ASSOCIATIVE PERCEPTION OF THE CONCEPT OF "FOOD" BY PERSONS WITH AND WITHOUT ORTHOREXIA (EMPIRICAL RESEARCH FINDINGS, 2016-2018, IN THE CITIES OF UKRAINE AND OUTSIDE OF IT)

04.09.2019

(full text of article presented at the poster session in Paris, 2019, Conference of European Council on Eating Disorders)

Annotation: the article is devoted to the actual topic of an eating disorder. The author has analyzed the researches in this sphere and has interviewed 326 respondents using modern methods. The associative fields are defined and compared in persons with and without orthorexia.

Keywords: orthorexia, associative field, eating disorder, Roman questionnaire for the diagnosis of orthorexia nervosa, associative chain experiment.

1. Introduction

Recently, the theme of healthy eating and eating behavior attracts more and more attention both by scientists and by ordinary people. Scientists around the world pay increasing attention to the nutrition psychology, as from the moment of the birth of human being food is associated with the interpersonal connection and is an integral part of the process of socialization. Establishing business and close relationships, spending family holidays are accompanied, as a rule, by food. That is, human eating behavior is directed at satisfaction, both physiological and social needs.

The media space is full of tv-shows that are connected with cooking. Such a trend is observed throughout the world, but it is particularly prevalent in countries like Japan, France, Italy, and this is due to the centuries-old culture of these peoples (high quality of life and longevity are observed in these countries). A wide range of issues related to food is gaining signs of subculture. The subculture of orthorexia ("obsessive healthy lifestyle" and strict food restrictions) as opposed to traditional values as a table full of meals and thus it is a cultural group within a broader, traditional culture.

Nowadays, in the academia of Ukraine, the interest in this issue, the peculiarities of the person's food behavior and certain eating disorders, is growing rapidly. Some of them are thoroughly researched (Shebanova V. 2015, 2016, 2017, 2018), but concerning such eating disorder as orthorexia nervosa (so-called fixation with the correctness and cleanliness of food), there is insufficient information and scientific research in Ukraine. The term "orthorexia" comes from the Greek ὀρθός - "right" "correct" and ὄρεξις - "appetite", firstly used by the American physician S. Bratman in 1997.

This eating disorder is characterized by an obsessive desire for "healthy and proper eating", which leads to significant restrictions in the choice of food. [4] Persons suffering from orthorexia carefully plan their diet, compile lists of products, recipes for cooking, and have various rituals. According to the American psychologist Mathieu J, those who have orthorexia are highly disturbed when they are hampered in carrying out activities related to planning, procurement, preparation, and control over food consumption. They have a feeling of guilt and hatred towards others. Unlike other eating disorders, according to the Italian researcher Donini L.M., orthorexia is not focused on the quantity, but on the quality of the food that is consumed [2]. Eating disorders may progress and lead to further exclusion of almost all kinds of food from the diet. The desire to adhere to a strict diet, performing certain rituals allows people prone to orthorexia to feel better, cleaner, and healthier than others. As noted by Mathieu J., people with nervous orthorexia complain that the obsessive need for a sense of cleanliness and health, which at first depended only on the quality of the food consumed, eventually begins to affect other areas of life [6]. First of all, it comes out in social isolation. Differences in values and lifestyles lead to the fact that persons prone to orthorexia feel their moral superiority over others in connection with selectivity and "purity", which leads to a further deepening and deterioration of the mental state. Subsequently, faced with rejection by others, they avoid expressing their views and withdraw into themselves. If they fail to fulfill the planned, they are very anxious and subject themselves to self-punishment by additional detoxification of the body.

Despite the prevalence of the phenomenon, experts do not have a common opinion about its nosology. At the initial stage of the development of ideas about the orthorexia nervosa, Stephen Bratman, who suggested this term, argued that this disorder is a unique form of eating disorders. In his opinion, the excessive fixation of the individual on the quality of food is caused by the desire to maximize a person's physical health and well-being. Based on his own experience, he argues that orthorexia nervosa has the right to be considered a mental disorder since it can have negative consequences for an individual’s physical, psychological and social state [1]. Some scientists believe orthorexia as a separate eating disorder, and others as a form of obsessive-compulsive disorder.

