address  a l b e i t not e x h a u s t i v e , dimensions  numerous,.  r e l e v a n t to  a c c u l t u r a t i o n r a n g i n g from c o g n i t i v e and  attitudinal  b e l i e f s to behavioural c h a r a c t e r i s t i c s .  Specific  assessed f a l l i n t o four f a c t o r analyzed content  items  areas:  (a) language f a m i l i a r i t y , usage and p r e f e r e n c e ; (b) e t h n i c i d e n t i t y ;  ( c ) c u l t u r a l behaviours;  and  (d)ethnic i n t e r a c t i o n . The  SL-ASIA c o n s i s t s o f 21 m u l t i p l e c h o i c e  t h a t a s s e s s language p r e f e r e n c e  (4 q u e s t i o n s ) , i d e n t i t y  (4 q u e s t i o n s ) , f r i e n d s h i p c h o i c e behaviours history  items  (4 questions).,  (5 q u e s t i o n s ) , g e n e r a t i o n and geography  (3 q u e s t i o n s ) , and a t t i t u d e s  Each response  (1 q u e s t i o n ) .  i s r e c o r d e d on a 5 - p o i n t s c a l e where "1"  i n d i c a t e s low a c c u l t u r a t i o n and "5" i n d i c a t e s h i g h a c c u l t u r a t i o n . 'The  t o t a l s c o r e i s o b t a i n e d by summing  a c r o s s a l l 21 items and d i v i d i n g the t o t a l by 21; a t o t a l s c o r e can range from 1.0G A s i a n i d e n t i f i e d ) t o 5.00  thus  (low a c c u l t u r a t i o n o r  (high a c c u l t u r a t i o n or  Western i d e n t i f i e d ) . The s c a l e a l s o r e c o g n i z e s a t h i r d interpretation, bicultural  ( w i t h an SL-ASIA s c o r e o f  " 3 " ) , which the a u t h o r s suggest  r e p r e s e n t s the  ability  46  to  i n t e g r a t e the b e s t o f b o t h w o r l d s w i t h o u t d e n i a l t o  either.  As such, the SL-ASIA addresses  only three of  the f o u r a c c u l t u r a t i o n o p t i o n s suggested by B e r r y (1989).  The o p t i o n o f m a r g i n a l i z a t i o n , i n which  n e i t h e r one's home c u l t u r e nor the h o s t c u l t u r e i s embraced, i s not r e c o g n i z e d by the SL-ASIA.  Although  t h i s i s a l i m i t a t i o n o f the SL-ASIA, the l a c k o f an a p p r o p r i a t e i n s t r u m e n t based on B e r r y ' s model n e c e s s i t a t e s i t s use.  In a d d i t i o n , g i v e n t h a t one  of  the g o a l s o f t h i s s t u d y i s t o o p e r a t i o n a l l y d e f i n e l e v e l o f a c c u l t u r a t i o n , the SL-ASIA, w h i l e not a d d r e s s i n g a l l a c c u l t u r a t i o n o p t i o n s , does appear t o address the degree t o which one  i n t e r n a l i z e s Western  values. A l t h o u g h Suinn, R i c k a r d - F i g u e r o a , Lew, (1987) p r o v i d e d i n i t i a l p s y c h o m e t r i c  and  Vigil  v a l u e s f o r the  SL-  ASIA, the i n s t r u m e n t has r e c e n t l y undergone more extensive scrutiny.  Suinn, Ahuna, an Khoo (1992)  i n d i c a t e d t h a t the r e l i a b i l i t y c o e f f i c i e n t alpha)  f o r the SL-ASAI i s . 9 1 .  (Cronbach's  This estimate i s  comparable t o the a l p h a c o e f f i c i e n t o f .88 r e p o r t e d i n the o r i g i n a l study  (Suinn e t a l . , 1987)  and t o the  e s t i m a t e o f .89 r e p o r t e d by A t k i n s o n and Gim  (1989).  C o r r e l a t i o n a l a n a l y s i s and a n a l y s i s o f v a r i a n c e were  47  a l s o c a r r i e d out on the SL-ASIA (Suinn e t a l . , 1992). H i g h e r SL-ASIA s c o r e s were found t o have s i g n i f i c a n t p o s i t i v e c o r r e l a t i o n with: school US;  i n the US;  upon a t t e n d i n g  (c) y e a r s l i v i n g i n the US;  i n the US; and  (b) age  (a) t o t a l y e a r s  (d) age  attending  school  i n the  upon a r r i v i n g  (e) y e a r s l i v e d i n a n o n - A s i a n neighborhood;  (f) s e l f - r a t i n g of a c c u l t u r a t i o n .  In a d d i t i o n ,  r e s u l t s of the f a c t o r a n a l y s i s i n d i c a t e t h a t the ASIA has was  the  SL-  a s t r u c t u r e s i m i l a r t o t h a t of the s c a l e i t  modelled a f t e r .  - '  Even though the SL-ASIA i s s t i l l  a relatively  new  measure, and would most l i k e l y b e n e f i t from f u r t h e r a n a l y s i s , the l a c k o f a more r e l i a b l e o b j e c t i v e measure of l e v e l o f a c c u l t u r a t i o n f o r a Chinese' p o p u l a t i o n necessitates  i t s use.  SAFE A c c u l t u r a t i v e S t r e s s S c a l e P a d i l l a and h i s a s s o c i a t e s as a means of " a s s e s s i n g  (SAFE-24).  d e v e l o p e d the o r i g i n a l SAFE  the s o u r c e s of s t r e s s  (immigrant) u n i v e r s i t y s t u d e n t s f r e q u e n t l y and  that  encounter  the c u m u l a t i v e degree o f s t r e s s f u l n e s s t h a t these  d i f f i c u l t i e s induce" 1986,  A.M.  p. 280).  The  (Padilla, Alvarez,  & Lindholm,  o r i g i n a l s c a l e i n c l u d e d 66  items  d e r i v e d from a r e v i e w of the l i t e r a t u r e as w e l l as  from  a s e r i e s of p r e l i m i n a r y s e m i - s t r u c t u r e d  in  interviews  48  which immigrant u n i v e r s i t y s t u d e n t s were asked t o r e l a t e d i f f i c u l t i e s t h e y e x p e r i e n c e d as immigrants o r had been aware o f as o f f s p r i n g o f i m m i g r a n t s . Accordingly,  t h e o r i g i n a l s c a l e c o n s i s t e d o f 66 items  measuring s t r e s s o r s i n t h e S o c i a l , A t t i t u d i n a l , F a m i l i a l , and E n v i r o n m e n t a l domains  (SAFE).  The s c a l e was i n i t i a l l y used w i t h a sample o f 247 u n i v e r s i t y students 1986).  Subjects  ( P a d i l l a , 1985; P a d i l l a e t a l . ,  i n c l u d e d 99 f i r s t - g e n e r a t i o n  immigrants, 47 s e c o n d - g e n e r a t i o n i n d i v i d u a l s , and 101 t h i r d or later-generation students.  Within the  immigrant group, 60 were o f A s i a n o r i g i n , 20 were o f d i v e r s e European background, and t h e remainder were from L a t i n A m e r i c a o r A f r i c a .  A l l s u b j e c t s were asked  t o r a t e each i t e m on a 5 p o i n t L i k e r t s c a l e from "NOT  STRESSFUL"  STRESSFUL"  ( r a t e d as 1) t o "EXTREMELY  ( r a t e d as 5 ) .  Discriminant authors'  ranging  a n a l y s i s o f t h e SAFE c o n f i r m e d t h e  o r i g i n a l preconceptions of the c a t e g o r i e s of  s t r e s s o r s e x p e r i e n c e d by i m m i g r a n t s .  Accordingly,  P a d i l l a and h i s a s s o c i a t e s found t h a t t h e b e s t discriminates of generational Cultural/Familial function p r e d i c t e d variance)  s t a t u s was a  (accounting  f o r 63% o f t h e  and a S o c i a l / E n v i r o n m e n t a l  function  49  (accounting  f o r a n o t h e r 2 6% o f the p r e d i c t e d v a r i a n c e ) .  Together b o t h f u n c t i o n s c o r r e c t l y c l a s s i f i e d 91% o f l a t e immigrants and 82% o f the t o t a l s u b j e c t s i n t o g e n e r a t i o n a l groups  ( P a d i l l a e t a l . , 1986).  Following this i n i t i a l  trial,  m o d i f i c a t i o n s were  made t o the SAFE t o improve w o r d i n g problems eliminate questions  four  and  which f a i l e d t o d i s c r i m i n a t e  between the g e n e r a t i o n a l s t a t u s o f the s u b j e c t s . Accordingly,  6 items were d e l e t e d from the  questionnaire.  The m o d i f i e d  60 i t e m SAFE has since,  been u t i l i z e d w i t h a sample o f 114 Japanese  and  Japanese American, and 114 M e x i c a n and M e x i c a n American u n i v e r s i t y s t u d e n t s ( P a d i l l a , Wagatsuma, & Lindholm, 1985a; 1985b).  Once a g a i n , d i s c r i m i n a n t a n a l y s i s  c o n f i r m e d t h a t 90% o f the s u b j e c t s were c o r r e c t l y grouped i n t o g e n e r a t i o n a l l e v e l s on the b a s i s o f t h e i r responses on the SAFE ( P a d i l l a e t a l . , 1985b). More r e c e n t l y Mena, P a d i l l a , & Maldonado  (1987)  u t i l i z e d a m o d i f i e d 24 i t e m v e r s i o n o f the SAFE 24) .  (SAFE-  Seventeen o f the items were t a k e n from the 60  i t e m SAFE.  These items were found i n an e a r l i e r s t u d y  ( P a d i l l a e t a l . , 1985b) t o d i s c r i m i n a t e between generations students.  f o r b o t h Japanese and M e x i c a n American An a d d i t i o n a l 7 new statements were added  50  which p e r t a i n e d t o p e r c e i v e d d i s c r i m i n a t i o n o r m a j o r i t y group s t e r e o t y p e s  towards immigrant p o p u l a t i o n s .  Like  i n t h e o r i g i n a l SAFE, a l l items were r a t e d on a 5 p o i n t L i k e r t scale ranging  from "NOT  "EXTREMELY STRESSFUL"  STRESSFUL"  (1) t o  ( 5 ) . I f an i t e m was n o t  a p p l i c a b l e t o a s u b j e c t i t was a s s i g n e d Thus t h e p o s s i b l e s c o r e s  a s c o r e o f 0.  f o r t h e 24 i t e m SAFE range  from 0 t o 120. Although there i s l i m i t e d psychometric concerning promising.  information  t h e SAFE-24, t h e i n i t i a l i n f o r m a t i o n i s F i r s t , a r e l i a b i l i t y check on t h e s c a l e  w i t h a s u b j e c t p o p u l a t i o n o f 214 m u l t i c u l t u r a l u n i v e r s i t y students  r e s u l t e d i n a Cronbach A l p h a  C o e f f i c i e n t o f .89 (Mena e t a l . , 1987). appears t o be h i g h l y r e l i a b l e .  Thus t h e s c a l e  A d d i t i o n a l l y , l e v e l s of  a c c u l t u r a t i v e s t r e s s as measured by t h e SAFE-24 d i f f e r e d s i g n i f i c a n t l y among t h e f o u r  generational  groups. W h i l e t h e SAFE-24 i s s t i l l  a r e l a t i v e l y new  measure and l a c k s i n t e n s i v e p s y c h o m e t r i c a n a l y s i s , t h e l a c k o f a more r e l i a b l e b r i e f measure o f a c c u l t u r a t i v e s t r e s s n e c e s s i t a t e s i t s use.  A d d i t i o n a l l y , the  o r i g i n a l SAFE, as w e l l as t h e SAFE-24, was d e v e l o p e d and v a l i d a t e d on a u n i v e r s i t y p o p u l a t i o n , s i m i l a r t o  51  the p o p u l a t i o n t o be used i n t h i s s t u d y . a s i g n i f i c a n t proportion  Furthermore,  o f t h e more, r e c e n t r e s e a r c h  u t i l i z i n g t h e SAFE-24 has u t i l i z e d v a r i o u s A s i a n p o p u l a t i o n s , y e t another c h a r a c t e r i s t i c o f the p o p u l a t i o n t h i s s t u d y attempts t o a c c e s s . Hypothesis The  f o l l o w i n g r e l a t i o n s h i p s are hypothesized i n  t h i s study: 1)  an e t h n i c d i f f e r e n c e  i n e a t i n g a t t i t u d e s and  b e h a v i o u r s as f o l l o w s : for  the Caucasian subjects  (more, p a t h o l o g i c a l ) for 2)  t h e mean EAT s c o r e  t h e Chinese  w i l l be h i g h e r  t h a n t h e mean EAT s c o r e  subjects;  a d i r e c t r e l a t i o n s h i p between l e v e l o f a c c u l t u r a t i o n and e a t i n g a t t i t u d e s as f o l l o w s : As t h e Chinese s u b j e c t s ' scores increase  ( i n d i c a t i n g a h i g h e r degree  of W e s t e r n i z a t i o n or a s s i m i l a t i o n ) t h e i r EAT s c o r e s pathological  SL-ASIA  so w i l l  ( i n d i c a t i n g more  e a t i n g a t t i t u d e s and b e h a v i o u r s .  A d d i t i o n a l l y , the following t e n t a t i v e hypothesis w i l l be a d d r e s s : 3)  a d i r e c t r e l a t i o n s h i p between a c c u l t u r a t i v e s t r e s s and e a t i n g a t t i t u d e s as f o l l o w s : As  52  the Chinese s u b j e c t s ' SAFE s c o r e i n c r e a s e ( i n d i c a t i n g more p e r s o n a l and f a m i l i a l s t r e s s ) so w i l l t h e i r EAT s c o r e s ( i n d i c a t i n g more p a t h o l o g i c a l e a t i n g a t t i t u d e s and behaviours). 4)  a d i r e c t r e l a t i o n s h i p between l e v e l o f • a c c u l t u r a t i o n and e a t i n g a t t i t u d e s , independent o f t h e e f f e c t s o f a c c u l t u r a t i v e s t r e s s , as f o l l o w s : Amongst the Chinese s u b j e c t s , l e v e l o f a c c u l t u r a t i o n as measured by t h e SL-ASIA, w i l l be found t o be the b e s t predictor of pathological eating attitudes and b e h a v i o u r s .  S t a t i s t i c a l Analysis F i r s t , t - t e s t s were conducted t o determine any significant differences survey i n t h i s study.  a c r o s s t h e two c u l t u r a l groups A s i g n i f i c a n c e l e v e l of p  l e v e l was used u n l e s s o t h e r w i s e s p e c i f i e d .  <.05  Next,  p e a r s o n p r o d u c t moment c o r r e l a t i o n a l a n a l y s i s was used t o determine t h e n a t u r e o f the r e l a t i o n s h i p between l e v e l o f a c c u l t u r a t i o n and e a t i n g a t t i t u d e s as w e l l as the n a t u r e o f t h e r e l a t i o n s h i p between a c c u l t u r a t i v e s t r e s s and e a t i n g a t t i t u d e s .  53  F i n a l l y , multiple regression  analysis  was  performed t o t e s t the h y p o t h e s i s t h a t l e v e l acculturation influences  e a t i n g p a t h o l o g y and  i n d e p e n d e n t l y of a c c u l t u r a t i v e s t r e s s . multiple-regression EAT  e q u a t i o n was  a c c u l t u r a t i o n , a c c u l t u r a t i v e s t r e s s and variables.  A  behaviour  stepwise  then c o n s t r u c t e d  s c o r e s as the dependent v a r i a b l e and  predictor  of  level age  as  of the  with  54  Chapter.IV Results E a r l i e r i n t h i s p a p e r , • f o u r hypotheses were proposed.  B r i e f l y , they s t a t e d  (a) t h a t female  C a u c a s i a n s u b j e c t s would e x h i b i t more p a t h o l o g i c a l e a t i n g a t t i t u d e s and b e h a v i o u r s than the C h i n e s e s u b j e c t s ; and  (b) t h a t h i g h l y a c c u l t u r a t e d female  Chinese s u b j e c t s would e x h i b i t more p a t h o l o g i c a l e a t i n g a t t i t u d e s and b e h a v i o u r s than l e s s a c c u l t u r a t e d female Chinese s u b j e c t s .  Two  e x p l o r a t o r y hypotheses were a l s o  s t a t e d , p r e d i c t i n g (a) t h a t Chinese experiencing  subjects  a h i g h amount o f a c c u l t u r a t i v e s t r e s s  would show more p a t h o l o g i c a l e a t i n g a t t i t u d e s b e h a v i o u r s ; and  and  (b) t h a t l e v e l o f a c c u l t u r a t i o n would  be the s t r o n g e s t p r e d i c t o r of the Chinese s u b j e c t s ' e a t i n g a t t i t u d e s and b e h a v i o u r s . tested s t a t i s t i c a l l y  These hypotheses were  and the r e s u l t s o f those  are p r e s e n t e d i n t h i s c h a p t e r . '  analyses  To b e g i n , however, a  d e t a i l e d d e s c r i p t i o n , o f the sample i s p r e s e n t e d . Demographic D e s c r i p t i o n of the Sample As o u t l i n e d i n the Chapter Three, s u b j e c t s t h i s s t u d y were r e c r u i t e d by two p r i m a r y  for  researchers.  A p p r o x i m a t e l y h a l f of the s u b j e c t s were r e c r u i t e d by t h i s researcher  (Sample 1) , w h i l e the  remaining  55  s u b j e c t s were r e c r u i t e d w i t h the a s s i s t a n c e of  Dr.  Ishiyama i n c o n j u n c t i o n w i t h a l a r g e r r e s e a r c h  study  (Sample 2 ) .  present  In a l l cases, t h i s r e s e a r c h e r was  d u r i n g the a c t u a l d a t a c o l l e c t i o n .  Table 1 o u t l i n e s  the number of s u b j e c t s r e c r u i t e d i n each sample as w e l l as the q u e s t i o n n a i r e items completed by each s u b j e c t . As Table 1 i n d i c a t e s , Sample 1 c o n s i s t e d of subjects  (48 C a u c a s i a n and  67 Chinese s u b j e c t s ) , w h i l e  Sample 2 c o n s i s t e d of an a d d i t i o n a l 116 C a u c a s i a n and  115  64 Chinese s u b j e c t s ) .  subjects  In t o t a l ,  s u b j e c t s were r e c r u i t e d f o r t h i s s t u d y .  (52  231  A l l of the  s u b j e c t s i n Sample 1 completed the e n t i r e q u e s t i o n n a i r e package o u t l i n e d i n Chapter 3.  