The Roles of Anxiety and Self-Esteem in the Risk of Eating Disorders and Compulsive Buying Behavior

Round 1

Reviewer 1 Report (Previous Reviewer 2)

Authors

Congratulations on your review. I think the article is more appealing and sustained.

Significant improvements have been promoted. However, there are some issues that I think should still be considered.

I keep thinking that you should rethink how you approach the key concepts of your work (did not evaluate the Compulsive Buying Syndrome but yes behaviors Compulsive Buying and did not evaluate eating disorder but yes binge eating behavior).

Share:

Title- ‘The Roles of Anxiety and Self‐Esteem in the Risk of Eating Disorders and Compulsive Buying Syndrome’ - You still don't answer this question. In my view it is essential to review: With the scale you use (CBS) not assessing a syndrome but compulsive buyers (behaviors and not pathology), therefore removed the syndrome from the title and placed behavior.

 

Abstract- Improvements have been made.

 

 Introduction

. Distribution of themes elaborated more equitably.

. Paragraph 66 to 70 presents data for 2017. Prevalence data at 5 years? From my perspective it is important to update.

. Clearer and with a more integrated and systematic sequence. It is already explained why self-esteem is a mediator between anxiety and Eating Disorders and Compulsive Buying Syndrome

. The goal is clearer “The main goal of this study is to investigate the possible mediating role that self-esteem had between trait anxiety and two specific new addictions: compulsive buying behavior and eating disorders. Furthermore, it was verified through a multigroup analysis, if trait anxiety had a greater effect on eating disorders in the group of compulsive consumers”

 Materials and Methods

. Line 174- Mage? Review, it's average.

. I continue to draw attention that the sample description is poor- would it be interesting to have information regarding: psychological support, psychiatric support, pharmacological treatment, physical health problems? Psychological health problems? Students/Assets professionally? I suggest your contemplation in the limitations.

. You refer to “It was used individual and anonymous questionnaire with several scales, comprising also a question relating to mental health, according to the eventual diagnosis DSM‐5 and/or pharmacological treatment and psychotherapeutic.“ but you still don't present data in this sense.

. Binge Eating Scale (BES)- I continue to question you why the choice of the evaluation designation is whether this is a screening scale - evaluates symptomatology and not the presence of disturbance. The results must be described according to the objective of the scale.

. Compulsive Buying Scale (CBS) is a screening scale and was reviewed.

. The State‐Trait Anxiety Inventory (STAI) psychometric characteristics or the form of interpretation are now presented.

 Discussion

. I still think that the designation should be revised, in the case of Compulsive Buying Syndrome and the Binge eating.

 