Nowadays, there is a need to establish, using the free associations' method, signs of an associative field in persons having eating disorder orthorexia and those who do not have it. It was decided to use the technique of associative experiment to determine the associative series associated with the word "food" for a better understanding of the attitude to food by people with orthorexia. The methodology of this particular experiment allows revealing not only the conscious but also the unconscious concept of ​​food. The associative test is quite simple and easy to use, the broad capabilities in group work determine it, the use of any stimulus, and the ability to conduct not only quantitative but also qualitative characteristics.

Similar attempts to research the associative field of the concept of "food" were developed earlier in world science with various social groups, but they had only a clear ethnic direction. So, in 1978, Szalay and Deese (1978) researched associations to the concept of "food" among students from the United States and Korea. Korean students mostly associated food with rice and kimchi (a traditional Korean spice). Later, French scientists surveyed nearly 2,000 respondents; the task for them was to provide the first five associations with the word "to eat" (Lahlou, 1994, 1998). In 2010, a group of scientists investigated an associative field associated with traditional food using an associative experiment. Scientists interviewed 721 people from six regions of Europe and found that people in southern countries associate traditional food with culture, history, and heritage, while northern European areas tend to focus primarily on practical issues such as convenience, health or expediency. [5] Another study proves that Americans are more likely to be concerned about what they eat, whereas the French get great pleasure from food (Rozin et al., 1999).

2. Materials and methods

In 2016-2018 the empirical research (Fatieieva) was conducted in Ukraine, the task of which was to compare the signs of the associative field in people with orthorexia and without orthorexia. Three hundred twenty-six people were selected, men and women aged 18 to 68 years. The average age was 30.64 years, a standard deviation of 11.61. These marks indicate sufficient representativeness of the sample and the required age range of subjects. Empirical research was conducted in the following cities of Ukraine: Kyiv, Kramatorsk, Zaporizhzhya, Odessa, Kharkiv, other countries: St. Petersburg, Minsk. Using the ORTO-15 method (Rome Orthorexia Nervosa Questionnaire), the sample was divided into two groups — with and without orthorexia. According to the results of this method, 64% of the subjects had orthorexic behavior patterns.

The Roman orthorexia nervosa questionnaire consists of 15 items, for each the respondent can give one of four answers: "always", "often", "sometimes" and "never". Points for all items are summed up, one value is calculated throughout the scale. The structure of the questionnaire and its content are based on the expanded and revised survey by S. Bratman. As a result of statistical analysis, it was found that the threshold value of 40 points is statistically significant. The Italian researchers selected 525 respondents - adults (persons under 16 years were not considered sufficiently independent in the choice of their diet) for the study of the validity and reliability of the survey. The group was divided randomly, a sample of 404 subjects participated in the construction of the ORTO-15 questionnaire, and a sample of 121 subjects in the validation of the test. The study showed that the psychometric characteristics of this questionnaire are: efficiency 73.8%, sensitivity 55.6%, and specificity 75.8%. These indicators are satisfying and indicate that the survey can be used in professional activities as a component of a comprehensive diagnosis, or for screening: the identification of a group of people who need an expert’s advice.

During the analysis of the data from an associative experiment, its weaknesses were taken into account - sensitivity to the phonetic composition of the word, language stamps, and difficulty in processing large volumes of associative products. The author used the chain type of associative experiment, where the subject was asked to give an unlimited number of associations to the stimulus for one minute. The most significant interest in this research is the studies of dynamic processes of consciousness; that is why the chain experiment is the most effective one. It is clear that the subject himself did not realize what exact processes were taking place in his consciousness. Therefore our task was to create a situation of natural response under the given context in which these processes could proceed most naturally. Taking into account the nature of the task, the author has decided not to impose conditions on the presentation of associations, except for the time limit. Considering that an associative experiment can be conducted both verbally and in writing, the author chose the written form with the maximum level of anonymization to relieve stress from the subject and avoid the desire to provide socially desirable answers.