F o r t y - n i n e of the  64  Chinese s u b j e c t s i n Sample 2 r e c e i v e d and completed the Suinn-Lew A s i a n S e l f - I d e n t i t y A c c u l t u r a t i o n S c a l e  (SL-  ASIA) , and none r e c e i v e d the SAFE A c c u l t u r a t i v e S t r e s s Scale  (SAFE). To ensure t h a t t h e r e were no  d i f f e r e n c e s between the two  significant  samples, the means and  s t a n d a r d d e v i a t i o n s o f key v a r i a b l e s were compared. Table 2 i n d i c a t e s , no s i g n i f i c a n t d i f f e r e n c e s were found a c r o s s the two was  samples.  A c c o r d i n g l y , the  c o l l a p s e d a c r o s s samples f o r a l l subsequent  analysis.  data  As  56  Table 1 Break Down o f S u b j e c t s i n each Sample Ethnicity  Sample 1  Sample 2  Total  ( a l l scales)  (EAT only)  Caucasian  48  52  0  100  Chinese  67  15  49  131  115  67  49  231  Total  (EAT+SL-ASIA)  57  Table 2 Means and S t a n d a r d D e v i a t i o n s f o r Age  Years L i v i n g i n  r  N o r t h A m e r i c a , E a t i n g A t t i t u d e s and B e h a v i o u r s (EAT) and L e v e l o f A c c u l t u r a t i o n  Category  AGE ( y r ) LIFE(yr) EAT  Samplel Mean (SD) c  d  e  SL-ASIA  f  (SL-ASIA) between  Sample2 Mean (SD)  a  i.  b  Samples  level of significance  19.97 (2.24)  20.13 (2.51)  0.51  ns  16.06 (6.71)  17.12 (6.68)  -1.13  ns  8.82 (8.96)  9.39 (10.21)  -0.46  ns  2.74 (0.59)  2.71 (0.56)  . 30  ns  Note: L i f e = y e a r s l i v i n g i n N o r t h America; EAT = f u l l s c a l e EAT; SL-ASIA =. f u l l s c a l e SL -ASIA a  n = 115.  e  t h e h i g h e r the s c o r e , t h e g r e a t e r the e a t i n g  b  I l = 116.  p a t h o l o g y ; f i t = 229.  c  df  = 222.  d  c l f = 204.  ^low s c o r e s i n d i c a t e  i d e n t i f i e d , h i g h s c o r e s i n d i c a t e Western df  = 114.  Chinese  identified;  58  Table 3 p r e s e n t s information obtained  some o f t h e demographic i n the f i r s t s e c t i o n of a l l the  q u e s t i o n n a i r e packages. Chinese s u b j e c t s  F o r t y - s i x percent of the  (n = 131) i n d i c a t e d t h a t t h e y were t h e  o l d e s t s i b l i n g i n t h e i r f a m i l y , w h i l e 50% o f t h e Caucasian subjects  (n = 100) i n d i c a t e d t h a t t h e y were  the e l d e s t s i b l i n g .  A n o t h e r 24% o f t h e C h i n e s e  s u b j e c t s and 28% o f t h e C a u c a s i a n s u b j e c t s  indicated  t h a t t h e y were t h e youngest s i b l i n g i n t h e i r f a m i l i e s , suggesting  t h a t t h e m a j o r i t y o f t h e s u b j e c t s came from  two s i b l i n g f a m i l i e s . N i n e t y - s e v e n p e r c e n t o f a l l t h e s u b j e c t s were undergraduate s t u d e n t s w o r k i n g towards t h e i r B a c h e l o r degrees.  Of t h e 131 Chinese s t u d e n t s r e c r u i t e d f o r  t h i s s t u d y , 47% were S c i e n c e m a j o r s , 24% were from t h e Faculty of Arts  ( i n c l u d i n g H i s t o r y , P s y c h o l o g y and  S o c i o l o g y ) , and t h e r e m a i n i n g 29% were A s i a n students. half  Studies  Of t h e 100 C a u c a s i a n s u b j e c t s , more t h a n  (64%) were from t h e F a c u l t y o f A r t s , w h i l e t h e  r e m a i n i n g s u b j e c t s were majors i n e i t h e r S c i e n c e (31%) or A s i a n Studies  (5%) .  As p l a c e o f b i r t h was a c r i t e r i o n f o r i n c l u s i o n i n t h i s study f o r the Caucasian subjects, i t i s not  59  Table 3 Demographic Data f o r a l l S u b j e c t s i n c l u d i n g  Sibling  Order, Department, Program,' P l a c e o f B i r t h , and Generation Level Category-  Description  Sibling Order  Oldest Youngest Only Middle Other Unknown  60(46%) 31(24%) 5-( '4%) 24 (18%) 1 (15%) •10 ( 8%)  50 (50%) 110 (48%) 28 (28%) 59 (26%) 6 ( 6%) .11( 5%) 11 (11%) 35(15%) 4 ( 4%) 5 (2%) 1 ( 1%) 11 ( 5%)  Dept.  BioChem/Chem. Arts Asian Studies  62(47%) 31(24%) 38(29%)  31 (31%) 64 (64%) 5 ( 5%)  Program  Bachelors Diploma Masters Doctoral Unclass. Unknown  Place of Birth  Canada North America Other No Answered  Generation Level 1st. 2nd. 3rd. 4th. 5th. a  Chinese n ('%) 131  Caucasian n (%) • 100  127(97%) 0( 0%) 0 ( 0%) 1(.8%) 0 (05%) 3 ( 2%) 53(40%) 1(.8%) 54 (41%) 23 (18%) 65(54%) 51 (44%) 0 C 0%) 0 ( 0%) 0(0%)  Total M '(%) 231  93 (.40%) 95 (41%) 43 (19%)  97 (97%) 224(97%) 0 ( 0%) 0 ( 0%) 1 ( 1%) 1 C.4%) 0 ( 0%) 1(.4%) 2 ( 2%) 2(.9%) 0 ( 0%) 3 ( 1%) . 96 (96%) 149(65%) 4 ( 4%) 5( 2%). 0 ( 0%) 54 (23%) .0 ( 0%) 23 (10%) N/A  N/A  Taken from Q u e s t i o n 12 of the SL-ASIA: g e n e r a t i o n 1 s t . = I was born i n A s i a or o t h e r ; g e n e r a t i o n 2 n d . = I was born i n Canada, e i t h e r p a r e n t was born i n A s i a or o t h e r . a  60  s u r p r i s i n g t h a t 100% o f t h e C a u c a s i a n s u b j e c t s were b o r n i n N o r t h A m e r i c a , w i t h 96% i f them i n d i c a t i n g t h a t t h e y were b o r n i n Canada.  A l t e r n a t i v e l y , o f t h e 108  Chinese s u b j e c t s who i n d i c a t e d t h e i r p l a c e o f b i r t h , 40% were b o r n i n Canada w h i l e 41% were b o r n abroad. E i g h t e e n p e r c e n t o f t h e Chinese s u b j e c t s d i d n o t i n d i c a t e where t h e y were t h e y were b o r n . Of t h e 54 Chinese s u b j e c t s b o r n abroad, 95% i n d i c a t e d t h a t t h e y were b o r n i n e i t h e r Hong Kong, C h i n a o r T a i p a i , Taiwan.  F i v e p e r c e n t o f t h e Chinese  s u b j e c t s b o r n abroad d i d n o t i n d i c a t e where t h e y were born. A c c o r d i n g t o Q u e s t i o n 12 from t h e Suinn-Lew A s i a n S e l f - I d e n t i t y A c c u l t u r a t i o n S c a l e (SL-ASIA), 56% o f t h e Chinese s u b j e c t s c l a s s i f i e d themselves as f i r s t g e n e r a t i o n , i n d i c a t i n g t h a t t h e y were b o r n i n A s i a o r other.  The r e m a i n i n g 44% Chinese s t u d e n t s c l a s s i f y i n g  themselves as second g e n e r a t i o n , i n d i c a t i n g t h a t t h e y were b o r n i n Canada w h i l e a t l e a s t one o f t h e i r p a r e n t s was b o r n i n A s i a o r o t h e r .  No s u b j e c t s  classified  themselves as t h i r d , f o u r t h , o r f i f t h g e n e r a t i o n . Table 4 p r e s e n t s a d d i t i o n a l demographic i n f o r m a t i o n , i n c l u d i n g t h e means and s t a n d a r d d e v i a t i o n s f o r age, number o f y e a r s l i v i n g i n N o r t h  61  Table 4 Means and Standard D e v i a t i o n s f o r Demographic Data i n c l u d i n g Age, Years L i v i n g i n N o r t h America, and Years i n School i n North  America  Category-  Chinese Mean (SD)  Age  19. 61 (1.75) 12.81 (7.12) 10.09 (5.71)  Life Schooling  8  Caucasian Mean (SD) 20.59 (2.86) 20.47 (2.93) N/A  1  3.15* 9.98**  Note: L i f e = Number o f y e a r s l i v i n g i n N o r t h A m e r i c a ; S c h o o l i n g = Number o f y e a r s a t t e n d i n g s c h o o l i n N o r t h America. a  H = 131.  *p_<.05.  b  n = 100.  **p_<.001.  62  America, and number o f y e a r s a t t e n d i n g s c h o o l i n N o r t h A m e r i c a a c r o s s t h e two c u l t u r a l groups.  The mean age  v a r i e d s i g n i f i c a n t l y between groups £(222) = 3.14, p_ <.05, w i t h a mean o f 19.61 y e a r s  {SB. - 1.75 years) f o r  the Chinese s u b j e c t s and 20.59 y e a r s  (SD = 2.86 years)  f o r t h e C a u c a s i a n s u b j e c t s . As a n t i c i p a t e d , t h e r e was a l s o a s i g n i f i c a n t d i f f e r e n c e i n t h e number o f y e a r s each group i n d i c a t e d t h e y had l i v e d i n N o r t h A m e r i c a £(204) = 9.96, £ <.001, w i t h a mean o f 12.81 y e a r s {SB. = 7.12 years) f o r t h e Chinese s u b j e c t s and 20.47 y e a r s (SD = 2.8 6 years) f o r t h e C a u c a s i a n s u b j e c t s . I n f o r m a t i o n r e g a r d i n g t h e number o f y e a r s t h e C a u c a s i a n s u b j e c t s a t t e n d e d s c h o o l i n N o r t h A m e r i c a was n o t collected.  However, t h i s i n f o r m a t i o n was c o l l e c t e d f o r  the Chinese s u b j e c t s . A c c o r d i n g l y , t h e mean number o f y e a r s t h e Chinese s u b j e c t s a t t e n d e d s c h o o l i n N o r t h A m e r i c a was 10.09 y e a r s  {SB = 5.71 y e a r s ) .  H y p o t h e s i s One: E a t i n g A t t i t u d e s and B e h a v i o u r s a c r o s s C u l t u r a l Groups A l t h o u g h i t was h y p o t h e s i z e d t h a t t h e C a u c a s i a n s u b j e c t s would d i s p l a y s i g n i f i c a n t l y more p a t h o l o g i c a l t e n d e n c i e s i n t h e i r e a t i n g a t t i t u d e s and b e h a v i o u r s than t h e Chinese s u b j e c t s , s t a t i s t i c a l support t h i s p r e d i c t i o n .  analyses d i d not  These a n a l y s e s a s s e s s e d  63  whether t h e two c u l t u r a l groups under c o n s i d e r a t i o n i n t h i s s t u d y d i f f e r e d from each o t h e r on t h e s c o r e s o f the f u l l s c a l e EAT, as w e l l as i t s t h r e e s u b s c a l e s . Table 5 p r e s e n t s t h e means and s t a n d a r d d e v i a t i o n s a c r o s s groups f o r a l l t h e s c a l e s .  Only t h e o r a l  c o n t r o l s u b s c a l e approached a s i g n i f i c a n t l e v e l w i t h p_ = .058 [£(229) = - 1 . 9 0 ] . While t h e r e were no s i g n i f i c a n t d i f f e r e n c e s i n EAT s c o r e s a c r o s s t h e Chinese and C a u c a s i a n s u b j e c t s , t h e Chinese s u b j e c t s ' mean f u l l s c a l e EAT s c o r e appears h i g h e r on v i s u a l e x a m i n a t i o n than t h e mean EAT s c o r e o f 5.93  (SD=5.46) r e p o r t e d by Lee (1993) f o r h i s sample o f  646 female Chinese u n i v e r s i t y s t u d e n t s s t i l l China.  living i n  U t i l i z i n g t h e i n f o r m a t i o n p r o v i d e d by Lee  (1993), a £ t e s t f o r independent employing  samples was  conducted  the f o l l o w i n g formula: £  = X1-X2  While t h e r e s u l t s o f t h i s p r o c e d u r e must be viewed w i t h c a u t i o n as t h e s i m i l a r i t y o f sample c h a r a c t e r i s t i c s and s t u d y methodology can n o t be ensured, t h e p r e s e n t s t u d y ' s sample o f Chinese s t u d e n t s appears t o have  64  Table 5 Means and S t a n d a r d D e v i a t i o n s  f o r t h e f u l l S c a l e and  S u b s c a l e EAT Scores a c r o s s C u l t u r a l Groups Category  EAT  Chinese Mean (SD)  3  Caucasian* £. • Mean (dj£=229) (SD) 3  level of significance  9.51 (8.92)  8.59 (10.43)  -.72  ns  -Diet  5.51 (6.39)  5.45 (7.35)  -.05  ns  -Bulimia  1.22 (2.27)  1.17 (2.38)  -.17  ns  - O r a l C o n t r o l 2.79 (3.64)  1. 97 (2.61)  -1. 90  Note: EAT = f u l l  p_=. 058  s c a l e EAT;'Diet = d i e t s u b s c a l e ;  Bulimia = bulimia subscale; OralControl = o r a l c o n t r o l subscale. a  n = 131.  b  n = 100.  65  s c o r e d s i g n i f i c a n t l y h i g h e r on the EAT t h a n Lee's sample o f Chinese s t u d e n t s £(773) = 6.05,  p_ <  .001.  A c c o r d i n g l y , i t appears t h a t the female Chinese s u b j e c t s s u r v e y e d i n t h i s s t u d y d i s p l a y e d more e a t i n g p a t h o l o g y than the female Chinese s u b j e c t s s u r v e y e d i n China. As suggested by Garner, Olmsted, Bohr, & G a r f i n k e l (1982), a t o t a l EAT  s c o r e o f 20 was used as the c u t - o f f  p o i n t between p a t h o l o g i c a l and n o n - p a t h o l o g i c a l e a t i n g a t t i t u d e s and b e h a v i o u r s .  A c c o r d i n g l y , the p e r c e n t a g e  of s t u d e n t s i n each c u l t u r a l group s c o r i n g over the c u t - o f f p o i n t was compared.  As Table 6 p r e s e n t s , 12%  of the Chinese s t u d e n t s and 10% o f the C a u c a s i a n s t u d e n t s s c o r e d over the c u t - o f f p o i n t . a n a l y s i s was  Chi-squared  conducted and r e v e a l e d t h a t the d i f f e r e n c e  a c r o s s groups was  i n s i g n i f i c a n t , X (1,N_=231) = 0.502 p_ 2  >.50. H y p o t h e s i s Two  and Three: C o r r e l a t i o n a l A n a l y s i s  One o f the p r i m a r y o b j e c t i v e s o f t h i s s t u d y was examine any p o s s i b l e c o r r e l a t i o n s between l e v e l o f a c c u l t u r a t i o n , a c c u l t u r a t i v e s t r e s s , and e a t i n g p a t h o l o g y amongst the Chinese s u b j e c t s .  In t h i s  s e c t i o n I w i l l p r e s e n t and a n a l y z e the c o r r e l a t i o n  to  66  Table 6 C o n t i n g e n c y Table o f Chinese and C a u c a s i a n S u b j e c t s who D i s p l a y e d E a t i n g P a t h o l o g y (EAT > 20) o r no E a t i n g P a t h o l o g y (EAT < 21) Category  EAT>2 0 EAT<21 Total n =  Chinese N (%)  Caucasian N (%.)  Total  16  (12.21%)  10  (10.00%)  26  115 131  (87.79%)  90 100  (90.00%)  205 231  X  2  = 0.552, p_ > .50  67  c o e f f i c i e n t s o b t a i n e d f o r l e v e l of a c c u l t u r a t i v e s t r e s s and  acculturation,  eating attitudes  and  b e h a v i o u r s as w e l l as the i n t e r c o r r e l a t i o n s f o r measures of l e v e l o f a c c u l t u r a t i o n a t t i t u d e s and b e h a v i o u r s  the  (SL-ASIA) and  eating  (EAT).  I n t e r c o r r e l a t i o n s of the EAT  and  SL-ASIA.  To  e x p l o r e the v a l i d i t y o f the EAT  w i t h Chinese  i n t e r c o r r e l a t i o n a l a n a l y s i s was  conducted (see Appendix  H). and  Thus, the i n t e r c o r r e l a t i o n s between the f u l l s u b s c a l e EAT  scores for a l l subjects  Caucasian subjects, investigated. and  subjects,  The  s u b s c a l e EAT  and  Chinese s u b j e c t s  combined, were  i n t e r c o r r e l a t i o n s of the f u l l  s c o r e s f o r the Chinese  scale  scale  subjects  c l o s e l y resembled those of the C a u c a s i a n s u b j e c t s ,  with  the e x c e p t i o n of the o r a l c o n t r o l s u b s c a l e .  While  the  p o s i t i v e l y c o r r e l a t e d to  the  o r a l c o n t r o l s u b s c a l e was d i e t subscale  (r_ = .364)  was  not  for  the Chinese s u b j e c t s  f o r the C a u c a s i a n s u b j e c t s , i t  s i g n i f i c a n t l y c o r r e l a t e d t o the d i e t s u b s c a l e ( r = .037).  This f i n d i n g  echoes Lee's (1993) r e s u l t s which i n d i c a t e d t h a t o r a l c o n t r o l s u b s c a l e f a i l e d t o be  the  significantly  c o r r e l a t e d w i t h the d i e t s u b s c a l e f o r h i s sample o f Chinese s u b j e c t s  l i v i n g i n China.  A s i d e from the  oral  68  c o n t r o l s u b s c a l e , however, the i n t e r c o r r e l a t i o n s appear s i m i l a r a c r o s s b o t h groups. S i m i l a r l y , i n t e r c o r r e l a t i o n a l a n a l y s i s of l e v e l of a c c u l t u r a t i o n measure (SL-ASIA) f o r Chinese s u b j e c t s  was  the  the  conducted (see Appendix I ) .  The  r e s u l t s r e v e a l e d t h a t a l l of the s u b s c a l e s were h i g h l y c o r r e l a t e d to each o t h e r as w e l l as the f u l l  scale  score. L e v e l of A c c u l t u r a t i o n  and  Eating Attitudes  B e h a v i o u r s Amongst the Chinese S u b j e c t s . s e c t i o n I w i l l p r e s e n t and  a n a l y z e the  and  In t h i s  correlation  c o e f f i c i e n t s o b t a i n e d f o r l e v e l of a c c u l t u r a t i o n , measured by the SL-ASIA, and b e h a v i o u r s , as measured by  eating attitudes  as  and  EAT.  A l t h o u g h s i g n i f i c a n t p o s i t i v e c o r r e l a t i o n s were h y p o t h e s i z e d , no s i g n i f i c a n t r e l a t i o n s h i p s were o b s e r v e d on the  f u l l s c a l e l e v e l (Table 7 ) .  s u b s c a l e l e v e l , however, the EAT o r a l c o n t r o l was  language p r e f e r e n c e and a f f i n i t y for ethnic  acculturated  f i v e subscales  usage, e t h n i c  i d e n t i t y and p r i d e  full  SL-  including,  interaction, i n the  and  negative  These r e s u l t s appear to i n d i c a t e t h a t Chinese s u b j e c t s ,  the  subscale addressing  s i g n i f i c a n t l y r e l a t e d to the  ASIA as w e l l as t h r e e o f the  direction.  