Author Response

Congratulations on your review. I think the article is more appealing and sustained. Significant improvements have been promoted. However, there are some issues that I think should still be considered. I keep thinking that you should rethink how you approach the key concepts of your work (did not evaluate the Compulsive Buying Syndrome but yes behaviors Compulsive Buying and did not evaluate eating disorder but yes binge eating behavior).	Answer: We thank the reviewer for the valuable suggestions he gave us, which allowed us to improve the manuscript. We agree with him in differentiating syndrome from behavior and have tried to emphasize this difference throughout the manuscript. The reason why we maintain the concept of eating disorders instead is because we have not only used the BES as a tool but also the EDI-2.
Share: Title- ‘The Roles of Anxiety and Self‐Esteem in the Risk of Eating Disorders and Compulsive Buying Syndrome’ - You still don't answer this question. In my view it is essential to review: With the scale you use (CBS) not assessing a syndrome but compulsive buyers (behaviors and not pathology), therefore removed the syndrome from the title and placed behavior.   .	Answer: we had already followed your suggestion and made the change you requested in the title within the manuscript, now we have highlighted it.
Abstract- Improvements have been made.    Introduction . Distribution of themes elaborated more equitably. . Paragraph 66 to 70 presents data for 2017. Prevalence data at 5 years? From my perspective it is important to update. . Clearer and with a more integrated and systematic sequence. It is already explained why self-esteem is a mediator between anxiety and Eating Disorders and Compulsive Buying Syndrome . The goal is clearer “The main goal of this study is to investigate the possible mediating role that self-esteem had between trait anxiety and two specific new addictions: compulsive buying behavior and eating disorders. Furthermore, it was verified through a multigroup analysis, if trait anxiety had a greater effect on eating disorders in the group of compulsive consumers”	Answer: thank you     Answer: thank you Answer: We have replaced the reference with a more recent one   Answer: thank you   Answer: thank you
Materials and Methods . Line 174- Mage? Review, it's average. . I continue to draw attention that the sample description is poor- would it be interesting to have information regarding: psychological support, psychiatric support, pharmacological treatment, physical health problems? Psychological health problems? Students/Assets professionally? I suggest your contemplation in the limitations.	Answer: done Answer: We cannot add the requested information because our sample is related to the general population, it is not a question of patients. we prefer not to add it within the limits, because we don't consider it a limit but simply a different focus. However, we thank the reviewer for his suggestion.
. You refer to “It was used individual and anonymous questionnaire with several scales, comprising also a question relating to mental health, according to the eventual diagnosis DSM‐5 and/or pharmacological treatment and psychotherapeutic.“ but you still don't present data in this sense.	Answer: We agree with the reviewer, in fact we had already followed his suggestion and deleted the sentence from "comprising also a question relating to mental health, according to the eventual diagnosis DSM-5 and/or pharmacological treatment and psychotherapeutic". We have highlighted in the manuscript the phrase as it stands now.
-Binge Eating Scale (BES)- I continue to question you why the choice of the evaluation designation is whether this is a screening scale - evaluates symptomatology and not the presence of disturbance. The results must be described according to the objective of the scale. . Compulsive Buying Scale (CBS) is a screening scale and was reviewed. . The State‐Trait Anxiety Inventory (STAI) psychometric characteristics or the form of interpretation are now presented.  Discussion . I still think that the designation should be revised, in the case of Compulsive Buying Syndrome and the Binge eating	Answer: we changed the terminology in the final discussion by adjusting some sentences so as not to create confusion on the construct measured by the scales, the reviewer is in fact right, it is symptomatology and not a disturbance.                   Answer: The discussion has been entirely reviewed by us and adjusted in the light of the revisions made previously.

 

Author Response File: Author Response.docx

This manuscript is a resubmission of an earlier submission. The following is a list of the peer review reports and author responses from that submission.

Round 1

Reviewer 1 Report

The discussion requires refinement because only a few things have been discussed, very very insufficiently. This is (at this moment) a significant deficit in this article. On the other hand, there is so much data based on statistical models and results. Authors should relate the results of their study to the results of other studies and explain why these results are just like that. Hypotheses should not be repeated at the beginning of the discussion, but it is necessary to discuss "why?" our results show "this?". Authors should discuss about results and write what the authors think about why it is so. for example, why is self-esteem partially mediated in the relationship between Trait Anxiety in this study, what the authors think is why is it so, and what other studies show. Furthermore, why is an association between compulsive buying behavior and eating disorders; what were shown other studies, why is the possible mediating role that self-esteem has between anxiety and two specific new addictions;etc..etc..

 

In general, the discussion requires significant revision.

Author Response

The discussion requires refinement because only a few things have been discussed, very very insufficiently. This is (at this moment) a significant deficit in this article. On the other hand, there is so much data based on statistical models and results. Authors should relate the results of their study to the results of other studies and explain why these results are just like that. Hypotheses should not be repeated at the beginning of the discussion, but it is necessary to discuss "why?" our results show "this?". Authors should discuss about results and write what the authors think about why it is so. for example, why is self-esteem partially mediated in the relationship between Trait Anxiety in this study, what the authors think is why is it so, and what other studies show. Furthermore, why is an association between compulsive buying behavior and eating disorders; what were shown other studies, why is the possible mediating role that self-esteem has between anxiety and two specific new addictions;etc..etc..

 

In general, the discussion requires significant revision.

 

Answer: Thank you so much for your valuable comment and revision. It helps us a lot to re-think and write a new discussion.

Reviewer 2 Report

Very interesting, pertinent and current theme, however, I think you should rethink how you approach the key concepts of your work.