Processing of the results consisted of searching for the same associations, extracting them with their frequency (weight) of mention, as well as ranking by frequency. The rate of association in groups was taken as the total number of references to a particular association by the subjects of the group. Due to the wide variety of associations, the frequency of their use by the group was small. Associations used with a frequency more than twice were taken as the basis of the analysis because they were the most informative in a group associative experiment. This is due to the fact that each test subject, as a rule, chose associations from their personal experience, which means from a large number of possible (more than hundreds or thousands). The probability of an accidental coincidence of associations in a chain experiment (where no additional conditions are set, except for time limit) is minimal. Therefore, the case when certain words occur in two, three or more subjects are treated as an essential criterion for analysis. The association used by persons with orthorexia and without orthorexia is not accidental, it is included in the semantic universals of the stimulus for this group. A set of non-random associations to a particular word (stimulus) for a given group is called associative semantic universals of stimuli; they are analyzed only qualitatively.

3. Results and discussion

The list of associations for the word-stimulus “food” was divided into groups, common root words, words of Ukrainian, Russian, and English origin were combined; after that was done the ranking procedure. As a result, 1,168 words were obtained in persons with orthorexia and 829 words in persons without orthorexia.

The following associations were observed in individuals with orthorexia: “tasty” - the frequency of which is 97 words, a rank is assigned (1), “useful” - 54 (2), “pleasure” - 42 (3), “healthy” - 32 (4) , “mood” - 21 (5), “fruits” - 14 (7), “joy” - 14 (7), “vegetables” - 14 (7), “energy” - 13 (10), “ satisfying”- 13 (10), “beautiful”- 13 (10),“ nourishing ”- 11 (13),“ high-calorie ”- 11 (13),“ hunger ”- 11 (13),“ sweets ”- 10 ( 16), “meat” - 10 (16), “fat” - 10 (16), “sweet” - 9 (20.5), “fresh” - 9 (20.5), “pleasant” - 9 (20 , 5), “necessity” - 9 (20,5), “pleasure” - 9 (20,5), “harm” - 9 (20,5), “calm” - 8 (26), “communication” - 8 (26), " cooking "- 8 (26)," weight "- 8 (26)," appetizing "- 8 (26)," warm "- 7 (29.5)," water "- 7 (29.5)," soup "- 6 (34.5)," family "- 6 (34.5)," salad "- 6 (34.5)," meal"- 6 (34.5), "lunch"- 6 (34, 5), “saturation” - 6 (34.5), “kitchen” - 6 (34.5), “shape” - 5 (44.5), satisfaction - 5 (44.5), heavy - 5 (44 , 5), juicy - 5 (44,5), force - 5 (44,5), cooked - 5 (44,5), foodstuff - 5 (44,5), rest - 5 (44,5), love - 5 (44.5), breakfast - 5 (44.5), wine - 5 (44.5), flavor - 5 (44.5), chocolate —4 (56), good - 44 (56), use - 4 (56), mother - 4 (56), quality - 4 (56), exquisite - 4 (56), life - 4 (56), friends - 4 (56), diet - 4 (56), money - 4 (56), borscht - 4 (56), emotions - 3 (73.5), want - 3 (73.5), dinner - 3 (73.5), plate - 3 (73.5), cheese - 3 (73.5), stress - 3 (73.5), fear - 3 (73.5), sport - 3 (73, 5), salty - 3 (73.5), restaurant - 3 (73.5), relaxation - 3 (73.5), products - 3 (73.5), cucumber - 3 (73.5), ice cream - 3 (73.5), seafood - 3 (73.5), eating - 3 (73.5), candies - 3 (73.5), to eat - 3 (73.5), natural - 3 (73.5 ), food - 3 (73.5), hot - 3 (73.5), evening - 3 (73.5), cheerful - 3 (73.5), dish - 3 (73.5).