On  less  as measured by the above.  69  Table 7 C o r r e l a t i o n M a t r i x o f F u l l S c a l e and S u b s c a l e EAT and SL-ASIA Scores f o r t h e Chinese EAT  SL-ASIA  Diet  Subjects Bulimia  OralControl  -0.15  -0.06  -0.10  -0.20*  -Language  -0.14  -0.02  -0.10 •  -0.23*  -Friend  -0.16  -0.05  -0.14  -0.22*  -Affinity  -0.21*  -0.10  -0.19*  -0.22*  -Generation  -0.05  -0.06.  -0.01  -0.01  -Food  -0.03  -0.001  -0.06  -0.11  Note: SL-ASIA = f u l l s c a l e SL-ASIA; Language = language preference  subscale;  Friend =ethnic i n t e r a c t i o n  s u b s c a l e ; A f f i n i t y = a f f i n i t y f o r e t h n i c i d e n t i t y and p r i d e subscale; Generation subscale;  = generational  Food = food p r e f e r e n c e  identity  subscale.  N e g a t i v e r. i n d i c a t e s a tendency t h a t t h e l e s s a c c u l t u r a t e d , t h e more e a t i n g p a t h o l o g y . . n = 116. *p_<.05, t w o - t a i l e d .  70  subscales,  d i s p l a y more s e l f - c o n t r o l around food and  p e r c e i v e more p r e s s u r e  from o t h e r s  the more a c c u l t u r a t e d s u b j e c t s .  t o g a i n weight t h a n  Similarly,  the SL-ASIA s u b s c a l e measuring a f f i n i t y f o r e t h n i c i d e n t i t y and p r i d e p r o v e d t o be s i g n i f i c a n t l y r e l a t e d t o t h e f u l l EAT s c a l e as w e l l as t h e b u l i m i a and o r a l c o n t r o l subscales,  a g a i n i n d i c a t i n g t h a t those  subjects  d i s p l a y i n g g r e a t e r a f f i n i t y f o r t h e Chinese c u l t u r e d i s p l a y more p a t h o l o g i c a l e a t i n g a t t i t u d e s and behaviours. scores  EAT s c o r e s were p l o t t e d a g a i n s t  SL-ASIA  to investigate a possible c u r v i l i n e a r  r e l a t i o n s h i p between t h e s e two v a r i a b l e s .  No  s i g n i f i c a n t c u r v i l i n e a r r e l a t i o n s h i p was found. In a p o s t hoc a n a l y s i s , S u i n n e t a l . ' s (1987) suggested p r o c e d u r e o f d i v i d i n g t h e f u l l s c a l e SL-ASIA scores  i n t o low (1-2), medium (3) and h i g h (4-5)  c a t e g o r i e s was f o l l o w e d .  Accordingly,  t h e Chinese  s u b j e c t s ' f u l l s c a l e SL-ASIA s c o r e s were  categorized  and t h e i r mean f u l l s c a l e EAT s c o r e s were compared a c r o s s t h e t h r e e groups.  Utilizing  this.procedure  r e s u l t e d i n o n l y 9 cases i n t h e " h i g h " a c c u l t u r a t i o n category.  Therefore,  d a t a from two SL-ASIA  questions  (Questions #3 and #20) t h a t d i r e c t l y asked s u b j e c t s t o i n d i c a t e t h e i r l e v e l o f a c c u l t u r a t i o n were a l s o d i v i d e d  71  i n t o low, medium and h i g h s c o r e s and t h e mean f u l l s c a l e EAT s c o r e s were compared a c r o s s groups.  This  p r o c e d u r e r e s u l t e d i n a b e t t e r d i s t r i b u t i o n o f cases a c r o s s the t h r e e l e v e l s o f a c c u l t u r a t i o n . Table 8 p r e s e n t s t h e r e s u l t s o f the one-way analyses of variance  (ANOVAs).  i n d i c a t e d t h a t the d i f f e r e n c e s  These a n a l y s e s a c r o s s the t h r e e l e v e l s  of a c c u l t u r a t i o n were s i g n i f i c a n t r e g a r d l e s s measure o f l e v e l o f a c c u l t u r a t i o n .  o f the  Subsequent a n a l y s i s  u t i l i z i n g the S c h e f f e method d e t e r m i n e d t h a t o n l y the d i f f e r e n c e s between t h e low and medium l e v e l s o f a c c u l t u r a t i o n were s i g n i f i c a n t . A c c o r d i n g l y ,  while  i n s p e c t i o n o f the means p r e s e n t e d i n Table 8 suggest t h a t i n d i v i d u a l s who i n d i c a t e a h i g h l e v e l o f a c c u l t u r a t i o n have a t e n d e n c y ' t o d i s p l a y g r e a t e r  eating  p a t h o l o g y than the those who i n d i c a t e a medium l e v e l o f a c c u l t u r a t i o n , t h e d i f f e r e n c e s were found n o t t o be significant. A c c u l t u r a t i v e S t r e s s and E a t i n g A t t i t u d e s and Behaviours f o r the Chinese Subjects. exploratory  One o f the  g o a l s o f t h i s s t u d y was t o address the  r e l a t i o n s h i p between a c c u l t u r a t i v e s t r e s s , as measured by t h e SAFE, and e a t i n g a t t i t u d e s and b e h a v i o u r s . predicted,  a c c u l t u r a t i v e s t r e s s was  significantly  As  72  Table 8 Qne-wav A n a l y s i s o f Variance o f F u l l Scale EAT Scores across Level of A m i l t n r a r i n n Level of Acculturation SL-ASIA  Low  (total)  EAT Mean  (SD)  a  ii=33  12. 62  . (10.86)  Medium n=77  7.61  (7.51)  12.67  (10.54)  ii=47  •11.32  (9.83)  Medium n=50  6.76-  (7.67)  High  ii=6 #3  SL-ASIA  Low  High  4.29*  b  n=19  SL-ASIA #20  Low  F (d£=2,113)  11.01  (8.74)  3. 69*  c  n=43  12.49  (10.18)  Medium n=57  7.21  (8.13)  High  8.19  (5.83)  n=16  4.65*  Note: low SL-ASIA s c o r e s i n d i c a t e Chinese- i d e n t i f i e d , h i g h s c o r e s i n d i c a t e Western a  F u l l s c a l e SL-ASIA  ^How do you i d e n t i f y c  identified.  How would you r a t e  *p_ < .05  yourself? yourself?  73  r e l a t e d t o t h e f u l l s c a l e EAT as w e l l as t h e d i e t and bulimia  subscales,  experiencing  i n d i c a t i n g that  greater  subjects  a c c u l t u r a t i v e s t r e s s d i s p l a y more  e a t i n g p a t h o l o g y (see Table 9 ) . I n a p o s t hoc a n a l y s i s , t h e SAFE was a l s o found t o be s i g n i f i c a n t l y r e l a t e d t o t h e f u l l s c a l e SL-ASIA, as w e l l as a l l b u t one o f t h e s u b s c a l e s ,  i n d i c a t i n g that  subjects'  d i s p l a y i n g lower l e v e l s o f a c c u l t u r a t i o n e x p e r i e n c e more a c c u l t u r a t i v e s t r e s s  (see Table 1 0 ) .  H y p o t h e s i s Four: R e g r e s s i o n A n a l y s i s I n t h i s s e c t i o n , I w i l l examine and a n a l y z e t h e r e s u l t s of the regression  analysis.  simultaneous m u l t i p l e regression of a c c u l t u r a t i o n stress  First, a  was conducted.  (SL-ASIA s u b s c a l e s ) ,  Level  acculturative  (SAFE), and age were used as p r e d i c t o r  variables.  P a t h o l o g i c a l e a t i n g a t t i t u d e s and  b e h a v i o u r s ( f u l l s c a l e EAT) was t h e c r i t e r i o n v a r i a b l e . Next, a model o f t h e r e g r e s s i o n  o f t h e f u l l s c a l e and  s u b s c a l e EAT s c o r e s on a l l t h e p r e d i c t o r v a r i a b l e s was conducted w i t h t h e use o f a s t e p w i s e  regression.  A n a l y s e s were performed u s i n g SPSS* REGRESSION w i t h an a s s i s t from SPSS* FREQUENCIES f o r e v a l u a t i o n o f assumptions.  74  Table 9 Correlation Matrix  o f F u l l S c a l e and S u b s c a l e EAT  Scores w i t h SAFE  SAFE  EAT  Diet  Bulimia  OralControl  .45**  .37*  .36*  .24  n = 67.  *p<.01, t w o - t a i l e d .  **p_<.001, t w o - t a i l e d .  75  Table 10 Correlation Matrix Scores w i t h  o f F u l l S c a l e and S u b s c a l e SL-ASIA  SAFE SAFE  SL-ASIA (Total)  -0.42**  language  -0.35**  -friend -Affinity  -0.31* •  -0.39**  -Generation  -0.23  -Food  -0.29*  n = 67. *p.<.05, t w o - t a i l e d .  **p_<.6l, t w o - t a i l e d  76  Results of evaluation  o f assumptions l e d t o square  r o o t t r a n s f o r m a t i o n o f t h e EAT v a r i a b l e s s l i g h t skewness i n t h e i r d i s t r i b u t i o n , number o f o u t l i e r s ,  and improve t h e  t o reduce a  reduce t h e  normality,  l i n e a r i t y , and h o m o s c e d a s t i c i t y o f r e s i d u a l s . use  With the  o f a p_ < .001 c r i t e r i o n f o r M a h a l a n o b i s d i s t a n c e  outliers  among cases were found.  no  No cases had m i s s i n g  data. Table 11 p r e s e n t s a summary o f t h e f i n d i n g s the m u l t i p l e  regression  analysis predicting  a t t i t u d e s and b e h a v i o u r s .  from  eating  The e q u a t i o n p r e d i c t i n g  e a t i n g a t t i t u d e s and b e h a v i o u r s reached s i g n i f i c a n c e , F(7, 59)  = 2.285, p_ < .05.  Only one v a r i a b l e ,  a c c u l t u r a t i v e s t r e s s , was s i g n i f i c a n t l y r e l a t e d t o e a t i n g a t t i t u d e s and behaviours> £(1, 65) .01.  = 2.985, p_<  C o n t r a r y t o H y p o t h e s i s f o u r o u t l i n e d i n Chapter  3, l e v e l o f a c c u l t u r a t i o n ,  as measured by t h e f u l l  s c a l e SL-ASIA, was n o t s i g n i f i c a n t l y r e l a t e d t o e a t i n g a t t i t u d e s and b e h a v i o u r s . variables  i n the regression  Entering  the f i v e  predictor  e q u a t i o n produced an R-  squared o f .21, w i t h an a d j u s t e d R-squared o f .12 (see Table 9 ) .  T h e r e f o r e , a modest amount o f v a r i a n c e (12%)  i n e a t i n g a t t i t u d e s and b e h a v i o u r s i s accounted f o r , almost w h o l l y by a c c u l t u r a t i v e  stress.  77  Table 11 M u l t i p l e Regression Analysis of Predictors of P a t h o l o g i c a l E a t i n g A t t i t u d e s and B e h a v i o u r s  Source  Beta  Age  -.072  -.585  ns  .039  .224  ns  SL-friend  -.111  -.768  ns  SL-generation  -.037  -.267  ns  .112  .767  ns  -.109  -.716  ns  .401  2.985  SL-language  SL-food SL-affinity SAFE Note:Beta Percentage  i s the standardized of variance  £  (n=67)  l e v e l of significance  p_=. 0041  regression coeffient.  i n e a t i n g a t t i t u d e s and  b e h a v i o u r s accounted  f o r by t h e r e g r e s s i o n  (R  .12). O v e r a l l £(7,59) = 2.285,  p  2  i s .21 (Adjusted  <.05.  equation  78  Second, a model o f t h e r e g r e s s i o n o f t h e f u l l s c a l e EAT on a l l o f t h e p r e d i c t o r v a r i a b l e s was conducted w i t h t h e use o f a s t e p w i s e r e g r e s s i o n (see Table 1 2 ) . A g a i n , o n l y a c c u l t u r a t i v e s t r e s s , as measured by t h e SAFE, p r o v e d t o be s i g n i f i c a n t , a c c o u n t i n g f o r almost a l l o f t h e v a r i a n c e . recent  controversy  regarding  Despite the  t h e v a l i d i t y o f employing  s t e p w i s e methods (Thompson, 1989/ Wampold & Freud, 1987) t h e s i m i l a r i t y o f f i n d i n g s a c r o s s b o t h methods o f regression  support t h e v a l i d i t y o f t h e r e g r e s s i o n  p a t t e r n noted i n the stepwise procedure. F i n a l l y , a model o f t h e r e g r e s s i o n o f t h e t h r e e EAT s u b s c a l e s on a l l o f t h e p r e d i c t o r v a r i a b l e s was conducted w i t h t h e use o f a s t e p w i s e r e g r e s s i o n (see Tables 13-15).  Both t h e d i e t and b u l i m i a  subscales  r e g r e s s e d i n as s i m i l a r manner as t h e f u l l s c a l e EAT, i d e n t i f y i n g a c c u l t u r a t i v e s t r e s s as t h e b e s t p r e d i c t o r of e a t i n g p a t h o l o g y .  The o r a l c o n t r o l  subscale,  however, i n d i c a t e d t h a t t h e l e v e l o f . a c c u l t u r a t i o n s u b s c a l e measuring a f f i n i t y f o r e t h n i c i d e n t i t y and p r i d e was t h e b e s t p r e d i c t o r o f e a t i n g p a t h o l o g y . The r e s i d u a l s o f a l l o f t h e above r e g r e s s i o n s p l o t t e d against  the p r e d i c t e d values.  were  These a n a l y s e s  showed t h a t over 95% o f the. r e s i d u a l s f e l l w i t h i n  +/-  79  Table 12 Stepwise R e g r e s s i o n o f t h e F u l l S c a l e EAT on a l l of t h e Predictor Variables  Source  B e t a Weight  t  R'  Step One: SAFE  .423  3.760**  .401  2.985*  .18  Step Two; SAFE Age  -.072  -.585  SL-generation  -.037  -.267  .112  .767  SL-friend  -.111  -.768  SL-affinity  -.101  -.716  SL-language  .039  .224  SL-food  n = 67.  *p_<.05.  **p_<.001  .21  80  Table 13 Stepwise R e g r e s s i o n o f t h e D i e t S u b s c a l e on a l l , of t h e Predictor Variables  Source  B e t a Weight  t  371  3.218*  E'  Step One; SAFE  14  Step Two; SAFE  .505  Age  .204  •1.500  SL-generation  ,068  -.494  SL-food  ,080  .549  SL-friend  ,057  -.396  SL-affinity  ,194  1.281  SL-language  ,140  .3 60  II  = 67.  *p<.005.  **p<.001  3.773**  ,21  81  Table 14 Stepwise R e g r e s s i o n o f t h e B u l i m i a S u b s c a l e on a l l o f the P r e d i c t o r  Variables  Source  B e t a Weight  t  R'  Step One: SAFE  .288  2.368*  SAFE  .2 61  1.950*  Age  .048  .376  -.099  -.689  .219  1.439  SL-friend  -.157  -1.014  SL-affinity  -.110  -.696  .09  Step Two;  SL-generation SL-food  SL-language n = 67. *p_.05.  **p<.001.  . 084  .463  .15  82  Table 15 Stepwise R e g r e s s i o n o f t h e O r a l C o n t r o l S u b s c a l e on a l l of the P r e d i c t o r V a r i a b l e s  Source  B e t a Weight  t  Rj  Step One; SL-affinity  -.468  -4.265**  -.448  -3.039*  .22  Step Two: SL-affinity Age  .195  1.626  SAFE  -.049  -.379  SL-food  -.018  -.127  .067  .512  SL-friend  -.076  -.544  SL-language  -.048  -.565  SL-generation  n = 67. *p_<.01.  ** p<.001.  .25  83  2.00 SD. ( a l l w i t h i n +/-  3.00 SJQ) .  Again, a n a l y s i s of  Cook and M a h a l a n o b i s d i s t a n c e s i n d i c a t e d no s i g n i f i c a n t outliers. A d d i t i o n a l l y , e n t e r i n g s c o r e s which had been t r a n s f o r m e d t o account f o r t h e p o s s i b i l i t y o f a quadratic e f f e c t d i d not c o n t r i b u t e s i g n i f i c a n t l y t o the r e g r e s s i o n .  Thus, i t appears t h a t no s i g n i f i c a n t  curvilinear relationship exists.  84  Chapter V Discussion The p r i m a r y purpose o f t h i s r e s e a r c h s t u d y was t o compare the e a t i n g a t t i t u d e s and b e h a v i o u r s o f Chinese and  C a u c a s i a n female u n i v e r s i t y s t u d e n t s . A d d i t i o n a l l y ,  t h i s s t u d y i n v e s t i g a t e d whether a r e l a t i o n s h i p e x i s t s between l e v e l o f a c c u l t u r a t i o n , a c c u l t u r a t i v e s t r e s s , and p a t h o l o g i c a l e a t i n g a t t i t u d e s and b e h a v i o u r s amongst Chinese female u n i v e r s i t y s t u d e n t s .  No such  s t u d i e s had p r e v i o u s l y been c a r r i e d out w i t h A s i a n subjects  who do not have o r i g i n s i n t h e I n d i a n  s u b c o n t i n e n t , n o r have any s t u d i e s i n c l u d e d b o t h a measure o f l e v e l o f a c c u l t u r a t i o n and a c c u l t u r a t i v e stress. In t h i s c h a p t e r t h e r e s u l t s o b t a i n e d i n t h i s s t u d y are d i s c u s s e d findings.  and compared w i t h e x i s t i n g r e s e a r c h  The l i m i t a t i o n s o f the s t u d y a r e s t a t e d ,  along with suggestions f o r further research. the c o u n s e l l i n g i m p l i c a t i o n s o f the c u r r e n t  Finally/ study'  r e s u l t s are o u t l i n e d . Review o f the Research  Findings  C u l t u r a l group d i f f e r e n c e s .  T h i s s t u d y found no  s i g n i f i c a n t d i f f e r e n c e s between t h e Chinese and Caucasian subjects  i n e a t i n g a t t i t u d e s and b e h a v i o u r s .  85  Both groups s c o r e d T e s t (EAT)  s i m i l a r l y on the E a t i n g A t t i t u d e s  and the p e r c e n t a g e o f s u b j e c t s who  or more p o i n t s on the EAT e a t i n g d i s o r d e r ) was groups.  scored  (the c u t - o f f s c o r e  also roughly  20  f o r an  the same a c r o s s  Such f i n d i n g s were not a n t i c i p a t e d o r  hypothesized.  However, t h e y are i n k e e p i n g w i t h  Pumariega's f i n d i n g s o f no s i g n i f i c a n t d i f f e r e n c e s between h i s sample of H i s p a n i c  and C a u c a s i a n s u b j e c t s .  