I also suggest:

 Title- ‘The Roles of Anxiety and Self‐Esteem in the Risk of Eating Disorders and Compulsive Buying Syndrome’

. With the scale you use (CBS) not assessing a syndrome but compulsive buyers (behaviors and not pathology), therefore removed the syndrome from the title and placed behavior

 

Abstract

. If the goal is to: to investigate the possible mediating role that self‐esteem has between trait anxiety and two specific new addictions: compulsive buying behavior and eating disorders. Furthermore, we want to verify through a multigroup analysis if anxiety has a greater effect on eating disorders in the group of compulsive consumers

. And in the Keywords has compulsive shopping; binge eating; self‐esteem; eating disorder; anxiety

- Very confused, should use the same designation:  

   - compulsive buying behavior/ compulsive shopping

   - and eating disorders/binge eating- are two very different concepts. What are you studying anyway?

. From my perspective, not having longitudinal data makes no sense to talk about relationship.

 

 Introduction

. You give a detailed description of compulsive shopping and address the eating disorders in a very generalistic way.

. Paragraph 66 to 70 presents data for 2017. Prevalence data at 5 years?

. Very confusing and without an integrated sequence. It does not explain why self-esteem is a mediator between anxiety and Eating Disorders and Compulsive Buying Syndrome

. You refer to “Starting from this theoretical framework, the aim of the present study was to examine the influence and predictive value of the variables self‐esteem and trait anxiety on emerging adulthood and young adults to the risk of developing eating disorders and compulsive buying behavior”- here you already mention that you want ‘examine the influence and predictive value of the variables self‐esteem and trait anxiety on emerging adulthood and young adults to the risk of developing eating disorders and compulsive buying behavior’. But in the abstract it's not what they say, but rather ‘to investigate the possible mediating role that self‐esteem has between trait anxiety and two specific new addictions: compulsive buying behavior and eating disorders.’ Very confusing.

. The hypotheses should be sustained in the literature, which is not the case.

 

Materials and Methods

. The sample description is poor- would it be interesting to have information regarding: psychological support, psychiatric support, pharmacological treatment, physical health problems? Psychological health problems? Students/Assets professionally?

. You refer to “It was used individual and anonymous questionnaire with several scales, comprising also a question relating to mental health, according to the eventual diagnosis DSM‐5 and/or pharmacological treatment and psychotherapeutic.“ but do not present data in this sense.

. Binge Eating Scale (BES) evaluates symptomatology and not the presence of disturbance. The results must be described according to the objective of the scale.

. Compulsive Buying Scale (CBS) is a screening scale, not an evaluation scale. Which makes all the difference. This issue should be rethought.

. The State‐Trait Anxiety Inventory (STAI) psychometric characteristics or the form of interpretation are not presented.

 

Results

Review based on previous comments

 

Discussion

. The objective is not as mentioned in the abstract.

. The designation should be revised, in the case of Compulsive Buying Syndrome and the Binge eating.

. You refer to ‘Our findings also have some practical implications.’- It would be important to specify.

Author Response

Reviewer 2

 

Very interesting, pertinent and current theme, however, I think you should rethink how you approach the key concepts of your work.

Answer: We thank the review for its valuable suggestions, we have done everything possible to follow them while maintaining the main asset of our work. Thanks to the reviewer, we think our manuscript has improved.

I also suggest:

 Title- ‘The Roles of Anxiety and Self‐Esteem in the Risk of Eating Disorders and Compulsive Buying Syndrome’. With the scale you use (CBS) not assessing a syndrome but compulsive buyers (behaviors and not pathology), therefore removed the syndrome from the title and placed behavior

 Answer: Done

Abstract

. If the goal is to: to investigate the possible mediating role that self‐esteem has between trait anxiety and two specific new addictions: compulsive buying behavior and eating disorders. Furthermore, we want to verify through a multigroup analysis if anxiety has a greater effect on eating disorders in the group of compulsive consumers

. And in the Keywords has compulsive shopping; binge eating; self‐esteem; eating disorder; anxiety

- Very confused, should use the same designation:  

   - compulsive buying behavior/ compulsive shopping

Answer: we aligned the terminology and changed the keywords

   - and eating disorders/binge eating- are two very different concepts. What are you studying anyway?