In persons without orthorexia, the following associations were observed: “tasty” - 56 (1), “pleasure” - 20 (2), “meat” - 12 (4), “to cook” - 12 (4), “sweet” - 12 ( 4), “joy” - 11 (6.5), “food” - 11 (6.5), “pleasant” - 10 (8), “energy” - 9 (10.5), “fat” - 9 (10.5), “life” - 9 (10.5), “friends” - 9 (10.5), “health” - 8 (14.5), “weight” - 8 (14.5), “lunch” - 8 (14.5), “hunger” - 8 (14.5), “family” - 7 (19), “dinner” - 7 (19), “food” - 7 (19), “ high-calorie ”- 7 (19),“ healthy ”- 7 (19),“ saturation ”- 6 (24.5),“ vegetables ”- 6 (24.5),“ tea ”- 6 (24.5), “salad” - 6 (24.5), “spicy” - 6 (24.5), “smell” - 6 (24.5), “warm” - 5 (31.5), “useful” - 5 ( 31.5), “rest "- 5 (31.5)," need "- 5 (31.5)," satiety "- 5 (31.5)," harmful -, 5 (31.5), "ice cream" - 5 (31, 5), "powers" - 5 (31.5), "bread" - 4 (43), "care" - 4 (43), "communication" - 4 (43), "body" - 4 (43), “cafe” - 4 (43), “peace” - 4 (43), “breakfast” - 4 (43), “necessity” - 4 (43), “pizza” - 4 (43), “soup” - 4 (43), “fruits” - 4 (43), “delight” - 4 (43), “cheese” -, 4 (43), “good” - 4 (43), “borscht” - 3 (57.5 ), “chocolate” - 3 (57.5), “restaurant” - 3 (57.5), “hot” - 3 (57.5), “gravity” - 3 (57.5), “love” - 3 (57.5), “dishes” - 3 (57.5), “holiday” - 3 (57.5), “time” - 3 (57.5), “diet” - 3 (57.5) , “travel” - 3 (57,5), “appetizing” - 3 (57, 5), “potato” - 3 (57.5).

The analysis was carried out only for those associations that were used in the group non-randomly according to the principle of indirect measurement and comparison - the frequency (weight) used in the association group and that allows us to construct a conditional group “measure” of severity (Table 1) of the description parameter. With this aim, all non-random descriptions were normalized based on the total number of associations. We compared the representation in the reports of the group of the characteristics of the "food" based on the normalized estimate. Thus, attributes with the severity of 0.08 are not random.

The measure of semantic proximity of different values, which was determined by the confluence of their semantic fields, was established with comparing the associative fields of two stimuli. The D. Diz intersection coefficient is usually used in psycholinguistics; however, there is an easier way to obtain data for analysis. It was proposed to determine the degree of semantic proximity using a simpler for the calculation and more logical in essence (just the distribution of matches for the total amount) the formula:

K= N1,2/ N1+ N2

where N1,2 is the sum of matches of associations;

 N1 is the number of associations for the first stimulus;

N2 is the number of associations for the second stimulus.

K=545+369/1168+829;

K=0,457

Only those associations are defined in the summary table and are common for both persons with existing or absent orthorexia. These associations are included in the group of associative semantic universals to the stimulus "food" and are subject to further analysis.

Table 1

The general statistical series of estimates of dichotomous scales in individuals with and without orthorexia

№ п/п

Associations of individuals with orthorexia on the word-stimulus "food"

Frequency of individuals with orthorexia on the word-stimulus "food"

A degree of association with persons with orthorexia

The frequency of not orthorexes on the word-stimulus "food"

The degree of expressiveness of the association for persons without orthorexia

1

«delicious»

97

0.46

57

0.49

2

«useful»

58

0.28

11

0.09

3

«pleasure»

42

0.20

20

0.17

4

«health»

32

0.15

8

0.07

5

«fruits»

14

0.07

4

0.03

6

«vegetables»

14

0.07

6

0.05

7

«joy»