In a d d i t i o n , a l t h o u g h the d i f f e r e n c e s were not s i g n i f i c a n t , the f a c t t h a t more Chinese than C a u c a s i a n s u b j e c t s s c o r e d over the c u t - o f f p o i n t on the EAT c o n s i s t e n t w i t h Mumford e t a l . ' s (1991; 1992)  findings.  A c l o s e r l o o k at the demographic d a t a of Chinese s u b j e c t s may groups on EAT  scores.  the  h e l p e x p l a i n the s i m i l a r i t y The  demographic d a t a  is  across  revealed  t h a t more t h a n h a l f of the Chinese s u b j e c t s were b o r n i n North America.  A d d i t i o n a l l y , o f those s u b j e c t s  born  abroad, 95% i n d i c a t e d t h a t t h e y were b o r n i n Hong Kong or T a i p a i , Taiwan. Lee,  C h i u and Chen (1989) s t a t e d t h a t p e o p l e i n  i n d u s t r i a l i z e d urban c i t i e s such as Hong Kong  and  Taiwan have r e c e n t l y begun t o f e e l the e f f e c t s of Westernization  as e v i d e n c e d by the development o f f a s t  food r e s t a u r a n t s  and a e r o b i c gyms.  Thus, the  majority  86  o f Chinese s u b j e c t s who  i n d i c a t e d t h e i r p l a c e of b i r t h  were e i t h e r N o r t h America o r urban c i t i e s  currently  undergoing W e s t e r n i z a t i o n . S i m i l a r l y , the mean number o f y e a r s a l l o f the Chinese s u b j e c t s i n d i c a t e d t h e y had l i v e d i n N o r t h America was  12.81  y e a r s , and t h e i r mean number o f y e a r s  a t t e n d i n g s c h o o l i n N o r t h A m e r i c a was  10.09 y e a r s .  Thus, i n g e n e r a l , the Chinese s u b j e c t s s u r v e y e d i n t h i s s t u d y had a h i g h degree o f exposure t o Western a t the time o f the s t u d y .  culture  I t i s therefore possible  t h a t the Chinese s u b j e c t s s u r v e y e d i n t h i s s t u d y a l r e a d y had enough exposure t o Western i d e a l s  and  v a l u e s t o put them a t s i m i l a r r i s k as t h e i r C a u c a s i a n counterparts of developing p a t h o l o g i c a l e a t i n g a t t i t u d e s and b e h a v i o u r s . Such an i n t e r p r e t a t i o n o f the r e s u l t s i s s u p p o r t e d by Furnham and A l i b h a i ' s p r e f e r r e d body shape.  (1983) s t u d y o f Kenyan women's  T h e i r r e s u l t s found t h a t when  non-Western women a r e p l a c e d i n a Western c u l t u r e t h e y q u i c k l y a s s i m i l a t e Western i d e a l s and v a l u e s , such as • the t h i n n e s s i d e a l , and s u r r e n d e r the t r a d i t i o n a l  ideal  o f f e m i n i n e beauty h e l d i n t h e i r home c u l t u r e . While no s i g n i f i c a n t d i f f e r e n c e s were found between the two c u l t u r a l groups s u r v e y i n t h i s s t u d y ,  87  the Chinese s u b j e c t s ' mean s c o r e on t h e f u l l s c a l e EAT was  s i g n i f i c a n t l y h i g h e r than t h a t r e p o r t e d by Lee  (1993) f o r h i s sample o f female Chinese' u n i v e r s i t y students l i v i n g i n China.  While t h i s f i n d i n g must be  i n t e r p r e t e d w i t h c a u t i o n as t h e s i m i l a r i t y o f sample c h a r a c t e r i s t i c s and s t u d y methodology can -not be ensured,  i t does appear t o m i r r o r Mumford e t a l . ' s  (1992) f i n d i n g t h a t A s i a n s u b j e c t s l i v i n g i n B r a d f o r d , London d i s p l a y e d h i g h e r EAT s c o r e s and more cases o f a n o r e x i a and b u l i m i a compared t o A s i a n s u b j e c t s l i v i n g i n t h e i r home c o u n t r i e s o f Lahore (Mumford e t a l . , 1992)  and M i r p u r  (Choudry & Mumford,  1992).  Thus, t h e f i n d i n g s o f t h i s s t u d y support Mumford and h i s c o l l e g u e s ' (Choudry & Mumford, 1992; Mumford e t al.,  1991, 1992) c l a i m t h a t non-white women l i v i n g i n  Western c o u n t r i e s and exposed t o Western v a l u e s and ideals are at higher r i s k of developing p a t h o l o g i c a l e a t i n g a t t i t u d e s and b e h a v i o u r s than s i m i l a r non-white women s t i l l  l i v i n g i n t h e i r country of o r i g i n .  A d d i t i o n a l l y , t h e f i n d i n g s o f t h i s s t u d y suggest t h a t female Chinese u n i v e r s i t y s t u d e n t s l i v i n g i n B r i t i s h Columbia,  Canada (as an example o f Western c u l t u r e ) ,  d i s p l a y a s i m i l a r l e v e l o f e a t i n g p a t h o l o g y as t h e i r Caucasian c o u n t e r p a r t s .  Without  further analysis,  88  however, i t i s d i f f i c u l t t o determine whether these f i n d i n g s , a r e due s i m p l y t o l e v e l o f a c c u l t u r a t i o n and a s s i m i l a t i o n o f Western c u l t u r e , i d e a l s , and v a l u e s o r the a c c u l t u r a t i v e s t r e s s o f t e n a s s o c i a t e d w i t h t h e r e l o c a t i o n process.,  T h i s query i s a d d r e s s e d i n t h e  following sections of t h i s  chapter.  L e v e l o f a c c u l t u r a t i o n and e a t i n g a t t i t u d e s and behaviours. negative and  C o r r e l a t i o n a l analysis revealed  several  r e l a t i o n s h i p s between l e v e l o f a c c u l t u r a t i o n  e a t i n g a t t i t u d e s and b e h a v i o u r s amongst t h e C h i n e s e  subjects.  S p e c i f i c a l l y , t h e EAT s u b s c a l e  addressing  o r a l c o n t r o l was s i g n i f i c a n t l y r e l a t e d t o t h e f u l l s c a l e measure o f l e v e l o f a c c u l t u r a t i o n (SL-ASIA) as w e l l as t h r e e o f i t s f i v e s u b s c a l e s . .  This f i n d i n g  suggests t h a t t h e l e s s a c c u l t u r a t e d Chinese  subjects  d i s p l a y e d more p a t h o l o g i c a l c o n t r o l around food and p e r c e i v e more p r e s s u r e  from o t h e r s  the more a c c u l t u r a t e d s u b j e c t s .  t o g a i n weight t h a n  S i m i l a r l y , t h e SL-ASIA  s u b s c a l e measuring a f f i n i t y f o r e t h n i c i d e n t i t y and p r i d e was n e g a t i v e l y r e l a t e d t o t h e f u l l s c a l e EAT as w e l l as t h e b u l i m i a and o r a l c o n t r o l  subscales  i n d i c a t i n g t h a t those s u b j e c t s d i s p l a y i n g g r e a t e r a f f i n i t y and p r i d e f o r t h e i r Chinese c u l t u r e d i s p l a y e d more p a t h o l o g i c a l e a t i n g a t t i t u d e s and b e h a v i o u r s .  89  W h i l e t h e s e f i n d i n g s were n o t h y p o t h e s i z e d , t h e y do s u p p o r t Mumford e t a l . ' s  (1991) f i n d i n g t h a t t h e i r more  " t r a d i t i o n a l " Asian subjects l i v i n g i n B r i t a i n displayed  more e a t i n g p a t h o l o g y than t h e r e s t o f t h e i r  Asian subjects l i v i n g i n B r i t a i n . While c o r r e l a t i o n a l a n a l y s i s acculturation  of l e v e l . o f  and e a t i n g p a t h o l o g y i d e n t i f i e d o n l y  n e g a t i v e r e l a t i o n s h i p s , one-way a n a l y s i s  of variance  a c r o s s low, medium and h i g h l e v e l s o f a c c u l t u r a t i o n , provided additional insight. significant difference the  S p e c i f i c a l l y , t h e r e was a  i n f u l l s c a l e EAT s c o r e s a c r o s s  low and medium l e v e l s o f a c c u l t u r a t i o n  with  i n d i v i d u a l s i n d i c a t i n g a low l e v e l o f a c c u l t u r a t i o n d i s p l a y i n g more p a t h o l o g i c a l  eating  a t t i t u d e s and  b e h a v i o u r s t h a n i n d i v i d u a l s i n d i c a t i n g a medium l e v e l of a c c u l t u r a t i o n .  A d d i t i o n a l l y , although the r e s u l t s  were n o t s i g n i f i c a n t , t h e r e a l s o seemed t o be a tendency f o r i n d i v i d u a l s i n d i c a t i n g a h i g h l e v e l o f acculturation  t o d i s p l a y more e a t i n g p a t h o l o g y t h a n  i n d i v i d u a l s i n d i c a t i n g a medium l e v e l o f a c c u l t u r a t i o n . Thus, t h e r e s u l t s o f t h e one-way ANOVAs riot o n l y r e v e a l e d which o f t h e Chinese s u b j e c t s may be a t greatest r i s k f o r developing pathological  eating  a t t i t u d e s and b e h a v i o u r s , t h e y a l s o suggest who may be  90  at l e a s t r i s k f o r e a t i n g pathology. appears t h a t those Chinese s u b j e c t s  Accordingly, i t who i n d i c a t e d a  medium l e v e l o f a c c u l t u r a t i o n d i s p l a y e d e a t i n g a t t i t u d e s and b e h a v i o u r s . al.  (1987), t h i s  the h e a l t h i e s t  A c c o r d i n g t o Suinn e t  " b i c u l t u r a l " s t a t u s may r e f l e c t t h e  a b i l i t y to s u c c e s s f u l l y i n t e g r a t e the best of both the h o s t and t r a d i t i o n a l culture's w i t h o u t d e n i a l t o e i t h e r . Although s t a t i s t i c a l s i g n i f i c a n t quadratic  a n a l y s e s r e v e a l e d no  r e l a t i o n s h i p between l e v e l o f  a c c u l t u r a t i o n and e a t i n g p a t h o l o g y i n t h i s study, t h e f i n d i n g that a b i c u l t u r a l l e v e l of a c c u l t u r a t i o n ' i s r e l a t e d t o h e a l t h i e r e a t i n g a t t i t u d e s and b e h a v i o u r s o f f e r s some s u p p o r t t o G i l , Vega, and Dimas' (1994) p r e d i c t i o n o f a c u r v i l i n e a r r e l a t i o n s h i p between l e v e l of a c c u l t u r a t i o n and mental h e a l t h s t a t u s .  Thus, i n  accordance w i t h G i l e t a l . ' s p r e d i c t i o n s , t h e f i n d i n g s o f t h i s s t u d y may suggest t h a t b i c u l t u r a l s u b j e c t s experience b e t t e r psychological  outcomes  (i.e.,  h e a l t h i e r e a t i n g a t t i t u d e s and b e h a v i o u r s ) due t o t h e i r knowledge o f and p a r t i c i p a t i o n i n the h o s t c u l t u r e , while r e t a i n i n g the p o s i t i v e , p r o t e c t i v e f a c t o r s of their t r a d i t i o n a l culture thinness).  (i.e.,  less i d e a l i z a t i o n of  91  A c c u l t u r a t i v e s t r e s s and e a t i n g a t t i t u d e s and behaviours.  A l t h o u g h examining the r e l a t i o n s h i p  between a c c u l t u r a t i v e s t r e s s and e a t i n g a t t i t u d e s and b e h a v i o u r s was done f o r an e x p l o r a t o r y  purpose, t h e  r e s u l t s of t h i s study revealed  stronger  a much  r e l a t i o n s h i p between a c c u l t u r a t i v e s t r e s s and e a t i n g p a t h o l o g y than t h e r e l a t i o n s h i p n o t e d between l e v e l o f a c c u l t u r a t i o n and e a t i n g p a t h o l o g y . analyses revealed  Correlational  t h a t a c c u l t u r a t i v e s t r e s s , as  measured by the SAFE, was p o s i t i v e l y r e l a t e d t o t h e f u l l s c a l e EAT as w e l l as t h e d i e t i n g and b u l i m i a subscales.  A d d i t i o n a l l y , p o s t hoc a n a l y s i s  indicated  t h a t a c c u l t u r a t i v e s t r e s s was n e g a t i v e l y ' r e l a t e d t o l e v e l o f a c c u l t u r a t i o n , i n d i c a t i n g t h a t more acculturative stress i s associated acculturation. experiencing  w i t h lower l e v e l s o f  Thus, i t appears t h a t those i n d i v i d u a l s  greater  a c c u l t u r a t i v e s t r e s s d i s p l a y lower  l e v e l s o f a c c u l t u r a t i o n as w e l l as more e a t i n g pathology.  One p o s s i b l e I n t e r p r e t a t i o n o f t h i s f i n d i n g  may be t h a t t h e e l e v a t e d Chinese s u b j e c t s  e a t i n g p a t h o l o g y n o t e d amongst  d i s p l a y i n g low l e v e l o f a c c u l t u r a t i o n  may be due t o t h e e f f e c t s o f a c c u l t u r a t i v e s t r e s s . The s t r o n g  r e l a t i o n s h i p between a c c u l t u r a t i v e  s t r e s s and e a t i n g pathology, n o t e d i n t h i s s t u d y i s  92  consistent  with the r e s u l t s of a recent s e r i e s of  a r t i c l e s s p e c i f i c a l l y i n v e s t i g a t i n g the r e l a t i o n s h i p between e a t i n g p a t h o l o g y and a c c u l t u r a t i v e  stress  (Ahmad, W a l l e r , & Verduyn, 1994/ H i l l & B h a t t i , 1995; McCourt & W a l l e r , 1995). interpersonal  These s t u d i e s  concluded  that  and i n t r a f a m i l i a l c u l t u r a l c o n f l i c t was  s i g n i f i c a n t l y r e l a t e d to the occurrence of p a t h o l o g i c a l e a t i n g a t t i t u d e s and b e h a v i o u r s . F i n a l l y , t h i s r e l a t i o n s h i p i s f u r t h e r s u p p o r t e d by a s e r i e s o f case r e p o r t s  of g i r l s of Asian o r i g i n  l i v i n g i n Western c u l t u r e s who p r e s e n t e d w i t h  anorexia  n e r v o s a ( i . e . , Bryant-Waugh & Lask, 1991; B u l i k , 1987/ B h a d r i n a t h , 1990/ Ford, 1992/ Schmidt, 1993).  Bryant-  Waugh & Lask (1991), f o r example, n o t e d c l e a r e v i d e n c e of c u l t u r a l c o n f l i c t i n a l l o f t h e i r c a s e s , c o n f l i c t t h a t w a s . c e n t r a l t o t h e onset and p r o g r e s s o f t h e disorder. family,  They made t h e p o i n t  that for a t r a d i t i o n a l  s o c i o c u l t u r a l c o n f l i c t may a r i s e over a range  of i s s u e s ,  i n c l u d i n g a r r a n g e d m a r r i a g e s , norms  r e g a r d i n g d r e s s , c o n t a c t w i t h t h e o p p o s i t e sex, t h e r o l e o f women, mealtimes, and c o o k i n g .  Thus, g i v e n one  has  some f a m i l i a r i t y w i t h Western c u l t u r e , i t s norms  and  i d e a l s , t h i s s t r e s s and c o n f l i c t may i n t u r n  increase  one's chances o f d e v e l o p i n g an e a t i n g  disorder  93  or p a t h o l o g i c a l e a t i n g a t t i t u d e s and b e h a v i o u r s as s t r u g g l e t o f i n d a way  t o cope.  Regression a n a l y s i s .  The  regressive  conducted i n t h i s s t u d y r e v e a l e d s t r e s s was  that  analysis  acculturative  the o n l y v a r i a b l e a c c o u n t i n g f o r  s i g n i f i c a n t variance  t r u e f o r the f u l l s c a l e EAT,  and b u l i m i a s u b s c a l e s .  may  p a t t e r n ; one  v a l u e s and  One  which  possible  be t h a t t h e s e r e s u l t s r e f l e c t the  had  fact  surveyed i n t h i s  a h i g h degree of exposure t o Western  i d e a l s a t the time of the s t u d y  t h e r e f o r e may  diet  variable  s i g n i f i c a n t variance.  t h a t , on average, the Chinese s u b j e c t s study already  This f i n d i n g  Only the o r a l c o n t r o l s u b s c a l e  found l e v e l of a c c u l t u r a t i o n as the o n l y  explanation  and  as w e l l as the  resulted i n a d i f f e r e n t regression  a c c o u n t i n g f o r any  any  i n the e a t i n g a t t i t u d e s  b e h a v i o u r s amongst the Chinese s t u d e n t s . was  they  have a l r e a d y  and  a c h i e v e d the minimum l e v e l  of a c c u l t u r a t i o n n e c e s s a r y t o put  them at r i s k  p a t h o l o g i c a l e a t i n g a t t i t u d e s or b e h a v i o u r s .  of Thus, as  Mumford et a l . (1991) suggested, t h o s e i n d i v i d u a l s d i s p l a y i n g p a t h o l o g i c a l e a t i n g a t t i t u d e s and may  be those who  behaviours  e n c o u n t e r e d a s t r e s s , such as  a c c u l t u r a t i v e s t r e s s , and  responded by t u r n i n g t o a  Western c o p i n g mechanism such as e a t i n g p a t h o l o g y .  94  Thus, Mumford e t a l . ' s c o n c l u s i o n s t h a t " i t i s p r o b a b l e t h a t these A s i a n g i r l s pathology]  [those d i s p l a y i n g e a t i n g  are i n c r e a s i n g l y adopting  'Western' p a t t e r n s  o f r e a c t i n g t o p e r s o n a l c o n f l i c t s and s t r e s s f u l  life  c i r c u m s t a n c e s " ( p . 226), may be e q u a l l y c o n c l u s i v e o f t h i s study's  findings.  