. From my perspective, not having longitudinal data makes no sense to talk about relationship.

 Answer: by relationship between the variable we mean the mediation effect, but we understood your suggestion and changed the terminology to "the effect of trait anxiety on eating disorders"

 

 Introduction

. You give a detailed description of compulsive shopping and address the eating disorders in a very generalistic way.

Answer: Thanks for this suggestion. On the line ……… .we added “Eating disorders are defined as the disruption in the eating behavior with excessive concern about body weight that impairs physical health or psychosocial functioning. Anorexia nervosa (AN) involves refusal to maintain normal weight, fear of becoming fat or gaining weight, disturbed perception of body shape, while bulimia nervosa (BN) is characterized by recurrent and / or uncontrollable binge eating with inappropriate compensatory behavior to prevent weight gain , and by an over concern with body shap. Binge eating disorder (BED) included in the DSM V as a diagnostic category is characterized by recurrent episodes of binge eating in the absence of regular compensatory behavior such as vomiting or laxative abuse. [2]".

. Paragraph 66 to 70 presents data for 2017. Prevalence data at 5 years?

Answer: are the latest data that we have been able to find, the others are all post pandemic

. Very confusing and without an integrated sequence. It does not explain why self-esteem is a mediator between anxiety and Eating Disorders and Compulsive Buying Syndrome

Answer: We have added a bibliographic entry which integrates the unclear concept. Added text: Is very important to analyze the relationship between self-esteem, weight loss behavioral patterns, with the risk of developing eating disorders and to investigate the relationships of these factors among subjects most vulnerable to developing eating disorders. Regarding the data relating to trait anxiety, it is our hypothesis which was then confirmed in the results.

. You refer to “Starting from this theoretical framework, the aim of the present study was to examine the influence and predictive value of the variables self‐esteem and trait anxiety on emerging adulthood and young adults to the risk of developing eating disorders and compulsive buying behavior”- here you already mention that you want ‘examine the influence and predictive value of the variables self‐esteem and trait anxiety on emerging adulthood and young adults to the risk of developing eating disorders and compulsive buying behavior’. But in the abstract it's not what they say, but rather ‘to investigate the possible mediating role that self‐esteem has between trait anxiety and two specific new addictions: compulsive buying behavior and eating disorders.’ Very confusing.

Answer: Thank you. We have modified the period from the line …… .. following his suggestion.

. The hypotheses should be sustained in the literature, which is not the case.

 Answer: we have tried as much as possible to align the hypotheses with the literature, but our study would also like to add something new so that we can start reflecting on other possible aspects as well. Given that it is a sample of non-patients, reflection has begun on the importance of practical interventions on possible risk situations as you have rightly suggested (we have in fact changed the title). Thanks for your valuable suggestions, we have done everything possible to follow them

 

Materials and Methods

. The sample description is poor- would it be interesting to have information regarding: psychological support, psychiatric support, pharmacological treatment, physical health problems? Psychological health problems? Students/Assets professionally?

Answer: We have not given this information because the sample is not of patients. we added some socio-demographic information which, however, was missing.

. You refer to “It was used individual and anonymous questionnaire with several scales, comprising also a question relating to mental health, according to the eventual diagnosis DSM‐5 and/or pharmacological treatment and psychotherapeutic.“ but do not present data in this sense.

Answer: The second part of the sentence generates confusion and we have removed it

. Binge Eating Scale (BES) evaluates symptomatology and not the presence of disturbance. The results must be described according to the objective of the scale.

. Compulsive Buying Scale (CBS) is a screening scale, not an evaluation scale. Which makes all the difference. This issue should be rethought.

Answer: We have tried to address and resolve both issues in the results

. The State‐Trait Anxiety Inventory (STAI) psychometric characteristics or the form of interpretation are not presented.

Answer: done

Results

Review based on previous comments

 Answer: done

Discussion

. The objective is not as mentioned in the abstract.

Answer: We have reported the purpose of the abstract in the discussion so that it coincides

. The designation should be revised, in the case of Compulsive Buying Syndrome and the Binge eating.

Answer: Done

. You refer to ‘Our findings also have some practical implications.’- It would be important to specify.

Answer: Done