14

0.07

11

0.09

8

«energy»

13

0.06

9

0.08

9

«full»

13

0.06

5

0.04

10

«nourishing»

11

0.05

10

0.09

11

«high-calorie»

11

0.05

7

0.06

12

«hunger»

11

0.05

8

0.07

13

«meat»

10

0.05

12

0.10

14

«fat»

10

0.05

9

0.08

15

«sweet»

9

0.04

12

0.10

16

«pleasant»

9

0.04

10

0.09

17

«need»

9

0.04

4

0.03

18

«enjoyment»

9

0.04

4

0.03

19

«harmful»

9

0.04

5

0.04

20

«calmness»

8

0.04

4

0.03

21

«communication»

8

0.04

4

0.03

22

«to cook»

8

0.04

12

0.10

23

«appetizing»

8

0.04

3

0.03

24

«warm»

7

0.03

5

0.04

25

«weight»

8

0.04

8

0.07

26

«soup»

6

0.03

4

0.03

27

«family»

6

0.03

7

0.06

28

«salad»

6

0.03

6

0.05

29

«nutrition»

6

0.03

7

0.06

30

«supper»

6

0.03

8

0.07

31

«saturation»

6

0.03

6

0.05

32

«heavy»

5

0.02

3

0.03

33

«power»

5

0.02

5

0.04

34

«love»

5

0.02

3

0.03

35

«relaxation»

5

0.02

5

0.04

36

«breakfast»

5

0.02

4

0.03

37

«chocolate»

4

0.02

3

0.03

38

«good»

4

0.02

4

0.03

39

«life»

4

0.02

9

0.08

40

«friends»

4

0.02

9

0.08

41

«diet»

4

0.02

3

0.03

42

«borscht»

4

0.02

3

0.03

43

«dinner»

3

0.01

7

0.06

44

«cheese»

3

0.01

3

0.03

45

«restaurant»

3

0.01

3

0.03

46

«ice cream»

3

0.01

5

0.04

47

«food»

3

0.01

11

0.09

48

«hot»

3

0.01

3

0.03

 

 Sum of matches of associations

545

 

369

 

4. Conclusions

The signs of the associative field of the word “food” are established based on the mentioned above, which allowed for a more in-depth analysis of the attitude to this word in both individuals with orthorexia and those without it. The basis of the associative field of the concept “food” is the word “delicious” and its derivatives. The following words are more thematically removed and constitute the center of meanings (as compared to the severity, for example, 0.46 is “tasty” in people with orthorexia, and 0.28 is “useful”. Whereas those without orthorexia are 0.49 " tasty "and 0.09" useful").

The essential characteristics with which food is associated is its taste, healthy properties, and pleasure as for those who have orthorexia, and for those who do not have orthorexia. Associative links with the word "health" are a notable feature in people with orthorexia, while those with absent orthorexia do not have these signs. Concerning persons without manifestations and symptoms of orthorexia, their characteristic associations are joy, energy, nutrition, sweetness, cooking, meat, life, friends, and food.

Critical indicators of food (tactility, emotionality, orderliness) are stored both in the core of the personality structure of individuals with orthorexia and without it. For persons with orthorexia, the most important characteristic is usefulness to which the word health refers (0,15). For subjects without orthorexia, the essential features are emotional characteristics — joy (0.09) and tactile like nutritional value (0.09), sweetness (0.10). Also for those with orthorexia, the social environment is important: cooking (0.10), life (0.08), friends (0.08) and neutral associations like food (0.09) and meat (0.10).

Thus, among the respondents without orthorexia, the social component is an essential basis for the attitude to food. However, for people with orthorexia, the social element of food consumption does not matter; an important component is a benefit derived from food.

References

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  9. Szalay, L. B., & Deese, J. (1978). Subjective meaning and culture: An assessment through word associations. Hillsdale, NJ: Lawrence Erlbaum.
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The materials were primarily published in Ukrainian language at http://lib.iitta.gov.ua/716083/1/Zb%201_2019.pdf

 

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