Review o f t h e C r o s s - C u l t u r a l V a l i d i t y o f t h e E a t i n g A t t i t u d e s Test  (EAT)  T h i s s t u d y d i d not p u r p o r t t o c a r r y out a f u l l f a c t o r a n a l y s i s o f t h e EAT because p r e v i o u s r e s e a r c h found t h e t w e n t y - s i x i t e m EAT t o be a v a l i d measure o f e a t i n g a t t i t u d e s and b e h a v i o u r s  f o r A s i a n women l i v i n g  i n Western c u l t u r e s (Choudry & Mumford, 1992; Mumford et a l . , 1991, 1992). conducted,  I n t e r c o r r e l a t i o n a l a n a l y s i s was  however, and r e v e a l e d t h a t t h e EAT  subscales  were c o r r e l a t e d t o each o t h e r and t h e f u l l s c a l e EAT i n a s i m i l a r manner f o r b o t h t h e Chinese subjects.  and C a u c a s i a n  The o n l y i n c o n s i s t e n c y t o t h i s f i n d i n g was  the o r a l c o n t r o l s u b s c a l e which proved t o be p o s i t i v e l y c o r r e l a t e d t o the d i e t subscale f o r the Caucasian s u b j e c t s b u t not t h e Chinese  subjects.  This f i n d i n g i s  echoed by t h e f i n d i n g t h a t t h e o r a l c o n t r o l  subscale  was t h e o n l y i n d i c a t o r o f e a t i n g p a t h o l o g y i n t h i s study which came c l o s e t o b e i n g s i g n i f i c a n t l y  different  95  across  c u l t u r a l groups w i t h t h e Chinese  subjects  d i s p l a y e d s l i g h t l y more u n h e a l t h y a t t i t u d e s oral control.  regarding  A d d i t i o n a l l y , when a model o f s t e p w i s e  r e g r e s s i o n was conducted f o r t h e f u l l s c a l e and subscale  EAT s c a l e s , t h e o r a l c o n t r o l s u b s c a l e  was t h e  o n l y s c a l e found n o t t o be r e l a t e d t o a c c u l t u r a t i v e stress. W h i l e t h e s e f i n d i n g have n o t been p r e v i o u s l y n o t e d b y . r e s e a r c h e r s i n v e s t i g a t i n g e a t i n g a t t i t u d e s and b e h a v i o u r s i n non-white females l i v i n g i n Western c u l t u r e s , Lee (1993), I n h i s s u r v e y o f Chinese u n i v e r s i t y s t u d e n t l i v i n g i n C h i n a , n o t e d t h a t b o t h men as w e l l as women s c o r e d r e l a t i v e l y h i g h on t h e o r a l c o n t r o l subscale.  Consistent w i t h t h i s study's  f i n d i n g s , Lee a l s o r e p o r t e d t h a t t h e o r a l c o n t r o l s u b s c a l e was n o t s i g n i f i c a n t l y r e l a t e d w i t h t h e d i e t subscale  i n h i s sample o f Chinese women.  Thus, t h e  r e s u l t s o f t h i s s t u d y seem t o s u p p o r t Lee's s p e c u l a t i o n s t h a t some items on t h e o r a l c o n t r o l subscale  (i.e.,  "Other p e o p l e t h i n k t h a t I am t o o  thin",. "Feel that others pressure  me t o e a t " , and " F e e l  t h a t o t h e r would p r e f e r i f I a t e more") may  simply  r e f l e c t Chinese women's s m a l l e r , t h i n n e r b u i l d and t h e  96  normal c u l t u r a l p r e s s u r e  on women t o e a t more and may  not n e c e s s a r i l y r e f l e c t e a t i n g p a t h o l o g y . In t h e i r o r i g i n a l f a c t o r a n a l y s i s o f the 26-item EAT,  Garner, Olmsted, Bohr, and G a r f i n k e l (1982) found  that the o r a l c o n t r o l subscale  accounted f o r o n l y 5.0%  of t h e f u l l s c a l e EAT's v a r i a n c e , w h i l e t h e two remaining subscales the v a r i a n c e  accounted f o r s u b s t a n t i a l l y more o f  ( d i e t accounted f o r 26.4% o f t h e v a r i a n c e  and b u l i m i a accounted f o r 10.8% o f t h e v a r i a n c e ) . Accordingly,  w h i l e t h e f i n d i n g s o f t h i s s t u d y suggest  t h a t some o f t h e items on t h e o r a l c o n t r o l s u b s c a l e may have had d i f f e r e n t c o n n o t a t i o n s  t o t h e Chinese  subjects  and may n o t r e f l e c t e a t i n g p a t h o l o g y f o r t h i s population,  t h i s does n o t n e c e s s a r i l y r e f l e c t on t h e  v a l i d i t y o f t h e e n t i r e measure.  Moreover, t h e  i n t e r c o r r e l a t i o n a l a n a l y s i s o f t h e EAT conducted i n t h i s s t u d y appears t o s u p p o r t s Mumford e t a l . ' s (1991, 1992)  and Lee's (1993) f i n d i n g s t h a t t h e f u l l s c a l e EAT  as w e l l as t h e d i e t and b u l i m i a s u b s c a l e s  appear t o be  v a l i d measures o f e a t i n g p a t h o l o g y f o r Chinese women l i v i n g Western c u l t u r e s . still  As r e s e a r c h  i n t h i s area i s  i n i t i n f a n c y , however, any c o n c l u s i o n must be  made w i t h c a u t i o n .  Further  i n v e s t i g a t i o n of the cross-  97  c u l t u r a l v a l i d i t y o f the EAT  i s required  before  any  c o n c l u s i v e statement can be made. Limitations F i r s t , i t i m p o r t a n t to remember t h a t the w h i c h s p e c i f y the p o p u l a t i o n and  the sample examined i n  t h i s s t u d y r e s t r i c t t o whom the r e s u l t s may generalized.  Thus, the  be g e n e r a l i z e d  criteria  be  f i n d i n g s of t h i s s t u d y may  t o female C h i n e s e and  only  Caucasian  u n i v e r s i t y s t u d e n t s i n B r i t i s h Columbia, Canada. A d d i t i o n a l l y , as the m a j o r i t y o f the Chinese s u b j e c t s s u r v e y e d i n t h i s s t u d y were from Hong Kong or  Taipai,  Taiwan, the r e s u l t s of t h i s s t u d y are  limited  further  to those female Chinese u n i v e r s i t y s t u d e n t s from Hong Kong or T a i p a i , Taiwan, as opposed t o M a i n l a n d C h i n a . The  f a c t that p a r t i c i p a t i o n i n t h i s study  v o l u n t a r y may results.  have added an a d d i t i o n  D e n i a l and  constraint  and  behavioiurs  pathological  eating  attitudes  ( G a r f i n k e l & Garner, 1982).  have chosen not  the  and  Consequently problems  to p a r t i c i p a t e i n t h i s s t u d y .  Since, t h i s study required  t h a t the  s u b j e c t s be u n i v e r s i t y s t u d e n t s and  as  eating  those i n d i v i d u a l s w i t h the most extreme e a t i n g may  on  shame have l o n g been r e c o g n i z e d  common c h a r a c t e r i s t i c s of i n d i v i d u a l s w i t h disorders  was  Chinese  p r o f i c i e n t enough  98  i n E n g l i s h i n o r d e r t o complete  the q u e s t i o n n a i r e  on  t h e i r own,  the range o f the l e v e l o f a c c u l t u r a t i o n  s c o r e s may  have been r e s t r i c t e d , and t h i s may  have  l i m i t e d the degree t o which the r e l a t i o n s h i p s ( p a r t i c u l a r l y between l e v e l o f a c c u l t u r a t i o n and a t t i t u d e s and b e h a v i o u r s ) c o u l d be t e s t e d . w i t h a b r o a d e r range o f a c c u l t u r a t i o n might  eating  A sample demonstrate  more s i g n i f i c a n t r e s u l t s . The r e s u l t s o f t h i s s t u d y are a l s o l i m i t e d by the c o r r e c t i o n a l d e s i g n , t h e r e f o r e cause and e f f e c t cannot be i n f e r r e d .  S i m i l a r l y , t h e r e may  be unknown,  unmeasured, v a r i a b l e s t h a t account f o r the r e l a t i o n s h i p between l e v e l o f a c c u l t u r a t i o n , a c c u l t u r a t i v e s t r e s s , and e a t i n g a t t i t u d e s and b e h a v i o u r s . I t s h o u l d be r e i t e r a t e d t h a t w i t h o u t d o i n g c l i n i c a l assessments  i t i s not p o s s i b l e t o i d e n t i f y  c l i n i c a l cases o f e a t i n g d i s o r d e r s . not w i t h i n the parameters  Therefore, i t i s  o f t h i s s t u d y t o address  e x i s t e n c e o f e a t i n g d i s o r d e r s per se, but r a t h e r  the  those  e a t i n g a t t i t u d e s and b e h a v i o u r s found t o be c h a r a c t e r i s t i c of e a t i n g d i s o r d e r s . F i n a l l y , the r e s u l t s o f t h i s s t u d y r e i n f o r c e the c a u t i o n r e q u i r e d when employing a measure t h a t  was  d e s i g n e d and v a l i d a t e d i n one c u l t u r e t o s t u d y r e l a t e d  99  phenomena i n another c u l t u r e .  Thus,  notwithstanding  the apparent o v e r a l l v a l i d i t y o f t h e f u l l s c a l e EAT and the d i e t and b u l i m i a s u b s c a l e s  f o r t h i s s t u d y ' s sample  of female Chinese u n i v e r s i t y s t u d e n t s ,  the r e s u l t s of  t h i s s t u d y a l s o suggest t h a t p a r t i c u l a r c a u t i o n must be taken with the i n t e r p r e t a t i o n o f o r a l c o n t r o l scores  f o r Chinese s u b j e c t s .  s u b j e c t s ' scores  subscale  Review o f t h e Chinese  as w e l l as p r e v i o u s  l i t e r a t u r e (Lee,  1993) and Chinese c u l t u r e suggest t h a t some items on t h i s s c a l e may r e f l e c t Chinese women's s m a l l e r , b u i l d s and normal c u l t u r a l p r e s s u r e and n o t e a t i n g p a t h o l o g y .  thinner  on women t o e a t ,  Thus, much more  i n v e s t i g a t i o n and i t e m a n a l y s i s o f t h e o r a l c o n t r o l subscale  i s r e q u i r e i f i t i s t o be employed w i t h  f u r t h e r Chinese  populations.  S u g g e s t i o n s f o r F u t u r e Research There i s much scope f o r f u r t h e r r e s e a r c h .  First,  more a t t e n t i o n needs t o be p a i d t o t h e i n s t r u m e n t s u t i l i z e d i n s t u d i e s such as t h i s one. research  Additional  i n v e s t i g a t i n g the c r o s s - c u l t u r a l v a l i d i t y of  the EAT, e s p e c i a l l y i t s o r a l c o n t r o l s u b s c a l e , i s e s s e n t i a l t o the meaningfulness of future research i n this  area.  100  S i m i l a r l y , as the r e s u l t s o f t h i s s t u d y r e v e a l e d • a s t r o n g r e l a t i o n s h i p between a c c u l t u r a t i v e s t r e s s  and  e a t i n g p a t h o l o g y , f u r t h e r r e s e a r c h i n t o t h i s a r e a would be p r u d e n t .  S p e c i f i c a l l y , the development o f a more  d e t a i l e d measure o f a c c u l t u r a t i v e s t r e s s may i d e n t i f y which s p e c i f i c components o f stress  (i.e., interpersonal  help  acculturative  c o n f l i c t or i n t r a f a m i l i a l  c o n f l i c t ) are most i m p o r t a n t i n the development o f eating  pathology.  Other p r o m i s i n g r e s e a r c h d i r e c t i o n s i n c l u d e  the  t r a n s l a t i o n o f the i n s t r u m e n t s used i n t h i s s t u d y i n t o Chinese languages Taiwanese.  such as Mandarin,  Cantonese and  Making t h e s e i n s t r u m e n t s a v a i l a b l e i n o t h e r  languages may  h e l p access a wider range o f l e v e l o f  a c c u l t u r a t i o n and may  provide additional information  r e g a r d i n g the e a t i n g a t t i t u d e s and b e h a v i o u r s i n d i v i d u a l s who  have l e s s exposure  of  t o Western c u l t u r e .  S i m i l a r l y , r e p l i c a t i o n of t h i s study w i t h other groups such as an Indo-Canadian o r N a t i v e I n d i a n p o p u l a t i o n , may  h e l p extend the f i n d i n g s o f t h i s s t u d y  and p r o v i d e g r e a t e r i n s i g h t as t o the r e l a t i o n s h i p between l e v e l o f a c c u l t u r a t i o n and e a t i n g a t t i t u d e s behaviours.  and  101  F i n a l l y , s i n c e the r e s u l t s o f t h i s s t u d y t h a t e a t i n g p a t h o l o g y e f f e c t s female Chinese s t u d e n t s a t a p p r o x i m a t e l y a s i m i l a r r a t e as  suggest university  female  Caucasian u n i v e r s i t y students, i t i s i n c r e a s i n g l y i m p o r t a n t t o do r e s e a r c h on t h i s t o p i c w i t h t h i s e t h n i c group.  Important  s t u d i e s may  include qualitative  r e s e a r c h which would a l l o w Chinese women s t r u g g l i n g w i t h p a t h o l o g i c a l e a t i n g a t t i t u d e s and b e h a v i o u r s share t h e i r s t o r i e s .  to  Q u a l i t a t i v e research addressing  the onset and p r o g r e s s o f e a t i n g p a t h o l o g y as w e l l the r e c o v e r y p r o c e s s i s e s s e n t i a l .  as  Such s t u d i e s would  a i d i n the e d u c a t i o n , p r e v e n t i o n and d e t e c t i o n o f e a t i n g p a t h o l o g y amongst t h i s p o p u l a t i o n s . a d d i t i o n , such s t u d i e s may components o f t r e a t m e n t  In  help i d e n t i f y p a r t i c u l a r  (such as i n d i v i d u a l and f a m i l y  t h e r a p y s p e c i f i c a l l y a d d r e s s i n g and a i d i n g the a c c u l t u r a t i o n p r o c e s s ) which may  be unique,  yet  e s s e n t i a l f o r recovery i n t h i s population. Implications for Counselling The p r e s e n t study, the e x i s t i n g knowledge base o f r e s e a r c h s t u d i e s , and the ones recommended above, are v a l u a b l e o n l y so f a r as t h e i r p r a c t i c a l u s e f u l n e s s i n the c o u n s e l l i n g p r o c e s s are r e a l i z e d and  utilized.  T h e r e f o r e , one needs t o t r a n s f o r m the r e s u l t s o f these  102  studies i n t o the c o u n s e l l i n g process,  i n order to help  c l i e n t s d e a l w i t h t h e demands o f t h e i r l i f e . r e q u i r e s t h a t t h e r e s u l t s o f t h i s s t u d y be and acknowledged by t h o s e i n t h e h e l p i n g First,  This recognized  professions.  the prevalence of eating pathology i n  C h i n e s e females heeds t o be acknowledged n o t o n l y by c o u n s e l l o r s , b u t o t h e r p r o f e s s i o n a l s who may have frequent  contact with t h i s population.  i n d i v i d u a l s such as f a m i l y d o c t o r s ,  Thus,  teachers,  school  n u r s e s and community l e a d e r s need t o be made aware t h a t p a t h o l o g i c a l e a t i n g a t t i t u d e s and b e h a v i o u r s no l o n g e r s i m p l y o c c u r i n a f f l u e n t w h i t e women, as once thought. A d d i t i o n a l l y , t h e s e i n d i v i d u a l s need t o be aware t h a t ethnic m i n o r i t i e s , i n general, out p r o f e s s i o n a l a s s i s t a n c e and G e i s t  a r e l e s s , l i k e l y t o seek  (Sue, 1977).  Cheng, Leong,  (1993) found t h a t w h i l e A s i a n s e x p e r i e n c e  j u s t as many p e r s o n a l  and e m o t i o n a l problems as members  of t h e mainstream c u l t u r e , t h e y a r e l e s s l i k e l y t o seek a s s i s t a n c e from p r o f e s s i o n a l s .  These r e s e a r c h e r s  also  n o t e d t h a t when A s i a n s do seek o u t p r o f e s s i o n a l h e l p , i t i s o f t e n i n t h e g u i s e o f academic o r c a r e e r problems. Thus, c o u n s e l l o r s and o t h e r p r o f e s s i o n a l s need t o be aware o f t h e s e t e n d e n c i e s when s e e i n g  Chinese  103  clients.  Even i f t h e c l i e n t p r e s e n t e d n o t h i n g more  than academic o r c a r e e r i s s u e s , i t might be wise f o r the p r o f e s s i o n a l t o a s s e s s p o s s i b l e p e r s o n a l and emotional areas.  A d d i t i o n a l l y , i t may be b e n e f i c i a l  to  r e i n f o r c e to the c l i e n t the appropriateness of a d d r e s s i n g p e r s o n a l and e m o t i o n a l i s s u e s , such as e a t i n g pathology,  i n the c o u n s e l l i n g session.  Doing so  may h e l p break down some o f t h e stigma t h a t i s o f t e n a t t a c h e d t o p e r s o n a l and e m o t i o n a l problems (Cheng e t al.) . Beyond i d e n t i f i c a t i o n ,  t h e r e may be a need f o r  c u l t u r e s p e c i f i c models o f c o u n s e l l i n g and t r e a t m e n t f o r Chinese women e x p e r i e n c i n g e a t i n g p a t h o l o g y . A c c o r d i n g l y , i n t e r p e r s o n a l and i n t r a f a m i l i a l i s s u e s specific  t o t h e a c c u l t u r a t i o n p r o c e s s may need t o be  addressed  f o r t h e r e c o v e r y p r o c e s s t o be s u c c e s s f u l .  Finally,  e d u c a t i o n and p r e v e n t i o n campaigns  s p e c i f i c a l l y t a r g e t i n g female Chinese be developed throughout  s t u d e n t s need t o  and p r e s e n t e d t o t h e g e n e r a l p u b l i c  t h e Chinese  community.  This w i l l not only  h e l p educate i n d i v i d u a l s as t o t h e p r e v a l e n c e and identification  o f e a t i n g p a t h o l o g y , b u t may a l s o h e l p  inform i n d i v i d u a l s struggling with p a t h o l o g i c a l eating a t t i t u d e s and b e h a v i o u r s  about l o c a l c o u n s e l l i n g  104  a g e n c i e s , w h i l e r e i n f o r c i n g the a p p r o p r i a t e n e s s of u t i l i z i n g such a g e n c i e s . Conclusions The  p r i m a r y purpose of t h i s r e s e a r c h s t u d y was  to  compare the e a t i n g a t t i t u d e s and b e h a v i o u r s o f female Chinese and  Caucasian u n i v e r s i t y students.  A d d i t i o n a l l y , t h i s s t u d y attempted t o  investigate  whether a r e l a t i o n s h i p e x i s t s between l e v e l o f a c c u l t u r a t i o n , a c c u l t u r a t i v e s t r e s s and  pathological  e a t i n g a t t i t u d e s and b e h a v i o u r s amongst female C h i n e s e u n i v e r s i t y students. T h i s s t u d y found no d i f f e r e n c e s  i n eating  a t t i t u d e s and b e h a v i o u r s between the Chinese Caucasian subjects. the EAT  and  and  Both groups s c o r e d s i m i l a r l y on  a p p r o x i m a t e l y the same number s c o r e d over  the c u t - o f f p o i n t  f o r e a t i n g p a t h o l o g y on the  Thus, the r e s u l t s of t h i s s t u d y r e v e a l e d  that  EAT. female  Chinese u n i v e r s i t y s t u d e n t s l i v i n g i n B r i t i s h Columbia, Canada appear t o d i s p l a y s i m i l a r e a t i n g a t t i t u d e s  and  b e h a v i o u r s as t h e i r f e l l o w female C a u c a s i a n u n i v e r s i t y students. I t was  h y p o t h e s i z e d t h a t the e a t i n g a t t i t u d e s  b e h a v i o u r s o f the C h i n e s e s u b j e c t s  would be  i n a p o s i t i v e d i r e c t i o n w i t h l e v e l of  and  correlated  acculturation,  105  and  t h a t t h i s r e l a t i o n s h i p would be the  p r e d i c t o r of e a t i n g p a t h o l o g y . study, however, do not C o r r e l a t i o n and general,  The  strongest  r e s u l t s of  this  s u p p o r t such p r e d i c t i o n s .  regression  a n a l y s i s found t h a t , i n  the e a t i n g a t t i t u d e s and b e h a v i o u r s of  Chinese s u b j e c t s  the  were more s t r o n g l y c o r r e l a t e d  a c c u l t u r a t i v e s t r e s s than l e v e l of  acculturation.  E x a m i n a t i o n of the demographic c o l l e c t e d f o r these subjects  with  information  suggests t h a t the  students r e c r u i t e d f o r this' study already  Chinese  had  extensive  exposure t o Western c u l t u r e at the time of the T h e r e f o r e , i t may  be p o s s i b l e t h a t t h e y had  exposure t o Western i d e a l s and norms t o put s i m i l a r r i s k as the C a u c a s i a n s u b j e c t s p a t h o l o g i c a l e a t i n g a t t i t u d e s and Accordingly,  one  study.  enough them at  of d e v e l o p i n g  behaviours.  possible explanation  f o r the  strong  r e l a t i o n s h i p found between a c c u l t u r a t i v e s t r e s s e a t i n g a t t i t u d e s and b e h a v i o u r s may those Chinese s u b j e c t s and  who  a c c u l t u r a t i v e p r o c e s s and  be t h a t i t r e f l e c t s  encountered  i n t r a f a m i l i a l c o n f l i c t s and  and  interpersonal  stress regarding  the  responded by a d o p t i n g a  Western c o p i n g mechanism, namely e a t i n g p a t h o l o g y .  106  References Abrams, K.K., A l l e n , L.R., Gray, J . J . (1993). D i s o r d e r e d e a t i n g a t t i t u d e s and b e h a v i o u r s , p s y c h o l o g i c a l adjustment, and e t h n i c i d e n t i t y : A comparison o f b l a c k and w h i t e female c o l l e g e students. I n t e r n a t i o n a l Journal of Eating Disorders, 1A, 49-57. Ahmad, S., W a l l e r , G., & Verduyn, C. (1994). E a t i n g a t t i t u d e s among A s i a n s c h o o l g i r l s : The r o l e o f perceived parental c o n t r o l . International Journal of E a t i n g D i s o r d e r s , 15, 91-91. American P s y c h i a t r i c A s s o c i a t i o n (1994). D i a g n o s t i c and s t a t i c a l manual o f mental d i s o r d e r s (4rd e d . ) . A u t h o r : Washington, D.C. Anderson, A.E. (1985). P r a c t i c a l comprehensive t r e a t m e n t o f a n o r e x i a n e r v o s a and b u l i m i a . New York: John Hopkins U n i v e r s i t y P r e s s . Anderson, A.E., Hay, A. (1985). R a c i a l and s o c i o e c o n o m i c i n f l u e n c e s i n a n o r e x i a n e r v o s a and b u l i m i a nervosa. I n t e r n a t i o n a l Journal of Eating D i s o r d e r s , 4_, 479-487. Anderson, A.E. & DiDomenico, L. (1992). D i e t v s . shape c o n t e n t o f p o p u l a r male and female magazines: A dose-response r e l a t i o n s h i p t o t h e i n c i d e n c e o f eating disorders. International Journal of Eating D i s o r d e r s , 11, 283-287. A t k i n s o n , D., & Gim, R. (1989). A s i a n - A m e r i c a n c u l t u r a l i d e n t i t y and a t t i t u d e s toward mental h e a l t h s e r v i c e s . J o u r n a l o f C o u n s e l l i n g P s y c h o l o g y , 3_6_, 209-212. A t k i n s o n , D., W h i t e l y , S., & Gim, R. (1990). A s i a n American a c c u l t u r a t i o n and p r e f e r e n c e s f o r h e l p p r o v i d e r s . J o u r n a l o f C o l l e g e Student Development, 11, 155-161.  107  B e r r y , J.W., Kim, U., Minde, T.,. & Mok, D. (1987). Comparative s t u d i e s of a c c u l t u r a t i v e s t r e s s . I n t e r n a t i o n a l M i g r a t i o n Review, 21, 491-511. B e r r y , J.W., Kim, U., Powers, ,S., Young, M., & B u j a k i , M. (1989). A c c u l t u r a t i o n a t t i t u d e s in- p l u r a l s o c i e t i e s . A p p l i e d P s y c h o l o g y : An I n t e r n a t i o n a l Review, 18, 185-206. B h a d r i n a t h , B.R. (1990). A n o r e x i a n e r v o s a i n a d o l e s c e n t s of A s i a n e x t r a c t i o n . B r i t i s h J o u r n a l P s y c h i a t r y , 156, 565-568.  of  Bruch, H. (1973). E a t i n g d i s o r d e r s : O b e s i t y , a n o r e x i a n e r v o s a and the p e r s o n w i t h i n . New York: B a s i c Books. Bryant-Waugh, R., & Lask, B. (1991) •. A n o r e x i a n e r v o s a I n a group o f A s i a n c h i l d r e n l i v i n g i n B r i t a i n . B r i t i s h J o u r n a l of P s y c h i a t r y , 15£, 229-233. B u h r i c h , N. (1981). Frequency o f p r e s e n t a t i o n of a n o r e x i a n e r v o s a i n M a l a y s i a . A u s t r a l i a n and New Z e a l a n d J o u r n a l of. P s y c h i a t r y , U>, 153-155. B u l i k , CM. (1987). E a t i n g d i s o r d e r s i n Immigrants: case r e p o r t s . I n t e r n a t i o n a l J o u r n a l o f E a t i n g Disorders, 133-141.  Two  Chen, Z.F., M i t c h e l l , J.E., L i , K., Yu, W.M., Lan, Y.D., Jun, Z., Rong, Z.Y., Huan, Z.Z., F i l i c e , G.A., Pomeroy, d, & P y l e , R.L. (1992). The p r e v a l e n c e o f a n o r e x i a n e r v o s a and b u l i m i a n e r v o s a among freshman m e d i c a l c o l l e g e s t u d e n t s i n China. I n t e r n a t i o n a l J o u r n a l ' of E a t i n g D i s o r d e r s . 12, 209-214. Cheng, D., Leong, F.T.L., & G e i s t , R. (1993). C u l t u r a l d i f f e r e n c e s i n P s y c h o l o g i c a l d i s t r e s s between A s i a n and C a u c a s i a n A m e r i c a n c o l l e g e s t u d e n t s . J o u r n a l o f M u l t i c u l t u r a l C o u n s e l l i n g and Development, 21, 182190.  108  Choudry, T.Y. & Mumford, D.B. (1992). A p i l o t s t u d y o f e a t i n g . d i s o r d e r s i n M i r p u r ( P a k i s t a n ) u s i n g an Urdu v e r s i o n of the E a t i n g A t t i t u d e s Test. I n t e r n a t i o n a l J o u r n a l o f Eating. D i s o r d e r s , 1 1 ( 3 ) , 243-251. Cooper, P . J . & F a i r b u r n , C.G. (1983). Binge e a t i n g and s e l f - i n d u c e d v o m i t i n g i n t h e community: A p r e l i m i n a r y survey. B r i t i s h J o u r n a l of P s y c h i a t r y , , 112, 139144. C r i s p , A.H., Hsu. L.K.G., H a r d i n g , B., H a r t s h o r n , J . (1980). C l i n i c a l f e a t u r e s o f a n o r e x i a n e r v o s a . J o u r n a l o f Psychosomatic Research, 21, 179-191. C r i s p , A.H., Palmer, R.L., & K a l u c y , R.S. (1976). How common i s a n o r e x i a nervosa? A p r e v a l e n c e s t u d y . B r i t i s h J o u r n a l o f P s y c h i a t r y . 128, 549-554. C r i s p , A.H. & Toms, D.A. (1972). P r i m a r y a n o r e x i a n e r v o s a o r weight p h o b i a i n t h e male: Report on 13 c a s e s . B r i t i s h M e d i c a l J o u r n a l , 1, 334-338. C u e l l a r , I . , H a r r i s , L., & J a s s o , R. (1980). An a c c u l t u r a t i o n s c a l e f o r M e x i c a n American normal and c l i n i c a l populations. Hispanic Journal of Behavioral Sciences. 2, 199-217. C u e l l a r , R.E., Van T h i e l , D.H. (1986). G a s t r o i n t e s t i n a l complications of the e a t i n g d i s o r d e r s anorexia n e r v o s a and b u l i m i a nervoas. American J o u r n a l o f G a s t r o e n t e r o l o g y , &1, 1113-1124. D i N i c o l a , V. F. (1990a). A n o r e x i a m u l t i f o r m e : S e l f s t a r v a t i o n i n h i s t o r i c a l and c u l t u r a l c o n t e x t . ,Part I: S e l f - s t a r v a t i o n as a h i s t o r i c a l chameleon. T r a n s c u l t u r a l P s y c h i a t r i c Research Review, 21, 165244. . D i N i c o l a , V.P. (1990b).,Anorexia m u l t i f o r m e : S e l f s t a r v a t i o n i n h i s t o r i c a l and c u l t u r a l c o n t e x t . P a r t I : A n o r e x i a n e r v o s a as a c u l t u r e - r e a c t i v e syndrome. T r a n s c u l t u r a l P s y c h i a t r i c Research Review/ 21, 2.45286.  109  Dolan, B. (1991). C r o s s - c u l t u r a l a s p e c t s o f a n o r e x i a n e r v o s a and b u l i m i a : A r e v i e w . I n t e r n a t i o n a l J o u r n a l o f E a t i n g D i s o r d e r s , 10, 67-78. Edwards, A.L. (1968). E x p e r i m e n t a l d e s i g n i n p s y c h o l o g i c a l r e s e a r c h ( 3 r d ed.) . New York: H o l t , R i n e h a r t ' a n d Winston. Furnham, A. & A l i b h a i , N. (1983). C r o s s - c u l t u r a l d i f f e r e n c e s i n t h e p e r c e p t i o n o f female body shape. P s y c h o l o g i c a l M e d i c i n e , 13, 829-837. Furnham, A., & P a t e l , R. (1994). The e a t i n g a t t i t u d e s and b e h a v i o r s o f A s i a n and B r i t i s h s c h o o l g i r l s : A p i l o t s t u d y . The I n t e r n a t i o n a l J o u r n a l o f S o c i a l P s y c h i a t r y , M , 214-226. G a r f i n k e l , P.E. & Garner, D.M. (1982). A n o r e x i a n e r v o s a : A m u l t i d i m e n s i o n a l p e r s p e c t i v e . New York: Brunner/Mazel. Garner, D.M. & G a r f i n k e l , P.E. (1979). The E a t i n g A t t i t u d e s T e s t : An i n d e x o f t h e symptoms o f a n o r e x i a n e r v o s a . P s y c h o l o g i c a l M e d i c i n e , % 273-279. Garner, D.M. & G a r f i n k e l , P.E. (1980). S o c i o - c u l t u r a l ' f a c t o r s i n t h e development o f a n o r e x i a n e r v o s a . P s y c h o l o g i c a l M e d i c i n e , U l , 647-656. Garner, D.M., G a r f i n k e l , P.E., Schwartz D., & Thompson, M. (1980). C u l t u r a l e x p e c t a t i o n s o f t h i n n e s s i n women. P s y c h o l o g i c a l R e p o r t s , 41, 483-491. Garner, D.M.., Olmsted, M.P., Bohr, Y., & G a r f i n k e l , P.E. (1982). The E a t i n g A t t i t u d e s T e s t : P s y c h o m e t r i c f e a t u r e s and c l i n i c a l c o r r e l a t e s . P s y c h o l o g i c a l M e d i c i n e , 12, 871-878. Garner, D.M., Olmsted, M.P., P o l i v y , J . (1983). Development and v a l i d a t i o n o f a m u l t i d i m e n s i o n a l e a t i n g d i s o r d e r i n v e n t o r y f o r a n o r e x i a n e r v o s a and bulimia. International Journal of Eating Disorders, 2, 15-35.  110  Gibbs, R.B. (1986). S o c i a l f a c t o r s i n e x a g g e r a t e d e a t i n g b e h a v i o r s among h i g h s c h o o l s t u d e n t s . I n t e r n a t i o n a l J o u r n a l o f ' E a t i n g D i s o r d e r s , 5, 11031107. G i l , G., Vega, W.A., & Dimas, J.M. (1994). A c c u l t u r a t i v e s t r e s s and p e r s o n a l adjustment among H i s p a n i c a d o l e s c e n t boys. J o u r n a l o f Community P s y c h o l o g y , 22, 43-54. Goldbloom, D.S., & G a r f i n k e l , P.E. (1993). A n o r e x i a n e r v o s a and b u l i m i a n e r v o s a : D i a g n o s t i c i s s u e s and r i s k f a c t o r s . I n S.H. Kennedy (Ed.), Handbook o f e a t i n g d i s o r d e r s (pp.1-9). Toronto, Ont.: U n i v e r s i t y o f Toronto. G o l d f a r b , L.A., Dykens, E.M., & G e r a r d , M. (1985). The G o l d f a r b Fear o f F a t S c a l e . J o u r n a l o f P e r s o n a l i t y Assessment, 19_, 329-332. Gray, J . J . , Ford, K., & K e l l y , L.M. (1987). The prevalence of b u l i m i a i n a black c o l l e g e population. I n t e r n a t i o n a l J o u r n a l o f E a t i n g D i s o r d e r s , 6, 733740. Gross, J . , & Rosen, J . (1988). B u l i m i a i n a d o l e s c e n t s : P r e v a l e n c e and p s y c h o s o c i a l c o r r e l a t e s . I n t e r n a t i o n a l J o u r n a l o f E a t i n g D i s o r d e r s , 1, 51-61. Halmi, K.A., Jones, F.R., & Schwertz, E. (1981). Binge e a t i n g and v o m i t i n g : A s u r v e y o f a c o l l e g e p o p u l a t i o n . P s y c h o l o g i c a l M e d i c i n e , 1 1 , 697-706. Hawkins, R.C., & Clement, P.F. (1980). Development and c o n s t r u c t v a l i d a t i o n o f a s e l f - r e p o r t measure o f b i n g e e a t i n g t e n d e n c i e s . A d d i c t i v e B e h a v i o r s , Zi, 219-226. Herman, D., & Mack, D. (1979). R e s t r a i n e d and u n r e s t r a i n e d e a t i n g . J o u r n a l o f P e r s o n a l i t y , 13, 647-660.  Ill  H i l l , A . J . , B h a t t i , R. (1995). Body shape p e r c e p t i o n and d i e t i n g i n p r e a d o l e s c e n t B r i t i s h A s i a n g i r l s : Links with eating disorders. International Journal of E a t i n g D i s o r d e r s , H , 175-183. Hoek, H.W. (1993). Review o f t h e e p i d e m i o l o g i c a l studies of eating disorders. I n t e r n a t i o n a l Review of P s y c h i a t r y , 5, 61-74. Hsu, L.K.G. (1987). A r e t h e e a t i n g d i s o r d e r s becoming more common i n b l a c k s ? I n t e r n a t i o n a l J o u r n a l o f E a t i n g D i s o r d e r s , 6, 113- 125. Hsu, L.K.G. (1990). E a t i n g D i s o r d e r s . New York: G u i l f o r d Press. Iancu, I . , S p i v a k , B., R a t z o n i , G., A p t e r , A., & Weizman, A. (1994). The s o c i o c u l t u r a l t h e o r y i n t h e development o f a n o r e x i a n e r v o s a . P s y c h o p a t h o l o g y , 2 2 , 29-39. I s n e r , J.M., R o b e r t s , W.C., & H e y m s f i e l d , B.C. (1985). A n o r e x i a n e r v o s a and sudden d e a t h . A n n a l s o f I n t e r n a l M e d i c i n e , 102, 4 9-52. Johnson, C. (1984). I n i t i a l c o n s u l t a t i o n f o r p a t i e n t s w i t h b u l i m i a and a n o r e x i a n e r v o s a . I n D.M. Garner & P.E. G a r f i n k e l (Eds.), A n o r e x i a Nervosa and B u l i m i a (p. 19-55). New York: G u i l f o r d P r e s s . Kamata, K., Nogami, Y., & Momma, K. (1987). Binge e a t i n g among female s t u d e n t s . J o u r n a l o f P s y c h i a t r y and Neurology, A l , 151-152. Katzman, M.A., W o l c h i k , S.A., & B r a v e r , S.L. (1984). The p r e v a l e n c e o f f r e q u e n t b i n g e - e a t i n g and b u l i m i a i n a n o n - c l i n i c a l c o l l e g e sample. I n t e r n a t i o n a l J o u r n a l o f E a t i n g D i s o r d e r s , 3, 53-61. K e n d e l l , R.E., H a l l , D.J. H a i l e y , A., & Babigan, H.M. (1973). The e p i d e m i o l o g y o f a n o r e x i a n e r v o s a . P s y c h o l o g i c a l M e d i c i n e , 3_, 200-203.  112  Kim, U., & B e r r y , J.W. (1986). P r e d i c t o r s o f a c c u l t u r a t i v e s t r e s s : Korean immigrants i n Toronto, Canada. I n L.H. E k s t r a n d (Ed.), E t h n i c m i n o r i t i e s an immigrants i n a c r o s s - c u l t u r a l p e r s p e c t i v e (p. 159170). L i s s e , Sweden: Swets & Z e i t l i n g e r . K i n g , M.B. (1989). E a t i n g d i s o r d e r s i n a g e n e r a l p r a c t i c e p o p u l a t i o n : P r e v a l e n c e , c h a r a c t e r i s t i c s and f o l l o w - u p a t 12 t o 18 months. P s y c h o l o g i c a l M e d i c i n e Monographs, 14 ( 3 4 ) . Lacey, J.H. & Dolan, B.M. (1988). B u l i m i a i n B r i t i s h B B l a c k s and A s i a n s : A catchment a r e a s t u d y . B r i t i s h J o u r n a l o f P s y c h i a t r y , 152, 73-79. Lee, S. (1991) . A n o r e x i a n e r v o s a i n Hong Kong: A Chinese p e r s p e c t i v e . P s y c h o l o g i c a l M e d i c i n e , 2 1 , 703-311. Lee, S. (1993). How abnormal i s t h e d e s i r e f o r s l i m n e s s ? A s u r v e y o f e a t i n g a t t i t u d e s and b e h a v i o u r s among Chinese undergraduates i n Hong Kong. P s y c h o l o g i c a l M e d i c i n e , 23, 437-451. Lee, S., C h i u , H.F.K., Chen, C. (1989). A n o r e x i a • Nervosa i n Hong Kong: Why n o t more i n China? B r i t i s h J o u r n a l o f P s y c h i a t r y . 154, 683-688. Lee, S., Ho, T.P., & Hsu, L.K.G. (1993). F a t p h o b i c and non-fat phobic anorexia nervosa: A comparative study of 70 Chinese p a t i e n t s i n Hong Kong. P s y c h o l o g i c a l M e d i c i n e 23, 999-1017. Lee, S.,& Hsu, L.K.G. (1992). B u l i m i a n e r v o s a i n Hong Kong Chinese p a t i e n t s . B r i t i s h J o u r n a l o f P s y c h i a t r y 545-551. Lucero, K., H i c k s , R.A., B r a m l e t t e , J . , B r a s s i n g t o n , G.S., & W e l t e r , M.G. (1992). Frequency o f e a t i n g problems among A s i a n and C a u c a s i a n c o l l e g e women. P s y c h o l o g i c a l R e p o r t s , 71, 255-258.  113  Mena, F . J . , P a d i l l a , A.M., & Maldonado, M. (1987). A c c u l t u r a t i v e s t r e s s and s p e c i f i c c o p i n g s t r a t e g i e s among immigrant and l a t e r g e n e r a t i o n c o l l e g e students. Hispanic Journal of.Behavioral Sciences, 2L, 207-225. McCarthy, M. (1990). The t h i n i d e a l d e p r e s s i o n and e a t i n g d i s o r d e r s i n women. B e h a v i o r a l R e s e a r c h and Theory, 2SL, 205-215. McCourt, J . , & W a l l e r , G. (1995). Developmental r o l e o f perceived p a r e n t a l c o n t r o l i n the eating p s y c h o p a t h o l o g y o f A s i a n and C a u c a s i a n s c h o o l g i r l s . I n t e r n a t i o n a l J o u r n a l o f E a t i n g D i s o r d e r s , 12, 277282. Morgan, G. & S y l v e s t e r , D. (1977). A n o r e x i a n e r v o s a . I n O.W. H i l l ( e d . ) , Modern t r e n d s i n p s y c h o l o g i c a l m e d i c i n e ( V o l . 3, p. 382-403). London: B u t t e r w o r t h s . Mumford, D.B. (1993). E a t i n g d i s o r d e r s i n d i f f e r e n t c u l t u r e s . I n t e r n a t i o n a l Review o f P s y c h i a t r y , 5_, 109-114. Mumford, D.B., Whitehouse, A.M., & P l a t t s , M. (1991). S o c i o c u l t u r a l c o r r e l a t e s o f e a t i n g d i s o r d e r s among Asian s c h o o l g i r l s i n Bradford. B r i t i s h Journal of P s y c h i a t r y , 151, 222-228. Mumford, D.B., Whitehouse, A.M., & Choudry, I.Y.(1992). Survey o f e a t i n g d i s o r d e r s i n English-medium s c h o o l s i n Lahore, P a k i s t a n . I n t e r n a t i o n a l J o u r n a l o f E a t i n g D i s o r d e r s . 2, 173-184. Nasser, M. (1986). Comparative study o f t h e p r e v a l e n c e of abnormal e a t i n g a t t i t u d e s among Arab female s t u d e n t s o f b o t h London and C a i r o u n i v e r s i t i e s . P s y c h o l o g i c a l M e d i c i n e . 16, 621-625. Nasser, M. (1988a). C u l t u r e and weight c o n s c i o u s n e s s . J o u r n a l o f Psychosomatic Research, 3_2, 573-577. N a s s e r , M. (1988b). E a t i n g d i s o r d e r s : The c u l t u r a l d i m e n s i o n . S o c i a l P s y c h i a t r y and P s y c h i a t r i c ' E p i d e m i o l o g y , 22, 184-187.  114  Neuman, P.A. & H a l v o r s o h , P.A. (1983). A n o r e x i a n e r v o s a and b u l i m i a : A handbook f o r c o u n s e l o r s and t h e r a p i s t s . New York: Van N o s t r a n d R e i n h o l d . Nevo, S. (1985). B u l i m i c symptoms: P r e v a l e n c e and e t h n i c d i f f e r e n c e s among c o l l e g e women. I n t e r n a t i o n a l J o u r n a l o f E a t i n g D i s o r d e r s , A, 151 -168. Ong, Y.L., T s o i , W.F. (1982). A c l i n i c a l and p s y c h o l o g i c a l s t u d y o f seven cases o f a n o r e x i a n e r v o s a i n S i n g a p o r e . Singapore M e d i c a l J o u r n a l , 23, 255-261. P a d i l l a , A.M. (1985). A c c u l t u r a t i o n and s t r e s s among immigrants and l a t e r - g e n e r a t i o n i n d i v i d u a l s . S p a n i s h Speaking M e n t a l H e a l t h Research C e n t r e , 2Q_, 41-60. P a d i l l a , A.M., A l v a r e z , M., & Lindholm, K . J . (1986). G e n e r a t i o n a l s t a t u s and p e r s o n a l i t y f a c t o r s as predictors of stress i n students. Hispanic Journal of B e h a v i o r a l S c i e n c e s , 3_, 275-288. P a d i l l a , A.M., Wagatsuma, Y., Lindholm, K . J . (1985a). A c c u l t u r a t i o n and p e r s o n a l i t y as p r e d i c t o r s o f s t r e s s i n Japanese and Japanese-Americans. J o u r n a l of S o c i a l Psychology. 125, 295-305. P a d i l l a , A.M., Wagatsuma, Y., Lindholm, K . J . (1985b). G e n e r a t i o n a l d i f f e r e n c e s i n a c c u l t u r a t i v e s t r e s s and p e r s o n a l i t y among Mexican and Japanese Americans. S p a n i s h Speaking M e n t a l H e a l t h Research C e n t r e , 20., 15-38. Pate, J.E., Pumariega, A . J . , H e s t e r , C, & Garner, D.M. (1992). C r o s s - c u l t u r a l p a t t e r n s i n e a t i n g d i s o r d e r s : A r e v i e w . J o u r n a l o f t h e American Academy o f C h i l d & A d o l e s c e n t P s y c h i a t r y . 31, 802-809. Pope, H.G., J r . , Hudson, J . I . , & Yurgelum-Todd, D. (1984). A n o r e x i a n e r v o s a and b u l i m i a among 300 suburban women shoppers. American J o u r n a l o f P s y c h i a t r y . H I , 292-294.  115  Pumariega, A . J . (1986). A c c u l t u r a t i o n and e a t i n g a t t i t u d e s i n a d o l e s c e n t g i r l s : A c o m p a r a t i v e and c o r r e l a t i o n a l s t u d y . J o u r n a l o f t h e American Academy o f C h i l d P s y c h i a t r y . 23., 276-279. P y l e , R.L., H a l v o r s o n , P.A., Neuman, P.A., & M i t c h e l l , J . E . ( 1 9 8 6 ) . The i n c r e a s i n g p r e v a l e n c e o f b u l i m i a i n freshman c o l l e g e s t u d e n t s . International J o u r n a l o f E a t i n g D i s o r d e r s , 5, 631-648. P y l e , R.L., Neuman, P.A., H a l v o r s o n , P.S., & M i t c h e l l , J.E. (1991). An ongoing c r o s s - s e c t i o n a l s t u d y o f the p r e v a l e n c e o f e a t i n g d i s o r d e r s i n freshman c o l l e g e students. International Journal of Eating D i s o r d e r s , 1_Q_, 667-677. Rastam, M., G i l l b e r g , C , & .Garton M. (1989). A n o r e x i a n e r v o s a i n a Swedish urban r e g i o n : A p o p u l a t i o n based s t u d y . B r i t i s h J o u r n a l o f P s y c h i a t r y , 155, 642-646. Rathner, G., & Messner, K. (1993). D e t e c t i o n o f e a t i n g d i s o r d e r s i n a s m a l l r u r a l town: An e p i d e m i o l o g i c a l s t u d y . P s y c h o l o g i c a l M e d i c i n e , 21, 175-184. R u s s e l l , G.F.M. (1979). B u l i m i a n e r v o s a : An ominous v a r i a n t of anorexia nervosa. P s y c h o l o g i c a l Medicine, 1, 429-448. Schmidt, U. (1993). B u l i m i a n e r v o s a i n t h e C h i n e s e . I n t e r n a t i o n a l J o u r n a l o f E a t i n g D i s o r d e r s , A, 505509. Sue, S. (1977). Community mental h e a l t h s e r v i c e s t o m i n o r i t y groups: Some optimism, some pessimism. American P s y c h o l o g i s t , 3_2_, 616-624. Suematsu, H., I s h i k a w a , H., Kuboke, T., & I t o , T. (1985). S t a t i s t i c a l s t u d i e s on a n o r e x i a n e r v o s a i n Japan: D e t a i l e d c l i n i c a l d a t a on 1011 p a t i e n t s . P s y c h o t h e r a p y & P s y c h o s o m a t i c s , j), 96-103.  116  Suinn, R.M., R i c k a r d - F i g u e r o a , K., Lew, S., & V i g i l , P. (1987). The Suinn-Lew A s i a n S e l f - I d e n t i t y A c c u l t u r a t i o n S c a l e : An i n i t i a l r e p o r t . E d u c a t i o n a l and P s y c h o l o g i c a l Measurement. 47, 401-407. Suinn, R.M., Ahuna, C , 5= Khoo, G. (1992). The SuinnLew A s i a n S e l f - I d e n t i t y A c c u l t u r a t i o n S c a l e : C o n c u r r e n t and f a c t o r i a l v a l i d a t i o n . E d u c a t i o n a l and P s y c h o l o g i c a l Measurement, 5_2_, 1041-1047. Thompson, B. (1989). Why won't s t e p w i s e methods d i e ? Measurements and E v a l u a t i o n i n C o u n s e l l i n g and Development, 21, 146-148. Wampold B.E., Freud, R.D. (1987). Use o f M u l t i p l e regression i n counseling psychology research: A f l e x i b l e data-analytic strategy. Journal of C o u n s e l i n g P s y c h o l o g y , 2A, 372-382. W i l l i a m s , P., Hand, D., & T a r n o p l o s k y , A. (1982). The problem o f s c r e e n i n g f o r uncommon d i s o r d e r s : A comment on t h e E a t i n g A t t i t u d e s T e s t . P s y c h o l o g i c a l Medicine, 12, 431-434. Wiseman, C.L., Gray, J . J . , Mosimann, J.E., & Ahrens, A.H. (1992). C u l t u r a l e x p e c t a t i o n s o f t h i n n e s s i n women: An update. I n t e r n a t i o n a l J o u r n a l o f E a t i n g D i s o r d e r s , 11, 85-8 9. Wiseman, C.L., Gunning, F.M., & Gray, J . J . (1993). I n c r e a s i n g p r e s s u r e t o be t h i n : 19 y e a r s o f d i e t p r o d u c t s i n t e l e v i s i o n commercials. E a t i n g D i s o r d e r s , 1, 52-61. Zheng, Y.M. (1982). The p s y c h o t h e r a p y o f c h i l d a n o r e x i a n e r v o s a : A f o l l o w - u p study o f a case f o r 23 y e a r s . Chinese J o u r n a l o f N e u r o l o g y and P s y c h i a t r y , 15_, 4648.  Appendix A Demographic Q u e s t i o n n a i r e  118  DEMOGRAPHIC INFORMATION 1. Age: 2. U n i v e r s i t y y e a r :  (degree:  Subject:  3. C i t y and Country o f b i r t h ? : 4. E t h n i c background:  '_  5. How l o n g have you l i v e d i n N o r t h  America?  6. A r e you an i n t e r n a t i o n a l s t u d e n t : 7. I have I am  b r o t h e r s , and (  siters  Yes  No.  (how many?)  ) the oldest c h i l d the youngest c h i l d the o n l y c h i l d the m i d d l e o r one o f t h e m i d d l e other:  children  9. How many times have you moved i n t h i s c o u n t r y s i n c e b i r t h ? (not i n t h e same c i t y ) times. 10. How many times have you moved between c o u n t r i e s since birth? times. 11. P a r e n t s ' background  (answer as much as you c a n ) . Father  Age: Occupation; Education; Ethnic  background:  City of birth; No. o f y e a r s i n Canada: Languages  spoken:  Mother  Appendix B E a t i n g A t t i t u d e s Test  120  EATING ATTITUDES TEST Instructions: P l e a s e c i r c l e the l e t t e r which b e s t a p p l i e s to each of the numbered statements. P l e a s e answer each q u e s t i o n c a r e f u l l y . Thank you. A=always;  U=usually;  0=often;  S=sometimes;  R=rarely;  N=never  A  U  0  s  R  N  1.  Am  A  U  0  s  R  N  2.  A v o i d e a t i n g when I am  A  U  0  s  R  N  3.  F i n d myself p r e o c c u p i e d w i t h  A  U  0  s  R  N  4.  Have gone on e a t i n g binges where I f e e l t h a t I not be a b l e t o stop  A  U  0  s  R  N  5.  Cut my  A  U  0  s  R  N  6.  Aware of the c a l o r i e content o f the food t h a t I e a t .  A  U  0  s  R  N  7.  P a r t i c u l a r l y a v o i d food w i t h h i g h carbohydrates  A  U  0  s  R  N  8.  F e e l t h a t o t h e r s would p r e f e r I a t e more.  A  U  0  s  R  N  9.  Vomit a f t e r I have eaten.  A  U  0  s  R  N  10. F e e l extremely  A  U  0  s  R  N  11. Am  A  U  0  s  R  N  12. Think about b u r n i n g up c a l o r i e s when I e x e r c i s e .  A  U  0  s  R  N  13. Other people t h i n k t h a t I am too  A  U  0  s  R  N  14. Am p r e o c c u p i e d w i t h the thought body.  A  u  0  s  R  N  15. Take l o n g e r than o t h e r s t o eat my  A  u  0  s  R  N  16. A v o i d foods w i t h sugar i n them.  A  u  0  s  R  N  17. Eat d i e t  A  u  0  s  R  N  18. F e e l t h a t food c o n t r o l s my  A  u  0  s  R  N  19. D i s p l a y s e l f - c o n t r o l around food.  A  u  0  s  R  N  20.  A  u  0  s  R  N  21. Give too much time and thought  A  u  0  s  R  N  22.  A  u  0  s  R  N  23. Engage i n d i e t b e h a v i o i u r s .  A  u  0  s  R  N  24.  A  u  0  s  R  N  25. Enjoy t r y i n g new  foods.  A  u  0  s  R  N  26. Have the impulse  to d i e t a f t e r meals.  t e r r i f i e d about b e i n g  overweight.  hungry. food. may  food i n t o s m a l l p i e c e s .  content  guilty after eating.  p r e o c c u p i e d w i t h a d e s i r e to become t h i n n e r .  o f h a v i n g f a t on  meals.  foods. life.  F e e l t h a t o t h e r s p r e s s u r e me  F e e l uncomfortable  L i k e my  thin  to e a t . to food.  a f t e r e a t i n g sweets.  stomach to be empty.  my  Appendix C Suinn-Lew A s i a n  Self-Identity  A c c u l t u r a t i o n Scale  122  SUINN-LEW ASIAN SELF-IDENTITY ACCULTURATION SCALE INSTRUCTIONS: The q u e s t i o n which f o l l o w a r e f o r t h e purpose o f c o l l e c t i n g i n f o r m a t i o n about your h i s t o r i c a l background as w e l l as more r e c e n t b e h a v i d u i r s which may be r e l a t e d t o your c u l t u r a l i d e n t i t y . Choose t h e one answer which b e s t d e s c r i b e s you. What language can you speak? 1. A s i a n o n l y ( i e . , C h i n e s e , Japanese, Korean, Vietnamese, etc.) 2. M o s t l y A s i a n , some E n g l i s h 3. A s i a n and E n g l i s h about e q u a l l y w e l l ( b i l i n g u a l ) 4. M o s t l y E n g l i s h , some A s i a n 5. Only E n g l i s h What language do you p r e f e r ? 1. A s i a n o n l y ( i e . , C h i n e s e , Japanese, Korean, Vietnamese, etc.) 2. M o s t l y A s i a n , some E n g l i s h 3. A s i a n and E n g l i s h about e q u a l l y w e l l ( b i l i n g u a l ) 4. M o s t l y E n g l i s h , some A s i a n 5. Only E n g l i s h How do you i d e n t i f y y o u r s e l f ? 1. A s i a n o n l y ( i e . , C h i n e s e , Japanese, Korean, Vietnamese, etc.) 2. M o s t l y A s i a n , some E n g l i s h 3. A s i a n and E n g l i s h about e q u a l l y w e l l ( b i l i n g u a l ) 4. M o s t l y E n g l i s h , some A s i a n 5. Only E n g l i s h Which i d e n t i f i c a t i o n does (did) your mother use? 1. O r i e n t a l 2. A s i a n 3. A s i a n - C a n a d i a n 4. C h i n e s e - C a n a d i a n , Japanese-Canadian, Korean-Canadian, etc. 5. Canadian Which i d e n t i f i c a t i o n does (did) your f a t h e r use? 1'. O r i e n t a l 2. A s i a n 3. A s i a n - C a n a d i a n 4. Chinese-Canadian,. Japanese-Canadian, Korean-Canadian, etc. 5. Canadian  123  6.  What was t h e e t h n i c o r i g i n o f t h e f r i e n d s and peers you had, as a c h i l d up t o age 6? 1. Almost e x c l u s i v e l y A s i a n s , A s i a n - C a n a d i a n s , O r i e n t a l s 2. M o s t l y A s i a n s , A s i a n - C a n a d i a n s , O r i e n t a l s 3. About e q u a l A s i a n groups and A n g l o groups 4. M o s t l y A n g l o s , B l a c k s , H i s p a n i c s , o r o t h e r non-Asian e t h n i c groups 5. Almost e x c l u s i v e l y A n g l o s , B l a c k s , H i s p a n i c s o r o t h e r non-Asian e t h n i c groups  7.  What was t h e e t h n i c o r i g i n s o f t h e f r i e n d s and peers you had, as a c h i l d from 6 t o 18? 1. Almost e x c l u s i v e l y A s i a n s , A s i a n - C a n a d i a n s , O r i e n t a l s 2. M o s t l y A s i a n s , A s i a n - C a n a d i a n s , O r i e n t a l s 3. About e q u a l A s i a n groups and A n g l o groups 4. M o s t l y A n g l o s , B l a c k s , H i s p a n i c s , o r o t h e r non-Asian e t h n i c groups 5. Almost e x c l u s i v e l y A n g l o s , B l a c k s , H i s p a n i c s o r o t h e r non-Asian e t h n i c groups  8.  Whom do you now a s s o c i a t e w i t h i n t h e community? 1. Almost e x c l u s i v e l y A s i a n s , A s i a n - C a n a d i a n s , O r i e n t a l s 2. M o s t l y A s i a n s , A s i a n - C a n a d i a n s , O r i e n t a l s 3. About e q u a l A s i a n groups and A n g l o groups 4. M o s t l y A n g l o s , B l a c k s , H i s p a n i c s , o r o t h e r non-Asian e t h n i c groups 5. Almost e x c l u s i v e l y A n g l o s , B l a c k s , H i s p a n i c s o r o t h e r non-Asian e t h n i c groups  9.  I f you c o u l d p i c k , whom would you p r e f e r t o a s s o c i a t e w i t h i n t h e community? 1. Almost e x c l u s i v e l y A s i a n s , A s i a n - C a n a d i a n s , O r i e n t a l s 2. M o s t l y A s i a n s , A s i a n - C a n a d i a n s , O r i e n t a l s 3. About e q u a l A s i a n groups and A n g l o groups 4. M o s t l y A n g l o s , B l a c k s , H i s p a n i c s , o r o t h e r non-Asian e t h n i c groups 5. Almost e x c l u s i v e l y A n g l o s , B l a c k s , H i s p a n i c s o r o t h e r non-Asian e t h n i c groups  10.  What i s you music p r e f e r e n c e ? 1. Only A s i a n mUsic ( i e . , Chinese, Vietnamese, e c t . ) 2. M o s t l y A s i a n 3. E q u a l l y A s i a n and E n g l i s h 4. M o s t l y E n g l i s h 5. Only E n g l i s h  11.  What i s you movie p r e f e r e n c e ? 1. A s i a n - l a n g u a g e movies o n l y 2. A s i a n language movies m o s t l y 3. E q u a l l y A s i a n / E n g l i s h 4. E n g l i s h - l a n g u a g e movies m o s t l y 5. E n g l i s h - l a n g u a g e movies o n l y  Japanese, Korean,  124  Where were you Canada Where was your Canada Where was your Canada Where was your Canada Where was your Canada Where was your Canada Where was your Canada  born? Asia Other f a t h e r born? Asia Other mother born? Asia Other f a t h e r ' s f a t h e r born? Asia Other f a t h e r ' s mother born? Asia Other mother's f a t h e r born? Asia Other mother's mother born? As i a Other -  where where where where where where where  On t h e b a s i s o f t h e above answers, c i r c l e t h e g e n e r a t i o n t h a t b e s t a p p l i e s t o you: 1. 1 s t G e n e r a t i o n = I was b o r n i n A s i a o r o t h e r 2. 2nd G e n e r a t i o n = I was b o r n i n Canada, e i t h e r p a r e n t was b o r n i n A s i a o r other . 3. 3 r d G e n e r a t i o n = I was b o r n i n Canada, b o t h p a r e n t s were b o r n i n Canada, & a l l grandparents born i n A s i a or o t h e r 4. 4 t h G e n e r a t i o n = I was b o r n i n Canada, b o t h p a r e n t s b o r n i n Canada, and a t l e a s t one grandparent b o r n i n A s i a o r o t h e r & one g grandparent b o r n i n Canada 5. 5 t h G e n e r a t i o n = I was b o r n i n Canada, b o t h parents & a l l grandparents a l s o b o r n i n Canada 6. Don't know what g e n e r a t i o n b e s t f i t s s i n c e I l a c k some information 13.  Where were your r a i s e d ? 1. I n A s i a o n l y 2. M o s t l y i n A s i a n , some i n Canada 3. E q u a l l y i n A s i a and Canada 4. M o s t l y i n Canada 5. I n Canada o n l y  14.  What c o n t a c t have your had w i t h A s i a ? 1. R a i s e d one y e a r o r more i n A s i a 2. L i v e d f o r l e s s than one your i n A s i a 3. O c c a s i o n a l v i s i t s t o A s i a 4. O c c a s i o n a l communications ( l e t t e r s , phone c a l l s , e c t . ) t o people i n Asia 5. No exposure o r communications w i t h p e o p l e i n A s i a  125  15.  What i s your food p r e f e r e n c e a t home? 1. E x c l u s i v e l y A s i a n f o o d 2. M o s t l y A s i a n food, some Canadian 3. About e q u a l l y A s i a n and Canadian 4. M o s t l y Canadian f o o d 5. E x c l u s i v e l y Canadian food  16.  What i s your f o o d p r e f e r e n c e i n r e s t a u r a n t s ? 1. E x c l u s i v e l y A s i a n f o o d 2. M o s t l y A s i a n food, some Canadian 3. About e q u a l l y A s i a n and Canadian 4. M o s t l y Canadian food 5. E x c l u s i v e l y Canadian food  17.  Do 1. 2. 3. 4. 5.  18.  Do you 1. w r i t e 2. w r i t e 3. w r i t e 4.. w r i t e 5. w r i t e  you read read read read read  o n l y an A s i a n language an A s i a n Language b e t t e r than E n g l i s h b o t h A s i a n and E n g l i s h e q u a l l y w e l l E n g l i s h b e t t e r than an A s i a n language only English o n l y an A s i a n language an A s i a n Language b e t t e r than E n g l i s h b o t h A s i a n and E n g l i s h e q u a l l y w e l l E n g l i s h b e t t e r than an A s i a n language only English  i  19.  I f you c o n s i d e r y o u r s e l f a member o f t h e A s i a n group ( O r i e n t a l , A s i a n , A s i a n - C a n a d i a n , Chinese-Canadian, e t c . , whatever term you p r e f e r ) , how much p r i d e do you have i n t h i s group? 1. E x t r e m e l y proud 2. M o d e r a t e l y proud 3. L i t t l e proud 4. No p r i d e b u t do n o t f e l l n e g a t i v e toward group 5. No p r i d e b u t do f e e l n e g a t i v e toward group  20.  How would you r a t e y o u r s e l f ? 1. Very A s i a n 2. M o s t l y A s i a n 3. B i c u l t u r a l 4. M o s t l y W e s t e r n i z e d 5. Very W e s t e r n i z e d  21.  Do you p a r t i c i p a t e i n A s i a n o c c a s i o n , h o l i d a y s , t r a d i t i o n , etc.? 1. n e a r l y a l l 2. Most o f them 3. Some o f them 4. A few o f them 5. None a t a l l  126  Appendix D SAFE A c c u l t u r a t i v e S t r e s s  Questionnaire  127  SAFE ACCULTURATIVE STRESS SCALE I n s t r u c t i o n s : P l e a s e c i r c l e the number which b e s t a p p l i e s t o each of the numbered s t a t e m e n t s . P l e a s e answer each q u e s t i o n carefully. t h e r e are no r i g h t answers. Thank you. O=not a p p l i c a b l e ; l=not s t r e s s f u l ; 2=a l i t t l e s t r e s s f u l ; 3=moderately s t r e s s f u l ; 4=quite s t r e s s f u l ; 5=extremely s t r e s s f u l 0 12 3 4 5  1.  I f e e l u n c o m f o r t a b l e when o t h e r s make j o k e s about o r put down p e o p l e o f my e t h n i c background.  0 1 2 3 4 5  2.  I have more b a r r i e r s t o overcome than most people.  0 1 2 3 4 5  3.  I t b o t h e r s me t h a t f a m i l y members I am c l o s e t o do not u n d e r s t a n d my new v a l u e s .  0 12 3 4 5  4.  C l o s e f a m i l y members & I have c o n f l i c t i n g e x p e c t a t i o n s about my f u t u r e .  0 1 2 3 4 5  5.  I t i s h a r d t o e x p r e s s t o my f r i e n d s how I really feel.  0 12 3 4 5  6.  My f a m i l y does not want me t o move away but I would l i k e t o .  0 1 2 3 4 5  7.  I t b o t h e r s me t o t h i n k t h a t so many p e o p l e us drugs.  0 1 2 3 4 5  8.  I t b o t h e r s me t h a t I cannot be w i t h my f family.  0 1 2 3 4 5  9.  I n l o o k i n g f o r a good j o b , I sometimes f e e l t h a t my e t h n i c i t y i s a l i m i t a t i o n .  012  10. I don't have any c l o s e f r i e n d s .  345  0 1 2 3 4 5  11. Many p e o p l e have s t e r e o t y p e s about my c u l t u r e or e t h n i c group & t r e a t me as i f t h e y are true.  0 1 2 3 4 5  12. I don't f e e l a t home.  0 12 3 4 5  13. People t h i n k I am u n s o c i a l when i n f a c t I have t r o u b l e communicating i n E n g l i s h .  0 12 3 4 5  14. I o f t e n f e e l t h a t p e o p l e a c t i v e l y me from a d v a n c i n g .  t r y t o stop  128  0 1 2 3 4 5  15.  I t b o t h e r s me when p e o p l e p r e s s u r e me t o assimilate.  0 1 2 3 4 5  16.  I o f t e n f e e l i g n o r e d by p e o p l e who a r e supposed t o a s s i s t me.  0 1 2 3 4 5  17.  Because I'm d i f f e r e n t I don't g e t enough c r e d i t f o r t h e work I do.  0 1 2 3 4 5  18.  0 1 2 3 4 5  19.  I t b o t h e r s me t h a t I have an a c c e n t .  0 1 2 3 4 5  L o o s e n i n g t h e t i e s w i t h my c o u n t r y i s difficult. 20. T o f t e n t h i n k about my c u l t u r a l background.  0 1 2 3 4 5  21.  Because o f my e t h n i c background, I f e e l t h a t o t h e r s o f t e n e x c l u d e me from p a r t i c i p a t i n g i n their activities.  0 1 2 3 4 5  22.  I t i s d i f f i c u l t f o r me t o "show o f f " my family.  0 %2 3 4 5  23.  People l o o k down upon me i f I p r a c t i c e customs o f my c u l t u r e .  0 1 2 3 4 5  24.  I have t r o u b l e u n d e r s t a n d i n g o t h e r when t h e y speak.  129  Appendix E Introductory  L e t t e r to Professors  130  Dear: Dr. My name i s C o l l e e n Hyland. I am a MA s t u d e n t i n the Department o f C o u n s e l l i n g P s y c h o l o g y w o r k i n g under the s u p e r v i s i o n o f Dr. Ishu Ishiyama. I am c o n t a c t i n g you because I am d e s p e r a t e l y s e e k i n g s u b j e c t s t o p a r t i c i p a t e i n my s t u d y which e x p l o r e s the r o l e o f s o c i o c u l t u r a l f a c t o r s i n the o c c u r r e n c e o f p a t h o l o g i c a l ' e a t i n g a t t i t u d e s and b e h a v i o u r s . I would g r e a t l y a p p r e c i a t e the o p p o r t u n i t y t o i n v i t e a l l o f your female s t u d e n t s t o complete P a r t One o f my q u e s t i o n n a i r e ; t h i s w i l l t a k e about 10 minutes. P a r t Two i s a p p l i c a b l e t o female Chinese s t u d e n t s o n l y and w i l l r e q u i r e an a d d i t i o n a l 5-10 minutes t o complete; t h i s can be completed w i t h i n c l a s s time o r on the s t u d e n t s ' own t i m e . Your ' a s s i s t a n c e i n my endeavour t o l o c a t e s u b j e c t s would be g r e a t l y a p p r e c i a t e d , and w i l l be acknowledges i n any e n s u i n g p u b l i c a t i o n s . A l s o , I would be happy t o o f f e r p r e s e n t a t i o n o f my r e s e a r c h t o your c l a s s l a t e r t h i s year. I f you are a b l e t o h e l p me o r have any q u e s t i o n s , p l e a s e c o n t a c t me o r Dr. Ishiyama a t 822-5329, o r f a x the f o l l o w i n g form t o 822-2328. Thank you! C o l l e e n Hyland  Dr. Ishu Ishiyama Cutting Line  Fax  TO: C o l l e e n Hyland c/o Dr. I . Ishiyama FROM: <name> Dept.  TEL: 2 FAX: 2 I am w i l l i n g t o a l l o w C o l l e e n Hyland a c c e s s t o my c l a s s to do t h e following: i n v i t e female student t o p a r t i c i p a t e on t h e i r own time. complete P a r t One o f t h e q u e s t i o n n a i r e complete P a r t One & Two o f t h e q u e s t i o n n a i r e P r e f e r r e d survey date and time:  Appendix F P a r t i c i p a n t I n f o r m a t i o n Sheet and Consent Form  132  C o l l e e n Hyland, M.A. Candidate S u p e r v i s o r : Dr. Ishu i s h i y a m a Research Study: A c c u l t u r a t i o n and E a t i n g A t t i t u d e s i n Female Chinese and Caucasian U n i v e r s i t y Students  Dear P a r t i c i p a n t s : I am w r i t i n g t o r e q u e s t your h e l p w i t h a r e s e a r c h s t u d y t h a t I am c o n d u c t i n g . As a graduate s t u d e n t , t h i s s t u d y c o n s t i t u t e s the f i n a l requirement f o r a Master o f A r t s i n C o u n s e l l i n g P s y c h o l o g y a t the U n i v e r s i t y o f B r i t i s h Columbia. The purpose o f my s t u d y i s t o examine s t u d e n t s ' e a t i n g a t t i t u d e s and b e h a v i o u r s . Your p a r t i c i p a t i o n i n t h i s s t u d y i s e n t i r e l y v o l u n t a r y and you may choose t o d i s c o n t i n u e a t any p o i n t w i t h o u t p e n a l t y . A l l i n f o r m a t i o n i s c o n f i d e n t i a l , o n l y m y s e l f and my r e s e a r c h s u p e r v i s o r , F r . I . Ishiyama, w i l l see the questionnaires. Should you choose not t o p a r t i c i p a t e i n t h i s study, you a r f r e e t o l e a v e . Should you consent t o p a r t i c i p a t e , you w i l l be r e q u e s t e d t o complete a q u e s t i o n n a i r e package. C o m p l e t i o n o f the q u e s t i o n n a i r e w i l l t a k e C a u c a s i a n s t u d e n t s a p p r o x i m a t e l y 5-7 minutes, and Chinese s t u d e n t s a p p r o x i m a t e l y 10-15 m i n u t e s . Upon c o m p l e t i o n the q u e s t i o n n a i r e your commitment t o the s t u d y i s o v e r . I t i s assumed t h a t consent has been g i v e n i f t h i s q u e s t i o n n a i r e has been completed and submitted. A copy o f the t h e s i s w i l l be made a v a i l a b l e i n the Main L i b r a r y a t UBC upon c o m p l e t i o n . Should you have any q u e s t i o n s about the study, p l e a s e f e e l f r e e t o ask me now o r c o n t a c t me a t the address l i s t e d above. Thank you i n advance f o r you c o n s i d e r a t i o n . Your c o o p e r a t i o n w i l l be i n v a l u a b l e t o t h i s r e s e a r c h which hoped t o add t o the body o f knowledge c o n c e r n i n g e a t i n g a t t i t u d e s and b e h a v i o u r s . Sincerely, Colleen  Hyland  Appendix G Follow-up*-Sheet  134  THANK YOU?!f f ? f o r your p a r t i c i p a t i o n i n t h i s s u r v e y as i t can not be done w i t h o u t the s u p p o r t o f p e o p l e l i k e you. I f you would and outcomes o f contact Colleen w i l l be p l e a s e d information:  l i k e some more i n f o r m a t i o n on the g o a l s t h i s survey, please f e e l f r e e to Hyland a t the f o l l o w i n g address and I t o p r o v i d e you w i t h a l l r e l e v a n t  C o l l e e n Hyland c/o Department o f C o u n s e l l i n g P s y c h o l o g y Faculty of Education The U n i v e r s i t y o f B r i t i s h Columbia 2125 Main M a l l Vancouver, BC V6T 1Z4 A d d i t i o n a l l y , examining one's e a t i n g a t t i t u d e s and b e h a v i o u r s can o f t e n r a i s e q u e s t i o n s f o r p e o p l e . A c c o r d i n g l y , I have i n c l u d e d the name and t e l e p h o n e number o f a l o c a l r e s o u r c e than can h e l p answer any q u e s t i o n s o r concerns t h a t you may have. E a t i n g D i s o r d e r Resource C e n t r e o f BC 631-5313 P l e a s e f e e l f r e e to t e a r t h i s page o f f and you wish.  keep i t i f  135  Appendix H I n t e r c o r r e l a t i o n s o f the E a t i n g A t t i t u d e s Test  (EAT)  f o r a l l S u b j e c t Combined, Chinese S u b j e c t s , and Caucasian Subjects  136  Appendix H I n t e r c o r r e l a t i o n s o f the E a t i n g A t t i t u d e s Test  (EAT)  f o r a l l S u b j e c t Combined. Chinese S u b j e c t s , and Caucasian  Subjects  Scale  Subjects  EAT  Diet  EAT  Diet  Bulimia  OralCon.  (total) All Chin Cauc Subscale All Chin Cauc  Bulimia  Subscale AllChin Cauc  .924** .877** .971** .756** .716** .802**  .668** .573** .772**  O r a l C o n t r o l Subscale All .479** Chin .466** .532** Cauc  .157* .037 .364**  .121 .12 6 .118  Note.: ( A l l ) = a l l s u b j e c t s combined (N_=231) ;  (Chin)=  Chinese s u b j e c t s (n=131); (Cauc)=Caucasian s u b j e c t s (n=100). *p_ < .05, t w o - t a i l e d .  **p_ < .001, t w o - t a i l e d .  137  Appendix I I n t e r c o r r e l a t i o n s of Level of A c c u l t u r a t i o n f o r the Chinese S u b j e c t s  (SL-ASIA)  138  Appendix I I n t e r c o r r e l a t i o n s of Level of A c c u l t u r a t i o n  (SL-ASIA)  f o r the Chinese S u b j e c t s Scale SL-ASIA  (Total)  (L)  (A)  (Ft)  (G)  (Total)  -Language -Friend -Affinity  (L).865** (Fr).538**  .482**  (A).622**  .503**  .283*  -Generation(G).745**  .437**  .292*  .425**  -Food  .551**  .289*  .302*  (Fd).609**  11 = 116. *p< ,01, t w o - t a i l e d .  **p_< .001, t w o - t a i l e d  .362**  

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